Empagliflozin and colchicine in patients with reduced left ventricular ejection fraction following ST-elevation myocardial infarction: a randomized, double-blinded, three-arm parallel-group, controlled trial.

PURPOSE: There is accumulating evidence regarding the potential benefits of empagliflozin in individuals with acute myocardial infarction (MI). Based on the literature, colchicine could also reduce the risk of MI and death in individuals with cardiovascular disease (CVD). However, trials investigating the effects of the combination of empagliflozin with colchicine and high-dose empagliflozin monotherapy in this setting are lacking. METHODS: In this trial, 106 non-diabetic participants with reduced left ventricular ejection fraction (LVEF) following recent ST-elevation MI were randomly assigned to empagliflozin 10 mg/day, empagliflozin 10 mg/day plus colchicine 0.5 mg twice daily, or empagliflozin 25 mg/day groups within 72 h after primary percutaneous coronary intervention (PCI). The study's primary outcomes were the changes in New York Heart Association (NYHA) functional class and high-sensitivity C-reactive protein (hs-CRP) over 12 weeks. RESULTS: The baseline characteristics of individuals were statistically similar between the study groups. Changes in NYHA functional class over 12 weeks were not significantly different between the study groups. hs-CRP was significantly reduced in all groups (all P < 0.001); however, there was no significant change between the groups over the study period. Changes in tumor necrosis factor-alpha (TNF-α), LVEF, and left ventricular end-diastolic dimension (LVEDD) during the research period did not differ significantly between groups. CONCLUSION: This study showed that neither the combination treatment of empagliflozin 10 mg/day with colchicine nor the monotherapy of empagliflozin 25 mg/day was superior to empagliflozin 10 mg/day in terms of changes in clinical, inflammatory, and echocardiographic outcome parameters in patients with recent MI with reduced LVEF over 3 months. Further studies are warranted to confirm the findings. TRIAL REGISTRATION: Clinical trial ID: IRCT20111206008307N39. Registration date: 27 October 2022. https://www.irct.ir/trial/66216.

The association between diet quality index-international and dietary diversity score with preeclampsia: a case-control study.

BACKGROUND: Preeclampsia is a significant complication that occurs during the second half of pregnancy. Recent studies have indicated that dietary factors play a crucial role in the development of preeclampsia. The Diet Quality Index-International (DQI-I) and Dietary Diversity Score (DDS) are appropriate indices for assessing the quality of foods, meals, and diets. This study aimed to investigate the relationship between DQI-I, DDS, and preeclampsia. METHODS: This study utilized a case-control design. A total of 90 newly diagnosed preeclampsia cases and 90 healthy controls were included from a referral hospital in Tabriz, Iran. DQI-I and DDS were calculated based on information obtained from a reliable Food Frequency Questionnaire consisting of 168 food items, which assessed participants' usual diet. Logistic regression analysis adjusted for age, body mass index, education, family history of preeclampsia, and total energy intake was used to estimate odds ratios (ORs). RESULTS: The mean age and pre-pregnancy body mass index of the participants were: 27.14 ± 4.40 years and 26.09 ± 3.33 kg/m2, respectively. After adjusting for various confounders, we found significant inverse association between the risk of developing preeclampsia and both DQI-I and DDS. The highest quartile of DQI-I had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.02, 95% CI [0.005, 0.08]) (P < 0.001). Similarly, the highest quartile of DDS had a significantly lower risk of developing preeclampsia compared to the first quartile (OR = 0.09, 95% CI [0.03, 0.31]) (P = 0.001). CONCLUSIONS: Our findings suggest that maintaining a high-quality and diverse diet is associated with a lower risk of preeclampsia. Further studies are needed to confirm these associations and explore potential causal relationships.

The effects of an educational intervention based on the protection motivation theory on the protective behaviors of emergency ward nurses against occupational hazards: a quasi-experimental study.

