Plant-based diets and risk of disease mortality: a systematic review and meta-analysis of cohort studies.

We aimed to examine the association between adherence to plant-based diets (PBDs) and the risk of mortality among the general population. Relevant investigations were identified through PubMed, Scopus, Embase, and ISI Web of Knowledge. Data were pooled using a random-effects or a fixed-effects model. Twelve prospective cohort studies with 42,697 deaths among 508,861 participants were included. The hazard ratios (HRs) for the highest compared to the lowest category of adherence to the PBDs were 0.90 (95% confidence interval [CI]: 0.82, 0.99; I2 = 91%, n = 12) for all-cause and 0.77 (95% CI: 0.70, 0.86; I2 = 36%, n = 8) for coronary heart disease (CHD) mortality. Among PBDs subtypes, there was an inverse association between healthy plant-based 0.92 (95% CI: 0.88, 0.96; I2 = 0%, n = 2), Pesco-vegetarian 0.81 (95% CI: 0.70, 0.92; I2 = 0%, n = 2), and Pro-vegetarian 0.74 (95% CI: 0.55, 0.88; I2 = 61.2%, n = 2) diets and the risk of all-cause mortality. A vegetarian diet was also associated with lower risk of mortality due to cardiovascular 0.92 (95% CI: 0.85, 0.99; I2 = 0%, n = 5) and CHD 0.76 (95% CI: 0.68, 0.85; I2 = 35%, n = 7). Our findings show the potential protective role of PBDs against chronic disease mortality. As there were certain limitations in some of the studies included in this systematic review and meta-analysis, further research is necessary to confirm our findings.

Saffron (Crocus sativus L.) supplements improve quality of life and appetite in atherosclerosis patients: A randomized clinical trial.

Background: Atherosclerosis is the most common cause of the cardiovascular disease. Saffron is a traditional food that affects many diseases and disorders. Therefore, the aim of this study was to identify the effects of Saffron (Crocus sativus L.) on quality of life (QOL) and appetite in patients with atherosclerosis. Materials and Methods: This was a randomized, double-blind, placebo-controlled clinical trial. A total of 63 participants with atherosclerosis were recruited from Emam Sajjad Hospital, Valiasr Hospital, and Zafaranieyh Clinic in Tehran, Iran. The participants were divided randomly into two groups. Participants received 100 mg/d saffron or placebo capsule for 6 weeks. QOL and appetite levels were measured by the McNew QOL questionnaire, and visual analog scale questionnaire, respectively. Furthermore, anthropometric indices of participants were measured before and after the intervention. Results: Statistical analysis showed that there was a statistically significant difference between atherosclerosis patients who received placebo and those who consumed saffron in terms of the physical domain (P = 0.008) and social domain (P = 0.012) of QOL. In the saffron group increased score in Total score Macnew (P < 0.001), physical domain (P = 0.025), and social domain (P < 0.001) was significant after the intervention. Moreover, the consumption of saffron did not significantly affect emotional domains of QOL, and appetite levels. Conclusion: Saffron may be considered as a novel agent in patients with atherosclerosis to improve the QOL. A great deal of further research will be needed to critically validate the efficacy of saffron and its mechanisms in atherosclerosis.

The interplay between fasting, gut microbiota, and lipid profile.

