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Introduction. Valproic acid is a medication most commonly used in the treatment of emotional and neurological depression, psychological imbalances, epilepsy, and bipolar disorder. Dark honey, like thyme honey, contains more antioxidant compounds than other samples. The purpose of this study was to evaluate the effect of thyme honey on the potential hepatic effects of valproic acid. Methods. In this study, 48 male rats were randomly divided into 8 groups ( n = 6 ): G1 (control): healthy rats (normal saline 0.9%), G2: thyme honey (1 g/kg), G3: thyme honey (2 g/kg dose), G4: thyme honey (3 g/kg dose), G5: VPA (500 mg/kg), G6: VPA (500 mg/kg) and thyme honey (1 g/kg), G7: VPA (500 mg/kg) and thyme honey (2 g/kg dose), and G8: VPA (500 mg/kg) and thyme honey (3 g/kg dose). Groups G1 to G5 received the drug for 28 days. On day 14, administration of thyme honey for G6 to G8 groups was carried out using gavage until day 28. VPA was administered one hour after honey. To carry out the biochemical evaluation, blood samples were collected from all the groups and their serums were used for MDA, TAC, and liver enzymes (AST, ALT, and GGT). Tissue samples of each rat were also removed for histological studies with hematoxylin-eosin and Masson’s trichrome staining. Results. The use of thyme honey significantly improved the histopathological parameters of the liver tissue, including hypertrophic degeneration and nucleus alteration, expansion of sinusoids, fibrosis and hepatic necrosis, and inflammation as well as hypertrophy of Kupffer cells. In the groups receiving VPA, the rate of lipid peroxidation increased, which indicates the destruction of the liver cell membrane due to drug consumption. TAC levels also increased following increase in thyme honey dosage ( p ≤ 0.05 ). The results of liver enzyme analysis showed a decrease in AST and ALT levels in the G6 group and a decrease in GGT level in the G8 group ( p ≤ 0.05 ). Conclusion. Based on the results of this study, it seems that high percentage of antioxidants in thyme honey enabled it to improve hepatic complications and reduce the rate of hepatocellular destruction.

Background: Physician burnout is a serious issue associated with physician attrition, mental and physical problems, and medical errors. Objectives: This study aimed to investigate the prevalence of overall burnout among interns-residents and general physicians (GPs)-specialists during the coronavirus disease 2019 (COVID-19) pandemic in Iran. Methods: This cross-sectional study was conducted among 220 interns-residents and 212 GPs-specialists in university-affiliated hospitals and clinics in Shiraz, Iran. A convenience sampling method was used to recruit the samples, and the data were gathered using Maslach Burnout Inventory that was previously validated for the Persian language. We used covariance analysis and multiple logistic regression to analyze the data. Results: The mean age of participants was 31.44 (ranged 21-62) years. Multiple logistic regression for GPs-specialists showed that working in COVID-19 wards during June-July (OR = 13.93, P = 0.01, CI: 3.61 - 53.51) was associated with increased odds of overall burnout. Moreover, older age among GPs-specialists was associated with decreased odds of overall burnout (OR = 0.94, P = 0.01, CI: 0.90 - 0.98). On the other hand, the odds of overall burnout among interns-residents was not significantly different between various periods (P = 0.94). Furthermore, age (OR = 0.24, P = 0.01, CI: 0.04 - 0.47) and being married (OR = 0.31, P = 0.02, CI: 0.12 - 0.81) were positively associated with decreased odds of overall burnout among interns-residents. Conclusions: This study revealed that the risk of professional burnout among specialists and GPs increased over time during the COVID-19 pandemic. Moreover, older physicians had a lower risk of burnout. Despite the disagreements regarding the association between burnout and the duration of exposure to patients during epidemics, the findings of this study have the potential to remind policymakers of the importance of the issue among physicians during pandemics to taking appropriate action to prevent this phenomenon.

