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One of the symptoms of burning is chronic and severe pain that affects the quality of life of patients. The aim of this article was to compare of the effect of prayer and ginger on the severity of pain and anxiety in inpatients with burn.This study is a clinical trial study on 120 patients referred to the Burn Ward of Kashani Hospital affiliated to Shahrekord University of Medical Sciences in the southwest of Iran. Patients were randomly divided into three groups: control, prayer and ginger. The visual analogue scale (VAS) was used to determine the severity of pain and the standard measure Spielberger Anxiety Inventory was used to assess anxiety. In this study, group 1 received placebo (starch) capsules (250 mg) daily, group 2 - ginger capsules (250 mg) plus 20 ml water after each meal on a daily basis and group 3 was asked to recite the prayer for 10 minutes three times in the morning, evening and night every day. Data analysis was done by descriptive and inferential statistics (ANOVA and Tukey's test) in the SPSS.After the intervention, the pain levels in the prayer and ginger groups at days 3 and 6 of hospitalization, were lower than the control group. On day 6 mean anxiety level was significantly lower in the prayer group than in the ginger group (P0.05).According to the results of this study, it is recommended that using ginger or prayer be applied to reduce the pain and anxiety of burn patients, because they not only cause no side effects but also are low cost, leading to reduction in drug consumption and the resulting side effects.

Restless legs syndrome (RLS) is a neurological disorder characterized by sleep disorders, which leads to adverse health consequences in the mother and fetus. Studies have reported different prevalence rates for RLS in pregnant women. This systematic review and meta-analysis aimed to estimate the prevalence of RLS in pregnant women.A literature search was performed via national and international databases, including Scientific Information Database (SID), MagIran, IranMedex, Google Scholar, Science Direct, PubMed, ProQuest, and Scopus. In total, 31 articles were selected without a time limit. The random effects model was used to analyze the data, and the heterogeneity between the studies was examined using the I2 index. The analyses were performed in the Stata software, version 12 and R, version 4.The reviewed studies (n=31) were conducted on a total sample size of 59,151, and the prevalence of RLS in pregnant women was estimated at 21.4% [95% confidence interval CI: 17.7-25.1]. Asia with a prevalence rate of 18.5%, [95% CI: 13.8-23.1] and Europe with a prevalence rate of 25.5%, [95% CI: 19.5-31.6] had the lowest and highest RLS prevalence, respectively. No significant correlations were observed between the prevalence of RLS, publication year of the articles (P=0.972), and participants' age (P=0.202).According to the results, RLS is highly common in pregnant women, and it is essential to identify women with RLS to control and eliminate the adverse consequences of the disorder.

Introduction: Vesicoureteral reflux (VUR) is considered as the most common urogenital abnormality occurring in children. There is no reliable and routine clinical test that is non-invasive and rapid for recognizing the renal scars from VUR. Objectives: Urine neutrophil gelatinase-associated lipocalin (uNGAL) can be the best indicator for early diagnosis of scar formation in children with VUR. Patients and Methods: Children with primary VUR admitted to Hamadan’s Besat hospital from March to December 2020 were included in this cross-sectional study. A dimercaptosuccinic acid (DMSA) scan was employed to assess all subjects in order to diagnose scar formation at least 180 days after the last episode of urinary tract infection (UTI). Additionally, uNGAL and its ratio to urine creatinine (uCr) levels were measured. Results: During the study, all 63 cases (male/female, 13.50) with VUR were included for further evaluation. The mean age of the patients was 59.1 ± 34.7 months (range 2 to 132 months). Twelve subjects suffered from unilateral VUR, while bilateral VUR inflicted 51. According to the disease severity, nine patients had mild, 35 had moderate, and 19 had a severe form of VUR. No significant difference was observed between patients with (n = 31) and without (n = 32) renal scars regarding mean levels of the uNGAL and uNGAL/uCR ratios (P>0.05). Conclusion: We found no significant difference between the groups with and without the renal scar in terms of biomarker levels.

INTRODUCTION. Chronic non-communicable diseases (NCDs), global health problem and it is a threat to health and the development of countries. Currently, the number of people with COVID-19 as well as the resulting death toll is rising sharply worldwide. People with underlying diseases may be at greater risk. AIM. The purpose of the present study was to investigate the chronic non-communicable diseases in the epidemic (COVID-19): Investigation of risk factors, control and care. METERIALS AND METHODS. To access the articles, including international databases Scopus, PubMed, Web of Science, Embase were searched using the keywords of chronic non-communicable diseases (NCDs), chronic, risk factors, prevention and control, self-efficacy and self-care and their various combinations using AND/OR operators. No language restrictions were applied to the search process. RESULTS. Based on the evidence, NCDs, exacerbate the negative consequences of COVID-19. according to the results of this study, Among the patients admitted with COVID-19, The most common underlying diseases, were in these people, include, cardiovascular disease, hypertension, chronic obstructive pulmonary disease (COPD), smoking, malignancy, chronic kidney disease, and diabetes mellitus. Obesity may be considered as a potential COVID-19 risk factor. CONCLUSIONS. Although lifestyle, nutrition, and medical interventions are important for the early prevention of NCDs, having the tools and resources to use information more effectively is more important One of the determining and effective factors in maintaining health and preventing the aggravation of signs and symptoms of the disease COVID-19, especially in chronic diseases, is to perform self-care behaviors.

The aim of this study was to explore the effectiveness of Methadone Maintenance Treatment (MMT) from the perspective of drug users and their families. For this qualitative content analysis study, 1...

Background and aims: Postpartum depression has a high prevalence in communities and needs great financial resources. On the other hand, the world views the spiritual health as a new and complementary dimension of health. The aim of this study was to investigate the correlation between postpartum depression and spiritual health.Materials and Methods: This correlational-analytic study was conducted on 152 women who gave birth 8 months ago, referred to Hajar Hospital, Imam Ali hospital, Molavi clinic, or other health centers of Shahrekord, and were also satisfied with participating in the study. They were selected by the simple sampling method and completed the Palutzian and Ellison Spiritual Health Questionnaire. Finally, the collected data were entered in SPSS software and descriptive statistics in addition to the Pearson correlation coefficient and K2 test were used to analyze the data.Results: In the present study, the mean age of the subjects was 29.15 (SD=5.45) with the range of 16-45 years. The mean scores of spiritual health and depression were obtained 96.3 and 8.94, respectively. The results of this study showed that the Pearson correlation coefficient was -75.5% (P˂ 0.001), demonstrating an inverse correlation between the scores of postpartum depression and spiritual health.Conclusion: In general, the correlation between postpartum depression and spiritual health was an inverse correlation and the level of depression decreased by an increase in spiritual health. It can be concluded that without the need for specific treatments, the level of postpartum depression can be reduced by increasing the level of spiritual health.

Introduction: Gentamicin is an aminoglycoside antibiotic that is widely administered to treat infections caused by gram-negative bacteria. Gentamicin may cause renal injury in patients after seven days of administration. Atorvastatin is a cholesterol-lowering statin that acts through the mevalonate pathway. Objectives: In this study, we investigated the histopathological effects of atorvastatin against gentamicin-induced renal injury. Materials and Methods: Twenty male Wistar rats were randomly assigned into five groups and treated as the following; group 1 (normal group, no drug), group 2 [gentamicin group, daily 80 mg/kg, intra-peritoneal (i.p.) for 7 days], groups 3 to 5 (gentamicin 80 mg/kg + atorvastatin at doses of 5, 25 and 75 mg/kg, respectively). Kidney sections were examined for histopathological parameters including vacuolization of the kidney tubular cells, degeneration, necrosis, flattening of the tubular cells and debris in the tubular lumen. Results: Compared to the normal group, gentamicin significantly exacerbated the histopathological parameters. Treatment with atorvastatin significantly decreased vacuolization, degeneration, necrosis and debris in the nephrotoxic rats. Conclusion: The findings of this research indicated that atorvastatin therapy can ameliorate histopathological renal injury following gentamicin injection.

