Adherence to plant-based diet during pregnancy and risk of gestational diabetes: a prospective birth cohort study.

BACKGROUND: Studies have shown that plant-based foods have a protective effect against gestational diabetes (GDM). We examined the association between plant-based dietary patterns and the risk of GDM in a sample of Iranian adults. METHODS: We enrolled 635 pregnant women for the present study. Dietary intakes were evaluated by using a 90-item food frequency questionnaire during the first trimester of pregnancy. Three plant-based including plant-based (PDI), unhealthy (uPDI) and healthy (hPDI) were calculated. Cox proportional hazard model were fitted to estimate hazard ratio (HR) and 95% confidence interval (CI) of GDM across categories of the plan-based dietary indices, while controlling for age, educational level, physical activity, family income, prepregnancy body mass index, gestational weight gain, and total energy intake. RESULTS: A total of 635 mothers were included, of whom 79 participants were diagnosed with GDM. Those in the third tertile of the PDI (HR: 0.55, 95% CI: 0.30, 0.98) and hPDI (HR: 0.43, 95% CI: 0.24, 0.78) had a lower risk of developing GDM during their current pregnancy as compared to the first tertile. There was no association between uPDI and risk of GDM. CONCLUSIONS: We found that higher adherence to a plant-based diet during early pregnancy may be associated with a lower GDM risk among Iranian women. Confirmation of this finding is necessary in larger cohort studies, taking into account other pregnancy outcomes such as birth weight.

The Impact of Muscle Energy Techniques on the Temporomandibular Motions Following Extraction Surgery of the Third Molar Tooth: A Randomised Clinical Trial.

BACKGROUND: Trismus and subsequent restricted range of motion in the temporomandibular joint may impede vital activities of daily living. OBJECTIVE: The primary purpose of the current study was to explore the impact of muscle energy techniques on the range of temporomandibular motions in individuals with trismus and restricted range of the temporomandibular motions after third molar extraction surgery. METHODS: Eligible volunteers were randomly assigned to either the intervention or control group. Participants in the intervention group received muscle energy techniques over seven consecutive postoperative days, while those in the control group did not receive any intervention. Both groups adhered to the recommended postoperative healthcare protocol provided by a single dentist. The range of cardinal and linear intra-articular motions of the temporomandibular joint was assessed on the first, second and seventh postoperative days in each group using a vernier calliper and an ultrasound machine, respectively. RESULTS: The range of linear intra-articular motion (p-value < 0.001) and cardinal motion (p-value < 0.032) of the TMJ significantly increased within groups after the first postoperative week. The range of temporomandibular motions, except for the forward displacement of the mandibular condyle (p-value = 0.193), and the range of mandibular retrusion (p-value = 0.339) exhibited a significant difference between groups (p-value < 0.017) after the first postoperative week. CONCLUSION: The current study revealed, for the first time, that muscle energy techniques increase the range of cardinal and linear intra-articular motions in individuals with trismus and restricted range of the temporomandibular motions following third molar extraction surgery. TRIAL REGISTRATION: Clinical Trials: IRCT20211016052783N1.

Risk Factors of COVID-19 associated mucormycosis in Iranian patients: a multicenter study.

BACKGROUND: To evaluate the demographic, clinical, and prognostic characteristics of patients diagnosed with COVID-19-associated mucormycosis (CAM) in Iranian patients. METHODS: This prospective observational study was conducted in 8 tertiary referral ophthalmology centers in different provinces of Iran during the fifth wave of the COVID-19 pandemic. All patients were subjected to complete history taking and comprehensive ophthalmological examination and underwent standard accepted treatment strategy based on the disease stage. RESULTS: Two hundred seventy-four CAM patients (most were males (150, 54.7%)) with a mean age of 56.8 ± 12.44 years were enrolled. Patients with a history of cigarette smoking (Adjusted Odds Ratio (AOR) = 4.36), Intensive Care Unit admission (ICU) (AOR = 16.26), higher stage of CAM (AOR = 2.72), and receiving endoscopic debridement and transcutaneous retrobulbar amphotericin B (AOR = 3.30) had higher odds of mortality. History of taking systemic corticosteroids during COVID-19 was significantly associated with reduced odds of mortality (AOR = 0.16). Generalized Estimating Equations analysis showed that the visual acuity of deceased patients (LogMAR: 3.71, 95% CI: 3.04-4.38) was worse than that of patients who were discharged from the hospital (LogMAR: 2.42, 95% CI: 2.16-2.68) (P < 0.001). CONCLUSIONS: This study highlights significant risk factors for mortality in patients with CAM, such as cigarette smoking, ICU admission, advanced CAM stages, receiving transcutaneous retrobulbar amphotericin B and worser visual acuity. Conversely, a history of systemic corticosteroid use during COVID-19 was linked to reduced mortality. These findings underscore the critical need for early identification and targeted interventions for high-risk CAM patients to improve clinical outcomes.

