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Abstract The present research was conducted aiming at predicting the resilience based on parenting and coping strategies in patients with psychosomatic disorders. The statistical population of the present research consisted of all patients suffering from psychosomatic disorders who had visited medical clinics related to Medical Sciences (University) of Arak County in 2019-20. The statistical sample includes 347 women, aged 18 to 55 years-old, who were selected by available sampling. Data collection tool included Young parenting, Moss and Billings coping strategies questionnaire and Connor and Davidson resilience questionnaire. Pearson’s correlation coefficient and multiple regression analysis were used to analyze the data. The findings showed that parenting (dependency, preoccupied/untransformed self) have a negative and significant relationship with resilience. Coping strategies focused on emotion, coping focused on physical restraint or physicalization of problems have a negative and significant relationship with resilience and have a positive and significant relationship with coping strategies focused on problem-solving and coping focused on cognitive evaluation. According to the findings, it can be concluded that it is possible to pave the way for increasing resilience and preventing the development of psychosomatic disorders by creating suitable conditions during the childhood, improving parent-child relationships, and by strengthening coping strategies focused on problem-solving and coping focused on cognitive evaluation.

BackgroundComplications related to diabetic foot ulcers (DFU) due to diabetes are increasing. One of the factors influencing the management and treatment of complications related to DFU is the vitamin D serum levels of patients. Therefore, we sought to comprehensively review meta-analyses from randomized controlled trials and observational studies examining the link between serum vitamin D levels and DFU outcomes in diabetic patients.MethodsWe searched PubMed, Scopus, and ISI Web of Science until September 2024 and extracted the required data from related articles according to Inclusion criteria. The certainty of the evidence and the quality of conduct of the published meta-analyses were rated using the ASMTAR 2 tools, respectively.ResultA total of 8 meta-analyses studies that met inclusion criteria were included. Based on the obtained results, it has been noted that individuals with DFU exhibit serum vitamin D levels significantly lower, ranging from −7.14 (5.44, 8.83) to −0.93 (95% CI: 0.17, 1.68) ng/ml, compared to those with diabetes but without DFU. Furthermore, individuals exhibiting severe vitamin D deficiency are found to be at least 1.82 times more susceptible to developing DFU. Conversely, administering varying doses of vitamin D supplementation has been shown to positively affect the size and number of ulcers in DFU patients.ConclusionThis study suggests a potential link between lower levels of vitamin D in the blood and the risk of DFU, hinting at the benefits of vitamin D supplementation in improving outcomes associated with DFU. However, caution is warranted due to the potential bias present in the included studies.

Background: Caffeine is commonly used as an ergogenic aid to increase strength and endurance in athletes. The results of meta-analyses in this regard are still conflicting. Therefore, the current umbrella meta -analysis was conducted to determine the effects of caffeine supplementation on muscle strength and endurance as a clear and final conclusion. Methods: Relevant studies were searched in international databases including PubMed, Scopus, and Web of Science until August 15, 2022. Meta-analysis studies examining the effects of caffeine supplementation on muscle strength and endurance were included in this study. Random effects model was used to perform meta-analysis. Additional analyses including subgroup and sensitivity analyzes were performed. Findings: In general, 9 meta-analyses were included in the study. The results showed that caffeine supplementation led to a significant increase in muscle strength (SMD = 0.18, 95 % CI: 0.14, 0.21; p

