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Background: Epidemiological evidence has shown that antioxidant supplements may play an important role in preventing exercise-induced muscle damage and oxidative stress. Recent years, some researchers have shown high levels of unique compounds in pomegranate polyphenol antioxidants. The aim of this study was to evaluate the impact of natural pomegranate juice on oxidative stress, muscle damage and inflammation induced by exercise in healthy young men. Methods: This clinical trial study was conducted on 30 healthy young men who exercised 3 times a week and were eligible for the study. They was randomly divided into two experimental (supplement) and control (placebo) groups. Experimental group received a daily cup of 250 ml of natural pomegranate juice, prepared by the researcher, and the control group received a daily cup of 250 ml of placebo, for 8 weeks at the same time. Blood samples were collected after at least 8 hours of fasting to assess indicators of muscle damage including creatine kinase (CK) and lactate dehydrogenase (LDH), lipid peroxidation including malondialdehyde (MDA) and inflammation including C-reactive protein (CRP), at the beginning and end of the study. Statistical analysis was performed using the paired and independent-samples t test. Findings: Following 8 weeks of consumption of pomegranate juice, MDA levels decreased from 1.5 to 1.1 μmol/l in pomegranate group and increased from 1.5 to 1.7 μmol/l in control group. The change of this indicator was significantly different between the two groups (P = 0.047). Changes in LDH, CRP and CK were not significant in any of the groups. Conclusion: The findings of this study suggest potential beneficial effects of pomegranate juice in strengthening the antioxidant defense system and reducing oxidative stress.

Background: Flavonoids consider as a large group of plant metabolites that 6,000 types of them have been identified till now. In some studies, it has been shown that they can increase aerobic performance and maximal oxygen consumption (VO 2 max).The aim of this study was to evaluate the effect of anthocyanin (as one of the most important kind of flavonoids) supplementation on body composition, exercise performance and muscle damage indices in athletes. Methods: This double-blinded clinical trial involved 54 female and male athletes at Isfahan University of Medical Sciences with athletic history of at least 3 years. Body composition, exercise performance, creatine kinase, and lactate dehydrogenase were assessed. Individuals were selected by simple sampling method, they divided into two groups using permuted block randomization method. First group received 100 mg anthocyanin pills, and the second group received 100 mg placebo pills, daily for 6 weeks. Participants asked to continue their routine diet and physical activity during the study period, and they were followed through phone calls or text messages. Results: Soft lean mass, total body water and percent body fat were not changed significantly in the anthocyanin group after intervention but VO 2 max increased significantly in the anthocyanin group (48.65 ± 4.73 vs. 52.62 ± 5.04) (P ≤ 0.0001), also a significant difference was observed between two studied groups (52.62 ± 5.04 for intervention group vs. 49.61 ± 5.33 for placebo) (P = 0.003). Conclusions: Our findings suggested that the supplementation with anthocyanin in athletes may improve some indices of performance such as VO 2 max.

Background: Prediabetes is a high-risk condition for type 2 diabetes mellitus. The growing prevalence of diabetes emphasizes on the necessity of concentrating on various strategies to prediabetes prevention and management. Probiotics as a group of functional foods might exert antidiabetic effects. This study aimed to assess the effects of probiotic administration on blood lipid profile and blood pressure in patients with prediabetes. Methods: This randomized controlled trial consisted of 60 prediabetic patients, aged 25-65 years old, that were randomly assigned to the intervention (receiving 500 mg probiotic capsules, n = 30) or control group (receiving placebo, n = 30) for 8-week period. Demographic and anthropometric data were collected at baseline. Blood samples were collected at baseline and after 8 weeks for biochemical measurements. Blood pressure was measured at the baseline an after 8 weeks of intervention. Data regarding dietary intakes and physical activity were also collected during the study. We used SPSS software version 16 (SPSS Inc. Chicago, USA) for data analyzing. Results: Probiotic supplementation did not contribute to significant changes in total cholesterol, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, Triglycerides (TG), TG/LDL and LDL/HDL ratios, after 8 weeks. After adjusting for potential confounders, HDL-cholesterol reduced significantly in the placebo group compared with probiotic group. Percent change in systolic blood pressure was significantly different in the probiotic group in comparison with a placebo group (−3.10 ± 2.22 vs. 3.24 ± 1.96, P = 0.01), although this significance did not exist anymore after adjusting for confounders (P > 0.05). Conclusions: Our study showed that probiotics did not have significant effects on lipid markers although they had positive effects on systolic blood pressure.