Retinal and choroidal thickness in fuchs uveitis syndrome: a contralateral eye study.

BACKGROUND: To investigate the subfoveal retinal and choroidal thickness in patients with unilateral Fuchs Uveitis Syndrome (FUS). METHODS: This comparative contralateral study was performed in affected eyes with FUS versus fellow eyes. For each eye parameters such as subfoveal choroidal thickness (SCT), subfoveal choriocapillary thickness (SCCT), central macular thickness (CMT), and central macular volume (CMV) were measured; then the measured values of affected and fellow unaffected eye were compared. RESULTS: Thirty-seven patients (74 eyes) including 19 females (51.4%) with a mean age of 36.9 ± 7.6 years were enrolled. The mean SCT was lower in the affected eyes (344.51 ± 91.67) than in the fellow (375.59 ± 87.33) with adjusting for duration of disease and axial lengths (P < 0.001). The mean SCCT, CMT, and CMV were higher in eyes with FUS than in fellow eyes (P < 0.05). CONCLUSIONS: The result of our study demonstrated that affected eyes in patients with FUS tend to have thinner SCT and thicker SCCT and CMT compared to uninvolved fellow eyes.

A Comparison of 2 Exercise Protocols in Athletes With Primary Subacromial Impingement Syndrome: A Randomized Clinical Trial.

CONTEXT: To stabilize the humeral head within the glenoid fossa during arm elevation, the rotator cuff muscles may contribute through internal and external rotation. The main purpose of the current study was to compare the acromiohumeral distance between athletes with primary subacromial impingement syndrome who received progressive resistance exercises consisting of either shoulder internal or external rotation. DESIGN: A randomized and controlled clinical study. METHODS: Thirty athletes with primary subacromial impingement syndrome were enrolled and randomly divided into 2 experimental groups. The progressive resistance exercise protocol in experimental group I comprised shoulder internal rotation, while in experimental group II consisted of shoulder external rotation. The experimental groups worked out 3 days a week for 6 weeks. The experimental groups were compared with the control group consisting of 15 healthy athletes. The acromiohumeral distance was measured before and after the intervention using an ultrasound machine under the passive and active across no arm elevation and 45°of arm elevation. RESULTS: The acromiohumeral distance significantly increased in both experimental groups under the passive and active arm positions following the intervention (P < .001), with no significant differences detected between the experimental groups (P > .665). The paired comparisons of the acromiohumeral distance discrepancy indicated a significant difference between the control group and each experimental group under the active and passive arm positions (P < .001), while no significant difference was observed between the experimental groups (P > .999). CONCLUSIONS: The present study revealed, for the first time, that both progressive resistance exercise protocols involving either the shoulder internal or the external rotation increased the acromiohumeral distance in individuals with primary subacromial impingement syndrome and improved associated pain and disabilities.

Predisposing Factors and Clinical-Microbiological Profile of Neonatal Corneal Ulcer: A Systematic Review and Analysis.

