Phoenix dactylifera L. pollen versus pentoxifylline on improvement of sperm parameters in idiopathic male infertility: A randomized clinical trial

ETHNOPHARMACOLOGICAL RELEVANCE

Phoenix dactylifera L. pollen is the male reproductive dust of palm flowers known as a natural product that is considered a strong stimulant of sexual potency and fertility in Iranian traditional medicine (ITM). In this regard, no evidence-based medications are empirically prescribed to treat IMI. However, applying traditional medicine for the treatment of male infertility has attracted more attention in recent years.

AIM OF THE STUDY

Phoenix dactylifera L. pollen was compared with pentoxifylline (PTX) to evaluate its efficacy on sperm parameters.

MATERIALS AND METHODS

During this parallel randomized controlled trial, 80 adult men with asthenozoospermia, oligozoospermia, or teratozoospermia (age 20-35 years) were enrolled. In two separate groups of participants with a 1:1 ratio, participants received either 6 g of Phoenix dactylifera L. pollen powder daily or 400 mg of PTX tablets daily for 90 days. We measured the sperm parameters as well as the serum sex hormones in the sample. ANCOVA and t-tests were used to compare groups.

RESULTS

There was no significant difference between the study groups in terms of baseline characteristics or demographic characteristics. According to the results, participants who took Phoenix dactylifera L. pollen powder had significantly improved sperm concentration (p = 0.016), morphology (p = 0.029), sperm counts (p = 0.012), progressive motility (p = 0.016), total motility (p = 0.018), and reduced immotile sperms (p = 0.014) compared to those who took PTX.

CONCLUSIONS

In light of these results, Phoenix dactylifera L. pollen is recommended as a treatment factor for ameliorating IMI by enhancing sperm functional capacity and semen parameters.

Positive relation between dietary inflammatory index and osteoporosis in postmenopausal women

Background: Previous studies have shown that some dietary components may be implicated in the aetiology of postmenopausal osteoporosis. Objective: We examined the relationship between Dietary Inflammatory Index (DII®) and osteoporosis in postmenopausal women. Study design: Eight hundred and fifty postmenopausal women aged 50-65 years were randomly selected from 87 health care centers. Bone mineral density (BMD) was measured using the anterior-posterior lumbar spine (L1-L4) and proximal femur neck through Hologic QDR 4500W (S/N 50266) dual-energy X-ray absorptiometry device. After checking inclusion and exclusion criteria and diagnosis of osteoporosis, 124 women with normal bone mineral density (normal-BMD) and 108 women with osteoporosis were selected. Demographic, anthropometric, physical activity, midwifery, and dietary intake questionnaires were completed. DII was calculated based on a valid and reliable 168-item semi-quantitative food frequency questionnaire using 37 (out of 45) food parameters. A Logistic regression model adjusted for confounders was applied to estimate osteoporosis's odds ratio (OR) based on modeling DII as a continuous and dichotomous variable. Results: In this study, DII scores ranged from -3.71 (the most anti-inflammatory score) to +4.16 (the most pro-inflammatory score). The median DII value among the osteoporosis group was 0.97, among the normal group it was -0.31, indicating a more pro-inflammatory diet for osteoporosis. There were positive associations between osteoporosis and DII based on both continuous (Adjusted OR=3.467, 95% confidence interval (CI): 2.280-5.272, P-value<0.001) and dichotomous (Adjusted OR: DII ≤-0.31 / >-0.31=0.248, 95% CI: 0.110-0.561, P-value=0.001) measures in modeling adjusted for age, BMI, post-menopausal years, parity, education, total energy intake, and physical activity. Conclusions: These data suggest a pro-inflammatory diet, as indicated by increasing the DII score, may be a risk factor for osteoporosis in postmenopausal Iranian women.

The efficacy of topical sodium pentaborate formulation on hemorrhoid disease: A randomized, double-blind, placebo-controlled trial

Background

The topical application of boron has been significantly associated with intensifying wound healing. Using 3% boric acid in deep wounds significantly contributes to wound healing and reduces the duration of hospitalization in the intensive care. The objective of this study was to assess the therapeutic impact of a topical gel containing sodium pentaborate pentahydrate on the management of wounds resulting from grade 1 to 3 hemorrhoids.

Methods

In this randomized double-blind placebo-controlled trial, we applied a topical gel consisting of sodium pentaborate pentahydrate 3% on 206 eligible patients with the diagnosis of grade 1, 2, and 3 hemorrhoid diseases. Then patients were randomly allocated to two groups of sodium pentaborate pentahydrate or placebo gel with a ratio of 1:1 and received the allocated gel for four weeks. Patient hemorrhoid symptoms severity, hemorrhoid degree, and anoscopy findings were compared before and after the trial.

Results

Before the intervention, symptom severity (p > 0.05) and anoscopy findings (p = 0.815) were similar between the two groups. Subsequent to the intervention, a majority of patients in the intervention group experienced a reduction in anal itching compared to the placebo group [adjusted mean difference (aMD) 95% CI: -1.98 (-2.2 to -1.8), p = 0.007]. Moreover, resting pain [aMD (95% CI): -1.37 (-1.6 to -1.1), p = 0.015], pain during defecation [aMD (95% CI): -2.19 (-2.4 to -2.0), p = 0.005], feeling a lump in the anus (aMD (95% CI): -0.71 (-1.2 to -0.2), p = 0.011), bleeding during defecation (41.7% vs. 66.9%, p = 0.027), and hemorrhoid degree (p < 0.001) in the intervention group was less than the placebo group.

Conclusion

Our findings indicate the effectiveness of the study gel on hemorrhoid symptoms and anoscopy findings in patients.

The effect of lavender on mood disorders associated with the use of combined oral contraceptives (COCs): a triple-blinded randomized controlled trial

BACKGROUND

The use of contraceptive methods is influenced by their effectiveness, availability, and minimal side effects. OCPs are one of the most effective and widely used methods of pregnancy prevention worldwide. This method not only prevents pregnancy but also helps prevent and treat other diseases. One of the main reasons for discontinuing this method is the emotional disturbances associated with its use. Lavender is an evergreen, fragrant plant that has gained significant attention for its anti-anxiety effects. This study was conducted to investigate the effect of lavender essential oil capsules on mood disorders during the use of COCs.

METHODS

This triple-blinded clinical trial was conducted on 60 married women (aged 15-49 years old) who were consumers of COCs, referring to 26 health centers in Tabriz, Iran. The participants were randomly assigned to either the intervention (consuming one gelatin capsule containing 80 mg LEO daily) or control (consuming one placebo capsule daily) group. The intervention continued for 56 days. Scores for positive and negative were determined using the Positive and Negative Affect Schedule (PANAS) questionnaire; and for stress, depression, and anxiety were measured using the DASS-21 questionnaire on day's 28th and 56th post-intervention. Data analysis was conducted using the t-test and ANOVA with repeated measures, and a p-value of < 0.05 was considered significant for all analyses.

RESULTS

A statistically significant difference was observed in mood disorders, stress, and depression between women receiving LEO or placebo. The consumption of LEO increased the positive mood on day 28 [MD (95% CI): 4.5 (2.1 to 7.0), p = 0.001] and day 56 [5.9 (3.4 to 8.3), p < 0.001] while decreased the negative mood on day 28 [MD (95% CI): -3.5 (-5.3 to -1.3), p < 0.001] and day 56 [-4.3 (-6.3 to -2.2), p < 0.001], stress on day 28 [MD (95% CI): -4.9 (-7.1 to -2.8), p = 0.001] and day 56 [-5.3 (-7.6 to -3.1), p < 0. 001], and depression on day 28 [MD (95% CI): -3.0 (-4.9 to 1.1), p = 0.003] and day 56 [-3.1 (-5.0 to 1.2), p = 0.002]. There was no statistically significant difference between the two groups in terms of anxiety.

CONCLUSIONS

The consumption of LEO with COCs improved mood disorders and reduced stress and depression. The use of hormonal contraceptives and mood changes should be considered by providers. Therefore, regarding the possibility of mood changes, it is expected that appropriate counseling and education will be provided to women who consume COC., providing appropriate solutions, including the simultaneous use of LEO.

The effects of synbiotic supplementation on blood pressure and other maternal outcomes in pregnant mothers with mild preeclampsia: a triple-blinded randomized controlled trial

INTRODUCTION

Preeclampsia affects a significant percentage of pregnancies which is a leading cause of premature birth. Probiotics have the potential to affect inflammatory factors, and oxidative stress, which are linked to the development of preeclampsia. The study aimed to compare the effect of synbiotic and placebo on blood pressure and pregnancy duration as primary outcomes, and other pregnancy outcomes.

METHODS

This study comprised 128 pregnant women with mild preeclampsia and gestational ages exceeding 24 weeks who were referred to the high-risk pregnancy clinic. It was a randomized, controlled, phase III, triple-blinded clinical experiment. The intervention and control groups were distributed to the participants at random. Intervention group received one oral synbiotic capsule, and control group received placebo daily until delivery. Based on gestational age at the time of diagnosis, preeclampsia was stratificated as early (< 34 weeks) or late (≥ 34 weeks). Data obtained from questionnaires, and biochemical serum factors were analyzed using SPSS software version 23 software.

RESULTS

With the exception of the history of taking vitamin D3, there were no statistically significant variations in socio-demographic variables between the research groups. After the intervention, the means of systolic blood pressure (adjusted mean difference: -13.54, 95% CI: -5.01 to -22.07), and diastolic blood pressure (adjusted mean difference: -10.30, 95% CI: -4.70 to -15.90) were significantly lower in the synbiotic-supplemented group than in the placebo group. Compared to the placebo group, the incidence of severe PE (p < 0.001), proteinuria (p = 0.044), and mean serum creatinine level (p = 0.005) significantly declined in the synbiotic-supplemented group after the intervention. However, our analysis found no significant association for other outcomes.

CONCLUSION

Based on our results, synbiotic had beneficial effects on some pregnancy outcomes. Further studies with larger samples are needed to verify the advantages of synbiotic supplementation for high-risk pregnancies, particularly with regards to higher doses, and longer intervention periods.

TRIAL REGISTRATION

IRCT20110606006709N20.

