Frequency of Entamoeba Complex in Individuals Referred to the Medical Laboratories in Jahrom City, South of Iran.

This study aimed to determine the prevalence of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii, using microscopic and molecular methods in Jahrom city (Fars Province), south of Iran. Stool samples were collected from 360 outpatients referred to the medical laboratories in Jahrom city. Standard parasitological methods, including direct wet mount examination, formalin-ether sedimentation technique, and trichrome staining techniques, were used for detection of Entamoeba complex. Nested polymerase chain reaction (PCR) was used to identify the genus/species of Entamoeba. Entamoeba complex cysts were detected in 2.5% (9/360) of samples by microscopic methods, while 11 isolates were considered positive for the Entamoeba complex by nested PCR. Among them, 2 (18.18%) out of 11 samples were E. histolytica, 5 (45.45%) were E. dispar, and 4 (36.36%) were E. moshkovskii. Molecular positivity was more prevalent among females (4.16%), people living in rural areas (3.44%), and people over 60 years old (13.33%). Considering the clinical manifestations, the Entamoeba complex infection in patients with fever (7.69%), severe diarrhea (5.10%), and nausea (5%) was high. This study reported the presence of E. histolytica, E. dispar, and E. moshkovskii in Jahrom city. Therefore, we suggest more public health interventions in Jahrom city.

Latent Toxoplasmosis among Breast Cancer Patients in Jahrom, South of Iran.

Objective: Reactivation of latent toxoplasmosis is the main cause of severe infection among immunocompromised patients, including patients with cancer. Hence, this study is aimed at screening the status of Toxoplasma gondii infection among breast cancer patients by serological and molecular methods and determining their associated risk factors in Jahrom County, Fars Province, south of Iran. Methods: One hundred and seven women with breast cancer (aged 34 to 80 years) were screened for anti-T. gondii antibodies (IgG and IgM) during 2019-2020. A questionnaire regarding demographic factors was filled out by participants. Molecular detection was performed by polymerase chain reaction (PCR) using the primer pair targeting the repetitive element (RE) gene of T. gondii. The risk factors and demographic data were analyzed by SPSS software (ver. 20, Chicago, IL, USA) using the Chi-squared test. Results: Anti-T. gondii IgG was detected in 45.8% (49/107) of the patients, which indicates latent infection, but anti-T. gondii IgM and PCR were negative in all samples. Demographic factors revealed a statistically significant increased T. gondii seropositivity among nonmenopause cancer patients (P < 0.0005), patients without previous breast cancer (P = 0.0001), and human epidermal growth factor receptor 2- (HER2-) negative patients (P = 0.00002). As such, patients with a history of previous abortions and who were at stages II, III, and IIII of cancer had higher seropositivity rates than patients without a history of previous abortions or who were at stage I cancer, but the statistical analysis was not significant. We did not find a statistically significant association between T. gondii seropositivity and other risk factors of toxoplasmosis (e.g., education level, type of water source, washing raw fruits and vegetables, consumption of raw or undercooked meat, and contact with soil, cats, and domestic animal). Conclusion: A high seroprevalence rate of latent T. gondii infection was detected among patients with breast cancer; hence, these patients may be at high risk for reactivation of latent infection. Screening of T. gondii infection is recommended to detect active infection among patients with malignancies.

Toxoplasma gondii, HBV, and HCV co-infection and their correlation with CD4 cells among Iranian HIV-positive patients.

