فهرست مطالب karimollah hajian-tilaki

The suitable BMI cut-off point in persons with endometrial cancer or hyperplasia with abnormal uterine bleeding was investigated in this study.

This case-control research was conducted on 1470 women with abnormal uterine bleeding in Ayatollah Rouhani Hospital,Babol between 2010 and 2012, with 312 participants included in the study. In terms of uterine biopsy results, patients were split into six groups: simple hyperplasia without atypia, simple hyperplasia with atypia, complicated hyperplasia with atypia, complex hyperplasia without atypia, endometrial cancer, and normal persons.

The mean age and BMI of patients in these three groups were not significantly different (P equal to 0.081 and 0.435, respectively). The kind of disease exhibited a strong relationship with menstruation (P 0.001). The body mass index (BMI) values ​​did not have significant levels under the curve to determine the appropriate cut-off point in the diagnosis of hyperplasia plus endometrial cancer and endometrial cancer alone (P 0.380 and 0.124, respectively) and hyperplasia alone (P = 0.920). Based on logistic regression, age 50 years and older and irregular menstruation were significant with OR equal to 2.36 and 2.09 (P = 0.011) and HTN with OR equal to 0.44 (P = 0.026), respectively.

BMI has little predictive value in the detection of endometrial cancer or hyperplasia, according to the findings, and other diagnostic and screening modalities should be utilized instead. The findings backed up the theory that old age and irregular menstruation are linked to an increased risk of endometrial cancer.

This study aimed to investigate the integration of the health belief model (HBM) and the theory of intention to plan preventive behavior for COVID-19 during the pandemic.

In a cross-sectional study, a sample of 480 adult participants from different outpatient clinics were recruited in the study. The participant responded by self-report; the health belief model (HBM) scale, preventive behavior scale, subjective norms scale, the intention of planned behavior scale, and perceived control behavior scale were measured. The hypothesized causal path models were examined using SEM analysis.

The HBM had significant effects on perceived behavior control (β=0.60, P=0.001), the intended preventive behavior (β=0.32, P=0.001), and subjective norm (β=0.53, P=0.001). Subsequently, the intention of preventive behavior (β==0.39, P=0.001) and subjective norms (β=0.27, P=0.001) significantly affected the performance of preventive behaviors. The estimated fitting criteria showed that the hypothesized model fits relatively well.

The health belief model with the integration of subjective norms, perceived control behavior and mediation by the intention of planned behavior in a pathway relationship explains well the preventive behavior of COVID-19. The findings present a deeper understanding of how integrating HBM and intended planned behavior enhances people’s preventive behavior against COVID-19.

In hemodialysis patients, changes in dialysis adequacy are recorded at regular intervals and studied longitudinally. The aim of this study was to determine the factors affecting dialysis adequacy using the generalized estimating equation (GEE) and to compare them with the quadratic inference function (QIF).

This longitudinal study examined the records of 153 end-stage renal diseases (ESRD) patients. Longitudinal data on the dialysis adequacy index and demographic and clinical characteristics were obtained from the patient files. The first-order GEE (GEE1), second-order GEE (GEE2), and QIF models were fitted with different correlation structures, and then the best correlation structure was selected using the quasi-likelihood information criterion (QIC), Akaike information criterion (AIC), and Bayesian information criterion (BIC). Then, the selected models were compared based on the relative efficiency of the estimated regression coefficients.

The majority of patients (59.5%) had unfavorable dialysis adequacy (KT/V<1.2). Women had more favorable dialysis adequacy than men, and patients <60 years had more favorable dialysis adequacy than older. In the GEE1, GEE2, and QIF models, the coefficients of dialysis history, dialysis duration, weight, gender, and age showed a significant relationship with dialysis adequacy (p<0.05) The relative efficiencies of GEE2 versus GEE1,  and QIF versus GEE1  and GEE2 were 1.163, 1.13, and 1.028, respectively.

Dialysis adequacy is not optimal in most hemodialysis patients. The different models yield quite similar coefficient estimates, but GEE2 with unstructured correlation is more efficient than GEE1, and QIF is more efficient than both GEE1 and GEE2.

The changes of plasma transcobalamin-II (TCII) and Zinc (Zn) Levels in epileptic patients are not clearly understood. The aim of the current study was to evaluate the plasma contents of TCII and Zn levels in newly–diagnosed epileptic seizure patients, long-standing grand mal epileptic patients following treatment with sodium valproate and healthy control group.

