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Introduction: Many patients consult general practitioners instead of dentists for their oral and dental problems every year. This study aims to find the reasons why patients consult general practitioners when they have dental problems. Methods: The sample consisted of patients visiting dentists and general practitioners in Kerman, Iran. A thematic interview guide, semi-structured questions, and a mind map that allowed for structured and open-ended questions were prepared and used for the interviews. All interviews were recorded and transcribed verbatim by a final-year student. Data collection, transcription, and analysis were conducted simultaneously to allow for new topics to be raised and theoretical saturation to be reached. When researchers determined that sufficient information was available for analysis and understanding of patient opinions and beliefs, the interview process was stopped. As all audio conversations were recorded with the participant's permission, no note-taking was done during the interviews, which allowed for greater focus on the participants' conversation. The obtained data was analyzed using the content analysis. Results: A total of 52 patients were included in this study. The codes related to patients participating in this research, along with the number of respondent groups related to each code were as follows: patient's perceptions of general practitioner(GP) and dental practitioner's scope of work [21], flawed dental system (34), dental anxiety [28], financial considerations [25], and more accessibility to GPs (31). Dental abscesses and dental pain were reported as the most common reasons for consulting GPs. Conclusion: Most participants agreed that dental problems are more effectively treated by dentists. Reasons for visiting a general practitioner included lack of a specific dentist, dissatisfaction with dental treatments, lack of a dentist nearby, absence of emergency dental care, and familiarity with a physician. The most common reasons for visits were toothache and dental abscesses. Patients also sought treatment for TMJ pain, referred nerve pain, wisdom tooth pain, numbness and tingling in the jaw, gum inflammation, oral lesions, and ulcers. Furthermore, other factors such as opening hours, appointment systems and waiting time can also affect patient's consult behaviors regarding dental problems. [ABSTRACT FROM AUTHOR]

Background: Hashimoto's thyroiditis (HT) is an inflammatory disease characterized by increased reactive oxygen species. Diets rich in anti-inflammatory and antioxidant properties may be linked to a reduced risk of developing HT. The aim of this study was to investigate the association between the dietary inflammatory index (DII) and dietary total antioxidant capacity (DTAC) with HT in Iranian adults. Methods: The study was a hospital-based case-control study conducted on 230 participants (115 cases and 115 controls). Dietary intake was assessed using a food frequency questionnaire (FFQ). The FFQ data were used to calculate DII and DTAC scores. Anthropometric measurements, thyroid function, and antibody tests were evaluated using standard methods. Multivariable logistic regression analysis was performed in both raw and adjusted models to determine the association between DII and DTAC scores with HT. Results: The average age of the participants was 39.76 ± 9.52 years. The mean body mass index in the case and control groups was 28.03 ± 6.32 and 26.43 ± 5.13 (kg/m2), respectively (P = 0.036). In the HT group, the DII level was higher (P < 0.001) and the DTAC level was lower than those in the healthy group (P = 0.047). In the multivariable logistic regression model, after adjusting for confounding factors, subjects in the last tertile of DII had a nonsignificantly higher HT risk than those in the first tertile (OR = 1.75; 95% CI = 0.83–3.65; P = 0.130). Regarding DTAC, the subjects in the last tertile of DTAC had a significantly decreased risk of HT (OR = 0.47; 95% CI = 0.23–0.98; P = 0.043) compared to those in the first tertile. The DII had a positive correlation with anti-thyroid peroxidase antibody (anti-TPO), thyroglobulin antibodies (TG-Ab) and thyroid-stimulating hormone, while DTAC had a negative correlation with anti-TPO and TG-Ab (P < 0.050). Conclusion: The increase in DII is not associated with an increase in the risk of HT, while DTAC can significantly reduce its risk. Having an anti-inflammatory and antioxidative diet can be effective in improving thyroid function. These conclusions should be confirmed in additional prospective studies. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is often linked to chronic inflammation, which can be influenced by both lifestyle and dietary choices. However, the relationship between the inflammatory potential of diet and lifestyle factors and the risk of developing T2DM remains unclear. The present study aimed to investigate the associations of the empirical dietary inflammatory index (EDII), dietary inflammatory score (DIS), and lifestyle inflammatory score (LIS) with the risk of T2DM among Iranian adults. Methods: The current study was conducted on 5714 individuals from Yazd Health Study (YaHS) who were followed up for a mean period of six years. YaHS is a prospective cohort study which has been conducted since 2014. Dietary intakes were collected at baseline using the food frequency questionnaire. The relative risk (RR) of T2DM was calculated by Cox regression analysis across tertiles of EDII, DIS, and LIS, adjusted for potential confounders. Results: The mean ± SD for the age and body mass index of the study population were 47.0 ± 9.2 years and 26.7 ± 5.1 Kg.m2, respectively. A significant association between LIS and the risk of T2DM was observed (RR: 4.05, 95% CI: 2.61–6.27 P-trend < 0.001). Individuals in the highest compared to the lowest tertile of EDII-LIS (RR: 3.07, 95%CI: 2.01–4.68; P for trend < 0.001) and DIS-LIS (RR: 2.42, 95%CI: 1.69–3.49; P for trend < 0.001) had a higher risk of T2DM. However, no significant association was found between EDII and DIS scores and the risk of T2DM. Conclusion: Greater adherence to LIS, EDII-LIS, and DIS-LIS scores was associated with a higher risk of T2DM, while no significant association was found between EDII and DIS with T2DM risk. [ABSTRACT FROM AUTHOR]

Introduction: Multiple sclerosis (MS) is a chronic inflammatory disease characterized by central nervous system (CNS) lesions. Although the etiology and pathogenesis of MS remains unclear, nutrition is among the environmental factors that may be involved in developing MS. Currently, no specific diet has been associated with MS. This study aimed to investigate the relationship between the dietary phytochemical index (DPI), dietary acid load (DAL), and the risk of developing MS. Methods: This case‒control study was conducted on 174 patients with MS and 171 healthy individuals in Mashhad, Iran. Data were collected using a 160-item semiquantitative food frequency questionnaire (FFQ). The study investigated the association between DPI, DAL, and MS, considering anthropometric measures, dietary intake, smoking habits, and sex. DPI, potential renal acid load (PRAL), and net endogenous acid production (NEAP), as indicators of DAL, were calculated based on the FFQ. Results: The study analyzed 345 participants, comprising 174 (50.4%) MS patients and 171 (49.6%) healthy individuals. The mean age of the participants was 32.45 ± 8.66 years. The DPI score was significantly lower among MS patients, while the NEAP and PRAL scores were significantly higher among MS patients compared to the healthy group. There was no relationship between NEAP (OR 1.001; 95% CI 0.959–1.044; P = 0.974) and PRAL (OR 1.019; 95% CI 0.979–1.061; P = 0.356) and MS incidence. Conclusions: The study found higher smoking and obesity rates in MS patients, with a reduced DPI score and increased DAL. Further studies are needed before recommending plant-based foods and dietary acid–base balance evaluation as therapeutic approach. Highlights: • This case-control study examined the relationship between DPI, dietary acid load, and chance of developing MS in 174 MS patients and 171 healthy controls. • MS patients had significantly lower DPI scores compared to healthy controls, indicating lower intake of phytochemical-rich foods like fruits, vegetables, legumes, and whole grains. • MS patients had significantly higher NEAP and PRAL scores compared to controls, suggesting a more acidic dietary pattern. • Lower DPI was associated with increased chance of MS (88.2% reduction in MS for each unit increase in DPI score). • Male sex, lower smoking rates, lower waist circumference, lower body fat percentage, higher lean mass, and lower energy intake were associated with reduced chance of MS. • The study suggests that dietary patterns higher in phytochemical-rich plant foods and lower in acid-promoting animal proteins were related to reduced chance of MS, but further research on dietary interventions is needed. [ABSTRACT FROM AUTHOR]

Objective: As patients with acute-phase familial Mediterranean fever (FMF) require prompt diagnosis for optimal management, we are conducting a study to compare inflammatory markers during the attack and silent phases in individuals referred to the emergency department. Methods: This case-control study involved 184 FMF patients under 16 years old, with data collected at Bo Ali Hospital's emergency department in Ardabil city throughout 2022. Patients in the attack phase were assessed by emergency medicine specialists, while those in the silent phase were recruited fromthe rheumatology clinic. Hematological parameters were obtained from venous blood samples, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and red blood cell distribution width (RDW) were calculated. Statistical analyses included 1-Sample Kolmogorov-Smirnov, ANOVA, Tukey's-b post hoc, Independent Samples T-test, Kruskal-Wallis, and Pearson Chi-squared tests. Results: In the attack group, the NLR correlated with increased leukocytes (r=0.652, P<0.001) and RDW(r=0.310, P=0.003). The non-attack group showed a correlation between the NLR and higher leukocytes (r=0.384, P<0.001) and ESR (r=0.214, P=0.04). Additionally, the attack group exhibited a correlation between the PLR and higher leukocytes (r=0.711, P=0.009), and ESR (r=0.285, P=0.014) while no correlation was found in the non-attack group. Conclusion: Our study revealed that RDW levels were significantly higher in FMF patients, indicating clinical inflammation. During FMF attacks, NLR and PLR ratios were notably elevated, making them key markers for systemic inflammation in these patients. [ABSTRACT FROM AUTHOR]

Background: Low-grade inflammation and stress oxidative condition play a role in the pathogenesis of obesity, and the serum levels of these markers, such as pro-oxidant-antioxidant balance (PAB), high-sensitivity C-reactive protein (hs-CRP), and uric acid may indicate obesity progression. In this study, we aimed to investigate the relationship between obesity with PAB, hs-CRP, and uric acid in the Iranian population. Methods: This study was derived from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study. A total of 7985 subjects aged 35 to 65 years were divided into three groups according to body mass index (BMI) as: normal, overweight and obese groups. Anthropometric indices and biochemical parameters such as PAB, superoxide dismutase type 1 (SOD1), hs-CRP, and uric acid were measured in all the participants. We evaluated the association of obesity with inflammatory factors by using multivariate regression analysis. Also, those participants with hypertension, an endocrine disorder, history of cardiovascular diseases and diabetes mellitus were excluded from the study. Results: There was a positive significant correlation between BMI and serum PAB, hs-CRP and uric acid (p < 0.001). While no statistically significant relation was observed between BMI and SOD1 (p = 0.85). Multivariate regression analysis showed that the risk of overweight and obesity increased 1.02 and 1.03-fold according to increase 10 units of PAB raise in comparison to reference group (normal weight) [(odds ratio (OR): 1.02, 95% CI (1.01–1.03)] and [OR: 1.03, 95% CI (1.01–1.04)], respectively). In addition, hs-CRP serum concentration was significantly associated with a high risk of obesity [(OR: 1.02; 95% CI (1.01–1.03)]. While the high levels of serum uric acid were associated with increased odds of overweight and obesity risk [OR: 1.4; CI (1.39–1.58) and OR: 1.76; CI (1.63–1.89), respectively]. Conclusions: Generally, we showed a significant association between BMI and serum PAB, hs-CRP values and uric acid levels, suggesting the role of these factors as risk stratification factors for obesity. [ABSTRACT FROM AUTHOR]