This article reports the findings of a study designed to investigate the effectiveness of the Roy Adaptation Model, as it relates to improvements in nursing care outcomes for patients undergoing coronary bypass graft surgery. Results revealed that the implementation of a training program based on this model enhanced staff education and led to decreases in the level of fatigue and improved the quality of life for this group of patients.

Introduction. Determining the prevalence of SARS-CoV-2 in blood donors makes the control of virus circulation possible in healthy people and helps implement strategies to reduce virus transmission. The purpose of the study was to examine the seroprevalence of COVID-19 in blood donors using systematic review and meta-analysis. Materials and Methods. The electronic databases PubMed, Scopus, Web of Science, and the Google Scholar search engine were searched using standard keywords up to 2022-04-26. The variance of each study was calculated according to the binomial distribution. Studies were combined according to the sample size and variance. Q Cochrane test and I2 index were used to examine the heterogeneity of the studies. Data analysis was performed in STATA 14 software, and the significance level of the tests was P < 0.05 . Results. In the 28 papers examined with 227894 samples, the seroprevalence of COVID-19 in blood donors was 10% (95% CI: 9%, 11%), estimated 5% (95% CI: 4%, 7%) among men and 6% (95% CI: 4%, 7%) among women. This rate in different blood groups was as follows: A 12% (95% CI: 10%–14%), B 12% (95% CI: 10%–15%), AB 9% (95% CI: 7%–12%), and O 13% (95% CI: 11%–16%). The seroprevalence of COVID-19 in blood donors in North America 10%, Europe 7%, Asia 23%, South America 5%, and Africa was 4%; Moreover, the seroprevalence of IgG antibodies was estimated to be 23% (95% CI: 18%–29%) and IgM 29% (95% CI: 9%–49%). Conclusion. The highest prevalence of COVID-19 serum in women blood donors was among blood group O and Asia. The seroprevalence of IgG and IgM antibodies was high too.

PURPOSE. This study was conducted to examine the effect of quarantine caused by COVID-19 on people’s mental health and social trust. METHOD. In this study, the sample size covers 2919 people in the southwest of Iran that was selected cluster sample method and was evaluated online using tools of social trust and a checklist of mental disorder syndrome. RESULTS. Due to the results, COVID-19 affected all people’s mental health negatively, but there was a significant difference between the rates of COVID-19 caused anxiety and the dimensions of the psychological problems and social trust different between men and women and married and single people, and also the education level. There was no significant relationship between any of the demographic variables and social trust variables, corona anxiety, and dimensions of psychological problems. And there was a negative and significant relationship between the dimensions of social trust and the dimensions of psychological problems. Moreover, the social trust rate in the subjects was desirable. Based on the results and the cutoff point of 2.5 as a border of healthy and unhealthy psychological dimensions, 4.5% had pathological anxiety, 7.3% had pathological depression, 5% had aggression, and 5.9 % had pathological obsessive-compulsive disorder. Depression had the highest scores, and aggression had the lowest scores. CONCLUSION. Due to this study’s results, policymakers should consider measures that should be taken in crisis to support all people, especially vulnerable people in psychological, economic, social, spiritual, and psychological fields. On the other hand, the government must train the public through the mass media to cope with COVID-19

Introduction As a result of high transmission and mortality rates, the Covid-19 pandemic has led to a worldwide health crisis, isolation, and widespread fear, therefore negatively influencing people’s quality of life (QOL). The goal of the present study was to examine the psychometric properties (validity and reliability) of the Persian version of the COVID-19-Impact on Quality of Life (COV19-QoL) scale. Methods After translating the scale using the forward–backward method, face and content validly was qualitatively assessed. Then the scale was distributed to 488 individuals from the general population via online platforms. Construct validity was assessed using exploratory (EFA) and confirmatory (CFA) factor analysis. In addition, internal consistency was examined using Cronbach’s alpha coefficient and McDonald’s omega, relative stability was assessed using interclass correlation coefficient (ICC), and absolute stability was calculated through examination of standard error of measurement. Results The EFA revealed one factor that explained 55.96% of the total variance of the scale. Internal consistencies of 0.823 and 0.882 were found using Cronbach’s alpha coefficient and McDonald’s omega, respectively. In addition, an ICC of 0.837 (with a two-week interval) was found. Covid-19 had a greater impact on the QOL of healthy participants than that of those with underling conditions (p = 0.004), and also on the QOL of single participants than that of married ones (p = 0.032). Conclusion The Persian version of the COV19-QoL is a valid and reliable instrument that can be used to examine the impact of Covid-19 on QOL.

Introduction: Diabetic nephropathy (diabetic kidney disease) is a complication of diabetes that begins and progresses with several factors, including hyperglycemia, inflammation and oxidative stress. Objective: This study demonstrates the effect of sevelamer carbonate administration on hemoglobin A1c levels, blood sugar and inflammatory factors in diabetic nephropathy patients. Patients and Methods: In this clinical trial, 48 diabetic patients under treatment of least one drug who have proteinuria (urinary protein to creatinine ratio greater than 0.5) ≥ 2 times during the past 18 months, received sevelamer carbonate or placebo for two months. Patients’ blood samples were taken before and after the intervention. Data were analyzed by SPSS software. Results: According to the results, fasting blood sugar (FBS), hemoglobin A1c (HbA1c), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) showed no significant difference between the study groups before and after the intervention (P>0.05). The mean ICAM-1(intercellular adhesion molecule-1) and VCAM-1 (vascular cell adhesion molecule1) showed no significant difference between the study groups before the intervention (P>0.05). However we found a meaningful difference after the intervention, which was significantly lower in the intervention group (PConclusion: Sevelamer carbonate administration in patients with diabetic nephropathy has a significant effect on decreasing ICAM-1 and VCAM-1 levels. Trial registration: The trial protocol was approved in the Iranian Registry of Clinical Trial (identifier: IRCT20191111045401N1; https://en.irct.ir/trial/43662, ethical code; IR.SKUMS. REC.1397.181).

Type 2 diabetes mellitus (T2DM) is a multi-factorial disease in which influenced by several genetic and environmental factors. Insulin receptor substrate 2 (IRS 2) is the main mediator of insulin in the liver which controls insulin sensitivity. Gly1057Asp polymorphism is one of the candidates to increase risk of T2DM. The present study is an attempt to study the relationship of Gly1057Asp polymorphism of IRS-2 and T2DM by a meta-analysis. A systemic search was conducted in English and Persian databases such as Scopus, PubMed, Google Scholar, SID, and other academic databases for studies that have investigated the relationship of Gly1057Asp polymorphism of IRS-2 and T2DM. This association was determined using odds ratios (ORs) with a confidence interval of 95% (CIs). Heterogeneity of the studies was examined by I2 index. Funnel plots and Egger tests were used to determine bias or publication bias. The collected data was analyzed in STATA through meta-analysis. Nine articles were selected as eligible for further analysis, which represented 3,196 patients with T2DM and 3409 controls subjects without T2DM. The present meta-analysis showed a significant relationship between GA genotype of Gly1057Asp polymorphism and T2DM (OR=0.88; 95% confidence interval, 0.79-0.98), whereas no significant relationship between GG and AA genotype with T2DM was seen; OR for GG and AA genotypes were 1.10 (95% CI, 0.99 -1.22) and 1.13 (95% CI, 0.95- 1.33), respectively. The results of our study show that genotype GA of Gly1057Asp polymorphism of IRS-2 gene plays a protective role and may decrease the risk of T2DM, whereas GG and AA genotypes are considered as a risk factor and related to development of T2DM to some extents.