Thirty patients aged 36.76±12.91 years with newly–diagnosed and thirty long-standing grand mal epileptic patients aged 35.56 ±12.77 years were diagnosed based on the clinical symptoms. The control subjects were picked out from healthy individuals and matched to the patients, aged 36.30 ±12.80 years. Plasma Zn and TCN-2 was evaluated via spectrophotometry at 546 nm and 450 nm, respectively, using chimerical kits.

Plasma level of TCII in the newly–diagnosed epileptic seizures patients and long-standing grand mal epileptic patients were significantly increased, compared to the healthy controls [14.89 ±3.24 and 21.84± 2.73 vs. 9.55±1.24, (n=30)], respectively. Plasma level of Zn was decreased in the newly–diagnosed epileptic seizure patients, while it was increased in long-standing grand mal epileptic patients compared to the control group [69.28± 6.41 and 80.56 ±6.12 and vs.75.80±1.59, (n=30)], respectively.

This study suggests that sodium valproate may disrupt the homeostatic balance of TCII and Zn, and cause abnormality of their serum level in newly–diagnosed epileptic seizure patients and long-standing grand mal epileptic patients. Further research is recommended to identify the underpinning for these changes.

 The neonate's birth and subsequent hospitalization cause families to experience various needs. Identifying the family's needs can lead to the provision of qualitative services and the implementation of family-centered development care (FCDC) by nurses.

 This study aimed to assess the needs of Iranian families with neonates in Neonatal Intensive Care Units (NICUs).

 This cross-sectional study was conducted in northern Iran in 2018 - 2019 on 360 parents of neonates admitted by convenience sampling method to the neonatal intensive care unit (NICU). Data were collected by demographic questionnaire of parents and neonates and NICU Family Needs Inventory (NFNI) of Ward with five dimensions of proximity, assurance, information, comfort, and support. The data were analyzed using Pearson and Spearman correlation coefficients and a t-test by SPSS23 software.

 The most important dimensions of family needs were proximity to the infant (93.59%), information (90.53%), assurance (89.18%), comfort (86.70%), and support (80.78%). A comparison of the dimensions of the needs of primiparous, multiparous, and term preterm parents indicated that assurance for multiparous parents (P < 0.001) and comfort for parents with term infants (P < 0.02) were significantly higher than the other dimensions.

 The study found that proximity to infants is the most important dimension of family needs. Therefore, the relevant authorities should take effective measures to ensure parent-infant proximity.

Atorvastatin may alter glycemic traits and lipid profiles. This study aimed to evaluate the effects of atorvastatin on biochemical variables in patients with type 2 diabetes and pre-diabetes (borderline diabetes).

This study included 80 individuals divided intofive groups. Patients with type 2 diabetes mellitus and pre-diabetes used atorvastatin 20 mg/day for three months. After three months, variables such as serum fasting blood glucose (FBS), cholesterol, triglyceride, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol(HDL-C), and glycosylated hemoglobin (HbA1c) levels were measured to assess the status of diabetes and pre-diabetes condition. Linear regression was applied to determine the association between atorvastatin uses and alters of biochemical variables levels.

The serum FBS and HbA1c levels in patients with diabetes and pre-diabetes who use atorvastatin were significantly lower than in patients with diabetes and pre-diabetes who did not use atorvastatin (p=0.001). Serum cholesterol and LDL-C levels decreased in diabetic and pre-diabetic patients who used atorvastatin in comparison with diabetic and pre-diabetic patients who did not use atorvastatin (p=0.001). In patients with pre-diabetes, the use of atorvastatin slightly increased serum HDL-C levels. However, in patients with diabetes, the use of atorvastatin slightly decreased serum HDL-C level (p= 0.001). Diabetic and pre-diabetic patients who use atorvastatin significantly decreased serum triglyceride levels (p=0.016), while in diabetic and pre-diabetic patients, using atorvastatin slightly increased the serum insulin level (p= 0.003).

Atorvastatin using alters fat and sugar indices in diabetic and pre-diabetic patients.

In clinical practices, multiple biomarkers are frequently used on the same subjects for diagnosis of an adverse outcome. This study compares two alternative multiple linear regression approaches as the logistic regression model and the discriminant function score in combing several markers.

Ten thousand simulated data sets were generated from binormal and non-binormal pairs of distributions with different sample sizes and correlation structures. Each dataset underwent a logistic regression and the discriminant analysis simultaneously. The ROC analysis was performed with each marker alone and also their combining scores. For two alternative approaches, the average of AUC and its root mean square error (RMSE) were estimated over 10000 replications trials for all configurations and sample sizes used. The practical utility of the two methods is further illustrated with a clinical example of real data as well.

