محمدرضا مراثی

Thalassemia screening instructions in Iran consider couples with MCV = 75-80, MCH = 26-27, HbA2<3.5, and HbF<3 indices as low-risk couples, and therefore further genetic testing is not obligatory. If the blood indices of alpha thalassemia carriers (One alpha gene deletion or two alpha gene deletions) fall within the parameters of low-risk couples, the identification of such couples within the beta thalassemia screening program will not be feasible. However, if the blood indicators of alpha thalassemia carriers fall within the range of the suspected high-risk couple, these couples can be identified through beta thalassemia screening instructions.

In this cross-sectional study, information was extracted from 2359 individuals diagnosed with alpha thalassemia, identified between 2018 and 2021, in 22 marriage counseling centers in Isfahan province using the results of the PND test. The blood indices MCV and MCH of alpha thalassemia carriers were compared with the low-risk and high-risk values of beta thalassemia carrier couples.

The average MCH and MCV of couples affected by alpha thalassemia gene deletions 1 and 2 are respectively within the low-risk and high-risk ranges for beta-thalassemia.

Beta thalassemia screening guidelines can effectively identify individuals with two alpha thalassemia gene deletions, although they have no effect in identifying those with one alpha gene deletion. Current guidelines indicate that it is possible to prevent the occurrence and complications of pregnancy in mothers with Bart's hemoglobin infants; however, the identification of H hemoglobin disease remains unfeasible.

Low sleep quality is associated with a decrease in the body's immunity level and an increase in inflammatory markers. This study aimed to investigate the relationship between periodontal diseases and sleep quality.

In this analytical-cross-sectional study, two groups of 40 individuals (with and without periodontal disease) were selected from patients referred to the Faculty of Dentistry of Isfahan Azad University. After obtaining consent, the periodontal condition of the patients was checked. People's evaluation criteria include a gingival index, pocket probing depth, and loss of clinical adhesion level. Indicators were performed by an examiner using a periodontal probe in four areas of each tooth (mesiobuccal, buccal, distobuccal, and lingual). Sleep quality questionnaire (The Pittsburgh Quality Index) and depression, anxiety, and stress assessment questionnaire (Depression, Anxiety, Stress Scale: DASS) were completed by two groups. Data were analyzed using chi-square, Independent T, Mann-Whitney, and Fisher’s exact test (α = 0.05).

Independent T-test did not show a significant difference in the average age of the two groups (P = 0.787). According to the Mann-Whitney test, the sleep quality score of patients with periodontal disease was significantly higher than that of people without the disease (P < 0.001), and this score was observed more in people with the disease based on gender, different age groups, and employed and unemployed people.

Therefore, the treatment of one can be effective in the treatment of another and ultimately improve the individual's life.

Hirschsprung's disease (HD) is a congenital absence of ganglion cells. Due to the lack of consensus about the possibility of relying on the histology of the appendix to diagnose HD, appendectomy and sampling of the appendix are still performed in many centers in Iran and the world to diagnose it. This study aimed to evaluate the possibility of partial appendectomy and prevent total appendectomy to diagnose HD and determine the prevalence of aganglionosis in each part.

The present study was a prospective cohort study. The study population consisted of patients under 16 years of age in need of appendectomy who were referred to Isfahan teaching hospitals from March 2022 to March 2023. The inclusion criteria were age below 16 years and undergoing appendectomy with the diagnosis of appendicitis based on the Alvarado criteria, and the exclusion criteria were perforated or gangrene appendix and appendix neoplasia. The research variables included age and gender (as background variables) and the number of ganglion cells in each hpf (as dependent variable).

The average age of the examined patients was 8.84 ± 3.33 years. 58% of the patients were male. The total number of ganglion cells seen in the entire slide containing the samples was the highest in the middle and the lowest in the distal slides, which were significantly different (P = 0.038).

The middle part of the appendix has the highest number of ganglion cells and is the best part for biopsy for the HD diagnosis.

