Eating behaviors and dietary intake 2 to 4 years following sleeve gastrectomy: Are there any associations?

OBJECTIVES: A lack of research exists on associations between eating behaviors and dietary intake among patients undergoing bariatric surgery. This study aimed to ascertain the association between eating behaviors and dietary quantity and quality at mid-term postsleeve gastrectomy (SG). METHODS: This cross-sectional study included 146 adults within 2 to 4 years post-SG. Dietary intake and eating behaviors were assessed using a food frequency questionnaire and the Dutch Eating Behavior Questionnaire, respectively. Energy and the proportion of macronutrients were determined. Carbohydrate quality index (CQI), fat quality index (FQI), healthy plate protein quality index (HPPQI), macronutrient quality index (MQI), and Healthy Eating Index (HEI)-2015 were computed to evaluate diet quality. Participants were categorized into high and low groups based on median scores for each eating behavior scale. Least-squared (geometric) means and 95% confidence intervals were determined for each group using the analysis of covariance, adjusted for age and sex. RESULTS: The mean time since surgery for participants was 30.8 ± 6.5 months, and 77.4% were female. Participants with high emotional eating had higher energy and HPPQI. Individuals with high external eating had higher energy and percentages of fat and lower FQI and HEI scores. Individuals with high restrained eating scores demonstrated lower energy intake but a higher percentage of protein intake and higher CQI, FQI, MQI, and HEI scores. CONCLUSIONS: External eating showed the most unfavorable associations, while restrained eating showed the most favorable associations with quantity and quality of diet 2 to 4 years after SG. Emotional eating was minimally related to dietary characteristics.

Association of postoperative dietary macronutrient content and quality with total weight loss and fat-free mass loss at midterm after sleeve gastrectomy.

OBJECTIVES: This study aimed to investigate the associations of macronutrient quantities and qualities with percentage total weight loss and percentage of fat-free mass loss relative to total weight loss in adults undergoing sleeve gastrectomy. METHODS: This cross-sectional study included 146 patients on postoperative time since sleeve gastrectomy of 2 to 4 y. Diet was assessed using a food frequency questionnaire. Macronutrient quality index, carbohydrate quality index, fat quality index, and healthy plate protein quality index were calculated. The associations of dietary variables with percentage total weight loss and percentage of fat-free mass loss relative to total weight loss were determined using linear regression. Logistic regression was used to estimate the odds of non-response (percentage total weight loss < 25%) and excessive fat-free mass loss (percentage of fat-free mass loss relative to total weight loss > 28%) based on dietary intakes. RESULTS: Forty-six (31.5%) were non-responders, and 49 (33.6%) experienced excessive fat-free mass loss. The fully adjusted model showed a 0.75 decrease in percentage total weight loss per 5% carbohydrate increase (95% CI, -1.45 to -0.05). The odds of non-response were 53% lower per 5% increase in protein (95% CI, 0.23-0.94). Each 5-g higher intake of fat was associated with 0.29 higher percentage of fat-free mass loss relative to total weight loss (95% CI, 0.03-0.55). The odds of excessive fat-free mass loss were reduced by 5% per gram of fiber intake (95% CI, 0.90-0.99). Each 5% increment in energy intake from protein that was isocalorically substituted for either carbohydrate or fat was associated with lower odds of nonresponse. Macronutrient quality indices had no significant associations. CONCLUSIONS: Adherence to a high-protein, high-fiber diet after sleeve gastrectomy may enhance surgical success by improving total weight loss and preventing excessive fat-free mass loss.

Dietary Macronutrient Composition and Quality, Diet Quality, and Eating Behaviors at Different Times Since Laparoscopic Sleeve Gastrectomy.

