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Weight regain following bariatric surgery is a significant challenge for this obesity treatment method. This study aimed to identify factors associated with weight regain after bariatric surgeries in obese patients in Gorgan, Iran.

This longitudinal study included 143 obese individuals (125 women and 18 men) with a mean age of 43.13±9.83 years who underwent bariatric surgery in Gorgan, Iran during 2013-19. Participants were invited to join the study via phone calls. Research variables (type of surgery, blood group, pre-surgery weight, and body mass index [BMI]) were extracted from patient records, and their current weight and waist circumference were measured and recorded. Weight regain was determined based on one of three different criteria: (1) regaining more than 25% of the maximum weight lost post-surgery, (2) regaining more than 10 kg from the minimum weight post-surgery, or (3) an increase of more than 5 BMI units from the lowest BMI post-surgery.

Overall, 33% of individuals experienced weight regain, with 26.6% according to the first definition, 29.4% according to the second definition, and 18.2% according to the third definition. Men had a higher rate of weight regain (P<0.05). Additionally, 93.6% (44 cases) of those with weight regain had abdominal obesity. On average, 79.7% of participants who were 48 months post-bariatric surgery experienced some degree of weight regain. Individuals with a pre-surgery BMI of 50 or higher had a 2.69 times greater chance of weight regain compared to those with BMI lower 50 (P<0.05). The mean weight loss after surgery was significantly higher in individuals who experienced weight regain than those who did not (P<0.05). There was no significant statistical association between weight regain and the type of surgery, age, education level, marital status, or blood group.

Weight regain over time is a reality after bariatric surgery, indicating that this method is not a definitive cure for obesity. Therefore, long-term follow-up for weight control is crucial, especially for individuals with a pre-surgery BMI of 50 or higher or those who experienced significant weight loss post-surgery.

 Okra (Abelmoschus esculentus) has garnered scientific attention for its beneficial effects on various chronic disorders, including type 2 diabetes mellitus.

 The current study was designed and conducted to assess the influence of whole okra fruit powder on the serum levels of specific biochemical parameters in individuals with pre-diabetes.

 Seventy pre-diabetic patients, aged 30 - 55 years, were divided into two groups: The okra group (n = 35, fasting plasma glucose: 116.26 ± 6.02) and the placebo group (n = 35, fasting plasma glucose: 112.26 ± 5.8). The okra group received 3000 mg of okra capsules daily for eight weeks, while the placebo group received placebo capsules. Liver function, renal markers, and lipid profiles were assessed at both the baseline and the end of the experiment using a spectrophotometer. The impact of the okra intervention on biochemical parameters was determined using parametric or non-parametric analysis of covariance (ANCOVA).

 The serum levels of total cholesterol, low-density lipoprotein cholesterol, liver transaminases, and uric acid were significantly lower in the okra group compared to the placebo group. Conversely, the high-density lipoprotein cholesterol levels were significantly higher in the okra group than in the placebo group. However, there were no statistically significant differences between the two groups regarding triglycerides, creatinine, blood urea nitrogen, and alkaline phosphatase levels.

 The consumption of okra effectively improved the lipid profile and certain serum parameters (alanine transaminase, aspartate transaminase, and uric acid) related to liver and kidney health in pre-diabetic participants.

cactus pear (Opuntia stricta) is known as a source of polysaccharide compounds (mucilage) that can trap water by the three-dimensional network. Hydrogels are three-dimensional polymer networks with cross-links that can absorb large amounts of water. In recent years, the use of these compounds as a thickening or gelling agent has increased. In these systems, whey protein hydrogel due to its high nutritional value, good functional properties, and biocompatibility has attracted the attention of the food industry. In this study, the production of new hydrogels (hybrid hydrogels) in combination with a polysaccharide component for improving the functional properties of whey protein was investigated. The purpose of this study was to evaluate the behavior of Whey Protein Isolated-Opuntia hybrid hydrogels in terms of rheological behavior and textural properties as a subordinate of protein and polysaccharide concentrations.