BACKGROUND: Emergency ward nurses face a variety of occupational hazards due to the nature of their occupational and professional duties, which can negatively affect their health. Therefore, this study aimed to evaluate the effects of an educational intervention based on the protection motivation theory on the protective behaviors of emergency ward nurses against occupational hazards in Tehran, Iran, in 2023. METHODS: The present quasi-experimental study was conducted with two intervention and control groups, using a pretest-posttest design. A total of 124 nurses working in the emergency wards of four hospitals (two hospitals for the intervention group and two hospitals for the control group by random assignment) were selected by multistage sampling method. The educational intervention based on the protection motivation theory was implemented for the intervention group for three weeks. The nurses of both groups completed a demographic questionnaire and the scale of emergency ward nurses' protective behaviors against occupational hazards before, immediately, and one month after the intervention. Data analysis was performed using descriptive and inferential methods. RESULTS: The two groups were similar in terms of demographic characteristics at the baseline (p > 0.05). Protective behaviors of emergency nurses against occupational hazards and their sub-scales (physical, chemical, biological, ergonomics, and psychosocial hazards) were higher in the intervention group than in the control group immediately and one month after the educational intervention. In addition, the measurement over time also showed the positive effect of time and educational intervention on the protective behaviors of emergency nurses against occupational hazards and their sub-scales in the intervention group. CONCLUSION: These findings showed that the educational intervention based on the protection motivation theory can be effective and helpful in improving the protective behaviors of emergency ward nurses against occupational hazards and their sub-scales. Future studies can focus on a more specific design of this kind of intervention based on the type of occupational hazards and needs of nurses in different wards.

Comparison of global decolonization efficacy with mupirocin nasal drop and chlorhexidine mouthwash in acute leukemia patients: randomized clinical trial.

PURPOSE: Neutropenic fever remains a major complication in acute leukemia. Decolonization is assumed as a promising intervention for eradicating causative agents of infection. METHODS: In this randomized clinical trial, 96 patients with acute leukemia were assigned randomly to mupirocin nasal drop 2% (n = 32), chlorhexidine mouthwash 0.2% (n = 33), and control group (n = 31). In control group, patients did not receive any medication for decolonization. All patients received treatment for 5 days (2 days prior to chemotherapy until 3 days after chemotherapy). Pharynx and nasal swabs were taken prior to the intervention and at the end of decolonization period in all groups. Antibiotic susceptibility testing was performed by the disc diffusion method in order to identify bacterial isolates. RESULTS: Bacterial recovery of both nasal and pharynx swabs was observed after global decolonization with mupirocin nasal drop. Decolonization with mupirocin significantly eradicated Coagulase-negative staphylococci (CONS) in both nasal and pharynx swabs (p-value = 0.000). Moreover, mupirocin decreased Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) species. Chlorhexidine mouthwash significantly eradicated CONS in pharynx swabs (p-value = 0.000). In addition, both decolonization strategies decreased both antibiotic use and frequency of fever in leukemic patients. CONCLUSION: Global decolonization with mupirocin nasal drop not only eradicates both nasal and pharynx microorganisms, but also reduces antibiotic requirement and frequency of fever in patients with acute leukemia. The protocol of the present study was approved on December 2016 (registry number: IRCT20160310026998N6).

Factors affecting quality of life in women with breast cancer: a path analysis.

BACKGROUND: Breast cancer may negatively affect people's quality of life. We investigated the predictors of quality of life in women with breast cancer with the mediating role of resilience. METHOD: In a cross-sectional design, 218 patients completed a survey referring to the Valiasr International Hospital Oncology Center in Tabriz, Iran. Four validated self-report measures assessed HRQoL as measured by the SF-12, Resilience, Hope, and Perceived Social Support (MSPs). The mediating roles of resilience between HRQoL and the fitness of the proposed model were investigated using path analysis. SPSS version 24 software and Lisrel 8.8 software were used for data analysis. RESULTS: The results of path analysis showed that the final model had a good fit to the data (Chi-Square/ degrees of freedom (Normed Chi2) = 2.08, RMSEA = 0.014, goodness fit index = 0.99, both comparative fit index = 0.99 both CFI = 0.99 and IFI = 1). In this model, age and psychosocial factors predicted health-related quality of life. CONCLUSIONS: Age and psychosocial factors especially social support are important components in predicting health-related quality of life among those suffering from breast cancer.

