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Introduction: Metabolic and nutritional status are influential in the condition of the patients under MV and the ability to separate from it. This study was conducted to determine the effect of scheduled feeding on duration of weaning patients and length of stay in ICU. Methods: In this clinical trial with a post-test design, 42 patients admitted to the ICUs of Golestan and Imam Khomeini hospitals of Ahvaz, Iran who were under MV were randomly assigned to two groups of control and intervention. In the intervention group, Standard Entera Meal solution was used for energy supply. Administration of the solution starts from 50 cc and every 3 hours add 30 cc to reach the calculated energy in 48-72 hours. For the control group, homemade hospital solutions were used according to routine. Data were collected by demographic and medical information questionnaire, and interventions recording checklist then analyzed by using SPSS software version 23. Results: The results showed that the length of stay of patients in ICU was significantly affected by the scheduledfeeding (P = 0.004) and although in this study the duration of weaning patients from MV was numerically shorter in the intervention group than in the control group, but this difference was not statistically significant (5.23 ± 4.77 vs. 7.71 ± 6.14 minutes, P = 0.15). Conclusion: The scheduled nutrition can reduce the length of stay patients in ICU and also duration of weaning from the MV, although it was not statistically significant.

Introduction: Breast cancer (BC) is the most common cancer in women, which is the second most common malignancy in terms of mortality and prevalence after lung cancer. BC is a group of very diverse diseases that can be detected at a molecular, histopathological and clinical level. Objectives: The aim of the present study was to evaluate the expression of CK5/6 and its relationship to some of the factors affecting prognosis, such as tumor grade, lymph node involvement. Patients and Methods: In this cross-sectional study with descriptive and analytical aspects, 40 malignant and 20 benign tumors were collected in 2020 from the archives of the pathology department of two educational hospitals in the city of Ahvaz. The demographic and clinical characteristics of each specimen, including age, patient, lymphovascular and perineural invasion, lymph node involvement, tumor grade and tumor type were extracted from the patients’ record. Then the expression of CK5/6 intensity staining was examined by immunohistochemistry. Results: All benign breast lesions had positive expression for CK5/6 and staining intensity between six and nine. In the malignant group, 33 samples showed negative expression of CK5/6 and only seven samples (17.5%) showed positive expression with a low-staining index. A positive expression with a low-staining index. All seven positive specimens were invasive ductal carcinoma (IDC) lesions with staining index 2, 4, and 6. Additionally, none of the ductal carcinoma in situ (DCIS) specimens which immunostained were positive for CK5/6. In the present study, all IDCs with weak expression of CK5/6 were grade III. No statistically significant relationship was observed between perineural and lymphovascular invasion and lymph node involvement with the intensity of CK5/6 expression. Conclusion: Our study showed that cytokeratin immunohistochemical intensity is able to distinguish benign lesions from malignant IDC and DCIS lesions and accordingly in determining of tumor grade after weak staining in high-grade IDC, which may be due to squamous metaplasia in these tumors; however, more extensive research with a larger sample size are required to assess its effect in lymphovascular and perineural invasion and also lymph node involvement.

Introduction: Adrenal insufficiency is one of the most important life-threatening disorders with serious complications. Establishing a standard data element can provide earlier diagnosis, timely treatment, and follow-up to reduce disease crisis. Objectives: This study aimed to draft a data set for the registry of patients with adrenal insufficiency. Patients and Methods: The present cross-sectional study developed data elements for the registry of patients with adrenal insufficiency using a two-round Delphi technique of 2015. The informational elements selected by more than 75% of participants with a value of "very high" and "high" were accepted as the main elements. Results: The final data set included four main groups, 15 subclass and 114 data elements for the registry of patients with adrenal insufficiency. Our results have demonstrated that the primary data groups include administrative data; signs, symptoms, medical and family history data elements; paraclinical diagnostic data, treatment, and follow-up data to improve patient management. Conclusion: This study designed data set registry forms for patients with adrenal insufficiency using a standard method. Our finding indicated that, applying a uniform data set can provide better data management, patient care, and prevention of disease complications, especially in adrenal insufficiency disorder.