INTRODUCTION: Human immunodeficiency virus (HIV/AIDS) infected patients have a higher risk of opportunistic infections (OIs) depending on their immunological status, especially CD4 + cell count. Toxoplasma gondii, hepatitis C virus (HCV), and hepatitis B virus (HBV) are important OIs among Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) patients. However, little is known about co-infection of these pathogens among HIV-infected individuals and their correlation with the patient's CD4 + cell count. Hence, this study aimed to investigate the serological and molecular status of T. gondii infection among HIV-infected individuals who had co-infection with HBV and HCV infections. METHODS: A total of 100 HIV/AIDS patients in two cities in the southwest of Iran was tested for T. gondii Immunoglobulin G (IgG) and Immunoglobulin M (IgM) antibodies as well as DNA detection by polymerase chain reaction (PCR) targeting the RE gene. HBV and HCV were detected by hepatitis B surface antigen (HBsAg) test, hepatitis C antibody (HCV Ab) test, and Real-Time PCR. The number of CD4 + cell counts was determined by Flow cytometry. RESULTS: Anti-T. gondii IgG was positive in 22% of the patients, but anti-T. gondii IgM and PCR were negative in all samples. HBV and HCV were positive in 8% and 33% of the patients, respectively. Co-infections were as followed: HIV + HCV (16%), HIV + HCV + T. gondii (11%), HIV + T. gondii (5%), HIV + HBV (1%), HIV + HBV + T. gondii (1%), HIV + HBV + HCV (1%), and HIV + HBV + HCV + T. gondii (5%). A significant decline in CD4 + cell counts was found in such co-infection groups (HIV + T. gondii, HIV + HCV + T. gondii, and HIV + HBV + HCV + T. gondii) compared with the HIV mono-infection group. CONCLUSIONS: Our study showed that co-infections of T. gondii, HCV, and HBV were common among HIV-infected patients and co-infections had a negative correlation with CD4 + cell counts of the patients.

Associations between RORγt and T-bet Expressions, clinicopathological indices and survival rate in oral Squamous cell carcinoma patients.

BACKGROUND: Oral cancers are the sixth most common cancers around the world. According to the pivotal role of immune cells in the pathogenesis of oral squamous cell carcinoma (OSCC), as the frequent form of malignant epithelial neoplasm in the oral cavity, we investigated the association between the expression of RORγt and T-bet genes as two transcription factors, clinicopathologic indices, and survival rate. METHODS AND MATERIALS: Forty-two OSCC paraffin embded-blocks tissue samples and their surgical healthy margins (as a control group) were collected. Demographic information like age and gender, and medical history including tumor stage/grade, and following-up time were registered. The RORγt and T-bet expression were assessed by qPCR. The overall survival (OS) and disease free survival (DFS) were analyzed by SPSS V.23 software. RESULTS: The expression of RORγt and T-bet genes in OSCC patients were significantly higher than in surgical healthy margins (P < 0.001). Both expression demonstrated a significant difference between surgical healthy margins and tumor tissues related to gender and clinicopathological indices including stage and grade (P < 0.05). The expression of both genes in stage I patients was significant compared to stage IV (P < 0.05). The relation between expressions, OS, and DFS with clinical stage and histological grade of tumors was not statistically significant (P > 0.05). CONCLUSION: Overexpression of RORγt and T-bet in OSCC patients with higher grade and stage in compare to surgical healthy margin highlighted their critical role in OSCC pathogenesis including oral epithelial cell differentiation, tumorigenesis process, and malignant transformation. Moreover, both mentioned genes can apply as prognostic biomarkers in OSCC patients. We suggest surgical healthy margin be considered as valuable biological area.

The occurrence of cystic echinococcosis in slaughtered livestock in Jahrom, south of Iran.

Cystic echincoccosis (CE) is a major medical and veterinary concern in the world, especially in Iran. Domestic intermediate hosts are an important reservoir for the disease spread. The purpose of this study was to determine the prevalence of CE in slaughtered livestock in Jahrom, south of Iran. In this cross-sectional study, a total of 3074 animals (2325 (75.63%) goats, 423 (13.76%) sheep, and 326 (10.60%) cattle) were inspected macroscopically for CE. In this regard, a questionnaire about the age, sex, infected organ, number of cysts, and cyst fertility was accomplished for each animal. Moreover, PCR was applied by using the cytochrome c oxidase I (COX1) and NADH dehydrogenase subunit 1 (nad1) fragments of parasite mitochondrial genomes on some positive samples. Prevalence of CE in sheep, cattle, and goats was 11.34% (48/423), 11.04% (36/326), and 2.79% (65/2325), respectively. In all livestock, CE was more common in females than males. Moreover, the highest infection rate was observed in the age group of more than 72 months. Considering the fertility of cysts, the ratio of the number of fertile cysts to total cysts in sheep and goats were 83.3% (40/48) and 80% (52/65), respectively. All hydatid cysts were infertile in cattle. With regard to the location of the cyst on internal organs, the most were observed in the lungs and liver. Regarding the intensity of infection, 1-5, 6-9 and ≥ 10 cysts were detected in 78.52% (117/149), 6.71% (10/149) and 10.73% (16/149) of infected livestock, respectively. In all livestock, hydatid cyst with a diameter of 1-5 cm was the most frequent with 71.81% (107/149). All 149 cyst samples were subjected to PCR. Among them, a total of 18 samples (six samples of each animal) were prepared for sequencing. G6 was the most dominant. According to the results of present study and the relatively high prevalence of CE in slaughtered livestock in Jahrom, health policy makers, health authorities, and experts should make effective approach in this regard, and implement careful inspections.