The two approaches yielded identical accuracy in particular with binormal data. With non- binormal data, the logistic regression risk score produced an equal or a slightly better accuracy than the discriminate function score.

Overall, the two approaches yield rather identical results. However, adopting the logistic regression model may incorporate slightly better accuracy index than discriminant analysis with non-binormal data.

This article aimed to evaluate nitric oxide (NO) and nitric oxide synthase (iNOS) markers in patients with erosive esophagitis (EE) and those with non-erosive reflux disease (NERD) and compare them with the control group.

Gastro-esophageal reflux disease (GERD) is one of the most common disturbances of the upper digestive tract. Inducible nitric oxide synthase (iNOS) is expressed in esophageal adenocarcinoma. NO, the product of this enzyme, has been implicated in the pathogenesis of this condition. Nevertheless, the data on whether iNOS and NO are expressed in the early stages of GERD is conflicting.

In this study, tissue samples were obtained from fifty-four patients (27 with erosive esophagitis and 27 with non-erosive reflux disease) and 27 controls. Tissue concentrations of nitrite, nitrate, and iNOS were measured using Enzyme-Linked Immunesorbent Assay (ELISA). The Bradford method was used to determine the protein concentration of samples. The results were analyzed by SPSS software (version 22.0). In multiple comparisons, the Tukey test was performed, and p < 0.05 was considered as the level of significance.

Results:

Tissue amounts of iNOS were significantly higher (p= 0.001) in EE patients compared with the control group. There was a significant difference (p= 0.01) in this factor between EE patients and patients with NERD. Moreover, tissue levels of nitrite and nitrate were significantly higher (p = 0.001) in patient groups compared with the control group.

It was observed that NO and iNOS protein were increased in human esophagitis tissue. The results indicated that nitric oxide and iNOS levels are useful and effective markers in the pathogenesis of GERD. While the results are not certain, it is thought that a link exists between the expressions of iNOS and disease progression.

 The predictive power of obesity measures varies according to the presence of coexistent measures. The present study aimed to determine the predictive power of combinations of obesity measures for diabetes by calculation of a linear risk score.

 Data from a population-based cross-sectional study of 994 representative samples of Iranian adults in Babol, Iran were analyzed. Measures of obesity including waist circumference (WC), body mass index (BMI), waist–to–height ratio (WHtR), and waist to hip ratio (WHR) were calculated, and diabetes was diagnosed by fasting blood sugar >126 mg/dl or taking antidiabetic medication. Multiple logistic regression model was used to develop a logit risk score based on BMI, WC, WHtR, and WHR. The ROC analysis was applied to determine the priority of every single index and combined logit score for the prediction of diabetes.

 All four measures of general and abdominal obesity were predictors of diabetes individually in both sexes (P=0.0001). Calculation of risk score for a combination of all measures use full model improved predictive power. Adjustment for age resulted in further improvement in diagnostic power and combined novel risk score differentiated individuals with and without diabetes with an accuracy of 0.747 (95%CI: 0.690-0.808) in men and 0.789 (95%CI: 0.740, 0.837) in women.

These findings indicate that the simultaneous calculation of age-adjusted risk score for all measures provides stronger diagnostic accuracy in both sexes. This issue suggests the calculation of combined risk scores for all obesity indices especially in a population at borderline risk.

Placenta accreta is one of the known causes of maternal mortality and morbidity. If diagnosed before delivery, appropriate actions can be taken. The aim of this study was to investigate the role of scaling combination of risk factors in predicting placenta accreta spectrum (PAS).

In this cross-sectional study, 120 pregnant women with two criteria and more of placenta previa in their ultrasound, underwent MRI. Clinical scores (history of surgery, cesarean section, previa, etc.) and paraclinical scores (ultrasound and MRI) were recorded and combined. In cases of hysterectomy, pathological examination was performed. The results were compared and analyzed using SPSS Version 22. The significance level was less than 0.05.

Of the120 studied patients, 90 (75%) women were diagnosed with placenta previa in which, 32(36%) patients had placenta accreta and 12 patients had placenta accreta without placenta previa. The mean ultrasound score in women without and with placenta accreta were 0.05±0.32 and 2.43±1.83 (p<0.001). The mean MRI score in women without and with placenta accreta were 0.05±0.27 and 2.07±2.02, respectively. The cut-off point, sensitivity and specificity were 0.50, 100% and 93.4%, respectively. The mean clinical score without and with placenta accreta were 1.97±1.32 and 4.89±3.21, respectively. The cut-off point, sensitivity and specificity were 2.50, 70% and 80%, respectively. The cut-off point of combination score, sensitivity and specificity were 3.50, 89%, 83%.