OBJECTIVE: The present study was aimed at assessment of effect of application of Chitosan/Nano Selenium biofilm on infected wound healing in rats METHODS: Sixty-eight male Wistar rats were randomized into four groups of 17 animals each. In group I (Normal) the wounds were created with no infection. In group II (MRSA), the wounds were infected with methicillin resistant Staphylococcus aureus (MRSA). In group III (MRSA/CHIT), animals with infected wounds were dressed with chitosan biofilm only. In group IV (MRSA/CHIT/NS), animals with infected wounds were dressed with Chitosan/Nano Selenium biofilm. RESULTS: There were significant differences in comparisons of group IV and other groups, particularly in terms of cellular infiltration and neovascularization. During the study period, scores for neovascularization was significantly higher in group IV rats than other groups (P

Background: Adult Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the neurodevelopmental disorders which is characterized by low focused concentration, distractibility, reduced self-regulation, and hyperactivity. They experience high rates of sleep and mental problems. Accordingly, the aim of this study was to investigate anxiety, depression, stress, and sleep among professional adult drivers with ADHD in an Iranian sample.Method: in this cross-sectional study, 547 professional adults drivers with ADHD that affirm their disorders by Conner adult ADHD rating scale (CAARS) complete survey that provides demographic data, Pittsburgh Sleep Quality Index (PSQI) for assessing quality of sleep, and DASS 21 survey to evaluate Depression, Anxiety and Stress Scale.Results: professional adult drivers with ADHD reveals a significant association of anxiety, depression, stress with poor sleep quality. Among these drivers, Poor quality of sleep was substantially associated with driving at night (P=0.039), but no substantial correlation was found with age, marital status, education, a model of car, and daytime driving (P>0.05). Conclusion: Given the significant correlation of anxiety, depression, stress, and ADHD with low quality of sleep, ADHD drivers may be a potential preventive measure that contributes to the identification of vulnerable drivers in terms of psychological state and improvement of their quality of sleep by setting acceptable rules for juggling working hours and supporting acts.

Background Corona virus epidemic may be acts as a stressor or trauma that affects both physical health and mental health. People exhibited various reactive behaviors to confront with this stressful situation. In Iran, one of the common motives for alcohol consumption is to scape problems and cope with stresses. It has been shown that personality factors influence alcohol consumption, since they are associated with drinking motives. The main purpose of this study was to investigate the correlation between temperament and character and alcohol abuse. Methods This cross-section study was conducted on 135 alcohol intoxicated patients admitted to emergency room in March 2020 and 255 participants who were randomly selected from public in Shiraz. A questionnaire consisted of TCI (Temperament and character inventory) and several questions about COVID-19 pandemic. It was completed by a trained interviewer using the matched answer technique. Demographic factors were self-reported. Results Among the alcohol intoxicated group, 117 (86.7%) were males and 18(13.3%) were females. The mean age of the participants was 32.43 ± 10.81 years. Among control group, 99 (38.8%) were males and 156 (61.2%) were females. The mean age of control group was 33.12 ± 14.77 years. Alcohol toxicity was mostly observed among the young males (male/female ratio was 6.45). According to temperament and character index, mean scores of novelty seeking, harm avoidant, and self-transcendence were higher in the alcohol toxicity group than normal population (P P P = 0.718). Conclusion Alcohol intoxicated patients had higher scores of novelty-seeking and self-transcendence and lower scores of reward-dependency scores, cooperativeness and self-directedness. These scores are associated with higher likelihood of personality disorders.

The aim of this study is to evaluate the role of All-Trans Retinoic Acid, the biologically active metabolite of retinoids, on liver steatosis in a rabbit model of high fat induced lever steatosis. 30 male rabbits were evaluated in 5 groups: group 1 treated with normal diet, group 2-5 included rabbit's groups 2 to 5 were fed on high cholesterol diet, group 2 received no drugs, group 3 received atorvastatin, group 4 received atRA, and group 5 received both the drugs. the liver was obtained for histopathological evaluation. oral administration of atRA, atorvastatin or their combination significantly decreased serum levels of total cholesterol, LDL, AST and ALT. atorvastatin slightly but atRA remarkably decreased liver steatosis where the difference was significant. atRA group showed the highest TAC and the lowest PCO concentrations. atRA can be effective in reducing liver steatosis and its antioxidant effect plays a crucial role in the process.HighlightsNon-alcoholic fatty liver disease (NAFLD) is the most common disorder of the liver in general population and is strongly associated with metabolic risk factors including hyperlipidaemia, obesity and diabetes.atRA is very effective in reducing liver steatosis and its antioxidant effect plays a crucial role in the process.we suggest focussing on other aspects of liver steatosis such as carbohydrate metabolism and insulin resistance in order to find better ways of controlling and treating liver steatosis.

