zeinab ghorbani

Hypertension (HTN) has become the costliest public health problem. After performing educational interventions, blood pressure (BP) of patients with this disease can be significantly reduced. The adaptation of the educational method to the individual learning style can be more effective on the patients' learning and thus better control of their BP with better educational effectiveness. The aim of this study was to compareeducating based on visual, aural, reading/writing, and kinesthetic (VARK) learning style versus lecture method on BP level of patients with primary HTN.

This study wasa semi-experimental and pretest-posttest study conducted on patients with primary HTN referred to the comprehensive health service centers in Bandar Abbas, Iran, from January 2019 to December 2019. 88 patients were selected by convenience sampling method and divided into two groups of education based on VARK learning style and lecture. The training sessions were presented for the members of education based on VARK learning style group based on their learning style and as a presentation for lecture group. Patients' BP was measured before and after the intervention as a measure of the effectiveness of training on patients' learning. Data analysis was done by SPSS statistical software and using descriptive indices, chi-square test, t-test, Mann-Whitney, pairedt, and Wilcoxon test.

Before the intervention, there was no significant difference between the average systolic BP (SBP) and diastolic BP (DBP) of the two groups (P<0.05). After the intervention, the difference between the average SBP and DBP before and after the intervention between the two groups was not significant (P >0.05).

Education based on VARK learning style does not have more effect in reducingSBP and DBP of patients than lecture method.

The B vitamins can potentially help prevent migraine. This study was designed to examine the effects of supplementation with thiamine (B1), pyridoxine (B6), cobalamin (B12), folic acid (B9), and a combination of these vitamins on women with episodic migraine (EM). This study was a double-blind, placebo-controlled, randomized, clinical trial conducted on 120 women with EM. The participants were divided into the 6 groups of B1 (n = 20), B6 (n = 20), B12 (n = 20), B9 (n = 20), vitamin B complex (n = 20), and placebo (n = 20). Subjects received 1 capsule daily for 12 weeks. As part of the baseline and post-intervention phases, paper-based headache diaries were used to record the number of abortive drugs consumed and the frequency of headache attacks, and the Migraine Disability Assessment Questionnaire (MIDAS) was used to assess migraine disability. A 16-week study on women with EM revealed that the mean changes in the frequency of headache attacks decreased significantly in all vitamin groups in comparison with the placebo group (P < 0.001). In contrast to the placebo, there was also a significant improvement in the migraine disability score in each vitamin group (P < 0.001). The 12-week supplementation with vitamins B9, B1, B6, B12, and B complex also brought on a significant decrease in the use of abortive drugs compared to the placebo group (P = 0.032). The results of this study showed that B1, B6, B12, and B9, and a combination of these vitamins could be effective as an adjuvant in treatment and prophylaxis of EM. Further large trials with long-term follow-ups will be required to confirm our results.

Hypertension has been a global public health crisis. Complications of hypertension can be reduced by educating patients. Consideration of the learning styles of patients is important for effective education. The aim of this study was to determine effects of self-care training based on visual, aural, reading/writing, and kinesthetic (VARK) learning style preference on blood pressure of hypertensive patients.

This semi-experimental study was conducted in Bandar Abbas, South of Iran in 2019. Forty-four eligible patients who were referred to six comprehensive health centers in Bandar Abbas were selected by convenience sampling and then allocated into four visual, aural, reading/writing, and kinesthetic groups based on the results of the VARK learning style questionnaire.Educational interventions were performed according to patients' learning style preference in four sessions. To evaluate effectiveness of the training, patients' blood pressure was measured before the intervention and two months after the intervention. Data were analyzed with SPSS 16 software using paired t-test, Wilcoxon test, and one-way analysis.

After the educational intervention, a statistically significant difference was observed in the mean systolic and diastolic blood pressures of all patients (P<0.001). After the intervention, the mean systolic blood pressure did not change significantly in the kinesthetic group (P>0.05) but decreased significantly in other groups (P<0.05). In addition, the mean diastolic blood pressure decreased significantly after the intervention in all study groups (P<0.05).