Suicidal thoughts in adolescence can have irreparable consequences due to poor control over life, feelings of social loneliness, problems with parents and friends, and weakness in problem-solving and emotion management (1). Although Iran ranks 58th in the world with a suicide rate of 6 people per 100,000 people, it is necessary to address this psychological-social variable (2). In the field of etiology of suicide, although suffering from mental disorders (3), including depression, has been reported in 40-60% of people (4), recent studies emphasize the effect of biological factors, including neurotrophins (5). Among the neurotrophins, BDNF has attracted more study attention. BDNF maintains normal neurogenesis, synaptic function, neuroplasticity, and neuronal survival (6). So far, different and sometimes contradictory results have been proposed regarding the relationship between BDNF and depression (7, 8), and some believe that BDNF levels decrease significantly in suicidal patients (9). Culture and cultural context are also vital factor influencing suicide (11). In Iran, several qualitative studies have been conducted to identify the causes of suicidal behavior and thoughts (2, 12, 13). Azimi et al. showed that the causes of suicidal thoughts in teenage girls are: 1- Negative attitude toward the father (due to hard family life, lack of warmth between family members, and deprivation of freedom) 2- Perception of hopelessness (individual and social) 3- Unsafe school (unfavorable role of the teacher, school staff and education system) 4- Lack of religious excellence (lack of correct knowledge about God, defective attachment to God, external orientation towards religion) 5- Individual lack of maturity (problem in skills life, cognitive and emotion regulation) (13).
Among the psychological treatments, CBT has received the most research for treating depression and suicide among adolescents. However, its effectiveness seems to be influenced by the cultural and religious backgrounds of the clients (22). Similarly, at least half of the patients who undergo CB still experience psychosocial symptoms after the termination of treatment (15). Kennedy (2019) believes that the reason for the emergence and persistence of disease symptoms in people should be sought in biological components (16). In the current research, in line with the need to pay attention to biological and cultural factors in psychotherapy, a treatment protocol based on the psychological-cultural model has been designed and examined and compared with CBT treatment on depression and suicidal thoughts and BDNF. Besides, the modulating role of BDNF on the effectiveness of treatments on psychological variables was investigated.

This is a quasi-experimental research (pre-test. post-test, and control group). The study population consisted of 15-year-old female students in Isfahan who were selected by multi-stage cluster sampling of 45 people and randomly assigned to three groups cognitive-behavioral therapy, culture-based psychotherapy, and control group (without intervention). The CBT was implemented according to the valid protocols provided (27, 28). To design psychotherapy based on culture, according to the components of the cultural-psychological model (13), the interventions whose effectiveness was confirmed were selected. The techniques were arranged in the form of an integrated and coherent treatment package and presented to six experts. The agreement coefficient about the content of the treatment sessions was between 0.96 to 0.98 was obtained. Both intervention groups included 12 sessions of adolescent education and three sessions of parent education. Research variables were assessed through Beck Depression Inventory (1996), the Multi-attitude Suicide Tendency Scale (Orbach et al., 1981), and blood samples Data were analyzed using SPSS-24 software, multivariate analysis of covariance (MANCOVA).

First, the statistical assumptions were checked through the Shapiro-Wilk test, and the results showed that the variables had a normal distribution. Lune's test also showed that the variances of the three groups were homogeneous. The assumption of homogeneity of the slope of the regression lines was also maintained. The results of the univariate covariance analysis test showed that after controlling the pre-test scores of the subjects, a difference was found between the mean post-test scores of the research groups in depression variables (F=6.230, P<0.05, η=0.247) and thoughts suicide (F=4.183, P<0.05, η=0.180) a significant difference was observed. However, no significant difference was found between the groups in BDNF (F=0.229, P<0.05, η=0.012). The statistical power indicated the relative adequacy of the sample size. Pairwise comparisons in the LSD test showed that both treatment groups decreased the scores of the participants in both depression and suicidal thoughts variables compared to the control group (P<0.05). However, in both mentioned variables, no significant difference was observed between culture-based psychotherapy and CBT. Furthermore, in this study, the modulating effect of BDNF was investigated. The assumptions of covariance analysis were valid. The assumption of sphericity was also checked and confirmed by using Mauchly's test of Sphericity W statistic (P<0.05). The results of covariance analysis with repeated measures indicated that BDNF could not moderate the effects of treatment on suicidal thoughts in any intervention groups (P<0.05).