The results of the present study showed that the most specific test to confirm the definitive diagnosis of placenta accreta is paraclinical score, alone.

The present study was performed to compare the analgesic effects of bupivacaine and magnesium sulfate combination on post-cesarean (C) section pain.

The present single-blind randomized clinical trial was conducted on 160 C-section candidates. The participants were randomly divided into four groups. When the fascia healed, the first group received 20 mL of 0.25% bupivacaine and the second group received 20 mL of 0.25% bupivacaine combined with subcutaneous adrenaline. In addition, both groups received 50 mL of intravenous normal saline. Further, the third group received subcutaneous bupivacaine and 50 mg/kg of magnesium sulfate and the fourth group received subcutaneous and intravenous normal saline as a placebo. The pain intensity was assessed 2, 6, 12, 18, and 24 hours after spinal anesthesia using the visual analogue scale (VAS) for pain. The dose of pethidine (as a standard analgesic) and hemodynamic parameters (i.e., heart rate [HR] and blood pressure [BP]) was recorded as well. The obtained data were then analyzed utilizing ANOVA, Tukey’s HSD, and repeated measures ANOVA tests.

The intensity of pain and the dose of pethidine decreased significantly in the combination of bupivacaine with magnesium compared to the other groups at all times (P < 0.001). However, diastolic BP significantly increased in the bupivacaine + adrenaline group in comparison with the other groups (P = 0.02).

Overall, bupivacaine combination with magnesium sulfate is suitable for controlling post-cesarean section pain.

An effective marker search in glioblastoma is precious in controlling and detecting the progression and monitoring of patients with glioblastoma. In this regard, the present study aimed to evaluate the diagnostic and prognostic role of glial fibrillary acidic protein (GFAP), insulin-like growth factor-binding protein -2 (IGFBP-2), and chitinase-3-like protein -1 (YKL-40) tissue and plasma levels in patients with GBM.

A total of 22 patients with newly diagnosed glioblastoma (the fourth grade of glioma) who had undergone surgery at the Erfan Hospital were included in the current study. The levels of GFAP, IGFBP-2 were evaluated in 22 tumor tissues, and non-timorous matched adjacent tissue samples of patients with glioblastoma using the enzyme-linked immunosorbent assay . Besides, 22 healthy subjects with no history of glioblastoma served as controls for plasma samples. All analyses were evaluated using the SPSS version 22.0.

The tissue levels of GFAP, IGFBP-2, and YKL-40 were significantly higher in patients with glioblastoma when compared to the healthy controls (p=0.001). Nevertheless, there was no significant difference in comparison to the healthy control group in the plasma samples.

Tissue levels of GFAP, IGFBP-2, and YKL-40 may be potential biomarkers for predicting and the progression in patients with glioblastoma.

Peers are influential people who can enhance self-efficacy (SE) factors by verbal encouragement and common experience sharing and affect maternal SE in promoting and maintaining breastfeeding (BF). This study aimed to determine the effect of peer education on BF SE among primiparous mothers.

This randomized clinical trial study was conducted on nulliparous mothers with hospitalized neonates in the neonatal ward of Amirkola Children's Hospital, Mazandaran Province, Iran, within May-September 2018. The statistical population of this research (n=120) was selected using the convenience method and randomly divided into two groups of intervention and control (n=60 each). The control group received the usual and standard center's education. However, the mothers in the intervention group received, two one-hour sessions of BF education from peers in addition to the usual training. These peers were qualified and experienced in two years of successful BF. The tools used for data collection were the demographic form and Breastfeeding Self-Efficacy (BE SE) Scale. The BE SE questionnaire was completed at the time of enrollment and the eighth week after primiparous delivery. The collected data were analyzed in SPSS software (version18) using an independent t-test and paired t-test. A p-value of less than 0.05 was considered significant.

The two groups were similar in demographic variables. The mean score of BF SE after the education in the control and intervention groups were obtained as 48.38±7.85 and 60.25±8.32, respectively, which was significant (P<0. 001).

Based on the results, breastfeeding through peer education increased SE in primiparous women. Therefore, it is recommended to adopt it as an appropriate educational method to improve the quality of BF education among mothers with newborns hospitalized in the neonatal ward.