Providing education based on the preferred learning style can be an effective way to educate patients with hypertension in comprehensive health care centers across the country.

Despite extensive research, the exact molecular mechanisms underlying migraine development and especially its progression and transformation from episodic into chronic is still unknown.

This study aimed to assess the role of somatosensory cortex and hippocampal transient receptor potential vanilloid 1 (TRPV1) in migraine in a rat model.

Adult male Wistar rats were divided into three groups, including sham, episodic migraine (EM), and chronic migraine (CM). The sham group received normal intraperitoneal (IP) saline injections every two days for 11 days, and the EM group received a single dose of trinitroglycerin (TNG) injection (IP; 10 mg/kg). For the CM group, TNG was administrated every two days (on days 3, 5, 7, 9, and 11; IP; 10 mg/kg). TRPV1 levels in plasma, somatosensory cortex, and hippocampus were detected with an enzyme-linked immunosorbent assay (ELISA) kit.

The findings showed that in both CM and EM groups the TRPV1 levels in plasma (P < 0.001 in both groups), somatosensory cortex (P < 0.05 and P < 0.001, respectively), and hippocampus (P < 0.01 in both groups) increased after migraine induction. Interestingly, in the somatosensory cortex, this TRPV1 elevation in the CM group was much greater than the EM group, and a significant difference was observed between the two groups (P < 0.05).

Our results suggested that headache severity and frequency may enhance concomitant with the upregulation of somatosensory cortex TRPV1. This new achievement can help to develop new drug approaches to prevent CM.

The environmental risk factors of neuromyelitis optica spectrum disorder (NMOSD) are not fully specified.Regarding the evidence on the possible protective effects of whole grains and legumes against inflammatory disorders, we examined the association between the mentioned dietary components and NMOSD. 70 patients with NMOSD with definite diagnosis and 164 hospital-based controls were included in this case-control investigation. Data on demographic, clinical, and anthropometric characteristics were collected. Dietary habits of participants were assessed using a previously validated food frequency questionnaire (FFQ) containing 168 food items. Daily intakes of whole grains and legumes were calculated and classified in quartiles. The odds of suffering from NMOSD according to the quartiles of whole grains and legumes were measured in the form of logistic regression models. The mean amount of whole grains (115.29 vs. 44.14 g) and legumes (59.43 vs. 34.50 g) consumption was significantly higher in the control group versus the case group. There was a reverse association between whole grains or legumes and NMOSD odds in both models [P < 0.05, odds ratio (OR) < 1]. In the fully-adjusted model, 90% [95% confidence interval  (CI): 0.02-0.39] and 92% (95% CI: 0.01-0.52) reduction in NMOSD odds was observed in the third and fourth quartiles of whole grains intake, respectively. Higher intake of legumes in the third and fourth quartiles led to 81% (95% CI: 0.05-0.71) and 95% (95% CI: 0.01-0.27) reduction in the odds of NMOSD, respectively. Aligned with the results of other investigations on inflammatory disorders, our results suggested a negative association between whole grains and legumes and NMOSD odds.

Migraine is recognized as a disease with unknown etiology andvarious pathophysiologic pathways which are not fully understood. Due to the relation between dairy intake and various chronic conditions in children and also the paucity of data on the probable role of dairy intake on pediatrics’ odds of having migraine, this study
was designed.

The present study was a population-based case-control design that was accomplished in a tertiary headache clinic.290 child (aged from7 to 14 years old) was included in this study. A definite diagnosis of migraine was performed by a neurologist; concerning the 2018 international classification of headache disorder 3 (ICHD3) criteria. Also, demographic and anthropometric characteristics were obtained. In addition, the usual dietary intake of participants was evaluated using a validated semi-quantitative food frequency questionnaire (FFQ).

Those children in the case group significantly had higher age and BMI means (P.value:0.000). In the second regression model, odds of migraine were 48% (OR: 0.52; 95%CI:0.27-1.00) diminished in the second tertile and 53% (OR:0.47;95%CI:0.24-0.92) in the third tertile of low-fat dairy intake (P-trend:0.03). In the fully adjustedmodel, the achieved migraine ORs were as followings:0.48 (95% CI:0.240.95) in the second tertile and 0.46 (95% CI:0.21-0.96) in the third tertile (P-trend:0.04), respectively. Children with more high fat dairy intake also consumed higher amounts of energy, pastries, simple sugar, unhealthy snacks, and hydrogenated oil (P<0.05).