Background: Migraine sufferers seek a range of treatments according to the frequency and severity of their symptoms. Just a few research studies have shown the effectiveness of ginger derivatives for migraine treatment. Ginger has analgesic properties and is effective for the acute treatment of migraines, and there is anecdotal evidence of its effectiveness in migraine prevention. Objectives: The goal of this research was to see whether ginger may help prophylaxis of migraine episodes. Methods: This randomized, double-blind, placebo-controlled clinical study was done in the Neurology Clinic of Golestan Hospital (Ahvaz, Iran). This research enrolled 103 individuals with episodic migraine aged 18 to 50 years. Randomization was used to divide the participants into two groups: Control and intervention. For three months, patients were given 500 mg dry extract of ginger (5% active component) or placebo (starch) tablets twice a day. At the baseline and end of the study, MIDAS score, the number and duration of migraine attacks, headache severity, demographic data, dietary intakes, and anthropometric indices were collected. The data were statistically analyzed using the SPSS (version 26). In all tests, a P < 0.05 was deemed statistically significant. Results: At the end of the study, MIDAS score, duration of migraine attacks, and headache severity decreased significantly in the ginger group compared to the placebo group (P < 0.05). Furthermore, there was no statistically significant difference in the number of migraine episodes between the two groups. Conclusions: Compared to the placebo, ginger has a stronger efficacy in the prevention of migraine.

Objective: The data on the changes in the prevalence of obesity and overweight could help policy makers to make better plans for improving the health status of people; hence, the aim of his study is to evaluate the prevalence and incidence of overweight, obesity and abdominal obesity in Ahvaz during five years. Materials and Methods: Cohort study was the method of choice in this survey, conducted on 605 people aged over 20 years who were selected among the people covered by health centers in Ahvaz. The participants weight, height, and waist circumferences were measured two times in 2009 and 2014. The incidence and prevalence of obesity, abdominal obesity and overweight were evaluated. The SPSS 22 statistical software was used to analyze the data, and paired T-test to compare the level of changes. The significant level for P-value < 0.05. Results: Among 605 people aged over 20 years, the prevalence of overweight, obesity and abdominal obesity in 2009 and 2014 were respectively: overweight (40% and 38.50%), obesity (26.90% and 27.10%), and abdominal obesity (26.80% and 33. 90%).This prevalence increased from 11.70% to 14.90% in men and from 39.90% to 50.50% in women. The incidence of overweight, obesity and abdominal obesity were respectively 102.50, 22.50 and 76.5 per 1000 person’s year in Ahvaz people. Conclusion: The findings of our study showed that the prevalence of overweight, obesity and abdominal obesity in adult population in Ahvaz is high. Also, the prevalence of obesity and abdominal obesity in women is higher than men; therefore special attention must be paid to this issue in women. Also the age groups 35-64 years are higher risk.

Summary Introduction Voice, as one of the most important communication tools in humans, can cause many problems in a person's daily life if it is damaged. One type of voice complaint is vocal fatigue, which is common among people who use their voices a lot. Rehabilitation therapists may be more vulnerable to a variety of vocal disorders and complaints due to extensive voice use and long-term relationships with clients. The aim of this study is to investigate and compare vocal fatigue among therapists in Ahvaz rehabilitation fields. Method This cross-sectional, descriptive-analytical study was performed on 100 therapists in Ahvaz rehabilitation fields. For this purpose, the Persian version of the vocal fatigue index questionnaire has been used. One Way Anova parametric tests were used to compare target variables. The relationship between vocal fatigue and work experience and working hours per day was calculated using Spearman correlation coefficient. Results A comparison of the scores of the vocal fatigue index in the rehabilitation therapists showed that there was a significant difference between the therapists scores in the field of speech therapy and the therapists scores in other fields (P Conclusion Due to the nature of rehabilitation fields and the use of voice during daily interactions with different clients, especially clients with special disabilities, the possibility of voice disorders and complaints in this population should be considered. Therefore, providing the necessary training for voice care and voice health of this population should be noted in order to prevent voice disorders and complaints

OBJECTIVE Melasma is an acquired hyperpigmentation disorder, and reactive oxygen species play important role in regulating melanin synthesis. Lycopene is one of the most effective oxygen neutralizers among tomato-derived carotenoids. Also, hydroquinone is a compound that has been used for the treatment of hyperpigmentation by mechanism of tyrosinase inhibition and can be found in wheat. METHODS An appropriate cream formulation containing 0.05% tomato lycopene and 3.45% wheat bran extract was prepared, and physicochemical characterization was performed. The prepared formulations were applied twice a day for three months in combination with SPF = 30 sunscreen by 22 patients diagnosed with melasma. MASI score in two groups was evaluated at weeks 0, 3, 6, 9, and 12 and 1 month after the treatment. RESULTS The prepared formulation shows smooth and homogeneous appearance with suitable spreadability and viscosity. The MASI score of intervention group from the sixth week until the end of the treatment was significantly decreased compared to the onset of the treatment (P