Nitric oxide (NO) has various physiological and biochemical effects. In many biological systems of the body, NO acts as a messenger molecule via cyclic guanosine monophosphate (cGMP), which affects the body cells. NO is synthesized in the body from the L-arginine amino acid by the NO synthases enzyme. This enzyme consists of three major isoforms including neurotransmitter, endothelial and inductive types. According to the results of numerous studies, the administration of ozone as a complementary therapy of the diseases is a less complicated and cost-effective way. Over the past forty years, the results of ozone therapy have been satisfactory and without any problems. Ozone therapy affects various diseases. For example, in treatment for vascular diseases and some degenerative diseases, it has an ameliorative impact. Regarding kidney disease, still many experimental or clinical studies are necessary to find its improvement/anti-oxidative effect.

Introduction: Diabetes mellitus (DM) is distinguished as a serious health problem worldwide. The universal outbreak of DM because of urban life and alteration of lifestyle, day to day is increasing. Objectives: The present investigation was designed to evaluate the nephroprotective effects of resveratrol (RSV) and silymarin (SM) on morphologic injury to renal tubular cells in adult male diabetic rats. Materials and Methods: Twenty-five male Wistar rats randomly were designated into five groups (n = 5) including group I (control); rats received normal saline by gavage for 14 days. Group II; rats received a single injection of STZ at a dose of 60 mg/kg intraperitoneally and were also given isotonic saline orally for 14 days. Group III; Rats, after STZ injection, received 100 mg/kg of SM by gavage for 14 days. Group IV; Rats, after STZ injection, received 100 ml/kg of RSV by gavage for 14 days. Group V; rats, after STZ injection, received the combination of SM and RSV at a dose of 100 mg/kg by gavage for 14 days. The kidneys were removed immediately after sacrificing and prepared for morphological examination. Kidney sections were examined for the intensity of kidney damage (vacuolization, flattening, degeneration and necrosis). Results: Significant differences were observed in types of morphologic injury to renal tubular cells (vacuolization, flattening, degeneration and necrosis) between groups (P < 0.05). Significantly, both the SM and RSV reduced the injury of renal tubular cells in diabetic rats (P < 0.05). Conclusion: The findings of the present study indicated that although the protective effect of SM and RSV was more significant on necrosis and flattening, respectively, SM and RSV produced a nephroprotective impact on the injury of renal tubular cells in diabetic rats than their combination influences.

Medical staff and healthcare providers are always involved in earthquakes; therefore, the aim of this study was to explore the experience of nurses in dealing with critical events and natural disasters. A qualitative study was conducted by semi-structured interviews with 12 medical staff. Data were analyzed by qualitative analysis hermeneutic approach. Four categories were developed as follows: “confusion,” “coercion,” “psychological disturbance,” and “wasting of resources.” The categories led to the development of the main theme of “miss management.” Earthquakes are considered serious challenges for nurses and health professionals involved in such disasters. It will culminate in dire consequences including physical, mental, and psychological damage as well as high mortality rate among people and healthcare providers.

Cytokines produced by T helper cells (Th cells) have essential roles in the body's defense against viruses. Type 1 T helper (Th1) cells are essential for the host defense toward intracellular pathogens while T helper type 2 (Th2) cells are considered to be critical for the helminthic parasites' elimination swine-origin influenza A (H1N1) virus, a disease led to an epidemic in 2009 and rapidly spread globally via human-to-human transmission. Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a global pandemic in 2020 and is a serious threat to the public health. Pulmonary immunopathology is the leading cause of death during influenza and SARS-CoV-2 epidemics and pandemics. Influenza and SARS-CoV-2 cause high levels of cytokines in the lung. Both inadequate levels and high levels of specific cytokines can have side effects. In this literature review article, we want to compare the Th1 and Th2 cells responses in SARS-CoV-2 and H1N1.

Background and Aim: The aim of this study was to investigate the effect of Covid-19 on anxiety, quality of work life and fatigue of health center staff in southwestern Iran. Materials and Methods: The present study was a descriptive comparative study and the statistical population of the study included the staff of health centers of Shahrekord University of Medical Sciences. Using random sampling method, 181 people who had direct involvement with patients with Covid-19 were selected and compared with 261 staff in other wards who had no direct contact with patients with Covid-19. For data collection, demographic information (demographic characteristics questionnaire) , Covid-19 Anxiety Questionnaire, quality of work life and Rhoten fatigue questionnaires were used.Results: The results showed that the quality of life in both groups decreased and fatigue and anxiety caused by Covid-19 increased, but there was no statistically significant difference between anxiety derived fatigues of personnel involved with Covid-19 with personnel of other wards which were no directly faced Covid-19 patients. Regarding the quality of work life, no significant difference was observed in other components except in the component of human resource development. The results also showed that there was a statistically significant relationship between the level of anxiety caused by Covid-19 with quality of work life and fatigue.Conclusion: According to the results of the present study, Covid-19 had a negative effect on physical, mental and various aspects of quality of life of health care staff and led to increased fatigue and burnout, resulting in absence from work and its consequences.

Chronic obstructive pulmonary disease (COPD) is an irreversible pulmonary obstruction. Respiratory exercise training by a feedback-based model besides the routine managements have been considered to perform.Eighty exacerbated COPD patients with informed consent were divided to the control group (n = 40) received the routine approach and the intervention group (n = 40) received a teach-back training method (TBTM) of respiratory exercise including diaphragmatic breathing (DB), pursed-lip breathing (PLB), and effective coughing (EC) plus routine approach. The clinical outcomes were evaluated by measurement of the FEV1/FVC ratio, the Borg scale of dyspnea (BSD), and the 6-minute walking test (6MWT) results at the baseline, just after TBTM, and next 3 months.FEV1/FVC ratio has been indicated the significant improvement followed by TBTM compare to the baseline (p 0.001). Moreover, the BSD scores in 3-month follow-up after TBTM were significantly lower compared to the baseline (6 ± 1.3 vs. 3.8 ± 0.78, p 0.001). Although a significant difference was reported in 6MWT distance between two groups after 3-month follow-up (p 0.001), there was no significant difference immediately after the TBTM (p = 0.992) that suggested a long-term effect of educational intervention on physical activity.Significant enhancement in the clinical variables can demonstrate the efficacy of the TBTM program in reducing COPD patients' symptoms.http//www.irct.ir.Unique identifier: IRCT20181024041449N5.