This study results proposed that a greater amount of lowfat dairy intake may attenuate the odds of having migraine attacks in pediatrics and adolescents who might be at risk of headache, which can be attributed to the micronutrient and also to the bioactive content of these dietary components.

Hypertension is one of the leading causes of death in the world. Some more effective management of this disease can be achieved by making changes in the lifestyles of patients by self-care education. It is important to use new educational methods to better influence education on people's learning. Therefore, the aim of this study was to investigate the effect of using educational tools appropriate to learning style during self-care training on the lifestyle of hypertensive patients.

This quasi-experimental study was performed on 44 patients with hypertension who were divided into four groups of visual, auditory, reading/writing and kinesthetic based on their answers to the VARK learning style questionnaire. Patients' self-care training was conducted in the form of four 60-minute sessions based on the learning style of each group. Before and two months after the intervention, the LSQ lifestyle questionnaire was completed by all patients, and finally, data were analyzed using SPSS ver.21.

According to the results of the present study, the mean score of lifestyle dimensions of all research units at all stages of lifestyle increased significantly after the educational intervention compared to before the intervention, (p< 0.001). Also, the increase in the mean of the total lifestyle score after the intervention compared to the time before it was statistically significant (p<0.001).

Considering the favorable effect of self-care education based on learning style in promoting patients' lifestyle, this educational method can be used as a cheap and practical method in changing the behavior of hypertensive patients.

Migraine is a chronic medical problem and sometimes progressive disorder characterized by recurrent episodes of headache. Nutritional factors can reduce and prevent the severity and frequency of migraine.

This study aimed to assess the relationship between major dietary patterns and disease severity among migraine patients.

This cross-sectional study included 266 females (18 - 50 years old) who attend neurology clinics of Sina and Khatam Alanbia hospitals, and a professional headache clinic, both in Tehran, Iran, for episodic migraine diagnosis in 2016. The participants’ data was gathered using a general questionnaire and medical history. Dietary intake was assessed using a 147-item semi-quantitative food frequency questionnaire (FFQ). Anthropometric measurements were taken for all cases. visual analog scale (VAS) and migraine disability assessment (MIDAS) questionnaires were used by a neurologist for assessing migraine disability and pain severity, respectively. Also, principal component analysis (PCA) was used to identify major dietary patterns. The association between dietary patterns and disease severity was evaluated using multinomial logistic regression.

Using the PCA, two major dietary patterns, including the healthy and unhealthy diet, were identified. More adherence to the healthy dietary pattern (high in fruits, fruit juices, and dried fruits, vegetables, whole grains, liquid oil, brains, beans, low-fat dairy, and white meat) was associated with a lower VAS score after adjusting for energy intake, BMI, water intake, and increased salt intake (OR = 1.82, 95% CI = 0.96 - 3.44, P-trend < 0.005). The intensity of migraine headache increased by 82% in the lowest adherence to this pattern compared to the most adherence. There was no significant association between healthy and unhealthy dietary patterns with MIDAS before and after controlling for confounding variables.

This study showed that adherence to a healthy dietary pattern reduces the severity of pain in migraine patients. However, further studies are needed to evaluate the relationship between the unhealthy dietary pattern and the severity of migraine symptoms.

Among multiple sclerosis (MS) related symptoms and complications, fatigue might impact roughly 90% of patients. Decline in cognitive function is one of the other complications that occur in the first years after disease onset. The Mediterranean diet is one of the well-known anti-inflammatory dietary approaches. Therefore, this study aimed to explore the effects of a modified Mediterranean-like diet on cognitive changes and fatigue levels in comparison with a conventional standard diet over a 1-year follow-up.