OBJECTIVE: To provide a comprehensive overview of predisposing factors and clinical-microbiological profile of neonatal corneal ulcer. METHODS: The literature search was undertaken in PubMed, SCOPUS, Embase, Web of Science, and Google Scholar databases on published papers from inception to May 31, 2023. The included articles were independently assessed for methodological quality using a Joanna Briggs Institute checklist. Weighted analysis was utilized, assigning a weight of one to each case report and a weight equivalent to the sample size for the case series/original studies. RESULT: We included 34 relevant case reports/series and one original study. Seventy-four neonates were enrolled with a boy-to-girl ratio of 1.3:1 and a median age of 17 days (1-27 days). Prematurity and neonatal intensive care unit (NICU) care (21.6%), congenital horizontal tarsal kink (13.5%), neonatal herpes infection (13.5%), congenital entropion (5.4%), and jaundice (5.4%) were the most common potential risk factors and coexisting conditions. Microbiology evaluation showed positive results in 53.8% (21/39 cases). Viral and bacterial infections were the most common cause, followed by fungal infections. Herpes virus (18.9%), Pseudomonas aeruginosa (18.9%%) and Staphylococcus epidermidis (6.7%) were the most prevalent causative agents. Negative microbiology was significantly more common in neonates with structural abnormalities (14.9%) compared to others (6.8%) (p = 0.01). CONCLUSION: Based on the findings of reported studies, this systematic review has increased awareness of the risk factors and etiologies that lead to developing corneal ulcers in neonates.

Consumption of red and processed meat during early pregnancy and risk of gestational diabetes: a prospective birth cohort study.

To investigate the association of red and processed meat intake with the risk of gestational diabetes (GDM) in Iranian mothers. A total of 635 pregnant mothers were included. Dietary intake was assessed by a 90-item food frequency questionnaire during the first trimester of pregnancy. Intakes of total red meat, unprocessed red meat, and processed meat were calculated and then, Cox proportional hazard model was used to calculate the hazard ratios (HR) and 95%CIs of GDM across tertiles of red meat intake while controlling for age, occupation, pre-pregnancy body mass index, physical activities, history of cardiovascular disease, hypertension, hypothyroidism, hyperthyroidism, and pregnancy hypertension, order of pregnancy, nausea during current pregnancy, multivitamin use during current pregnancy, weight gain during current pregnancy and total energy intake. The average age of the mothers was 28.80 ± 5.09 years, the average pre-pregnancy body mass index was 25.13 ± 4.43 kg/m2, and the average weight gain during pregnancy was 13.50 ± 5.03 kg. The multivariable-adjusted HRs of GDM for the third tertiles of red and processed meat, red meat, and processed meat intake were, respectively, 1.92 (95% CI 1.06, 3.49), 1.52 (95% CI 0.85, 2.72) and 1.31 (95% CI 0.73, 2.34) when compared to the first tertiles. Our prospective cohort study suggested that there was a positive association between the consumption of red and processed meat and with risk of GDM in a small sample of Iranian mothers with low red meat intake. More large-scale cohort studies in the Iranian population are needed to present more robust evidence in this regard.

The linear intra-articular motions of the temporomandibular joint in individuals with severe forward head posture: A cross-sectional study.

BACKGROUND: The cervical vertebrae and the temporomandibular joint (TMJ) may be linked through their common muscles. OBJECTIVES: The aim of the present study was to compare the linear intra-articular motions of the TMJ between individuals with the normal craniocervical posture (CCP) and severe forward head posture (FHP). DESIGN: Cross-sectional study. METHODS: Volunteers (N = 38) were equally assigned to either the severe FHP group or the normal CCP group according to their craniovertebral angle (CVA). The CVA angles greater than 49° were considered as the normal CCP while angles between 44 and 40° were regarded as the severe FHP. The TMJ was imaged at the closed, median, and maximum open positions of the mouth using an ultrasound machine with a 7.5 MHz linear transducer in the sitting position. The best-fitting curve in the contour registration method was employed to measure displacement of the mandibular condyle on the transverse and vertical axes. RESULTS: The forward displacement of the mandibular condyle in the severe FHP group was significantly (p-value = 0.037) reduced compared to the normal CCP group at maximum open position of the mouth, while no significant difference was revealed at closed (p-value = 0.937) or median open (p-value = 0.699) positions. The perpendicular displacement of the mandibular condyle exhibited no significant (p-value>0.107) difference between groups at any mouth position. DISCUSSION: The current study demonstrated, for the first time, that severe FHP may impact the intra-articular motion of the TMJ. This study presumed that individuals with severe FHP may encounter a force imbalance in the anterior-posterior direction.

Adherence to the Mediterranean diet and risk of gestational diabetes: a prospective cohort study.