Background. Recurrent pregnancy loss is defined as at least two consecutive clinical pregnancy losses before 20th week of gestation. In this study, we investigated microRNA-1 and microRNA-1229 in recurrent miscarriage patients before and after lymphocyte therapy in comparison to control group. Methods. First, a written and informed consent will be obtained from the target population of this study, who are people with RPL referring to Waliasr International Hospital. According to the standard protocol, the number of 2×107 is injected subcutaneously to patients. Real-time PCR technique will be used to check the expression level of microRNA-1 and microRNA-1229. Results. The gene expression level of micro-RNA 1 in RPL women before of lymphocyte therapy was 2.030±1.445 and the gene expression level of the same microRNA after the lymphocyte therapy of the mother was 1.101±0.4780. Also, the expression level of micro-RNA 1229 in these women was reported to be 2.100±0.6296 before treatment and 1.247±0.9631 after treatment with lymphocytes. This level of gene expression in control group, for micro-RNA 1 and micro-RNA 1229 genes is 1.000±0.08334 and 1.000±0.08091, respectively. Conclusion. The results of our study showed a noticeable decrease in the gene expression of microRNAs under study, both microRNAs 1 and 1229, in women with a history of three consecutive injections of the father's subcutaneous lymphocytes. Practical Implications. This study can show the therapeutic effect of lymphocyte for patients with recurrent miscarriage so that this treatment can be used along with other treatment methods. [ABSTRACT FROM AUTHOR]

Background and Objectives: Trichomonas tenax is a protozoan which participates in the human oral microflora. It is considered as a potential paradontopathogen. This microorganism is also reported in the respiratory tract. We aimed to analyze the available literature about the prevalence of Trichomonas tenax in the population affected by periodontal disease. Materials and Methods: Searching the Scopus, PubMed, and ScienceDirect databases with the keywords: "Trichomonas tenax" and "periodontal diseases" was able to identify several systematic reviews and original articles up until July 2023. All studies with patients suffering from periodontal disease, which mentioned the year of publication, the country, specified the detection methods, and included the total number of tested samples as well as the percentage of those infected with Trichomonas tenax were included. Irrelevant articles were excluded. Results: We found 137 studies, but only 64 studies about the distribution of Trichomonas tenax in patients with gum disease underwent qualitative analysis. The highest number of studies have been conducted in Iran, Poland and Iraq. Different methods have been used to detect the unicellular organism, each with a different specificity and sensitivity. Conclusions: Interest in Trichomonas tenax has grown considerably since 2000. Because of its association with periodontal disease, Trichomonas tenax's role in the inflammatory process should not be overlooked. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Periapical cyst and granuloma are inflammatory endodontic lesions. Periapical granuloma usually heals spontaneously after endodontic treatment; however, periapical cyst mostly needs to be removed via surgical approaches. Although some clinicians believe that microscopic examination of periapical lesions is unnecessary, it is proved that some of them has non-endodontic nature that need critical consideration. Purpose: The purpose of this study was to assess the disagreement between clinicoradiographic and microscopic diagnosis of periapical cysts and granulomas in a major center of oral pathology service in Iran. Materials and Method: In this retrospective, descriptive cross-sectional study, the archives of the oral and maxillofacial pathology department of Shahid Beheshti University of Medical Sciences served as the source of the material during an 18-year-period for this retrospective, descriptive cross-sectional study. The reports of all patients whose initial clinical diagnosis was a periapical cyst/granuloma were extracted. Results: In the present study, 474 cases were diagnosed with a periapical cyst/granuloma clinico-radiographically, of which 61 cases (12.86%) received a microscopic diagnosis of a non-endodontic pathology. The most frequent lesion was odontogenic keratocyst (n= 12, 19.67%) followed by infected odontogenic cyst (n= 12, 19.67%). About 21.31% of diagnoses were non-cystic lesions and 4.9% were malignancies. The most odontogenic tumors that were diagnosed as periapical cyst/granuloma in clinico-radiography were the ameloblastoma variants (n= 4, 6.55%). Conclusion: A wide variety of microscopic diagnoses, including aggressive lesions such as ameloblastoma, as well as other malignant lesions was noted in this study. These misdiagnoses can lead to an inappropriate treatment plan. It is important to microscopically examine all lesions removed from the jaw. [ABSTRACT FROM AUTHOR]

Background and Aim: COVID-19 pulmonary manifestations vary from mild pneumonia to acute respiratory distress syndrome. Regarding the lack of specific treatment, its wide range of clinical manifestations, and especially the similarity of manifestation to different types of pneumonia in Persian medicine references, this research wants to review pneumonia from the viewpoint of traditional Persian medicine. Methods: In this review study, the keywords of "zat-alrrieh", and "awram-e-rieh" were searched in the most important Persian medicine references. The results were classified and concluded. Results: In traditional Persian medicine references, diagnosis of diseases is mainly according to clinical manifestations of each patient. In those references, pneumonia is considered as hot inflammation of the lung. There are different clinical manifestations and treatments concerning the pathologic Khelt (Humor) and stage of the disease. The goals of treatments are regulating Mizaj (Temperament), excretion of pathologic Khelt, and body empowerment. In addition to diet modification and oral medication, topical medication such as anointment, poultice, enema, cupping, gargling, and aromatherapy and manual therapies such as bloodletting are recommended to treat pneumonia. Conclusion: Due to the similarity of manifestations of pneumonia especially emerging COVID-19 pneumonia to described pneumonia in Persian medicine references and the reports of successful experiences in the application of traditional treatment, clinical trials to evaluate the effect of Persian medicine treatments especially as a treatment package are recommended. [ABSTRACT FROM AUTHOR]

Systemic inflammation may contribute to the initiation and progression of type 2 diabetes mellitus (T2DM) through diet and lifestyle. We examined the association of dietary inflammation score (DIS), lifestyle inflammation score (LIS) and dietary and lifestyle inflammation score (DLIS) with T2DM and cardiometabolic risk factors among Iranian adults. In this study, we identified and recruited 619 patients with T2DM and 2113 without T2DM from 35 to 75 years old men and women in the baseline phase of the Sabzevar Persian Cohort Study. Using a validated 115-item semi-quantitative FFQ, we calculated a 19-component DIS and a 3-component LIS weighted by circulating inflammation biomarkers. The DIS, LIS and DLIS associations with diabetes were assessed by multivariable logistic regression analysis. The average age of the participants was 48·29 (sd 8·53) (without T2DM: 47·66 (sd 8·42); with T2DM: 50·44 (sd 8·57)). Individuals in the highest compared with the lowest tertiles of DLIS (OR: 3·40; 95 % CI 2·65, 4·35; P trend < 0·001), DIS (OR: 3·41; 95 % CI 2·66, 4·38; P trend < 0·001) and LIS (OR: 1·15; 95 % CI 0·90, 1·46; P trend = 0·521) had an increased risk of T2DM. For those in the highest relative to the lowest joint DIS and LIS tertiles, the results were OR: 3·37; 95 % CI 2·13, 5·32; P interaction < 0·001. No significant associations were found between DLIS and cardiometabolic risk factors, including blood pressure, liver enzymes and glycaemic and lipid profiles, except for waist circumference (P < 0·001) and waist-to-hip ratio (P = 0·010). A higher DIS and DLIS score was associated with a higher risk of T2DM, while the LIS score was not associated with T2DM risk. [ABSTRACT FROM AUTHOR]

• Women with polycystic ovary syndrome had higher Inflammatory diet score. • Dietary Inflammatory Pattern is positively associated with polycystic ovary syndrome. • Carbohydrate intake was significantly higher in polycystic ovary syndrome women. Polycystic ovary syndrome (PCOS), as the most common endocrine disorder in women of reproductive age, is influenced by various factors. Because there is evidence linking inflammation with chronic diseases, we hypothesized that there is a relationship between an empirical dietary inflammatory pattern score (EDIP) with odds of PCOS among the adult population. This case control study was conducted on Tehranian women in Iran. A total of 494 participants (203 women with PCOS in the case group and 291 healthy people in the control group), aged 18 to 45 years, were recruited for the study. Demographic information, anthropometric indices, physical activity level, and dietary intake were collected by a trained nutritionist. EDIP score was calculated to estimate overall dietary inflammatory potential based on 18 food groups. Statistical analysis was performed with SPSS version 19. Based on the results, the mean age of participants in the case and control groups were 28.98 ± 5.43 and 30.15 ± 6.21 years, respectively. Individuals with PCOS had a significantly higher difference in EDIP score compared with healthy participants (2.03 ± 1.13 vs 1.70 ± 0.93, P <.001). Also, the odds ratio and 95% confidence interval for the risk of PCOS across quartiles of EDIP showed a significant direct relationship (P =.003). In conclusion, our study showed that there was a direct association between PCOS risk and EDIP score. Findings suggest that inflammatory index might be a potential mechanism linking diet and PCOS development. This case control study, the possible association between an empirical dietary inflammatory pattern score (EDIP) and risk of polycystic ovary syndrome (PCOS), was investigated. A total of 494 participants (203 women with PCOS in the case group and 291 healthy people in the control group), aged 18 to 45 years were recruited. The results showed that there was a positive association between PCOS risk and EDIP score. [Display omitted] [ABSTRACT FROM AUTHOR]