In the current single-blind randomized controlled trial, 34 MS patients in the Mediterranean- like diet group and 38 patients in the standard  healthy diet group were studied for 1 year. The dietary interventions were modified each month by an expert nutritionist. MS-associated fatigue level was evaluated using the Modified Fatigue Impact Scale (MFIS). Cognitive assessment was also performed using Minimal Assessment of Cognitive Function in MS (MACFIMS).

Intergroup ‎comparisons demonstrated that after considering confounding variables in ANCOVA, fatigue scores appeared significantly lower in patients who were treated with the Mediterranean-like diet than those in the standard healthy diet group [Mean 95% confidence interval (CI)}: 33.93 (32.97-34.89) and 37.98 (36.99-38.97), respectively; P < 0.001]. However, the intergroup ‎analysis of cognitive status only showed a difference in the mean score of Brief Visuospatial Memory Test-Revised (BVMT-R) subtest of the MACFIMS. The BVMT-R‎ was higher among standard healthy diet patients compared to the Mediterranean-like diet group after the intervention following adjustment for covariates [Mean (95% CI): 23.73 (21.88-25.57) and 20.56 (18.60-22.51), respectively; P = 0.020].

In conclusion, the results of this study highlighted the higher protective effects of the Mediterranean-like diet against MS-related fatigue than the standard healthy diet. However, no significant improvement was observed in the cognitive status of MS patients after a 1-year treatment with the Mediterranean-like diet. More randomized clinical trials with larger sample sizes are needed to elucidate the effects of dietary modifications on MS-associated symptoms and complications.

City managers need a practical and ethical framework to guide and control both their behavior and the value system of urban management in their dealing with the complex and pervasive ethical problems in urban planning. Following a combined method and basic-applied approach, this study is aimed at the assessment of the status of professional ethics in Isfahan from the views of city managers. To achieve of the goals of this research, interviews were conducted with the city managers through purposeful sampling method in the qualitative phase. In the quantitative phase, questionnaires were presented to all city managers of the municipality of Isfahan and the associated organizations by the counting method. The results were analyzed through content analysis, one-sample t-test, and Friedman test. The analysis of the data led to a model of professional ethics of urban managers containing five criteria including conditions and effective factors, norms and values, understanding ethical issues, reaching to ethical solutions and trying for ethical conduct. All criteria of professional ethics in city management in Isfahan are at an average level from the viewpoints of city managers. The average status of professional ethics in districts 1, 3 and 5 of Isfahan Municipality was at a high level according to city managers. Understanding ethical issues was more important for of city managers.

The purpose of this study was to compare the performance of Fe2+ activated persulfate and electro-persulfate process in Acid Blue 25 removal from aqueous solution. For this reason, the effects of different parameters including pH, dye, sodium persulfate and ferrous sulfate concentrations were investigated. The removal efficiency of 92% at the time of 60 min was obtained at pH= 3, dye concentration= 50 mg/L, sodium persulfate concentration= 500 mg/L and Fe (II) sulfate concentration= 100 mg/L for Fe2+ activated persulfate system and the removal efficiency of 95% at pH= 5, dye concentration = 200 mg/L, sodium persulfate concentration = 500 mg/L and ferrous sulfate concentration = 100 mg/L for electro-persulfate system by means of graphite materials as the neutral electrodes. COD removal efficiency in Fe2+ activated persulfate and electro-persulfate in the mentioned conditions were 90% and 89% in 180 minutes, respectively. Moreover, the result of process kinetics showed that using electrochemical process improved the reaction velocity from 0.0016 to 0.0487 mg/L/min. The comparison between these two-process showed that using electrochemical process improved dye removal efficiency by 4 times.

Headache is among the most common disabling neurologic disorders. We measured quality of life in chronic migraine (CM) and episodic migraine (EM), stratified by medication overuse headache (MOH) and presence of aura.

In this observational study, conducted from January 2016 to December 2018, adult patients referred to the tertiary headache clinic of Sina Hospital in Tehran, Iran, who met International Classification of Headache Disorders, 3rd Edition-beta (ICHD-3 β) criteria for migraine were classified to EM and CM subtyped based on presence of aura and MOH. Validated Farsi versions of Migraine Disability Assessment Scale (MIDAS) and 6-item Headache Impact Test (HIT-6) questionnaires were used.