Background: The impact of honey or vinegar on several metabolic abnormalities has been studied separately, a mixture of these two ingredients known as honey vinegar syrup (HVS) has not been investigated previously so far. The aim of this study was to assess the impact of HVS consumption (Iranian′s traditional syrup) on glycemic parameters and lipid profiles in healthy individuals. Methods: We conducted a 4-week, randomized, controlled, parallel study consisting of two groups of nonobese healthy volunteers. All subjects were asked to stay on their normal diet. Intervention group (n = 36) received a cup of HVS daily in the evening snack for 4-week (250 cc syrup contains 21.66 g honey vinegar). Assessments of fasting blood sugar (FBS), insulin, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were conducted at the baseline and after 4-week of study. Results: We observed no significant effect of HVS on FBS, HOMA-IR, LDL-C and TG. A significant effect of HVS was found on increasing fasting insulin and HOMA-IR and reduction in TC level only in intervention group (Δ =3.39 P = 0.01, Δ =1.65 P = 0.03, Δ = −9.43 P = 0.005, respectively). Changes of FBS, TG and LDL-C were 1.83 mg/dl, −1.53 mg/dl and − 3.99 mg/dl respectively in the intervention group. These changes were not significant. An unfavorable and significant reduction in HDL-C level was also observed between two groups (Δ = −4.82 P < 0.001 in the intervention group). Conclusions: Honey vinegar syrup increased fasting insulin level and decreased TC level in the intervention group. HVS had an unfavorable effect on HDL-C level. Further prospective investigations are warranted to confirm these findings.

Background: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the worldwide. It is associated with chronic disorders such as diabetes and heart diseases. Inflammation is one of the basic causes of metabolic diseases. Several studies have shown that Vitamin D can reduce inflammation. The purpose of this study was to investigate the effect of Vitamin D supplementation on inflammation in patients with NAFLD. Methods: This study involved 60 NAFLD patients, divided equally into two intervention and placebo groups. During 10 weeks, patients in the intervention group receive Vitamin D (capsules containing 50,000 IU vitamin D), weekly. Vitamin D levels, C-reactive protein (CRP), triglyceride (TG), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were measured at the beginning and end of the study. Data were analyzed using analysis of covariance tests. Analyses were done using SPSS software (version 16) (SPSS Inc., Chicago, USA). P < 0.05 set as significant level. Results: Vitamin D supplementation resulted in an increase of serum 25(OH) D concentrations in inter group (P < 0.05) and intra-group (P < 0.05) in intervention group. At the end of the study, in the intervention group, TG and CRP reduced significantly compare with baseline (P < 0.05). A significant increase was seen in calcium serum in the intervention group in comparison with baseline (P < 0.05) and compared with the placebo group (P < 0.05). After adjusting for baseline values, level of ALT, AST, TG, and CRP were reduced in the intervention group compared with the placebo group, but this decrease was not significant between the two groups. Conclusions: Vitamin D supplementation had no effect on CRP and other variables in the intervention group compared with the placebo group. Further studies with strong design and more sample must conduct to demonstrate the effect of Vitamin D supplementation on inflammation in patients with NAFLD.

Background: Obesity is a common health problem around the world. Studies have shown inverse relationship between serum vitamin D levels with obesity among patients and healthy population. The aim of this present study is to examine the relationship between serum vitamin D levels with general and abdominal obesity among migraine patients. Methods: The present study is a cross-sectional and 66 migraine patients aged 19-61 years were included for analysis. Partial correlation was performed to assess association between serum 25-OH-D with general and abdominal obesity. Adjustments were performed for age, sex, and education. Results: No relationship was found between serum levels of vitamin D with general and abdominal obesity. However, a significant association was shown between waist circumferences (WC) with body mass index (BMI). Conclusions: Serum levels of 25-OH-D were not associated with WC and BMI. Furthermore, after adjustment for confounder variables, no association was observed.