The study of bioaerosol dispersion in wastewater treatment plants (WWTPs) has received considerable attention. This study aimed to investigate the seasonal changes and spatial distributions of airborne bacteria around different parts of Ahvaz WWTP, the capital city of Khuzestan Province, Iran, over 4 months in the cold and warm seasons. Samples were collected from 2 and 10-m intervals of grit chamber (GCh), primary sludge dewatering basin (PSDB), aeration tank (AT), as well as 60-m upstream (US) and downstream (DS) of the WWTP. Further, bacteria in the indoor air of administrative building (AB) of WWTP were investigated. Bioaerosols were collected by passive sampling method. The total bacteria count was 105.3 ± 98.5 CFU/plate/h. The dominant bacteria stood 2 m away from the AT with an average 244.2 ± 73.1 CFU/plate/h in the warm season while they were the lowest with an average 43 ± 11.4 CFU/plate/h in the 10-m distance of the GCh in the cold season. According to the sequencing results, the dominant bacterial species included Bacillus pumilus (26.7%), Staphylococcus arlettae (23.2%), Kocuria turfanensis (13.6%) and Alicycliphilus (9.2%), respectively. There was a positive relationship between the release of bacteria, temperature and wind speed. However, there was a significant negative correlation between total bacteria concentration and humidity. There are accumulative perils to WWTP workers and neighbors exposed by persistent exposure to airborne bacteria. Therefore, AT should be paid more attention as a dominant source of airborne bacteria emissions, especially in the warm season.

Facial soft tissues have different thicknesses among different genders and ethnicities. This study was aimed to investigate the association of sex, ethnicity and body mass index (BMI) with facial soft tissue thickness measurements using magnetic resonance imaging to make a database for the Iranian southwest population (for Lur and Arab populations). In this analytical cross-sectional study, measurements of superficial soft tissues were taken at nine points of midline including glabella (GB), nasion (NA), end of nasals (END), mid-philtrum (MID), upper lip margin (UL), lower lip margin (LL), chin-lip fold (CLF), mental eminence (ME) and beneath chin (BC), eight points of axial sections including frontal tubers (FT), supraorbital margin (SO), external orbital margin (EX) and zygomatic arch (ZY) on both sides, and also two points of coronal section including both sides of the masseteric region (MST). For association of sex with the measurements, NA, MID, UL, LL and BC were significantly higher in men (Pc

The purpose of this study was to investigate the effect of the cognitive-behavioral therapy program (CBT) on the sexual function and sexual self-efficacy of 100 women after childbearing.In this experimental pretest-posttest and control group design study, women who passed eight weeks of their delivery and were referred to three health centers, in Shadegan, Iran, from January to April 2019 registered using the simple sampling method and randomly allocated into two groups of case and control. For the CBT group eight weeks of counseling (one session/week), and for the control group, routine educations were provided by health care providers. Both groups filled out the female sexual function index and sexual self-efficacy questionnaires before intervention and eight weeks after the last session.There was no significant difference between the CBT and control groups before the intervention in terms of sexual function and sexual self-efficacy, but eight weeks after the intervention, there was a statistically significant difference between the two groups (P = 0.001).Proper implementation of counseling based on the CBT model improved sexual function and self-efficacy of nulliparous women after childbirth.

[Purpose] The purpose of this study was to assess the efficacy of breathing exercises alongside traditional therapy on respiratory indexes and the level of anxiety of generalized anxiety disorder patients. [Participants and Methods] Forty-one patients were assigned a study group undergoing medication and routine counselling plus breathing exercises (EXS), and a control group received medication and routine counselling only (Non-EXS). Every two weeks, patients are called (weeks 2, 4, 6, and 8) to monitor their schedule adherence. [Results] This study's results showed FEV1/FVC ratio significantly increased in the EXS group in the second study follow-up period after two months. Anxiety, FVC, FEV1, Etco2, respiration, and pulse rate over time have tended towards desirable results in the exercise group than control groups, especially after two months, but significant differences not seen. [Conclusion] This study's findings indicated that breathing exercises could improve generalized anxiety disorder's pharmacotherapy and psychotherapy. Our data bring up this hypothesis that longer follow up, increasing breathing period, and more exercising is associated with higher outcome.