Opuntia fruit powder was prepared from the fruit pulp by a hot air dryer. To prepare the main/final mixture of the hydrogel, two hydrogel bases including Opuntia pulp hydrogel (Op) (20% w/w) and whey protein isolate hydrogel (W) (15% w/w) were mixed in different ratios (W/Op: 80-20, 70-30, 60-40, 50-50) by an electric mixer at low speed for 1 minute. Finally, textural properties including (viscosity, consistency, hardness, adhesiveness), water holding capacity, swelling ratio, and rheological properties were tested. Data were analyzed using SAS software and the mean values were compared using Duncan's multiple range test at the 5% level.

Increasing ratio of Opuntia hydrogel to Whey protein hydrogel caused a significant increase in Viscosity, Consistency, Hardness, and Adhesiveness of hybrid hydrogels (W-Op H) compared to protein control (Whey protein) (p≤0.05). Also, Water Holding Capacity and Swelling ratio increased with increasing the ratio of Opuntia hydrogel in the samples (p≤0.05). Opuntia and Whey Protein Isolate hydrogel had the highest (694.71± 42.89 %) and lowest (340.22 ± 7.19 %) swelling ratios among the other samples, respectively. On the other hand, the addition of Opuntia hydrogel to Whey Protein Isolate hydrogel enhanced the viscoelastic behavior of the mixture, so that with increasing Opuntia hydrogel ratio, the storage and loss modulus was increased. The loss factor of hydrogel samples was between 0.24-0.36, which can be obtained as semi-gel material and the elastic behavior was more dominant than the viscose behavior.

hybrid hydrogel (W/Op: 60-40) due to its highest viscosity, maximum water holding capacity, and swelling ratio, as well as the presence of appropriate rheological behavior, was suggested as the best sample for thickening agent and texture improvement in food products such as ice cream, sauces, meat products, dairy products, Tofu, Noodles, etc.

Hemoptysis is defined as the expectoration of blood from the lower respiratory tract. Bronchiolitis, bronchogenic carcinoma, and bronchiectasis are the most common causes of hemoptysis in developed countries, while infections caused by Mycobacterium tuberculosis are the most common cause in endemic countries. This study was conducted to determine the frequency of causes of hemoptysis and some related factors.

This descriptive-analytical study was done on 68 patients (37 men and 31 women, average age 56.85±17.27 years) who were referred to the Shahid Sayyad Shirazi Hospital in Gorgan, north of Iran during 2014-16 with the complaint of hemoptysis. Demographic information, cause of hemoptysis and history of illness or drug abuse were extracted from the patients’ records.

Based on the results, 42.6%, 45.6%, and 17.6% of the patients had a history of smoking, drug abuse, and diabetes, respectively. The most frequent causes of hemoptysis were bronchiectasis (25%), pneumonia (20.6%), tuberculosis, and lung cancer (16.4%). Gender was determined as an independent risk factor for hemoptysis (P<0.05). The most common causes of hemoptysis were bronchiectasis, lung cancer and pneumonia in men, and tuberculosis and bronchiectasis in women. Age, drug abuse, smoking, and diabetes had no significant association with the occurrence of hemoptysis.

Bronchiectasis, tuberculosis, and lung cancer are the main causes of hemoptysis, and gender is an independent risk factor for hemoptysis in the study area.

Diabetes is one of the most common non-communicable diseases with debilitating complications and mortality rate those results from insulin deficiency, resistance to it or both. The role of nutrition and some micronutrients in the development and progression of diabetes has been investigated. Studies have shown that Magnesium deficiency can reduce insulin secretion and cell resistance. This study was done to determine the association of serum Magnesium level with glycemic control, serum lipids and renal function in type 2 diabetes mellitus and pre-diabetic patients.

This case-control study was done on 70 patients with type 2 diabetes, pre-diabetes and 35 healthy individuals. Fasting glucose, HbA1c, lipid profile, creatinine and Magnesium were determined.

Serum Magnesium level in diabetic and pre-diabetic patients were significantly lower than control group (P<0.05). Serum Magnesium level had reverses correlation with HbA1c in diabetic patients. Serum Magnesium level had reverse correlation with glycemic index (FBS, 2hpp) and creatinine in control group (P<0.05) were evaluated in all groups but there was no significant correlation between Renal function test (Cr, eGFR) and serum Mg level.