Harnessing tumor-derived exosomes: A promising approach for the expansion of clinical diagnosis, prognosis, and therapeutic outcome of prostate cancer

Prostate cancer is the second leading cause of men's death worldwide. Although early diagnosis and therapy for localized prostate cancer have improved, the majority of men with metastatic disease die from prostate cancer annually. Therefore, identification of the cellular-molecular mechanisms underlying the progression of prostate cancer is essential for overcoming controlled proliferation, invasion, and metastasis. Exosomes are small extracellular vesicles that mediate most cells' interactions and contain membrane proteins, cytosolic and nuclear proteins, extracellular matrix proteins, lipids, metabolites, and nucleic acids. Exosomes play an essential role in paracrine pathways, potentially influencing Prostate cancer progression through a wide variety of mechanisms. In the present review, we outline and discuss recent progress in our understanding of the role of exosomes in the Prostate cancer microenvironment, like their involvement in prostate cancer occurrence, progression, angiogenesis, epithelial-mesenchymal transition, metastasis, and drug resistance. We also present the latest findings regarding the function of exosomes as biomarkers, direct therapeutic targets in prostate cancer, and the challenges and advantages associated with using exosomes as natural carriers and in exosome-based immunotherapy. These findings are a promising avenue for the expansion of potential clinical approaches.

The Effectiveness of Perinatal Omega-3 Supplements in Neurodevelopment and Physical Growth of 9- and 12-month-old Infants: A Follow-up of a Clinical Trial

BACKGROUND

Omega-3 fatty acids (FAs) are essential long-chain polyunsaturated fatty acids (LCPUFAs) that are essential for optimal health and development.

OBJECTIVE

The present study aimed to evaluate the effectiveness of maternal fish oil (containing omega-3 LCPUFA) intake from 21th week of pregnancy to 30 days postpartum for neurodevelopment and growth of infants at 9 and 12 months.

METHODS

This was a follow-up study of a triple-blinded clinical trial. The study population was 9-- month-old infants. Their mothers were randomly divided into two groups of 75 people with a 1:1 ratio to take one fish oil supplement or a placebo daily. The anthropometric indicators of infants at months 9 and 12 and neurodevelopment at month 12 by the ASQ questionnaire were measured. In the fish oil and placebo groups, respectively, 73 and 71 infants at nine months, as well as 71 and 69 at 12 months, were analyzed.

RESULTS

No statistically significant impact was observed following consuming omega-3 capsules on the neurodevelopmental domains, growth parameters, and the profile of maternal serum FAs (p > 0.05) except DHA. Neurodevelopmental problems were illustrated in one case in the intervention group and two cases in the placebo group.

CONCLUSION

Perinatal relatively low-dose omega-3 LCPUFAs supplements indicated no statistically significant impacts on the growth and neurodevelopment of 9- and 12-month-old infants in a population with low consumption of marine products. Further studies investigating the effect of higher doses of omega-3 LCPUFAs are suggested.

The Efficacy of Nigella sativa L. and Curcumin Nanomicelle Alone or Together on Lipid Profile, Glycemic Control Indices, and Serum 17-Β Estradiol in Postmenopausal Women

Introduction

Menopause is a condition for metabolic disorders. This study aimed to evaluate the effect of Nigella sativa (NS), curcumin nanomicelle (CN), lipid profile, glycemic status and 17-β estradiol (ES) levels in postmenopausal women.

Methods

Triple-blind randomized clinical trial was conducted on 120 postmenopausal women. Participants were randomly assigned to four groups: 1) NS capsule 1000 mg and CN placebo, 2) 80 mg CN capsule and NS placebo, 3) both NS and CN capsules and 4) NS and CN placebo. Participants received a single dose daily for 6 months. The serum lipid profile, glycemic control biomarkers, and ES were measured pre-and post-intervention using biochemical methods.

Results

Total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, fasting blood sugar (FBS), fasting insulin (FI), insulin resistance (IR), and ES showed significant improvement in NS group. CN significantly reduced TC, FI, and IR, and significantly increased ES. The combination of NS-CN significantly decreased TC, LDL, FI, and IR, and increased HDL and ES. The comparison of the studied with the placebo groups showed that these changes were significant in glycemic indices and NS significantly increased estrogen.

Conclusion

NS, CN and NS-CN improved lipid profiles, blood sugar, and hormone levels. However, this improvement was significant in glycemic indices and estrogen levels compared to the placebo group. No superiority of combined NS-CN over NS or CN was found in this trial.

The self-care behaviors and health literacy can play important preventive roles in older female osteoporosis

BACKGROUND

Osteoporosis is a common complication of aging and menopause. Self-care and health literacy are among the factors affecting health status. The purpose of this research was to determine the preventive roles of self-care behaviors and health literacy in older women with osteoporosis.

METHODS

This cross‑sectional analytical research was conducted on 250 postmenopausal women consisting of 125 osteoporotic and 125 healthy people aged 60-70. They were selected by purposive sampling in Tabriz Sina Hospital from September 2021 to December 2021. Data collection instruments were a demographic questionnaire, a Menopausal Self‑Care Questionnaire, and a European Health Literacy Survey Questionnaire. Data were analyzed using SPSS 23 software.

RESULTS

The mean (SD) total score of self-care in healthy women was 118.97 (19.92) and in women with osteoporosis was 84.7 (14.98) (p < 0.001). Also, healthy women all had sufficient health literacy (100%), but 52.8% of women with osteoporosis had insufficient health literacy. The odds of osteoporosis decreased significantly with the rise in the total score of self-care behaviors [Odds ratio 95% confidence interval (95% CI); p: 0.909 (0.880 to 0.939); p < 0.001] and its subdomains as well as with increasing health literacy level [OR (95% CI); p: 0.322 (0.266 to 0.383); p < 0.001]. There was a significant positive correlation between self-care behaviors and health literacy (r = 0.616, p < 0.001).

CONCLUSIONS

Self-care in aged women is particularly important in reducing the risk of osteoporosis, and empowering women in the field of health literacy is an important factor in improving self-care behaviors and ultimately the health of these people.

The effect of the boron-based gel on the treatment of diabetic foot ulcers: A prospective, randomized controlled trial

BACKGROUND

Chronic ulcers represent impaired healing capacity with high mortality in the elderly or patients with systemic disorders such as diabetes. Boron is an effective agent in wound healing by promoting cell migration and proliferation and reducing inflammation in the wound area. This study aimed to evaluate the therapeutic effect of a sodium pentaborate-based topical formulation compared to control on the treatment of diabetic foot ulcers.

METHODS

A prospective, double-blind, randomized controlled trial was conducted to apply randomly the topical sodium pentaborate 3% gel or topical conventional remedy (control) by patients diagnosed with diabetic foot ulcers. The 171 eligible participants aged 18-75 years received the allocated medicines twice a day for a month with an allocation ratio of 3:1. Twenty-five days and two months after the end of the trial, participants were reinvestigated for their ulcer condition and any recurrence. Wagner's classification of diabetic foot ulcers was applied to this purpose (0-5).

RESULTS

161 participants (57 females, 104 males; mean age: 59.37) completed this study. After the intervention, most participants in the intervention group had a lower ulcer grade than the control group (adjusted mean difference (95% CI): - 0.91 (-1.1 to -0.73); p < 0.001). Moreover, most participants in the intervention group (n = 109 (90.8%)) were treated at a higher rate than the control group (n = 5 (12.2%)) after intervention (adjusted odds ratio (95% CI): 0.008 (0.002-0.029); p < 0.001). There was no case of recurrence in the intervention group while its rate was (n = 2 (40%)) in the control group (p < 0.001).

CONCLUSION

The present study suggests that topical sodium pentaborate gel may help treat and decrease the grade of diabetic foot ulcers and prevent the recurrence of diabetic foot ulcers.

Anticancer Effect of Enterococcus faecium, Isolated from Vaginal Fluid, on Ovarian Cancer Cells

Background

Given the association between cervicovaginal microbiota and OVC, we investigated the effect of Enterococcus faecium conditioned medium (CM) on OVC (Caov-4) cells.

Methods

CM was obtained from the bacterium E. faecium isolated from the vagina of healthy women. The Caov-4 cells were treated with varying concentrations of CM that comprised co-cultured bacteria with 0.2, 0.5, 1, 1.5, and 2 OD for 12, 24, and 48 h. The apoptosis and growth of cancer cells were evaluated by 4′,6-diamidino-2-phenylindole (DAPI) staining, flow cytometry, and DNA laddering assay. Moreover, the expression of PTEN, BAX, BCL2, and AKT1 genes were analyzed using real-time PCR.

Results

The CM at a concentration of 0.5 OD from the cultured bacteria and incubation time of 48 h showed the highest negative effect on the viability of cancer cells. The CM treatment increased DNA fragmentation and also induced apoptosis in Caov-4 cells. Interestingly, CM could decrease the expression of proapoptotic genes were less, while antiapoptotic genes were more than fluorouracil in the presence of CM.

Conclusion

CM of human-derived E. faecium could have an anticancer effect on OVC cells in a concentration- and time-dependent manner. This study demonstrated that E. faecium secretes anticancer substances into the CM, which could directly affect the viability and apoptosis of cancer cells.

Anticancer Effect of Enterococcus faecium, Isolated from Vaginal Fluid, on Ovarian Cancer Cells

Background

Given the association between cervicovaginal microbiota and OVC, we investigated the effect of Enterococcus faecium conditioned medium (CM) on OVC (Caov-4) cells.

Methods

CM was obtained from the bacterium E. faecium isolated from the vagina of healthy women. The Caov-4 cells were treated with varying concentrations of CM that comprised co-cultured bacteria with 0.2, 0.5, 1, 1.5, and 2 OD for 12, 24, and 48 h. The apoptosis and growth of cancer cells were evaluated by 4′,6-diamidino-2-phenylindole (DAPI) staining, flow cytometry, and DNA laddering assay. Moreover, the expression of PTEN, BAX, BCL2, and AKT1 genes were analyzed using real-time PCR.

Results

The CM at a concentration of 0.5 OD from the cultured bacteria and incubation time of 48 h showed the highest negative effect on the viability of cancer cells. The CM treatment increased DNA fragmentation and also induced apoptosis in Caov-4 cells. Interestingly, CM could decrease the expression of proapoptotic genes were less, while antiapoptotic genes were more than fluorouracil in the presence of CM.