BACKGROUND: Limited data is available on the association between adherence to the Mediterranean diet during early pregnancy and risk of gestational diabetes (GDM) in countries located in the Middle East, one of the regions with the highest prevalence of GDM. METHODS: A total of 647 pregnant mothers were included in the present prospective birth cohort study in Iran. Dietary intake was assessed by a 90-item food frequency questionnaire during the first trimester of pregnancy. Cases of GDM were ascertained by a two-step approach with a 50-g screen followed by a 100-g oral glucose tolerance for those who tested positive. Cox proportional hazard model was used to calculate the hazard ratio and 95%CI of GDM across tertiles of the Mediterranean diet score, while controlling for a wide range of potential confounders. RESULTS: A total of 647 pregnant mothers were included, of whom 77 mothers were diagnosed with GDM during their pregnancy. The average age of the mothers was 28.8 ± 5.1 years. In the multivariable analysis, being in the third tertile of the score of adherence to the Mediterranean diet was associated with a 41% lower risk of developing GDM as compared to those in the first tertile (adjusted hazard ratio: 0.59, 95%CI: 0.35, 0.99). CONCLUSIONS: Based on our findings, greater adherence to the Mediterranean diet during early pregnancy may be associated with a lower risk of developing GDM in Iranian women. Larger cohort studies are needed to confirm the findings.

Evaluation of the anti-inflammatory activity of fisetin-loaded nanoparticles in an in vitro model of osteoarthritis.

Cartilage lesions, especially osteoarthritis (OA), are a common health problem, causing pain and disability in various age groups, principally in older adults and athletes. One of the main challenges to be considered in cartilage tissue repair is the regeneration of cartilage tissue in an active inflammatory environment. Fisetin has various biological effects including anti-inflammatory, antioxidant, apoptotic, and antiproliferative activities. The only disadvantages of fisetin in the pharmaceutical field are its instability and low solubility in aqueous media. This study is aimed at preparing chitosan (CS)-based nanoparticles to yield fisetin with improved bioavailability features. Then, the effect of fisetin-loaded nanoparticles (FNPs) on inflammatory responses in interleukin-1ß (IL-1ß) pretreated human chondrocytes has also been investigated. FNPs presented an average size of 363.1 ± 17.2 nm and a zeta potential of + 17.7 ± 0.1 mV with encapsulation efficiency (EE) and loading capacity (LC) of 78.79 ± 7.7% and 37.46 ± 6.6%, respectively. The viability of human chondrocytes was not affected by blank nanoparticles (BNPs) up to a concentration of 2000 µg/mL. In addition, the hemolysis results clearly showed that FNPs did not damage the red blood cells (RBCs) and had good hemocompatibility within the range investigated. FNPs, similar to fisetin, were able to inhibit the inflammatory responses induced by IL-1ß such as the expression of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) while increasing the production of an anti-inflammatory cytokine such as interleukin-10 (IL-10). Overall, the in vitro evaluation results of the anti-inflammatory activity showed that FNPs can serve as delivery systems to transfer fisetin to treat inflammation in OA.

Is the Co-administration of Metformin and Clomiphene Superior to Induce Ovulation in Infertile Patients With Poly Cystic Ovary Syndrome and Confirmed Insulin-Resistance: A Double Blind Randomized Clinical Trial.

Objective: This study aimed to compare the effects of clomiphene citrate (CC) combined with metformin or placebo on infertile patients with poly cystic ovary syndrome (PCOS) and insulin resistance (IR). Materials and methods: We included 151 infertile women with PCOS and IR in a university hospital from November 2015 to April 2022 in this prospective, double-blind, randomized, placebo-controlled trial. Patients were randomized into two groups; group A: received CC plus metformin (n = 76) and group B: received CC plus placebo (n = 75). The ovulation rate was the main outcome measure. Clinical pregnancy, ongoing pregnancy, live birth and abortion rates were secondary outcome measures. Results: There was no remarkable difference in ovulation rate in two groups. Moreover, no significant changes were observed in clinical pregnancy, ongoing pregnancy, live birth and abortion rates between two groups. A larger proportion of women in group A suffered from side effects of metformin (9.3% versus 1.4%; p=0.064), although this was not significant. Conclusion: In IR infertile women with PCOS, metformin pre-treatment did not increase the ovulation, clinical pregnancy and live birth rates in patients on clomiphene citrate.

The relationship between adherence to the Mediterranean dietary pattern during early pregnancy and behavioral, mood and cognitive development in children under 1 year of age: a prospective cohort study.