Are Blastocystis hominis and Cryptosporidium spp. playing a positive role in colorectal cancer risk? A systematic review and meta-analysis.

OBJECTIVE: Intestinal protozoa Blastocystis hominis and Cryptosporidium spp. are two influential factors in intestinal complications and malignancies. In present study, we estimated the pooled prevalence and odds ratio (OR) of the two parasites in colorectal cancer (CRC) patients and their possible association with the deadly disease. METHOD: Our systematic search was conducted for published researches between January 1, 2000 and April 30, 2022 by using four international databases include Scopus, PubMed, and Web of Science as well as Google scholar search engine. The random- and fixed-effects models were used to estimate the pooled prevalence, OR, and 95% confidence interval (CI) by comprehensive meta-analysis (V2.2, Bio stat) software. Inclusion and exclusion criteria were applied. RESULTS: Thirteen papers (seven case-control and six cross-sectional studies) for B. hominis/CRC and six papers (two case-control and four cross-sectional studies) for Cryptosporidium spp./CRC were eligible to include in data synthesis. Pooled prevalence of B. hominis and Cryptosporidium spp. in CRC patients was calculated to be 26.8% (95% CI 19.4-35.7%) and 12.7% (95% CI 6.8-22.5%), respectively. Based on case-control studies, significant difference was found between case and controls in both protozoa (B. hominis OR 2.10; 95% CI 1.39-3.18% vs. Cryptosporidium spp. OR 5.06; 95% CI 1.8-13.6%). Considering the Blastocystis subtypes, ST1 (5/6; 83.33% studies) and ST3 (5/6; 83.33% studies) had the highest number of reports in CRC patients. Regarding the Cryptosporidium species, only C. parvum and C. hominis were reported. CONCLUSION: Given the significant prevalence of both parasites in CRC patients and their statistically significant association, there is a need to pay more attention to these two intestinal parasites in under treatment patients.

Menstrual and Reproductive Factors and Risk of Breast Cancer in Iranian Female Population: A Systematic Review and Meta-Analysis.

Background: Breast cancer (BC) is the most frequent cancer in Iranian females. Due to the changes in lifestyle and reproductive risk factors, the BC incidence rate has been rapidly increasing. Knowing risk factors of BC could significantly contribute to improve preventive behaviors. To investigate the relationship between menstrual and reproductive factors and BC in Iranian female population. Methods: Web of Science, PubMed, Scopus, and SID as well as references of included studies were searched. Among relevant published observational studies, 27 studies met the inclusion criteria. Pooled risk estimates for the risk factors were determined using random-effects models due to the presence of substantial heterogeneity (P < 0.05). Results: All of the selected studies had case-control design. There was a positive relationship between maternal age at first pregnancy and risk of BC (OR = 1.79 95% CI: 1.36-2.35). Also, menopausal status was associated with higher risk of BC (OR = 1.60 95% CI: 1.18-2.17), whereas, there was no association between menarche age and increased risk of BC (OR = 0.55 95% CI: 0.29-1.03). History of abortion (OR = 1.21 95% CI: 0.97-1.5), nulliparity (OR = 1.43 95% CI: 0.89-2.31), and breastfeeding history (OR = 0.68 95% CI: 0.42-1.09) were not associated with BC risk. Conclusions: Our findings suggest that age at the first pregnancy and menopausal status were significantly associated with BC risk among Iranian women, whereas menarche age, nulliparity, and history of breastfeeding were not. In regard to the history of abortion, our findings revealed no association with BC, but in high-quality studies, this relationship was significant.