Objectives This study aimed to determine the prevalence of central auditory processing disorder (CAPD) in elementary school students in Kerman, Iran, during 2018-2019. Materials & Methods This cross-sectional study was conducted on 1369 elementary school students in Kerman. These students were selected by cluster sampling from different areas of Kerman and then screened using the Buffalo Model Questionnaire (BMQ). Based on the data obtained from the questionnaire, normal children were excluded from the study. Then, children with suspected central auditory processing disorder (CAPD) underwent ear exams and were excluded from the study in case of abnormal results in the tympanic membrane examination (rapture- effusion). The remaining subjects underwent peripheral audiometry evaluation, and children with abnormal audiometry were excluded from the study. Finally, the remaining children with suspicious screening results, a normal examination, and normal audiometry underwent a specific test to detect Central auditory processing disorder. Data analysis was carried out using SPSS software. Results One thousand three hundred sixty-nine primary school students with a mean age of 9.15 ±2.63 years enrolled in this study. 52%% of students were male. 8.03% of them had CAPD. A statistically significant relationship was found between the prevalence of CAPD and gender (P<0.001), place of residence (P<0.001), history of middle ear inflammation (P<0.001) and history of head injury. Conclusion The quality of life of these students with CAPD can be improved via timely recognition of CAPD and the provision of appropriate preventive and therapeutic facilities. [ABSTRACT FROM AUTHOR]

Background & Objective: Toll-like receptors (TLRs) are proteins that play key roles in inflammation. METH and buprenorphine (BUP) both modulate pain, but the exact mechanism underlying their antinociceptive effects is unknown. As a result, the expression of TLR1 and TLR2 genes was examined in METH rats that had been treated with or without BUP. Materials & Methods: A total of 77 rats were classified into 11 subtypes (n = 7): control (saline), BUP 6 or 10 mg/kg, METH (10 mg/kg), METH+BUP 6 or 10 mg/kg, or withdrawal groups. The treatments were intraperitoneally administered for 5 or 14 days. RT-PCR evaluated genes expressed in the brain stem area. Results: The results showed that TLR1 gene expression in the METH group (10 mg/kg; 5 days) considerably improved compared with the control group. Furthermore, BUP injection (10 mg/kg) acutely decreased TLR2 gene expression compared with the METH group. In the METH + BUP (10 mg/kg; 14 days) group, TLR1 expression was higher than in the METH group. The coadministration of METH+BUP (10 mg/kg) acutely decreased TLR2 gene expression compared with METH. Conclusion: There are limited changes in these genes, and their role in METH consumption and inflammation is unclear. Due to the presence of these two genes in the inflammatory pain and addiction signaling pathways, they may have more clear roles in other parts of the nervous system. [ABSTRACT FROM AUTHOR]

Introduction: On average, patients suffering from non-alcoholic steatohepatitis after about seven years, their disease turns into fibrosis and reversibility at this stage becomes very difficult because this disease is an irreversible stage of the disease. Therefore, the effect of eight weeks of high-intensity interval training in water on inflammatory factors in patients with nonalcoholic steatohepatitis was investigated. Methods: In this study, eight-week-old male Sprague-Dawley rats were divided into healthy (n=20) and high-fat diet (HFD) (n=20) groups. After eight weeks and proof of disease induction, the HFD group was randomly divided into two groups: control-disease (n=9) and exercisedisease (n=9); Also, the healthy group was divided into two groups: control-healthy (n=9) and exercise-healthy (n=9). The rats in the training group performed HIIT swimming training, including 20 times of 30 seconds of swimming with 30 seconds of rest between each time, for eight weeks (three days a week). One-way ANOVA and Bonferroni's post hoc test (P<0.05) were used to determine the difference between groups. The proposal of this study has been approved by the Ethics Committee of Shiraz University of Medical Sciences (IR.SUMS.REHAB.REC.1400.008). Results: As shown in diagram 1; Based on the results of the one-way analysis of variance test, it can be said that there was a significant difference between the mean TNF-α blood serum (P=0.001). According to the results of Bonferroni's post hoc test, there was a significant increase in the patient-control group compared to the healthy-control group (P=0.001) and also a significant decrease in the patient-exercise group compared to the patient-control group (P=0.012). Also, a significant decrease was observed in the exercise-healthy group compared to the control-patient group (P=0.001) and the exercise-patient group (P=0.002). Conclusions: The results of the present research showed that high-intensity intermittent swimming exercises reduce inflammatory and fibrotic factors, and in general, it can be concluded that eight weeks of high-intensity intermittent swimming exercises improve the inflammatory and fibrotic factors associated with non-alcoholic steatohepatitis. . However, to obtain a definitive result, this type of exercise should be studied in human studies in this patient community. [ABSTRACT FROM AUTHOR]

Background: Idiopathic granulomatous mastitis (IGM) is an uncommon inflammatory disorder, which tends to occur in childbearing women. Although IGM has a benign nature, it can mimic a vast spectrum of diseases and may lead to an erroneous diagnosis of carcinoma. Also, the patients usually experience a prolonged course of the disease, which is distressing. But, the clinicopathological of IGM is nonspecific and not clear enough. Objectives: This study aims at evaluating the clinicopathological aspects of IGM. Methods: This cross-sectional retrospective study was performed in Shohada-e-Tajrish Hospital, Tehran, Iran on patients between 20 to 50 years old, preliminary diagnosed with IGM from 2010 to 2019. Then, the demographic, clinical, ultrasound, and histopathologic features of patients enrolled were evaluated. Results: A total number of 60 women aged 20 to 50 years old and initially diagnosed with IGM were enrolled in this study. Their mean age was 34.5 ± 6.73. Among all participants, 38.3% of patients had a family history of breast cancer. The most common location of the lesion was the upper outer quadrant (UOQ) with the predominance of the left side (36.6%). They were more likely to present with pain, erythema, swelling, and warmth (51.6%) of the breast followed by palpable mass (38.3%). With ultrasound assessment, the results were matched with a tubular hypoechoic mass in 43.3% of the patients, while the remainder showed a tumor-like lesion (21.6%) and abscess formation (15%). Histologically, non-caseating granulomas associated with mixed inflammatory cells (70%) and cystic space formations surrounded by neutrophil aggregations (15%) composed the dominant features. Conclusions: Despite the rarity of the disease, IGM is a diagnostic challenge as it can masquerade various breast conditions. A definite diagnosis needs collaboration of clinical, radiological, and histopathological findings. [ABSTRACT FROM AUTHOR]

Introduction: Coronary artery disease (CAD) is the main cause of death and is characterized by atherosclerosis in coronary arteries. Inflammation plays a crucial role in the progression and development of atherosclerosis. Methods: The present study consisted of 132 Iranian individuals who underwent coronary angiography, 65 patients with CAD, and 67 controls. The matrix metalloproteinase-9 (MMP-9), TNF-α, IL-6, and vitamin D serum levels were measured by the ELISA technique. The gene expression of MMP-9 and tissue inhibitors of metalloproteinase (TIMP-1) was estimated by realtime PCR assay. Results: A considerable increase in levels and PBMC gene expression of MMP-9 and serum levels of IL-6 and TNF-α were found in CAD patients compared with controls. A significant decrease was detected in vitamin D levels of CAD patients in comparison with controls. A considerable direct correlation was found between MMP-9 levels and MMP-9 and TIMP1 gene expression in CAD patients. MMP-9 levels positively correlated with LDL-C in CAD patients. The correlation between TIMP1 gene expression and IL-6 levels was also negatively significant. There were positive correlations between MMP-9 levels with IL-6 and TNF-α serum levels in CAD patients. Conclusion: This study showed that the interaction between MMPs, TIMP1, and cytokines could play a role in the pathogenesis of atherosclerosis. The present study suggested that high levels of TNF-α and IL-6 and vitamin D deficiency in our studied patients could disturb the MMP-9/TIMP-1 balance and lipid metabolism, leading to plaque formation/ rupture in predisposed CAD patients. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the efficacy of dietary modifications based on complementary and alternative Iranian medicine (CAIM) in patients with secondary-progressive multiple sclerosis (SPMS). Design: In this randomized controlled trial, 70 SPMS patients were randomized to receive either a moderate-nature diet based on Persian medicine (as intervention) or usual diet plus health-related diet recommendations (as control) for 2 months. Serum high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), Expanded Disability Status Scale (EDSS), Modified Fatigue Impact Scale (MFIS), State-Trait Anxiety Inventory (STAI), Global Pain Scale (GPS), Gastrointestinal Symptom Rating Scale (GSRS), anthropometric measurements, and quality of life (QOL) were assessed at baseline and end of trial. Analysis of covariance was performed, and the results were adjusted for potential confounders using SPSS v.14. Results: All participants completed the study for 2 months. There were significant improvements across the mean changes of hs-CRP (−0.1 ± 0.2 mg/L for intervention vs. −0.01 ± 0.13 mg/L for control; padjusted = 0.012), MFIS (−11.0 ± 11.8 vs. −0.7 ± 9.9; padjusted <0.001), GSRS (−19.9 ± 16.3 to 1.2 ± 17.5; padjusted <0.001), GPS (padjusted = 0.032), and QOL (padjusted <0.05). No significant difference was observed across the ESR, EDSS, STAI, and anthropometric measurements. Conclusion: Dietary modifications based on CAIM may improve inflammation and clinical manifestations in SPMS patients. Nonetheless, further trials are required to confirm these findings. Clinical Trial Registration: IRCT20181113041641N2. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a common inflammatory joint disease. Because inflammation and nitrosative stress play an important role in the pathogenesis of RA, drugs that have antioxidant and anti‐inflammatory effects can be effective as adjuvant treatment in these patients. Selenium is a compound that has been shown in recent studies to have anti‐inflammatory and antioxidant effects. Therefore, the aim of this study was to investigate the effect of oral selenium on the reduction of clinical symptoms and joint pain in patients with RA. Fifty‐one patients with moderate and severe RA were randomly divided into selenium and placebo groups. The first group of patients received selenium at a dose of 200 μg twice a day for 12 weeks along with standard RA interventions and treatments, and the second group received standard treatments of RA along with a placebo. Clinical symptoms were evaluated with standard indicators to evaluate disease activity before and after the intervention in the 12th week. Examination of clinical symptoms at the end of the study showed that in the selenium group and after 12 weeks, a reduction in clinical symptoms and joint pain were observed, which was statistically significant compared with before the study began. Meanwhile, no significant changes were observed in the patients of the placebo group in terms of reducing symptoms and joint pains. A dose of 200 μg of oral selenium twice a day for 12 weeks can significantly reduce clinical symptoms and joint pain in patients with RA. [ABSTRACT FROM AUTHOR]