Background: University entrance is accompanied by major changes in social relationship, rules, and expectations that lead to psychological disorders in susceptible students. The goal of this research is to study the anxiety rate in Iranian medical residents in 2010-2011. Methods: This study is a cross-sectional, descriptive study. It contains 370 medical residents from the 1 st year to the 4 th year of medical universities in Isfahan, Gilan, Zahedan, Sanandaj, and Kashan. The stratified sampling method proportionate to volume of participants is used in this study. The information is collected based on researchers′ questioners and Zung self-rating anxiety scale and analyzed with the use of spss software version 16, addition to descriptive and analytic tests (Pearson, one-way analysis of variance, t-test). Meaningful level is regarded as P ≤ 0.05. Results: The study showed that more than 92% of residents participated in the study did not demonstrate anxiety. Among 370 subjects 5.5% presented with mild symptoms of anxiety and no one had symptom of severe anxiety. A meaningful statistical relationship was observed between anxiety and sex, major of study and the city of study (P < 0.05). The results showed a positive meaningful relationship between the number of visits and the score of anxiety. On average the number of night floats were two in 1 week and the number of patient visit was 19 in the past 24 h. A meaningful statistical relationship between anxiety score and number of patient visits was observed. Conclusions: The anxiety rate in medical students in this study compared to the findings of previous studies reveled very low anxiety in medical residents. The low rate of anxiety could be attributed to the sense of job security and the hope for a better future among residents. The high percentage of anxiolytics abuse and absence of anxiety producing factors among residents in addition to inaccurate response to the questionnaire may all contribute to the low rate of anxiety in this study.

Background: Stroke happens when blood flow to parts of brain stops. Stroke is sometimes called "brain attack." Risk factor is something that increases the chance of getting a disease. Some risk factors for stroke cannot be changed, but some can be altered. The chance of stroke is higher in people who live an unhealthy lifestyle by: Being overweight as a result of over-eating, eating too much fat, smoking, etc., Therefore, we compared the fat intake between patients with stroke and normal population. Materials and Methods: Sixty nine patients with stroke (46 men and 23 women) as cases and 60 subjects (30 men and 30 women) as controls during April 2009 and May 2010 from Alzzahra hospital, Isfahan, Iran were evaluated. Dietary intakes were collected using a food frequency questionnaire (FFQ) through their close relatives such as spouse, daughter or mother. Also, anthropometry measurements such as weight, height and waist extracted from their medical files, however, body mass index (BMI) and waist to hip ratio (WHR) were calculated. Result: The intake of saturated fatty acids (SFA) and monounsaturated fatty acids (MUFA) both in men and women with stroke were significantly higher than controls (P = 0.04 and P = 0.03 for men and P = 0.05 and P = 0.02 for women, respectively). Also, the mean intake of hydrogenated fats, butter, cream, mayonnaise sauce and nuts were higher in men with stroke with respect in control group; while, women with stroke consumed more hydrogenated fats, vegetable oils, cream and mayonnaise sauce than controls. Conclusion : Increased fat intake was observed in patients with stroke compared with normal population.