High occurrence of Acanthamoeba spp. in the water samples of public swimming pools from Kerman Province, Iran.

Acanthamoeba spp. is a free-living amoeba that can cause major infections in humans, including keratitis and granulomatous encephalitis. Thus, water resources play an important role in transmitting Acanthamoeba spp. infection to humans. The purpose of this study was to investigate the presence of Acanthamoeba spp. in public swimming pools from three cities of Kerman Province, southeastern Iran. Eighty water samples of 20 public indoor swimming pools were taken from Kerman, Jiroft, and Kahnauj cities. Water temperature (°C), pH, and free chlorine concentration (ppm) were measured. Filtration and cultivation were applied on non-nutrient agar medium. The polymerase chain reaction was applied by using the genus-specific primers (JDP1 and JDP2) on positive samples; these primers can amplify the 423-551 bp fragment. Eighteen of the 20 swimming pools (including 32/80; 40% samples) were contaminated with Acanthamoeba spp. All swimming pools of Jiroft and Kahnauj and 88.2% of swimming pools in Kerman were contaminated. As such, all 32 Acanthamoeba isolates were amplified using the JDP primer pairs. Two genotypes, T3 and T4, were also identified. The present research is the first to report Acanthamoeba spp. in public swimming pools from Kerman Province. Due to high occurrence of this protozoan, it is recommended to use warning signs around swimming pools to create awareness of this infection.

Silybum marianum ethanolic extract: in vitro effects on protoscolices of Echinococcus granulosus G1 strain with emphasis on other Iranian medicinal plants.

BACKGROUND: Cystic echinococcosis (CE), is a parasitic zoonosis caused by Echinococcus granulosus (E. granulosus) larvae in liver and lungs of both humans and animals. Surgical intervention is the mainstay for CE treatment, using scolicidal agents that inactivate live protoscolices. This study evaluated the scolicidal effects of Silybum marianum ethanolic extract and its combination with albendazole in vitro for the first time. Moreover, in a literature review, we investigated the effects of a wide range of Iranian medicinal plants on protoscolices of E. granulosus. METHODS: S. marianum ethanolic extract was prepared and high-performance liquid chromatography (HPLC) analysis was used to establish the proportions of its component compounds in the extract. Cytotoxicity was evaluated in mouse macrophage cells (J774A.1 cell line) using MTT method. Next, the scolicidal activity of the extract alone and combined with albendazole was tested as triplicate at various concentrations incubated for 5, 10, 20, 30, and 60 min. Finally, protoscolex viability was determined using 0.1% eosin as a vital stain. PCR-RFLP and DNA sequencing techniques were used to characterize the genotype of E. granulosus. RESULTS: HPLC analysis showed that S. marianum ethanolic extract contained mostly silydianin (14.41%), isosilybin A (10.50%), and silychristin (10.46%). The greatest scolicidal effects were obtained with the combination of S. marianum with albendazole (79%), S. marianum ethanolic extract alone (77%) and albendazole (69%), at a concentration of 500 µg/ml for 60 min, respectively (P < 0.05). Molecular analysis showed that all the cysts used were G1 genotype. CONCLUSION: The data suggest that S. marianum ethanolic extract is a potential scolicide in vitro; however, further investigations are required to determine its efficacy in vivo.

In-depth computational analysis of calcium-dependent protein kinase 3 of Toxoplasma gondii provides promising targets for vaccination.