Background: Celiac disease is one of the most common genetic allergies worldwide. The prevalence of celiac disease in Iran is similar to or even higher than the global prevalence. Celiac disease is a chronic inflammatory disease that affects the small intestine. Affected patients are allergic to gluten protein that exists in some grains, such as wheat and barley. Methods: Serological endomysial IgA antibody (EMA-AB) and tissue transglutaminase IgA antibody (TTG-IgA) tests were performed on 114 patients aged the ages of 0-18 years with histopathological findings of celiac disease. The results of these tests were compared to the results of the histopathological study of the duodenal biopsy. Results: Based on the receiver operating characteristic (ROC) curve and a calculation of the TTG-IgA test's sensitivity and specificity, the best diagnostic limit for the TTG-IgA test is 144, which has the best sensitivity and specificity. At this value (cut-off), the test's sensitivity was 62%, and the specificity was 93.7%. For the endomysial test, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 80%, 93%, 90%, and 75%, respectively. Conclusion: The diagnostic accuracy of the endomysial test is better than that of the TTG-IgA test in general for diagnosing patients with celiac disease. In the TTG-IgA test, false-positive cases are high due to a cut-off of 20, reducing the test's specificity. In these false-positive cases, the endomysial test helps in better diagnosis. [ABSTRACT FROM AUTHOR]

Background: Middle molecules, including some cytokines such as IL-6 and TNF-α, parathyroid hormone, etc., are types of uremic toxins having roles in the development of inflammation in hemodialysis patients. Different studies evaluating effects of coenzyme Q10 (CoQ10) on different inflammation markers in hemodialysis patients have controversial results. Moreover, no study determined the effect of CoQ10 on plasma concentration of IL-6, the most powerful predictor of poor outcomes and mortality, in hemodialysis patients. Therefore, a study was designed to examine the effects of CoQ10 supplementation on IL-6, TNF-α, and intact parathyroid hormone (iPTH) in chronic hemodialysis patients. Methods: In this single-blind randomized controlled trial, patients undergoing hemodialysis were randomly assigned to CoQ10 (100 mg/day) or control group. The duration of the study was 12 weeks. The plasma concentrations of IL-6, as the primary outcome, and TNF-α and iPTH, as the secondary outcomes, were measured at baseline and week 12. Results: Of 73 enrolled patients, 68 completed the study. At the end of the study, there were no significant differences in the concentrations of IL-6 (p=0.570), TNF-α (p=0.301), and iPTH (p=0.642) between the two groups. The standardized mean difference (CoQ10 vs. control) was -0.13 (95% CI -0.60; 0.35) for IL-6, -0.25 (95% CI -0.73; 0.22) for TNF-α, and 0.11 (95% CI -0.36; 0.59) for iPTH. Conclusion: This study showed a trivial effect of CoQ10 supplementation on the concentrations of IL-6 and iPTH and a small effect on the level of TNF-α in hemodialysis patients. [ABSTRACT FROM AUTHOR]

Objective Since December 2019, the coronavirus disease has spread among the people of the world. Past studies have shown that viral diseases are more common and the immune response is stronger among menopausal women than nonmenopausal women. Therefore, in this study, we aimed to compare the amount of immunoglobulin (Ig)G against COVID-19 between postmenopausal and nonmenopausal women vaccinated with Sinopharm vaccine. Methods In this case-control study, 90 females vaccinated with the Sinopharm vaccine were randomly selected from February to April 2022: 45 menopausal participants as the case group and 45 nonmenopausal controls. Demographic characteristics were obtained and blood samples were taken from all subjects. A complete blood count was carried out and the levels of IgG against COVID-19 were measured by using the enzyme-linked immunosorbent assay method. Results The mean age was 33.3 ± 7.3 years and 60.2 ± 7.02 years for control and menopausal women, respectively. A significant difference was found between the 2 groups for the levels of IgG antibodies against COVID-19 (P  = .002, 17.2 ± 9.83 relative unit for case group and 10.2 ± 9.80 relative unit for control subjects). After adjusting, IgG against COVID-19 was significantly correlated to the menopausal state (odds ratio [confidence interval] = 1. 08 [1.03–1. 15]; P  = .003). Conclusion The results of this study showed that menopausal women had higher levels of IgG against COVID-19 in comparison with nonmenopausal females. However, more complementary studies are needed in this regard. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis, a prevalent bone malady, is prevalent in Iran. Several studies have represented the role of dietary antioxidants on osteoporosis. The dietary antioxidant index (DAI) is a valid and reliable index, which indicates a comprehensive view of dietary antioxidant capacity. This study aimed to survey the relationship of the DAI with the risk of osteoporosis in postmenopausal women in Iran. This research aimed to examine the association between the DAI and the risk of osteoporosis among postmenopausal women in Iran. Materials and Methods: In this case-control study, 440 postmenopausal women (220 cases and 220 controls) were enrolled. The dietary intake of contributors was evaluated using a 147-item food frequency questionnaire. To estimate the DAI, the amount of six antioxidant micronutrients such as Vitamins A, C, and E, selenium, manganese, and zinc was standardized. Then, the DAI was estimated by collecting the standardized consumption of these antioxidant micronutrients. Results: Our findings represented the participants in the first (crude odds ratio [OR] = 1.79, 95% confidence interval [CI]: 1.13-2.85, P = 0.013) and second (crude OR = 1.60, 95% CI: 1.01-2.55, P = 0.043) tertiles of the DAI scores had significantly higher odds of osteoporosis compared to those in the third one; while after modifying for confounding factors, this significant reverse relationship was observed just between women in the first and third tertiles of the DAI scores (adjusted OR = 1.90, 95% CI: 1.34-3.18, P = 0.015). Conclusion: The consequence of this study suggested that adherence to a diet rich in antioxidant compounds may have protective effects against osteoporosis. [ABSTRACT FROM AUTHOR]

Background: The neutrophil-to-lymphocyte ratio (NLR) is an inflammation biomarker in patients with liver cirrhosis. While increased NLR is linked to poor clinical outcomes and mortality in diseases like cancers, its association with cirrhosis complications has been sparsely examined. Objectives: This study aimed to evaluate the association between NLR and cirrhosis complications in patients with compensated liver cirrhosis. Methods: This retrospective cohort study was conducted on 256 patients with compensated liver cirrhosis visiting the Gastroenterology Clinic of Imam Khomeini Hospital, Ahvaz, Iran, in 2020. The peripheral blood lymphocyte and neutrophil counts were evaluated, and the NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. Cirrhosis complications were assessed based on clinical and laboratory evaluation during 1 year of follow-up. Results: During the retrospective follow-up period, 59 patients (23.05%) experienced cirrhosis complications such as spontaneous bacterial peritonitis (n = 23), gastrointestinal bleeding (n = 22), and hepatic encephalopathy (n = 14). The baseline NLR, Model for End-Stage Liver Disease (MELD) score and Child-Pugh score were significantly higher in patients who later developed complications than in those who did not (P < 0.0001). The NLR with an optimal cut-off of > 1.95 had a sensitivity of 84.75% and specificity of 93.91% in predicting complications during the 1-year follow-up (AUC = 0.905, P < 0.0001). Conclusions: Our results indicated that the NLR is a simple, non-invasive, and cost-effective marker for predicting short-term complications in patients with compensated liver cirrhosis. [ABSTRACT FROM AUTHOR]

Background. As one of the most frequent procedures, breast surgery puts high healthcare costs. The significance of surgical quality and complications before and after breast surgery entailed using methods with the highest outcomes and the least complications. Methods. Throughout this research, postoperative complications and factors affecting the quality of surgery were evaluated in the Kowsar hospital between the 2019 and 2020.Patients undergoing breast surgeries were randomly categorized into two groups: electrocautery (A) and harmonic scalpel (B). Results. Out of the 56 people, 28 patients were in group A, and the remaining 28 patients were in group B. After matching the patients, intraoperative bleeding, drainage rate, a period of drainage, duration of hospitalization in group B were significantly lower (P<0/05). Further, the extent of pain in both groups was different (P<0/001), so that there was less postoperative pain in women who experienced harmonic breast surgery. Patients throughout Group A reported more complications than in Group B, such that 7 (25%) of patients underwent limb anesthesia and 3 (10/7%) of patients experienced seroma, however, the difference between the two groups was not significant. Conclusion. Harmonic scalpel usage in breast surgery has fewer complications, better operation quality and shorter hospital stay than other older methods, so it is suggested that the use of harmonic scalpel may substitute different surgical strategies. Practical Implications. According to the results of this study, the use of harmonic has fewer complications for patients, and suffering of patients are reduced and they pay less. [ABSTRACT FROM AUTHOR]

In this study, we aimed to examine the relationship between energy-adjusted dietary inflammatory index (E-DII) and a comprehensive profile of malnutrition in Iranian haemodialysis (HD) patients. In this cross-sectional study, 291 participants on HD for at least 6 months before enrollment were included. The current dietary intakes of participants were assessed using a 4-d diet diary-assisted recall, including 2 non-dialysis days and 2 dialysis days to calculate E-DII. To determine the malnutrition status of HD patients, BMI, subjective global assessment (SGA), dialysis malnutrition score (DMS) and malnutrition inflammation score (MIS) were used. Overall, 291 HD patients comprised our study population. After controlling for potential confounders, E-DII was associated with a higher risk of malnutrition, as evidenced by SGA (OR = 2·23; 95 % CI: 1·11, 4·49), DMS (OR = 2·31; 95 % CI: 1·16, 4·60) and MIS (OR = 2·50; 95 % CI: 1·28, 4·88). No significant association was detected between E-DII and BMI either before (OR = 1·78; 95 % CI: 0·83, 3·81) or after adjustment for possible confounders (OR = 1·43; 95 % CI: 0·58, 3·54). This study showed that E-DII was significantly associated with reliable malnutrition markers including SGA, DMS and MIS in HD patients. However, further longitudinal studies are warranted to infer a cause-and-effect relationship between DII and malnutrition. [ABSTRACT FROM AUTHOR]