Background: Clinical studies, investigating the effect of β-Alanine (BA) supplementation on recovery biomarkers in physically active individuals, have generated inconsistent results. This systematic review and meta-analysis study aimed to clarify the clinically relevant dietary effects of BA supplementation. Methods: A comprehensive search was done in the electronic databases of Scopus, PubMed, ISI Web of Science and Embase from inception to 2022. Meta-analysis was done using the random-effects model. Pooled effect size was evaluated using standard mean difference (SMD) and 95% confidence intervals (CI). Heterogeneity of between-study was evaluated according to Cochran’s Q test and I2 . Subgroup analysis was conducted to identify the potential sources of heterogeneity. Results: Overall, 32 studies were included in the current study. The results suggested that BA supplementation increases carnosine level significantly (SMD: 0.22mmol/L, 95%CI: -0.17, 0.61, P=0.27) but no effect was shown about lactate, fatigue, VO2 , pH and bicarbonate (HCO3 - ) (P>0.05). Subgroup analysis revealed a significant association of VO2, carnosine and fatigue with supplementation dosage, gender and duration of administration respectively. Conclusion: BA supplementation emerged its beneficial effects on enhancing carnosine level which highlights its ergogenic effects. In contrast, no significant effects had been shown in term of fatigue delay and blood levels of lactate, HCO3 - , pH, and VO2 value. These results warrant more investigation in a prospective design to clarify the exact mechanism in this way.

Mandibular deviation due to premature contact of teeth in crossbite may be associated with facial asymmetry.

Summary: Background: N-acetylcysteine (NAC) as a potent anti-inflammatory and antioxidant compound, has raised scientific interest to affect endothelial function. The present systematic review aimed to summarize the potential therapeutic effects of NAC in different health status. Methods: PubMed, Web of Science, Scopus, and Google Scholar were searched up to 2023 to obtain relevant studies. The PRISMA guidelines were employed during all steps. Two reviewers independently extracted the information from the included studies. The studies investigating the effect of oral and intravenous NAC on vascular function were included in the current study. Results: A total of 4455 studies were identified. Finally, fifteen studies were included in the present systematic review. Both oral and intravenous NAC administration have been evaluated in eight and seven studies, respectively. Most of included studies, illustrated no significant changes in the markers of vascular function due to NAC supplementation. However, 3 studies showed significant reduction in the Intercellular adhesion molecule-1 (ICAM-1) level based on NAC supplementation. Whereas, there was inconsistent results in term of vascular adhesion molecule-1 (VCAM-1) and NO levels. In general, NAC supplementation had led to an improvement in the markers of vascular function (ET, FMD, SVR, CVR) in a non-significant model. Conclusion: It seems that NAC may have favorable effects in vascular dysfunction. However, more studies are needed to confirm these results and clarify the relevant mechanisms.

Inconsistencies are evident within the literature regarding the effect of cocoa consumption on anthropometric outcomes. To address the influence of cocoa consumption on weight, body mass index (BMI), and waist circumference (WC) in overweight and obese subjects we conducted a time and dose–response meta-analysis of randomized controlled trials (RCTs). Scopus, Web of Science, Embase, and PubMed/Medline were searched for relevant articles from inception until July 11, 2023. The random effects method meta-analysis compared changes in anthropometric outcomes in participants Results are displayed as weighted mean difference (WMD) with 95 % confidence interval (CI). 19 RCTs were included in the present meta-analysis. Cocoa consumption significantly decreased body weight (WMD: −0.26 kg, 95 % CI: −0.49 to −0.02, P = 0.028), BMI (WMD: −0.16 kg/m2, 95 % CI: −0.30 to −0.02, P = 0.021), and WC (WMD: −0.69 cm, 95 % CI: −1.35 to −0.03, p = 0.038). In subgroup analyses, cocoa consumption resulted in lowered body weight in dosages ≤20 g/day (WMD: −0.33 kg), and treatment duration ˃4 weeks (WMD: −0.35 kg). In the non-linear dose–response assessment, a negative correlation was found between cocoa consumption dose (up to 50 g/day) and changes in WC (P = 0.001) and body weight (P = 0.0007). Cocoa consumption is associated with a reduction in BMI, weight, and WC in overweight and obese subjects; however, statistically significant effects were only detected in doses less than 20 g/day and interventions longer than 4 weeks.