Predictors of Pediatric COVID-19 vaccination: a case-control study in Tabriz, Iran.

INTRODUCTION: COVID-19 vaccination of children can help reduce the severity of the infection and the death rate caused by it and also helps achieve herd immunity. The level of acceptance and high vaccination coverage is the main elements in the success of immunization programs. Children's vaccination is dependent on their parent's decision. This study aims to identify predictors of the children's COVID-19 vaccination accomplishment by their parents. METHOD: In this case-control study, 577 vaccinated children as cases and 366 un-vaccinated children as controls were randomly selected from the general population of Tabriz, Iran 2022, and their data were collected by telephone calls and interviews with the children's parents. Cases and controls were compared in terms of clinical and demographic factors of the child as well as the socioeconomic status (SES) of their parents by using a multivariable mixed-effect logistic regression model. RESULTS: According to the results of the multivariable logistic regression, the age of the child (OR = 1.26 95% CI (1.14, 1.40), p-value < 0.001), previous COVID-19 infection of the child (OR = 1.92, 95% CI (1.21, 3.04), p-value < 0.001), having no underlying disease in the child (OR = 1.76, 95% CI (1.02, 3.02), p-value = 0.04), the dwelling place of the household (the high-level dwelling in compared to a low level (OR = 3.34, 95% CI (1.6, 6.64), p-value = 0.001), the middle level of dwelling compared with low level (OR = 4.87, 95% CI (2.46, 9.51), p-value < 0.001)), and Father's job (Employee and technician Fathers compared to worker fathers (OR = 2.99, 95% CI (1.55, 5.77), p-value = 0.001)) were significant independent predictors of children COVID-19 vaccination. CONCLUSION: Several demographic and socioeconomic factors were associated with children's vaccination. Older children, children without any underlying disease, children with a history of COVID-19 infection, and children of parents with higher levels of SES were more likely to receive the COVID-19 vaccine. This finding can be considered in children's vaccination policymaking.

Factors associated to patients' referral to public or private Covid-19 healthcare centers in Tabriz, Iran.

BACKGROUND: In Iran, tracking of patients and its associated data recording in private healthcare centers are poor, and thus a majority of patients suffering from Covid-19 are treated without any control on the isolation and quarantine processes. The present study aims to investigate the factors contributed to referral to private or public healthcare centers that provide Covid-19 care services. METHODS: This cross-sectional study was conducted from November 2021 to January 2022 in Tabriz, Iran. We invited a total of 258 and 202Covid-19 patients from governmental and private healthcare centers, respectively, to participate in the study by convenient sampling method. Applying a self-administered questionnaire, we collected data on the reason of referring to the healthcare centers, patient's waiting time, quality of healthcare services received by the patients, patients' level of satisfaction, accessibility, insurance coverage, perceived severity of the disease, and the level of staff compliance from health protocols. Logistic regression model was used for data analysis by using SPSS-26 software. RESULTS: Adjusted for other variables, higher socio-economic status (AOR (Adjusted Odds Ratio) = 6.64), older age (AOR = 1.02), referral of friends and family members (AOR = 1.52), shorter waiting time (AOR = 1.02) and higher satisfaction (AOR = 1.02) were contributed to referral to private centers. Better accessibility (AOR = 0.98) and wider insurance coverage (AOR = 0.99) were also contributed to referral to governmental centers. CONCLUSION: Providing more appropriate insurance coverage by private healthcare centers, and promoting their level of accessibility seems to promote patients' referral to such centers. Moreover, establishing an accurate system for recording patients' information and follow up in private centers might promote the role of private healthcare centers in managing the overload of patients on healthcare system during such epidemics.