Background: Dietary advanced glycation end products(AGEs) may contribute to increased inflammation and oxidative stress as risk factors for chronic diseases such as liver disease. In the current study, we aimed to examine the possible association of dietary AGEs with the odds of non-alcoholic fatty liver disease (NAFLD) in Iranian adults. Methods: A total of 675 participants (225 newly diagnosed NAFLD cases and 450 controls), aged 20–60 years, were recruited for this case-control study. Nutritional data were measured using a validated food frequency questionnaire, and dietary AGEs were determined for all participants. An ultrasound scan of the liver performed the detection of NAFLD in participants of the case group without alcohol consumption and other causes of hepatic disorders. We used logistic regression models, adjusted for potential confounders, to estimate the odds ratios(ORs) and 95% confidence interval(CI) of NAFLD across tertiles of dietary AGEs. Results: Mean ± SD age and body mass index of the participants were 38.13 ± 8.85 years and 26.85 ± 4.31 kg/m2, respectively. The median(IQR) of dietary AGEs in participants was 3262(2472–4301). In the sex and age-adjusted model, the odds of NAFLD were increased across tertiles of dietary AGEs intake(OR:16.48;95%CI:9.57–28.40, Ptrend<0.001). Also, in the final model, after controlling for confounding effects of BMI, smoking, physical activity, marital status, socio-economic status, and energy intake, the odds of NAFLD were increased across tertiles of dietary AGEs intake(OR:12.16; 95%CI:6.06–24.39, Ptrend<0.001). Conclusion: Our results showed that greater adherence to dietary pattern with high dietary AGEs intake was significantly related to increased odds of NAFLD. [ABSTRACT FROM AUTHOR]

Background: Primary hypothyroidism is a common endocrine disorder caused by impaired production of thyroid hormones. Recent studies have shown that dietary habits, oxidative stress, and inflammation may play roles in thyroid hypofunction. Thus, the present article aimed to determine the relationship between major dietary patterns and oxidative stress and inflammation in primary hypothyroid patients and healthy people in Iranian adults. Methods: This matched case-control study was conducted on 200 participants (100 cases and 100 controls). The presence of primary hypothyroidism was determined by endocrinologists based on American Thyroid Association (ATA) criteria. Dietary intake was assessed using a validated 168-item, semi-quantitative food frequency questionnaire (FFQ). The principal component analysis (PCA) method was used to derive major dietary patterns. Statistical analysis was performed using logistic regression analysis, and the findings were reported using odds ratios (ORs) with 95% CIs. Results: We identified 2 major dietary patterns (i.e., healthy and Western dietary patterns). After adjusting for confounding variables, participants in the highest tertile of the healthy eating pattern had lower odds of primary hypothyroidism. Also, there was a significant relationship between total antioxidant capacity (TAC) levels and thyroid hypofunction; however, no significant correlation was seen between the Western dietary pattern and malondialdehyde (MDA) and C-reactive protein (CRP) with hypothyroidism. Conclusions: There were statistically direct associations between healthy dietary patterns (loaded with vegetables, nuts and seeds, fruits, dried fruits, olives, garlic, black pepper, starchy vegetables, low-fat dairy, and legumes) and increased TAC levels with a decreased risk of thyroid hypofunction. However, Western dietary patterns and MDA and CRP levels did not associate with an underactive thyroid. [ABSTRACT FROM AUTHOR]

Background: To determine the prevalence of keratoconus in Shiraz University of Medical Sciences Employees and the related risk factors including oxidative stress biomarkers. Methods: 2546 subjects' mean age ± SD, 40.35 ± 6.70 (46% male) were recruited. All participants underwent objective refraction using auto-refractometer and retinoscopy, followed by subjective refraction, and bio-microscopy. Pentacam imaging was performed for the detected keratoconus patients. The prevalence of keratoconus and frequency of the visual impairment among keratoconus cases were evaluated. Potential risk factors of sex, age, family history of keratoconus, body mass index ≥ 30 kg/m2, serum levels of glucose ≥ 100 mg/d, low-density-lipoprotein-cholesterol (LDL) ≥ 110 mg/dL, high-density-lipoprotein-cholesterol ≤ 40 mg/d, and triglycerides ≥ 150 mg/dL in the blood were evaluated. Results: The prevalence of keratoconus at least in one eye was 0.98% (95% CI: 0.6- 1.4%). The best corrected visual acuity in the keratoconus group was 0.06 ± 0.1 and the rest of the population was 0.01 ± 0.07 logMAR (p < 0.001). The frequency of visual impairment in the keratoconus group was zero. Odds ratios of the family history of keratoconus (21.00, 95% CI: 9.00–48.00, p < 0.001) and LDL ≥ 110 mg/dL (3.00, 95% CI: 1.20–6.40, p = 0.01) were significant. Conclusions: Keratoconus is rare and is not considered a risk factor for visual impairment. A family history of keratoconus and elevated serum LDL levels are contributing risk factors, suggesting an inflammatory background for the disease. Serum levels of LDL ≥ 110 mg/dL in the blood increased the risk of keratoconus three folds. [ABSTRACT FROM AUTHOR]

Context. We assessed the association between the severity of COVID-19 and the thyroid function, and the relationship of thyroid hormones with inflammatory markers in COVID-19 patients. Subjects and methods. This observational study contained 95 COVID-19 patients. The covariates of interest included the thyroid-stimulating hormone (TSH) and the total form of thyroid hormones thyroxine and triiodothyronine. Furthermore, the inflammatory markers including C-reactive protein, erythrocyte sedimentation rate, lactate dehydrogenase (LDH), and lymphocyte were measured. To analyze the data, the t-test, the nonparametric test for comparing the medians, and the Spearman correlation were used. Results. The median (interquartile range) of ages was equal to 53 (41-66) years old, including 54 men (56.8%). As the severity of COVID-19 progressed from moderate to severe, increasing, though non-significant, trends of thyroid dysfunction were observed, the most remarkable for TSH. The only significant association between thyroid hormones and inflammatory markers was a Spearman correlation of -0.28 between TSH and LDH. Moreover, a direct association was found between the severity of COVID-19 and the LDH levels (p-value<0.001). Conclusions. A direct relation between the severity of COVID-19 and the LDH level and a reverse association between the LDH level and the thyroid hormone, TSH was obtained. [ABSTRACT FROM AUTHOR]

Unsuccessful anesthesia often occurs under an inflammatory tissue environment, making dentistry treatment extremely painful and challenging. Articaine (ATC) is a local anesthetic used at high (4%) concentrations. Since nanopharmaceutical formulations may improve the pharmacokinetics and pharmacodynamics of drugs, we encapsulated ATC in nanostructured lipid carriers (NLCs) aiming to increase the anesthetic effect on the inflamed tissue. Moreover, the lipid nanoparticles were prepared with natural lipids (copaiba (Copaifera langsdorffii) oil and avocado (Persia gratissima) butter) that added functional activity to the nanosystem. NLC-CO-A particles (~217 nm) showed an amorphous lipid core structure according to DSC and XDR. In an inflammatory pain model induced by λ-carrageenan in rats, NLC-CO-A improved (30%) the anesthetic efficacy and prolonged anesthesia (3 h) in relation to free ATC. In a PGE2-induced pain model, the natural lipid formulation significantly reduced (~20%) the mechanical pain when compared to synthetic lipid NLC. Opioid receptors were involved in the detected analgesia effect since their blockage resulted in pain restoration. The pharmacokinetic evaluation of the inflamed tissue showed that NLC-CO-A decreased tissue ATC elimination rate (ke) by half and doubled ATC's half-life. These results present NLC-CO-A as an innovative system to break the impasse of anesthesia failure in inflamed tissue by preventing ATC accelerated systemic removal by the inflammatory process and improving anesthesia by its association with copaiba oil. [ABSTRACT FROM AUTHOR]

Background: Scientific evidence support that imbalance between inflammatory and anti-inflammatory cytokines play a critical role in preeclampsia (PE). Objective: To investigate the relationship between the maternal serum level of interleukin (IL)-23, a pro-inflammatory cytokine, PE and its severity risk was investigated. Materials and Methods: The case-control study included a total of 145 women counting 75 PE cases, 35 healthy pregnant and 35 healthy non-pregnant controls from Zahedan, southeast of Iran. The maternal levels of IL-23 in circulation were determined via enzyme-linked immunosorbent assay. Results: The maternal serum levels of IL-23 were increased in PE and its 2 subgroups severe PE and mild PE, so that these increases were significant in PE and severe PE, but not in mild PE compared with the controls (p < 0.001 and p < 0.001, p = 0.08, respectively). Besides, the maternal IL-23 serum level was statically significant in the early onset PE, but not in the late onset-PE group compared to healthy pregnant controls (p < 0.001, p = 0.46 respectively). Conclusion: The results of our study showed a positive association between IL-23 level and PE, especially in severe type and early onset PE, which suggests that IL-23 may be involved in the pathogenesis of this systemic syndrome. [ABSTRACT FROM AUTHOR]

Background: Statins play a vital role in the management of high-risk patients with atherosclerotic cardiovascular disease. The aim of this study was to evaluate the effect of two doses of 40 and 80 mg of atorvastatin on lipid profiles and inflammatory markers among patients with acute coronary syndrome (ACS). Materials and Methods: This single-blind, randomized clinical trial was conducted on 60 patients with ACS referred to Heshmatiyeh Hospital, Sabzevar, Iran. Eligible subjects were randomly assigned to either 80 mg/day (atorvastatin, 80 mg/day) or 40 mg/day intervention (atorvastatin, 40 mg/day) groups. Serum lipid profiles (low-density lipoprotein [LDL], high-density lipoprotein [HDL], triglyceride [TG], and total cholesterol), an inflammatory marker (creatine phosphokinase [CPK]), and liver function biomarkers (alanine aminotransferase, aspartate aminotransferase) were assessed before starting treatment and 3 months later. Results: According to the paired t-test, there was a significant difference before and after intervention in each group regarding mean LDL and HDL values (P < 0.05). The result of the ANCOVA test revealed that the LDL and CPK was substantially lower in the 80 mg/day group as compared to the 40 mg/day group after 3-month intervention (62.45 ± 16.78 mg for 80 mg/day vs. 73.63 ± 20.00 for 40 mg/day P = 0.040 and 84.85 ± 6.53 IU/L for 80 mg/day vs. 120.70 ± 6.41 IU/L for 40 mg/day P = 0.001, respectively). Although the mean of HDL, TG, and cholesterol in the 80 mg/day group was lower than that of the 40 mg/day group after implementing the intervention, these differences were not statistically significant (P > 0.05). Conclusion: Findings suggest that increasing the dose of atorvastatin decreases the mean serum levels of LDL and CPK but has no effect on the mean serum HDL levels and liver function biomarkers. [ABSTRACT FROM AUTHOR]