The effectiveness of both treatment groups in reducing depression and suicidal thoughts was confirmed, and no difference was observed between the two groups in terms of effectiveness. Emphasis on self-knowledge, recognition of thoughts and feelings, cognitive errors, problem-solving, lifestyle, and communication skills leads to the effectiveness of both treatments on the level of depression of people. Indeed, four axes of depression have been considered in both treatments, including cognitive, emotional, behavioral, and physiological changes (through lifestyle).
In the field of suicidal thoughts, in culture-based psychotherapy (according to the research of Azimi et al.), in addition to individual maturity and cognitive skills, the cultural context, including the socio-economic characteristics of the family, religious characteristics, identity background (with an emphasis on gender identity) as a girl and existing conditions (such as facilities and characteristics of schools and the possibility of employment in the future) were widely considered. Although the role-playing method is one of the CBT techniques, in culture-based psychotherapy, this technique was used in a more evolved derived from psychodrama therapy in most therapy sessions, and interpersonal relationships and regulation of emotions and behavioral skills. It was investigated practically and more deeply. Also, in culture-based psychotherapy, in addition to cognitive treatments, ultra-modern treatment techniques were used. Besides, based on the three axes of mind awareness and acceptance of emotions and thoughts, the need to persevere in reaching the goal (committed action) and cultivating a compassionate mind was emphasized. For example, one of the factors predicting vulnerability to suicide is the ability to resist negative emotions and coping strategies; this ability under the title of accepting and tolerating distress was one of the techniques in culture-based psychotherapy (derived from the DBT approach). Furthermore, considering that suicide is an injury arising from the conflict between the situations (socio-economic conditions). It desires that the techniques used in culture-based psychotherapy can lead to acceptance of the situation and realistic goal setting, reducing the lead to suicidal thoughts. Techniques used in culture-based psychotherapy, such as self-knowledge, distress tolerance, problem-solving, considering family relationships, purposefulness, self-efficacy, and cognitive flexibility, not only the totality of the individual's psyche but also family relationships and problem-solving methods according to environmental and cultural conditions, were considered.
In the present study, the significant effect of both interventions on BDNF was not confirmed, and the moderating effect of BDNF on psychological variables was not significant. The present results are inconsistent with some studies based on the moderating role of BDNF on the effectiveness of treatment (18, 19, 21) and consistent with some studies that show no effect of BDNF on the results of therapeutic interventions (29, 30). Response to pharmacological treatment occurs more quickly (33), whereas the response to psychotherapy may take months (32) and depends on factors such as the therapeutic relationship (35). BDNF levels tend to be stable over time (36); therefore, it is necessary to investigate the treatment results on this biological variable for a longer time. Seemingly, the contradictory findings in different studies are due to the influence of other variables (including biological and clinical variables) that have not yet been identified and taken into account. Future studies regarding the interaction of biological variables, psychological components, and treatments may provide additional insights.

Ethical Considerations
Compliance with ethical guidelines
In compliance with ethical guidelines, the Ethics Committee of the University of Isfahan (IR.UI.REC.1396.048) has granted requisite ethical approvals. Written informed consent was obtained from the adolescent. They were informed about the confidentiality of the information and their voluntariness in participation in the study.

Authors' contributions
Akram Azimi participated in the research design, data collection, analysis, revision, and article writing. Fariba Yazdakhasi participated in the research article’s design, analysis, and writing. Mohammadreza Maracy and Amraleh Ebrahimi participated in the data analysis and revision of the article. All authors read and approved the final version.

Funding
No financial support has been received for this research.

Acknowledgments
The author appreciated Isfahan Education Organization, school principals, and students who cooperated with the researchers in this research. The researchers are also grateful to Sharife Joshanpoosh and Zahra Akhtarian, who collaborated with the researchers in the research’s statistical analysis and implementation stages of the.

Conflicts of interest
The authors declare no conflicts of interest.

Infertility is described as inability of a couple to bring a child within 12 months or more of regular unprotected intercourse. Studies have suggested associations between semen quality and lifestyle factors, including physical activity and dietary intakes. This cross-sectional study aimed to assess the relationship between physical activity and sperm quality parameters in infertile men who referred to infertility clinic of Isfahan City, Iran, in 2019.

In this cross-sectional study, 175 infertile men (18-55 years old) who referred to Royan infertility clinic in Isfahan, entered the study after completing the written consent form. Demographic data were collected using a questionnaire and physical activity information was collected by International Physical Activity Questionnaire (IPAQ). Sperm quality parameters including sperm concentration (SC), total sperm motility (TSM), normal sperm morphology (NSM), and sperm volume were investigated by spermogram test. For all analyses, SPSS software was used and P ˂ 0.05 was considered as significance level.

Due to the lack of dissemination of physical activity data, all subjects were classified in the group of physical activity with moderate intensity. Multivariate logistic regression [odds ratio (OR)] with 95% confidence interval (CI) was used to assess more accurately the relationship between physical activity and abnormal sperm parameters. Median values of metabolic equivalent of task (METs) were used to analyze the data due to lack of dissemination of physical activity data and no significant relationship was observed between sperm quality parameters and levels above median compared to the reference level (levels below median) in participants.

No significant relationship was found between sperm quality parameters and physical activity pattern in infertile men. Furthermore, no relationship was found between body mass index (BMI) and sperm quality parameters.

Education on scientific evidence can decrease the consumerschr('39') concerns toward new foods such as genetically modified foods (GMF). In the present study, the effect of education on knowledge, attitude, and practices of students of Isfahan University of Medical Sciences, Isfahan, Iran, toward GMF was evaluated.