BACKGROUND: This study aimed to investigate the consequence of Ramadan fasting on gut bacterium (Bacteroides and Firmicutes), serum concentration for butyrate, and lipid profile. METHODS: Thirty healthy subjects were enlisted and investigated two times (before and at the end of Ramadan). Fasting blood samples were obtained for measuring fasting blood sugar (FBS) and lipid profile and serum butyrate concentration. Anthropometrics variables were measured before and after Ramadan for all 30 subjects. Quantitative reverse transcription polymerase chain reaction (RT-PCR) analysis, targeting the genome of Bacteroides and Firmicutes was performed to determine its presence in the stool samples. Food intake was assessed by a 3-day food record before and after Ramadan. Statistical analysis was performed by SPSS ver.13 and Minitab ver.17. P < 0.05 considered the level of significance. RESULTS: The study results showed that serum levels of butyrate significantly increase during the month from 0.23 ± 0.02 mM to 0.46 ± 0.03 mM (P < 0.05). The gut Bacteroides and Firmicutes increased by 21 and 13 percent after Ramadan compared to before (P < 0.05). The increment in Bacteroides occurred in both sexes, but Firmicutes significantly increased only in women. Food intake was decreased during Ramadan. Ramadan fasting caused significant reduction in BMI from 25.72 ± 0.58 kg/m2to 25.25 ± 0.55 kg/m2 (P < 0.05). Serum levels of LDL, HDL, LDL/HDL ratio, and total cholesterol significantly decreased during Ramadan (P < 0.05). However, the decrease in FBS and TG level were not statistically significant (P > 0.05). CONCLUSION: It can be stated that the promotion of Bacteroides and Firmicutes in the gut might play a crucial role in health promotion. However, more research is needed to achieve a definite conclusion.

Effectiveness of self-management program on arthritis symptoms among older women: A randomized controlled trial study.

We aimed to determine the effectiveness of a self-management program amongst older women with rheumatoid arthritis. The intervention group (n = 40) received a six-week arthritis self-management program. Assessments were recorded prior to and after the program using a demographic questionnaire, Visual Analogue Scale, Arthritis Self-Efficacy Scale, and self- reported questions regarding mobility. Significant improvements in self-efficacy for functional ability and pain management were found in the intervention group compared to those before the intervention and the control group. Our trial indicates that the program used in conjunction with exercise interventions for aged patients may lead to benefits perceived self-efficacy.

Comparison of the Efficacy of Honey Gel and Clotrimazole Cream in the Treatment of Vaginal Candidiasis Signs: A Randomized Clinical Trial.

Introduction: Due to the increasing resistance to synthetic antifungal drugs, the use of drugs with a natural origin, with low side effects and low prices is a priority. This study was performed to evaluate the effect of topical honey gel and clotrimazole cream in treatment of signs of vaginal candidiasis. Methods: This randomized clinical trial was conducted to evaluate the topical use of honey and clotrimazole in the signs of vulvovaginal candidiasis in clinics and medical centers in Tabriz. The study was performed on 106 non-pregnant women (18 to 45 years old) who had clinical signs of candidiasis. Patients were randomly divided into two groups receiving honey gel and clotrimazole vaginal cream (53 people per group). Each group was treated for 8 days. Before, 4, and 8 days after the intervention, patients recorded the sings of disease and possible side effects of drugs using a researcher-made questionnaire. The results were analyzed using SPSS software ver. 22. Inter-group comparison was carried out using McNemar, Cochran Q and independent t tests. P value < 0.05 was considered statistically significant. Results: sults: In the three evaluation periods, a significant reduction in the sings was observed compared to the before starting of treatment regimes. The results of the cultures were similar and there was no significant difference between the two honey gel and clotrimazole cream groups. Conclusion: Our results may suggest that honey gel could have promising benefits in the treatment of vulvovaginal candidiasis as the main drug or as an adjunct to other antifungal drugs.

Occupational fatigue and mental health complaints among 8-hour shift workers of petrochemical industries in Iran.

BACKGROUND: Shift working is unavoidable in many industries with continual material processing such as petrochemical plants. So, the adverse effects of shift working on workers should be seriously considered. OBJECTIVE: This cross-sectional study evaluated occupational fatigue and mental health complaints and their relationship in rotating 8-hour shift workers. METHOD: In this study, 287 shift workers participated. The Multidimensional Fatigue Inventory (MFI-20) and General Health Questionnaire (GHQ-28) were used to evaluate the level of fatigue and mental health, respectively. RESULT: A relatively high prevalence of mental health complaints (particularly social dysfunction) and fatigue (especially general fatigue) were found among the study population. In general, 43.4% of participants reported a mental health problem. A moderate correlation was found between fatigue and mental health (r = 0.58). The stepwise regression model revealed that fatigue was significantly related only to "anxiety and insomnia" and "severe depression". CONCLUSION: This study revealed that the 8 h shift workers in studied areas are exposed to a considerable risk of mental health and fatigue. So, improving the ergonomics and health aspects of the workplace is recommended to reduce related risk factors.