PURPOSE: To investigate the potential relationship between diet quality, represented by the Mediterranean diet score, during early pregnancy and behavioral, mood, and cognitive development in children under 1 year of age in a prospective cohort study in Iran. METHODS: 658 Iranian pregnant women and their infants participated in this prospective birth cohort study. The Mediterranean diet score was calculated by using data from a food frequency questionnaire during the first trimester of pregnancy. We assessed the children's development using the Ages and Stages Questionnaire (ASQ) at 6-month age. We used Cox proportional hazard model to calculate the hazard ratio (HR) and 95% confidence interval (CI) of ASQ domains across categories of the Mediterranean diet score. RESULTS: The mean age of the mothers was 28.8 ± 5.08 years old, and the average follow-up duration was 90 weeks. The mean BMI of the mothers before pregnancy was 25.1 ± 4.43 kg/m2. In the multivariable-adjusted model, those infants whose mothers were in the second (HR: 0.44; 95% CI: 0.19, 1.04; P = 0.06) and third (HR: 0.39; 95% CI: 0.17, 0.89; P = 0.03) tertiles of the Mediterranean diet score had a lower risk of communication impairment compared to those who were at the first tertile. There was no association between maternal adherence to the Mediterranean diet during early pregnancy and other domains of the ASQ. CONCLUSIONS: Greater adherence to the Mediterranean dietary pattern during the first trimester of pregnancy may be favorably associated with communication abilities at 6-month aged infants. More large-scale cohort studies are needed to confirm our findings.

Depression and Suicidal Ideation among Patients Receiving Opioid Maintenance Treatments Considering Cognitive Flexibility.

Objective: Cognitive flexibility is associated with psychiatric disorders. Drug addicts experience more psychiatric disorders. This research aimed to examine depression and suicidal ideation among those receiving opioid maintenance treatment (OMT), taking into account the mediating role of cognitive flexibility. Method : This cross-sectional research was conducted on patients who were enrolled in the OMT program in Semnan in 2021 and abstained from opioid use for at least one year. 126 participants (115 males and 11 females) were randomly selected from among patients in three therapeutic groups (42 from each of the methadone, buprenorphine, and opium tincture groups). The main data collection tools were the Beck Scale for Suicide Ideation (BSSI), Cognitive Flexibility Inventory (CFI), and Beck Depression Scale (BDI-II). Data analysis was done through logistic regression models. Results: Correlation analysis between depression scores, suicidal ideation, and cognitive flexibility showed a significant correlation between each of them. Adjusting for the type of treatment, the increase in cognitive flexibility was associated with a decreasing chance of depression (odds ratio [OR] = 0.87; 95% CI [0.82, 0.92]), and the use of buprenorphine (OR = 15.1) and opium tincture (OR = 9.3), compared to methadone, were associated with a depression increase. Yet, multivariate analysis did not show an independent and significant association between cognitive flexibility and the risk of suicide. Conclusion: Based on the results, patients receiving maintenance treatments are in different conditions in terms of depression and suicide, and psychological flexibility is in correlation with depression and suicidal thinking and behavior in them. This suggests that these patients seem to benefit from cognitive training, at least in reducing their depression.

Global clinicoepidemiological pattern of childhood vitiligo: a systematic review and meta-analysis.

BACKGROUND: Childhood vitiligo differs from adult vitiligo in many aspects. To the best of the authors' knowledge, there is no systematic review of different clinicoepidemiological patterns of vitiligo in children. This study aimed to review the characteristics of vitiligo among the paediatric population. METHODS: In June 2022, a comprehensive search was conducted using MeSh-based keywords on online databases including PubMed, Scopus and Web of Sciences. The papers were assessed, and the eligible articles were selected. The selection of articles followed three distinct steps. The extracted clinicoepidemiological data were then imported into the STATA software for meta-analysis. RESULTS: The meta-analysis of 17 studies with 4365 subjects yielded 2475 women (estimated=56.8%, 95% CI 54.45 to 59.22). The female-to-male ratio was determined to be 1.3:1. Meta-regression demonstrated a significant relationship between continents and gender (p=0.03). The most prevalent types of non-segmental vitiligo were vulgaris (42.49%), focal (27.21%) and acrofacial (17.8%). The pooled ratio of non-segmental to segmental was 4.6:1. The highest and lowest ratios were found in Africa with one study (estimated=11.56%, 95% CI -0.98 to 24.10) and America with two studies (estimated=3.02%, 95% CI 1.54 to 4.50), respectively. Using meta-regression, the relationship between continents and vitiligo type was found to be insignificant (p=0.47). Positive family history was recorded in 657 patients (estimated = 16.88%, 95% CI 13.37 to 20.39). Positive family history varied by country of study from 13.91% (Asia with 11 studies) to 27.01% (Europe with two studies) (p=0.11). Kobner phenomena and leukotrichia were noted in 687 (25.47%) and 461 (18.52%) patients, respectively. CONCLUSION: The review indicated that childhood vitiligo is more prevalent in women. Non-segmental forms of childhood vitiligo were the most common, including vulgaris, focal and acrofacial. The clinicoepidemiological pattern of childhood vitiligo is variable in different geographic areas.