Background: Depression is one of the major psychiatric disorders in the world. The present study was conducted to determine the prevalence of depression among Iranian school students through a meta-analysis. Methods: All national and international information databases including PubMed, Scopus, Web of Science, SID, Magiran, Medlib were searched. The search phase was performed without language and time restrictions, but the searched studies were all in Persian and English, and the sources were updated by 03.08.2020. As the selected studies had high heterogeneity, the random effects model was used. Results: In 51 studies with a sample of 537144 people, the prevalence of depression in Iranian school students was 37% (95%CI: 32, 42). In addition, the prevalence of depression in girl school students was 45% (95%CI: 25-65) and in boys was 28% (95%CI: 20-35). The prevalence of mild, moderate and severe depression in school students is 31%, 18% and 11%, respectively. Also, the prevalence of depression in primary school students was 12%, middle school students 32%, high school students 47% and pre-university students 46%. Conclusions: About a third of Iranian school students suffer from some degree of depression, and the prevalence of depression in girls is about twice that of boys. The prevalence of mild depression among school students is higher than moderate and severe depression. On the other hand, the prevalence of depression in school students from primary to pre-university level is increasing, which is very worrying.

Coronaviruses are a large family and a subset of Coronaviridae that include common cold viruses and other severe diseases like severe acute respiratory syndrome (SARS-CoV), Middle East respiratory syndrome (MERS-CoV), and coronavirus disease 2019 (COVID19). This is an ecological study based on statistics of the prevalence of coronavirus disease until 30 April 2020, based on the reports sent to the World Health Organization (WHO). This study investigates the distribution of the incidence and trend of the incidence rate of COVID-19 in countries, and its relation with the human development index (HDI) until 30 April 2020. The results showed that the most cases of coronavirus disease until the mentioned date were in the United States of America (1,003,947 cases), Spain (212,917 cases), Italy (203,591 cases), the United Kingdom (165,225 cases), and Germany (159,119 cases), in sequence. The results exhibited a significant positive correlation between the incidence of COVID-2019 and HDI in the world (r = 0.470, P < 0.0001). Keywords: COVID-19, Pandemic, Human Development Index

Introduction: Low levels of fetuin-A in patients with chronic kidney disease (CKD) are associated with arterial stiffness, vascular calcification and cardiovascular mortality. Objectives: The aim of the present study was to investigate and compare the effect of omega-3 supplements with plant (flaxseed) and animal origins on fetuin-A levels in patients with chronic renal failure. Patients and Methods: In the present clinical trial, 90 patients with chronic renal failure (chronic kidney disease) were randomly divided into three groups. The first group received two grams of omega-3 tablets per day of animal origin (fish oil), the second group received 2 g of omega-3 tablets per day of plant origin (flaxseed oil), and the third group received one placebo per day as the control group. The duration of the drug treatment was 90 days. Before and after the intervention, blood levels of fetuin-A, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C) and triglyceride (TG) were determined. Data were analyzed by SPSS statistical software. Results: Before and after the intervention, LDL-C and HDL-C levels were not significantly different in the study groups. In the animal origin omega-3 group, the levels of triglycerides and cholesterol decreased significantly after the intervention compared to before the intervention (P=0.004), however they did not change significantly in the plant origin omega-3 and control groups. Before and after the intervention, fetuin-A and ESR levels were not significantly different in the study groups. The frequency of positive CRP results in the animal and plant origin omega-3 groups was 20% and 24% respectively before intervention and 4% and 24% after intervention respectively, indicating a decrease in the levels of CRP in the animal origin omega-3 group. Conclusion: Animal origin omega-3 is more effective in reducing serum lipids and CRP than plant-origin omega-3. Omega-3 supplements of plant or animal origin have been more effective in men than in women.

Background: Coronary angiography is an invasive procedure used to diagnose coronary artery disease, and standard nursing care before, during, and after this procedure. A comparison of the current care with the existing standards can lead to improved nursing care quality, increased patient safety, and reduced medical costs. Objectives: Therefore, the aim of this study was to audit the nursing care provided before angiography. Methods: In this analytical descriptive study, the nursing care provided to 400 patients undergoing coronary angiography was evaluated using the event-based sampling method in the angiography ward of hospitals affiliated to Shahrekord University of Medical Sciences. Data were collected by a demographic form and a standard nursing care checklist. Data were analyzed using descriptive statistics (i.e., frequency, mean, and standard deviation) and analytical statistics (i.e., chi-square, independent t-test and analysis of variance) in SPSS 18 version. Results: Before angiography, nursing care compliance score was 51.63 ± 4.21, which was significantly different than the normal value (normal score: 61 - 81). At the preoperative stage, 25 (6.3%), 374 (93.5%), and 1 (3%) caring cases, the standard of nursing care was poor, moderate, and good, respectively. Conclusions: Based on our results, in one case, the provided nursing care was in accordance with the standard of nursing care at the preoperative stage of angiography, which can be attributed to the lack of education, control, facilities and awareness among nurses about the importance of standard care.

Objectives Self-care is a major factor in managing diabetes. This study aimed to determine the self-care status of Iranian patients with diabetes and to estimate the percentage of self-care in these individuals through a systematic review and meta-analysis. Methods In this systematic review and meta-analysis 53 domestic articles published in Farsi and English were evaluated. We conducted database searches in domestic and foreign databases of Scientific Information Database (SID), MagIran, Google Scholar, Web of Science, Pub Med, and Scopus with no time limit. Data analysis was performed in Stata version 12 using meta-analysis method and the random effects model. Results A total of 50 articles (53 groups) with a sample size of 9565 were systematically reviewed. The percentage of self-care in patients with diabetes was reported to be 48.86 (95% confidence interval [CI]: 43.79–53.94). According to the results, the percentage of self-care score was higher in patients with type I diabetes (55.53) when compared with patients with type II diabetes (49.26). Conclusions Since patients with diabetes obtained only half of the self-care score and given the importance of self-care in controlling and treating diabetes, it is necessary to perform actions to improve self-care such as benefiting from health facilities, and social and family support.

Patients with type 1 diabetes mellitus (T1DM) are at high risk for celiac disease (CD) due to the common genetic background and interaction between environmental and immunological factors. The purpose of this systematic review and meta-analysis was to estimate the prevalence of CDamong Iranian patients with type 1 diabetes. The search for articles was conducted using the following keywords: “celiac disease,” “celiac,” “coeliac disease,” “diabetes,” “Iran,” and all other possible combinations of these terms. The following databases were searched from inception to June 2019: Scientific Information Database (SID), MagIran, Web of Science, PubMed, and Scopus. Meta-analysis was performed using the random-effects models, and the heterogeneity of results across the studies was assessed using the Cochran’s Q test and quantified by the I2 statistic. Data analysis was performed by Stata version 14. A total of 14 papers were included in the meta-analysis, involving 2030 Iranian patients with T1DM. The pooled prevalence of CD in patients with T1DM was 5% (95% CI 3–7). The prevalence of CD in Tehran (4%; 95% CI 1–6) was lower than in other provinces of the country (6%; 95% CI 4–8). Meta-regression analysis showed that, with increasing sample size, the prevalence of CD was significantly reduced (p = 0.018).Given the adverse effects of CD, such as osteoporosis and malignancy (especially lymphoma), patients with T1DM must be screened for CD.