Effects of early mobilization on pulmonary parameters and complications post coronary artery bypass graft surgery.

This study compared the effects of a four-phase and a three-phase early mobilization protocol on respiratory parameters and complications in patients following coronary artery bypass graft surgery. This is a three-arm, parallel-group, randomized controlled clinical trial with 120 candidates for coronary artery bypass graft surgery. Participants were randomly allocated to three groups: four-phase early mobilization protocol, three-phase early mobilization protocol, and control. Arterial blood gases, oxygen saturation, and incidence of pulmonary complications were compared among the groups. Mean arterial blood gases and oxygen saturation improved significantly over time in both four-phase early mobilization protocol and three-phase early mobilization protocol groups compared to control (p < 0.05). There were observed trends for greater improvements in the study outcomes with three-phase early mobilization protocol than four-phase early mobilization protocol; however, did not reach statistically significant levels. The incidence of pulmonary complications was significantly in both intervention groups compared to control (odds ratio: 0.48, 95 % CI 0.007-0.537; p < 0.001). Both four-phase early mobilization and the three-phase early mobilization protocols improved respiratory parameters and reduced pulmonary complications. Statistically insignificant trends were found trends in the three-phase early mobilization protocol, focusing on chest physiotherapy and breathing exercises.

Comparing the effect of intermittent diazepam and continuous phenobarbital in preventing recurrent febrile seizures among children under 6 years old: A systematic review and meta-analysis.

Background: Febrile convulsion (FC) is the most common and preventable seizure in children. This study aimed to assess the effectiveness of the diazepam and phenobarbital for preventing recurrent FC. Materials and Methods: In this systematic review study, literature published in English language were carefully searched in biological databases (Cochrane Library, Medline, Scopus, CINHAL, Psycoinfo, and Proquest) by February 2020.Randomized clinical trials (RCTs) and Quasi randomized trial were included in the review. Two researchers checked the literature independently. The quality of studies was assessed using the JADAD score. The potential risk for publication bias was assessed by Funnel plot and Egger's test. Meta regression test and sensitivity analysis were used to identify the reasons for heterogeneity. Given the results of assessing heterogeneity, the random effect model in RevMan5.1 software was used for meta analysis. Results: Four out of 17 studies had compared the effect of diazepam and phenobarbital in preventing recurrent FC. The result of the meta analysis showed that the use of diazepam in comparison with phenobarbital reduces the risk of recurrence FC by 34% (risk ratio = 0.66, 95% confidence interval [CI] = [0.36-1.21]), but the relationship was not statistically significant. In assessing the effect of diazepam or phenobarbital versus placebo, the results showed that the use of diazepam and phenobarbital has reduced the risk of recurrent FC by 49% (risk ratio = 0.51, 95% CI = [0.32-0.79]) and 37% (risk ratio = 0.63, 95% CI = [0.42-0.96)]), respectively, and these relationships were statistically significant (P < 0.05). Results of the meta regression test showed that the follow up time can be a reason for the heterogeneity between trials with the comparison of diazepam versus phenobarbital (r = 0.047, P = 0.049) and Phenobarbital versus placebo (r = 0.022, P = 0.016). According to the results of Funnel plot and Egger's test, there was evidence of publication bias (P = 0.0584 for comparison of diazepam vs. phenobarbital; P = 0.0421 for comparison of diazepam vs. placebo; P = 0.0402 for comparison of phenobarbital vs. placebo). Conclusion: The results of this meta analysis indicated that preventive anticonvulsants can be useful in preventing recurrent convulsions in cases of febrile seizures.

The effects of date seed (Phoenix dactylifera) supplementation on exercise-induced oxidative stress and aerobic and anaerobic performance following high-intensity interval training sessions: a randomised, double-blind, placebo-controlled trial.