A randomized controlled trial for evaluating an occupational therapy self management intervention in adults with type 2 diabetes.

This study evaluated the efficacy of the Occupational Therapy Diabetes Self-Management intervention (OTDSM) to enhance glycemic stability and self-management skills in people with diabetes type-2. Based on this single-blind randomized trial, 30 subjects with diabetes type-2 were assigned to two groups of intervention and control. The intervention group received a 10-week program, consisting of four group visits and six individualized sessions. The control group received an individual session and three weekly phone calls. The primary study outcome, blood hemoglobin A1C, was measured before and three months after the study. The secondary outcome was assessed in terms of the participants' self-management behaviors, self-efficacy, diabetes distress, depressive symptoms, and performance and satisfaction with daily activities. These outcomes were evaluated three times: before, one month into, and three months after the study. The study findings demonstrated significant differences between the two groups in the hemoglobin A1C levels, self-management behaviors, self-efficacy, and performance and satisfaction with daily routines after the intervention (P < 0.05). No significant differences existed between the groups for the extent of diabetes distress and depressive symptoms. Inclusion of occupational therapy protocol into the plan of care for people with diabetes can improve health outcomes by promoting their routine participation in self-management activities.

A qualitative quantitative mixed methods study of domestic violence against women.

BACKGROUND: Violence against women is one of the most widespread, persistent and detrimental violations of human rights in today's world, which has not been reported in most cases due to impunity, silence, stigma and shame, even in the age of social communication. Domestic violence against women harms individuals, families, and society. The objective of this study was to investigate the prevalence and experiences of domestic violence against women in Semnan. METHODS: This study was conducted as mixed research (cross-sectional descriptive and phenomenological qualitative methods) to investigate domestic violence against women, and some related factors (quantitative) and experiences of such violence (qualitative) simultaneously in Semnan. In quantitative study, cluster sampling was conducted based on the areas covered by health centers from married women living in Semnan since March 2021 to March 2022 using Domestic Violence Questionnaire. Then, the obtained data were analyzed by descriptive and inferential statistics. In qualitative study by phenomenological approach and purposive sampling until data saturation, 9 women were selected who had referred to the counseling units of Semnan health centers due to domestic violence, since March 2021 to March 2022 and in-depth and semi-structured interviews were conducted. The conducted interviews were analyzed using Colaizzi's 7-step method. RESULTS: In qualitative study, seven themes were found including "Facilitators", "Role failure", "Repressors", "Efforts to preserve the family", "Inappropriate solving of family conflicts", "Consequences", and "Inefficient supportive systems". In quantitative study, the variables of age, age difference and number of years of marriage had a positive and significant relationship, and the variable of the number of children had a negative and significant relationship with the total score and all fields of the questionnaire (p < 0.05). Also, increasing the level of female education and income both independently showed a significant relationship with increasing the score of violence. CONCLUSIONS: Some of the variables of violence against women are known and the need for prevention and plans to take action before their occurrence is well felt. Also, supportive mechanisms with objective and taboo-breaking results should be implemented to minimize harm to women, and their children and families seriously.

Adjuvant Treatment with Oral Dydrogesterone in the Prevention of Preterm Labor: A Randomized, Double-Blinded, Placebo-Controlled Trial.