Background: The inflammation accelerates the progression of bipolar disorder. Supplementation of anti-inflammatory supplements in adjuvant with medications may alleviate disorder signs. This study aimed to investigate the effects of omega-3 fatty acid supplementation on the serum concentrations of pro-inflammatory cytokines and depression status in patients with bipolar disorder. Materials and Methods: This randomized clinical trial study was conducted in Zahedan city in 2021. Patients with bipolar disorder (n = 60) were grouped into two groups: omega-3 fatty acid supplement group (n = 30, 15 men and 15 women) and placebo one using a permuted block stratified randomization. The patients in the omega-3 group received 2 g of omega-3 fatty acids daily for 2 months while patients in the placebo group received 2 g soft gels daily in the same form. Depression score and the serum concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) were assessed before and after the study. Results: Depression score and the serum concentrations of TNF-α, IL-6, and hs-CRP were decreased after intervention in the omega-3 fatty acid group also compared with the placebo group (P < 0.001). The results also show a positive correlation between the serum concentrations of TNF-α, IL-6, and hs-CRP with depression scores (P < 0.001). Conclusion: Prescription of omega-3 fatty acids can decrease inflammatory parameters and help to decrease depression in patients with bipolar disorder. This supplement can be used along with medications for decreasing the inflammatory markers in these patients. [ABSTRACT FROM AUTHOR]

Background and Aims: The surgical removal of mandibular third molar is frequently accompanied by significant postsurgical complications, and different protocols have been described to decrease such complications. The aim of this study was to compare the postoperative complications of mandibular impacted third molar removal with two conventional rotary and piezoelectric methods. Materials and Methods: In this study 27 patients with bilateral mandibular impacted third molars were selected. The patients' teeth were extracted by the piezoelectric method on a random side and the opposite tooth was extracted by conventional rotary technique. On operation and post operation days, edema, pain, and mouth opening were assessed. The duration of each operation was also measured. Data were analyzed by Mann-Whitney test and independent t-test. Results: The mean duration of operation in the rotary group was less than that of the piezoelectric group, which was statistically significant (P=0.001). Pain was significantly higher in the rotary group on days 0 to 5 (P<0.05). Whereas, difference in pain on day 6 was not statistically significant (P=0.067). There was no significant difference between the two groups in each day after surgery regarding mouth opening (P>0.05). Edema was significantly higher in the rotary group on the first, third, and fifth days after surgery (P<0.05). Also, edema was higher in the rotary group on the seventh day after surgery, but not statistically significant (P=0.076). Conclusion: According to the results of the present study, it can be concluded that pain and swelling in patients after impacted tooth surgery using time consuming piezoelectric technique can be reduced. [ABSTRACT FROM AUTHOR]

COVID-19, the infectious disease caused by the most recently discovered coronavirus was declared as a pandemic by The World Health Organization (WHO) on March 11, 2020. The widespread spread of infections created an immediate emergency, with the number of affected patients exceeding the capacity of many involved healthcare systems, resulting in significant morbidity and mortality (1). More than 300 million people have been infected as a result of this pandemic disease (2). A significant number of people have also been affected by the acute and chronic complications of the pandemic disease COVID-19. Large-scale studies revealed that many COVID-19 patients experience symptoms for at least six months after recovery. The quality of life of about 10–30% of patients is severely impacted by lingering symptoms. This clinical condition has been acknowledged and labeled as a post-COVID-19 condition by the World Health Organization. Physical, neurocognitive, and psychiatric symptoms of this condition that last longer than two months and cannot be accounted for by another diagnosis are present three months after the onset of COVID-19 (2). Most clinicians have focused on pulmonary manifestations of this disease since its inception; however, neurologic complications may occur subtly and significantly increase morbidity and mortality in these patients. Although SARS-CoV-2 primarily affects the respiratory system, several studies have found neurological complications in COVID-19 patients. Headache, dizziness, loss of taste and smell, encephalitis, encephalopathy, and cerebrovascular diseases are the most common neurological complications associated with COVID-19. Seizures, neuromuscular junction disorders, and Guillain-Barré syndrome, as well as neurodegenerative and demyelinating disorders, have also been reported as COVID-19 complications (3). PCNS denotes prolonged post-COVID-19 neurological symptoms. Several studies have found that PCNS can manifest as long-term symptoms that last for months, such as muscle pain and weakness, myopathy, sleep impairment, anxiety, depression, severe post-traumatic stress disorder (PTSD), dizziness, headaches, and anosmia. Previous findings suggest that COVID-19 patients should be followed up after recovery for possible long-term post-COVID-19 neurological complications (3). Indeed, SARS-CoV-2 acts on angiotensin-converting enzyme-2 receptors found in lung alveoli type 2 as well as the brain (mainly in the brainstem). In this framework, the neuro-invasion of SARS-CoV2 has even been advocated to explain the development of respiratory failure in some patients (1). Fatigue, muscle weakness, depression, sleep difficulties, headaches, loss of smell and taste, tingling sensations, dizziness, nausea, and severe fatigue are some of the other symptoms. Furthermore, COVID-19 has been shown to be a risk factor for acute ischemic stroke (AIS). AIS in SARSCoV2 patients is associated with more severe neurological deficits and higher in-hospital mortality. The incidence of AIS in COVID-19 patients is estimated to be around 1.5%, though this percentage is higher in critically ill patients (4). Myoclonus and ataxia, with or without opsoclonus, have recently been identified as a central nervous system syndrome associated with coronavirus disease-2019 (COVID-19), one of the other distinct neurological manifestations (5, 6). The exact mechanism of COVID-19's effects on the brain is unknown: either direct invasion to the brain or indirect invasion through hypoxia of the brain or a severe inflammatory response of the body (3). Many COVID-19 patients with severe hypoxia have disproportionately few symptoms of cerebral hypoxia, a phenomenon known as "happy hypoxia" (7). As a result, the brain's oxygen supply is underestimated, resulting in neurological damage, particularly in brain regions such as the hippocampus, which are particularly vulnerable to hypoxia. According to studies, a severe inflammatory response involving different immune cells around the vascular system and in brain tissue, as well as microhemorrhages, can develop in the CNS of COVID-19 patients (8). Because of the neuronal damage, patients may experience ongoing neurological and psychological issues that negatively impact their quality of life. After recovering from COVID-19, many patients, according to researchers, continue to struggle with cognitive issues such as memory loss and impaired concentration for several months. These COVID-19 neurological manifestations can be diagnosed using imaging, laboratory tests, and CSF analysis, depending on the patient's symptoms. Although CT and MRI are the primary methods used to evaluate these patients, some neurological complications show no abnormal findings in these imaging modalities. Brain SPECT, or single photon emission computed tomography, uses 99m-Tc ECD/HMPAO as a radioactive tracer to measure regional cerebral perfusion and create tomographic images of the three-dimensional distribution of the radiopharmaceutical. As a functional, anatomical, and molecular imaging technique, this method can be utilized for the diagnosis and treatment of neurologic complications in COVID-19 patients. The imaging algorithm of COVID-19 does not prioritize brain scanning, and for some patients, it may not even be practical. In a small subset of patients, magnetic resonance imaging (MRI) may be useful during the acute phase and may be useful in understanding neuro-COVID mechanisms immediately following recovery. Even though the mid- and long-term effects of SARS-CoV-2 neuro-infection are still unknown, cases of postCOVID-19 likely autoimmune (steroid responsive) but seronegative encephalitis as well as patients with anosemia have been reported in the absence of any change on MRI in COVID-19 patients (1). There are many uses for brain perfusion scintigraphy in COVID patients that have been demonstrated in the literature, including the assessment of cerebrovascular disease, convulsions, psychiatric issues, etc. By using baseline imaging and follow-up imaging, this imaging modality is useful for the diagnosis and assessment of the severity of cerebrovascular disease, such as CVA, and the assessment of the viability of brain tissue. It is also helpful for choosing the best therapy and evaluating the response to treatment. The evaluation of epileptogenic focus could also be done using this technique. Pharmaceuticals that improve local cerebral blood flow, like acetazolamide, can be used in conjunction with this modality (carbonic anhydrase). In transient ischemic attack and stroke patients with COVID-19, acetazolamide increases local pCO2 and causes arteriolar dilation, allowing for the assessment of cerebrovascular reserve. It can also be used to differentiate between vascular and neuronal causes of dementia (9). Additionally, brain SPECT can help with the differential diagnosis and diagnosis of various psychiatric issues, such as mood disorders, depression, anxiety, mild cognitive impairment, and loss of smell, and it can tell a factitious disorder from a real disease (9). Brain SPECT results can be used to guide the individualized treatment of COVID-19 patients with neurological and psychological complications. Additionally, by comparing baseline and follow-up images, which is done by visually and quantitatively measuring brain perfusion, SPECT brain images could be used to assess treatment response. Brain perfusion scintigraphy may be useful for proper diagnosis, improving patient management, and predicting prognosis. Prompt diagnosis of neurologic and psychiatric manifestations of COVID-19 is essential for appropriate management. According to an analysis of the literature, brain perfusion scans may be an important imaging tool for the differential diagnosis of neurological sequelae, therapeutic management, and patient follow-up. It is also a helpful research tool because it is widely accessible and allows for non-invasive in vivo evaluation of brain function. Clarification of this method's role in treating COVID patients with neurologic complications requires additional research. [ABSTRACT FROM AUTHOR]