High-intensity interval training (HIIT) is an efficient method to improve vascular function, maximal oxygen consumption, and muscle mitochondrial capacity. However, acute HIIT overstresses the oxidative system and causes muscle soreness and damage. The aim of the present study was to investigate the effects of date seeds on exercise-induced oxidative stress and aerobic and anaerobic performance following HIIT sessions. Thirty-six physically active men and women aged 18-35 years were assigned to take 26 g/d of date seed powder (DSP, n 18) or wheat bran powder (placebo, n 18) before and after HIIT workouts for 14 d. Total antioxidant capacity (TAC), oxidative stress index (OSI), total oxidant status (TOS), superoxide dismutase (SOD), glutathione peroxidase (GPx), uric acid, malondialdehyde (MDA), and 8-iso-PGF2α were determined at baseline, at the end of the intervention, and 24-h post-intervention. We used the Cooper and running-based anaerobic sprint test to assess aerobic and anaerobic performance at the study's beginning and end. Independent-samples Student's t tests, ANCOVA and repeated-measures ANOVA were used to compare the quantitative variables. Positive changes were observed in TAC, TOS, OSI, GPx, MDA and visual analogue scale after intervention and at 24-h post-exercise (P < 0·05). Likewise, peak power and fatigue index were significantly improved in DSP in comparison with the placebo group. Levels of SOD, uric acid, 8-iso-PGF2α, VO2 max and average power were not changed after training. Our results showed that date seed supplementation in active participants performing HIIT bouts ameliorated oxidative stress and improved performance parameters.

Randomized study of the effects of vitamin D and/or magnesium supplementation on mood, serum levels of BDNF, inflammation, and SIRT1 in obese women with mild to moderate depressive symptoms.

OBJECTIVES: This study aimed to evaluate the effects of vitamin D and/or magnesium supplementation on mood, serum levels of BDNF, inflammation, and SIRT1 in obese women with mild to moderate depressive symptoms. METHODS: In this trial, the 108 obese women with mild to moderate depressive symptoms were randomly allocated into 4 groups: (1) co- supplementation group (n = 27): receiving a 50000 IU vitamin D soft gel weekly + a 250- mg magnesium tablet daily; (2) vitamin D group (n = 27): receiving a 50000 IU vitamin D soft gel weekly + a magnesium placebo daily; (3) magnesium group (n = 27): receiving a vitamin D placebo weekly + a 250- mg magnesium tablet daily; (4) control group (n = 27): receiving a vitamin D placebo weekly + a magnesium placebo daily, for 8 weeks. Before and after the intervention, anthropometric indices, depressive symptoms, serum levels of BDNF, 25(OH)-D, inflammation, and SIRT1, were measured. RESULTS: At the end of the study, ANCOVA demonstrated significant differences between the 4 groups in 25(OH)-D, magnesium, TNF-α, IL-6, and BDNF levels. But, we found no significant differences in terms of hs-CRP and SIRT1 levels. A significant reduction in depression score was observed in 3 intervention groups and also in control group. No significant differences in BDI-II score were shown among the 4 groups at the end of the intervention. CONCLUSION: Vitamin D plus magnesium supplementation in obese women with mild to moderate depressive symptoms has beneficial influences on mood, serum levels of BDNF, inflammation, and SIRT1.

Health care providers' effect on long-term mortality after the first-ever stroke: application of shared frailty survival models.

BACKGROUND: Stroke is a global public health challenge. Frailty models can detect and consider the effects of the unknown factors influencing survival along with other known factors. This study aims to evaluate health care providers' effect, along with the demographic and clinical factors, on the stroke patients' survival by using the shared frailty survival models. METHODS: In the 2-year follow-up, a total of 1036 patients with first-ever stroke were recruited from 2013 up to 2015 with census sampling method from two hospitals of Iran, as the health care providers. For model selection, we fitted parametric and semiparametric survival models with parametric shared frailty and used the goodness of fit criteria to compare the models. RESULT: The median follow-up was 730 days. The rate of mortality was 38% during the follow-up period. The Weibull model with gamma frailty had a better fit than the other survival models. The significant variables from the Weibull model were NIHSS score as the stroke severity (score < 5: reference category; scores 5-19: HR = 2.99, p value < 0.001; score ≥ 20: HR = 5.66, p value < 0.001) and age (HR = 1.03, p value < 0.001). Even with the incorporation of the demographic and clinical factors in the survival model, the effect of health care providers as the shared frailty effect was significant (p < 0.001). CONCLUSIONS: Despite considering the known demographic and clinical prognostic factors, health care providers' effect on the patients' survival after stroke was still significant. This may be due to the existing difference between two hospitals in facilities, management, coordination, and efficiency of treatment.