Neonatal Intensive Care Unit Nurses' Perceptions and Knowledge of Newborn Individualized Developmental Care and Assessment Program: A Multicenter Study.

BACKGROUND: The newborn individualized developmental care and assessment program (NIDCAP) is a new multifaceted approach, which is developmentally and functionally supportive of health especially in premature newborns at the neonatal intensive care unit (NICU). This study is designed for assessing the knowledge and perception of nurses as the most important members of the multidisciplinary team of NIDCAP about this program. MATERIALS AND METHODS: This cross-sectional study was conducted on 120 nurses working in the NICUs of Alzahra, Taleghani, and Children hospitals affiliated to the educational and treatment centers of Tabriz University of Medical Sciences as well as 29 Bahman Hospital affiliated to Tabriz Social Security Organization in 2016 using census sampling method. Three questionnaires were employed to collect demographic data and to explore the nurses' perceptions and knowledge of the NIDCAP program. RESULTS: Findings of the study indicated that the mean (SD) nurses' knowledge and perception scores for NIDCAP were 71.83 (1.64) and 76.80 (0.79), respectively. In the terms of knowledge, significant differences were found with regard to being married (t = -2.39, p < 0.019), having an MSc degree (t = -2.14, p = 0.034), and employment experience (t = -3.38, p = 0.001). However, there was no significant relationship between perception and demographic variables (p > 0.05), nor was there any significant relationship between perception and knowledge (p = 0.275). CONCLUSIONS: The results of this study showed that the majority of nurses participating in the study had high knowledge about NIDCAP.

Comparison of the efficacy of honey gel and clotrimazole cream in the treatment of vaginal candidiasis symptoms: a randomized clinical trial.

BACKGROUND: Reproductive tract infection is a global health problem among women, particularly in East Asia. Accordingly, researchers are seeking drugs with fewer side effects, compared to chemical agents. In this regard, the antifungal properties of honey have been confirmed. OBJECTIVE: This study was conducted to examine the effects of vaginal honey gel and clotrimazole cream on symptoms of candidiasis in 2014-2015. METHODS: This single-blind clinical trial was conducted on 106 patients with clinical complaints and positive cultures. The study was conducted in Tabriz clinics and health centers during 2014-2015. The participants were randomly divided into clotrimazole cream and honey gel groups (n, 53 per group) and were assessed both pretreatment and post treatment (before, 4 and 8 days after treatment). The results were analyzed and compared in IBM-SPSS version 22, using McNemar's test, Cochran's Q test, generalized mixed model, and independent-samples t-test. The significance level was set at 0.05. RESULTS: At all 3 time intervals, significant reductions were observed in vaginal symptoms, compared to pretreatment due to the use of honey gel and clotrimazole cream (p<0.001). On the other hand, the culture results were similar, and there was no significant difference between the groups (p>0.05). CONCLUSION: Honey was effective in the treatment of candidiasis symptoms and could be used as an alternative or adjuvant for other antifungal drugs in the treatment of vaginal candidiasis symptoms. CLINICAL TRIAL REGISTRATION: This study was registered in the Iranian Registry of Clinical Trials (http://www.irct.ir) with the registration code IRCT201604144317N9. FUNDING: The authors received no financial support for the research.

Pro- and prebiotic effects on oxidative stress and inflammatory markers in non-alcoholic fatty liver disease.