Conclusion

CM of human-derived E. faecium could have an anticancer effect on OVC cells in a concentration- and time-dependent manner. This study demonstrated that E. faecium secretes anticancer substances into the CM, which could directly affect the viability and apoptosis of cancer cells.

The role of bone turnover markers in screening low bone mineral density and their relationship with fracture risk in the postmenopausal period

Background

Using bone turnover marker (BTM) monitoring to identify "quick losers" who may develop osteoporosis in the coming years is one of the main challenges in clinical practice. This study was implemented to examine the association of BTMs with bone mineral density (BMD) as well as to determine their relationship with the fracture risk assessment tool (FRAX) in women in the postmenopausal period.

Materials and Methods

This study was observational cross-sectional research that was done on women between the ages of 50 and 65 who were in the postmenopausal period. A dual-energy X-ray absorptiometry was applied to select 120 eligible women with normal BMD and 120 women without normal BMD. BTMs were assessed using enzyme-linked immunosorbent assay. Osteoporosis's Odds Ratio (OR) was estimated using a confounder-adjusted logistic regression model. The area under curve was calculated for the differentiation of low BMD in the postmenopausal period through receiver-operator characteristic (ROC) curves. To assess the probability of major osteoporotic fracture and hip fracture for the future 10 years, FRAX was applied.

Results

Higher serum osteocalcin (OC) (OR: 1.134, 95% confidence interval [CI]: 1.086-1.184), osteopontin (OP) (OR: 1.180; 95%CI: 1.105-1.261), and alkaline phosphatase (ALP) (OR: 1.007; 95%CI: 1.001-1.144) concentrations were potential risk factors for developing low BMD in women after menopause. The area under curve (AUC) (95%CI) for OC, OP, and ALP was 0.75 (0.668-0.8130), 0.75 (0.685-0.812), and 0.602 (0.524-0.670), respectively. ROC analysis indicated that at the cut-off point of 16.28 ng/mL, sensitivity and specificity were 70.3% and 70.9%, respectively, for OC. Furthermore, at the cut-off point of 28.85 ng/mL, the sensitivity of 70.3% and specificity of 66.6% were obtained for OP. The serum OC and OP were significantly related to hip and major osteoporotic fractures (P < 0.05).

Conclusion

The higher serum concentration of OC, OP, and ALP had significant associations with lower BMD. These BTMs can be complementary tools and helpful in the postmenopausal period as measures for screening of bone loss and possible bone fracture.

The effect of an anti-inflammatory in comparison with a low caloric diet on physical and mental health in overweight and obese women with knee osteoarthritis: a randomized clinical trial

PURPOSE

To evaluate the effect of an anti-inflammatory compared to a low-calorie diet on the physical and mental health of patients with knee OA.

METHODS

In this randomized parallel clinical trial, participants were selected among overweight and obese women aged 40 years or older with mild to moderate OA. Sixty women with a ratio of 1:1 were randomly assigned to receive either low-calorie or anti-inflammatory accompanied by a low-calorie diet for two months. The dietary intake and weight of participants were measured. Study variables were assessed using the Western Ontario and McMaster Index (WOMAC), visual analog pain scale (VAS), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI-I), and the Short Form 36 Health Survey Questionnaire (SF-36) to indicate the quality of life (QoL).

RESULTS

There was no statistically significant difference between the two groups in demographic and baseline variables except for the emotional well-being subscale of QoL. There was significant difference in anti-inflammatory compared to low-calorie diet in terms of weight (MD (95% CI): - 4.02 kg (- 6.77 to - 1.28); p = 0.005), VAS (MD (95% CI): - 0.97 (- 1.53 to - 0.41); p = 0.001), WOMAC-total score (MD (95% CI): - 9.91 (- 15.05 to - 4.78); p < 0.001), WOMAC-pain subscale (MD (95% CI): - 3.30 (- 5.30 to - 1.29); p = 0.002), WOMAC-physical function (MD(95% CI): - 5.48 (- 9.41 to - 1.53); p = 0.007), depression (p = 0.003), anxiety (p = 0.011), QoL-physical functioning (0.041), and QoL-pain (0.010) after the intervention.

CONCLUSION

An anti-inflammatory accompanied by a low-calorie diet resulted in greater weight loss and greater improvement in pain intensity, functional status, depression, anxiety, and some dimension of QoL in overweight and obese women with knee OA compared to the low-calorie diet. Trial registration number and date of registration: IRCT201610220030424N2; 2018-04-23.

Is hyperemesis gravidarum associated with transient hyperthyroidism? A systematic review and meta-analysis

Emerging evidence suggests an association of hyperemesis gravidarum (HG) with transient hyperthyroidism and high HCG levels. For synthesizing the current evidence to determine the association between HG with hormones related to thyroid function, a comprehensive systematic search was performed in the electronic databases comprised Medline, Web of Science, Scopus, Embase, ProQuest, and Cochrane Library up to December 2021. All published observational studies that evaluated the association of hyperemesis gravidarum with transient hyperthyroidism were investigated considering the PICO method. The standardized Joanna Briggs Institute Meta-Analysis of Statistics, Assessment, and Review Instrument were applied to appraise the included studies. Twenty-nine studies consisted of 6525 women included in the systematic review. Among them, 28 studies with 2446 participants were included in the meta-analysis. There were significant associations of HG with fT3 (MD: 1.31 pg/mL, 95% CI: 0.61 to 2.01), fT4 (MD: 1.95 ng/dL, 95% CI: 1.17 to 2.73), TSH (MD: -1.22μIU/mL, 95% CI: -1.75 to -0.68), TT4 (MD: 0.56 nmol/L, 95% CI:-0.43 to 1.24), and HCG (MD: 1.90IU/L, 95% CI: 0.497 to 3.301). In conclusion, the serum levels of fT3, fT4, and TT4 increased but TSH decreased significantly in women with compared without HG, indicating the significant association of HG with GTT.

The Associations between Bone Mineral Density and Oxidative Stress Biomarkers in Postmenopausal Women

BACKGROUND

Oxidative stress plays an essential role in bone health among postmenopausal women. This study aimed to compare the oxidative stress biomarkers among postmenopausal women aged 50-65 years with normal bone mineral density, osteopenia, and osteoporosis.

METHODS

In this observational study, 120 women with normal bone mineral density, 82 with osteopenia, and 86 with osteoporosis were selected based on the densitometry data obtained from the dual-energy X-ray absorptiometry method. The serum total antioxidant capacity (TAC), superoxide dismutase (SOD) activity, and malondialdehyde (MDA) levels were measured using biochemical methods. A binary logistic regression model adjusted for confounders was used to estimate the risk of osteopenia and osteoporosis. The P-value of <0.05 was considered statistically significant.

RESULTS

There were significant differences between the three groups in age, menopausal age, body mass index, and education (P<0.05). According to the binary logistic regression model, higher SOD activity and serum TAC levels were associated with a lower risk of osteoporosis (adjusted odds ratio [aOR], 0.991; 95% confidence intervals [CI], 0.986 to 0.996; and aOR, 0.373; 95% CI, 0.141 to 0.986, respectively). MDA was a significant risk factor for osteopenia in postmenopausal women (aOR, 1.702; 95% CI, 1.125 to 2.576).

CONCLUSION

Higher SOD activity and serum TAC levels in the studied postmenopausal women were associated with a significantly lower risk of osteoporosis. Moreover, the risk of osteopenia increased significantly with higher serum MDA levels.

The Efficacy of Salvia Officinalis on the Prevention of Recurrent Vulvovaginal Candidiasis: A Randomized, Controlled Clinical Trial

Background:

In addition to physical discomfort, recurrent vulvovaginal candidiasis imposes a significant financial and psychosocial burden, such as lower levels of self-esteem, a higher level of stress, clinical depression, and less satisfaction with their life. Recurrent vulvovaginal candidiasis interferes with emotional and sexual relationships.

Objective:

This study aimed to compare the effect of vaginal Salvia officinalis, clotrimazole, and their combination on the prevention of recurrent vulvovaginal candidiasis.

Methods:

This randomized triple-blinded trial was conducted on 111 women aged 18-49 years with vulvovaginal candidiasis. Participants were randomly assigned into one of the three groups of vaginal tablets of Salvia officinalis-400mg and placebo of clotrimazole-100mg, clotrimazole-100mg and placebo of Salvia Officinalis-400mg, or Salvia officinalis and clotrimazole that were applied every night for 7 consecutive days. A recurrence rate of vulvovaginal candidiasis was evaluated by WET test and vaginitis symptoms examination after 12 weeks. In the case of positive evaluation, the culture of vaginal discharge was performed.

Results:

Totally, 29 patients (80.6%) in group clotrimazole, 33 patients (94.3%) in group Salvia Officinalis and 35 patients (97.2%) in group Salvia officinalis-clotrimazole were treated (P=0.43). Out of cured patients, 4 (13.8%) patients in the group clotrimazole, 1 patient (3%) in group Salvia Officinalis, and no case in group Salvia officinalis-clotrimazole experienced the recurrence of infection. There was a significant difference among the 3 groups in terms of recurrence (P=0.023). Moreover, no adverse event during the 12 weeks after treatment was observed.

Conclusion:

Adjuvant therapy of Salvia Officinalis alongside routine vaginal clotrimazole could successfully prevent recurrent vulvovaginal candidiasis after three months.

Curcumin and vitamin E improve hot flashes, lipid profile, and fasting blood glucose without any detrimental effect on the liver and renal function in postmenopausal women: A triple-blind placebo-controlled clinical trial

We conducted this study to evaluate the efficacy of Curcumin and vitamin E on hot flashes, lipid profile, blood glucose, and hepatic & renal biomarkers. Eighty-four postmenopausal women were randomly assigned into three groups to receive one Curcumin 500 milligram, vitamin E 200 IU, or placebo capsules twice/daily/eight weeks. In comparison with placebo, vitamin E significantly decreased the number of hot flashes (P = 0.002), serum triglyceride (P < 0.001), and aspartate aminotransferase (P = 0.007), while it increased high-density lipoprotein cholesterol (P = 0.005). Curcumin decreased significantly fasting blood glucose (P = 0.007), total cholesterol (P = 0.015), and triglyceride (P = 0.007) compared to placebo. We conclude that vitamin E reduced the incidence of hot flashes by nearly one-third of the base amount. It improved serum lipid profile and aspartate aminotransferase. Curcumin ameliorated fasting blood glucose and serum lipid profile.