Background: Human polyomavirus BK virus (BKV) belongs to the Polyomaviridae family and seems to be a drastic virus in prostate cancer (PCa) etiology. BK virus induces oncogenesis via the expression of large tumor antigen (LTAg) and small tumor antigen (stAg). Also, BKV infection seems to play an essential role in prostate cancer development. Objectives: In this study was aimed to study the prevalence of BKV in benign and cancerous prostate tissues. Methods: In this study, 100 formalin-fixed paraffin-embedded tissues of PCa specimens and benign prostatic hyperplasia (BPH) were collected. The DNA was extracted from tissue samples, and the BKV DNA was investigated using a semi-nested polymerase chain reaction (PCR). The MEGA 6.0 software was used for phylogenetic analysis to assemble the viral genome. A phylogenetic tree was constructed by neighbor-joining analysis with 1,000 replicates of the bootstrap resampling test. Results: The BKV DNA was found in 66% (33/50) of patients with PCa and 36% (18/50) of patients with benign prostatic hyperplasia (BPH) (P = 0.003). The frequency of BKV DNA in different classes of Gleason score (5 - 10) was not significant (0.094). The distribution of BKV DNA among different age groups was not significant (P = 0.086). Conclusions: High frequency of BKV infection was detected in patients with PCa compared to patients with BPH (P = 0.003), and the coexistence of BKV DNA was confirmed in 51% (51/100) of tissue samples, which were confirmed to be subtype 1 of BKV infection.

Introduction The association of individuals’ anthropometric indices with their development of metabolic syndrome (MetS) has been investigated in several studies. Taking into account the ethnic differences, this study aimed to determine the most appropriate cut-off points of anthropometric indices in predicting the incidence of MetS and its components in Ahvaz. Methods This study is part of a cohort study conducted at the Diabetes Research Center of Ahvaz Jundishapur University of Medical Sciences on a population of over 20 in Ahvaz during 2009–2014. Of the 592 patients, 505 patients who were not diagnosed with MetS in 2009, were entered into this study. The data analyzed involved demographic information including age and sex, anthropometric information including height, weight, waist circumference (WC), hip circumference (HC) and the ratios between them, laboratory data including blood levels of Triglyceride (TG), Fasting plasma glucose (FPG) and High-density lipoprotein cholesterol (HDL-C), and clinical data including systolic(S) and diastolic(D)blood pressure(BP). After 5 years, the subjects were re-evaluated for MetS based on the National Cholesterol Education Program – Adult Treatment Panel III (NCEP-ATP III) criteria and the most appropriate cut-off points of anthropometric indices for the prediction of the incidence of MetS using the Receiver Operative Characteristic (ROC) curves were obtained. Results Waist-to-Height Ratio (WHtR) index with a cut-off point of 0.53 followed by WC with a cut-off point of 87.5 cm had the highest power to predict the incidence of MetS. The cut-off points of WC and Body mass index (BMI) were respectively 89.5 cm and 26 kg/m2 for men, and 83.5 cm and 27.5 kg/m2 for women. All anthropometric indices were able to predict the components of this syndrome (with the exception of low HDL-C). The cut-off point of WC in predicting High FBS, High TG and High BP was 84.5, 84.8, and 86.5 cm, respectively. Conclusion Overall, it seems that given its ease of measurement, the WC index is preferred to other indices for predicting the incidence of MetS and its components in clinical screening.