Serum Magnesium levels in diabetics and pre-diabetics were lower than healthy individuals and had reverse correlation with HbA1c in diabetic patients.

Type 2 diabetes mellitus (T2DM) is a common metabolic disorder. In traditional medicine, camel milk has been used in the treatment of some of diseases such as diabetes. The studies on effect of camel milk on glycemic control are limited and contradictory.

The effect of camel milk on blood glucose and lipids in T2DM patients and compare it with the control group. Setting and Design: This case-controlled clinical trial study was performed in the endocrinology clinic in Iran.

50 patients with T2DM were allocated into two groups. 25 participants in the intervention group consumed 500 ml camel milk and 25 participants in the control group consumed 500 ml cow milk daily for 8 weeks. Weight, fasting blood sugar (FBS), total cholesterol (TC), and triglyceride (TG) were measured at the baseline and end of intervention. Statistical Analysis Used: Data were analyzed using SPSS v.16, independent t-test and analysis of covariance.

Mean of glycosylated hemoglobin (HbA1c) and TG concentration was significantly decreased in the camel milk group at the end of the study (P < 0.05). There was an increase in HbA1c in the cow’s milk group, while the TG was not changed in this group. No significant differences were shown in weight, FBS, and TC at the end of the study in comparison with baseline values in any of the two groups.

Camel milk can improve glycemic control according to HbA1c index. It might contribute to decreasing TG level in patients with T2DM.

Acute diarrhea is one of the most important health issues in developing countries. Yogurt drink (Dough) is used in home remedies and some medical advice as a useful ingredient in treating dehydration and diarrhea; but no controlled studies have been conducted in this regard. The aim of this study was to compare the effect of fluid therapy along with dough or yogurt in the treatment of acute diarrhea in children.

In this randomized clinical trial study, 210 children aged 1-5 years with acute diarrhea, who were admitted to Taleghani hospital in Gorgan, Iran, were entered. The first group received low-fat yogurt, and the second group received dough, which the volume was three times the volume of yogurt in the first group. The third group was control group. Standard fluid therapy groups had done for all patients. Decrease in diarrhea frequency and hospitalization in these three groups were compared.

The highest reduction in diarrhea was in yogurt group with an average of 6.144, and the lowest in dough group with a mean of 5.344 (P = 0.108). After controlling the effect of the severity of the disease, the dough-receiving group had the longest hospitalization time, and this difference was significant.

The results of this study showed that the use of dough and yogurt, along with fluid therapy, did not reduce the frequency of acute diarrhea and duration of admission in children under five years of age. Further research with higher sample sizes and the implicating probiotic drinks along with dough seems necessary. Due to the small number of studies in this issue and the result of the present study, at present dough cannot be recommended as an effective agent in the treatment of diarrhea.

For many reasons, having children with the desired gender has long been a concern for human societies. Some studies have shown the effect of a maternal diet pregnancy on gender ratios. Considering that during the holy month of Ramadan, women's diet is undergoing a major change, and studies about the association of such diet change, especially the mother's fasting, on the gender of the fetus are rare and the results have contradictory; the present study, was conducted, to investigate the relationship of mother's fasting in the follicular phase of the last menstrual cycle and gender of newborn. This descriptive - analytical study was conducted on 139 pregnant women who had started their last menstrual period before their pregnancy during Ramadan and referred to midwifery clinic of Sayyad Shirazi hospital or health centers in Gorgan city for prenatal care in 2016 and 2017. The data collection tool was a checklist containing the demographic characteristics of the pregnant mother, date of the last menstruation, gestational age, number of pregnancy and days of mother fasting. 86 pregnant women (62 %) were fasting and 53 non-fasting (38%). Frequency of newborn's gender in pregnant women who were fasting was 43 boys and 43 girls and in non-fasting women were 35 and 18, respectively. The frequency of boys in non-fasting mothers was higher than girls but this difference was not significant. In analysis of simultaneous effects of variables on baby's gender, none of the variables were statistically significant with the newborn's gender. Variables such as the number of pregnancies (P=0.051) and maternal fasting (P=0.083) non significantly reduced the ratio of boy born to 30%. There is no relationship between gender of babies and mother's fasting in the follicular phase of the last menstrual cycle.