Background: Nowadays Medical equipment plays an important role in the treatment and in the medical education. Using outdated preventive maintenance (PM) system may cause problems in the cutting edge medical equipment, Nervous system disease′s equipment (In diagnosis and treatment) which are crucial for every medical center. Based on above facts we focused on nervous system treat units′ equipment and informed the supervisors and their colleagues about the latest equipment maintenance status and promoted methodical and correct method to be used for medical equipment maintenance. Methods: This research is an analytical descriptive and has been done on the base information from a particular time to past. We gathered our required information of 2009 from Alzahra Medical Center. We divided this research info 2 main phases. In the first phase, we picked out Neurosurgery and Neourology diseases medical equipment (diagnosis and therapy equipment) and in the second phase, we need to implement a methodical PM for every equipment. Results: Research has shown that there are 19nervous system equipment in Alzahra Medical center, categorized in diagnostic (13 pcs), therapeutic (4 pcs) and diagnostic-therapeutic (2 pcs). As we declare in methods part of this research, we categorized medical equipment in Food and Drug Administration (FDA) segmentation. Capital-scarce equipment: Magnetic resonance imaging, Eco Doppler, Kamalaarak ultrasonic surgical aspirator, Stereotactic, computed tomography-scan, euroendoscope/vital-scarce equipment: Coblation, Sonoco, vaterjet/scarce equipment: Transcranial color Doppler, electroencephalogram, electromyography, surgical microscope. Conclusions: Survey of application and preventive maintenance of neurology medical equipment in Isfahan Alzahra hospital show there is no P.M system. Implementing a complete P.M system for this medical center is crucial to preventing cause problems for these medical equipment and decreasing maintenance costs and gaining uptime. Researchers of this article have tried to provide PM, use of texts, web and experts.

Background: Ischemic brain strokes consisttwo-thirdsof strokesand their complications bear a lot of disability for patient and society. In this study, we seek for effect of Erythropoietin on ischemic brain stroke′s outcomes according to National Institutes of Health Stroke Scale (NIHSS) changes. Methods: This study is a RCT (randomized clinical trial). All patients with focal neurologic deficit with primary suspicion of brain stroke undergone neuroimaging evaluations.After confirmation of new ischemic brain stroke, the patients with inclusion criteria′srandomized into two groups of cases and controls. NIHSS was defined for each patient and all patients received a routine treatment protocol. Erythropoietin 16,000 IU as a bolus intravenous dose was given to case patients as soon as neuroimaging study confirmed new ischemic stroke and continued as 8000 IU each 12 h up to total dose of 56,000 IU during 3 days. Patients re-evaluated at days 14 and 28 and NIHSS was assessed by another neurologist blinded to patient′s group. Finally, NIHSS changes of both groups compared with each other′s. Results: Evaluations revealed that in days14 and 28 during follow-up, Erythropoietin was effective in NIHSS (P= 0.0001). This effect was of value in level of consciousness Commands (P= 0.024), facial palsy (P= 0.003), motor arm (P= 0.0001), motor leg (P= 0.0001), sensory (P= 0.009), and best language (P= 0.023). Conclusions: Administration of high-dose erythropoietin in first 24 h can be effective on reduction of ischemic stroke complication. A larger scale clinical trial is warranted.

Background : Stroke is one of the leading causes of death and certainly the major cause of disability in the world. Diet and nutrient has an effective role in prevention and control of the risk of stroke. The aim of this study was to review the studies on the relationship between dietary intake and stroke incidence. Methods : In this study, the terms of "Fat", "cholesterol", "antioxidant", "vitamins", "salt", "potassium", "calcium", "carbohydrate", "vegetables", "fruits", "meat", "tea", "whole grains", "sugar-sweetened beverages", "Mediterranean diet", "dietary approaches to stop hypertension diet (DASH diet)", "Western diet", and "stroke"were searched in Pubmed search engine. The observational studies, cohort studies, clinical trial studies, systemic review, and meta-analysis reviews are also included in this study. Results : The study revealed that adherence to theimprovements in nutrition and diet canreducethe incidence ofstroke. Higher antioxidant, vitamins, potassium, calcium, vegetables, fruits, whole grain intake, and adherence to the Mediterranean dietor DASH diet can lower stroke incidence. Conclusions : Adherence to Mediterranean diet or DASH diet and increasing the consumption of antioxidant, vitamins, potassium, calcium food sources, vegetables, fruits, and whole grains intake can lower the risk of stroke. Healthy diet is effective in reducing risk of stroke, however, more studies need to be carried out in this area.