Effect of Aromatherapy with Essential oil of Lavandula Angustifolia Mill- Citrus Bergamia and Mindfulness-Based Intervention on Sexual Function, Anxiety, and Depression in Postmenopausal Women: A Randomized Controlled Trial with Factorial Design

BACKGROUND

Due to the importance of psychological support for women during menopause as a period with a high prevalence of mental health problems, this study aimed to evaluate the effect of the essential oil of lavender-Bergamot (La-Ber) and Mindfulness-Based Intervention (MBI) on sexual function, anxiety (primary outcome), and depression score (secondary outcome) in postmenopausal women with sexual dysfunction.

MATERIALS AND METHODS

This controlled randomized trial with a factorial design was performed on 132 postmenopausal women. Participants were randomly allocated into four equal groups: Aromatherapy-Routine Care (Aroma-RC), MBI-Placebo (MBI-P), Aromatherapy-MBI (Aroma-MBI), or Routine Care-Placebo (RC-P). Two to three drops of La-Ber or a similar placebo were inhaled three times a day for 8 weeks. Eight sessions of MBI intervention were conducted. At the end of the intervention and eight weeks afterward, the outcomes were assessed.

RESULTS

The sexual function score improved significantly in Aroma-MBI (adjusted Mean Difference [aMD]: 2.4, 95% CI: 0.01 to 4.80) and MBI-P (aMD: 2.6, 95% CI: 0.2 to 5.1) groups compared to the RC-P group. The anxiety score was reduced in the Aroma-RC group at the end of the intervention (aMD: -4.12, 95% CI: -7.41 to -0.72; p = 0.020) and eight weeks later as well as in the Aroma-MBI group. In terms of depression, the mean score of depression was significantly lower than the RC-P group in the Aroma-RC group at the end of the intervention (p = 0.011).

CONCLUSIONS

MBI and aromatherapy seem effective on sexual function and menopausal anxiety. MBI improves sexual function, while aromatherapy ameliorated anxiety and depression.

The effect of decision-aid-based counseling on cervical cancer screening behavior among women: An interventional study

BACKGROUND

Performing appropriate and regular screening can effectively reduce cervical cancer and mortality rate, however, the available evidence suggests that women's participation in cervical cancer screening remains low in middle- and low-income countries, and that it is necessary to identify appropriate intervention methods to change behavior. The present study was designed to determine the effect of decision-aid-based counseling on cervical cancer screening behavior among women.

MATERIALS AND METHODS

This trial study was conducted on 154 women with no history of Pap smear during the past 3 years and refers to Tabriz health care centers. The participants were assigned to the intervention (decision aid based counseling) and control (routine health education) groups through randomized block design with block sizes of 4 and 6 and a 1:1 allocation ratio. The data were collected using the sociodemographic and fertility characteristics, stages of change checklist, and shared decision-making (SDM) and decisional conflict (DC) questionnaire before and 6 months after the intervention by interview and then, analyzed by SPSS24 software. The independent t-test, ANCOVA tests were used.

RESULTS

A significant difference was observed between the two groups in terms of changing the stages of cervical cancer screening behavior 6 months after the intervention. As after the intervention, the frequency of individuals entered the preparation or action stage was more than the control group (P = 0.001). The mean score of SDM in the intervention group was significantly higher than the control group after intervention ([45.49 ± 1.18] vs. [27.56 ± 1.18] [Mean Difference (MD): 17.92; 95% confidence interval [CI]: 14.59-21.25; P < 0.001]). The mean score of DC in the intervention group was significantly lower than the control group after intervention ([29.16 ± 1.09] vs. [34.14 ± 1.09] [MD: -4.97; 95% CI: 1.09-8.04; P < 0.002]).

CONCLUSIONS

This study revealed that evidence-based information communicated between clients and clinicians has very important role in clients' health-related behavior. It is recommended, health care providers apply decision-aid-based counseling for promoting the cervical cancer screening behavior among women.

The effect of counseling based on acceptance and commitment therapy on anxiety, depression, and quality of life among female adolescent students

BACKGROUND

Adolescence is a stressful time period. Adolescents experience new changes physically, mentally, emotionally, and socially. The purpose of this study was to determine the effects of acceptance and commitment therapy (ACT) on anxiety (primary outcome), depression, and quality of life (secondary outcomes) of adolescents.

MATERIALS AND METHOD

This was a quasi-experimental study with pre and postintervention design. One hundred female students aged 16-18 years with mild to moderate anxiety selected through multistage cluster sampling from five educational districts of Tabriz. During six group counseling sessions, students were consulted with the acceptance and commitment approach according to the protocol. Beck Anxiety and Depression Inventory and the World Health Organization brief Quality of Life Questionnaire consultation were completed before, immediately after, and 8 weeks after the consultation. Data were analyzed using repeated measure ANCOVA.

RESULTS

The mean anxiety score decreased significantly immediately after the intervention (mean difference [MD]: -4.0, 95% confidence interval [CI]: -5.9 to - 2.0; P < 0.001) and 8 weeks later (MD: -3.9, 95% CI: -5.8 to - 1.9; P < 0.001). The mean depression score immediately (P < 0.001) and 8 weeks after intervention (MD; -4.2, CI: -1.6 to - 6.8), P < 0.001) declined significantly. The mean overall quality of life score increased significantly after the intervention (P < 0.001) and 8 weeks later (MD: 4.7, 95% CI: 7.1-2.3, P < 0.001) compared to baseline.

CONCLUSIONS

Based on the effectiveness of counseling based on ACT on anxiety, depression, and quality of life in the female students with the mild and moderate anxiety over time, it can be used as a helpful method in high schools.

The Effect of Selected Herbal Medicines on Bone Turnover Markers: A Systematic Review and Meta-Analysis

Objective: To evaluate systematically the therapeutic effects of five herbal medicines (curcumin, black seed, ginger, cinnamon, and flaxseed oil) on bone turnover markers as a primary outcome. Materials and methods: A comprehensive systematic search of the literature was conducted in the electronic databases consisting of the Cochrane Library, MEDLINE, Web of Science, Scopus, Embase, ProQuest, and Google scholar, as well as SID, Magiran, and Irandoc for Persian literature up to December 2020. All Randomized controlled trials and quasi-experiments evaluated the impact of studied herbal medicines on bone turnovers of Bone Specific Alkaline Phosphatase (BSAP), osteocalcin, C-terminal Telopeptide type 1 Collagen (CTX-I), Deoxypyridinoline (DPD) were analyzed. Results: Sixteen interventional studies comprised 968 participants included in systematic review. Ten of eligible studies with 603 participants included in meta-analysis. Curcumin, black seed and flaxseed did not have a significant effect on BSAP (SMD=-1.76, 95%CI: -6.85 to 3.33, p=0.50, I2=0.99, 6 trials, 241 participants), CTx (SMD=-0.17ng/mL, 95%CI:-0.43 to 0.09, p=0.21, I2=1.000, 5 trials, 216 participants), DPD (MD=0.82nmol/mmol, 95%CI:-0.05 to 1.68, p=0.06, I2=0.000, 2 trials, 67 participants), osteocalcin (SMD=-2.02ng/mL, 95%CI:-4.49 to 0.45, p=0.11, I2=0.79, Six trials, 229 participants). As secondary outcomes, femoral neck Bone Mineral Density (BMD) increased significantly (p=0.03, I2=0.12) but lumbar spine BMD didn’t differ (p=0.28, I2=0.97). Curcumin significantly increased total hip BMD (p<0.001, I2=0.12). QiangGuYin containing cinnamon as a combined Chinese medicine had significant effect on P1NP, β-CTx, and BMD. Conclusion: Studied herbs except for QiangGuYin had no significant effects on bone turnover markers. Due to high heterogeneity between trials, further high-quality trials are suggested.

Efficacy of nanomicelle curcumin, Nigella sativa oil, and their combination on bone turnover markers and their safety in postmenopausal women with primary osteoporosis and osteopenia: A triple-blind randomized controlled trial

Literature supports the potential effects of nanomicelle curcumin and Nigella sativa on the amelioration of osteoporosis, a health concern of postmenopausal women. This study aimed to evaluate the impacts of nanomicelle curcumin (CUR), Nigella sativa oil (NS), and their combination on bone turnover biomarkers and assess their safety. This triple-blind randomized controlled trial was performed on 120 postmenopausal women aged 50-65 with primary osteoporosis or osteopenia. The subjects were randomly allocated to receive microcrystalline cellulose (placebo), 80 mg of CUR, 1000 mg of NS, or their combination (CUR-NS) for 6 months. All patients were also treated with alendronate (70 mg) and calcium (500 mg), vitamin D (400 IU) supplements. The serum levels of alkaline phosphatase (ALP), osteocalcin (OC), and osteopontin (OP) were measured at the baseline and after the intervention. For safety assessment, the hepatic enzyme levels of aspartate transaminase and alanine transaminase as well as serum urea and creatinine were evaluated. ALP levels were significantly reduced in the NS (p = .029) and CUR-NS (p = .015) groups compared with those in the placebo. After adjustment for the covariates, this effect was still significant in the CUR-NS group (p = .004). The OC levels were decreased in the placebo, CUR, and NS groups, and the OP concentration also was attenuated in all groups through the trial. However, the intergroup differences were not significant for both biomarkers. Evaluating the key renal metabolites and hepatic enzyme levels indicated no toxicity of the administered doses. This study reveals the beneficial effects of CUR-NS on the improvement of some bone turnover biomarkers. These compounds seem to be safe at the current dosage for supplementation in postmenopausal women.