Illness acceptance, medication adherence and the quality of life in patients with heart failure: A path analysis of a conceptual model.

Heart failure (HF) is a chronic disease that negatively affects different aspects of the patients' lives, diminishing their quality of life. This research studied factors that impact the health-related quality of life (HRQoL) of patients with HF, particularly medication adherence and acceptance of illness. In this cross-sectional study, data were collected from 273 patients admitted to a tertiary hospital with the diagnosis of HF. Participants' level of illness acceptance, medication adherence, and HRQoL were assessed using validated questionnaires, and data were analyzed using the regression path analysis. There was found a moderate level of acceptance of illness (24.9 ± 6.79) and low levels of medication adherence (3.44 ± 3.15) and HRQoL (53.81 ± 17.99) among participants. Gender, education, income, history of coronary artery bypass (CABG), the New York Heart Association (NYHA) class, acceptance of illness, and medication adherence were statistically significantly associated with HRQoL. Patients with diminished HRQoL were more likely to be female, less educated, have lower income, higher NYHA class, no prior CABG, low medication adherence, and low level of acceptance of illness. The final path model demonstrated a good fit with the data (χ^2/df = 1.70, CFI = 0.92, RMSEA = 0.05, and p = 0.01). Health care providers should target and promote medication adherence and the acceptance of illness as modifiable factors to help improve the HRQoL of patients with HF.

Hidden patterns among the fatally injured pedestrians in an Iranian population: application of categorical principal component analysis (CATPCA).

BACKGROUND: Identifying hidden patterns and relationships among the features of the Fatal Pedestrian Road Traffic Injuries (FPRTI) can be effective in reducing pedestrian fatalities. This study is thus aimed to detect the patterns among the fatally injured pedestrians due to FPRTI in East Azerbaijan province, Iran. METHODS: This descriptive-analytic research was carried out based on the data of all 1782 FPRTI that occurred in East Azerbaijan, Iran from 2010 to 2019 collected by the forensic organization. Categorical Principal Component Analysis (CATPCA) was performed to recognize hidden patterns in the data by extracting principal components from the set of 13 features of FPRTI. The importance of each component was assessed by using the variance accounted for (VAF) index. RESULTS: The optimum number of components to fit the CATPCA model was six which explained 71.09% of the total variation. The first and most important component with VAF = 22.04% contained the demographic and socioeconomic characteristics of the killed pedestrians. The second-ranked component with VAF = 12.96% was related to the injury type. The third component with VAF = 10.56% was the severity of the injury. The fourth component with VAF = 9.07% was somehow related to the knowledge and observance of the traffic rules. The fifth component with VAF = 8.63% was about the quality of medical relief and finally, the sixth component with VAF = 7.82% dealt with environmental conditions. CONCLUSION: CATPCA revealed hidden patterns among the fatally injured pedestrians in the form of six components. The revealed patterns showed that some interactions between correlated features led to a higher mortality rate.

The association between cigarette smoking attitudes and social capital among Iranian health and medical students: a cross-sectional study.