PURPOSE: The Toxoplasma gondii calcium-dependent protein kinase-3 (CDPK3) is a key enzyme for parasite egress, control of calcium-dependent permeabilization in parasitophorous vacuole membrane and tissue cyst formation. In this study, we comprehensively explored the bioinformatics features of this protein to improve vaccine design against T. gondii. MATERIALS AND METHODS: Various web servers were employed for the analysis of physico-chemical properties, post-translational modifications, localization in the subcellular milieu, secondary and tertiary structures, as well as B-cell, major histocompatibility complex (MHC)-binding and cytotoxic T-lymphocyte (CTL) epitopes. RESULTS: This protein was a 537 amino acid antigenic and non-allergenic molecule with a molecular weight of 60.42 kDa, a grand average of hydropathicity score of -0.508, and aliphatic index of 79.50. There exists 46.74% alpha helix, 12.48% extended strand, and 40.78% random coil in the secondary structure. Ramachandran plot of the refined model demonstrated 99.3%, 0.7%, and 0.0% of residues in the favored, allowed and outlier areas, respectively. Besides, various potential B-cell (continuous and conformational), MHC-binding and CTL epitopes were predicted for Toxoplasma CDPK3 protein. CONCLUSION: This article provides a foundation for further investigations, and laid a theoretical basis for the development of an appropriate vaccine against T. gondii infection.

Evaluation of CD24 and CD44 as cancer stem cell markers in squamous cell carcinoma and epithelial dysplasia of the oral cavity by q- RT-PCR.

BACKGROUND: Squamous cell carcinoma (SCC) is the most common cancer of the oral cavity and may be preceded by dysplastic epithelial lesion. Oral SCC (OSCC) contains a rare subset of cancer cells with self-renewal ability, termed as cancer stem cells (CSCs). CD24 and CD44 as CSC markers are cell surface glycoproteins. These markers contribute to the onset, maintenance, and extension of tumor growth, as well as angiogenesis. In the present study, these two markers were simultaneously evaluated to provide a specific phenotype for carcinogenesis process in oral cavity. MATERIALS AND METHODS: In this analytical-cross-sectional study, the expression of CD24 and CD44 genes was evaluated in 45 OSCCs (20 low-grade and 25 high-grade) and 15 oral epithelial dysplasia specimens by real-time quantitative reverse transcription polymerase chain reaction. Kruskal-Wallis and Mann-Whitney U-test, Kendall, and Spearman tests were used for statistical analysis. The significance level was considered <0.05. RESULTS: High expression of both markers genes was reported in two-thirds of samples. There was no significant difference between studied groups in gene expression of CD24 and CD44 whereas statistically significant association between CD24 and CD44 was observed in all three groups. This correlation was more significant in OSCC groups (P < 0.001). CONCLUSION: High expression of CSC markers in OSCC and oral epithelial dysplasia revealed the importance of accurate examination of dysplastic lesions with high expression of these markers and the possibility of malignant transformation. Regarding a significant association of two markers, further studies are necessary to provide a specific phenotype (CD44 high CD24 high) for these lesions.

Qualitative Study to Determine Stressors Influencing Dietary and Physical Activity Behaviors of Overweight and Obese Adolescents in Iran.

INTRODUCTION: Childhood obesity has become a global endemic public health problem. Emotional distress has been proposed to be a strong mediator of unhealthy lifestyle behaviors among youth. The aim of this study was to explore the sources and role of stress on developing unhealthy lifestyle practices pertaining to diet and physical activity among overweight and obese adolescents. METHODS: This qualitative study was conducted in 2016-2017 in two large cities of Iran, Mashhad and Isfahan. Fifty-two overweight and obese adolescents were selected through purposeful sampling. In-depth semi-structured interviews and focus group discussions were conducted to obtain perceptions and experiences regarding underlying factors of obesity and the sources and role of stress in inducing unhealthy lifestyle. Ten parents were also interviewed. Data were analyzed using conventional content analysis with MAXQDA software. Study rigor was verified using criteria proposed by Lincoln and Guba. RESULTS: After analyzing the data, two main categories which triggered emotional overeating and physical inactivity among adolescents were: "school originated stress" and "family originated stress." Three subcategories of school originated stress were "Too much homework," "Frequent exams" and "Priority for studying at both school and home" and family originated stress subcategories were "Parental destructive conflicts," "Divorce" and "Socio-familial issues.". CONCLUSIONS: Our findings highlighted the sources and role of stress in emerging unhealthy lifestyle practices including emotional overeating and physical inactivity among adolescents which could lead to weight gain. Therefore, to improve lifestyle behaviors of students and prevent childhood obesity, addressing school, and family stressors is a crucial subject.