Background: Low levels of vitamin D are found in a great part of breast cancer women. Study subjects using vitamin D3 supplement had lower rates of cancers and fewer markers of inflammation. Additionally, recent studies demonstrate the power of vitamin D supplementation to lower inflammation and oxidative stress biomarkers associate with VDR polymorphism to reduce inflammation. This study was aimed to assess the impact of vitamin D3 supplementation on the serum concentration of inflammatory markers and antioxidant capacity with regard to VDR polymorphism in the VDR gene in breast cancer women. Methods: A randomized, double-blind, placebo-controlled trial was conducted on 56 breast cancer women. Participants were assigned to 2 treatment arms: placebo and vitamin D3 for 2 months intervention. Supplementation group received 50,000 IU of vitamin weekly. Blood samples were collected at baseline and after the intervention to measure the 25(OH) D3, TNF-α, TGF- β and TAC. Genotyping was performed for FokI, BsmI, ApaI, and TaqI polymorphism. Results: After eight weeks supplementation, the intervention group showed a significant increase in the serum concentration of 25(OH) D3 (28±2.6 to 39±3.5; p=0.004 and TAC (48.9±13.3 to 63.5±13.3; p= 0.017). Changes in TNF-α, TGF- β1 were not significant. Serum TAC levels of participants with the TT/Tt, Ff genotypes were more responsive to supplementation. Conclusions: Supplementation with a vitamin D3 increased the TAC in breast cancer women, although it had no effect on inflammatory markers. Serum TAC in the TT/Tt, Ff were more responsive to vitamin D supplement compared with those with the FF/ff and tt genotypes.

To investigate the effects of glaucomatous damage on the mfVEP parameters of patients suffering from primary open-angle glaucoma (POAG). Fifteen healthy subjects and 15 patients with unilateral POAG participated in this study. In addition, routine ophthalmological examinations including visual acuity, anterior segment examination, posterior segment examination, intraocular pressure, mfVEP with electrophysiological system, RETI-port/Scan 21, and visual field test with automated Humphrey ZEISS HFA II 750i Perimeter were also performed. The results show that there was a strong correlation between the ∆MDs and the number of abnormal points with the ∆amplitudes more than 256 nV, in patients (n = 15, r = 0.802, p

Objectives: The current study mainly aimed at studying the effect of Knowledge of Result (KR) feedback timing and result-estimation opportunity before receiving delayed KR on learning a new speech motor skill in monolingual healthy adults. Methods: Thirty-nine Persian healthy adults were randomly divided into three groups. Each group received immediate KR, delayed KR (after eight seconds), or delayed KR (after eight seconds) with self-estimation of the result in the delay interval. All three groups received verbal KR feedback. Participants were trained to produce a French phoneme (/ɪn/) in the context of words in four training sessions. The correct production of the target phoneme was judged by a bilingual Persian-French examiner holding an academic degree in French language teaching. Later, a transfer test and two retention tests were administered. The two retention tests were administered one day and two weeks after the last training session respectively. Results: The effect of feedback timing on motor performance and motor learning was examined by repeated-measures ANOVA. Performance in both acquisition and retention phases was significantly different between groups (P=0.04 for both phases). One-way ANOVA was used to investigate the transfer of learning (P=0.001). Tukey test results indicated that the groups 1 and 2 were different in both acquisition and retention phases and all three groups were different in transfer test. Discussion: The results showed that the immediate KR is beneficial for the acquisition phase, and delayed KR is more beneficial for the retention and transfer tests compared with immediate KR.

Diabetes mellitus is a metabolic disease that manifested as hyperglycemia due to the defect in secretion or function of insulin. Studies have shown that saffron and its derivatives cause a significant reduction in plasma glucose levels in experimental models. The purpose of this study was to investigate the effect of the saffron extract on fasting plasma glucose (FPG), glycated hemoglobin level (HbA1c), lipid profile, liver enzymes, and renal function tests in type 2 diabetic patients. In this double-blind randomized clinical trial, 64 type 2 diabetic patients who were on oral anti-diabetic drugs were examined. Participants received either 15 mg of saffron or placebo capsules (two pills per day) for 3 months. Anthropometric indices, dietary intake, FPG, HbA1c, lipid profiles, liver enzymes (ALT, AST, ALP), and renal function (BUN, Cr.) tests were measured pre and post intervention after 3 months. Independent t test and paired t test were used for data analysis. After 3-months intervention, mean difference of FPG, Cholesterol, LDL-c, and LDL/HDL ratio between two groups showed significant reduction(p 0.05). In saffron group, FPG, HbA1c, cholesterol, LDL-c, and LDL/HDL ratio decreased significantly after 3-months intervention compare with baseline (p < 0.0001).