Background: Visfatin is an adipocytokine which is secreted from adipose tissue and can affect on the diabetes inflammatory reaction and also serum lipids level. On the other hand, Omega-3 can also prevent formation of insulin resistance. In the present study, the effect of Omega-3 on the serum visfatin concentration was evaluated. Methods: 71 women with type II diabetes were randomly assigned to the group that took Omega-3 capsules or control group with placebo capsules. In the first step, study subjects filled a questionnaire collecting their age, height, weight, waist circumference, and hip circumference. Also their blood samples were taken for blood tests. In the second step, the intervention was done for 8 weeks and in the third step the aforementioned were collected again. In the blood samples visfatin and lipid profiles (low density lipoprotein [LDL], high density lipoprotein [HDL], triglyceride [TG], and cholesterol), glucose and HbA1c were measured. Results: There was no significant difference in serum visfatin level between Omega-3 and placebo groups before the intervention (p = 0.14), while after the intervention, the mean serum visfatin level in the Omega-3 group was significantly higher (p < 0.001). In addition, the mean difference between the serum visfatin level before and after the intervention in both groups was significant (p < 0.001). Conclusions: This study showed an increase in visfatin level following consuming Omega-3 fats but according to controversial issues on insulin-like function of visfatin, the effects of Omega-3 on diabetes should be studied more in further studies.

Background: Alzheimer′s disease (AD) is a progressive neurodegenerative disease and nowadays the role of endothelial cell (EC) injury has been proposed in pathological process in AD. Peroxisome proliferator-activated receptor-γ (PPAR-γ) agonist has anti-inflammatory properties through activation in glial cells and improves vascular function and prevent atherosclerotic disease progression. The aim of this study is evaluation of pioglitazone effects as a drug of PPAR-γ agonist on endothelial apoptosis induced by sera from AD patients. Methods: Human umbilical vein endothelial cells (HUVECs) were treated with sera from AD patients (n = 10) and sera from controls (n = 10). Apoptosis was identified by annexin V-propidium iodide staining and cell death detection kit. Apoptosis was evaluated after and before adding of 10 ΅M pioglitazone on EC. Nitrite (NO 2 - ) levels were determined in the culture supernatants. Results: Induced apoptosis by the serum of patients was inhibited markedly when pioglitazone used before treating HUVECs with the sera of AD. Also, the measurement of nitrite concentration showed significantly greater levels of dissolved NO 2 /NO3 metabolite in the culture media of HUVECs treated by sera of AD patients (P < 0.05), while the rate of nitric oxide significantly decreased when pioglitazone exists in culture media. Conclusion: Further studies are justified to investigate the novel role of the PPARs in the prevention of the neuronal and endothelial damage in neurological disorder and present a new therapeutic approach for Alzheimer`s patients.

Background: The prevalence of children obesity is increasing all over the world. Healthy diet is one of the interventions for obesity treatment. Behavioral therapy approaches can affect child’s food behaviors. One of these approaches is motivational interviewing. Methods: This study was a paralleled randomized clinical trial. 96 children were randomly allocated to 3 groups: first group, diet and motivational interview, second group, diet, and the third one, control. Participants were under intervention for 8 weeks. Anthropometric indecies and blood pressure were measured at baseline and at the end of the intervention. To make sure about the maintenance of intervention effects, participates were assessed 3 month later again. Adherence to diet was assessed by measuring healthy eating index. Findings: The mean body mass index (BMI) and waist circumference (WC) in first (P < 0.001) and second (P = 0.001) groups decreased after intervention, but this difference were not significant in control group. In first group, this reduction was more than the second group. The mean blood pressure had no significant difference between the 3 groups. The mean healthy eating index was higher in first group than the second group. There was an inverse relation between healthy eating index with body mass index and waist circumference (P = 0.001). Conclusion: Healthy diet can reduce mean body mass index and waist circumference in overweight and obese children. Using diet therapy with motivational interview increases this effect and also the adherence to diet.