Preeclampsia is the most common cause of prenatal and maternal mortality in the world. It is also the second most common cause of maternal death in Iran. Deficiency of some trace elements such as zinc, calcium and magnesium in pregnant women may be involved in preeclampsia. The aim of this study was to measure serum and urinary levels of zinc, calcium and magnesium in healthy pregnant women and those with preeclampsia.
In this cross-sectional study, we recruited 100 pregnant women (second trimester) who were referred to the gynecology clinic of 5th Azar hospital in Gorgan (Iran) during 2014-15. The subjects were assigned into a preeclampsia group (N=50) and an age-matched healthy control group (N=50). Serum and urinary levels of zinc, calcium and magnesium were measured by enzymatic method. Data were analyzed by SPSS (version 19) using t-test and chi-square test. P-values less than 0.05 were considered as statistically significant.
Mean serum concentration of calcium in the preeclampsia group (8.17± 0.64mg/dl) was significantly lower than that in the control group (8.70±0.40mg/dl). However, the mean urinary level of calcium in the preeclampsia group (222.33± 19.35mg/dl) was significantly higher than that in the control group (158.61± 40.16 mg/dl). Mean urinary level of zinc in the preeclampsia group was significantly lower than that in the control group. No significant difference was found between serum concentrations of zinc and magnesium in the preeclampsia and control group.

Osteoporosis is a common disease in Iran, which is associated with insufficient intake of vitamin D and calcium. Therefore, this study aimed to compare consumption of dietary supplements between healthy individuals and patients with osteoporosis referred to bone densitometry centers in Gorgan, north of Iran.
This case-control study was conducted on women aged over 55 years who were at least 5 years postmenopausal. Overall, two groups of 130 subjects were enrolled via convenience sampling at 95% confidence interval. The subjects were divided into two groups of healthy individuals and patients with osteoporosis using Hologic QDR 4500 Elite Bone Densitometers and T-scores (-2.5: osteoporosis, above 1: normal). Anthropometric measurements (height, weight and waist circumference), and amount of dietary intake of calcium, vitamin D, vitamin E and multivitamins supplements were recorded by trained experts. Data collected were analyzed using SPSS software (version 16).
Healthy subjects consumed significantly higher amount of calcium supplement (18.5%) compared to subjects with osteoporosis (P = 0.001). Intake of vitamin D supplement was significantly higher (23.3%) in healthy subjects compared to patients (P = 0.003). Intake of vitamin E supplement and multivitamin was slightly higher in healthy subjects, but the difference was not statistically significant.
At least half and two-thirds of individuals aged over 55 years take vitamin D and calcium supplements, respectively. Intake of calcium and vitamin D is significantly higher in healthy individuals compared to those with osteoporosis.

Selenium (Se) is a rare element with well-demonstrated anti-oxidative effects that acts as an enzyme co-factor in physiological interactions. Low plasma Se level and malnutrition in hemodialysis (HD) patients could increase the risk of morbidity and mortality among these patients. Moreover, Se deficiency leads to oxidative stress and inflammatory response. Therefore, this study aimed to determine the association of plasma Se levels with malnutrition and inflammatory markers in HD patients.
This cross-sectional study included 88 patients undergoing routine HD at dialysis unit of 5th Azar Hospital in Gorgan, northeastern Iran. In addition, 88 healthy individuals were selected from the patients’ families as controls. Level of Se, C-reactive protein (CRP), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG) and albumin were measured in the patients and controls by the atomic absorption method. Se levels were categorized into two groups of "over half-normalized" and "under half-normalized" for further analysis.
Hyposeleniemia was found in two patients (2.3%). The mean level of Se in HD patients was lower than in the healthy controls (P The mean plasma Se level of HD patients in this area is in the normal range. There is no association between plasma Se level and malnutrition. Based on our findings, hyposelenemia is not a problem in HD patients in the Golestan Province.