The associations between bone mineral density with body composition parameters in postmenopausal women

Body composition plays an essential role in bone health among postmenopausal women thus we decided to compare body composition in normal bone mass density, osteopenia and osteoporosis women. In this cross-sectional study, 142 normal, 109 osteoporotic, and 194 osteopenic postmenopausal women were selected. Socio-demographic and anthropometric characteristics were investigated. IPAQ-SF questionnaire was applied for evaluating physical activity. Body composition data were obtained using the bioimpedance analysis (BIA) method. A logistic regression model adjusted for confounders was used to estimate the risk of osteopenia and osteoporosis. The odds of osteopenia decreased by increasing Percent Body Fat, PBF (aOR: 0,922; 95% CI 0,867-0,980), Mass of Body Fat, MBF (aOR: 0,909; 95% CI: 0,872 to 0,947), Soft Lean Mass, SLM (aOR: 0,921; 95% CI 0,880-0,964), Lean Body Mass, LBM (aOR: 0,910; 95% CI 0,871-0,951), Visceral Total Body Water, TBW (aOR: 0,878; 95% CI 0,828-0,933), mineral mass (aOR: 0,356; 95% CI 0,231-0,548), body weight (aOR: 0,955; 95% CI 0,934-0,976), and Body Mass Index, BMI (aOR: 0,896; 95% CI 0,848-0,947). The odds of osteoporosis decreased by increasing PBF (aOR: 0,838; 95% CI 0,773-0,909), MBF (aOR: 0,840; 95% CI 0,792-0,891), SLM (aOR: 0,889; 95% CI 0,839-0,941), LBM (aOR: 0,910; 95% CI 0,871-0,951), Visceral Fat Mass, VFM (aOR: 0,465; 95% CI 0,351-0,615), mineral mass (aOR: 0,163; 95% CI 0,086-0,307), body weight (aOR: 0,907; 95% CI 0,876-0,938), and BMI (aOR: 0,797; 95% CI 0,733-0,867). Increased body composition parameters reduced the risk of low bone mass density.

Comparing the effect of electronic and lecture education of pain management on the knowledge, attitude, and practice of nurses: A randomized-controlled trial

INTRODUCTION

Efficient pain management by nursing staff initially needs accurate knowledge and proper attitude in this field. The aim of present study was to compare the effects of lecture and electronic education on the knowledge, attitude, and practice of nursing staff regarding pain management.

MATERIALS AND METHODS

The present superiority randomized controlled trial with two parallel arms was conducted on 78 occupied nurses of surgery wards of X. The participants were recruited randomly and divided into two groups of lecture and electronic education through random blocking (4 and 6 blocks). For allocation concealment, coded nontransparent pockets numbered 1-78 containing the type of intervention were used. Educational material was presented using teacher-centered method in lecture group, as well as through multimedia program using FLASH software in e-learning group through 1-h sessions for 4 weeks. Data on nurses were collected before and 4 weeks after the training using demographic questionnaire, Pain Management Principles Assessment Tool, Nurses' Attitude Survey, and nursing practice checklist. Data were analyzed using SPSS software (version 24) utilizing descriptive and analytic statistical test such as Chi-square, Fisher, independent t-test, and ANCOVA. P < 0.05 was considered statistically significant.

RESULTS

Mean ± standard deviation of nurses' knowledge, attitude, and practice regarding pain management had significant increase in both groups post-training (P < 0.001). According to ANCOVA the mean postintervention knowledge score in e-learning group by controlling baseline score had significant increase compared to the lecture group (adjusted mean difference [aMD] = 1.8: 95% confidence interval [CI] = 1.5-2.1, P < 0.001). Furthermore, the mean of total scores of post-intervention attitude and practice in e-learning group adjusted for baseline score significantly increased compared to lecture group (aMD = 1.8: 95% CI = 1.5-2.1, P < 0.001) and (aMD = 3.2: 95% CI = 2.7-3.6, P < 0.001).

CONCLUSION

Electronic education was more efficient than lecture education in increasing of knowledge, attitude, and practice on pain management among nursing staff.

The effect of nanomicelle curcumin supplementation and Nigella sativa oil on the expression level of miRNA-21, miRNA-422a, and miRNA-503 gene in postmenopausal women with low bone mass density: A randomized, triple-blind, placebo-controlled clinical trial with factorial design

This study aimed to investigate the effect of nanomicelle curcumin (CUR), Nigella sativa oil (NS), and CUR and NS on the plasma levels of miR-21, miR-422a, and miR-503 expression in postmenopausal women with low bone mass density (BMD). This randomized, triple-blind, placebo-controlled clinical trial with a factorial design was conducted on 120 postmenopausal women from the integrated healthcare system, Tabriz-Iran. The BMD was determined using dual-energy X-ray absorptiometry (DEXA). Women were randomly divided into four groups of 30 participants: (a) CUR (80 mg) and placebo of NS, (b) NS (1,000 mg) and placebo of CUR, (c) CUR (80 mg) and NS (1,000 mg), and (d) both placebos (containing microcrystalline cellulose). The plasma level of miRNA-21, miRNA-422a, and miRNA-503 was determined by qRT-PCR. The expression level of miRNAs at the baseline was similar. At the end of the intervention, only the expression level of miRNA-21 changed statistically significantly between the four groups (p = .037) and between the NS and placebo groups (p = .005). Also, its expression in the two groups receiving NS (p = .037) and NS-CUR (p = .043) was significantly increased. NS and NS-CUR supplementation can increase the expression level of miRNA-21 in postmenopausal women with low bone density, and bring perspective to further studies of the target.

The Effect of Probiotics or Synbiotics on the Hypertensive Disorders of Pregnant Women with Gestational Diabetes: A Systematic Review and Meta-analysis

Introduction: Antioxidants and anti-inflammatory drugs have been suggested to treat preeclampsia. This systematic review and meta-analysis was conducted to investigate the efficacy of probiotic or synbiotic supplementation on hypertensive disorders in women with gestational diabetes mellitus (GDM)

. Methods: The databases including Cochrane, Embase, Ovid, ProQuest, Scopus, Web of Science, and PubMed were systematically searched for collecting the randomized controlled trials (RCTs) investigating the efficacy of probiotic or synbiotic supplementation versus placebo on hypertensive disorders and pregnancy outcomes in GDM until July 2020.

Results: Five RCTs with a total sample size of 402 women were included in the meta-analysis. There was no significant decline in systolic blood pressure (standardized mean difference [SMD]=-3.41, 95% confidence interval [CI]=-8.32 to 1.50, P=0.17), diastolic blood pressure (SMD=-5.11, 95% CI=-14.20 to -3.98, P=0.27), preeclampsia (odds ratio [OR]=1.56, 95% CI=0.61 to 3.98, P=0.35), cesarean section (OR=0.52, 95% CI=0.18 to 1.50, P=0.23), and macrosomia (OR=0.81, 95% CI=0.41 to 1.57, P=0.53). No significant increase was observed in terms of 5-minute Apgar (SMD=0.16, 95% CI=-0.06 to 0.39, P=0.15, I²=0%), birth weight (SMD=-0.18, 95% CI=-0.43 to 0.06, P=0.13, I²=0%), and gestational age (SMD=0.13, 95% CI=-0.11 to 0.37, P=0.28, I²=0%).

Conclusion: Probiotic or synbiotic supplements are not associated with significant effects on pregnancy outcomes in GDM. However, due to the limited number of studies in this regard and heterogeneity between studies, future high-quality RCTs are recommended.

Comparison of the effect of Ceratonia siliqua L. fruit oral capsule and vitamin E on semen parameters in men with idiopathic infertility: a triple-blind randomized controlled clinical trial

OBJECTIVES

To compare the effect of oral Ceratonia siliqua (Carob) and vitamin E on sperm parameters in idiopathic infertile men.

METHODS

In this triple-blind randomized controlled trial study, fifty 20-45-year-old infertile men with idiopathic abnormal sperm parameters were selected among men referring to the infertility clinic of Al Zahra-Iran Hospital, and randomly allocated into two groups. The first group received Carob capsules, 500 mg, and the second group received vitamin E capsules three times a day for 90 days. The primary outcomes of this study were the sperm parameters (count, motility, and morphology).

RESULTS

After the intervention, the mean of sperm count increased from 49.08 to 60.22 million/mL in the carob vs. it increased from 47.64 to 58.88 million/mL in the vitamin E group (adjusted mean difference (aMD)=1.124 million/ml, 95% CI: -12.892 to 15.141). The mean sperm motility increased from 45.90 to 52.90% in the carob group but decreased from 55.23 to 38.10% in the vitamin E group (aMD=17.22%, 95% CI: 8.53 to 25.92). The mean sperms with normal morphology increased from 11.52 to 67.05% in the carob, and from 10.20 to 77.47% in the vitamin E group (aMD=-10.88%, 95% CI: -22.30 to 0.536). There was no serious side effect during the treatment course.

CONCLUSIONS

Taking 1,500 mg oral dose of Carob capsule per day for 90 days improved sperm motility but had no significant effect for improving morphology and count comparing to vitamin E capsule.

Prevalence of primary osteoporosis and low bone mass in postmenopausal women and related risk factors

BACKGROUND

Globally, 30% of female over 50 years old have osteoporosis. This disease is one of the major causes of disability and death in the elderly. This research was aimed to determine the prevalence of primary osteoporosis and low bone density based on bone mineral density in postmenopausal women and its sociodemographic, obstetric, and life style risk factors.

MATERIALS AND METHODS

This cross-sectional descriptive-analytical study was performed by simple random sampling on 850 postmenopausal women aged 50-65 years covered by all health centers, from August 2018 to April 2019, in Tabriz-Iran. Four hundred and forty-five eligible women underwent densitometry using dual-energy X-ray absorptiometry in the lumbar spine and femoral neck. Socio-individual, obstetric-medical, international physical activity questionnaires-short form, and anthropometric questionnaires were completed. Data analyzed using descriptive and analytical statistics including multivariate logistic regression in SPSS 21 software.

RESULTS

The prevalence of primary osteoporosis based on lumbar vertebra T-score, femoral neck T-score, and total was 23.4%, 3.4%, and 24.5%, respectively, and the prevalence of primary osteopenia based on lumbar vertebra T-score, femur neck T-score, and total was 42%, 35.5%, and 43.6%, respectively. The present study showed that the odds of osteoporosis increased by increment of age (odds ratio [OR]: 1.18; 95% confidence interval [CI]: 1.07-1.30), but it decreased by increasing menopausal age (OR: 0.92; 95% CI: 0.85-1.01), body mass index (OR: 0.87; 95% CI: 0.78-0.97), arm circumference (OR: 0.84; 95% CI: 0.74-0.95), and education level (P = 0.028). It was higher in unmarried women (OR: 2.65; 95% CI: 0.99-7.08) and those with nonpersonal housing (OR: 4.02; 95% CI: 1.24-13.07).

CONCLUSIONS

Given the high prevalence of primary osteoporosis and low bone mass in postmenopausal women, health education is necessary for preventing modifiable risk factors and reducing the complications of this disease.