We conducted a double-blind, randomized, placebo-controlled clinical trial to evaluate the efficacy of oral dydrogesterone (DG) on maternal and neonatal consequences in the treatment of preterm labor. We included 100 nulliparous mothers (24-34 weeks) with normal pregnancy who had preterm labor pain. Participants who received magnesium sulfate were randomly assigned to the investigation group (DG 30 mg/day) or placebo group. Maternal and neonatal outcomes were compared between the two groups. Recurrent uterine contraction (UC) rates (92% vs. 88%, P = 0.862) and the incidence of preterm delivery (66% vs. 58%, P = 0.834) were not different in the DG and placebo groups. No significant differences were observed in terms of gestational age at delivery (33.5 ± 3.5 vs. 34.2 ± 3.2, P = 0.281), latency period (5.53 ± 2.29 days vs. 5.59 ± 2.57 days, P = 0.622), cervical dilation (1.82 ± 0.26 cm vs. 1.84 ± 0.29 cm, P = 0.281), and effacement (53 ± 4.47% vs. 57.21 ± 6.27%, P = 0.622) between the placebo and DG groups. The percentage of neonates with a 1-min Apgar score < 7 was higher in the placebo group compared with that of the DG group (12% vs. 0%, P = 0.0001). However, both groups were similar in the frequency of a 5-min Apgar score < 7. No differences in the term of adverse effects of medications were recorded. Our results showed that DG adjuvant to magnesium sulfate could not be effective in improving the incidence of preterm labor, rate of recurrent UC, latency period, pregnancy outcomes, and maternal and neonatal outcomes when compared with the placebo group.

Anti-TPO antibody and thyroid hormone levels in Iranian female breast cancer patients and their association with prognostic factors: a case-control study.

The aim of this study was to assess prevalence of anti-thyroid peroxidase (anti-TPO) antibody and thyroid hormones in Iranian female breast cancer patients, compare them to a control population, and investigate their association with prognostic factors. In this case-control study, breast cancer patients were selected from a surgery clinic in a tertiary hospital and control group participants were enrolled from those who had visited for mammography screening. Participants with any history of thyroid disease, or thyroid related medication were excluded from both groups. Groups were assessed for levels of thyroid stimulating hormone (TSH), T3, T4, and anti-TPO. In addition, the status of estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2) was determined for cancer patients. Overall 69 participants (39 cancer patients and 30 controls) were included. Difference in serum anti-TPO levels between the two groups was not statistically significant (p-value: 0.184). While a significant difference was observed for T4 and TSH levels between groups (p-value: 0.034 and <0.001, respectively), T3 levels did not reveal any significant difference (p-value: 0.177). In addition, ER, PR, and HER2 status were not correlated with anti-TPO levels. This results can serve as preliminary evidence that thyroid autoimmunity is not correlated with breast cancer incidence in Iranian female population. However, additional studies with larger sample sizes are required for more conclusive evidence.

Association of plant-based dietary patterns in first trimester of pregnancy with gestational weight gain: results from a prospective birth cohort.

BACKGROUND/OBJECTIVES: Plant-based dietary patterns are becoming more popular worldwide. We aimed to examine the relationship between plant-based dietary patterns and the risk of inadequate or excessive gestational weight gain (GWG) in Iranian pregnant women. METHODS: We prospectively followed 657 pregnant women in Iran. Adherence to the plant-based diet, represented by plant-based (PDI), healthy (hPDI) and unhealthy plant-based (uPDI) dietary indexes was evaluated by applying a 90-item food frequency questionnaire during the first trimester of pregnancy. Multivariable-adjusted Cox proportional-hazards regression model was used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) across quartiles of plant-based diet scores. RESULTS: Over 25,562 person-weeks of follow-up, we documented 106 and 294 participants with inadequate and excessive GWG, respectively. We found a strong inverse association between adherence to the PDI and inadequate GWG after adjustment for demographic and confounding variables. Women in the highest quartile of the PDI had 50% lower risk of inadequate GWG than those in the lowest quartile (adjusted HR: 0.50; 95%CI 0.29, 0.89; P = 0.02). No significant association was found between hPDI and uPDI and inadequate GWG. There was no association between PDI, hPDI, and uPDI and the risk of excessive GWG. CONCLUSIONS: Greater adherence to a plant-based diet during the first trimester of pregnancy may be associated with a lower risk of inadequate GWG. This finding needs to be confirmed in larger cohort studies, considering other pregnancy outcomes such as birth weight and the potential changes across the trimester in terms of food types and quantity.