Ramadan is an Islamic month during which Muslims abstain from eating, drinking and smoking from dawn to sunset. Ramadan is a model of prolonged intermittent fasting. Previous studies have shown that fasting has beneficial effects on human health. However, the results of these studies have been inconsistent. The aim of present study was to investigate the effect of fasting during Ramadan on biochemical parameters and inflammatory markers.
This prospective observational study was conducted in July 2013. Thirty healthy men who were fasting during Ramadan were enrolled in the study. Anthropometric measurements were taken from each subject. Fasting venous blood samples were taken one week before Ramadan, during the last week of Ramadan and four weeks after Ramadan. Serum interleukin-6, high sensitivity C-reactive protein, fasting blood sugar (FBS), insulin, total cholesterol, triglycerides, low-density lipoprotein and high-density lipoprotein levels were measured.
No significant change was observed in serum total cholesterol, systolic and diastolic blood pressure, interleukin-6 and high sensitivity C-reactive protein. Fasting in Ramadan significantly decreased body mass index (P This study indicates that fasting during Ramadan has some positive effects on body mass index, serum triglycerides, high-density lipoprotein, FBS, insulin and HOMA index.

It is especially true that prevalence of overweight and obesity is increasing worldwide and it is probably because of changes in diet and physical behavior pattern..
The current study aimed to test the effect of weight loss program on overweight and obese females based on protection motivation theory..
A randomized clinical trial (RCT) was implemented in the form of single blind. In total, 150 females with overweight and obesity were randomly divided into three groups including: 1, standard program group; 2, motivation interviewing (MI) group and; 3, motivation interviewing (MI) and intention intervention (II) condition (50 subjects in each group). They participated in a randomized clinical trial, also attended a private nutrition clinic in Gorgan city (Golestan province, North of Iran) for the first time. A researcher-made questionnaire and participant’s sheets (including three days food recall and anthropometric traits) were used to collect data. Data were analyzed using SPSS (ver.11) and statistical tests including Kruskal-Wallis, One-way ANOVA, Friedman test, Tukey test, Paired T-test and linear regression model were employed..
The mean age of females was 38.45 ± 9.49 years, most of them had academic degree 46.7% (n = 70), 78.7% (n = 118) were married and 60.7% (n = 91) were housewives. ANOVA repeated measure test showed that daily energy intake decreased two (P = 0.001) and six months (P = 0.001), weight (P = 0.007) and body mass index (BMI) (0.005) after intervention. Threat appraisal statistically differed six months after intervention (P = 0.001)..
Motivational interviewing resulted in decreased daily energy intake, anthropometric characteristics as well as augmented scores of coping and threat appraisal..

The prevalence of overweight and obesity is on the increase the world over, which imposes an ever-increasing burden on societies and health care systems.. This study sought to investigate the effect of motivational interviewing (MI) on a weight-loss program based on the protection motivation theory (PMT)..Patients and This randomized clinical trial study, comprising pretest-posttest with a control group, was conducted on 150 overweight and obese women attending a private nutrition clinic for the first time. Samples were randomly selected using the clinic’s records and then allocated to three groups (50 women in each group) receiving: 1) a standard weight-control program; 2) motivational interviewing; and 3) MI plus intention intervention. Data were collected using a researcher-made questionnaire through in-person interviews and were analyzed using SPSS (version 11) and statistical tests, including the Kruskal-Wallis test, one-way analysis of variance, paired t-test, and linear regression model.. In the two intervention groups, the PMT construct scores, namely susceptibility (P = 0.001), severity (P = 0.001), rewards (P =0.004), self-efficacy (P = 0.001), response efficacy (P = 0.001), and costs (P = 0.014), were significantly increased compared to those in the control group. The anthropometric status was statistically significant in the MI group (P = 0.001) and the MI plus intention-intervention group (P = 0.001) at 2 months’ follow-up, while in the control group, weight was meaningfully different after the intervention (P = 0.027). Weight was different between the groups after the intervention, with the Tukey test demonstrating that the differences were statistically significant between the control group and the MI group.. Our results demonstrated that MI, combined with the implementation of intention intervention, increased weight loss and PMT construct scores in our study population..