Atorvastatin hinders cardiovascular disease by reducing cholesterol levels. Proprotein convertase subtilisin/kexin type 9 (PCSK9) enhances the secretion of insulin by binding to LDLreceptor. Sortilin is committed in the transfer of intracellular proteins through the plasma membrane.

The purpose of this research was to determine the effect of atorvastatin consumption on alterations in the levels of 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA-R), PCSK9 and sortilin in diabetic patients and pre-diabetics. Patients and

This study was carried out on 80 individuals including normal subjects, diabetic patients and pre-diabetics. The participated individuals were divided as control group (i) (healthy individuals without diabetes mellitus), diabetic group receiving statin (ii), diabetic group not receiving statin (iii), pre-diabetic group receiving statin (iv) and pre-diabetic group not receiving statin (v). Levels of HMG-COA-R, PCSK9 and sortilin were determined by ELISA method.

In diabetics and pre-diabetics taking atorvastatin, the level of HMG-COA-R was not altered significantly compared to diabetics and pre-diabetics not taking atorvastatin, respectively (P> 0.05). The serum PCSK9 level in diabetics and pre-diabetics was significantly higher than the healthy individuals (P= 0.001). Additionally, the serum PCSK9 level in diabetics and pre-diabetics receiving atorvastatin was significantly higher than diabetics and pre-diabetics not receiving atorvastatin, respectively (P=0.001). The serum sortilin level in diabetics and pre-diabetics was significantly higher than the healthy individuals (P=0.001). In addition, the serum sortilin level in pre-diabetics receiving atorvastatin was significantly higher than pre-diabetics not receiving atorvastatin (P=0.001).

Atorvastatin improved insulin secretion and sensitivity by increasing serum sortilin and PCSK9 levels. Thereby, it prevented the development of diabetes in diabetics and the progression of pre-diabetes to diabetes in pre-diabetics.

Observing the enhancing plaques in magnetic resonance imaging (MRI) is one of the most valuable diagnostic modalities in confirming the diagnosis of multiple sclerosis (MS), its recurrence and for better detection of active disease. Since active lesions discovery can improve designating diffusion in time diagnosis of MS and controlling disease activity, and there is not any definite time for delay image acquisition, therefore, the aim of the current study was to evaluate the enhancement of MS plaques in different delayed phases.

In this interventional study, after receiving written consent, 40 MS patients with at least one enhancing plaque in a previous MRI were evaluated in Babol Ayatollah Rouhani Hospital. Gadolinium was injected to all patients at the dose of 0.1 mg/kg, and MRI was taken at 5 and 15 minutes. The results were analyzed using SPSS 23. A p<0.05 was considered as significant level.

The mean of plaque signal intensity was 1190.20 and 1349.60 at 5 and 15 min, respectively, and this difference was significant (p<0.001). Moreover, the mean of plaque total size was 5.16 cm and 7.04 cm at 5 and 15 min with significant difference, respectively (p<0.001). The mean of plaque number was 1.92 and 2.58 at 5 and 15 min, respectively, which was significantly different (P<0.001).

The results indicated improvement in detection of MS plaques in images taken in the delayed phase compared to those in the early phase. The plaque intensity, size and number were significantly higher in the delayed phase (15 min), than early phase (5 min).

Carpal tunnel syndrome is the most prevalent neuropathy caused by trapping and median nerve compression in the wrist. This study aimed at comparing the effects of minimal incision and double incision in treatment of patients with carpal tunnel syndrome.

This randomized controlled trial was performed in 50 patients with carpal tunnel syndrome attending Shahid Beheshti and Ayatollah Rouhani hospitals in Babol, Iran, candidates for surgery. The patients were divided into two groups using random number table to have either minimal incision (n=25) or double incision (n=25). All patients completed the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and Visual Analogue Scale (VAS) before and three months after the surgery.

The patients included 40 (80%) males and 10 (20%) females. The mean age of the patients was 51.78±8.22 years old. The mean scores for paresthesia, numbness, pain, weakness, nighttime symptoms and functional status (according to BCTQ), and also mean VAS score significantly reduced after the intervention in both groups (P<0.001). The mean scores for these parameters were not significantly different between the two groups neither before nor after the treatment.

The results of treatment with minimal incision and double incision were not different, but minimal incision is suggested as a selective therapeutic approach due to smaller cut.

Currently, no potent tools are available to differentiate diagnose between patients with benign prostatic hyperplasia (BPH) and newly diagnosed prostate cancer patients (NDPCa) based on increased serum prostate-specific antigen (PSA) as the value may increase in both conditions. Therefore, finding new biomarkers is considered to be a major issue in this regard.