In this study, 298 students from 6 schools of Isfahan University of Medical Sciences were randomly selected. Knowledge, attitude, and practices of students toward GMF were examined based on completion of the researcher-made questionnaire. Afterwards, the education was performed in person and in group with presentation of pamphlet. In the period of one month, questionnaires were refilled out by students to determine the effect of education. Statistical analysis was done in SPSS software.

Before education, the mean scores of knowledge, attitude, and practice in case group of education were 4.83 ± 1.97, 28.50 ± 2.68, and 6.97 ± 3.57, respectively. In parallel, these scores increased to 7.97± 1.28, 31.01 ± 2.59, and 10.21 ± 3.09 after education. These scores were evaluated in group of control, too. Before education, mean scores of knowledge, attitude, and practice of control group were 5.47 ± 2.46, 28.50 ± 3.44, and 6.40 ± 4.64, respectively. The scores improved to 5.69 ± 2.37, 28.73 ± 3.39, and 6.95 ± 4.55 after education. Significant differences in the mean scores of knowledge, attitude, and practice of students of education and control groups were observed after education (P < 0.05).

Education of students about GMF leads to improvement of their scores of knowledge and attitude. In addition, it has positive effects on their practices in choosing these groups of products.

Congenital malformations are one of the causes of infants disability and death. this study was performed to determine the incidence of major congenitals anomalies and their relationship with some related factors at birth.

In this cross-sectional study, all newborns born in hospitals of Chaharmahal va Bakhtiari province were evaluated for major congenital malformations at birth. information recorded in the case file including parent and infant characteristics was extracted from the mother and infant system. data were analyzed using Generalized Linear Model, family (poisson).

Of the 19666 newborns studied, 63 (3.2 per 1,000) had major congenital malformations at birth. in the crude model, pregnancy age, neonatal birth weight, neonatal height, and neonatal head circumference variables were significantly associated with congenital malformations. but in adjusted model 1, residence was significantly related to the incidence of congenital malformations and in adjusted model 2, the incidence of congenital malformations was related to neonatal pregnancy age, neonatal birth weight and neonatal head circumference.

Some of MCAs with early diagnosis and treatment can prevent disability. Therefore, the emphasis on public education to consider appropriate gestational age, proper nutrition before and during pregnancy, emphasis on prenatal and prenatal care is necessary to prevent congenital anomalies.

Metabolic syndrome refers to a cluster of disorders including abdominal obesity, glucose intolerance, hypertension, hypertriglyceridemia, low HDL) High-density lipoprotein( levels. The metabolic syndrome increases the risk of developing cardiovascular disease and type 2 diabetes. Recently, it has been found that selenium can also be effective in the carbohydrates and fat metabolism. The aim of this study was to evaluate the effects of selenium supplementation on glucose homeostasis parameters and lipid profile in women with metabolic syndrome.

This randomized, double-blind, placebo-controlled trial was conducted among 70 women diagnosed with MS and aged 20-49 years old. Participants were randomly divided into two groups to receive 200 μg per day selenium supplements (N=35) or placebo (N=35) for 8 weeks. Fasting blood samples were taken at baseline and after 8 weeks' intervention to quantify glucose, insulin and lipid concentrations.

After 8 weeks of intervention in two groups, there was no significant difference between the two groups in the variables studies include fasting blood sugar (FBS), Insulin, homeostasis model of assessment-insulin resistance (HOMA-IR), Quantitative insulin sensitivity check index (QUICKI), triglyceride, total cholesterol, HDLand LDL cholesterol )Low- density lipoprotein(.

Supplementation of 200 μg of selenium for 8 weeks had no significant effect on glucose homeostasis and lipid profile in the participants with metabolic syndrome.

Nowadays, flexibility is the subject of special attention in the field of mental health and the scope of related research is increasing every day. The purpose of the present study was to construct and investigate the psychometric properties and factor structure of the adolescents' psychological flexibility scale. Four-hundred-sixty students were selected from six schools from the eighth and ninth grades (with emphasis on the ninth grade) by the multistage sampling method from six schools in Isfahan city. The instruments were Acceptance and Action Questionnaire (AAQ-II) and General Health Questionnaire (GHQ). In factor analysis, the three factors of commitment, lack of perfectionism, and openness to experience were effective in forming themental flexibility variable. The obtained results showed that the present scale is a tool that has appropriate reliability (stability, internal consistency) and validity for measuring psychological flexibility. The results of exploratory and confirmatory factor analyses in this study confirmed the appropriate construct validity of this scale.

Schools of health sciences play an important role in public health by training the workforce and the development of scientific work. However, several factors can threaten the position and status of these centers and disrupt their interactions with executive-industrial environments. Since no comprehensive study has been conducted on the barriers facing the schools of health sciences, this study is conducted with the objective to identify the concerns of the schools of health sciences for interaction with executive-industrial environments.