PURPOSE: This study aimed to compare energy, macronutrients (quantity and quality), the overall dietary quality, and eating behaviors of patients undergoing laparoscopic sleeve gastrectomy (LSG) at different times since surgery. MATERIALS AND METHODS: This cross-sectional study included 184 adults at least 1 year post-LSG. Dietary intakes were assessed by a 147-item food frequency questionnaire. Macronutrient quality was assessed by computing the macronutrient quality index (MQI), carbohydrate quality index, fat quality index, and healthy plate protein quality index (HPPQI). The Healthy Eating Index (HEI)-2015 was used to assess diet quality. The Dutch Eating Behavior Questionnaire was used to assess eating behaviors. Based on the time since LSG, the time at which eating data were also collected, participants were categorized into three groups: 1-2 years (group 1), 2-3 years (group 2), and 3-5 years (group 3). RESULTS: Group 3 consumed significantly more energy and absolute carbohydrates than group 1. The MQI and HPPQI scores of group 3 were significantly lower than those of group 1. The HEI score was significantly lower in group 3 compared to group 1, with a mean difference of 8.1 points. Compared to patients with 1-2 years following LSG, those with 2-3 and 3-5 years consumed more refined grains. Eating behavior scores did not differ between groups. CONCLUSION: Patients at 3-5 years post-LSG consumed more energy and carbohydrates than those at 1-2 years after the surgery. Protein quality, overall macronutrient quality, and overall diet quality decreased as time passed following surgery.

Association Between Energy and Macronutrient Intakes and Weight Change After Bariatric Surgery: a Systematic Review and Meta-analysis.

OBJECTIVES: This systematic review and meta-analysis aimed to summarize the evidence on the associations of energy and macronutrient intakes (carbohydrates, fats, and proteins) with weight loss in adults after sleeve gastrectomy or gastric bypass and to determine whether these dietary characteristics of patients with suboptimal weight loss (SWL) or weight regain differ from those without these experiences. METHODS: PubMed, Scopus, and Web of Science were searched until December 2021. Twenty-three observational studies were included. RESULTS: Studies on the association of postoperative energy and macronutrients and weight loss used diverse approaches. Pooled results showed that patients with SWL consumed more energy than those with acceptable weight loss. Weight regainers consumed more energy and carbohydrates and less protein than non-regainers. CONCLUSIONS: Higher energy consumption is related to SWL and weight regain after surgery. Associations between macronutrients and weight outcome following bariatric surgery warrant further investigation.

Determining the frequency of Candida species in women with candidal vaginal infection frequency of Candida species in women with candida vaginal infection.

BACKGROUND: Candidiasis vaginitis is an opportunistic and common mucosal infection. Although Candida albicans is the most common isolated species, other species of Candida such as Candida glabrata, Candida krusei, Candida parapsilosis, and Candida tropicalis have also increased significantly in recent years. The aim of this study was to identify Candida species in women with candidal vaginal infection in order to promote health in women. MATERIALS AND METHODS: This cross-sectional descriptive study was performed on nonpregnant women of childbearing age who referred to health centers in Neyshabur in 2018. At the beginning of the study, 163 people entered the study and the culture results were positive in 68 of them. In vitro, culture was performed in subduxtrose agar medium containing chloramphenicol and gentamicin. Species identification was performed using Candida specific culture medium (Saburo dextrose agar and chloramphenicol). After culture, 15% of the residual wet slide with potash (KOH) was prepared and observed with a lens. Finally, the data were analyzed with SPSS software version 24. RESULTS: The participants in the study were women with a mean age of 35.55 ± 5.47 and the average number of deliveries was 1.38 ± 1.15. In this study, the prevalence of C. albicans was 59.7%, C. tropicalis was 14.8%, C. krusei was 15%, and C. glabrata was 7.61% and also krusei and tropicalis were 3% simultaneously. Therefore, C. albicans was the most common species isolated from clinical specimens. CONCLUSION: In this study, the most common species after albicans were C. tropicalis and cruciferous. Considering the role of C. glabrata in the development of resistance to antifungal drugs, the lower prevalence of this species in the present study can be associated with improved treatment outcomes in patients.

Investigating the relationship between the dimensions of mindfulness and maternal attachment to the fetus during pregnancy.

BACKGROUND: Maternal attachment to the fetus is a term used to describe the emotional relationship between mother and fetus. This emotional connection increases during pregnancy and is reflected in her feelings, perceptions, and behaviors. Mindfulness is important as one of the factors affecting the mental health of people during pregnancy. Therefore, the present study was conducted to determine the relationship between the dimensions of mindfulness and maternal attachment to the fetus during pregnancy. MATERIALS AND METHODS: The present study was performed on 500 pregnant mothers referred to health centers affiliated to Isfahan University of Medical Sciences. The samples were entered into the study by available sampling method and if they had inclusion criteria and no exclusion criteria. The research instruments were the Fetal Attachment Questionnaire and the Bauer Mindfulness Questionnaire. The collected data were analyzed by SPSS software version 22. RESULTS: The results of the data showed that there was no significant relationship between the overall score of mindfulness and the overall score of maternal attachment to the fetus (P = 0.62). While from the dimensions of mindfulness such as "action with awareness" there was a significant negative relationship (P = 0.03) with maternal attachment to the fetus and a significant positive relationship "observation" with maternal attachment to the fetus (P = 0.03). CONCLUSION: According to the results of this study, there is a relationship between maternal attachment to the fetus during pregnancy and a number of dimensions of mindfulness. For this purpose, since mindfulness can increase the mother's interactions with the fetus, and this interaction begins during pregnancy and with the mother's attachment to the fetus, it is important to pay attention to this.