The present study aimed to differentiate BPH and NDPCa patients and evaluate serum and urine sarcosine levels as reliable markers.

This study was conducted on 67 patients with NDPCa and BPH and healthy controls. PSA evaluation was performed on all the patients, and the serum and urine levels of sarcosine were measured using the ELISA assay. In addition, the serum and urine sarcosine levels were assessed using the receiver operating characteristic (ROC) curve analysis.

The mean serum and urine sarcosine levels in the healthy controls were 3.0 ± 2.0 and 6.0 ± 2.0 ng/mL, respectively, while they were 9.0 ± 1.0 and 8.0 ± 1.0 ng/mL in the patients with BPH, respectively. The serum and urine sarcosine levels in the patients with NDPCa were 21.02 ± 2.0 and 15.0 ± 2.0 ng/mL, respectively. Significant differences were observed in the serum and urine sarcosine between the patients with BPH and NDPCa (P < 0.001). In addition, the serum sarcosine content increased in the patients with NDPCa and BPH compared to the healthy controls. The serum and urine levels of sarcosine had the following order: healthy controls < patients with BPH<patients with NDPCa.

According to the results, the serum and urine sarcosine contents might provide beneficial evidence for PCA diagnosis, while differentiating the patients with BPH and NDPCa. Furthermore, sarcosine levels may be valuable markers for PCA with clinical significance compared to PSA

The superiority of TG/HDL-C and LDL-C/HDL-C ratios in predicting  CVD risk is a matter of debates. Thus, the objective of this study was to compare TG/HDL-C and LDL-C to HDL-C ratios in predicting the risk of CVD events.

In a population-based cross-sectional study, 567 representative participants aged 40 years or older were entered in the study in Babol, North of Iran. The demographic data, anthropometric measures, and the cardio metabolic risk factors were measured. The individual risk of CVD events was assessed by ACC/AHA risk model. ROC analysis was applied to estimate the diagnostic accuracy and the optimal cut-off points of TG/HDL-C and LDL-C/HDL-C ratios.

The AUC of TG/HDL-C and LDL-C/HDL-C ratios were rather similar and both parameters significantly predicted CVD risk in men comparably, and TG/HDL-C at optimal cutoff point of 3.6 produced 75% sensitivity and 39% specificity. However,in women TG/HDL-C with AUC of 0.65( p= 0.091) at optimal cutoff value of 3.4  produced a sensitivity of 82% and specificity of 51%. The LDL-C/HDL-C ratio had no discriminative ability in predicting CVD risk in women.
The adjusted OR of TG/HDL-C at 2nd quartile was significant (OR=3.22, 95%CI:1.25-8.29) and a greater association was found with 3rd and 4rth quartiles

Both TG/HDL–C and LDL-C/HDL-C ratios comparably predict CVD risk in men, whereas in women only TG/ HDL-C is a significant predictor but not LDL-C/HDL-C.

Several factors contribute to the effectiveness of phototherapy. The aim of this study was to compare the effect of kangaroo mother care (KMC) and field massage on bilirubin level of term neonates with hyperbilirubinemia under phototherapy in the neonatal ward.

This double-blind clinical trial was performed on 90 term neonates aged 48 hours with hyperbilirubinemia, hospitalized in Fereydunkenar Hospital during 2018-2019. The infants were randomly divided into 3 groups of massage with phototherapy, KMC with phototherapy and control (received conventional phototherapy without KMC and massage). The massage group used field technique for three 15-minutes in 3 days and the KMC group received KMC for five 30 minutes in 3 days as well. In three groups, the serum bilirubin levels were compared at baseline, 24, 48, 72 hours after the onset and at the end of phototherapy. Moreover, the mean duration of phototherapy and hospitalization was compared during the treatment.

Serum bilirubin levels at baseline in the control, field massage and KMC groups were (17±1.38, 17.01±1.46 and 16.97±1.27mg/dl) and at the end of phototherapy were (6.97±0.47, 5.56±0.48 and 5.91±0.52 mg/dl) respectively. There was a significant difference between the intervention and control groups (p<0.001). The mean duration of phototherapy and hospitalization had no significant difference between two intervention groups (p>0.001), but it was significantly higher in control group than intervention groups (p<0.001).

The use of massage or KMC with phototherapy, compared to the phototherapy alone, can reduce the bilirubin level, phototherapy duration and hospital stay.

Iron overload is one of the medical problems in some diseases. Recent reports have indicated a need for iron chelator. In this study, the possible iron chelating properties of aqueous extracts of A.graveolens, Urtica dioica and milk thistle on total iron binding capacity, iron and ferritin levels in iron overloaded rats were investigated.

