Purpose: Investigations of the hemodynamic changes of the venous system in patients with multiple sclerosis (MS) have shown contradictory results. Herein, the biomechanical parameters of the internal jugular vein (IJV) and common carotid artery (CCA) of MS patients were extracted and compared to healthy individuals. Methods: B-mode and Doppler sequential ultrasound images of 64 IJVs and CCAs of women including 22 healthy individuals, 22 relapsing-remitting multiple sclerosis (RRMS) patients, and 20 primary-progressive multiple sclerosis (PPMS) patients were recorded and processed. The biomechanical parameters of the IJV and the CCA walls during three cardiac cycles were calculated. Results: The IJV maximum and minimum pressures were higher in the MS patients than in the healthy subjects, by 31% and 19% in RRMS patients and 39% and 24% in PPMS patients. The venous wall thicknesses in RRMS and PPMS patients were 51% and 60% higher than in healthy subjects, respectively. IJV distensibility in RRMS and PPMS patients was 70% and 75% lower, and compliance was 40% and 59% lower than in healthy subjects. The maximum intima-media thicknesses of the CCAs were 38% and 24%, and the minimum intima-media thicknesses were 27% and 23% higher in RRMS and PPMS patients than in healthy individuals, respectively. The shear modulus of CCA walls in RRMS and PPMS patients was 17% and 31%, and the radial elastic moduli were 47% and 9% higher than in healthy individuals. Conclusion Some physical and biomechanical parameters of the CCA and IJV showed significant differences between MS patients and healthy individuals.

The present study aims to assess the effect of group reality therapy on depression and anxiety in breast cancer patients undergoing chemotherapy in Ali-Ibn-Abitalib hospital, Zahedan, in 2017-2018. The current study is an application of research using a semi-experimental design. It employs a pretest-posttest design and separates participants into control and experiment groups. Additionally, it is a qualitative study in terms of data collection.Beck’s depression and anxiety inventory (1998, 2000) was used to collect data. The statistical population of this study consists of all the breast cancer patients hospitalized in Ali-Ibn-Abitalib hospital, Zahedan. Non-probability available sampling was used to select the sample. The sample size consisted of 24 individuals randomly divided into two groups of experiment and control. The inclusion criteria were doctors’ diagnosis and depression and anxiety diagnosis based on the BDI and BAI. The experiment group received reality therapy in 10 90-minutes sessions, and the control group received no intervention. Data were analyzed using univariate covariance analysis. The results showed that group reality therapy leads to less depression and anxiety in breast cancer patients undergoing chemotherapy.

Introduction: This study aimed to evaluate knowledge, attitudes, practice associated with Human Papillomavirus (HPV) Vaccine for Young Children among lecturers and health staffs of Shahid Beheshti University of Medical Sciences (SBMU). Method: This was a cross-sectional study with 220 adults from five different specialties, randomly selected. Data was collected using 45-item questionnaire on knowledge (12- item), attitude (18-item) and practice (15-item) (KAP) about HPV. The demographic questionnaire included information on age, gender, level of education, occupation, and marital status. Content validity was calculated by content validity ratio (CVR) and content validity index (CVI). Reliability was evaluated using test-retest and by Cronbach’s Alpha coefficient, internal consistency was calculated values >0.81 which considered as satisfactory. Results: The mean age of the studied population was 37.70± 8.07 (23-67) years. Of the 220 participants, 80 (36.4%) were males and 140 (63.6%) were females. In evaluating KAP in the men and women, the mean and standard deviation of knowledge were estimated at good level and one-way ANOVA analysis showed significant differences between women and men (p=0.019). There was no significant difference in men and women related to attitude (p=0.92) and practice (p=0.38). Conclusion: The KAP about HPV among participants was significantly higher at good levels compared to average levels. Women's knowledge was significantly higher than men. Attitude and practice could have been higher because there was consensus to the usage of vaccine among the specialists to prevent HPV.