Effect of spiritual care education on the spiritual health of preeclamptic women with postpartum stress disorder.

BACKGROUND: Spiritual health in the field of health has a great importance in mental disorders and posttraumatic stress disorders, in treatment process. The present study was done aiming "determine the effect of spiritual care education on the spiritual health of preeclamptic women with postpartum stress disorder." MATERIALS AND METHODS: This randomized clinical trial was done in 2017 on 260 women with preeclampsia in Mashhad. Data collection was done with questionnaires Perinatal Posttraumatic Stress Questionnaire (PPQ), the posttraumatic disorder checklist, Duke University Religion Index, and the Spiritual Well-Being Scale (SWBS). In the intervention group, first, women were educated on spiritual care each day based on Richards and Bergin's pattern, in three sessions, which lasted 45-60 min. The control group also received routine cares. All units completed the questionnaire SWBS at the 8th postpartum period. P < 0.05 was meaningful. RESULTS: After the intervention, this score of spiritual health in the intervention and control groups had a significant difference with independent test (P = 0.004). Spiritual health significantly increased in the interventional group. CONCLUSIONS: Providing spiritual care to pregnant mothers with preeclampsia, increase their spiritual health.

Relationship between fear of childbirth and the sense of cohesion with the attachment of pregnant mothers to the fetus.

INTRODUCTION: Maternal-fetal attachment is a term used to describe the emotional relationship that a pregnant woman has with her developing fetus. Mental care for pregnant women (fear of childbirth and a sense of cohesion of pregnant women) is one of the most important aspects of prenatal care that affects the mother's attachment to the fetus. If fear and anxiety are relieved, psychological and physical relaxation will be replaced. Therefore, the present study was conducted with the aim of determining the relationship between fear of childbirth and the sense of cohesion with the attachment of pregnant mothers to the fetus. METHODS: The present study is a descriptive study that was performed by multi-stage sampling method on 500 pregnant mothers who referred to health centers in Isfahan in 2017. The study participants completed the following questionnaires: fear of childbirth, sense of cohesion, and mother's attachment to the fetus. The data were analyzed by descriptive and analytical statistical methods (Pearson correlation) using SPSS software version 22. RESULTS: The results showed that there was a significant negative relationship between the overall score of maternal attachment to the fetus and fear of childbirth (r = -0.153, P = 0.001). However, there is a significant positive relationship between the overall score of maternal attachment to the fetus and the sense of cohesion (r = 0.112, P = 0.01). The results also showed a significant negative relationship between the fear of childbirth and the dimensions of maternal attachment to the fetus, including interaction with the fetus (P = 0.04), self-sacrifice (P = 0.04), and attributing characteristics to the fetus (P = 0.05). There was a positive and significant relationship between the sense of coherence and the subsequent acceptance of the maternal role of maternal attachment to the fetus (P = 0.004). CONCLUSION: More attention of prenatal care provider to the psychological issues of the pregnant mother and their fears and worries can lead to appropriate interventions in this field, and as a result, mothers' attachment to their fetus has increased so that they can take proper care during and after pregnancy.

The Relationship between religious orientation and promotion of sexual satisfaction and marital satisfaction in women of reproductive age.