Abstract Purpose Dyslipidemia is considered as a known risk factor for cardiovascular disease. Yet various trials with wide ranges of doses and durations have reported contradictory results. We undertook this meta-analysis of randomized controlled trials (RCTs) to determine whether omega-3 supplementation can affect lipid profile in children and adolescents. Methods Cochrane Library, Embase, PubMed, and Scopus databases were searched up to March 2021. Meta-analysis was performed using random-effect method. Effect size was expressed as weighted mean difference (WMD) and 95% confidence interval (CI). Heterogeneity was assessed using the I 2 index. In order to identification of potential sources of heterogeneity, predefined subgroup and meta-regression analysis was conducted. Results A total of 14 RCTs with 15 data sets were included. Based on the combination of effect sizes, there was a significant reduction in TG levels (WMD: -15.71 mg/dl, 95% CI: -25.76 to -5.65, P=0.002), with remarkable heterogeneity (I2=88.3%, P

Abstract Objectives: Several meta-analyses have suggested the beneficial effect of vitamin D on patients infected with severe acute respiratory syndrome coronavirus-2. This umbrella meta-analysis aims to evaluate influence of vitamin D supplementation on clinical outcomes and the mortality rate of COVID-19 patients. Design: Present study was designed as an umbrella meta-analysis. The following international databases were systematically searched till March 2023: Web of Science, PubMed, Scopus, and Embase. Settings: Random-effects model was employed to perform meta-analysis. Using AMSTAR critical evaluation tools, the methodological quality of the included meta-analyses was evaluated. Participants: Adult patients suffering from COVID-19 were studied. Results: Overall, 13 meta-analyses summarising data from 4 randomised controlled trial and 9 observational studies were identified in this umbrella review. Our findings revealed that vitamin D supplementation and status significantly reduced mortality of COVID-19 [Interventional studies: (ES = 0·42; 95 % CI: 0·10, 0·75, P < 0·001; I 2 = 20·4 %, P = 0·285) and observational studies (ES = 1·99; 95 % CI: 1·37, 2·62, P < 0·001; I 2 = 00·0 %, P = 0·944). Also, vitamin D deficiency increased the risk of infection and disease severity among patients. Conclusion: Overall, vitamin D status is a critical factor influencing the mortality rate, disease severity, admission to intensive care unit and being detached from mechanical ventilation. It is vital to monitor the vitamin D status in all patients with critical conditions including COVID patients.

The integration of 3D printing technology in maxillofacial surgery in Iran represents a significant advancement in medical practice, offering unprecedented precision and efficiency in surgical procedures. Employing the Non-Adoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework and the WHO Health Systems Framework, this study analyzes the complex impact and challenges of 3D printing adoption within the Iranian healthcare sector. Maxillofacial surgery has seen transformative progress with 3D printing’s ability to produce accurate surgical models and customized implants. The results indicate a notable improvement in surgical precision and patient recovery times, alongside combatting identified barriers including technological access, cost, and skill acquisition. This conclusion underscores the critical need for targeted educational programs, policy support, and infrastructure development to overcome these obstacles. This paper highlights 3D printing’s potential to revolutionize maxillofacial surgery in Iran, provided that comprehensive strategies are implemented to address the current limitations and fully leverage this innovative technology’s benefits.