BACKGROUND AND OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is related to inflammation and oxidative stress. Probiotics and prebiotics are considered anti-inflammatory and antioxidative factors. In this study, we evaluated the effects of probiotic and/or prebiotic on oxidative stress and inflammatory markers in patients with NAFLD. METHODS AND STUDY DESIGN: Seventy-five NAFLD subjects were divided into four groups. The first group received a pro-biotic capsule of Bifidobacterium longum (B.L) and Lactobacillus acidophilus (L.A) (2 × 107 CFU/day), the second group received prebiotic (10 g/day inulin), the third group received pro-biotic and prebiotic, and the fourth group received placebo, for three months. Anthropometric, inflammatory and oxidative/ anti-oxidative indices were measured in all patients before and after the intervention. RESULTS: We showed that consumption of pro- and/or prebiotic compared to placebo is able to significantly decrease body weight, body mass index, waist and hip circumferences, tumour necrosis factor-α and increase serum levels of total antioxidant capacity in patients with NAFLD (p<0.01). There were not any significant differences between probiotic, prebiotic and co-administration of them on the mentioned parameters. Co-administration of pro- and prebiotic caused significant decrease of high-sensitive C-reactive protein (hs-CRP) compared to the placebo and other groups (p<0.01). Interlekin-6 and malondialdehyde were not significantly different among groups at the end of study. CONCLUSIONS: Probiotic or/and prebiotic supplementation can be effective for improvement of some anthropometric, inflammatory and oxidative indices in patients with NAFLD. Co-administration of pro- and prebiotic is more effective than probiotic and prebiotic alone in modifying hs-CRP in patients with NAFLD.

Predictors of short-term mortality after acute stroke in East Azerbaijan province, 2014.

Introduction: Stroke is one of the important causes of death and disability in Iran. This study aimed to examine the factors influencing the short-term mortality of stroke in Northwest of Iran. Methods: Study population were all patients with confirming the diagnosis of the first-ever stroke who were hospitalized in two referral teaching hospitals from October 2013 to March 2015. They were followed up to 30 days after onset of stroke. A neurology year three resident was responsible for extracting the clinical data and assessment of stroke severity on admission using National Institute of Health Stroke Scale (NIHSS), and information about risk factors and socio-demographic factors were collected using face to face interview. Data were analysed using Cox proportional regression by STATA software version 14. Results: A total of 1036 consecutive patients with first-ever stroke were included in this study. Of them, 228 patients (22%) died within 30 days after stroke accordance. Advanced age was significantly associated with a hazard for early mortality (HR=1.05 95% CI 1.09-1.04), the inverse was true for education level; mortality decreased as the education level increased; it was 25.7 percent among illiterate and 14.3 among patients with higher education. The NIHSS score on admission for 30-days mortality and hemorrhagic stroke were associated with HR=1.11 (95% CI 1.09-1.13) and HR= 1.65 (95% CI 1.15-2.36) respectively. Conclusion: Advanced age, stroke subtype and high NIHSS score are the independent predictors of early mortality in this study. This provides important implications for the clinicians to target the high-risk patients for the specific therapies and management strategies.

The Correlation between Serum Levels of Anti-Toxoplasma gondii Antibodies and the Risk of Diabetes.

BACKGROUND: This study investigated the presence of specific antibodies against Toxoplasma gondii infection among people with diabetes (type I and II) in comparison with control group. METHODS: Overall 300 serum samples were collected equally from three groups including patients with type I and type II diabetes and non-diabetic healthy control that referred to Tabriz Central Laboratory in northwest Iran during July to Sep 2015. The level of specific IgG and IgM antibodies against T. gondii were measured using the chemiluminescence immunoassay (CLIA) method. Chi-square and One-Way ANCOVA were used for data analysis. RESULTS: Overall, 300 samples from diabetic patients (type I and type II) and control group were examined and results showed 3, 8 and 2 cases were seropositive for anti-T. gondii IgM respectively. Anti-T. gondii IgG seropositivity in type I and type II diabetes and control groups were 69%, 63% and 59% respectively. We did not observe any statistical differences among all studied groups in terms of toxoplasmosis. There was no statistically significant relationship between all variables and seropositivity for anti-T. gondii antibodies in type I and II diabetes and non-diabetic groups. CONCLUSION: Although there was no statistically significant relationship between diabetes and toxoplasmosis further investigations especially experimental studies using animal models are needed. Furthermore, these findings would not be contrary to the need for healthcare in order to the prevention of infectious disease in diabetic patients.