Short-term Outcomes of Launching Mother's Milk Bank in Neonatal Intensive Care Unit: A Retrospective Study

BACKGROUND

The WHO and UNICEF have suggested pasteurized donor milk (PDM) as the best alternative for infants who do not receive enough milk from their mothers. Objective: This study aimed to assess the short-term outcomes of launching the first mother's milk bank in North-West of Iran.

METHODS

The present retrospective study included 366 premature infants (181 pre-launch and 185 post-launch) who were hospitalized in Al-Zahra Hospital of Tabriz, Iran. The study included infants with birth weight ˂2000 g and/or gestation age ˂32 weeks who were born before and after the launch of mother's milk bank. Frequency of necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), late onset sepsis (LOS) and mortality rate were compared. Data were analyzed using SPSS 23 with the chi-square test, Fisher exact test, independent t test, and logistic regression test.

RESULTS

In total, NEC grade ≥2 was reported in 9 cases; 8 cases (4.41%) in pre-launch and one case (0.54%) in post-launch (adjusted OR=0.091; 95% CI=0.010 to 0.849, P=0.035). ROP was reported in 21 cases in two groups. Nineteen cases (10.5%) belonged to the pre-launch group and 2 cases (3.7%) to the post-launch group (adjusted OR=0.105; 95% CI=0.022 to 0.488, P=0.004). LOS was also found in 17 cases (9.39%) in the pre-launch group and 4 cases (2.16%) in the post-launch period, suggesting a significant difference between the two groups (adjusted OR=0.297; 95%CI=0.089 to 0.995, P=0.049). There was no significant difference in mortality of infants during hospitalization between the two groups (P=0.789); however, it was decreased from 15 to 8.

CONCLUSION

Launching the human milk bank significantly improved the outcomes of premature infants.

Effect of smartphone-based education on knowledge and self-care of reproductive health in married students

BACKGROUND

Education by smartphone-based software is a new method among the world's educational practices. Due to the lack of studies on the effect of this education on promoting knowledge and self-care behaviors of students' reproductive health this study aimed to determine the effect of smartphone-based software education on knowledge and self-care behaviors in the field of reproductive health.

MATERIALS AND METHODS

This RCT with 164 married female students (82 in each group) conducted from October 2019 to January 2020, in Tabriz University and Tabriz medical University. Participants were randomly allocated to two groups of educational intervention and control. Smartphone-based software education designed in four areas of reproductive health. Intervention group was trained for 4 weeks. The score of knowledge and self-care behaviors of participants in both groups were compared at baseline and 8 weeks after intervention. Data were analyzed by SPSS-23 software using Chi-square, independent t-tests, and analysis of covariance tests.

RESULTS

Eight weeks after the intervention, a significant increase was observed in the mean (standard deviation [SD]) score of overall knowledge for reproductive health and all its subdomains (P < 0.001), as well as in in the mean (SD) self-care score of reproductive health and all subdomains (P < 0.05), except for the family planning in the education group compared to the control group.

CONCLUSION

The findings indicate a significant effect of smartphone-based software on increasing students' knowledge and self-care in all areas of reproductive health except for family planning subdomain of self-care.

Health-promoting lifestyle and quality of life in affected and unaffected menopausal women by primary osteoporosis

BACKGROUND

Primary osteoporosis is a common complication of aging and menopause. The negative effects of osteoporosis in the coming years will increase by increasing life expectancy and population aging. The purpose of this research was to compare health-promoting lifestyle and quality of life in postmenopausal women with and without primary osteoporosis.

MATERIALS AND METHODS

This cross-sectional analytical research was conducted on 445 postmenopausal women aged 50-65 selected by simple random sampling in Tabriz health centers from September 2018 to July 2019. Data collection instruments included demographic, midwifery, anthropometric, health-promoting lifestyle profile II and menopausal quality-of-life questionnaire questionnaires, and serum test checklist (25-hydroxy vitamin D, complete blood count/diff, thyroid-stimulating hormone, fasting blood sugar, Calcium, and Phosphor). Dual-energy X-ray absorptiometry method was used to measure bone density. Data were analyzed using SPSS/23 through descriptive and inferential statistics such as Chi-square, independent t-test, Mann-Whitney, and multiple regression.

RESULTS

The mean score of lifestyle was 141.2 ± 21.9 in normal and 127.2 ± 25.4 in osteoporosis group, and differences were statistically significant in total score (P < 0.001) and all subdomains. The mean score of quality of life was 3.9 ± 1.2 in the normal and 4.5 ± 1.4 in the osteoporotic group. The differences were significant in total score (P < 0.001) and all subdomains except for sexual function subdomain (P = 0.064). Logistic regression adjusted for confounders indicated by one unit increase in total lifestyle score, the odds of primary osteoporosis reduced by 2.2% (adjusted odds ratio [0.95% confidence interval]: 0.978 [0.963-0.994], P = 0.006).

CONCLUSION

To prevent of primary osteoporosis and improve the quality of life of postmenopausal women, it seems that education and implementation of health-promoting lifestyle are essential. The research findings can be used to plan for health care in middle and old ages.

Objective and Subjective Investigation of Physical Activity Levels and Its Relation with Socio-Demographic Characteristics among Medical Students

Background

Combining the results of objective and subjective assessments of physical activity (PA) can provide a more complete assessment of PA patterns in medical students. This study aimed to determine the relationships between objective and subjective measured PA and its relation with socio-demographic characteristics among different stages of medical training.

Methods

This cross-sectional study was conducted on 186 students of four stages of medical training. The International Physical Activity Questionnaire Short-Form (IPAQ-SF) and pedometer were used.

Results

There were significant differences in total PA in terms of gender, weight, and serious illness. Differences between four stages of medical training in total (p = 0.002), vigorous (p < 0.001), and moderate PA (0.026) based on IPAQ-SF as well as pedometer-counted steps in Tuesday (p = 0.002) and Wednesday (p = 0.006) were significant. The results demonstrated a positive significant relationship between total PA based on IPAQ-SF and pedometer-determined steps in four days of the week.

Conclusion

There were positive low correlations between PA based on IPAQ-SF and pedometer among medical students. The PA of medical students at different years of medical training was different based on both IPAQ-SF and pedometer, which shows the need to pay attention to the special needs of students in terms of PA at each stage.

The effect of Nigella sativa on oxidative stress and inflammatory biomarkers: a systematic review and meta-analysis

OBJECTIVES

The present systematic review of literature was conducted to study the effect of Nigella sativa (N.S) on oxidative stress and inflammatory biomarkers.

CONTENT

Different online databases such as Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), Scopus, Web of Sciences, EMBASE, and Clininaltrial.gov for English articles and national databases of SID, Magiran, Irandoc, and Iranmedex for Persian articles, which were published until March; 2019 were scrutinized. All Randomised Controlled Trials (RCTs) and quasi-experimental studies that aimed to compare the impact of N.S along, with placebo or without supplementation, on inflammatory factors and oxidative stress were entered in the present study.

SUMMARY

Finally, 11 RCTs covering 710 women and men, in total, were participated in the present meta-analysis. Significant differences were observed in Tumor Necrosis Factor alpha (TNF-α) (Weighted Mean Difference (WMD) =-2.15 pg/mL, 95% Confidence Interval (CI) =-3.22--1.09, I²=32%; 5 trials with 262 participants) superoxide dismutase (WMD=63.79 µ/gHb, 95% CI=6.84-120.75, I²=0%; 2 trials, with 88 participants), and total antioxidant capacity (WMD=0.34 mmol/L, 95% CI=0.04 to 0.63, I²=94%; 5 trials with 232 participants). Nevertheless, there was no significant difference in high sensitivity C-reactive protein (WMD=-0.98 mg/L, 95% CI=-1.98-0.03, I²=78%; 5 trials with 267 participants), Interleukin 6 (IL-6) (WMD=-0.25 pg/mL, 95% CI=-0.65 to 0.16, I²=0%; 2 trials with 134 participants), and malondialdehyde (WMD=-0.95 nmol/mL, 95% CI=-1.97-0.08, I²=68%; 4 trials with 179 participants).

OUTLOOK

Generally speaking, N.S probably results in the improvement of superoxide dismutase serum levels, TNF-α, and total antioxidant capacity. Thus, further studies are required to fully assess its impacts on all oxidative stress and inflammatory biomarkers.

Predictors of preventive behaviors of AIDS/HIV based on Health Belief Model constructs in women with high-risk sexual behaviors: A cross-sectional survey

BACKGROUND

Worldwide, AIDS is an acute problem. Health Belief Model (HBM) is a model for prevention and control of diseases. This study examined the predictors of preventive behaviors of HIV/AIDS based on HBM constructs in participants.

MATERIALS AND METHODS

This cross-sectional study was performed on 200 women who were referred to vulnerable women's centers across Tabriz city between November and December 2018. Participants were selected by census sampling. Inclusion criteria were having a health record, multiple sexual partners, reading and writing skills, and willingness to participate in the study. To collect data, questionnaires of sociodemographic characteristics, HIV knowledge, self-efficacy for negotiating safe sex, perceived sensitivity, perceived severity, perceived benefits, perceived barriers, and behavioral prevention (BP) were used. The collected data were analyzed using SPSS version 19 through Pearson's correlation coefficient, one-way ANOVA, and multiple linear regression analyses. The significant level was set at α = 0.05.

RESULTS

Pearson's correlation test showed a statistically significant correlation between BP and perceived sensitivity (r = 0.25), perceived benefits (r = 0.32), self-efficacy (r = 0.33), and HIV knowledge (r = 0.25) constructs (P < 0.001). According to the multiple linear regression, perceived sensitivity (P = 0.020), perceived benefits (P = 0.036), and some of the sociodemographic characteristics were found to be predictors of preventive behaviors that explained in total 50% of variance of BP (P < 0.05 and R ² = 0.504).

CONCLUSION

It seems that the HBM is useful to predict HIV preventive behaviors among this vulnerable group. Training programs should be aimed on improving the health belief of HIV preventive behaviors.

Effectiveness of education based on family-centered empowerment model on health-promoting behaviors and some metabolic biomarkers in elderly women: A stratified randomized clinical trial

OBJECTIVE

The purpose of family-centered care interventions is to enhance the abilities of family members in certain areas that overcome the barriers to health and well-being, The purpose of the present research was to determine the effect of education based on family-centered empowerment model on health-promoting behaviors and some serum metabolic indicators in elderly women.