Background & aim: Pumpkin plant has medicinal properties in the treatment of various metabolic disorders, which despite its good effectiveness, there is still no consensus on its use during pregnancy. Therefore, the purpose of the present study was to determine and investigate the effect of using pumpkin on the treatment of non-alcoholic fatty liver disease and the occurrence of gestational diabetes in pregnant women. Methods: In the present study conducted as a randomized clinical trial in 2016, 60 pregnant women with non-alcoholic fatty liver disease were selected and randomly assigned to the group receiving the diet with pumpkin in the amount of 100 grams for 6 weeks and the group Diet recipients were divided alone. Serum metabolic indices, fatty liver grade, B-Mode ultrasound and gestational diabetes were compared between the two groups. Collected data were analyzed using Kolmogorov-Smirnov statistical tests, analysis of variance, chi-square, t-test, Wilcoxon, McNemar and chi-square. Results: The results of the present study indicated that the metabolic indices of ALT, AST, ALP, LDL, and Chol had a significant difference between the intervention and control groups after the intervention (p0.05). The amount of changes in B-Mode ultrasound after treatment was significant in both intervention (p=0.001) and control (p=0.046) groups. The point of the findings should be written in more detail, it is very dumb and incomprehensible Conclusion: Based on the obtained results, it was concluded that the use of pumpkin in pregnant mothers did not have a dissimilar effect than the placebo in the treatment of non-alcoholic fatty liver and on the incidence of gestational diabetes, so its use is not recommended for this purpose.

Background: Probiotics exert several promoting effects on the glycemic status, however, the results of meta-analyses are inconsistent. we conducted an umbrella meta-analysis, across existing systematic reviews and meta-analyses of clinical trials to determine the definite effects of supplementation with probiotics on glycemic indices. Methods: A comprehensive systematic search of PubMed/Medline, Scopus, EMBASE, and Web of Science was carried out till August 2021. The random-effects model was employed to conduct meta-analysis. Meta-analysis studies of randomized clinical trials examining the impacts of probiotics supplementation on glycemic indices were qualified in the current umbrella meta-analysis. Results: 48 articles out of 693 in the literature search qualified for inclusion in the umbrella meta-analysis. Pooled effects of probiotics on fasting plasma glucose (FPG), hemoglobin A1C (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), and insulin levels were reported in articles 45, 21, 35, and 33, respectively. The analysis indicated a significant decrease of FPG (ES= −0.51 mg/dL; 95% CI: −0.63, −0.38, p

We outline the indications and contraindications of carotid endarterectomy (CEA) and appraise four key areas still debated to this day; shunting versus non-shunting, patch angioplasty (PA) versus primary closure (PC) and local anaesthesia (LA) versus general anaesthesia (GA). Importantly, we compare CEA with Best Medical Therapy (BMT), which is an area that is still largely debated, principally because many of the studies conducted to date do not reflect the era of modern BMT practices, and these outcomes are eagerly awaited. Literature searches were conducted using Pubmed with the keywords 'carotid', and 'endarterectomy', which provided a wide variety of journals and articles. We further stratified our data by using only randomised control trials (RCTs), meta-analyses, and systematic reviews, and then excluded studies with asymptomatic disease, diabetes, and plaque-imaging studies, including studies that did not fit our four desired topics for discussion. For each of the different domain's, results demonstrated similar peri-operative outcomes when comparing shunting vs. non-shunting and modality of anaesthesia and therefore practice still remains dependent on operator experience and preference. Patch-angioplasty reduces the risk of subsequent stroke, transient ischaemic attack (TIA), and re-stenosis compared to PC. In carotid stenosis >50% BMT offers limited benefits without accompanying surgical intervention and BMT alone tends to be advantageous primarily for patients with <50% carotid stenosis. Where CEA is appraised in terms of superiority of the procedural components; the literature does not support wildly contrasting outcomes to change majority practice. However, the area of considerable interest is superiority of BMT to surgical intervention in terms of both carotid artery stenting (CAS) and CEA and more studies need to be conducted in this area. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid Arthritis (RA) is a systemic and chronic autoimmune disease with inflammation at the synovial joints. The purposes of this study were to evaluate the correlation between serological variables and temporomandibular disorders (TMDs) in patients diagnosed with RA, evaluated through diagnostic criteria for temporomandibular disorders (DC/TMD), and to check the influence of comorbidities on the different TMD signs and symptoms, or any serological variables. Methods: This observational cohort research study included seventeen patients affected by RA. The comorbidities and some variables from the initial serological analyses were collected from the clinical rheumatological charts. Then, the presence of any of the following TMD signs/symptoms, temporal myalgia, temporomandibular joint arthralgia, click or crepitus, was evaluated through the symptom questionnaire of the DC/TMD during clinical evaluation following the DC/TMD examination form. Results: Rheumatoid factor (RF), anticitrullinated protein antibodies (ACPA), and anti-nuclear antibody (ANA) positivity were present in 82.4%, 52.9%, and 41.2% of patients, respectively. Indicators of tissue inflammation were evaluated with median values of 21 mm/h for erythrocyte sedimentation rate (ESR) and 0.50 mg/dL for C-reactive protein (CRP). The RA patients presented comorbidities such as hypertension in 70.6% and diabetes in 23.5%. Negative ACPA had a significant association with myalgia (p = 0.03), and positive ANA was significantly associated with crepitus (p = 0.05). Conclusion: ANA and ACPA evaluation can be considered predictive serological tests associated with specific TMDs. Conversely, no influence of any comorbidities was found between different TMD signs and symptoms, or any serological variables.