BACKGROUND: Oral mucositis (OM) is one of the most common complications of mucotoxic cancer therapy. Mucositis induces clinically significant pain, increases the risk of infections and affects the patients' quality of life. OBJECTIVE: This study investigated the effects of an herbal preparation from Plantago ovata hydrocolloid in the prevention and treatment of OM, in breast cancer patients undergoing chemotherapy with a regimen including adriamycin. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS: This research was a double-blind, randomized, controlled crossover trial. The herbal compound consisted of a mixture of 500 mg of P. ovate husk in 30 mL water plus three drops of vinegar per dose, which was used as a mouthwash. Phytochemical and physicochemical tests of the compound were also performed. Twenty-eight patients who developed mucositis during the chemotherapy screening cycle were randomized to the herbal compound (n = 14) and placebo (n = 14) groups. They received herbal compound or placebo three times per day during their next chemotherapy cycle (cycle 1 of treatment). Patients were crossed over during cycle 2 of treatment and received the alternative therapy. An oral care protocol was prescribed to all patients in cycles 1 and 2 of the treatment. MAIN OUTCOME MEASURES: The patients were visited at baseline, the end of the first and second weeks of the screening cycle, and the end of the first and second weeks of each of two treatment cycles. The degree of mucositis was used as the main treatment outcome. Other indexes, such as the severity of pain, xerostomia grade and the quality of life were also measured. RESULTS: Compared with the placebo, the herbal compound significantly reduced the degree of mucositis, the severity of pain and the xerostomia grade; it also improved the patients' quality of life (P < 0.05). Comparison between the screening cycle and placebo treatment group showed that the oral care protocol had a significant effect in the reduction of OM (P < 0.05). CONCLUSION: The oral care protocol and the herbal compound based on P. ovata are effective ways for preventing and treating OM in patients undergoing mucotoxic cancer therapy. TRIAL REGISTRATION Iranian registry of clinical trials IRCT20180923041093N1.

Objective: To determine the effects of syringic acid on hepatic damage in diabetic rats. Methods: Diabetes was induced by streptozotocin. Diabetic rats were given syringic acid at doses of 25, 50 and 100 mg/kg by oral gavage for 6 weeks. Syringic acid effects on the liver were evaluated by examination of plasma biochemical parameters, and pathological study. In addition, biomarkers of lipid peroxidation and antioxidant status of liver tissues were assessed. Real time-PCR was performed to investigate the mRNA expression levels of mitochondrial biogenesis indices in different groups. Results: Syringic acid significantly attenuated the increase in most of plasma biochemical parameters in diabetic rats. Moreover, syringic acid treatment increased the catalase activity while it reduced the superoxide dismutase activity and hepatic malondialdehyde level in diabetic rats. There was no difference between the glutathione content of the treated and untreated groups. These findings were supported by alleviation of histopathological damages in the syringic acid-treated groups compared to the untreated diabetic group. Syringic acid also significantly up-regulated the hepatic mRNA expression of PGC-1a, NRF-1, and NRF-2 and increased the mtDNA/nDNA ratio in diabetic rats. Conclusions: Syringic acid can be considered as a suitable candidate against hepatic complications since it can reduce oxidative damages in diabetic cases. Furthermore, it has the potential of targeting hepatic mitochondria in diabetes.

OBJECTIVE: Accumulation of estrogenic compounds and other carcinogens in normal breast tissues contributes to unpredictable breast cancer incidence during adolescence and throughout life. To assess the role of parabens in this phenomenon, the paraben content of adjacent normal-malignant breast tissues is measured in women with breast cancer living in Isfahan Province, Iran. METHODS: Adjacent normal-malignant breast tissue samples were obtained from 53 subjects. The parabens including methyl-paraben (MePB), ethyl-paraben (EtPB), propyl-paraben (PrPB), and butylparaben (BuPB) were extracted from the sample supernatant and then subjected to gas chromatography analysis. RESULTS: Some risk factors for breast cancer were stimulated by parabens in adjacent malignant-normal breast tissues among young and middle-aged women with breast cancer. We observed a significant association for dose-response pattern of MePB [OR = 98.34 (11.43-185.2), P = 0.027] for both ER+ and PR+ women and MePB [OR = 164.3 (CI: 112.3-216.3), P < 0.001] for HER2+ women than women with negative receptors. The risk of 95-fold increase in MePB dose and 164-fold increase in ΣPBs dose were significant for women with hereditary breast cancer in first-degree relatives. CONCLUSION These results may promote future epidemiology studies and strategies to improve women's lifestyle and consume paraben-free products.