INTRODUCTION: Marital satisfaction is a situation in which the husband and wife enjoy marrying and feeling emotional; on the other hand, the existence of religious beliefs has a significant effect on family stability. The aim of this study was to determine the relationship between religious orientation, sexual satisfaction, and marital satisfaction in women of reproductive age. METHODS: This is a correlational study performed on 150 married women aged 45-45 years who referred to Neyshabur comprehensive health services centers. The sampling method was clustered. The present study used three questionnaires: Spinner Marital Satisfaction, Larson's Sexual Satisfaction, and Allport Religious Orientation Questionnaire. The reliability of these questionnaires was confirmed by the retest method. T-test, Pearson correlation, and one-way ANOVA were used for data analysis. RESULTS: Data analysis showed that there is a significant and positive relationship between religious orientation and sexual satisfaction and marital satisfaction. Religious commitment has a predictive role in promoting sexual satisfaction and marital satisfaction, with increasing religious commitment, increasing sexual satisfaction, and marital satisfaction. CONCLUSION: Psychologists and counselors in individual and couple counseling sessions with sexual problems and marital dissatisfaction and premarital counseling can increase marital satisfaction with regard to religious factors and religious and spiritual teachings.

Urine analysis with dipstick test in asymptomatic 7-year-old children.

INTRODUCTION: The incidence of renal failure in children is increasing worldwide, and most renal diseases do not show clinical symptoms for the patient. Moreover, given the importance of screening for patient identification and prevention planning that result from screening, the present study was performed. METHODS: This cross-sectional study was performed on 292 children aged 7 years who referred to Neyshabur health centers during 2017-2018. In addition, sampling was clustered. The first urine sample was taken in the morning, and the dipstick test was performed. Data were analyzed using SPSS software version 11.5 and Mann-Whitney, Chi-square, and Pearson's tests. RESULTS: Of the 292 children, 142 (48.6%) were male and 150 (51.4%) were female. All the boys had been circumcised. The children were 7-year-old. Urinary tract problems were present in 31 (10.61%) children. Urinary problems were observed in 163 children (55.82%) considering crystalluria. Some children had more than one type of urinary disorder. Pyuria was the most common disorder in 13 (8.7%) of the studied children, and proteinuria was the least common. Nitrite and hemoglobin were not found in the urine of the studied children. There was a statistically significant relationship between gender and white blood cell count (P < 0.001), crystalline oxalate (P = 0.004), and specific gravity (P = 0.009). There was also a statistically significant relationship between urinary-specific gravity and pH (P < 0.001). CONCLUSION: Asymptomatic urinary problems may be identified by screening tests in school-aged children. Therefore, it is necessary to determine the exact cause of the obtained abnormal results and determine whether or not they are related to renal disease in order to reduce the number of people with untreated renal diseases in future.

Investigating the relationship between social support and self-compassion by improving the adequacy of prenatal care.

INTRODUCTION: Getting pregnant care is different due to the psychological problems of pregnant mothers. Self-compassion and social support are the important components of mental health. Women with higher self-compassion and social support can take full care of their pregnancies. The aim of this study was to determine the relationship between social support and self-compassion with adequate prenatal care. METHODS: The present study is a cross-sectional descriptive study that was performed in 2018 using the available sampling method on 500 pregnant mothers referred to Isfahan health centers. Individuals entered the study if they had entry criteria and no exit criteria, and completed social support, self-compassion, and adequacy of pregnancy care questionnaires. The data were coded and analyzed by SPSS software version 22 and Pearson's correlation statistical test. RESULTS: The results of data analysis with Pearson's correlation test showed a positive and statistically significant relationship with pregnancy care between the overall score of social support (P < 0.001) and the dimensions of social support such as family support (P < 0.002), support of friends (P < 0.004), and the support of other people (P < 0.001). The results also showed a positive and statistically significant relationship between self-compassion and prenatal care (P < 0.001). There was a significant positive relationship between the subscales of the self-empathy questionnaire, including kindness to oneself, human commonalities, mindfulness and increasing replication, and pregnancy care, but there was a significant negative relationship between subscales of isolation and self-judgment with pregnancy care. CONCLUSION: According to the results of the present study, social support and self-compassion as two components of mental health can affect the quality of services during pregnancy. For this reason, it is recommended that health-care providers pay attention to these two issues in order to increase the level of care during pregnancy and thus ensure maternal health during pregnancy and childbirth and the health of the fetus and baby.

Comparison of attachment styles of addicted parents and non-addicted parents in health-care referents.