A total of 2454 patients (1907 women) were enrolled from which 1261 (51.4%) patients had EM and 1193 (48.6%) had CM, while 908 subjects (37.0%) had MOH, of whom 890 (98.0%) had CM. Median scores of MIDAS and HIT-6 were significantly higher in patients with CM compared to EM sufferers. Chronic migraineurs with MOH had a significantly higher median score of MIDAS and HIT-6 compared to patients with non-MOH CM. Also, there was a moderate positive correlation between MIDAS (disability) and HIT-6 scores (impact on patients’ life) and a moderate correlation between HIT-6 and pain severity.

The results of this study confirm that CM and MOH are associated with a higher headache-related disability and impact on life compared to EM. Therefore, treatment goals in prevention of MOH and migraine transformation warrant higher quality of life in patients with migraine.

The present study aims to measure the status of professional ethics based on the districts of Isfahan from the viewpoint of citizens. The research method is combined (qualitative and quantitative). In the qualitative section, qualitative content analysis method of conventional type including open and axial coding was used; and the statistical population consisted of 91 municipal managers of Isfahan among whom 15 were purposefully interviewed. In the quantitative section, data collection was descriptive and survey type; and, using the results of the qualitative method of the first stage, the criteria of professional ethics were obtained through findings of the interview and then a researcher-made questionnaire of professional ethics was developed. To answer the questions, one-sample t-test, Friedman test, and Pearson correlation coefficient test were used. The results showed that the average professional ethics in all districts of Isfahan Municipality, except for District 5, is at an average level. Application of professional ethics criteria in urban management measures is at a favorable level. From the citizens’ point of view, the priorities of observing the subscales were moral solution, recognizing moral issues, norms and values, trying to implement ethics, and effective factors and conditions.

Migraine is a debilitating neurological disorder with a high prevalence. This study was conducted to evaluate the relationship between body mass index (BMI) and disability, severity, frequency and duration of headaches in female migraine patients.

This cross-sectional study was designed to address the characteristics of migraine attacks (duration of each attack, frequency, and severity) and MIDAS (Migraine Disability Assessment) score in female migraineurs. The diagnosis of migraine was based on ICHD-3 beta criteria. Verbal rating scale (VRS) was used for headache severity. Height and weight were measured to calculate the BMI. Mann-Whitney and Kruskal-Wallis tests were used for comparison of means, and analysis of covariance (ANCOVA) test was used for adjustment of the confounding factors.

In the current study, 170 female migraine patients with a mean (±SD) age of 34.0 ± 8.0 years were enrolled. There were significant differences between the three groups (18.5 ≤ BMI< 25, 25 ≤ BMI < 30 and 30 ≤ BMI) in terms of headache frequency, duration and severity as well as total MIDAS score (P<0.001). These differences remained significant after adjustment for age.

This study revealed that migraineurs with higher BMI experienced higher headache frequency, severity and duration as well as higher disability score.

Idiopathic intracranial hypertension (IIH) encompasses patients with elevated intracranial pressure (ICP). Generally, it is difficult to make a differential diagnosis between IIH and co-existing migraine headaches. Thus, this article intends to estimate the prevalence of migraine in patients with IIH and explain the occurrence of new-onset migraine after the diagnosis of IIH. The case group included 108 patients with IIH referred to the neurology wards of three university hospitals. A random sample of controls (n = 103) were recruited from patients hospitalized in the surgery and orthopedics ward. A checklist for migraine diagnosis was filled out. Cerebrospinal fluid (CSF) pressure and presence or absence of papilloedema (PE) in the patients and any necessary data were also recorded from the inpatient medical documents. All statistical analyses were done by SPSS software. There were 70 (64.80%) and 22 (21.40%) migraineurs in the case and control groups, respectively, and the difference was found to be significant (P < 0.001). In 26 (37.14%) migraine cases in the IIH group, the disorder was diagnosed after developing IIH. Also, there was a past medical history of having migraine in 44 (62.85%) migraineurs. In the fully adjusted regression models, the odds of being affected by migraine in patients with IIH was 6.17 times greater than the controls [odds ratio (OR) = 7.15, 95% confidence interval (CI) = 3.56-14.36, P < 0.010]. The patients’ mean CSF opening pressure was 32.10 ± 1.03 cmH2O and 93 (81.60%) subjects were found to have PE. It was demonstrated that subjects with IIH might have about a 6-time higher likelihood of developing migraine headache than the general population. These considerations can help prevent misdiagnosis of migraine headache as the recurrence of IIH or uncontrolled IIH and subsequent inappropriate management.