Type 2 diabetes has a high spread and growing process. Using appropriate food diets is among therapeutic approaches has been applied for diabetic patients. Soya utilization has shown effective results in controlling metabolic abnormalities of these patients. The aim of this study is to investigate the effects of soy nut on glycemic conditions, blood pressure, lipid profile, antioxidant effects and vascular endothelial function of these patients.70 patients with type 2 diabetes were randomly divided into two groups of the test (35 people) and control (35 people). The patients in the intervention group were subjected to 60 g soy nut diet as a part of daily protein for 8 weeks and the control group under the usual diet of diabetes. The fasting glucose, blood pressure, lipid profile, brachial blood flow, the level of serum E-Selectin and total antioxidant capacity in control and test group were assessed before and after diet.Consuming 60 g soy nut for 8 weeks significantly decreased the fasting blood glucose (P = 0.03), total serum cholesterol (P 0.01), LDL-c (P = 0.01), and E-Selectin (P 0.01) and increased the capacity of serum total antioxidants (P 0.01), brachial blood flow (P 0.01) but didn't have any significant effect on systolic/diastolic blood pressure, HDL-c, and TG.Soy nut utilization in the patients with type-2 diabetes can significantly improve the glycemic condition, increase brachial blood flow, decrease E-selectin (improvement of endothelial function), increase serum total antioxidants and lipid profile but has no significant effect on blood pressure and HDL-c.

The purpose of this study was to investigate the incidence of obesity, overweight and hypertension in children and adolescents aged 10-15 in Ahvaz.This is a epidemiologic study performed on 176 people aged 10-15 in Ahvaz. In 2009, 300 people underwent weight, height and blood pressure measurements. Five years later, the same people were reassessed for obesity, overweight and hypertension, of whom a total of 176 people agreed to repeat the procedure.The study included 100 (57%) males and 76 (43%) females. Mean BMI was 22.1 ± 4.3 kg / m2 in year 2014, without any significant difference between the two sexes (P = 0.518). In the same year, the prevalence of obesity and overweight was 26 (14.8%) and 13 (7.4%), respectively. After 5years, BMI increased significantly (P 0.001). Of the 150 norma participants with normal BMI in 2009, 15 (10%) and 6 (4%) became overweight and obese in 2014 respectively. The mean systolic and diastolic blood pressures increased significantly over 5 years P = 0.042 and P 0.001.This study shows an increase in mean BMI and mean systolic and diastolic blood pressures after 5 years among people aged 10-15 in Ahvaz.

Aims Child growth is one of the important health indicators in pediatric care. Few studies focused on the impact of prenatal exposure to gestational diabetes mellitus (GDM) on growth trajectories particular in early years of childhood. The aim of this study was identifying growth pattern of GDM exposed offspring's, comparison with new WHO child growth standards. Methods and materials In a population-based Longitudinal study 438 infants exposed to gestational diabetes in utero, aged 0–24 months, born between 2014 and 2016 with at least 9 visits in first 2 years of life were enrolled. Twenty health centers of Ahvaz city (Capital of Khuzestan province, located in south western of Iran) and two referral centers for neonatal hypothyroidism involved the study. Results Of 438 GDM exposed infants, 54.6% were boys. Incidence of low birth weight and macrosomia were 4.6% and 8.7% respectively. Results 4.6% had birth weight less than 2500gr and 8.7% was rate of macrosomia. Boys had higher weight and BMI than girls. Peak of BMI was 17.8 (±2.07) at 6 months after Gender was significant factor in predicted of BMI growth trajectories in GDM exposed children (p = 0.001). BMI in GDM exposed infants, in first 2 years of life was higher than WHO growth standards 2006 (P Conclusion Medians of BMI in GDM exposed infants in all measures was higher than WHO reference data 2006 (P

Aims Various studies have demonstrated that the majority of the factors affecting the reluctance of individuals to insulin injections are rooted in psychological factors. Present study aimed to determine relationships between main causes of refusal to insulin injection in diabetic patients and factors such as age, gender, and educational degree of patients. Material & Methods This was a descriptive study which was conducted on diabetic patients (n = 505) who need insulin therapy. The data were collected with a questionnaire in following steps. First, the most important causes of patients’ reluctance, in the patients’ opinion, to insulin therapy were determined using the data of the previous studies. In the second step, the patients were asked to express their opinion on each of these factors and the recorded responses were analyzed. Results The results of the study showed that fear of ampoules, fear of pain caused by insulin and the embarrassment of patients from injections in public significantly depended on the gender of the patients, so that these factors were much lower in men than women. In addition, these factors in the patients with higher degrees of education led to lower level of refusal to insulin injections. Another factor influencing the reluctance to insulin injections was the forming of a sense of addiction due to daily insulin injections, which was significantly lower among the patients with higher education, but did not have a significant relationship with sex of the patients. In this regard, another factor was fear of hypoglycemia and insulin side effects, which did not have a significant relationship with gender and educational degree. In addition, there was no significant relationship between the patient's age and any of the factors effective in patients' reluctance to insulin injections. Conclusion Psychological factors seem to be effective in the emergence of the sense of reluctance to insulin injections. Therefore, not only patients but also the entire society need to receive training and appropriate services to improve their attitude to this issue with a psychological approach and help to solve this problem.