BACKGROUND: Growing interest in issues of attachment, sociocultural, psychological, and above all clinical perspectives is also reflected in the emergence of research on "attachment style and parental parenting style in referrals to addiction treatment centers." METHODS: This was a cross-sectional study. Three health centers were selected randomly from among the health centers of Neyshabur city in 2015-2016 year. The sampling was done so that all individuals who had the characteristics of the research unit and had the consent to participate in the study were justified by the researcher and completed questionnaire form. We used Chi-square, one-way analysis of variance, Mann-Whitney, and Kruskal-Wallis tests. RESULTS: In the present study, safe attachment scores in children with healthy parents were significantly more than children with addicted parents. CONCLUSION: Addiction has an important role in reducing attachment to children, and because this decrease in attachment has dangerous consequences in child's life.

The effectiveness of existential psychotherapy on attitude to life and self-flourishing of educated women homemakers.

INTRODUCTION: Women make up half of the world's population and play a critical role in the health and well-being of the family and society. The purpose of this study is to determine the effectiveness of existential psychotherapy on attitude to life and self-flourishing of educated women homemakers. METHODS: A quasiexperimental study with the pretest-posttest design is used in this work. The research population included 68 homemakers with university education who live in Neyshabur, Iran. Sampling method was available. The women were randomly assigned into two groups: intervention and control groups. The women in the intervention group participated in 10 sessions of existential therapy group. The data collection tool was a questionnaire of Life Regard Index (LRI) and Human Flourishing Questionnaire (HFQ). The data were analyzed by the SPSS software version 21 using Chi-square, independent t-test, and paired t-test while P < 0.05 considered as a significant level. RESULTS: Scores of attitude to life and self-flourishing in educated homemakers before intervention were not significantly different in the two groups. Independent t-test showed that self-flourishing was significantly increased in the intervention group (90.88 ± 15.27) compared to the control group (79.64 ± 15.87) (P = 0.004). The attitude to life was significantly increased in the intervention group (35.79 ± 14.21) compared to the control group (27.50 ± 8.77) (P = 0.005). CONCLUSIONS: The results of this study emphasize that existential group therapy is effective in attitude to life, and self-flourishing of educated homemakers. This therapy can also be used to enhance individual and social abilities the importance and impact of existential psychotherapy on enhancing capabilities such as a positive attitude to life and self-flourishing.

The effect of small group teaching on quality of life in pregnant women with nausea and vomiting: A clinical trial.

INTRODUCTION: Nausea and vomiting in pregnancy is the most common medical complication in the first trimester of pregnancy. That associated with a wide range of physical and mental symptoms for the patient and his family and can affect the quality of life of women's life. In addition, the training to improve knowledge, in adjusting diet and lifestyle, and leading to decrease nausea and vomiting. Due to the positive characteristics of training using the small groups, this study was applied with the objective of "The effect of small group teaching on quality of life in pregnant women with nausea and vomiting." METHODS: This study was applied based on intervention, on 59 nulliparous women with nausea and vomiting who referred to obstetrics ward of selected health and treatment centers in Neishaboor County. The training was presented by a researcher in group intervention in 8 sessions, each 45-30 min in small groups (3 groups 10 members). The control group received routine care. The study instruments (nausea and vomiting of pregnancy quality of life questionnaire) and (modified-PUGE) form. The results were analyzed using the Wilcoxon test, Mann-Whitney, and t-test. RESULTS: Research units were no statistically significant difference of personal data, at the beginning of the study, and before intervention, was not differences between the mean change scores of postpartum stress disorder in two groups (P = 0/192). While the mean quality of life score in the intervention and control groups was statistically significant difference after intervention (P = 0.001). Quality of life score in the intervention group had statistically significant difference before and after the intervention (P = 0.001). CONCLUSION: Training in the intervention group with small group strategies has more effective in comparison to conventional training of nausea and vomiting.

Effect of spiritual care education on postpartum stress disorder in women with preeclampsia.