The purpose of this study was to investigate the teachings of Islam and the Iranian traditional medicine and prevalent medicine points of view on the importance of breastfeeding.

At first, the data were extracted from the relevant Quranic verses, reliable collections of hadith and books of Iranian traditional medicine (ITM). Then prevalent medicine were searched in scientific databases such as Scopus, ScienceDirect and PubMed. Afterextracting the data, the results were classified in terms of concepts and table.

In the Holy Qur'an, several verses have focused on breastfeeding andtheappropriate length of breastfeeding has been considered for two full years. Breastfeeding is also considered as a worthy value in many hadiths.In ITM, breast milk has been considered as the most appropriate type of nutrition for the infants and recommended to continuation the breastfeeding in the first two years of life as much as possible. From the viewpoint of prevalent medicine, exclusive breastfeeding clearly is the preferred method of feeding the infant during the first six months of life, and WHO emphasizes for continuation of breastfeeding during the second year of life.

Taking into account all three perspectives, it is concluded that the feeding of the infant with breast milk in the first two years of life is of special and exclusive importance and cannot be compensated by any alternative form of nourishment.

Generalized anxiety disorder (GAD) is known as the most prevalent anxiety disorder. Saffron has been previously approved as an effective adjuvant therapy in depression and might alleviate GAD symptoms.
In the current double blind randomized controlled trial, 40 patients with mild to moderate GAD, diagnosed according to the diagnostic and statistical manual of mental disorders-V (DSM-V) and received sertraline were randomly assigned to the saffron receiving group (450 mg, n = 20) or placebo taking patients (n = 20). Interventions were administered as an add-on therapy to sertraline on a daily bases for 6 weeks. In addition to assessing anthropometric, demographic data, and dietary intakes of patients, a 14-item Hamilton anxiety rating scale (HAM-A) was used to assess the effect of treatment.
The mean (SD) of age was 29.65 (8.45) and 32.40 (6.74) years in the Saffron and placebo groups, respectively. Applying ANCOVA models adjusted for age, baseline energy intake, HAM-A total score, and weight changes from baseline to the 6th week, showed that at the end of the 6th week, saffron treated patients had a significantly lower mean HAM-A score compared to placebo group (2.95 vs. 5.05; P value = 0.005). Furthermore, within the group analysis it was shown that the total HAM-A score significantly declined in both groups (P value ≤ 0.000). Measuring changes in the HAM-A total score, relative to the baseline, following adjustment of ANCOVA models, showed that saffron was more effective than the placebo in reducing the mean HAM-A score of patients (-17.25 ± 2.67 vs. -15.35 ± 2.30; P value = 0.029). The side effects were tolerable and did not result in discontinuation of the supplementation.
Saffron as a sertraline add-on therapy may attenuate GAD symptoms. However, more randomized clinical trials with a larger sample size and longer duration of follow-up are needed to confirm this effect.