The occurrence of Cryptosporidium sp., and eggs of soil-transmitted helminths in market vegetables in the north of Iran.

AIM: This study aimed to investigate the presence of oocyst of Cryptosporidium sp., and egg of soil-transmitted helminths in market vegetables in the north of Iran. BACKGROUND: Fecal-oral transmission via consumption of contaminated food is the main route of transmission of intestinal parasites. Concerning the high risk of contamination of vegetable with intestinal parasites, raw consumption of crops can enhance the chance of transmission of intestinal parasites. METHODS: In this study, we collected 34 pre-washed vegetable samples including spinach, mint, parsley, oregano, chives, savory, radish, coriander, basil and tarragon from local markets in Tonekabon City, North of Iran. All vegetable samples were washed using sterile PBS. Parasitological examinations, including direct examination and staining with Lugol's iodine and modified Ziehl-Neelsen were performed on the pellet resulted from the washing process. RESULTS: The findings showed that 14/34 (41.17%) of collected samples were contaminated with at least one parasite. Eggs of Toxocara sp., Ascaris sp., Fasciola sp., Toxoascaris leonine, Trichuris sp. and Enterobius together with free-living larvae, amoeba cyst, cyst of Entamoeba coli and oocyst of Cryptosporidium sp., were observed among the positive samples. Furthermore, statistical analysis indicated that there was no significant correlation between parasitic contamination of vegetables and seasonal changes. CONCLUSION: This study signifies that some parasites due to their resistant cell wall usually remain in an environment with the harsh condition and thus, consumption of raw vegetables increases the risk of transmission of them.

Rhomboid antigens are promising targets in the vaccine development against Toxoplasma gondii.

Toxoplasma gondii (T. gondii) is an obligate intracellular parasite with worldwide distribution. It is estimated that near one-third of the people around the globe are latently seropositive for the parasite. Since the current common drugs are incapable in the elimination of parasites within tissue cysts, the development of an effective vaccine has high priority for researchers to limit the infection. During recent years, non-stop efforts of scientists have made great progress in the identification and development of T. gondii candidate vaccines. However, there is a lack of a commercially licensed vaccine for human application yet. Rhomboid proteases (ROMs) are a class of serine proteases that have an important role in the invasion of the parasites that can be considered as a new target for vaccine strategy. They also play critical roles in mitochondrial fusion and growth factor signaling, allowing the parasite to completely enter into the host cell. In the current review, we have summarized the recent progress regarding the development of ROM-based vaccines against acute and chronic T. gondii infection in animal models.

Relationship between serum high sensitivity C-reactive protein with angiographic severity of coronary artery disease and traditional cardiovascular risk factors.

Serum high-sensitivity C-reactive protein (hs-CRP) is predictive of coronary artery disease (CAD). The aim of this study was to examine the possible association of hs-CRP with presence and severity of CAD and traditional CAD risk factors. This case-control study was carried out on 2,346 individuals from September 2011 to May 2013. Of these 1,187 had evidence of coronary disease, and were subject to coronary angiography, and the remainder were healthy controls (n = 1,159). Characteristics were determined using standard laboratory techniques and serum Hs-CRP levels were estimated using enzyme-linked immunosorbent assay (ELISA) kits, and severity of CAD was assessed according to the score of obstruction in coronary artery. Serum hs-CRP levels were higher in those with severe coronary disease, who had stenosis ≥ 50% stenosis of at least one coronary artery (all p < 0.001 vs. individuals in healthy control), and correlated significantly with the score for coronary artery disease (all p < 0.01). After adjustment for conventional risk factors, regression analysis revealed that smoking habits, fasting blood glucose, total cholesterol, high-density lipoprotein, hs-CRP, blood pressure, anxiety, dietary intake of vitamin E, and cholesterol remained as independent determinants for angiographic severity of CAD. The area under the receiving operating characteristic (ROC) curve for serum hs-CRP was 0.869 (CI 95% 0.721-0.872, p < 0.001). The optimal values for the cut-off point was a serum hs-CRP of 2.78 mg/l (sensitivity 80.20%, specificity 85%) to predict severity of CAD. Increased serum hs-CRP levels are significantly associated with angiographic severity of CAD, suggesting its value as a biomarkers for predicting CAD.