Background: Neuropsychiatric abnormalities are among the most common manifestations of systemic lupus erythematosus (SLE). They have been proposed to be associated with impaired cerebral blood flow (CBF). Cerebral vasomotor reactivity (VMR) is a hemodynamic parameter effective in the autoregulation of CBF. The aim of the present study is to determine and compare the VMR of women with stable SLE and normal women. Materials and Methods: According to the study criteria 60 women in each group entered the study. VMR was evaluated with Transcranial Doppler (TCD) at rest and after one minute of breath holding. Results: There was no significant difference in the mean of age between two groups (31.76 ± 7.50 years in the SLE group versus 32.43 ± 4.55 years in the control group, P value: 0.64). The mean duration of SLE in the case group was 5.40 ± 3.60 years. The means of the Breath-Holding Index (BHI) in the SLE and control groups were 0.842 ± 0.72% and 0.815 ± 0.26%, respectively, which was not significantly different (P value: 0.82). Conclusion: This study indicates that the VMR of women with stable SLE is not significantly different from the age- and sex-matched normal population. However, further investigations on patients with longer SLE duration and more neuropsychological abnormality rates are suggested.

Background: Overweight and obesity are two important risk factors for nonalcoholic fatty liver disease (NAFLD). Controling the weight via using dietary fiber may help to manage patients with NAFLD by diet and physical activity. Psyllium as a fiber can reduce obesity and its consequences. Methods:This was a placebo-controlled, double-blind, randomized clinical trial study. 80 overweight or obese patients with NAFLD (age: 18-77 years) diagnosis via elastography were enrolled. Participants assigned to intervention and placebo groups using randomized block design; which were supplemented with 10 g psyllium or 10 g ground wheat, respectively. Both groups followed weight-loss diet and physical activity (PA) recommendations for 10 weeks. Serum liver enzymes (using enzymatic photometric method), dietary intake (via 3-day food record) physical activity (using physical activity questionnaire) and anthropometric measurements were assessed at baseline and the end of the study. Findings: 75 participants (mean age: 44.9 years) met the inclusion criteria, 13 men and 25 women in intervention group and 22 men and 15 women in placebo group. At the beginning, the mean body mass index (BMI) was 29.4 and 31.1 kg/m2 and the mean calorie intake was 2044.8 and 2449.7 kcal in intervention and placebo groups, respectively. Controling the confounding variables, calorie intake (P = 0.020), carbohydrate intake (P = 0.010), serum alanine aminotransferase (ALT) (P = 0.006), waist circumference (P = 0.006), body mass index (P = 0.006) and weight (P = 0.030) were reduced in intervention group as compared with placebo group. Waist to hip ratio reduced at a boarderline significancy (P = 0.050); and serum aspartate aminotransferase (AST) reduced unsignificantly (P = 0.980). Conclusion: Weight-loss diet program supplemented with psyllium, in parallel with increasing the physical activity, can be useful in reducing NAFLD outcomes.

Background: Quercetin is a bioflavonoid occurs in many food items. Some previous studies on quercetin showed the inconsistent results on exercise performance and muscle damage in athletes. The aim of this study was to determine the effects of 8 weeks of quercetin supplementation on exercise performance and muscle damage indices in student athletes. Methods: This placebo-controlled, double-blind clinical trial was conducted on 60 male students for 8 weeks. The subjects were randomly assigned to one of the four groups: a) quercetin (500 mg/day quercetin + 200 mg/day placebo), b) quercetin+ vitamin C (500 mg/day quercetin + 200 mg/day vitamin C), vitamin C (500 mg/day placebo + 200 mg/day vitamin C), and placebo (500 mg/day placebo + 200 mg/day placebo). Time to exhaustion (TTE) for measuring performance, aspartate transaminase (AST), and creatine kinase (CK) for measuring muscle damage and body fat percent (BFP) were measured before and after intervention. Results: CK levels reduced in group 1 significantly (P=0.045) and BFP reduced in group 1, 3, and 4, significantly, too (P=0.018, P=0.013, and P=0.043, respectively). Whereas statistically significant changes between groups were not observed for TTE, AST, CK, and BFP after 8 weeks of intervention. Conclusions: Supplementation with quercetin and vitamin C for 8 weeks did not improve exercise performance but reduced muscle damage and body fat percent in healthy subjects.