Progesterone is an endogenous hormone secreted by ovaries that prepares uterine endometrium for implantation. The aim of this study was to evaluate the relation of serum progesterone level on the day of transferring frozen embryo with pregnancy occurrence. MATERIALS AND METHODS 161 women were chosen for frozen embryo transfer. From the second day of their cycle, they were treated with 2 mg per 8 hours estradiol. From the 13th day, 5 mg intramuscular (IM) progesterone was injected every 12 hours to increase endometrium thickness above 8 mm. 4 days after progesterone administration, embryo transfer was performed, and progesterone level was measured. Pregnancy occurrence was also evaluated. RESULTS The average progesterone level in 25 women with positive beta HCG was 26.26 +/- 8.58 on 1st day, 26.63 +/- 8.22 on 17th day and 24.3 +/- 11.48 on the 18th day of transfer. In 136 non-pregnant women it was 25.61 +/- 16.01 on 1st day, 29.03 +/- 14.45 on 17th day and 15.42 +/- 2.77 on 18th day. CONCLUSION There was no relationship between serum level of progesterone on the day of transfer and pregnancy occurrence.

The present study was undertaken to evaluate the synergistic effect of combining hyperthermia with irradiation and calcium carbonate nanoparticles (CC NPs) on proliferation of MCF-7 cells. The cells were randomly allocated to 19 groups: one negative control, three positive controls and 15 treatment groups. MCF-7 cells were treated with three concentrations of CC NPs (50, 100 and 150 μg/mL), gamma radiation (200 cGy), hyperthermia (41 °C for 1 h) and three concentrations of doxorubicin (200, 400 and 800 nm) and incubated at 37 °C for 24 h. Then the cell viability, the percentage of apoptosis and the levels of caspase-3, -8 and -9 proteins were measured. The results indicated that the combination group (150 µg/mL CC NPs + thermoradiotherapy) had a significant (p .001) decrease in cell viability (48.65 ± 4.8%) and a significant (p .001) increase in apoptosis percentage (45 ± 1.63%) of MCF-7 cells, as compared with the negative control and most of the other treatment groups. Moreover, a significant (p .05) increase was observed in the activity of caspase-3 and caspase-9. Our findings revealed that CC NPs in combination with irradiation and hyperthermia could significantly reduce the cell viability and enhance the apoptosis of the MCF-7 breast cancer cells, the same as doxorubicin anti-cancer drug.

In diabetes, impaired wound healing and other tissue abnormalities are considered major concerns. The aim of the present study was to assess the wound-healing activity of methanolic extracts of the extract of Lycium depressum leaves. A total of 60 healthy male Wistar diabetic rats weighing approximately 160 to 180 g and 7 weeks of age were randomized into 10 groups for incision and excision wound models: sham surgery group (SHAM), including creation of wounds and no treatment; base formulation group (FG) with creation of wounds and application of base formulation ointment; treatment group 1 (TG1) with 1 g of powder extract of the plant material in ointment; treatment group 2 (TG2) with 2 g; and treatment group 4 (TG3) with 4 g of powder extract of the plant material in ointment. A wound was induced by an excision- and incision-based wound model in male rats. The mature green leaves of L depressum were collected and authenticated. Extractions of dried leaves were carried out. For wound-healing activity, the extracts were applied topically in the form of ointment and compared with control groups. The healing of the wound was assessed based on excision, incision, hydroxyproline estimation, and biomechanical and biochemical studies. The extract of L depressum leaves enhanced wound contraction, decreased epithelialization time, increased hydroxyproline content, and improved mechanical indices and histological characteristics in treatment groups compared with SHAM and FG ( P < .05). These findings permit the conclusion the extract of L depressum benefits parameters of wound healing in a diabetes induced model