BACKGROUND: Smoking remains a leading public health challenge globally. As a psychosocial determinant of health, social capital can influence health attitudes and behaviors, and thus it may have the capacity to reduce smoking rates. The aim of this research was to examine the association between social capital and attitudes towards smoking among university students. METHODS: This cross-sectional study was conducted among 538 health and medical students, recruited using the proportionate sampling method. Participants' social capital and attitudes toward smoking were assessed using the social capital questionnaire (SCQ) and the scale of cigarette smoking attitude (CSA). Data were analyzed using descriptive statistics, Pearson correlation coefficient, and the multiple regression analysis. RESULTS: About one in four health and medical students reported smoking, either currently or in the past, and 30% had either positive or indifferent attitudes towards smoking. The mean scores of the SCQ and the CSA were 105.1 ± 19.7 and 48.6 ± 11.2, respectively. There was a statistically significant negative association between the SCQ and the CSA scores (r = - 0.24; p < 0.001). In the regression analysis, the SCQ scores were also negatively and statistically significantly associated with the CSA scores, after controlling potential confounders (B: -0.09; 95% CI: - 0.13 to - 0.004). CONCLUSIONS: As future healthcare providers, who are expected to take the primary role in reducing smoking rates in the community, health and medical students should be supported to develop appropriate attitudes towards smoking. Promoting positive social capital among university students has the capacity to improve their attitudes towards smoking. Possessing negative attitudes towards smoking should hopefully reduce smoking behaviors among future health professionals and improve their participation in anti-smoking campaigns.

The Effects of home-based stabilization exercises focusing on the pelvic floor on postnatal stress urinary incontinence and low back pain: a randomized controlled trial.

INTRODUCTION AND HYPOTHESIS: Stress urinary incontinence (SUI) and low back pain (LBP) are common postnatal problems. We aimed to compare the effects of stabilization exercises focusing on the pelvic floor on postnatal SUI and LBP. METHODS: This two-arm, single-blind, parallel, randomized controlled trial was done on 80 women (mean age: 30.5, range: 20-45 years), with postnatal SUI and LBP. They were randomized into two equal control and intervention groups. The control group received no treatment while the intervention group received home-based stabilization exercises focusing on pelvic floor muscles (PFM) 3 days a week for 12 weeks, three sets a day; each set included three different types of exercise each week. Outcome measures were UI severity, assessed by ICIQ-UI-SF, low back pain functional disability, assessed by the Oswestry Disability Index (ODI), LBP severity, assessed by visual analog scale (VAS), and PFM strength and endurance, assessed by vaginal examination. Transverse abdominis (TrA) muscle strength was assessed by manometric biofeedback. All outcomes were measured directly before and after treatment. RESULTS: In the intervention group, PFM strength, TrA muscle strength, functional disability and pain severity were significantly improved (P < 0.05). Within-group results showed that all outcomes except pain severity (P = 0.06) had directly improved in the intervention group after treatment (P < 0.05), while in the control group only PFM strength and endurance and UI severity had improved (P < 0.05). CONCLUSIONS: Home-based stabilization exercises focusing on the pelvic floor muscles could be effective for postnatal LBP and SUI. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (Code: IRCT2017050618760N4).

Oral health status and associated lifestyle behaviors in a sample of Iranian adults: an exploratory household survey.