Fresh A.graveolens and Urtica dioica leaves and milk thistle seeds were obtained from the local market. Fortyeight male rats were randomly divided into six groups: negative control (normal), positive control (iron overload) and groups treated with deferoxamine (DFO), aqueous extracts of A.graveolens, Urtica dioica and milk thistle. Iron dextran was injected intraperitoneally (i.p.) at 50mg/kg body weight/day to establish the iron overload for twelve weeks. Normal group rats received normal saline, while the rats of the treated groups received (orally) aqueous extracts of A.graveolens, Urtica dioica and Milk thistle and DFO daily for eight weeks. Changes in biochemical factors were measured at the end of the experiment.

After twelve weeks of iron dextran treatment, we found a significant increase in iron and ferritin levels and a decrease in total iron binding capacity (TIBC) level compared to normal group (229.0±5.85, 181.22±5.53 and 200.54 ±1.51 vs. 131.90±6.85, 50.25 ±4.01 and 291.71, respectively). After eight weeks of treatment with extracts and DFO, there was significant reduction in serum iron level of extracts of A.graveolens, Urtica dioica and milk thistle and DFO treated groups compared to iron overloaded group (185.81±3.5, 180.88±2.73, 200.6±2.44, 176.48 ±2.29 vs. 229.0±85.5). Also, there was a significant increase in serum TIBC level in the extracts of A.graveolens, Urtica dioica and milk thistle and DFO treated groups compared to iron‑overloaded rats (218.62±2.44, 226.74±2.71, 211.06±1.86, 231.57 ±2.05 vs. 200.54±1.51, respectively). Furthermore, there was a significant reduction in serum ferritin level in the extracts of A.graveolens, Urtica dioica and milk thistle and DFO treated groups compared to iron‑overloaded rats (130.49±4.24, 121.96±4.31, 140.63±3.82, 112.87 ±4.60 vs.181.22±5.53). So after eight weeks treatment with aqueous extracts of A.graveolens, Urtica dioica and milk thistle, we found a significant reduction in iron and ferritin and an increase in TIBC level. These effects indicated the following hierarchy: Urticadioica >Anethum graveolens > milk thistle.

Anethum graveolens, Urtica dioica and milk thistle extracts may be a potential herbal plant to reduce liver damage caused by iron overload. These results indicated that Anethum graveolens, Urtica dioica and milk thistle extracts can preserve liver function.

Current literature has been focused on types of obesity with normal BMI (body mass index), but metabolically unhealthy.This study evaluates the prevalence of metabolical phenotypes of obesity. We also identified the best obesity index in predicting the components of metabolic syndrome (MetS).
A cross-sectional study has been conducted on 164 women over 60 years. Anthropometric parameters, body fat percentage (%BF), and biologic criteria were measured to assess the types of obesity. Unhealthy metabolic was defined by modified Adult Treatment Panel III, and obesity based on BMI≥25.ANOVA and logistic regression were utilized for the association of MetS components and obesity phenotypes, and linear regression logistic for finding the best MetS related obesity index.
The prevalence of metabolically unhealthy was 45.7%, out of which 33.3% was among the individuals with normal BMI.Logistic regression has shown that triglyceride (TG) (OR=3.30, p There is a high prevalence of unhealthy metabolic among the elderly women,even with normal weight.There were different associations between MetS components and various obesity phenotypes.TG was the most powerful indicator for the prognosis of unhealthy metabolic phenotypes which was independently correlated with the WC, %BF and BMI.

Cytomegalovirus (CMV) infection is one of the most common infectious diseases in pregnant women in terms of global impact and is related with many adverse health consequences during pregnancy. For the first time, we performed a systematic review and meta-analysis study to evaluate the possible association between CMV infection and preeclampsia (PE).
A comprehensive literature search to identify the relevant papers published earlier than February 2018 was performed in PubMed, ISI (Web of Science), Google Scholar and SCOPUS databases. We followed the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines for design, analysis and interpretation of results. Pooled odds ratio (OR) and 95% confidence intervals (CI) were estimated using a random-effects meta-analysis model. Heterogeneity was assessed with Q-test and I2 statistics.
A total of 13 studies including 6158 pregnant women (2734 women with PE and 3424 healthy controls) met the eligibility criteria. The results of meta-analyses based on PCR (OR: 3.09; 95% CI:0.72–13.24; I2=57.3%), IgG-ELISA (OR: 1.24; 95% CI:0.83–1.85; I2=71%) and IgM-ELISA (OR: 1.04; 95% CI:0.66–1.65; I2=0.0%) demonstrated that CMV infection could not be a potential risk factor for PE.
In conclusion, results of the present study demonstrated that CMV infection could not be a potential risk for developing PE. More epidemiological and experimental studies are needed to investigate the impact of CMV infection on the development of PE.