Ovarian torsion must be diagnosed and treated as much early as possible. The aim of the present study was to investigate effects of intraperitoneal administration of nimodipine on ischemia-reperfusion injury in ovaries.Thirty healthy male Wistar rats weighing approximately 250g were randomized into six experimental groups (n=5): Group Sham: The rats underwent only laparotomy. Group I: A 3-h ischemia only. Group I/R: A 3-h ischemia and a 3-h reperfusion. Group I/Nimodipine: A 3-h ischemia only and 1mg/kg intraperitoneal administration of nimodipine 2.5h after induction of ischemia. Group I/R/Nimodipine: A 3-h ischemia, a 3-h reperfusion and 1mg/kg intraperitoneal administration of nimodipine 2.5h after induction of ischemia.Nimodipine treated animals showed significantly ameliorated development of ischemia and reperfusion tissue injury compared to those of other groups (P0.05). The significant higher values of SOD, tGSH, GPO, GSHRd and GST were observed in I/R/Nimodipine animals compared to those of other groups (P0.05). The damage indicators (NOS, MDA, MPO and DNA damage level) were significantly lower in I/R/Nimodipine animal compared to those of other groups (P0.05).Intraperitoneal administration of nimodipine could be helpful in minimizing ischemia-reperfusion injury in ovarian tissue exposed to ischemia.

Background: Diabetes imposes an enormous burden on patients, families, societies, and healthcare systems. Determining the affordability of medications is an important complicated and vague task, especially in low- and middle-income countries (LMICs). This study aimed to assess the affordability of diabetes medication therapy in Iran’s health system. Methods: This paper presents a scenario-based assessment of the affordability of all registered anti-diabetes medications in Iran in 2017. To this end, 4 medication therapy scenarios were defined as mono, dual, triple, and insulin therapy in accordance with the existing guidelines and clinicians’ opinions. Then the affordability ratio of each treatment scenario was determined for type 1 and type 2 diabetes drawing on the World Health Organization (WHO)/Health Action International (HAI) Methodology. If the affordability ratio for treatment schedules was more than 1, the patients’ out-of-pocket (OOP) expenses exceeded the lowest-paid unskilled government worker (LPGW)’ wage per day, and the treatment was labelled as non-affordable. Results: The results revealed that the mono, dual, and triple (non-insulin) medication therapies in type 2 diabetes were affordable, despite an increase in the dosage or a switch from the monotherapy to the combination therapy of oral medications. However, some treatment scenarios in the triple therapy, including oral plus insulin and some insulin only therapies, were proved to be non-affordable. In type 1 diabetes, only insulin glulisine, detemir, and lispro were non-affordable in monotherapy. Regarding the combination therapy, only isophane insulin with aspart or regular insulin were affordable treatments. Conclusion: Although oral medication therapies were documented to be affordable, insulin therapy, with current coverage conditions, for patients with lowest paid wages and those receiving even less is unaffordable and a major barrier to treatment; hence, policy-maker should consider targeting and more financial protection policies to improve the affordability of insulin therapies among this group of patients.

The aim of this paper was examining the combined impacts of CuO nanoparticles (CuO NPs), hyperthermia (H), and irradiation (R) on an increment of MCF-7 cells. The MTT assay was employed to assess the antiproliferative effects of CuO NPs (25, 50, and 100 μg/ml), hyperthermia (41 °C for 1 h), and irradiation (200 cGy). Moreover, the perniciousness was estimated through the survival capability of cells, and apoptosis, ROS production, and levels of caspase-3, -8 and -9 proteins were determined. A significant (p.01) decrease in proliferation index (0.124 ± 0.021), a significant (p.01) increase in apoptosis (42% ± 1.54) of MCF7 cells, a significant (p.03) increase in ROS formation (32.16 ± 1.9) and a significant (p.01) increase in LDH release (33.28 ± 1.56) were recorded in the adjacency of MCF-7 cells by a combination of CuO NPs (100 µg/ml) and R + H compared to control and other treatments. The activities of caspase-3 (0.33 ± 0.014) and caspase-9 (0.389 ± 0.019) also increased significantly (p.05). However, caspase-8 showed no significant changes in its activity (p = .065). Based on these observations, a combination of CuO NPs, hyperthermia, and irradiation could suppress the growth of MCF-7 cells and evoke cell apoptosis via mitochondrial membrane potential.