In this study, the conversation flow of 20 specialists and heads of the schools of health sciences of Iranian type 1 universities was filmed at Isfahan University of Medical Sciences, Isfahan, Iran in summer 2018; the conversations were handwritten and then typed word for word; they were then analyzed by content analysis method.

As a result of data analysis, the related factors were classified into two main categories: 1) challenges and needs of interaction with health deputies, 2) challenges and needs of interaction with industry, which the latter itself included four categories.

For the first time, the present study achieved some important results on the categorization of a set of challenges and needs related to the interactions with the health deputy office, as well as the interactions with the office of industrial relationships as the barriers to the operations of the universities and the operational environments. Therefore, the above results can be used as a guideline for designing comprehensive programs to remove barriers to communication and interaction at the schools of health sciences with their offices of health deputy and industrial relationships.

Stress is unavoidable among the medical profession, and has become an integral part of professional life in some fields such as surgery and anesthesia. The aim of the present study was to determine the perceived stress with coping styles of stressful situations among the residents of surgery and anesthesiology.

 The present study was a cross-sectional descriptive-analytical study in Isfahan University of Medical Sciences, Isfahan, Iran, in 2019. The samples were enrolled the study using census sampling method. The data collection tool was a questionnaire that included three questionnaires of demographic characteristics, perceived stress scale, and questionnaire to deal with stressful situations. The data were evaluated using descriptive statistics, and chi-square, one-way ANOVA, and Tukey tests via SPSS software.

The mean perceived stress did not differ significantly between the two groups of surgery and anesthesiology residents (P = 0.370). There was a significant relationship between the age and frequency of stress management styles among surgery residents (P = 0.020). Surgery residents significantly used problem-oriented coping method more when the mean perceived stress level was lower (P = 0.011). In the anesthesiology group, the level of stress level was almost the same in all three coping styles, and there was no significant difference (P = 0.160). Moreover, using the Tukey test, in the surgical group, the mean perceived stress level was significantly less when using problem-oriented coping style, compared to emotion-centered stress coping style (P = 0.008).

 Among surgery residents, low perceived stress is an effective factor in the use of effective (problem-oriented) method in dealing with stress. Increasing in age and experience in the field of work, make people use effective coping style; possibly, having more responsibility in the operating room makes the surgery residents use more effective and efficient ways to deal with stress.

Congenital anomalies are also known as birth defects and congenital disorders. Congenital anomalies occur in about 3-7% of the newborn babies worldwide. The purpose of this study was to determine the incidence of congenital anomalies and their determinants in hospitals affiliated with Isfahan University of Medical Sciences in 1395.

This cross-sectional study was conducted in all infants born in 1395. The data were analyzed with the SPSS software version 20 using Binary logistic regression.

Of 5455 births in Isfahan hospitals, 121 neonates were diagnosed with major congenital anomalies. The total incidence of major congenital anomalies was 2.2 per 100 births. The results showed a statistically significant relationship between maternal blood group, consanguinity, sex and height of infant with congenital anomalies in newborns (P <0.05). Moreover, 26.7% of all abnormalities were related to limbs and the lowest percentage was related to genetic abnormalities, digestive system, anus, and spine with an incidence of 0.7% for each.

More attention should be paid to premarital genetic counseling in order to identify the consanguinity factor as a risk factor for genetic abnormalities. Moreover, pregnant women should be educated about the timely intake of micronutrients to control abnormalities.

In recent years, we have witnessed earthquakes with serious negative effects on the health of families. Given the importance of women's role in the family and society, their social and mental health status, especially in times of crisis, was highlighted. This study aimed to determine their average mental health status of exposed women in comparison with the social characteristics of their compatriots in the province of Kerman.

This is a descriptive survey study of 250 women under an earthquake in Kerman province in 2018 using the standardized questionnaire of women's mental health in an earthquake on sample group (α = 0.91), through inperson referral to women resettlement area in Kouhbanan city. The data were analyzed by the covariance test.

According to the results of this study, women who witnessed the earthquake did not have a favorable assessment of their social and mental health status. The results of this study concerning their mental health of women could be useful for policymakers, women's rights, health care providers, therapists and caregivers, managers, planners, specialists, and rescuers in the field of disasters and accidents.

According to the findings of the study, the components of women's mental health in crisis and disaster are varied and widespread. The findings of this study can be applied to empower women both psychologically and manage disaster behavior and emotion

Appropriate self-care is the base of treatment in hemodialysis patients. The aim of this study was to determine the relationship between psychological factors (personality traits, anxiety, depression and stress) and the self- care of hemodialysis patient.