OBJECTIVE: To compare the possible effects of wet-cupping therapy with conventional therapy on persistent nonspecific low back pain (PNSLBP). METHODS: In this randomized clinical trial, 180 participants with the mean age of 45±10 years old, who had been suffering from PNSLBP were randomly assigned to wet-cupping and conventional groups. The wet-cupping group was treated with two separate sessions (4 weeks in total) on the inter-scapular and sacrum area. In the conventional group, patients were conservatively treated using rest (6 weeks) and oral medications (3 weeks). The primary and the secondary outcome were the quantity of disability using Oswestry Disability Index (ODI), and pain intensity using Visual Analogue Scale (VAS), respectively. RESULTS: There was no significant difference in demographic characteristics (age, gender, and body mass index) between the two groups (P>0.05). Therapeutic effect of wet-cupping therapy was comparable to conventional treatment in the 1st month follow-up visits (P<0.05). The functional outcomes of wet-cupping at the 3rd and 6th month visits were significantly increased compared to the conventional group. Final ODI scores in the wet-cupping and conventional groups were 16.7 ± 5.7 and 22.3 ± 4.5, respectively (P<0.01). CONCLUSION Wet-cupping may be a proper method to decrease PNSLBP without any conventional treatment. The therapeutic effects of wet-cupping can be longer lasting than conventional therapy. (Registration No. IRCT2013021672741)).

· AIM:To evaluate the corneal densitometry in treatmentnaive patients with keratoconus and its relevance with anterior and posterior corneal elevation.· METHODS:Keratoconic corneas were examined using the Pentacam.Corneal densitometry was measured over a 12-mm diameter area,divided by annular concentric zones and depths,more over anterior and posterior corneal elevation was measured.Keratoconus was classified according to the topographic keratoconus classification.· RESULTS:A total of 152 subjects [72 patients with keratoconus (46 male,26 female) and 80 healthy control subjects (50 male,30 female)] were included in the study.There were significant differences in corneal densitometry values of the groups in central 2 mm keratoconus (KC)=19.62±4.17 gray scale unit (GSU),N=15.38±1.54 GSU(P＜0.0001),and in annulus of 2 to 6 mmin diameter (K=16.40±2.18 GSU,N=15.31±1.25 GSU,P＜0.0001).When densitometry values for different depths were examined,the anterior layer presented the highest value (KC =23.69±3.71 GSU,N =20.91 ±2.52 GSU,P＜0.0001),which was significantly higher than the values obtained in the central and posterior layer (KC =14.34± 1.70 GSU,N=13.61±1.21 GSU,P=0.001 and KC=11.40± 1.23 GSU,N =12.35±0.88,P=0.002 respectively).Analysis of the correlation between corneal densitometry for each layer depth (anterior,central and posterior) with posterior corneal elevation values demonstrated significant association (r =0.293,r =0.278 and r =0.294 respectively).The similar correlation was not found between corneal densitometry for each layer depth and anterior corneal elevation (r=-0.211,r=-0.101,r=0.99 respectively).In the control patients such a significant correlation between posterior/anterior corneal elevation and corneal light backscatter for each layer depth was not found.· CONCLUSION:The densitometry map reveals that light backscatter was higher in the central portion of the anterior keratoconic cornea.Corneal densitometry values of keratoconus patients were correlated with posterior corneal elevation in 0-2,6-10 and 10-12 annuli and in all anterior,central and posterior layers.The densitometry level was higher in more advanced stages.

OBJECTIVES: We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models. METHODS: Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45–84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis. RESULTS: The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02). CONCLUSIONS: Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke.
Atherosclerosis* ; Body Mass Index ; Cardiovascular Diseases ; Chickens ; Cholesterol ; Continental Population Groups ; Diet ; Fabaceae ; Fats ; Female ; Fibrinogen ; Humans ; Hypertension ; Incidence ; Interleukin-6 ; Least-Squares Analysis ; Lipoproteins ; Lycopersicon esculentum ; Male ; Meat ; Methods* ; Motor Activity ; Myocardial Infarction ; Oils ; Ovum ; Poultry ; Risk Factors* ; Siblings ; Smoke ; Smoking ; Solanum tuberosum ; Stroke* ; Tuna ; Vegetables

OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes. METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education. RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively. CONCLUSIONS: Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.
Blood Pressure ; Body Mass Index ; Classification ; Cohort Studies* ; Diabetes Mellitus* ; Education ; Hypertension ; Incidence* ; Iran ; Joints ; Models, Structural* ; Odds Ratio ; Prehypertension* ; Prospective Studies* ; Risk Assessment ; Smoke ; Smoking