We present here a case of central retinal artery occlusion (CRAO) occurring after blunt ocular trauma. This is a rare occurrence and has not been frequently reported in literature. It is important to consider this uncommon but visually catastrophic condition in the differential diagnosis of acute post-traumatic visual deterioration.

Analgesic and wound-healing effects of cinnamon, a widely used spice, have been shown in laboratory rats. However, we found no human studies in this area.

PURPOSE: The receptor activator of nuclear factor kappa B (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) system plays a significant role in osteoclastogenesis, activation of osteoclasts, and regulation of bone resorption. This study aimed to evaluate the use of the salivary soluble RANKL (sRANKL)/OPG ratio as a diagnostic marker for periodontitis in nonsmokers. METHODS: Twenty-five patients with chronic periodontitis and 25 individuals with a healthy periodontium were enrolled in this study. Samples containing 5 mL of unstimulated saliva were obtained from each subject. Salivary sRANKL and OPG concentrations were determined using a standard enzyme-linked immunosorbent assay. Statistical analysis was performed using SPSS ver. 18.0. RESULTS: The levels of sRANKL and OPG were detectable in all of the samples. Positive relationships were found between the plaque index and clinical attachment level and both the salivary concentration of sRANKL and the salivary sRANKL/OPG ratio (P<0.05). The salivary concentration of sRANKL and the sRANKL/OPG ratio were significantly higher in the periodontitis group than in the healthy group (P=0.004 and P=0.001, respectively). In contrast, the OPG concentration showed no significant differences between the groups (P=0.455). CONCLUSIONS: These findings suggest that the salivary sRANKL/OPG ratio may be helpful in the screening and diagnosis of periodontitis. However, longitudinal studies with larger populations are needed to confirm these results.
Biomarkers ; Bone Resorption ; Chronic Periodontitis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Mass Screening ; Osteoclasts ; Osteoprotegerin ; Periodontal Diseases* ; Periodontitis ; Periodontium ; RANK Ligand ; Receptor Activator of Nuclear Factor-kappa B* ; Saliva

BACKGROUND: Findings of most studies indicate that the only way to control diabetes and prevent its debilitating effects is through the continuous performance of self-care behaviors. Physical activity is a non-pharmacological method of diabetes treatment and because of its positive effects on diabetic patients, it is being increasingly considered by researchers and practitioners. This study aimed at determining factors influencing physical activity among diabetic women in Iran, using the extended theory of reasoned action in Iran. METHODS: A sample of 352 women with type 2 diabetes, referring to a Diabetes Clinic in Khoy, Iran, participated in the study. Appropriate instruments were designed to measure the desired variables (knowledge of diabetes, personal beliefs, subjective norms, perceived self-efficacy, behavioral intention and physical activity behavior). The reliability and validity of the instruments were examined and approved. Statistical analyses of the study were conducted by inferential statistical techniques (independent t-test, correlations and regressions) using the SPSS package. RESULTS: The findings of this investigation indicated that among the constructs of the model, self efficacy was the strongest predictor of intentions among women with type 2 diabetes and both directly and indirectly affected physical activity. In addition to self efficacy, diabetic patients' physical activity also was influenced by other variables of the model and sociodemographic factors. CONCLUSION: Our findings suggest that the high ability of the theory of reasoned action extended by self-efficacy in forecasting and explaining physical activity can be a base for educational intervention. Educational interventions based on the proposed model are necessary for improving diabetics' physical activity behavior and controlling disease.
Diabetes Mellitus ; Female ; Forecasting ; Humans ; Intention ; Iran ; Motor Activity ; Reproducibility of Results ; Self Care ; Self Efficacy