Context: Obesity is a major public health problem worldwide. This review aimed at providing an updated overview of obesity in Iranian women and its associated complications..
Evidence Acquisition: In this narrative review study, related systematic reviews or meta-analysis studies of high ranking journals conducted from 2000 to 2016 were searched in the PubMed, Medline, and Scopus with the following keywords: “women OR female” AND “weight OR overweight OR obesity”, “risk factors OR complications”, “reproduction OR cancer OR cardiovascular disease OR diabetes OR gestational diabetes OR maternal obesity OR fertility OR pregnancy OR polycystic ovary syndrome” OR management..
In Iran, women have shown a constantly higher risk of obesity compared to men. After a 9- year follow-up, the age-standardized incidence rate (95% CI) of diabetes was 10.1 (7.24 - 13.9) in women. The increases in overweight and obesity in menopausal women have an important role in endometrial, colon, and breast cancer. Obesity increases the risk of endometrial cancer 2.4 to 4.5 folds compared to the normal weight women. Maternal obesity increases the risk of gestational hypertension 4.5 to 8.7 times compared to normal weight women. An increasing number of obese women becoming pregnant is associated with short- and long-term maternal and child outcomes. The prevalence of childhood obesity in children of obese women aged 3 to 5 years increases up to 25%; and these children have an almost 6- fold chance of being obese in young adulthood. Weight reduction of obese women is accompanied with lower incidence of obesity complications. The most effective interventions are multiple behavioral management activities..
Considering the large population of young people in Iran and the lack of any effective preventive policy, the burden of obesity and its associated outcomes will be problematic in the near future..

Pancreatic cancer (PC) is classed as the 7th leading cause of cancer-related death in the world. Previous evidence indicates that hyperglycemia, insulin resistance, diabetes, and obesity are implicated in pancreatic carcinogenesis. Thus, evaluation of the dietary intakes in the etiology of PC can be useful to identify the risk factors of the disease.
Methods and Materials: We examined the association between total intake of fruits, vegetables, and dietary fiber and the risk of PC in 50,045 participants aged 40-75 years within the Golestan Cohort Study. Dietary data were collected using a validated semi-quantitative food-frequency questionnaire, which was administered at baseline. Cox proportional hazards models were used to estimate multivariate hazard ratio with 95% confidence interval.
During 383,630 person-years of follow-up and after excluding the participants with incomplete baseline information, a total of 48,676 adults were evaluated. Until October 30, 2014, 54 cases of PC were confirmed based on the exact cause of death using ICD10 criteria. After considering all potential confounding factors, there was only a statistically significant inverse association between the risk of PC for the highest tertile of daily fiber intake compared with the lowest tertile (HR=0.41; 95% CI= 0.15-1.05; P for trend= 0.05). However, the relationship between fruits and vegetables and PC risk was not statistically significant.
In summary, based on the findings of this study, increased dietary fiber may reduce the risk of PC. This result highlights the importance of a diet rich in fiber in order to prevent PC progression. Finally, given the limited number of studies in this field and inconclusive results, there is still a need for new prospective studies with long follow-up.

Pancreatic cancer (PC) is classified as one of the most deadly cancers. Since the role of diet in modifying the effects of known risk factors of PC has been well established¡ exploring the dietary intakes in relation to the etiology of PC can be useful for elucidating the mechanisms of the disease progression.
This study was conducted within the Golestan prospective cohort study. The estimated intake of total fat and various dietary fat sources was calculated using a validated semi-quantitative food frequency questionnaire. The relationship between these dietary intakes and risk of PC was examined using Cox Regression and hazard ratio (HR) with 95% confidence interval (CI 95%) was reported.
During 383¡630 person-years follow-up and after excluding subjects with incomplete baseline information¡ a total of 48¡676 adults were studied. Until October 30¡ 2014¡ 54 cases of PC were confirmed by medical professionals¡ based on the medical records and the exact cause of death using the criteria of the International Statistical Classification of Diseases and Related Health Problems 10 (ICD10). After adjusting for potential confounders we did not observe any statistically significant relationship between the intake of total fat and various dietary fat sources and risk of PC. There was only a significant positive association between the risk of PC and daily intake of butter¡ cream¡ and solid vegetable oil in the age-adjusted regression models (HR=2.10; 95% CI=1.04-4.21; P for trend=0.03). However¡ this relationship was not remained significant anymore in the fully adjusted models.
Based on the results of the current research¡ after taking into account all of the potential confounding factors¡ dietary intake of total fat as well as various dietary fat sources had no significant association with the risk of PC. However¡ it is likely that consuming substantially less saturated and trans fat sources such as dairy fats as well as solid vegetable oils may be beneficial to reduce the risk of this cancer.