BACKGROUND: Metabolic syndrome (MetS) is composed of a collection of risk factors for heart diseases and diabetes. In recent decades, metabolic syndrome has been identified as one of the important risk factors leading to the development of work-related diseases. OBJECTIVE: Since few studies have been conducted on evaluating the prevalence of MetS among Iranian workers, this cross-sectional study aimed at assessing the prevalence of MetS and the factors affecting it among Iranian steel workers. METHODS: This study was carried out on 510 employees working in a large steel producing company. The data pertaining to blood pressure, triglycerides, cholesterol, glucose, and demographic information were collected and the Adult Treatment Panel (ATP III) criteria were implemented to diagnose MetS. RESULTS: The prevalence of Mets was obtained equal to 13% and a significant positive relationship was observed between age and the prevalence of metabolic syndrome. From among MetS elements, low HDL cholesterol and increased waist circumference were recognized as the most and the least frequently involved elements with 39.3% and 6.5% prevalence, respectively. Chi-square test was run and the results showed that the prevalence of MetS and some of its components rose at higher BMI values. It was also indicated that MetS and its components had no significant relationship with shift work. CONCLUSION: The current findings revealed that the prevalence of MetS increased with aging. Low HDL and high triglycerides levels were among the main risk factors for MetS. Therefore, considering these risk factors, it should be attempted to develop relevant strategies at workplace to encourage workers to go for a healthier lifestyle so that they can prevent the incidence of MetS.

As a result of a nutrition transition, chronic diseases, including diabetes, have increased in Iran. Nutrition education is a cost-effective method for modifying diet and controlling diabetes. This study aimed to examine the effect of nutrition education using MyPlate recommendations on glycemic and lipid profiles and inflammatory markers in Iranian adults diagnosed with type 2 diabetes. A 12-week randomized clinical trial was conducted on 44 adults aged 30-50 years from Ahvaz, Iran. The participants were divided into education and control groups. The education participants were taught the MyPlate recommendations. Serum levels of fasting blood sugar (FBS), hemoglobin A1c (HbA1c), lipid profiles, and inflammatory markers, including high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α, and adiponectin, were measured at the baseline and the end of the study. The results showed that serum levels of FBS (p = 0.014) and HbA1c (p0.001) decreased significantly in the education group at the end of the study. The serum level of low-density lipoprotein in the education group declined significantly at the end of the study (p = 0.043). Furthermore, the serum level of hs-CRP (p = 0.005) declined significantly while the level of adiponectin (p = 0.035) increased in the education group at the end of the study. The evidence of this study showed that nutrition education using MyPlate recommendations is an effective method for controlling diabetes complications. A longitudinal analysis with a larger sample size is recommended to confirm the evidence of this study.Iranian Registry of Clinical Trials Identifier: IRCT2015031921443N2.

Human adenovirus 36 (Ad-36) causes obesity with increased adiposity, in contrast, Ad-36 infection reduces glucose and lipid metabolism; the results, however, are not consistent. In the current study, the effects of Ad-36 infection on glucose and lipid profile and inflammatory markers in Wistar rats were investigated. Sixty male Wistar rats were randomly divided into infected and control groups. Ad-36 virus suspension was injected in the experimental group rats. Blood samples were collected in the beginning and after 12 weeks in both groups. After 12 weeks, a significant improvement was observed in fasting blood glucose, fasting serum insulin, insulin sensitivity, serum triglycerides and total cholesterol in the infected group compared with the non-infected groups. There were no significant differences in inflammatory biomarkers including tumor necrosis factor-α, interleukin 6 and monocyte chemoattractant protein-1 levels between infected and control groups. This study showed that Ad-36 had favorable effects on glycemic and lipid control in infected rats, but inflammatory biomarker levels were similar for 2 groups. Ad-36 infections could potentially be a new way to develop novel antidiabetic and antihyperlipidemic therapeutic agents.