Background: Neonatal jaundice is a prevalent disease that causes many complications, including kernicterus and even death. Previous studies have shown that clofibrate as an aryloxy isobutyric acid derivate can be effectively applied for the treatment of neonatal jaundice. Thus, this review was carried out to investigate the effects and mechanism of action of clofibrate on neonatal jaundice. Methods: The keywords such as “Clofibrate” in combination with “Neonatal jaundice” or “Neonatal hyperbilirubinemia” or “Newborn Jaundice” were used to search for relevant publications indexed in the Institute for Scientific Information (ISI), Scopus, PubMed, and Google Scholar databases. Finally, after reviewing the studies, 24 papers were included in this study. Results: Results showed that the processes of albumin-bound bilirubin transfer to the hepatocytes, hepatic uptake, and storage via ligandin, hepatic conjugation via uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1), conjugation into the bile via MRP2 represent the main action mechanism of clofibrate that turns it into the bilirubin conjugates and expels it from the bile. Besides, clofibrate has been shown to reduce the level of Total Serum Bilirubin (TSB) in infants even at a dosage of 25 mg/kg without leaving side effects. Conclusions: The results of this review revealed that clofibrate effectively reduces TSB in short-term usage and can even have a promising effect at the dosage of 25 mg/kg in full-term infants. Most studies have shown this property over a short period in term infants, and there is no evidence about long-term usage in this regard.

Metformin is one of the oldest and commonly used blood sugar lowering drugs, having limited side effects and used as the first line treatment in patients suffering from diabetes mellitus. Moreover, various studies have emphasized on the anti-inflammatory and antioxidant role of metformin, with multiple mechanisms, which activation of AMPK by metformin has had a key role in many of them. During the searches on the internet websites of PubMed, Elsevier, Google Scholar, and Science Direct, 76 papers related to the anti-inflammatory and antioxidant role of metformin were selected and reviewed since 2003 to 2017. At the cellular level, metformin suppresses the inflammation in many cases and reduces or eliminates inflammatory factors mainly through dependent mechanisms and sometimes independent of AMPK at the cellular level and through other ways at the systematic levels. It is also effective in reducing the level of oxidative stress factors by regulating the antioxidant system of the cell. All evidence suggests the antioxidant and anti-inflammatory role of metformin in various conditions. Metformin can be an appropriate treatment option for many diseases, which inflammatory processes and oxidative stress play a role in their pathogenesis.

Objective: Pancreatic cancer is one of the leading causes of mortality in developed countries and a lethal malignant neoplasm worldwide. This study aims to evaluate the epidemiology of pancreatic cancer incidence and mortality and its relationship with HDI. Methods: This is a descriptive cross-sectional study that is based on cancer incidence data and cancer mortality rates derived from the GLOBOCAN in 2018. The incidence and mortality rates of Pancreas as well as Pancreas cancer distribution maps were derived for world countries. The data analysis was conducted using a correlation test, and regression tests were used to evaluate the correlation of the incidence and mortality of Pancreas with HDI. The statistical analysis was carried out by Stata-14, and a significance level of 0.05 was considered. Results: The highest incidence of pancreatic cancer was reported in Asia with 214499 (46.7%) cases and the lowest incidence was related to Oceania with 4529 cases (0.99%). The results showed a positive and significant correlation between incidence (r = 0.764, P Conclusion: Given the higher incidence and mortality of pancreatic cancer in countries with HDI, it is necessary to pay a greater attention to risk factors and appropriate planning to reduce these factors and minimize the impact and mortality rate of this disease.

Dual-pump electrospinning of antibacterial N-decyl-N, N-dimethyl-1-decanaminium-chloride (DDAC)-loaded polycaprolactone (PCL) nanofibers, and chitosan (CS)/polyethylene-oxide (PEO)-based wound dressings with hydrophilic and hydrophobic properties to eliminate and absorb pathogenic bacteria from wound surface besides antibacterial action and to support wound healing and accelerate its process. Physicochemical properties of the prepared nanofibrous mat as well as antibacterial, cytotoxicity, and cell compatibility were studied. The full-thickness excisional wound healing properties up to 3 weeks using hematoxylin and eosin and Masson-trichrome staining were investigated. Addition of DDAC to CS/PEO-PCL mats decreased the diameter of the nanofibers, which is a crucial property for wound healing as large surface area per volume ratio of nanofibers, in addition to proper cell adhesion, increases loading of DDAC in mats and leads to increased cell viability and eliminating Gram-positive bacteria at in vitro studies. In vivo studies showed DDAC-loaded CS/PEO-PCL mats increased epithelialization and angiogenesis and decreased the inflammation according to histological results. We demonstrated that hydrophobic PCL/DDAC mats, besides antibacterial properties of DDAC, absorbed and eliminated the hydrophobic pathological microorganisms, whereas the hydrophilic nanofibers consisted of CS/PEO, increased the cell adhesion and proliferation due to positive charge of CS. Finally, we were able to increase the wound healing quality by using multifunctional wound dressing. CS/PEO-PCL containing 8 wt % of DDAC nanofibrous mats is promising as a wound dressing for wound management due to the favorable interactions between the pathogenic bacteria and PCL/CS-based wound dressing.

Objective: The aim of this study was to explore the burden of care for patients undergoing hemodialysis from the experiences of family caregivers. Methods: In this qualitative study, a content analysis approach was used for data collection and analysis. Participants were 16 family caregivers selected through purposive sampling from four medical education centers affiliated with Ahvaz Jundishapur University of Medical Sciences, Iran. Semi-structured interviews were held to collect data. Results: Four categories were developed as follows: ‘care challenges’, ‘psychological vulnerabilities’, ‘the chronic nature of care ’and “care in the shade”. The categories led to the development of the main theme of ‘progressive exhaustion’ experienced by the family caregivers during the provision of care to patients undergoing hemodialysis. Conclusion: Family caregivers have a significant role in the process of patient care, and this role leads them to progressive exhaustion; therefore, the overall health of the caregivers should be taken into account and more attention should be paid to their quality of life, social welfare, and satisfaction level. Keywords: Family caregivers, Hemodialysis, Progressive exhaustion, Qualitative study

Vitamin D or cholecalciferol, as a steroidal hormone, regulates the calcium homeostasis, and bone formation with reabsorption through kidneys, parathyroid glands and bowel. There are at least 800 human genes connected with vitamin D. Previous research has confirmed the relationship between vitamin D and colorectal cancers, infections, heart diseases, multiple sclerosis (MS), bone disorders, inflammatory and autoimmune diseases, inflammatory bowel diseases, diabetes mellitus type-I and II and also progression of kidney disease. However, the relationship of vitamin D deficiency and developing of breast cancer, rheumatoid arthritis and osteoporosis is unknown. In fact, the effect of vitamin D deficiency on pathogenesis of different diseases is controversial. To cope with vitamin D deficiency, there are different recommendations such as daily intake of vitamin D supplements and more exposure to sunlight.

Background: Chronic kidney disease (CKD) is a consequence of progressive and irreversible destruction of nephrons, mainly due to uncontrolled diabetes mellitus and high blood pressure. Ghrelin is a peptide hormone which could play a substantial role in hunger sensation, may increase body fat percentage and might adjust the long-term body weight and is mostly secreted in the stomach. Objectives: This study aimed to evaluate the relationship between ghrelin levels and various biochemical and demographic indices in a group of non-diabetic hemodialysis patients. Patients and Methods: Around 39 non-diabetic patients undergoing hemodialysis in Hajar hospital at Shahrekord city were enrolled. Results: The mean age of patients was 57.10±20.20 years. Their mean weight was 56.65 ±16.25 kg. Their hemoglobin level mean was 10.43±1.84 g/dL. The serum ghrelin level had a positive but not significant correlation with the age, dialysis quality, dosage, calcium level, alkaline phosphatase (ALP), parathormone, vitamin D and hemoglobin in these patients. Conclusions: More studies in this subject of hemodialysis patients to define the exact role of ghrelin in hemodialysis patients are recommended.