Objectives: Inflammation has been proposed to be one of the main causes of musculoskeletal pain. Diet is a lifestyle factor that plays an important role in managing inflammation; thus, we assessed the inflammatory potential of diets using the empirical dietary inflammatory index (EDII) to investigate the relationship between diet and musculoskeletal pain. Methods: This cross-sectional study included 212 elderly individuals who were selected from health centers in Tehran, Iran. Dietary intake was evaluated using a valid and reliable 147-item food frequency questionnaire. To measure the intensity of pain, a visual analogue scale was used. Multiple linear regression was applied to assess the association between the EDII and musculoskeletal pain. Results: In total, 62.7% and 37.3% of participants had mild and severe pain, respectively. The EDII values were 0.97±0.72 and 1.10±0.66, respectively, in those with mild and severe pain. A higher EDII score was associated with more intense musculoskeletal pain after adjusting for age and sex (β=0.20; 95% confidence interval [CI], 0.06--0.26; p<0.001), but not after adjustment for other confounders (β=-0.13; 95% CI, -1.54 to 0.60; p=0.39). Conclusion: Our findings indicated that higher dietary inflammation might not be associated with musculoskeletal pain in older adults. However, further investigations are required to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the association of meals-specific food-based dietary inflammatory index (FDII), with cardiovascular (CVD) risk factors and inflammation among Iranian adults. Methods: In this cross-sectional study, we recruited 816 participants living in Tehran via two-staged cluster sampling. Three non-consecutive 24-h dietary recalls (two working days and one day off) were obtained from individuals to specify the main meals and meal-specific FDIIs. Anthropometric measures were done. Insulin and high-sensitivity c-reactive protein (hs-CRP) were measured. Multiple linear regressions were used to investigate the association of FDII with Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), hs-CRP, Triglyceride Glucose Index (TyG), and Lipid Accumulation Product Index (LAP). Results: The range of FDIIs for breakfast, lunch, and dinner were (-2.47,1.98), (-2.66,3.23) and (-4.09,3.13) in order, and the mean age was 42.2 ± 10.5 years. We found that there was no significant association between FDII and hs-CRP level in the three meals (β = -0.003; 95% CI: -0.030, 0.025 for breakfast,β = -0.020; 95% CI: -0.041, 0.001 for lunch, and β = 0.006; 95% CI: -0.016, 0.028 for dinner) after adjusting for age, sex, education, occupation, maritage, physical activity, smoking, morningness-eveningness score, energy, body mass index, and other FDIIs. Also, we found no significant association between breakfast, lunch, and dinner-specific FDII and HOMA-IR (β = -0.368, -0.223, 0.122), TyG index (β = -0.009, 0.060, -0.057) and LAP (β = 2.320, -0.278, -0.297). Conclusions: We found no associations between meal-based FDII scores and CVD and inflammation. Further research of prospective nature is needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: Systemic inflammation can be the initiator in developing chronic diseases that may be affected by the lifestyle and diet of individuals. In the current study, we aimed to assess the association of the inflammatory potential of diet and lifestyle, determined by the food-based index of dietary inflammatory potential (FBDI), dietary inflammation score (DIS), and lifestyle inflammation score (LIS), with risk of chronic kidney disease(CKD) in Iranian adults. Methods: A total of 6044 CKD-free individuals aged ≥ 18 years, were recruited from among participants of the Tehran Lipid and Glucose Study(surveys 3 and 4) and followed a mean of 6.03 years(follow-up rate:94.95%). Data on dietary intakes were determined using a food frequency questionnaire. The inflammatory potential of diet and lifestyle were determined based on three indices, including FBDI, DIS, and LIS. Using the National Kidney Foundation guidelines, we defined CKD as eGFR < 60 mL/min/1.73 m2. Results: Mean ± SD age of the study population(54.3% women) was 37.8 ± 12.8 years. We identified 1216(20.1%) new cases of CKD during the 6.03 years of follow-up (46,889.8 person-years). In the multivariable-adjusted model, the risk of CKD incident is increased across quartiles of FBDI (HR = 1.21;95%CI:1.03–1.42, Ptrend:0.014) and LIS (HR = 1.28;95%CI:1.07–1.55,Ptrend:0.006). However, no significant relationship was observed between the higher DIS score and CKD risk. Conclusion: Our findings showed that a higher inflammatory potential of diet and lifestyle, characterized by a higher score of FBDI and LIS, was related to increased incidence of CKD, while no significant relationship was reported between the DIS score and CKD incident. [ABSTRACT FROM AUTHOR]

Background: Non-Hodgkin lymphoma (NHL) is the eleventh leading cause of cancer-related death in the world. Diffuse large B-cell lymphoma (DLBCL) is the most common type of NHL. Up to winter 2021-2022, the death toll caused by the coronavirus disease 2019 (COVID-19) has exceeded 5.6 million worldwide. Possible molecular mechanisms involved in the systemic inflammation, and cytokine storm in COVID-19 patients are still not fully understood. MicroRNA-155 (miR-155) plays a role in the post-transcriptional gene regulation of hematopoiesis, oncogenesis, and inflammation. The present study aimed to evaluate the expression of miR-155 in patients with DLBCL and/or COVID-19. Methods: A cross-sectional study was conducted from July to December 2020 in Tehran (Iran) to evaluate the expression of miR-155 in adult patients diagnosed with DLBCL and/or COVID-19. The real-time polymerase chain reaction technique was used to evaluate the expression of miR-155 in the sera of 92 adults who were either healthy or suffering from DLBCL and/or COVID-19. Relative quantification of gene expression was calculated in terms of cycle threshold (Ct) value. Data were analyzed using SPSS software, and P<0.05 was considered statistically significant. Results: The expression of miR-155 was not associated with the sex or age of the participants. In comparison with healthy individuals (-ΔCt: -1.92±0.25), the expression of miR-155 increased in patients with COVID-19 (1.95±0.14), DLBCL (2.25±0.16), or both (4.33±0.65). Conclusion: The expression of miR-155 increased in patients with DLBCL and/or COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Cytokines are synthesized and released by immune system cells and mediate critical immune responses. Aging is associated with increased serum levels of some pro-inflammatory cytokines. A positive correlation between the concentration of several cytokines and blood pressure has been reported; higher cytokine concentrations may be related to the underlying causes of hypertension through the effects of inflammatory responses or as an independent aetiology for hypertension. The aim of this study is to assess the relationship between the serum levels of inflammatory cytokines and growth factors, with biochemical and anthropometric characteristics, in healthy Iranian subjects. Material and methods: Anthropometric measurements and blood sampling were performed in 103 healthy Iranian participants. Anthropometric measurements, blood pressure, fasting blood glucose (FBG), and lipid profile were measured in these participants. Twelve serum cytokines/growth factors (MCP-1, TNF-α, EGF, IFN-γ, VEGF, IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, and IL-10) were measured by cytokine biochip array. Results: FBG was positively associated with serum interleukin (IL) 2 (IL-2), IL-4, and IL-1α (p = 0.044, < 0.001, and = 0.017, respectively). Serum epithelial growth factor and IL-4 were positively associated with age (p < 0.001). Interleukin-8 was inversely associated with systolic blood pressure (p = 0.002) and gender (p = 0.028). There was a positive association between vascular endothelial growth factor and high-density lipoprotein (p = 0.007). The serum levels of interferon-γ and tumour necrosis factor-a were positively associated with serum triglycerides (p = 0.018 and 0.006, respectively). Serum interferon-γ and IL-1β levels were positively associated with hip circumference (p = 0.029 and 0.001, respectively). Conclusions: There are associations between various pro- and anti-inflammatory cytokines and growth factors in serum and age, sex, hip circumference and several biochemical measurements. [ABSTRACT FROM AUTHOR]

Purpose: The wound healing process involves a complex series of biological events. Skin grafts have several uses as a reconstructive method. There are several dressings for the skin graft donor site, but the optimum dressing agents that provide all the requirements at the same time are unclear. This prospective, randomized, placebo-controlled clinical trial aimed to evaluate the therapeutic effect of Zataria multiflora cream in the wound healing process of partial-thickness skin graft donor sites and compared it with a placebo. Materials and Methods: This clinical trial study was performed on patients who underwent split-thickness skin grafts. Enrolled patients applied Z. multiflora cream and placebo controlled (petrolatum ointment) twice a day, from the day of intervention at the skin graft donor sites in two parts, separately. On 7, 14, 21, and 28 days after surgery, the wound healing process was evaluated, photographed, and scored according to the Bates-Jensen assessment tool. Evidence of infection was evaluated. The main agent and placebo were compared during the wound healing process. Results: Decreases in wound surface area and total score were significantly greater in the Z. multiflora group (p < 0.05). The wounds of 30% of patients in the second week and 90% of patients in the third week were completely epithelialized in the Z. multiflora group. These values were 3.3% and 36.7% for the control group, respectively, and so, the healing rate was ∼9-fold in the second week and 2.45-fold in the third week in the Z. multiflora group compared with the control group (p < 0.05). Conclusion: Wound healing and reepithelialization accelerated significantly in the first, second, third, and fourth week after intervention in the Z. multiflora treatment group, due to modulating the inflammatory phase and improving the proliferative phase. Clinical Trial Registration Number: IRCT20210624051695N1. [ABSTRACT FROM AUTHOR]

Background: Erectile dysfunction, lower urinary tract symptoms (LUTS), and coronary artery disease (CAD) share common risk factors. Atherosclerosis, inflammation, and endothelial dysfunction with decreased nitric oxide synthase activity are the proposed etiologies for these disorders. Objective: This study compared the prevalence and severity of erectile dysfunction and LUTS in patients with and without significant CAD. Methods: This case-control study involved patients undergoing coronary artery angiography at Kowsar Hospital in Shiraz, Iran, between January 2019 and January 2020. Male patients aged 40 or older with or without significant coronary artery lesions diagnosed by coronary angiograms were considered the case and control groups, respectively. Both groups were asked to fill out the International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5) questionnaires, which evaluate the severity of LUTS and erectile dysfunction, respectively. The prevalence and severity of erectile dysfunction and LUTS were evaluated and compared between the groups using chi-squared tests and t-tests. Also, logistic regression was performed. Results: A total of 352 male patients participated in this case-control study, and each group included 176 patients. Erectile dysfunction occurred in 109 patients (61.9%) in the case group vs. 63 (35.7%) in the control group (P< 0.001). The mean IIEF-5 score was 17.03 ± 7.33 in the case group vs. 20.56 ± 6.51 in the control group (P = 0.003). Ninety-five patients (54.0%) in the case group complained of LUTS, vs. 51 (29.0%) in the control group (P < 0.001). The mean IPSS score was 7.70 ± 9.28 in the case group and 3.74 ± 3.74 in the control group (P < 0.001). Conclusion: Erectile dysfunction, LUTS, and CAD share common risk factors and are highly prevalent among the aging male population. As the extent of CAD increases, the prevalence and severity of erectile dysfunction and LUTS increase. We highly recommend that men older than 40 who complain of erectile dysfunction and LUTS be evaluated for CAD. [ABSTRACT FROM AUTHOR]