Obesity intervention programs among adolescents using social cognitive theory: a systematic literature review.

Social cognitive theory (SCT) is a well-known theory for designing nutrition education and physical activity programs for adolescents. This systematic review aimed to evaluate the efficacy of intervention studies based on SCT in reducing or preventing overweight and obesity in adolescents. An electronic literature search in PubMed-Medline, Web of Science and Scopus was performed to identify intervention studies based on SCT aiming at preventing or reducing obesity in adolescents. All the articles published up to July 2016 were included. Only studies reporting body mass index (BMI) or its variant as one of the outcome measures were included. From 240 initially identified studies, 12 met the eligibility criteria. Seven had moderate or strong study quality. Two of the eight randomized controlled trials (RCT) and two of the four quasi-experimental studies showed significant reduction in BMI among intervened participants compared to control. Impacts on diet and physical activity were mixed, but were mostly not significant. The current systematic review found only weak evidence for the efficacy of SCT-based interventions in treating and preventing obesity in adolescents. Further studies systematically using effective behavior change strategies or techniques, larger population sizes, better measurement tools and more robust designs are warranted for a conclusive judgment.

Efficacy of Violet oil, a traditional Iranian formula, in patients with chronic insomnia: A randomized, double-blind, placebo-controlled study.

ETHNOPHARMACOLOGICAL RELEVANCE: Violet oil is an ancient herbal drug which has been extensively used to treat insomnia in traditional Iranian Medicine clinics. Violet oil is an almond or sesame oil-based extract of Viola odorata, which is administered as nasal drops. This study aimed to evaluate the efficacy of Violet oil in the treatment of insomnia. METHODS AND MATERIALS: This study was conducted as a 3-arm double-blind randomized trial. A total of 75 patients with chronic insomnia were enrolled and randomly assigned to three groups in Traditional Iranian Medicine Clinic of Mashhad University of Medical Sciences, Mashhad, Iran. The treatment consisted of intranasal dropping of Violet oil, Almond oil or placebo (1% solution of Carboxymethyl cellulose) in each nostril every night before sleep for 30 days, i.e. three drops of the drug (including either Violet oil or Almond oil) or the placebo was used every night before the sleep. All the patients were asked to complete Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires before and after the intervention. RESULTS: There were no significant differences between patients in the three groups before the intervention (P > 0.05). However, there were significant differences between the three groups after the intervention in ISI scores (P<0.002) and PSQI scores (p<0.001). When comparing the pre- and post-treatment data, the ISI and PSQI scores improved significantly in all the three groups as follows: Violet oil (P<0.001), Almond oil (P<0.001) and placebo (P<0.001). The results also showed that the Violet oil had the most effect among the three groups. In addition, it was more effective on sleep quality than sleep quantity. CONCLUSION: Considering the effects of natural nasal drug on the improvement of sleep quality in insomniac patients, this study has proposed the use of Violet oil as a natural and herbal drug in a non-oral method without serious side effects for treatment of insomnia.

Immunocompromised patients with pulmonary tuberculosis; a susceptible group to intestinal parasites.