INTRODUCTION: Posttraumatic stress disorder is an anxiety disorder that occurs after exposure to an event that causes injury or threat. The prevalence of preeclampsia was reported to be 28%. Considering the significant role of spiritual care in physical and psychological outcomes of patients, this study was conducted to determine "the effect of spiritual care education on postpartum stress disorder in women with preeclampsia". MATERIALS AND METHODS: In this randomized clinical trial, 72 pregnant women (36 in each group) were selected in a convenient way between the ages of 34 and 38 weeks who had preeclampsia and admitted to two public hospitals in Mashhad. The questionnaires such as Duke University Religion Index, DASS 21, the Posttraumatic Stress Disorder Checklist (PCL), and Prenatal Posttraumatic Stress Questionnaire (PPQ) were used at the beginning in two groups. In the intervention group, first, women were educated each day based on Richards and Bergin's pattern, in three sessions, which lasted 45-60 min. The control group also received routine cares. All units completed questionnaires such as Prenatal Posttraumatic Stress Questionnaire (PPQ) at the 4th-6th postpartum period. Results were analyzed by independent t-test, Mann-Whitney test, Chi-square test, and SPSS version 16. RESULTS: The mean change score of postpartum stress disorder in the intervention and control groups was different after intervention (P = 0.001). CONCLUSION: Providing spiritual care to pregnant mothers with preeclampsia reduces their risk of postpartum stress disorder. Therefore, this kind of care as an effective intervention is included in the routine care of this group with high-risk pregnancies.

Situational Analysis of Cutaneous Leishmaniasis in an Endemic Focus of the Disease, Southeastern Iran.

BACKGROUND: Leishmaniasis is one of the most important vector-borne diseases in Iran, existing in a variety of forms ranging from cutaneous to visceral forms. Jask County has been recognized as an endemic focus of the disease in the southeastern region of Iran. This study analyzed the situation of cutaneous leishmaniasis (CL) during 2006-2014. METHODS: This cross-sectional analytical study was conducted on CL data got from health sector. ArcGIS 10.3 was exploited for the spatial analysis of CL. Potential high-risk areas of the disease regarding its' current geographical distribution were considered. RESULTS: Overall, 874 CL cases had been registered in the district health center, implying an average incidence of 162.5per 100000. More than 90% of the cases emerged from rural areas. The disease is geographically distributed in the southeastern regions of Jask County. Over one-third of the total study area can be classified as high-risk areas, involving 61 villages with a total population of about 18000. Remarkably, altitude and total precipitation were realized to play key roles in CL transmission within the study area. CONCLUSION: Although the national protocol for the control of ZCL recommends the substantial destruction of rodent colonies serving as reservoirs of the disease in infected foci, critical improvement of the knowledge of the residents in these areas is crucial for community-based management of the disease in Jask County.

The Effect of aerobic exercise on primary dysmenorrhea: A clinical trial study.

INTRODUCTION: Primary dysmenorrhea without pelvic pathology is one of the most common complaints in women's medicine. Primary dysmenorrhea can affect the quality of life of women. Aerobic exercise is one of the ways to reduce the severity of primary dysmenorrhea. The present study aimed to determine the effect of 8 weeks of aerobic exercise on the severity of primary dysmenorrhea. METHODS: This is a clinical trial study performed on 70 students with primary dysmenorrhea in dormitories of Mashhad University of Medical Sciences in 2015. Participants were randomly assigned to intervention and control groups. The instrument was a visual pain questionnaire completed by the two groups in the first 3 days of the menstrual cycle. The exercise protocol included aerobic exercise, which performed the intervention group for 8 weeks, three times a week, and each time for 30 min. Data were analyzed by Fisher and Chi-square tests. RESULTS: The control and intervention groups were homogeneous in terms of demographic characteristics. Results showed that the severity of primary dysmenorrhea at the beginning of the study was not significantly correlated with the two groups. At the end of the 4 weeks after the intervention, the intervention group did not show any significant changes in the control group (P = 0.423) but At the end of 8 weeks after the study, the intervention group showed significant changes compared to the control group (P = 0.041). CONCLUSION: The results of this study showed that performing aerobic exercise can improve primary dysmenorrhea. Therefore, aerobic exercise can be used to treat primary dysmenorrhea.

Stimulated and Unstimulated Saliva Levels of Calcium and Magnesium in Giardiasis.

Giardia lamblia causes malabsorption. The aim of this study was to evaluate serum and saliva calcium and magnesium levels in patients with giardiasis. Thirty patients with giardiasis as a case and 30 person without giardiasis as a control group were enrolled. The stimulated and unstimulated whole saliva and serum calcium and magnesium levels were assayed by Arsenazo reaction and xylidyl blue complex methods, respectively. Mean calcium and magnesium level was low in serum and stimulated saliva of case group than that of controls. However, they were higher in the unstimulated saliva of the case group. It is suggested that patients suffering from giardiasis have low calcium and magnesium levels, and they lose the most of calcium and magnesium by saliva during unstimulated condition.