Objective: To examine the effect of acupuncture-like transcutaneous electrical nerve stimulation (ACUTENS) on labor pain in nulliparous women. Methods: This randomized clinical trial was conducted at Razi Hospital in Qazvin, Iran between January and July 2018. After the screening process, 144 out of 184 pregnant women were selected by convenience sampling and assigned to an intervention group or a control group by the block randomization method. The intervention group received ACUTENS at Hegu (LI4), Shenmen (HT7), Sanyinjiao (SP6), and Neimadian (Extra) during various stages of delivery in addition to routine labor care at the delivery room. For the control group, the same routine labor care was performed alone. The severity of pain was assessed in the two groups using the visual analog scale (VAS). The data were analyzed using R software (ver. 4.0.2) and repeated measurement analysis of variance. Results: ACUTENS reduced the mean score of pain intensity in the first stage of labor in the intervention group more than that in the control group (P<0.001). Also, the mean scores of pain intensity in the second stage of labor, episiotomy, and one hour after delivery in the intervention group were significantly lower than those in the control group (P<0.001). Conclusion: ACUTENS at Hegu (LI4), Shenmen (HT7), Sanyinjiao (SP6), and Neimadian (Extra) can decrease the intensity of labor pain in nulliparous women. It can be used as a non-pharmacological method for reducing pain in and after labor.

Obesity is a substantial public health challenge across the globe. The use of resistant starch has been proposed as a probable management strategy for complications of obesity. We investigated the effects of resistant starch intake on lipid profiles, glucose metabolism, antioxidant status, lipid peroxidation marker, blood pressure, and anthropometric variables in subjects with overweight or obesity. In this 12-week, randomized, double-blind, placebo-controlled, 2 × 2 crossover trial, 21 Participants (mean age, 35 ± 7.0 years; body mass index, 32.4 ± 3.5 kg/m²) were given 13.5 g Hi-Maize 260 or placebo daily for 4 weeks, separated by a 4-week washout period. Changes in total antioxidant status (p = 0.04) and serum concentrations of insulin in 52.4% participants with insulin levels above 16 µIU/mL at the baseline (p = 0.04) were significantly different in the three phases. In addition, the mean of serum high-density lipoprotein cholesterol after the intervention was significantly higher than after baseline value (p = 0.04). We found no significant differences in serum concentrations of total cholesterol, triacylglycerol, low-density lipoprotein cholesterol, fasting blood sugar, insulin, homeostatic model assessment of insulin resistance, quantitative insulin sensitivity check index, superoxide dismutase activity, malondialdehyde, blood pressure, and anthropometric variables in the three phases of baseline, after intervention with resistant starch and after placebo. Resistant starch consumption improved serum insulin concentrations, lipid profiles, and antioxidant status in subjects with overweight or obesity. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01992783
Adult ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Dietary Fiber ; Fasting ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Lipid Metabolism ; Lipid Peroxidation ; Lipoproteins ; Malondialdehyde ; Metabolism ; Obesity ; Overweight ; Oxidative Stress ; Public Health ; Starch ; Superoxide Dismutase ; Triglycerides

Flaxseed is one of the rich sources of α-linolenic acid and lignan. Flaxseed and its components have antioxidant, hypolipidemic and hypoglycemic effects. The study aimed to investigate the effect of flaxseed enriched yogurt on glycemic control, lipid profiles and blood pressure in patients with type 2 diabetes. A randomized, open-labeled, controlled clinical trial was conducted on 57 patients with type 2 diabetes. Participants were assigned to receive 200 g 2.5% fat yogurt containing 30-g flaxseed or plain yogurt daily for 8 weeks. Anthropometrics and biochemical parameters were evaluated at the beginning and end of the study. After 8 weeks of supplementation, Hemoglobin A1c was significantly decreased in the intervention group compared to control (p = 0.007). Also, at the end of the study, significant differences were seen between the flaxseed enriched yogurt and control groups in triglycerides and total cholesterol concentrations (p = 0.04 and p = 0.01), systolic blood pressure and diastolic blood pressure (p = 0.02 and p = 0.002, respectively). However, we did not find any difference between 2 groups in low-density lipoprotein, high-density lipoprotein, body weight and waist circumference (p > 0.05). Our results showed that the addition of flaxseed to yogurt can be effective in the management of type 2 diabetes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02436369
Blood Pressure ; Body Weight ; Cholesterol ; Diabetes Mellitus, Type 2 ; Flax ; Humans ; Hypoglycemic Agents ; Lipoproteins ; Risk Factors ; Triglycerides ; Waist Circumference ; Yogurt