Comparison of the Effect of Plastic Cover and Blanket on Body Temperature of Preterm Infants Hospitalized in NICU: Randomized Clinical Trial.

Introduction: Preterm infants are unable to regulate their body temperature and there are insufficient research evidences on different kinds of covers for hospitalized preterm infants; therefore, the present study was conducted with the aim of comparing the effects of plastic and blanket covers on the body temperature of preterm infants under radiant warmer. Methods: This randomized cross-over clinical trial was carried out upon 80 infants with the gestational age of 28-30 weeks and birth weight of 800- 1250 gr who were in Neonatal Intensive Care Unit on the second day of their hospitalization. The study lasted for two days. In group 1, the plastic cover was used during the first day of the study while the blankets were used during the second day. Infants' heads were kept out of the cover and coated with a hat. In group 2, the plastic cover was used during the first day of the study while the blanket was used during second day. Digital thermometer was used to measure infants' axillary temperature. The data was analyzed using SPSS ver 13 and MiniTab software. Descriptive statistics, (Mean (SE), 95%CI) and inferential statistics (Repeated measurement and ANCOVA tests) were used. Results: The mean body temperature of the infants in the group covered with the plastic was calculated to be higher and the warmer was set on low temperature. Conclusion: Using plastic cover during the first few days of hospitalization in NICU resulted in regulation of preterm infants' body temperature.

Latent and Asymptomatic Toxocara Infection among Young Population in Northwest Iran: The Necessity of Informing People as a Potential Health Risk.

Objectives. This study was designed to determine the frequency of anti-Toxocara antibodies in youngsters aging from 2 to 20 years in northwest Iran. Materials and Methods. 397 samples were taken randomly almost equally from four locations in Urmia, west Azerbaijan, during August 2014 to September 2015. Anti-Toxocara IgG antibody assays were done on sera by using ELISA kit (IBL, Germany). In order to prevent cross-reaction, the samples of the patients who are infected with other parasites in stool exam, especially Ascarididae family, were also excluded. SPSS 16.0 software was used for statistical analysis. Results. 12 (3%) of the serum samples were positive for anti-Toxocara IgG. According to the Chi-square analysis, risk factors such as mother's educational level, keeping dogs or cats as pets, and history of coughing were related to Toxocara infection (P < 0.05). There was no relationship between toxocariasis and gender, history of onychophagy, pica, fever, abdominal pain, and anorexia; however, we found a significant relationship between Toxocara infection and chronic coughing (P = 0.045). Conclusion. Toxocariasis in northwest Iran can be considered as a public health problem. This study may also help to increase the awareness about this infection.

Fatigue and Psychological Distress: A Case Study Among Shift Workers of an Iranian Petrochemical Plant, During 2013, in Bushehr.

BACKGROUND: Shift work is a well-recognized occupational health hazard in both industrialized and industrially developing countries. Prolonged working time, day/night shift rotation, circadian rhythm and sleep disorders, family and social problems are the most important features of shift working, which have serious complications. OBJECTIVES: The present study evaluated the fatigue and psychological distress and their relationship among shift workers, in a petrochemical plant (Southern Pars gas field) in Southwest Iran. MATERIALS AND METHODS: In this cross-sectional field study, 400 shift workers from a plant were involved, with participation rate of 72.5% (290 persons). The multidimensional fatigue inventory (MFI-20) and general health questionnaire (GHQ-28) were used to evaluate the level of fatigue and psychological distress, respectively. RESULTS: The results showed that the fatigue and psychological distress (particularly social dysfunction, anxiety and insomnia) are frequent among 12-hour shift workers (the total MFI and total GHQ scores were 42.68 ± 17.88 and 34.66 ± 18.56). A relatively strong positive correlation was found between fatigue and psychological distress (r = 0.62). The results of the stepwise regression model indicated that the psychological distress was significantly related only to general fatigue, mental fatigue and reduced motivation, whereas it was not to the physical fatigue and reduced activity. CONCLUSIONS: The study findings highlight the importance of the mental aspect of fatigue in this working group. These results have possible implications for workers' health and well-being and for the design of shift work systems, for industrial workers.