Context: Type 2 diabetes mellitus (T2DM) is a multi-factorial disease with several genetic and environmental factors known to be associated with the disease. Tumor necrosis factoralpha (TNF-α) acts on fat cells associated with increased insulin resistance and obesity and its increase can be associated with the prevalence of T2DM. Previous studies on the relationship between 308 G/A polymorphism in TNF-α and T2DM were not conclusive. The aim of this study was to investigate the association between 308 G/A polymorphism in TNF-α gene and T2DM using a systematic review and meta-analysis. Evidence Acquisitions: In this systematic review we searched all published studies about the association between TNF 308 G/A polymorphism and T2DM through databases such as Scopus, Science direct, PubMed and Google scholar. A fixed or random effect model was used on the basis of heterogeneity. The heterogeneity was assessed using the I2 index. We used STATA software (version 11.2) for data analysis. Results: In 22 selected papers, the total number of T2DM and control subject was 8485 and 8615, respectively. Odds ratios (ORs) with 95% confidence intervals(CI) for the GG genotype polymorphism 308 G/A in total, Asian populations and whites (Caucasian) were estimated as OR=0.98 (95% CI: 0.96-1.00), OR=0.96 (95% CI: 0.93 to 0.99) and OR=1.00 (95% CI: 0.97 to 1.40). The Publication Bias/or heterogeneity was observed in this study. Conclusions: The present investigation have shown that 308 G/A polymorphism GG and GA genotypes in TNF-α gene cannot be considered as predictors of T2DM (P

Aims and background:Breast cancer (BC) is responsible for a large proportion of incidence of cancer in the world. Identifying the risk factors contributing to the incidence of BC is crucial to find efficient preventive and management strategies for this disease. Several studies have examined Arsenic (As), Cadmium (Cd), and Nickel (Ni) as risk factors for BC. The present study aimed at studying the link between As, Cd, and Ni concentrations and BC by using a meta-analysis. Materials and methods: All case�control studies addressing the relationship between As, Cd, and Ni concentrations with BC were identified through electronic search databases ( Scopus, ISI Web of Science, PubMed, EmBase, and Cochrane Library). The relevant data obtained from these papers were analyzed by a random-effects model. The heterogeneity of studies was secured by using I2 index. Funnel plots and Egger�s test were used to examine publication bias. Results: In the present study, due to different measurement methods used for measuring As, Cd, and Ni, the concentration of these elements was measured in various subgroups (1: plasma, 2: breast tissue, and 3: scalp hair and nail) of individuals with BC and healthy subjects. The overall integration of data from the 3 groups led to the conclusion that there was a significant difference in Cd and Ni statuses between healthy and BC patients; the standard mean difference was 2.65 (95 CI: 1.57�3.73; P=0.000) and 2.06 (95 CI: 1.20�3.32; P=0.000), respectively. Whereas, there was no significant statistical difference in As status between healthy subjects and BC patients; the standard mean difference between them being 0.52 (95 CI: �0.12�1.16; P=0.114). Conclusion: The present study indicates that there is a direct and positive association between Cd and Ni concentrations and BC risk. It is a warning to health care providers and policy makers to find viable solutions and take requisite measures to reduce BC risk in the society. © 2018 Jouybari et al.

Background Bed sores are among life-threatening factors in patients during hospital confinement. Thus, treating bed sores is one of the major responsibilities of nursing personnel. Objective This study aimed to compare the effects of Frankincense gel and hydrocolloid dressing on healing of second- and third-degree pressure ulcers among hospitalized patients. Methods This clinical trial was conducted on 75 patients with second- and third-degree pressure ulcers in the hospital affiliated Shiraz University of Medical Sciences, Iran. After obtaining the participants’ informed consent forms, they were randomly divided into three groups. Accordingly, groups A, B, and C were treated by Frankincense (Boswellia corteri) gel and hydrocolloid dressing, placebo gel and hydrocolloid dressing, and hydrocolloid dressing alone, respectively for five weeks. The study data were collected via Pressure Ulcer Scale for Healing (PUSH), which was used to assess and compare pressure ulcers regarding size, tissue, and exudate. Additionally, blood samples were taken from the patients before and two weeks after the treatment in order to measure the level of Transforming Growth Factor (TGF). Results Pairwise comparisons revealed a significant difference between different time points in respect to PUSH scores (p Conclusion The study results indicated that the ulcers were healing after five weeks and growth factors increased in the study groups. Furthermore, Frankincense is cheaper and more easily prepared compared to hydrocolloid and does not cause allergic reactions. Therefore, it can be utilized as an appropriate treatment for bed sores.

Introduction: Both watermelon and Persian melon extracts have various pharmacological properties like anti-diabetic, anti-viral, anti-cancer, and anti-urolithiasis effects. Objectives: The present study was conducted to investigate the effects of hydroalcoholic extracts of watermelon and Persian melon rind on kidney stone prevention in male Wistar rats. Materials and Methods: Fifty-six Wister rats were randomly divided into seven groups and treated for 28 days. The first group (healthy control) and the second group (negative control) received drinking water and water containing 1% ethylene glycol, respectively. The third and fourth groups, received 100 mg/kg/d hydroalcoholic extract of watermelon rind and Persian melon rind, respectively in addition to 1% ethylene glycol. The fifth and sixth groups, received 400 mg/kg/d hydroalcoholic extract of watermelon rind and Persian melon rind, respectively in addition to 1% ethylene glycol. The seventh group received 0.5 mEq/kg/d potassium citrate in addition to 1% ethylene glycol for prevention and treatment of kidney stone. A 24-hour urine collection was conducted to determine the levels of sodium, calcium, uric acid, oxalate and citrate concentration. Histological study of calcium oxalate crystals was also performed. The serum levels of urea, creatinine, uric acid, calcium, phosphorus, magnesium, SGPT (serum glutamic-pyruvic transaminase), SGOT (serum glutamic-oxaloacetic transaminase), total antioxidant capacity, and malondialdehyde (MDA) of blood were determined accordingly. Results: In the present study, administration of high-dose extract of watermelon and Persian melon rind (400 mg/kg/d) and potassium citrate showed significant changes in variables of sodium, calcium, uric acid, citrate, urine volume (PPConclusion: The extracts of watermelon and Persian melon rind are effective in preventing calcium oxalate stones by decreasing the levels of oxalate, sodium, and calcium and increasing citrate levels and urine volume and affecting the total antioxidant capacity. Persian melon rind extract was more effective than potassium citrate and watermelon rind extract in reducing urine sodium. High-dose watermelon rind extract showed similar effects as potassium citrate.

Introduction: Anemia is a common complication of chronic kidney disease (CKD) due to the insufficient production of erythropoietin by the kidneys. The administration of erythropoietin is one of the most common methods for the treatment of patients with anemia. Objectives: This study aimed to investigate the effect of the administration of synthetic erythropoietin on hemoglobin levels in dialysis patients using a systematic review and meta-analysis. Methods: In order to identify the related studies, the international databases of Web of Science, PubMed, Scopus, and Embase were searched from 2015 to 2020 using standard and valid keywords. The data were analyzed using STATA software (version 14), and a p-value of less than 0.05 was considered statistically significant. Results: In 12 reviewed articles with a sample size of 4,060 individuals, the standard effect size of the effect of synthetic erythropoietin on Hb in dialysis patients was reported as 2.08 (95% CI: 1.53-2.63), which was statistically significant; however, erythropoietin biosimilars did not show similar results. Conclusion: The administration of erythropoietin to hemodialysis patients increases Hb levels by more than 2 units.