Objectives: Urinary incontinence (UI) and anal incontinence (AI) cause concern, social exclusion, and ultimately reduced quality of life in women. The aim of present study was to assess the prevalence and related risk factors of UI, AI, and pelvic organ prolapse (POP). Methods: The present study recruited 340 menopausal women living in Tabriz in northwest Iran. The data collection tools included the Pelvic Floor Distress Inventory-20 and a personal and social information questionnaire. POP was diagnosed via clinical examination using the simplified pelvic organ prolapse quantification system. Results: The prevalence of UI and POP was approximately 50%, and approximately 16% of participants reported AI. Based on the odds ratios, the most remarkable risk factor of urinary stress incontinence was the number of vaginal deliveries, whereas that of urinary urge incontinence was obesity. Episiotomy and age were the most major risk factors of AI and POP, respectively. Conclusions The results of the present study showed that the prevalence of POP, UI, and AI is remarkably high among postmenopausal women, warranting the need to prioritize the assessment of POP and various incontinences in middle-aged women in the primary health care system. Furthermore, increased emphasis should be put on modifiable risk factors.

BACKGROUND: Due to the tropism of human parvovirus B19 to erythroid progenitor cells, infection in patients with an underlying hemolytic disorder such as beta-thalassemia major leads to suppression of erythrocyte formation, referred to as transient aplasia crisis (TAC), which may be life-threatening. We investigated the prevalence of parvovirus B19 among patients with beta thalassemia major attending the Zafar Adult Thalassemia Clinic in Tehran, Iran. METHODS: This cross-sectional study was performed to determine the presence of parvovirus B19 DNA in blood samples and parvovirus B19 genotypes in plasma samples of patients with thalassemia major. The population consisted of 150 patients with beta-thalassemia major who attended the Zafar clinic in Tehran. Specimens were studied using a real-time polymerase chain reaction assay. RESULTS: The prevalence of parvovirus B19 in our study population was 4%. Of 150 patients with thalassemia, six (4%) were positive for B19 DNA. There was no significant correlation between blood transfusion frequency and B19 DNA positivity. Finally, phylogenetic analysis of human parvovirus B19 revealed genotype I in these six patients. CONCLUSION: In this study, acute B19 infections were detected in patients with beta thalassemia major. Screening of such high-risk groups can considerably reduce the incidence and prevalence of B19 infection; thus, screening is required for epidemiologic surveillance and disease-prevention measures.
Adult ; beta-Thalassemia* ; Blood Transfusion ; Cross-Sectional Studies ; DNA ; Epidemiological Monitoring ; Erythrocytes ; Erythroid Precursor Cells ; Genotype ; Humans* ; Incidence ; Iran* ; Mass Screening ; Parvovirus ; Parvovirus B19, Human* ; Plasma ; Prevalence ; Real-Time Polymerase Chain Reaction ; Thalassemia ; Tropism

Objective: To compare effect of Hypericum perforatum (H. perforatum) vaginal gel with metronidazole on bacterial vaginosis (BV) in terms of initial response to treatment and preventing recurrence (primary outcomes) and also patient complaints (secondary outcomes). Methods: In this double-blind, double dummy trial, married women aged 18-49 with BV were randomized into two groups and administered 5 g of 3% H. perforatum and placebo of metronidazole (n=82), or 5 g of 0.75% metronidazole and placebo of H. perforatum (n=80) vaginally for 5 d. Amsel criteria were used for diagnosis and assessing cure and recurrence of BV. The comparisons was done using Chi-square, Fisher's exact and logistic regression. Results: At 10-12 d, cure rate was 82% in the H. perforatum and 85% in metronidazole group (risk ratio 0.9, 95% confidence interval 0.6 to 1.3). Among the cured women, recurrence rate was 9% in the H. perforatum and 13% in the metronidazole group at the 30-35 d visit (risk ratio 0.8, 95% confidence interval 0.4 to 1.3). There was no statistically significant difference between the groups regarding any patient complaints, except itching which was less in H. perforatum group (5% vs. 16%, P=0.018 at the first and 13% vs. 43%, P < 0.001 at the second follow-up). No significant adverse event was reported at any groups. Conclusions: H. perforatum could be a good option for treatment of BV. However, further studies are needed for its public use.