AIM: To investigate the presence of intestinal parasites in tuberculosis patients who suffered from immunodeficiency disorders. BACKGROUND: Tuberculosis is an important infectious disease that is endemic in some regions of Iran. However, there is a coverage in the endemicity areas of this infection with intestinal parasites. METHODS: Stool samples were collected from 50 immunocompromised tuberculosis patients. Direct smear using the normal saline (0.85% NaCl solution) and Lugol's iodine staining were performed to detect trophozoite of parasites. Moreover, stool samples were concentrated using routine formalin-ether to detect protozoan cysts and helminth's ova/larvae. Specific staining techniques including Trichrome, Modified Ziehl-Neelsen and chromotrope 2R were employed to detect amoeba, Giardia spp., coccidian parasites and microsporidia. RESULTS: From 50 participants, 42 (84%) and 8 (16%) were male and female, respectively. The mean age + SD of patients was 47.88 + 10.88 years. Among the participated patients, HIV positive, cancer, organ transplant and receiving corticosteroids were seen in 13, 10, 15 and 12 subjects, respectively. The prevalence of Intestinal parasites was 34 %( 17/50). Blastocystis (18%; 9/50), and intestinal helminth (Enterobius vermicularis) (2%; 1/50) were the most prevalent and less prevalent parasites, respectively. Statistical significance difference was not seen between presence of intestinal parasites and type of immunodeficiency. CONCLUSION: Our findings showed the high prevalence of intestinal parasites with majority of Blastocystis. Indeed, this study suggested that due to complicated immune conditions of TB patients with immunodeficiency disorders, this group of patients are at higher risk of infection by intestinal parasites.

Serum concentrations of MCP-1 and IL-6 in combination predict the presence of coronary artery disease and mortality in subjects undergoing coronary angiography.

Cytokines play a key role in the pathogenesis of coronary artery disease (CAD). The aim of current study was to investigate the relationship between the serum concentrations of 12 cytokines with mortality and extent of CAD in individuals undergoing angiography and healthy controls. 342 CAD patients were recruited and divided into 2 groups: those with ≥50% occlusion in at least one coronary artery [Angiography (+)] or <50% obstruction in coronary arteries [Angiography (-)]. Also 120 healthy subjects were enrolled as control group. Lipid profile, fasting blood glucose, body mass index, and blood pressure were evaluated in all the subjects. An Evidence Investigator® was used for measuring 12 cytokines (IL-1α, IL-1ß, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, MCP-1, IFN-γ, EGF, VEGF) using sandwich chemiluminescent assays. Univariate analysis, multivariate regression models, ROC, and Kaplan-Meier survival curves were used for exploring the candidate markers in CAD patients. Serum level of IFN-γ, IL-4, MCP-1, EGF, IL-6, and IL-8 were markedly higher in angiogram-positive patients, while VEGF concentrations were significantly (P < 0.05) lower, compared to control group. ROC analysis for MCP-1 showed that a cut-off of 61.95 pg/mL had 91% sensitivity and 91% specificity for predicting CAD patients. Moreover, >2.16 pg/mL IL-6 had a > 94% sensitivity and 70% specificity in predicting 2 years mortality in the subjects with a serum MCP-1 > 61.95 pg/ mL, and patients having IL-6/MCP-1 combination had a shorter survival.Our findings demonstrate that CAD patients with serum MCP-1 and IL-6 levels of >61.95 and >2.16 pg/mL had a higher mortality with 94.1% sensitivity and 70.5% specificity for predicting mortality in CAD patients.

Personal and socio-cultural barriers to cervical cancer screening in Iran, patient and provider perceptions: a qualitative study.

BACKGROUND: Although cervical cancer is preventable and early screening might decrease the associated mortality, challenges faced by the women and health care providers can postpone early detection. This qualitative study aimed to establish patient and provider perceptions about personal and socio-cultural barriers for cervical cancer screening in Mashhad, Iran. MATERIALS AND METHODS: In the present study, which was conducted in 2012, eighteen participants, who were selected purposefully, participated in individual in-depth, semi-structured interviews, which were recorded, transcribed verbatim, and analyzed using conventional content analysis and Atlas-Ti software. RESULTS: One theme and two categories were derived from data including: cognitive/behavioral factors (lack of a community-based approach to cervical cancer, lack of awareness, wrong attitude and lack of health seeking behaviors) and socio/cultural issues (socio-cultural invasion, mismatch between tradition, modernity and religious, extra marital relationships and cultural taboos). CONCLUSIONS: Providing community based approach education programs and employing social policy are needed for preventing of cervical cancer in Iran.