MATERIALS AND METHODS

In this stratified randomized controlled trial, 60 elderly women aged 60 years and older referring to elderly-friendly health centers in Tabriz-East Azerbaijan were divided randomly into intervention and control groups in 2019. Intervention group received a family-centered healthy lifestyle intervention once a week for 10 sessions and the control group received the routine care. The mean score of health-promoting behaviors using the Health Promoting Lifestyle Profile-II questionnaire, glycemia and serum lipid profile, liver and renal function, 25-hydroxy Vitamin D, and calcium serum levels were assessed before the intervention, 2 and 6 months after the intervention through SPSS/version 23 using independent t-test, ANCOVA, and repeated measure analysis.

RESULTS

The ANCOVA test showed a significant increase in total lifestyle score in the intervention compared to the control group, 2 (adjusted mean difference [aMD]: 13.7; 95% confidence interval [CI]: 5.6-21.8) and 6 months (aMD: 17.2; 95% CI: 7.7-26.7) after education. The score of the nutrition and health responsibility domains significantly increased two (P < 0.05) and 6 months (P < 0.001) after the intervention in the intervention group compared to control. In both groups, serum levels of total cholesterol, low-density lipoprotein cholesterol, urea, and creatinine showed a significant decrease, and high-density lipoprotein cholesterol and calcium levels showed a significant increase (P < 0.05).

CONCLUSION

A healthy lifestyle education based on family-centered empowerment model increased the total lifestyle score. So, it is recommended as an effective educational approach to improve the health of elderly.

The effect of counseling based on ex-PLISSIT model on sexual function and marital satisfaction of postpartum women: A randomized controlled clinical trial

INTRODUCTION

Since routine counseling does not suffice to resolve the sexual problems at postpartum period, the present study aimed to investigate the effect of counseling based on the Ex-PLISSIT model on sexual function and marital satisfaction of postpartum women.

METHODS

This was a randomized controlled clinical trial that was conducted on 68 postpartum women (within 3-6 months after childbirth) who obtained a score <28 on the Female Sexual Function Index (FSFI). The participants were randomly assigned to the intervention and control groups. Participants in the intervention group received counseling based on the Ex-PLISSIT model and those in the control group received the routine postpartum care. The required data were collected using a demographics form, the FSFI, and the ENRICH Marital Satisfaction Scale. The primary outcomes were the mean function and martial satisfaction score of participants 4 and 8 weeks after the intervention.

RESULTS

There was no statistically significant difference between the two groups in terms of sexual function at baseline (P = 0.381), but it was significantly higher in the intervention group than control group after intervention (the adjusted MD: 4.24, 95% confidence interval [CI]: 3.18-5.29, P < 0.001). There was no statistically significant difference between the two groups in marital satisfaction before the intervention (P = 0.433), but it increased significantly in the intervention group in comparison to control after intervention (adjusted MD: 23.17, 95% CI: 15.10-31.24, P < 0.001).

CONCLUSIONS

The study findings suggested that sexual counseling based on the Ex-PLISSIT model can improve the sexual function and increase marital satisfaction of postpartum women.

Association between dietary inflammatory index and inflammatory biomarkers with outcomes of in vitro fertilization treatment

AIM

To investigate associations between dietary inflammatory index (DII), high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) with outcomes of in vitro fertilization treatment.

METHODS

This observational prospective study included 144 women undergoing fresh in vitro fertilization cycles who attended infertility center of Al-Zahra Hospital in Tabriz, Iran. DII was computed based on dietary intake assessed using a 3-day 24-h food record diary. Outcomes of in vitro fertilization in this study were considered fertilization rate, embryo quality and positive pregnancy test. Inflammatory biomarkers were measured on the day of embryo transfer.

RESULTS

There was no statistically significant difference between pregnant and nonpregnant women in terms of infertility and demographic characteristics, quantity of retrieved and fertilized oocytes, fertilization rate and number of transferred embryos (P > 0.05). The mean quality scores of resultant embryos (P < 0.001) and transferred embryos (P = 0.019) were significantly lower in the group of pregnant women, indicating the better quality among them. Median (percentile 25-75th) DII in the pregnant women was 1.8 (0.5-2.7) and in the nonpregnant women was 1.6 (0.3-2.6). DII was significantly related to hs-CRP (r = 0.198, P = 0.017) but not to IL-6. There were no significant relationships between DII, serum hs-CRP, IL-6 and in vitro fertilization outcomes (P > 0.05).

CONCLUSION

These findings demonstrate that serum hs-CRP and IL-6 concentration and DII are not predictive markers of in vitro fertilization cycle outcomes in women undergoing in vitro fertilization.

The effect of counseling based on acceptance and commitment therapy on mental health and quality of life among infertile couples: A randomized controlled trial

INTRODUCTION

Infertility by creating a disturbing and debilitating condition is considered as an important individual, public, and social health problem. The purpose of this study was to determine the effect of counseling based on acceptance and commitment therapy (ACT) on mental health and quality of life in infertile couples.

METHODS

In this randomized controlled trial, 54 infertile couples referring to the Sanandaj-Iran Infertility Clinic were assigned into two groups of counseling and control by random blocking with a 1:1 ratio. The consulting group received 8 weekly 90-min sessions of group counseling based on ACT. The General Health Questionnaire-28 (GHQ-28) and Fertility Quality of Life were completed before and 1 month after the completion of the intervention. Primary outcome measures were mean score of mental health and quality of fertility life. Independent t-test, ANCOVA, and Mann-Whitney U-test were used to analyze data.

RESULTS

There was no significant intergroup difference in demographic information (P > 0.05). One month after the end of the intervention, the mean overall mental health score in the couples of the counseling group was significantly less than the control group (adjusted mean difference [aMD]: -8.4; 95% confidence interval [CI]: -10.4--6.4; P < 0.001). Furthermore, the mean overall score of quality of life in the counseling group couples was significantly more than the control group (aMD: 14.8; 95% CI: 11.8-17.9; P < 0.001).

CONCLUSION

Based on the effectiveness of counseling based on ACT on mental health and quality of life in infertile couples, it can be used in the infertility clinics. Health-care providers and counselors should train in the ACT courses to improve the mental health and quality of life of infertile couples.

Pre-natal and post-natal anxiety in relation to pre-pregnancy obesity: A cohort study on Iranian pregnant women

Background:

To determine the association between pre-conception obesity and screening results of pre-natal and post-natal anxiety in women that referred to the health centers of Tabriz, Iran.

Methods:

62 obese (class 2-3) and 245 normal-weight women were enrolled in the first trimester of pregnancy through the cohort study and followed-up 1 year after childbirth from December 2012 to January 2016. The Beck anxiety inventory scale (BAI-II) was completed in five time points: the first, second, third trimester of pregnancy, 6–8 weeks and 12 months after childbirth. Chi-square, Fisher’s exact tests, Independent t-test, Mann-Whitney, and multivariate logistic regression adjusted for confounders were used for data analysis. Statistically significant was considered as p<0.05.

Results:

The rate of moderate to severe anxiety in 1^st, 2^nd, 3^rd trimesters of gestation, 6–8 weeks and 12 months after birth was 8.6%, 10%, 12.6%, 7.8%, 6.5% in normal weight women versus 18%, 17.9%, 19.2%, 12.5%, 19.4% in obese class II women, respectively. The odds of anxiety in the first trimester of pregnancy for class 2–3 obesity was 2.72-fold greater than normal weight group [adjusted odds ratio (aOR) 2.72, 95% confidence interval (CI) 1.14–6.47; p=0.023]. This odd was 3.30- fold (aOR 3.30, 95%CI 1.13-9.60; p=0.045) for 1 year after birth.

Conclusion:

Obesity remained associated with positive screening for anxiety in the first trimester of pregnancy and one year after birth. Obese women more likely require special medical care during their pregnancy due to its impacts on mood.

The Effect of Motivational Interviewing on Women with Overweight and Obesity Before Conception

OBJECTIVE

To investigate the efficacy of motivational interviewing (MI) to elicit change in eating and physical activity behaviors in women with overweight and obesity before conception.

DESIGN

A randomized controlled trial was conducted. The participants were randomly divided into intervention and comparison groups. Data were gathered using the Three-Factor Eating Questionnaire Revised 18-item version (TFEQ-R18), International Physical Activity Questionnaire (IPAQ), and Stages of Change checklist.

SETTING

Primary health centers of Tabriz, Iran.

PARTICIPANTS

The participants were 70 women with overweight or obesity, aged 18-35 years, who were referred for preconception care.

INTERVENTION(S)

The intervention group received 6 MI sessions, and the comparison group received routine preconception care.

MAIN OUTCOME MEASURE(S)

Variables of primary outcomes were eating behavior measures and physical activity levels 8 weeks after intervention.

ANALYSIS

Independent t test, ANCOVA, Fisher exact test, Mann-Whitney U test, and Wilcoxon test were used.

RESULTS

The MI had a positive effect on physical activity in the moderate and vigorous levels in the intervention group (P = .01, P = .02, respectively). After the intervention, the mean score of cognitive restraint in the intervention group was higher than in the comparison group (adjusted mean difference, 16.9; 95% CI, 10.8 to 23.0; P < .001), whereas there were no significant differences between the 2 groups in terms of emotional and uncontrolled eating (P = .33 and P = .25, respectively).

CONCLUSIONS AND IMPLICATIONS

The MI had a positive effect on physical activity and eating behavior change, except for uncontrolled and emotional eating. Future studies to examine differences between overweight and women with obesity and within other populations is warranted.

Maternal C-reactive protein and in vitro fertilization (IVF) cycles

Embryo implantation is accompanied by a potent inflammatory response, and a gradient of cytokines and chemokines produced by endometrial cells supports the embryo-endometrial interaction. C-reactive protein (CRP) serves as an early marker of inflammation and recent studies have illustrated that controlled ovarian hyperstimulation (COH) could increase its levels. Interestingly, a high chance of pregnancy has been reported in women who had an elevated CRP level on the day of embryo transfer. It seems an elevated systemic inflammation in the in vitro fertilization (IVF) cycle can increase the implantation and pregnancy rates. However, the results regarding the association of CRP with ART outcomes are controversial. Therefore, in this review, we aimed to describe how CRP levels change during a cycle of IVF treatment and which factors can potentially affect this pattern of change. Furthermore, the association of CRP with ART outcomes has been discussed.