In a cross-sectional study 125 patients under chronic hemodialysis admitted to Al-Zahra and Noor hospitals of Isfahan city in 2012 were enrolled to the study with regard to the inclusion and exclusion criteria. Data collection tools were including three questionnaires (the five-factor personality inventory (Neo Big-5), Depression Anxiety Stress Scale (DASS) and Hemodialysis Self-care checklist that  after the choice of samples were given to complete. the data was analyzed by multivariate regression model.

Depression and conscientiousness are significantly correlated with self-care in hemodialysis patients. There is an inverse correlation between self-care and depression and a direct correlation between conscientiousness with self-care.

It seems that pay attention to psychological factors are required in practice with hemodialysis patients.

Despite the recent decrease in heart disease mortality in developed countries, ischemic heart disease (IHD)-induced mortality is still ranked first in Iran. However, there is no conceptualization of changes occurred in the disease process and the role demographic variables may play in this regard. Age-period-birth cohort (APC) analysis can deepen the understanding of mortality process, and help its prediction in the near future.

The present study was a panel of cross-sectional cohort estimating IHD-induced mortality rate during 2004-2013 with the use of the "APC model. Moreover, this study aimed to this mortality rate for 2014-2018 using the mortality-incidence analysis model-MIAMOD software. The study sample consisted of individuals selected from the database collected at Monitoring and Registration Unit of the Cardiovascular Diseases in Isfahan Cardiovascular Research Institute, Isfahan, Iran.

The age-adjusted death was higher in men than in women. The age-adjusted mortality rate of IHD during 2004-2013, on average, increased by 13.6% and 14.7% for men and women, respectively. Furthermore, it is predicted that the mortality rate would increase by 14.1% and 10% for men and women during 2014-2018in each year, respectively. The obtained results indicated that the increase of age led to the increase of mortality rate, meaning that mortality was higher in the subjects born during 1932-1936, compared to those born in 1972-1976.

The obtained results were indicative of the increasing trend of mortality in Isfahan among both men and women. Moreover, the estimation and prediction based on the (APC) Model can be used as a basis for the management of health services.

Nutrition education and introduction of procedures for choosing healthier food have an important role to reduce the rate of non-communicable diseases. It was shown the amount of risk factors of non-communicable diseases such as energy, salt, sugar, fat and trans fatty acid on the traffic light of food labelling. The status of risk is presented through three colors of red, yellow and green that are the signs of risk, precautious and safe use of food. The object of this study was to evaluate the influence of education on the knowledge, attitude and practices of Isfahan University of Medical Sciences students to the traffic light on food labeling.
This project was an empirical study performed by random sampling of 379 students of nine schools in Isfahan University of Medical Sciences from January 2017 to March 2018. The knowledge, attitude and practices of students toward the traffic light were assessed by self-administered and structured questionnaire. Education was performed face to face with the usage of pamphlet. In the period of three to six months, questionnaires were refilled out by students to determine knowledge, attitude and practice. Descriptive statistics were calculated using SPSS in mean± SD. Paired t-test was performed to assess the influence of education in total score of knowledge, attitudes and practices in test-retest. P value was considered less than 0.05 as statistically significant.
Before education, the average of scores for knowledge, attitude and practice was 1.12±0.84, 14.44±4 and 2.25±2.2, respectively. Afterwards, the scores were increased to 11.72±0.75, 18.67±3.18 and 17.69±4.7 after education. Significant difference was observed in the scores of knowledge, attitude and practice of students before and after education (P<0.05).
Education of traffic light had a significant role in the improvement of knowledge, attitude and to some extent of practice of students in selection of healthier food.

Major depressive disorder (MDD) is a prevalent and devastating psychiatric disorder worldwide that needs multidimensional interventions. Metacognitive treatment is a new psychotherapeutic approach of some psychiatric disorders. This study was conducted to comparatively evaluate the impact of citalopram and metacognitive interventions on major depressive disorder.
This was a clinical trial study with a pretest/posttest design. After selection of objects, the eligible patients were randomly assigned into three groups of citalopram (n = 12), metacognitive intervention (n = 16), and waiting list (n = 8). One experimental group received ten 1-houre sessions of metacognitive therapy; 10-40 mg citalopram was administered to other group; and third group did not receive any interventions and placed on waiting list. Outcome measures were done using Beck Depression Inventory (BDI), Metacognitions Questionnaire-30 (MCQ30), and Cognitive Emotion Regulation Questionnaire (CERQ) before and after interventions. Data analysis was performed using ANOVA and post hoc tests.
Findings: There was significant difference between the groups in terms of symptom of depression, metacognition, and emotion regulation before and after intervention. In term of metacognition, only metacognitive therapy was useful (P = 0.010). Symptom of depression were improved significantly with metacognitive therapy (P = 0.007); but in pharmacotherapy, despite clinical improvement, there was not any statistically significant improvement (P = 0.070). In addition, emotion regulation was improved with metacognitive therapy (P = 0.020).
Metacognitive therapy could be used in major depressive disorder. In addition, this intervention could lead to higher level of cognitive emotion regulation.