Inflammation is implicated in the development and progression of a variety of cardiovascular diseases. We hypothesized that the Dietary Inflammatory Index (DII) is associated with anthropometric indices and metabolic parameters in Iranian atherosclerosis patients. The present cross-sectional study was conducted on 320 Iranian atherosclerosis patients. The DII was estimated using a valid and reliable 168-item food frequency questionnaire. Odds ratios and 95% confidence intervals were evaluated for anthropometric indices and metabolic parameters according to the DII score. Linear regression was used to estimate the relationship between DII scores with atherosclerosis-related dependent variables. According to the continuous score of DII, there was no significant association between DII and odds of obesity, total cholesterol/high-density lipoprotein cholesterol ratio, and aspartate aminotransferase/alanine aminotransferase ratio in all 3 models (P ≥.05). In linear regression analysis, we found a significant association between DII score and fasting blood sugar, lipid profile (except for high-density lipoprotein cholesterol), liver enzymes (except for alkaline phosphatase), and serum sodium in adjusted models (P <.05). In this study, patients with atherosclerosis consuming a pro-inflammatory diet was positively associated with fasting blood sugar, lipid, and liver enzymes measures. Future studies with prospective and interventional designs are required to clarify the association between this dietary index and cardiovascular disease risk factors among patients with atherosclerosis. [Display omitted] [ABSTRACT FROM AUTHOR]

Background/objectives: The roles of potential inflammation of diet and lifestyle in the risk of insulin-related disorders are unclear. In the current study, we aimed to assess the relationship between dietary inflammation scores (DIS), lifestyle inflammation scores (LIS), and dietary and lifestyle inflammation score (DLIS) and the risk of insulin resistance (IR) and hyperinsulinemia in Tehranian adults.Subjects/methods: A total of 1,244 participants, aged ≥20 years, who were free of insulin-related disorders at baseline (2006-08), were followed for 3.2 years (2009-11) to ascertain the incidence of hyperinsulinemia and IR. A food frequency questionnaire was used to determine the score of DIS, LIS, and DLIS at baseline. Logistic regression models were used to determine the odds ratio (ORs) of insulin-related disorders across tertiles of DIS, LIS, and DLIS.Results: Mean ± SD age of participants (42.7% men) was 43.0 ± 13.0 years. During the 3.2 years follow-up, the incidence of IR and hyperinsulinemia was 30.0% and 20.0%, respectively. In the multivariable model, there was a direct association between the higher score of DLIS (OR = 2.10; 95% CI: 1.17-3.74) and DIS (OR = 1.84; 95% CI: 1.09-3.11) with the risk of IR incident (P for trend <0.05). Also, the higher score of LIS was related to increased risk of IR (OR = 2.28; 95% CI: 1.19-4.37) and hyperinsulinemia (OR = 1.69; 95% CI: 1.02-2.85) (P for trend <0.05). However, no significant association was observed between the higher score of DLIS and DIS with risk of hyperinsulinemia CONCLUSION: The higher inflammatory potential of diet and lifestyle, determined by DLIS, DIS, and LIS scores, were associated with a higher risk of IR. Also, individuals with a higher score of LIS are more prone to hyperinsulinemia risk. [ABSTRACT FROM AUTHOR]

Background and Objectives: Inflammatory factors are indicators of complications such as infection following trauma fracture healing that is necessary to identify the process of changes after surgery and the factors affecting it. Therefore, this study aimed to evaluate the extent of inflammatory factors before and after surgery in patients with fractures following trauma. Materials and Methods: This prospective study was performed on 200 patients with fractures requiring surgery. After obtaining patient satisfaction and recording demographic information, the white blood cells (WBC) count, erythrocyte sedimentation rate (ESR), and serum levels of C-reactive protein (CRP) changes before and during the first 6 weeks of the postoperative period were recorded. Repeated measure ANOVA and mixed ANOVA tests were used to compare the data. Results: According to our results, the day after surgery all inflammatory factors including WBC, ESR, and CRP increased significantly, and 2 weeks after surgery serum levels of WBC and CRP decreased, while ESR serum levels were still high and decreased from the 4th week. Conclusions: The results of this study showed the deviation of inflammation factors from the normal ranges and increase and decrease after surgery can indicate the presence of complications such as infection after surgery. Since CRP changes were more sensitive than ESR, it is recommended to check WBC and CRP changes to evaluate infection because ESR was elevated for a longer duration. [ABSTRACT FROM AUTHOR]

Background: Previous studies have been reported that vitamin D deficiency increased the risk of metabolic syndrome (MetS). Nonetheless, the exact mechanisms underlying this association is unclear. Besides, inflammation and deregulation of adipokines secretion have been recognized as pivotal factors that contribute to the pathogenesis of these conditions. Therefore, we assessed whether serum vitamin D status is associated with serum levels of adipokines and inflammatory markers in these patients. Methods: This case-control study was carried out among 65 patients with MetS who had vitamin D insufficiency (cases) and 130 MetS patients who had vitamin D sufficiency (controls). Cases and controls were recruited from among those referred to health centers in Zabol County, Iran. Vitamin D insufficiency was regarded as a serum 25-hydroxyvitamin D [25(OH)D] concentration below 30 ng/ml. Serum concentrations of leptin, adiponectin, visfatin, and resistin and also adiponectin/leptin ratio along with serum levels of interleukin 6 (IL-6), IL-10 and tumor necrosis factor-alpha (TNF-α), were evaluated. Results: Serum levels of leptin, resistin, and TNF-α were significantly higher, whereas, serum adiponectin and adiponectin/leptin ratio were significantly lower in cases than the controls. There was no significant difference in serum visfatin, IL-6, and IL-10 between the groups. Serum levels of 25(OH)D were inversely correlated with leptin, resistin, and TNF-α in both unadjusted models and after adjustment for potential confounders. Conclusion: Our findings indicated that vitamin D insufficiency in MetS patients is associated with increased inflammation and serum adipokine abnormalities which may be associated with developing metabolic complications in these patients. [ABSTRACT FROM AUTHOR]

Background and Aim: The COVID-19 disease is an emerging infectious disease that appeared in December 2019 in Wuhan, China. An uncontrolled systemic inflammatory response is one of the primary mechanisms causing death in this disease. In this study, the expression levels of some inflammatory cytokines, vitamin D, and some hematological and biochemical parameters were compared in patients with severe COVID-19 and mild types. Materials and Methods: In this cross-sectional study, 60 blood samples were taken from 30 severe coronavirus patients and 30 mild coronavirus patients. The expression levels of cytokines such as IL (interleukin)-6, interferon (IFN)-α, IL-12, transforming growth factor (TGF) β, IL-8 and tumor necrosis factor (TNF)-α were evaluated using Real-time PCR. A T-test was used for Statistical Analysis. Results: IL-6, IFN-α, IL-12, TGF-β, IL-8, and TNF-α cytokines in the peripheral blood of severe patients, were positive in 28/30 (93.33%), 27/30 (90%), 24/30 (80%), 25/30 (83.33%), 26/30 (86.66%), and 27/30 (90%) respectively. The positive rate of these cytokines in the mild patients were 20/30 (66.67%), 21/30 (70%), 18/30 (60%), 17/30 (56.67%), 19/30 (63.33%), 18/30 (60%), respectively. There was a statistically significant difference between these two groups in terms of cytokines biomarkers. A significant difference was found between both groups in terms of the serum level of lactate dehydrogenase (LDH), the mean number of lymphocytes and neutrophils as well as the mean percentage of neutrophils/ lymphocytes ratio (NLR). Conclusion: The expression of cytokine genes and their release into the peripheral blood was increased in both severe and mild patients with COVID-19. However, they were more intense in patients with severe symptoms than those with mild symptoms and can cause inflammatory and even destructive reactions. Vitamin D deficiency plays no role in causing severe COVID-19 in patients without risk factors. Severe COVID-19 is characterized by elevated serum levels of LDH and NLR≥3.45. [ABSTRACT FROM AUTHOR]

Geriatric psoriasis, due to its unusual clinical manifestations and higher rates of systemic complications in this age group, is a challenging issue for dermatologists. Therefore, we aimed to provide an overview of the epidemiological, clinical, and therapeutic consequences among patients aged over 60 years with psoriasis in a referral center in Iran. This cross‐sectional study was conducted on 156 patients over 60 years with the definitive diagnosis of psoriasis that were referred to our center between 2015 and 2019. By reviewing the recorded files of the patients, baseline characteristics including demographics, underlying comorbidities, age of disease onset, clinical type of the disease, clinical manifestations, and therapeutic approaches were extracted. The most common clinical feature was plaque type (73.1%) followed by pustular type (10.9%). The most frequent involved zone was the lower extremities (84.6%). Most of the patients were treated topically (87.1%), while as the most frequent systemic approaches, methotrexate and acitretin were considered for 74.4% and 60.3%, respectively. A significantly higher mean age at disease onset was found in female patients compared to male patients. The plaque type was more prevalent in men than in women. Also, the chance of nail involvement was 2.43 times higher in men than in women (p = 0.011, 95%CI: 1.22–4.84). The disease duration was significantly longer in patients suffering from plaque compared to those without this feature. Conversely, those with palmoplantar type experienced shorter disease duration. Psoriatic arthritis was also revealed in patients of lower ages. As in other societies, in our society, clinical characteristics, disease involvement patterns, as well as considered treatment approaches, can be influenced by demographic characteristics. [ABSTRACT FROM AUTHOR]

Background: It has been shown that chronic inflammation is a significant factor in cancer development and progression. The current study aimed to investigate whether a higher score on the empirical dietary inflammatory pattern (EDIP), which indicates a more pro-inflammatory diet, is related to higher odds of breast cancer in Iranian women., Methods: In the present case-control study, subjects in the case (n = 133) and control (n = 265) groups were chosen from the hospitals in Tehran, Iran. The cases consisted of women with newly diagnosed breast cancer, while the controls were selected from other parts of the same hospital and had no history of cancer or hormone therapy. Individuals whose reported energy intake deviated by three standard deviations above or below the mean energy intake of the population were excluded from the study. A reliable and valid semi-quantitative food frequency questionnaire was used to determine the participants' dietary intake. Additionally, the association between breast cancer and EDIP was evaluated by logistic regression analysis in both crude and adjusted models., Results: The median scores of EDIP in the case and control groups were 0.65 and 0.61, respectively. The findings also indicated that, in the adjusted model, the odds of developing breast cancer significantly increased in the last tertile of EDIP compared to the first tertile (odds ratio (OR) = 1.859; 95% confidence interval (CI): 1.059-3.265; P = 0.031). Additionally, after adjusting for potential confounders, higher odds of breast cancer were observed in the last tertile of EDIP compared to the first tertile in postmenopausal women (OR = 2.516; 95% CI: 1.081-5.856; P = 0.033)., Conclusions: The current study indicated that individuals with a higher pro-inflammatory diet score were more likely to develop breast cancer., (© 2024. The Author(s).)