OBJECTIVES: This study was conducted to determine the efficacy of mindfulness-based cognitive therapy (MBCT) on psychological symptoms and quality of life (QoL) in patients with systemic lupus erythematosus (SLE). METHODS: We conducted a randomized single-blind clinical trial in patients with SLE referred from the Imam Ali Clinic in Shahrekord, southwest Iran. The patients (46 in total in two groups of 23 each) were randomly assigned into the experimental and control groups. Both groups underwent routine medical care, and the experimental group underwent eight group sessions of MBCT in addition to routine care. The patient,s QoL was assessed using the General Health Questionnaire-28 and 36-Item Short Form Health Survey before, after, and six months after intervention (follow-up). RESULTS: A significant difference was seen in psychological symptoms and QoL between MBCT and control groups immediately after the intervention and at follow-up (p ≤ 0.050). However, the difference was not significant for the physical components of QoL (p ≥ 0.050). CONCLUSIONS: MBCT contributed to decreased psychological symptoms and improved QoL in patients with SLE with a stable effect on psychological symptoms and psychological components of QoL, but an unstable effect on physical components.

BackgroundObesity and overweight are among the most common and serious health issues in many countries, leading to numerous medical consequences such as heart disease, hypertension, fatty liver etc. This review article addressed the prevalence of obesity and overweight in Iranian students by using meta-analysis.MethodsA number of domestic and international databases were searched, including IranMedex, Magiran, SID, Scopus, PubMed, IranDoc, Web of Science and Google Scholar. Eligible publications were 160 articles that addressed the prevalence of obesity or overweight. Data were combined using random effects model. Heterogeneity of the studies was examined by Q statistics and the I2 index. Data were analyzed using STATA version 11.1.ResultsIn the 160 reviewed studies, a total of 481,070 individuals (6–20 years) were included. The prevalence of obesity among Iranian students based on body mass index (BMI) was 11% (95% confidence interval [CI]: 10%–12%) (in girls 8% [95% CI: 7%–10%] and in boys 11% [95% CI: 10%–13%]). The prevalence of overweight in students based on BMI was 12% (95% CI: 12%–13%) (in girls 13% [95% CI: 11%–14%] and in boys 11% [95% CI: 18%–30%]). The rate of obesity was 13% (95% CI: 11%–16%) in elementary school students, 10% (95% CI: 7%–14%) in secondary school students and 7% (95% CI: 6%–9%) in high school students.ConclusionsThe prevalence rate of overweight was more than that of obesity with a 1% difference. The prevalence of obesity was higher in boys, while the prevalence of overweight was higher in girls. The prevalence of obesity was higher in primary school students than in secondary school students. This prevalence was higher in secondary school students than in high school students.

Introduction: The administration of iodinated contrast medium is extensive in various imaging techniques including coronary angiography. Objectives: The present investigation was designed to examine the ameliorative effect of clove buds (Syzygium aromaticum) on contrast-induced acute kidney injury (CI-AKI) in rats Materials and Methods: Forty male Wistar rats with a mean body weight of 200-250 g were studied. Rats randomly assigned into four groups, 10 rats for each; Group 1; normal rats (control group; sham group); they did not receive any drugs. Group 2; rats were received 10 mL/kg as a single dose of iodixanol (contrast media) by intravenous (IV) injection. Group 3; rats received 10 mg/kg clove by intraperitoneal (IP) injection for three days, while in day forth, they received a single dose of iodixanol (10 mL/kg). Group 4; rats of this group first received a single dose of iodixanol (10 mL/ kg). Then rats treated by clove (10 mg/kg) by intraperitoneal (IP) injection for three days (days 2, 3 and 4th). Kidney sections were examined for degeneration, flattening, and necrosis of renal tubular cells and also dilatation of tubular lumen. Results: We found a significant difference between groups regarding the sum of injury (degeneration, flattening, necrosis and dilatation). A significant difference in types of injury (degeneration, flattening, necrosis and dilatation) among the groups (P=0.001) was seen too. We detected a significant difference between groups II (contrast media) and III (rats pretreated by clove; P 0.05). Conclusion: In this animal study, we found that post-pone treatment of clove was as effective as pretreatment to mitigate the injury induced by contrast media.

Background: Cardiac and respiratory arrest is reversible through immediate cardiopulmonary resuscitation (CPR). However, survival after CPR is very low for various reasons. This systematic review study was conducted to assess the effect of palliative care on quality of life and survival after CPR. Methods: In the present meta-analysis and systematic review study, two researchers independently searched Google Scholar and MagIran, MedLib, IranMedex, SID, and PubMed for articles published during 1994–2016 and containing a number of relevant keywords and their Medical Subject Headings (MeSH) combinations. A total of 156 articles were initially extracted. Results: The success of initial resuscitation was reported to be much higher than the success of secondary resuscitation (survival until discharge). Moreover, the early detection of cardiac arrest, a high-quality CPR, immediate defibrillation, and effective postresuscitation care improved short- and long-term outcomes in these patients and significantly affected their quality of life after CPR. Most survivors of CPR can have a reasonable quality of life if they are given proper follow-up and persistent treatment. Conclusions: Concerns about the low quality of life after CPR are therefore not a worthy reason to end the efforts taken for the victims of cardiac arrest. More comprehensive education programs and facilities are required for the resuscitation of patients and the provision of post-CPR intensive care.

Having desired facial features creates a better mental image, results in increased self-confidence and boosts social activities to a more acceptable level. The goal of the current study is to investigate how rhinoplasty surgery affects patients admitted to Shahrekord surgical clinic. The study was conducted on 100 patients randomly selected and referring for rhinoplasty surgery. The required information was collected through demographic questionnaires of rhinoplasty outcomes F 36 and Rosenberg’s self-esteem scale. The questionnaires were filled out by patients before surgery and 3 months after surgery. The data were analyzed using SPSS and data mining software. Out of the hundred participants, 63% were female and 37% were male. The number of individuals in the studied groups decreased in older age groups so that most of the participants were in the 20–24-year group followed by 25–30 y/o group. Patients from other age groups were less frequent. In terms of educational attainment, the highest frequency was associated with a BSc and the lowest with a diploma. In terms of employment status, the highest frequency was among students and the unemployed and employees and the self-employed followed. Body image and self-esteem were significantly improved after surgery (p

Background: Thalassemia is considered as a group of genetic blood disorders, characterized by anemia. The present research aimed at evaluating the effects of aquatic exercise on quality of life and blood indices in patients with beta-thalassemia major. Methods: A clinical trial study involving 40 patients with thalassemia major, divided into two groups: experimental and control. The tools used to collect the data included demographic information questionnaire, blood indicators questionnaire, and SF-36 quality of life questionnaire. The experimental group performed exercise in water three times per week for 8 weeks in the pool after obtaining the consent. In this research, the quality of life questionnaire was filled out 24 h before the intervention, 24 h after the last session of the exercise program, and 2 months after the end of the exercise program. Results: The current research revealed that exercise in water affected the quality of life, hemoglobin, hematocrit, iron and ferritin of serum such that the mean score of quality of life and blood indicators in the study showed a significant difference in the experimental group. Conclusions: The use of a regular exercise program combined with drug therapy and blood transfusion can be useful in the treatment of beta-thalassemia patients.