The aim of the present study is assessment of insulin resistance (IR) in obese women by TyG-Index and compared with the HOMA-IR index. This cross-sectional study was performed on 61 obese women aged 18-45 years. Weights, height, waist circumference (WC) were measured and body mass index (BMI) was calculated and recorded. A sample of fasting serum was collected to determine the glucose, triglyceride, insulin, total cholesterol, HDL-C and LDL-C concentration. HOMA-IR and TyG-Index were calculated as markers of insulin resistance. The mean age of the precipitants was 32.5 ±0.79 years old and the mean weight was 86.0±1.7 Kg. The number of people with IR who determined by HOMA and TyG index were 21(34%) and 36(61%), respectively. There was a significant relationship between HOMA-IR and TyG Index, r= 0.044 (P<0.001). TyG index represents a useful and accessible tool for assessment of IR instead HOMA_IR in Iranian population, but more researches with greater sample size and via gold standard lab test need to evaluate the specificity and sensitivity of this new method.

Nutrition has an essential role in health promotion. In some diseases it has a serious impact on disease control. This effect implies the need to have basic knowledge about nutrition in health care providers. We assessed viewpoints of interns in Golestan University of Medical Sciences toward clinical application of nutrition education. This descriptive study was conducted on all (n=55) interns who spent the last academic year (September-December2012). Research measurement was a questionnaire (its validity and reliability was evaluated in previous studies) consisting of demographic and questions about proportion of time and existing chapters with clinical needs، their ability to provide counseling and need to adding proposed new chapters. A total of 46 questionnaires were returned. Data were analyzed through descriptive statistics. Among the 46 interns (37females،mean age25. 3±1)، application of nutrition education in clinical section in58. 7% was evaluated “poor and very poor”، 15. 2% of them considered “good” in their ability to assess patient’s nutritional status and 8. 7% in their ability to nutritional counseling. Over all 8. 7%assessed usefulness of their nutritional counseling advice “good and very good.” 82. 6% agreed with providing course on specific nutrition topics. All of them remarked the need for education in medical nutrition therapy in cardiovascular and renal diseases، 97. 6%in diabetes and post surgical situations and 95. 2%in infectious diseases. Based on these data، current curricular in medical schools is not adequate and need to revise. Our participantsidentified gaps in their nutrition knowledge and their need during clinical problems. We proposed a nutrition education program based on reported essential topics to improve their nutritional skills in clinic. By upgrading consultation skills in general practitioners، they can work better in future.

Obesity is a worldwide health problem, with increasing prevalence associated with an increased risk of chronic diseases. Decrease in energy intake has been shown to lower the risk of coronary artery disease (CAD) in obese. The common form of dietary restriction is daily calorie restriction (CR). Another form is alternate-day fasting (ADF). The ability of modified ADF to facilitate weight loss and lower cardiovascular risk factors has not been tested. This study examined the effects of combination CR and ADF in obese adults. 26 female obese inpatients completed a 4 week trial of controlled food intake during modified ADF period. All subjects consumed very low calorie diet on the fast day and then consumed diet including 1600 - 1700 Kcal in every other day. Body weight (BW) and blood pressure (BP) were measured daily. Fasting blood samples were collected at the first and 29th day of trial for biochemical analysis. During the course of the trial (4 wk), BW of the subjects decreased (P < 0.0001) from 96.87 ± 21.34 kg to 92.16 ± 19.85 kg. Mean BMI of the subjects at baseline was 37.38 ± 7.35 kg/m2, at the end of course decreased (P < 0.0001) to 35.56 ± 6.78 kg/m2. Systolic BP decreased (P < 0.0001) from 142 ± 13 to 122 ± 12mm Hg. Total cholesterol decreased (P < 0.0001) from 6.12 ± 1.1 to 5.42 ± 1 mmol/L, LDL (P <0.0001) from 3.99 ± 0.96 to 3.34 ± 0.87 mmol/L, fasting blood sugar (P < 0.0001) from 5.87 ± 1 to 5.23 ± 0.9 mmol/L, whereas change in triacylglycerol concentrations was not significant, HDL decreased (P < 0.005) from 1.43 ± 0.38 to 1.3 ± 0.31 mmol/L. These findings suggest that short time CR plus ADF is a viable dietary option to help obese individuals lose weight and decrease systemic blood pressure and some CAD risk factors. More and longer-term studies in human subjects are needed to support this important result.