Vascular diseases and cognitive impairment are prevalent in elder people. Association between cardiovascular diseases and cognitive dysfunction is reported in previous studies and there are limited studies followed patients with cardiovascular diseases for cognitive functions. This study aimed to evaluate patients with coronary artery diseases and over 65 years of age for cognitive function.
This was a prospective cohort study on patients undergoing coronary artery angiography in Sina and Chamran hospitals, Isfahan City, Iran, during 2015-2016. At first, Neuropsychiatry Unit Cognitive Assessment Tool (NUCog), Tower of London (TOL) test, Color Trail Test (CTT) and Mini-Mental Status Exam (MMSE) were done for all participants and after one year, these patients were again evaluated for cognitive function.
Findings: 85 patients with mean age of 65.78 ± 5.30 years were evaluated; of them, 85.9% were men. The mean score of NUCog test was not statistically different between the beginning and end of the study (P = 0.670). The mean scores of MMSE and TOL tests and also the mean time of TOL test were statistically different between the first and second evaluation (P = 0.030, P = 0.020, and P Generally, presence of cardiovascular disease especially coronary artery disease can deteriorate cognitive function in elder patients over times.

By early detection and performing preventive interventions, it would be possible to significantly prevent side effects and burden of mood disorders. This study aimed to investigate the premorbid signs and symptoms of major mood disorders in a sample of Iranian patients.
All the patients hospitalized due to mood disorders in Noor hospital in Isfahan City, Iran, were interviewed to investigate past history of any psychiatric sign and symptom retrospectively using convenience sampling method. Independent sample t and chi-square tests were used to analyze the data.
Findings: From 175 patients (66 men and 109 women) with the mean age of 34.7 ± 12.1 years, 119 participants were diagnosed as bipolar mood disorder (BMD) and 56 as major depressive disorder (MDD). All the patients (except 1 with major depressive disorder) had at least 1 premorbid sign or symptom. Impulsivity (32.8%), irritability (29.4%), and over-sociality (26.1%) were the most frequent premorbid sign/symptom in the past history of the patients with bipolar mood disorder; impulsivity and irritability significantly increased the risk of the future bipolar mood disorder. Poor coping (78.6%), social isolation (33.9%), and anxiety (30.4%) were the most frequent premorbid sign/symptom among the patients with major depressive disorder; only poor coping significantly increased the risk of the future major depressive disorder.
Considering the high prevalence of premorbid signs and symptoms among Iranian patients with major mood disorders, more attention should be paid to them during childhood and adolescence periods to make early diagnosis and shorten the untreated phase of these disorders.

Depression is the second most prevalent psychological disorder in the elderly. This study was designed to evaluate the psychometric properties of the Cornell Scale for Depression in Dementia (CSDD) in the elderly population afflicted with dementia in Isfahan, Iran.
This psychometric study was performed on 110 elderly individuals who were selected randomly from among individuals who were referred to the elderly clinic of Isfahan and were diagnosed as a case of dementia based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria. All participants completed the CSDD, Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS). The collected data were analyzed descriptive statistics, Cronbach’s alpha, factor analysis, and the Pearson correlation coefficient in SPSS software.
Total scale reliability coefficient was 0.85 and the reliability of the factors of depression, psychotic depressive symptoms, sleep disorders, somatic symptoms, and anxiety was 0.77, 0.63, 0.79, 0.62, and 0.47, respectively. The correlation coefficient of GDS and MMSE with total scale of CSDD was obtained as 0.47 (P The Persian version of CSDD contained acceptable psychometric properties in this sample of Iranian elderly individuals with dementia.

Stigma is a mark of disgrace in the society's attitude that discredits a person or a group because of an attribute such as a deformity, color, or mental illness. Stigma can adversely affect all aspects of life. Depression is one of the most common mental health problems. The goal of the current study was to investigate some factors associated with stigma of depression among university students in Isfahan City, Iran, in order to facilitate possible interventions.
This cross-sectional study was designed to evaluate the stigma of depression in students of University of Isfahan, Isfahan University of Medical Sciences, and Art University of Isfahan, and was conducted among 553 participants. We used a questionnaire designed by Griffiths et al. and translated it to Persian to evaluate the personal and perceived stigma.
Findings: Personal stigma was statistically lower in participants with positive history of depression (P = 0.007). It was also lower in married participants (P = 0.030). Perceived stigma was significantly higher in students of University of Isfahan comparing to other universities (P = 0.009).
Positive history of depression, being a married person, and being a student of Isfahan University of Medical Sciences or Art University of Isfahan are protective factors against the stigma of depression in university students in Isfahan City.