Background: Prevalence of migraine, as a chronic neurovascular disorder, was approximately 10.3 and 23.1% among men and women, respectively, mostly in people younger than 40 years old. Migraine is prevalent in different geographic areas worldwide. The present study was designed to compare the impact of intranasal lidocaine 4% and peppermint essential oil drop 1.5% on migraine attacks. Methods: In this double-blind, parallel, randomized controlled trial, 120 adult patients with a diagnosis of migraine based on the International Headache Society criteria were treated with intranasal lidocaine drop 4% or peppermint essential oil drop 1.5% or placebo. Patients expressed their symptoms 5 and 15 min after dripping, and if they still had a headache after 15 min, they were given the second dose. Patients with a second dose of medication, 15 min later recorded their headache rate. All patients recorded their symptoms after 30 min. Symptoms of the patients were followed by a researcher through the phone and in-person after 2 months. Then, the questionnaires were filled. Results: In the present study, there was a significant difference among groups in headache intensity after treatment (P < 0.001). In 40% of the patients in the peppermint oil and lidocaine groups, the intensity of headache decreased. In the placebo group, fewer patients responded highly to the treatment, whereas 41.5% of patients in the lidocaine group and 42.1% of patients in the peppermint oil group responded to the treatment considerably. Conclusions: Concerning the findings of the present study, nasal application of peppermint oil caused considerable reduction in the intensity and frequency of headache and relieved majority of patients' pain similar to lidocaine. On the basis of findings of this study, it can be concluded that nasal menthol, such as lidocaine, can be used to relieve migraine headaches.

BACKGROUND: Although stenting for the treatment of large and multiple common bile duct stones has been acceptable to everyone, its efficacy and outcome have not been studied in comparison with other endoscopic procedures. The purpose of this study was to compare the consequences of stenting and endoscopic papilla balloon dilatation for the treatment of large and multiple common bile duct stones. METHODS: In a double-blind clinical trial, of 431 patients with bile duct stones referred to the treatment center, 64 patients with multiple common bile duct stones (≥3) and more than 15 cm were selected for the study, then by random allocation rule the participants were allocated in two groups. They were entered into two different endoscopic papillary balloon dilatation (EPBD) and common bile ducts stenting treatments so that both procedures were performed by a person. Both groups were assessed from the point of views therapeutic outcomes such as duct cleaning, pancreatitis, isolated pain, and duct rupture. Data were collected by a self-made questionnaire that was used before and after the procedure to obtain the needed information. Then data were analyzed using SPSS software version 22 and descriptive and analytical tests were used as appropriated. RESULTS: Although the duct cleaning and the complete removal of the stones in the stenting treatment procedure was 93.8%, and in EPBD was 78.3%, no significant difference was observed between the two groups ( p =0.14). Pancreatitis significantly increased after the first and second endoscopic retrograde cholangiopancreatography (ERCP) in the stent group compared with EPBD ( p =0.02). Also, the most frequent cases of isolated pain were in the endoscopic group EPBD ( p =0. 0). However, the occurrence of perforation after first ERCP and EPBD was zero, but in the second stage of ERCP, 3.3% of the patients had perforations ( p = 0.99). The results indicated that the shape of the stone (circular and angled) was not effective in the result of treatment in the two groups. CONCLUSION: The results of this study indicated that in case of experience and skill in conducting the ERCP, common bile duct stenting is still the first line of treatment for large and multiple stones of the common bile ducts. KEYWORDS: s CBD stone, Endoscopic treatment of EPBD, CBD stenting, ERCP

Introduction: surgery is a stressful experience for patients and most surgical patients have some degree of anxiety. The purpose of this study was to investigate the effect of a relaxation technique in addition to narcotic analgesic on health promotion in surgical patients. Methods: in this clinical trial, 70 patients who were candidates for elective upper and lower gastrointestinal system surgery were selected. They were randomly divided into two groups: case (morphine 0.15 mg/kg daily in divided doses and progressive muscle relaxation (PMR)) and control (morphine 0.15 mg/kg daily in divided doses). In each patient, the PMR intervention would be performed for 20 minutes every 6 hours for 2 days until 2 hours before the operation. Vital signs and anxiety were evaluated in the two groups after surgery. Data were analysed by t-test, analysis of variance, and chi-square test. Results: a statistically significant difference was seen in vital signs, pain and anxiety between the two groups. However, there was also a significant difference between them in terms of economic status and insurance coverage, which could have had an effect on stress and anxiety. Conclusion: PMR could increase the pain threshold, stress and anxiety tolerance and adaptation level in surgical patients. Therefore, using this technique could be an appropriate way to reduce analgesic drug consumption.

Introduction: Prostate cancer is the most common malignant cancer in men worldwide and after lung cancer, it is the second leading cause of cancer mortality in men. The purpose of this study was to investigate the relationship between prostate cancer and metformin consumption in men. Methods: The current study is a systematic and meta-analysis review based on the PRISMA statement. To access the studies of domestic and foreign databases, Iran Medex, SID, Magiran, Iran Doc, Medlib, ProQuest, Science Direct, PubMed, Scopus, Web of Science and the Google Scholar search engine were searched during the 2009- 2018 period for related keywords. In order to evaluate the heterogeneity of the studies, Q test and I2 indicator were used. The data were analyzed using the STATA 15.1 software. Results: In 11 studies with a sample size of 877058, the odds ratio of metformin consumption for reducing prostate cancer was estimated at 0.89 (95%CI: 0.67-1.17). Meta-regression also showed there was no significant relationship between the odds ratio and the publication year of the study. However, there was a significant relationship between the odds ratio and the number of research samples. Conclusion: Using metformin in men reduces the risk of prostate cancer but it is not statistically significant.

Background: Hypertension is a risk factor for renal disease. Therefore, this study was aimed at estimating the prevalence of hypertension in renal patients in Iran through meta-analysis. Methods: The search was carried out using authentic Persian and English keywords in national and international databases including IranMedex, SID, Magiran, IranDoc, Medlib, ScienceDirect, Pubmed, Scopus, Cochrane, Embase, Web of Science, Medline, and Google Scholar search engine without any time limitation until 2017. Heterogeneity of studies was assessed using the I2 index. Data were analyzed using STATA ver 11. Results: In 35 reviewed studies with a sample of 39,621 subjects, the prevalence of hypertension in renal patients was 35% (95% CI: 29%–41%) (25% in women and 18% in men). The prevalence of systolic hypertension in renal patients was 5%, diastolic hypertension 26%, and diabetes 23%. The prevalence of hypertension in hemodialysis patients was 34%, 27% in peritoneal dialysis, 43% in kidney transplantation, and 26% in chronic renal failure. In addition, meta-regression showed that the prevalence of hypertension in renal patients did not significantly decrease during the years 1988–2017. Conclusions: More than a third of kidney patients in Iran suffer from high blood pressure. The diastolic blood pressure of these patients is about five times higher than their systolic blood pressure. Moreover, the age group under 30 is a high-risk group. The prevalence of hypertension in women with kidney disease is higher than in men. In addition, patients who have kidney transplants are more likely to have high blood pressure than other kidney patients.