BackgroundPancreatic cancer (PC) is ranked as the 7th Leading cause of cancer death in the world and is among one of the most deadly cancers. Several lines of evidence indicate that insulin resistance, diabetes, and obesity are implicated in its carcinogenesis process.
Methods and MethodsWe examined the association between consumption of carbohydrate foods and risk of PC in the 50,045 participants (21241 men and 28804 women aged 40 to 75 years) of the Golestan Cohort Study in northeastern Iran. Dietary data was collected using a validated semi-quantitative food-frequency questionnaire. Cox proportional hazards models were used to estimate multivariate hazard ratio with 95% confidence interval.
Results During 8.5 years (383,630 person-years) of follow-up and after excluding participants with incomplete data, a total of 48,676 adults (20,683 men and 27,993 women) were studied. Until October 30, 2014, 54 cases of pancreatic cancer were confirmed by a medical team, based the medical records and the exact cause of death based on ICD10 criteria. After adjusting for age, total energy intake, history of diabetes, smoking status, education, opium, body mass index, waist to hip ratio, ethnicity, gender, MET, residential area and socioeconomic status we did not observe any statistically significant relationship between consumption of total carbohydrate and carbohydrate foods including whole grains and refined grains, sugars and potatoes and risk of PC.
ConclusionBased on the results of the present study, dietary intake of total carbohydrate as well as various carbohydrate food sources had no significant association with the risk of PC. Finally, given the limited number of studies in this field and their inconclusive results, there is still a need for new prospective studies with long follow up.

Current evidence is inconsistent about the association between dietary protein intake and risk of pancreatic cancer (PC). The aim of this study was to evaluate the association between total intake of major dietary protein sources and risk of PC in a large prospective study in Golestan Cohort Study (GCS).
We examined the association of total intake of major dietary protein sources with risk of PC in the 50,045 participants (20,855 men and 28,255 women) of the GCS in northeastern Iran. Participants were aged 40 and older at baseline and actively followed from 2004 to the present time. Dietary data were collected using a validated semi-quantitative food-frequency questionnaire that was administered at baseline. Cox proportional hazards models were used to estimate Multivariable hazard ratios with 95% confidence intervals (CI).
During 383,630 person-years of follow-up, 54 cases of pancreatic cancer were ascertained. There was only a statistically significant inverse association between risk of PC for the second versus lowest tertile of plant based protein intake in the first and multivariable models (HR = .27, 95% CI = .12–.64, HR = .28, 95% CI = .12 –.65 respectively); however, this association was not significant anymore when comparing the highest tertile with the lowest one, in the first and multivariable models (HR = .49, 95% CI = .19–1.24, HR = .52, 95% CI = .20–1.34 respectively).
In this large prospective cohort, we did not observe any clear and consistent evidence for an association between main dietary

Context: Turmeric is obtained from the plant Curcuma longa L; its major constituent, curcumin, is a polyphenol with multiple effects which can modulate some signaling pathways..Evidence Acquisition: Insulin resistance is a major risk factor for chronic diseases such as type 2 diabetes, atherosclerotic, metabolic syndrome and cardiovascular disease. In addition, Insulin resistance in peripheral tissue is one of the most important reasons of hyperglycemia which can cause global or systemic effects. The present study reviewed studies published in PubMed from 1998 to 2013, indicating the role of curcumin in attenuation of many pathophysiological processes involved in development and progression of hyperglycemia and insulin resistance.. Curcumin can reduce blood glucose level by reducing the hepatic glucose production, suppression of hyperglycemia-induced inflammatory state, stimulation of glucose uptake by up-regulation of GLUT4, GLUT2 and GLUT3 genes expressions, activation of AMP kinase, promoting the PPAR ligand-binding activity, stimulation of insulin secretion from pancreatic tissues, improvement in pancreatic cell function, and reduction of insulin resistance.. Curcumin has antihyperglycemic and insulin sensitizer effects. Thereby, more studies evaluating the effects of curcumin on hyperglycemic state and insulin resistance in related disorders such as diabetes are recommended..