Demographic Factors and their Relation to Fatigue and Mental Disorders in 12-Hour Petrochemical Shift Workers.

BACKGROUND: Shift workers may be exposed to fatigue and mental disorders due to various work-related risk factors. This study evaluated the impact of demographic characteristics on fatigue and mental disorders among 12-hour shift workers in petrochemical industries. METHODS: This study was conducted among 290 shift workers of Pardis Petrochemical Company in Iran. Data were collected using a general questionnaire for the demographic characteristic as well as multidimensional fatigue inventory (MFI-20) and general health questionnaire (GHQ-28). RESULTS: Married workers were less likely to suffer from reduced activity levels (P< 0.027), depression (P< 0.032) and mental disorders (P< 0.040). Social dysfunction score (P< 0.029) and mental disorders (P< 0.048) decreased with shift work experience. Shift workers with non-academic education less likely to suffer from reduced activity levels (P< 0.000) and mental fatigue (P< 0.028). CONCLUSION: Despite the significant difference between the variables, this study showed a weak effect of individual and occupational demographic characteristics on fatigue and mental disorders.

Molecular and parasitological study of cryptosporidium isolates from cattle in ilam, west of iran.

BACKGROUND: Cryptosporidiosis is one of the most important parasitic infections in human and animals. This study was designed for survey on the prevalence of Cryptosporidium infection in farms of Ilam, west of Iran, using parasitology method and genotyping by Nested PCR-RFLP. METHODS: Fecal samples of 217 cattle were collected fresh and directly from the rectum of cattle. All of the samples were examined by microscopic observation after staining with modified Ziehl-Neelsen (MZN). Genomic DNA extracted by using EURx DNA kit. A Nested PCR-RFLP protocol amplifying 825 bp fragment of 18s rRNA gene conducted to differentiate species and genotyping of the isolates using SspI and VspI as restriction enzymes. RESULTS: The prevalence of Cryptosporidium infection in cattle using both methods is 3.68%. Most of the positive cattle were calves under six months. Species diagnosis carried out by digesting the secondary PCR product with SspI that C. parvum generated 3 visible bands of 448, 247 and 106 bp and digested by VspI restriction enzyme generated 2 visible bands of 628 and 104bp. In this investigation all of the positive samples were Cryptosporidium parvum. CONCLUSION: C. parvum (bovine genotype) detected in all positive cattle samples in Ilam, west of Iran. The results of the present study can help for public health care systems to prevention and management of cryptosporidiosis in cattle and the assessment of cattle cryptosporidiosis as a reservoir for the human infection.

Honey and apoptosis in human gastric mucosa.

BACKGROUND: Gastric cancer is the fourth most common malignancy in the world. Honey is a complex mixture of special biological active constituents. Honey possesses antioxidant and antitumor properties. Nutritional studies have indicated that consumption of honey modulates the risk of developing gastric cancer. On the other hand, apoptosis has been reported to play a decisive role in precancerous changes. Our chief study was conducted to assess the relationship between consumption of honey and apoptosis in human gastric mucosa. METHOD: This cross-sectional study was conducted on 98 subjects over 18 years old, referred to two hospitals in Tabriz, Iran. Subjects were undergone an upper gastrointestinal endoscopy, 62 subjects were finally enrolled. Honey consumption was assessed by a Food Frequency Questionnaire (FFQ) and apoptosis was detected by TUNEL technique. We tested polynomial curve to find the best fit between honey consumption and apoptosis. RESULTS: A positive relation between honey consumption and apoptosis was found (P=0.024). Our results indicated that the final and the best fit curve was: apoptosis = 1.714+1.648(honey amount) - 0.533(honey amount)2 +1.833×10-5(honey amount)7. CONCLUSION: Honey consumption had positive effects on gastric cancer by inducing apoptosis in gastric mucosa.