Great interests have been drawn to the quality of diet. Dietary energy density is a good indicator of diet quality. In spite of the comprehensive concept of energy density rather than energy intake, no studies have evaluated the dietary energy density of lactating mothers. The purpose of the current study was to evaluate the association between dietary energy density and infants’ growth.
Dietary intake data were collected from 300 lactating mothers through the 168-item food frequency questionnaire. Data on physical activity were reported by participant’s responding International Physical Activity Questionnaire (IPAQ). The anthropometric features were taken from the health records in health centers.
Findings: Infants’ weight, height, head circumference, and weight for height at birth, and 2 and 4 months later were not significantly different within any of 4 categories of energy density.
The results of this study suggest that there is no association between quartiles of mothers’ dietary energy density and infants’ weight, length, weight for length, and head circumference growth by the age of 2 and 4 months.

The prevalence of overweight and obesity among children and adolescents has increased to a considerable level all over the world. Social support has been recognized as one the most important psychological factors which can affect nutritional behaviors of adolescents. Thus, the aim of this study was to assess the relationship between social support and nutritional behaviors in overweight and obese adolescents of Shahinshahr, Iran.
This cross-sectional study was conducted on 172 overweight and obese female students who studied in the middle schools of Shahinshahr. After random sampling and assessment of anthropometric indicators, the social support and meal frequency questionnaire was completed by the students. In addition, students were asked to provide a 24-hour food recall.
Findings: The mean age and BMI of the students were 13.4 ± 0.6 years and 28.2 ± 3.6 kg/m2, respectively. BMI had a reverse significant relationship with eating breakfast, and morning and afternoon snacks (P Social support was an efficient predictor of eating breakfast in obese students. It seems that to better understand the relationship between social support and nutritional behaviors more studies must be conducted in the future.

Today, oxidative stress is one of the most important risk factors for cardiovascular disease (CVD). Various studies have reported a strong association between increased consumption of plant flavonoids and reduced risk of chronic diseases. The purpose of this study was to evaluate the effect of green tea and sour tea on serum malondialdehyde (MDA), blood pressure, and body mass index (BMI) in male athletes.
In this study, 54 male athletes who met the inclusion criteria were selected and randomly divided into 3 groups using ternary block randomization. The first, second, and control groups, respectively, received 450 mg/d of green tea extract, 450 mg/d sour tea extract, and 450 mg/d maltodextrin. The serum MDA, blood pressure, and BMI of the subjects were measured at the beginning of and 6 weeks after the study.
Findings: Sour tea extract and green tea extract significantly reduced serum MDA level compared to placebo (P = 0.008). ýHowever, only sour tea extract significantly reduced systolic blood pressure (P 0.001). Neither of the extracts had a significant effect on diastolic blood pressure, weight, and BMI.
This study showed that green tea and sour tea extract consumption can decrease oxidative stress, and thus, reduce the risk of CVD in male athletes.

Obesity, high blood triglyceride, and high waist circumferences are some risk factors of cardiovascular disease (CVD). Studies have shown that ω-3 fatty acids can reduce the incidence of CVD. Portulaca oleracea is an herbaceous plant and its leaves contain a high level of ω-3 fatty acid (α-linolenic acid). The purpose of this study was to investigate the effect of Portulaca oleracea extract on fasting blood glucose, lipid profile, C-reactive protein (CRP) in men with metabolic syndrome.
This double-blind randomized clinical trial was performed on 80 men with metabolic syndrome for 8 weeks. Participants were randomly divided into intervention and control groups. The intervention group received two Portulaca oleracea ýcapsules each day and the control group received two placebo capsules. ANOVA was used to examine the effect of the intervention.
Findings: Fasting blood glucose, low-density lipoprotein (LDL), and CRP decreased in the control and intervention groups, but this reduction was not significant. Triglyceride level increased in both group, but this variation was not significant. HDL increased in the intervention group, but decreased in the control group. However, the difference between the two groups was not significant. Accordingly, total cholesterol and non-HDL cholesterol decreased in the intervention group, but increased in the control group. Nevertheless, no significant difference was observed between the control and intervention groups.
The results of this study showed that Portulaca oleracea ýcapsule consumption did not have a significant impact on fasting blood glucose, CRP, and lipid profile in men with metabolic syndrome.