Abstract Background Considering the adverse consequences of respiratory insufficiency in cleft lip and palate (CLP) patients, this study aimed to assess the pharyngeal airway dimensions in 9–12-year-old patients with unilateral CLP. This historical cohort evaluated the cone-beam computed tomography (CBCT) scans of 30 patients with non-syndromic unilateral CLP between 9 and 12 years and 30 age- and sex-matched non-cleft controls. Three-dimensional (3D) images were reconstructed by the Mimics software, and the nasopharyngeal, oropharyngeal, and total airway volumes, as well as the minimal cross-sectional area of the airway (minAx), and posterior airway length (PAL) were all measured in the sagittal plane. Data were analyzed by the Student’s t test. Results The oropharyngeal and the total airway volumes, as well as the minAx and PAL in CLP patients, were significantly smaller than the corresponding values in the control group (P 0.05). Conclusions Nine- to twelve-year-old non-syndromic unilateral CLP patients have smaller pharyngeal airway dimensions than non-cleft controls, and are therefore at higher risk of respiratory insufficiency.

Background and Aim: The main purpose of this study was to compare the metacognitive beliefs of people with hypochondriasis Covid 19 and normal people. Methods & Materials: In this research, the causal-comparative method has been used. The statistical population of the study included all people with hypochondriasis disorder Covid 19 in Arak, based on this, 30 people from the population with this disorder and 30 people from the normal population were selected by available sampling method and based on Age and education were matched. Data were collected based on the short form of the 1997 Wells Metacognition Questionnaire (MCQ-30). Multivariate analysis of variance was used to analyze the data. Ethical Considerations: The present study has been registered with the code IR.IAU.ARAK.REC.1399.036 in the ethics committee of Islamic Azad University Arak branch. Results: There was a significant difference between metacognitive beliefs in patients with hypochondriasis covid 19 and normal individuals (P

Objective: Patients with breast cancer have symptoms of anxiety, depression and anxiety. This study was aimed to investigate the effectiveness of cognitive-behavioral stress management on the clinical symptoms among patients with breast cancer. Methods: The was a quasi-experimental study with pre-test, post-test and follow up assessments. Twenty patients were randomly allocated into two groups: experimental group (10 patients) and control group (10 patients). Cognitive-behavioral stress management was administrated in 8 sessions for experimental group. The research instrument was SCL-90-R questionnaire. Data was analyzed by SPSS-25 software using repeated measure ANOVA. Results: The results showed that cognitive-behavioral intervention led to reduction in clinical symptoms in some dimensions as measured by the SCL-90-R among patients in experimental group (P < 0.05). Conclusion: The findings indicated that the cognitive-behavioral stress management could reduce clinical symptoms of patients with breast cancer. Indeed, using cognitive-behavioral stress management in cancer treatment centers can be regarded as a complementary therapy alongside medical treatments.