Association of quality of life with physical activity, depression, and demographic characteristics and its predictors among medical students

BACKGROUND

Medical students face a variety of challenges during their years of medical education that can affect their quality of life (QOL). This study aimed to investigate the association of QOL with physical activity (PA), depression, and demographic characteristics, as well as to determine its predictors among medical students in different stages of education.

METHODS

A cross-sectional descriptive-correlational study was conducted on 186 medical students of Tabriz University of Medical Sciences in different educational stages including basic sciences, physiopathology, externship, and internship using stratified random sampling method. Data were collected using demographic questionnaire, International PA Questionnaire, World Health Organization QOL Questionnaire, and Beck depression inventory-2. Data analysis was performed using SPSS/Ver 23 through descriptive and analytic statistics including one-way analysis of variance, independent t-test, Pearson and Spearman correlation coefficient, and multivariate linear regression model.

RESULTS

There were significant differences in total score of QOL among students in different stages (P < 0.05). There were indirect significant correlations between total score of QOL (β [confidence interval 95%]:-0.85 [-1.11--0.59]) and its all subdomains with Beck depression score but direct significant correlations with total PA (P < 0.05) except for social relationship. Educational stage, employment status, family income, inhabitant, moderate PA, and depression were the predictors of QOL and altogether explained 63% of its variance.

CONCLUSIONS

To pay attention to the predictors of QOL, life among medical students seems necessary for increasing their QOL to provide high-quality care for people with disabilities as well as for the whole community.

Anticancer effect of bacteria on cervical cancer: Molecular aspects and therapeutic implications

Cervical cancer is the second common cancer and the third leading cause of cancer deaths among women in less developed countries. It has been indicated that changes in vaginal microbiome play an important role in the occurrence and development of cervical cancer. However, studies have shown that probiotics play an effective role in fighting cancer by affecting pathogenic bacteria, inducing cancer cells apoptosis, and other anticancer activities. Therefore, the purpose of the present study is reviewing the anticancer effect of cervicovaginal bacteria and their potential for cervical cancer treatment.

The effect of clomiphene citrate, herbal mixture, and herbal mixture along with clomiphene citrate on clinical and para-clinical parameters in infertile women with polycystic ovary syndrome: a randomized controlled clinical trial

INTRODUCTION

To evaluate the effect of a herbal mixture (i.e., Mentha spicata, Zingiber officinale, Cinnamomum zeylanicum, and Citrus sinensis) alone and in combination with clomiphene citrate (CC) compared to CC on the treatment of polycystic ovary syndrome (PCOS).

MATERIAL AND METHODS

This single-blind randomized clinical trial was conducted on 60 infertile participants with PCOS who were randomly divided into three groups. After spontaneous or progestin-induced withdrawal bleeding, group 1 (n = 20) received routine treatment with CC (50-150 mg) for three menstrual cycles from the 3^rd to 5^th day of menstruation for 5 days while group 2 (n = 20) and group 3 (n = 20) received herbal mixture capsules 700 mg/day and the herbal mixture along with CC for 3 months, respectively. Finally, several related parameters were measured, including the level of sex steroids, homeostatic model assessment for insulin resistance (HOMA-IR), lipid profile (primary outcomes), thyroid hormones, and clinical features. The analysis was based on intention-to-treat analysis.

RESULTS

No statistically significant differences were observed between the groups in terms of socio-demographic characteristics. However, after adjustment for baseline, luteinizing hormone (aMD = 4.9; 95% CI: 3.7-6.2), luteinizing hormone/follicle-stimulating hormone (aMD = 0.9; 95% CI: 0.7-1.2), total testosterone (aMD = -0.12; 95% CI: -0.2 to -0.01) in group 2 and free testosterone (aMD = -6.0; 95% CI: -9.7 to -2.3) in group 3 revealed a significant difference compared to group 1. In addition, HOMA-IR in group 2 (aMD = -1.3; 95% CI: -2.4 to -0.2) decreased significantly compared to group 1. Further, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and very low-density lipoprotein cholesterol decreased significantly in group 2 (aMD = -21.8; 95% CI: -31.5 to -12.1; aMD = -29.9; 95% CI: -47.9 to -12.0; aMD = -21.2; 95% CI: -31.3 to -11.1; aMD = -5.1; 95% CI: -7.5 to -2.7) and group 3 (aMD = -18.3; 95% CI: -27.4 to -9.2; aMD = -26.9; 95% CI: -43.8 to -9.9; aMD = -21.4; 95% CI: -31.1 to -11.7; aMD = -5.9; 95% CI: -8.3 to -3.6) compared to group 1, respectively. However, high-density lipoproteins cholesterol in group 2 (aMD = 6.8; 95% CI: 2.9-10.7) and group 3 (aMD = 10.7; 95% CI: 7.2-14.7) increased remarkably compared to group 1. Overall, clinical outcomes improved significantly in all groups (p < 0.05).

CONCLUSIONS

In general, the herbal mixture along with CC was found to improve free testosterone, HOMA-IR, lipid profile, and clinical features of PCOS women.

Association of quality of life with physical activity, depression, and demographic characteristics and its predictors among medical students

BACKGROUND

Medical students face a variety of challenges during their years of medical education that can affect their quality of life (QOL). This study aimed to investigate the association of QOL with physical activity (PA), depression, and demographic characteristics, as well as to determine its predictors among medical students in different stages of education.

METHODS

A cross-sectional descriptive-correlational study was conducted on 186 medical students of Tabriz University of Medical Sciences in different educational stages including basic sciences, physiopathology, externship, and internship using stratified random sampling method. Data were collected using demographic questionnaire, International PA Questionnaire, World Health Organization QOL Questionnaire, and Beck depression inventory-2. Data analysis was performed using SPSS/Ver 23 through descriptive and analytic statistics including one-way analysis of variance, independent t-test, Pearson and Spearman correlation coefficient, and multivariate linear regression model.

RESULTS

There were significant differences in total score of QOL among students in different stages (P < 0.05). There were indirect significant correlations between total score of QOL (β [confidence interval 95%]:-0.85 [-1.11--0.59]) and its all subdomains with Beck depression score but direct significant correlations with total PA (P < 0.05) except for social relationship. Educational stage, employment status, family income, inhabitant, moderate PA, and depression were the predictors of QOL and altogether explained 63% of its variance.

CONCLUSIONS

To pay attention to the predictors of QOL, life among medical students seems necessary for increasing their QOL to provide high-quality care for people with disabilities as well as for the whole community.

The effect of oral capsule of curcumin and vitamin E on the hot flashes and anxiety in postmenopausal women: A triple blind randomised controlled trial

OBJECTIVE

The decline and eventual cessation of estrogen production cause a variety of symptoms during menopause, affecting each woman differently. Most women reported severe hot flashes and night sweats during menopause. The present study aimed to determine and compare the efficacy of curcumin and vitamin E on hot flashes and anxiety (primary objectives), sexual function, menopausal symptoms and adverse effects (secondary objectives).

MATERIALS AND METHODS

This was a triple-blind randomized controlled clinical trial. The participants consisted of 93 postmenopausal women in Ahar city-Iran. They were assigned into three groups (two intervention groups and one control group). The first intervention group received oral capsule of curcumin (500 mg), the second intervention group was given oral tablets of vitamin E (200 IU/day), and the third group (control) received placebo twice a day for eight weeks. The participants completed the hot flash checklist one week before the intervention, and 4 weeks and 8 weeks after the intervention. They also filled out the Anxiety Scale, the Female Sexual Function Index (FSFI), the Greene Climacteric Scale before the intervention, and 4 weeks and 8 weeks after the intervention. One-way ANOVA, repeated measures ANOVA and ANCOVA tests were used for data analysis.

RESULTS

There was no statistically significant difference between groups in terms of demographic characteristics, mean number of hot flashes, mean score of anxiety, sexual function index and menopausal symptoms before the intervention (p > 0.05). The mean age of participants was 51.7 years. Mean number of hot flashes in the curcumin group (adjusted mean difference = -10.7, 95%confidence interval = -3.6 to -17.9, P = 0.001) and in the vitamin E group (-8.7, -0.6 to -15.0, P = 0.029) was significantly lower than the placebo group after the intervention. The first significant effect of curcumin on hot flashes was observed after four weeks (P = 0.027). However, there was no significant difference between vitamin E group and placebo four weeks after intervention (P = 0.052) and the first significant effect of vitamin E on hot flashes was observed after eight weeks (P = 0.025). There was no statistically significant difference between the groups in terms of sexual function index, anxiety and menopausal symptoms (P > 0.05).

CONCLUSION

The results of this study showed that oral intake of curcumin and vitamin E significantly reduced hot flashes in postmenopausal women but had no significant effect on anxiety, sexual function and menopausal symptoms.

Nutrition knowledge and attitude in medical students of Tabriz University of Medical Sciences in 2017-2018

OBJECTIVES

In this cross-sectional study among 220 medical students we aimed to determine the nutritional knowledge and attitude of medical students through clinical training courses (externship and internship) of Tabriz University of Medical Sciences, Iran. A nutritional knowledge questionnaire included 51 questions was used to determine the correct, perceived and accuracy of knowledge of the participant in different aspects of nutrition sciences. The nutrition attitude questionnaire included 30 questions. Both questionnaires were confirmed in terms of the validity and reliability for assessing nutritional knowledge and attitude in this sample of Iranian medical students. Nutritional knowledge and attitude were calculated as percentage of correct or appropriate responses.

RESULTS

The correct knowledge was not significantly different among externs and interns (68.20 ± 7.50% and 67.87 ± 6.04% respectively, p = 0.729). Results showed that most of the participants (49.61% of externs and 57.14% of inters) had a poor nutritional knowledge, significantly varied by age (p = 0.035). The attitude index of the subjects was not significantly different among externs and interns (73.36 ± 9.42% and 74.59 ± 9.20%, p = 0.335). Most students (92.7%) had a very appropriate attitude toward nutrition, significantly varied by sex (p = 0.010). These findings indicate that there are multiple deficiencies in nutrition knowledge of medical students.