Fatty liver disease is commonly associated with inflammation, oxidative stress and apoptosis of hepatocytes. This study was designed to investigate the combinational therapeutic effects of curcumin (CMN) and Ursodeoxycholic acid (UDCA) on non-alcoholic fatty liver disease (NAFLD). Male Wistar rats were divided into 8 groups: NAFLD-induced rats, NAFLD-induced rats + CMN, NAFLD-induced rats + UDCA, and NAFLD-induced rats that received CMN + UDCA. CMN (200 mg/kg) and UDCA (80 mg/kg) was administered orally for 14 and 28 consecutive days. Biochemical and histopathological analysis were conducted in all the groups. It was seen that co-administration of CMN and UDCA significantly reduced fatty degeneration, cellular necrosis, edema, and immune cell infiltration compared to non-treated NAFLD-induced rats. Whereas, combinational therapy caused a significant decrease in levels of SGOT and SGPT enzymes and expression of p53, caspase III, iNOS and bcl-2 mRNA and proteins, in variant with the treatment of CMN and UDCA, respectively. Co-administration of CMN and UDCA was also associated with the restoration of the levels of serum TG and HDL-C however, had no effect on LDL-C. It also resulted in an in TAC, GSH- PX, and SOD and decrease in MDA level. Our study concludes that combinational therapy of CMN and UDCA is effective for the treatment of NAFLD, as compared to their solo treatment.

Background: There are many methods for inducing non-alcoholic fatty liver disease (NAFLD) in experimental animals. Due to the diversity of these methods and different variables involved in choosing the appropriate one, this study aimed to examine the effect of three different diets on development of NAFLD in rats. Methods: Twelve rats were divided to receive a standard, high fat high fructose (HFHFr), high cholesterol high fructose (HCHFr) or high fat high sucrose diet (HFHS); with access to tap water, fructose or sucrose solutions. The liver histopathological and biochemical assessments were examined after 40 and 60 days. Results: According to the histological findings, after 60 days of dietary exposures, all three experimental groups showed evidence of fatty changes; however a higher grade of ballooning and NAFLD activity score was found in the HFHFr compared with the other groups. Furthermore, all three diets induced a non-significant increase in serum liver enzymes relative to the control diet. Conclusion: This study indicates that HFHFr diet induce higher grade of hepatic steatosis and ballooning degenerations after 60 days in comparison with the other groups. So HFHFr diet can be considered as a suitable method for inducing of fatty liver for nutritional and pharmacological studies.

Objective: The purpose of this study was to document the demographic data, to assess the proportion of consumed medicines and the amounts and types of drugs available to households, and to to estimate the probable prevalence of certain diseases in the southern region of Iran. Methods: In this cross-sectional population-based study carried out in Shiraz (the central city in the Southern part of Iran), we documented and evaluated the drug usage details in a random sample of 1000 households during 2018–2020. We analyzed the usage of drug categories based on the anatomical therapeutic chemical classification, which the World Health Organization recommends. Findings: In the studied population, the average age (± standard deviation) was 45.54 ± 15.82, ranged 18–91 years. More than 90% had medical insurance coverage. About 81.8% of the participants had individual family medicine practitioners, and most of them (93.8%) received medications with a physician's prescription. The most frequently used medications were cough and cold preparations (12.9%), nervous system drugs (12.6%), and cardiovascular system drugs (11.6%). Conclusion: Despite the easy access to medications for most participants, few individuals (about 6%) received their medications without a prescription. The most frequently prescribed medicines were the common cold, acetaminophen, and metformin. Common cold, gastrointestinal (GI) disorder, and diabetes were the most commonly used medication classes. Furthermore, we have found a probably higher than average prevalence of cardiovascular, GI, and endocrine disorders. This information could be used by the local policymakers as a basis for the estimation and allotment of health-care resources.