The aim of this study was to explore the underlying latent factors that can explain the observed variation of components of metabolic syndrome (MetS) in Iranian non-diabetic adult population.
The researchers performed an exploratory factor analysis (EFA) of metabolic syndrome components, including body mass index (BMI), waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), triglyceride (TG), high density lipoprotein (HDL), and Fasting blood sugar (FBS). These observed variables were measured from a representative sample of 841 non-diabetic participants in a cross-sectional population-based study of adults aged 20 to 70 years in the North of Iran.
Three factors were extracted by EFA in both genders. In males, the 3 generated factors were, 1) blood pressure factor underlying systolic and diastolic blood pressure, 2) obesity factor manifested by BMI and WC, 3) lipid/glucose factor underlying TG, HDL and FBS that explained 23.9%, 23.0% and 18.4% of variance in the observed data, respectively, in males. However, in females, BMI and WC were revealed as obesity factors, and systolic and diastolic blood pressure were characterized as hypertension factor, and TG, HDL and FBS appeared to be loaded on lipid/glucose factor, similar to males, and designated 25.6%, 25.4%, and 15.8% of the variance, respectively. Triglyceride and FBS were positively loaded, whereas HDL was loaded negatively with similar loading pattern in both genders. Overall, these 3 underlying latent factors explained 65.3% of the variance of observed clinical data sets in males and 66.8% in females. When TG and HDL were replaced by TG to HDL ratio and also SBP and DBP by mean arterial pressure (MAP), the two-factor model was generated in both genders.
The 2-and 3-factor models were characterized indicating a single pathogenesis that could not explain the unified clustering of MetS in non-diabetic adults.

This study aimed at evaluating oxidant and antioxidant markers (including nitrite, nitrate, total antioxidant capacity (TAC), malondialdehyde (MDA), iron, selenium, glutathione peroxidase (GPx), and glutathione reductase (GR) in patients with inflammatory bowel disease (IBD) and compare them with healthy controls.
Serum samples were obtained from 35 patients (19 ulcerative colitis (UC) and 16 Crohn’s disease (CD) in the active phase of the disease) and 30 healthy controls. Serum levels of nitrite and nitrate, TAC, MDA, iron, selenium, glutathione peroxidase, and glutathione reductase were measured. The results were compared between the two groups using independent t-student test. The Pearson’s correlation coefficient (for continuous data) was performed using the SPSS software.
Serum levels of nitrite, nitrate, and MDA were significantly higher (P = 0.001) in patients with IBD, while the levels of TAC, trace elements, glutathione peroxidase (GPx), and Glutathione Reductase (GR) levels were lower (P There is an imbalance between oxidant and antioxidant properties in patients with IBD, which highlights the role of oxidative stress in the pathogenesis of this disease.

The low density lipoprotein cholestrol (LDL-C) has an important role in the pathogenesis of cardiovascular disease but its association and predictive accuracy with metabolic syndrome (MetS) remains controversial. The objective of this study was to investigate the association and predictive ability of LDL-C with MetS.
We analyzed the data from a population-based cross-sectional study conducted on representative samples of an Iranian adult population. The demographic data, anthropometric measures and the lipid profiles were measured with standard methods, and MetS was diagnosed by ATP III criteria. Logistic regression model and ROC analysis were used to estimate the predictive accuracy of LDL-C and its association with MetS.
The mean age (±SD) of participants with and without MetS was 47.6±12.5 years and 39.1±12.9 years, respectively (p=0.001). All anthropometric measures (body mass index, waist circumference, waist to hip ratio, waist to height ratio), systolic blood pressure, total cholesterol, triglycerides and fasting blood glucose were significantly higher in MetS, but a significantly higher difference in LDL-C was observed only in women. Accuracy of LDL-C in predicting MetS for men and women was 0.48 (95% CI: 0.43-0.54) and 0.55 (95% CI: 0.51-0.60), respectively. The unadjusted and adjusted odds ratios of different quartiles of LDL-C compared with 1st quartile did not reach to a significant level.
Serum LDL-C level is not significantly associated with MetS but exhibits a weak ability in predicting MetS in women.