BACKGROUND: Poor oral hygiene can lead to serious diseases, such as periodontitis, tooth decay, pain and discomfort in teeth or gums, infections, and loss of teeth. In Iran, adults aged 50 y and older are a high-risk group for oral health problems, and this age group will grow in the coming decades. Despite increasing attention on healthy aging, there is relatively less emphasis on oral hygiene and health-related problems. The present study investigated the oral health status of Iranian adults using the oral health self-assessment questionnaire (OHQ) developed by the World Health Organization (WHO). METHODS: A population-based household survey of a sample of adults aged 18-65 y was conducted. In this study, the participants were recruited between May and October 2016 in Tabriz, Iran, and the study population was sampled using a multi-stage cluster sampling design. The WHO's OHQ for adults was used for measuring oral health status and oral hygiene behavior. RESULTS: In total, 2310 respondents completed the survey. The mean age (SD) of the participants was 41.6(23.4) y. Males accounted for 48.8% of the participants. Of the 2310 respondents,187 (8.1%) individuals were edentulous, 152(20.7%) of whom were aged 51-65 y. Furthermore, 72.3% of those aged 51-65 y were dentate, and 50% of adults aged 51-65 y said they had 20 or more teeth. About one-third of the participants reported that they did not brush their teeth daily (23% of those aged 18-35 y,35.9% of those aged 36-50 y, and 44.6% for those aged 51-65 y). In the sample, 39.4% of individuals aged 18-35 y,34.1% of individuals aged 36-50 y, and 26.6% of individuals aged 51-65 y had visited a dentist less than 6 month ago. One-third of the participants consumed sweets and sugary drinks daily. CONCLUSIONS: Although the majority of Iranian adults considered their oral health status good, only a small percentage of the sample visited their dentist regularly. Furthermore, visits to the dentist declined in accordance with increasing age, a time when the incidence of oral health problems may increase. Poor oral health may increase the risk of adverse health outcomes, particularly among the aging population.

Effects of cumin (Cuminum cyminum L.) essential oil supplementation on metabolic syndrome components: A randomized, triple-blind, placebo-controlled clinical trial.

Prevalence of metabolic syndrome (MetS), as a major health problem, is increasing. Very limited data exist on the effect of Cuminum cyminum L. essential oil (CuEO) on MetS components. Accordingly, this study aimed to examine the effect of CuEO supplementation on anthropometric indices, glycemic control, blood pressure, lipid profile, and insulin resistance in patients with MetS. In a randomized, triple-blind, placebo-controlled clinical trial, 56 patients with MetS aged 18-60 years received either 75 mg CuEO or placebo soft gel thrice daily for 8 weeks. Anthropometric indices and biochemical measurements were assessed at baseline and end of the study. At the end of study, except for diastolic blood pressure (DBP), the other assessed variables were not significantly different between two groups. In intra group analysis, placebo and CuEO groups both had nonsignificant decrements in DBP (mean difference [MD] with 95% CI: -3.31 [-7.11, 0.47] and -1.77 [-5.95, 2.40] mmHg, respectively). However, DBP was significantly lower in CuEO compared with the placebo group at the end of study (81.41 ± 5.88 vs. 84.09 ± 5.54 mmHg, MD with 95% CI: -3.98 [-7.60, -0.35] mmHg, p < .05). The results indicated that CuEO does not have any effect on MetS components, except for DBP in patients with MetS.

The effect of cumin supplementation on metabolic profiles in patients with metabolic syndrome: A randomized, triple blind, placebo-controlled clinical trial.

Metabolic syndrome (MetS) is a cluster of interconnected serious disorders, which is a major health problem whose prevalence is increasing. Oxidative stress and inflammation contribute to the disease pathogenesis and its complications. The present study aimed to investigate the effect of Cuminum cyminum L. (which has antioxidant and anti-inflammatory properties) essential oil (CuEO) supplementation on inflammatory and antioxidant status in patients with MetS. In this clinical trial, 56 patients with MetS aged 18-60 years received either 75-mg CuEO or placebo soft gel, thrice daily, for 8 weeks. Data on anthropometric parameters, food consumption, tumor necrosis factor alpha, high-sensitivity C-reactive protein, superoxide dismutase (SOD), glutathione peroxidase, catalase, total antioxidant capacity (TAC), and malondialdehyde (MDA) were assessed at the beginning and at the end of the study. Compared with the placebo group, CuEO increased SOD (149.17; 95% CI, [67.93, 230.42]), TAC (0.24; 95% CI, [0.09, 0.38]) and decreased MDA (-0.36; 95% CI, [-0.66, 0.06]), (p < 0.01). In within-group analysis, CuEO led to 13.3% decrease in MDA and 6.7% increase in TAC levels (p < 0.04). The results indicated that CuEO supplementation can improve some antioxidative indices, as SOD and TAC, while decreasing MDA in patients with MetS.