BACKGROUND Atherosclerosis (AS) is one of the most prevalent causes of death around the world. Since there are different types of risk factors, different types of medications focus on preventing atheromas and plaques from establishing or on preventing established plaques from growing. OBJECTIVES The aim of this study was to evaluate the effect of all-trans retinoic acid (atRA) on AS in a rabbit model of fat-induced AS. MATERIAL AND METHODS Atherosclerosis was induced by a high-fat diet (HFD) for 75 days. Thirty rabbits were randomly divided into 5 groups. Group 1 was the negative control group and received a normal diet. The animals in the other groups were fed a HFD. Group 2 (the AS positive control group) received no drugs, Group 3 received atorvastatin orally (20 mg/kg/day), Group 4 received atRA (5 mg/kg/day, orally), and Group 5 received both drugs. All medications were started on day 45 and continued until the end of the study. Fasting blood samples were obtained for lipid profile evaluation. The aorta sections were evaluated for maximum wall and intima thickness. RESULTS Oral administration of atRA, atorvastatin or their combination significantly improved serum lipid profile (p < 0.001). Atorvastatin and atRA significantly decreased serum total cholesterol and LDL-cholesterol levels in HFD (p < 0.001). No difference was found in serum HDL-cholesterol levels among the studied groups. The HFD group (Group 2 - positive control) showed significant intima irregularities with fat deposition and foamy macrophage accumulation (atheroma). Administration of atRA and atorvastatin significantly decreased the size of atherosclerotic plaques (intima thickness). The maximum vessel wall and intima thickness were significantly decreased after atRA and atorvastatin administration (p < 0.001). No difference was found between atRA and atorvastatin effectiveness, but combination therapy significantly decreased AS size in comparison to using either of the drugs alone (p < 0.001). CONCLUSIONS In reducing AS plaque size, atRA is as effective as atorvastatin. Additionally, the combination therapy of atRA and atorvastatin decreased AS size much more effectively, showing their synergistic effect. atRA can also improve the serum lipid profile.

Summary Objective: Ovarian torsion must be diagnosed and treated as early as possible. The aim of the present study was to investigate the effects of intraperitoneal administration of nanocurcumin on ischemia-reperfusion injury in ovaries. Method: Thirty-five (35) healthy female Wistar rats weighing approximately 250 g were randomized into seven experimental groups (n=5): Group SSG – The rats underwent only laparotomy. Group I: A 3-hour ischemia only. Group I/R: A 3-hour ischemia and 3-hour reperfusion. Group I/C: A 3-hour ischemia only, and 1 mg/kg intraperitoneal administration of curcumin 2.5 hours after induction of ischemia. Group I/R/C: A 3-hour ischemia, 3-hour reperfusion, and 1 mg/kg intraperitoneal administration of curcumin 2.5 hours after induction of ischemia. Group I/NC: A 3-hour ischemia only and 1 mg/kg intraperitoneal administration of nanocurcumin 2.5 hours after induction of ischemia. Group I/R/C: A 3-hour ischemia, 3-hour reperfusion and 1 mg/kg intraperitoneal administration of nanocurcumin 2.5 hours after induction of ischemia. Results: Nanocurcumin-treated animals showed significantly improved development of ischemia and reperfusion tissue injury compared to those in the other groups (p

The metabolic syndrome (MetS) is one of the most important risk factors for type 2 diabetes and cardiovascular disease. This syndrome is characterized by abdominal obesity, hypertension, insulin resistance, and dyslipidemia. The plasma origin of Cholesteryl ester transfer protein (CETP) is responsible for transferring cholesterol esters from high-density lipoprotein particles to apolipoprotein B containing lipoproteins compartment. We conducted this study to investigate the association between CETP gene Taq1B (rs708272) polymorphism in the metabolic syndrome among Iranian subjects. A sample size of 200 patients diagnosed with MetS together with 200 healthy donors as control were enrolled in this study. The investigation of polymorphism was performed by the use of polymerase chain reaction and restriction fragment length polymorphism analysis. To determine the relationship between polymorphism and lipid profile, we measured lipids and CETP concentration in metabolic syndrome and control subjects. Genotype distribution and allelic frequencies of polymorphism were determined and compared in both groups. Our findings showed that all clinical and biochemical characteristics in patients differed from the control group. The results showed that genotype and allele frequency of the Taq1B polymorphism was not significantly different between two groups. Instinctively, CETP was significantly higher in metabolic syndrome (1.64 ± 0.32 µg/ml) than in control (1.53 ± 0.34 µg/ml). A low level of CETP was found in blood of B2B2 typified genotype. In spite of Taq1B polymorphism on ester transfer protein concentration, no direct correlation was found between this polymorphism and metabolic syndrome.