Effect of and the association between vitamin D and outcomes of assisted reproductive techniques among infertile men and women: protocol for an overview of systematic reviews and meta-analysis.

INTRODUCTION: Vitamin D is associated with many functions of the human reproductive system. Accordingly, it seems that on infertile couples undergoing assisted reproduction technology (ART), treatment outcomes may be affected by the vitamin D. This overview aims to show the effect of vitamin D on infertility treatments outcomes in recent studies by concluding systematic reviews and meta-analyses to achieve a comprehensive result. METHODS AND ANALYSIS: This overview protocol is being reported according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement and was registered in the International Prospective Register of Systematic Reviews. We will include all peer-reviewed systematic reviews and meta-analyses of randomised controlled trials published from inception until December 2022. PubMed, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effects, Scopus, Cochrane Central Register of Controlled Trials and Embase will be searched from the time of publication of the first articles onwards with a comprehensive search strategy. Endnote V.X7 software (Thomson Reuters, New York, New York, USA) will be used to store and manage records. The results will align with guidelines in the Cochrane Handbook of Systematic Reviews of Interventions and the PRISMA statement. ETHICS AND DISSEMINATION: This overview will be evaluating the effect of vitamin D status and vitamin D supplementing on results of ART in women and men who are undergoing treatment for infertility. The high prevalence of vitamin D deficiency worldwide and its effects on an important issue such as human fertility might be a very influential factor that leads scientists to strongly recommend its use. However, the more critical concern is that there is no definitive agreement in studies on the relationship between vitamin D and an increased chance of better fertility in men and women undergoing infertility treatment. PROSPERO REGISTRATION NUMBER: CRD42021252752.

Major and minor criteria for gastric dystemperaments in Persian Medicine: Sari gastric dystemperament criteria-I (SGDC-I).

Background: Gastric disorders are one of the most common human ailments, which impose a huge economic burden on countries. In Persian Medicine (PM), it is possible to predict the susceptibility to gastric diseases with diagnosis of gastric Mizajes (temperaments) and dystemperaments. The semiology of gastric dystemperaments has been investigated in PM textbooks, although the value of each sign and symptom is not mentioned. Consequently, this research is designed to determine the major and minor criteria for classifying gastric dystemperaments on the basis of valid manuscripts and with the help of PM specialists in the present era. Methods: This was a consensus-based study consisting of four phases. In the first phase, reference PM textbooks were studied. Symptoms and signs of gastric dystemperaments were collected and listed in four groups. In the second phase, semi-structured interviews with a sample of PM experts were carried out. Phase three included a focused group discussion with experts. Eventually, findings were integrated from the three study phases in a two-day meeting in Sari City. Results: Selected criteria included eight major and eight minor criteria for hot-cold dystemperament, as well as six major and eight minor criteria for wet-dry gastric dystemperament. Conclusion: Modern lifestyles and the interfering factors are responsible for some changes in diagnostic signs and symptoms according to PM. This was the first step to coordinate PM diagnostic criteria for gastric dystemperaments. Further studies are recommended to reach a unique protocol in the field of PM diagnostics. The next step includes design and validation of national diagnostic tools.

Effect of vitamin B6 on pain, disease severity, and psychological profile of fibromyalgia patients; a randomized, double-blinded clinical trial.

BACKGROUND: Given the role of vitamin B6 on pronociceptive/antinociceptive neurotransmitters balance, metabolic reactions, and inflammation, it is important to clarify the effect of vitamin B6 on pain and psychological disturbance in fibromyalgia (FM). This study aimed to evaluate whether an 80-mg daily dose of vitamin B6 improves pain, disease severity and psychological symptoms of FM compared to a placebo. METHODS: This randomized, double-blinded, placebo-controlled trial was performed on the FM patients whose diagnosis was confirmed by a rheumatologist based on the 2016 American College of Rheumatology (ACR). 90 Patients were randomized to receive either vitamin B6 (80 mg daily) or placebo in a 1:1 ratio, with a permuted block size of 30 stratified by disease severity. Primary outcomes included the Revised Fibromyalgia Impact Questionnaire (FIQR), Hospital Anxiety and Depression Scale (HADS), 12-item short-form health survey (SF-12), and pain visual analog scale (pain-VAS)). The mean differences in outcomes (before and after treatment) were compared between the vitamin B6 and placebo groups using an independent T-test. An ANCOVA model adjusted for baseline outcome value was also provided to compare the outcomes between the two groups. RESULTS: Of 90 eligible patients, 60 patients (31 patients in vitamin B6 and 29 in the placebo group) completed the trial. Overall, the FIQR, pain-VAS, and HADS-anxiety scores improved after treatment in both vitamin B6 and placebo groups; However, there was no statistically significant intergroup difference regarding primary outcomes. ANCOVA model also showed no difference in the treatment effects. CONCLUSIONS: Our results showed no priority for vitamin B6 over placebo in FM patients. Considering the potential ameliorating role of vitamin B6 on pain and psychological symptoms, acknowledgment of vitamin B6 as a relatively safe adjuvant treatment needs larger future studies. TRIAL REGISTRATION: Iranian Registry of Clinical Trials: IRCT20200920048782N2 on 2021/10/04.

Association of health literacy and nutritional literacy with sun exposure in adults using structural equation modelling.

BACKGROUND: Inadequate health and nutritional literacy is a common problem among adults, associated with poor health outcomes. Therefore, this study aimed to investigate the relationship between health literacy and nutritional literacy to sun exposure behaviour. METHODS: We conducted a cross-sectional study on 261 adults (18-65 years) in Iran. Data was collected on knowledge, motivation, health literacy, nutritional literacy, and sun exposure behaviour using an interview-assisted questionnaire. Using the information-motivation-behavioural skills model and structural equation modeling, we tested whether health and nutritional literacy were associated with the relationships between knowledge of vitamin D, attitudes toward sun exposure, and sun exposure behaviour. Different models using structural equation modeling were performed to analyze the data. RESULTS: The finding showed that health literacy (ß = 0.29, p < 0.001) and nutritional literacy (ß = 0.14, p = 0.02) was directly associated with sunlight exposure. Indirect relationships also existed between knowledge and sunlight exposure through health literacy (ß = 0.33, p < 0.001) and nutritional literacy (ß = 0.22, p = 0.01). The model had good fit (x2/df = 1.422; RMSEA = 0.040; CFI = 0.851; NFI = 0.657). There was no significant relationship between health literacy and motivation (ß = 0.11, p = 0.16), nutritional literacy and motivation (ß = 0.06, p = 0.42) and motivation and sun exposure (ß = 0.01, p = 0.91). CONCLUSIONS: The findings showed that individuals with sufficient health literacy and nutritional literacy were more likely to have exposure to sunlight. Health and nutritional literacy should be considered when educating adults about vitamin D supplements and sunlight exposure.

Herbs as old potential treatments for lymphedema management: A systematic review.

INTRODUCTION: Herbs have been reported to be effective in reducing lymphedema burden. This paper aimed to review literature reporting on herbs for lymphedema treatment. METHODS: A systematic review was performed using the PRISMA guideline. Clinical studies on herbal intervention and lymphedema were included. Evidence on the effectiveness of herbal interventions for desired outcomes including reduction of edema volume, other symptoms, quality of life and inflammation were collected and assessed in detail. RESULTS: In all twenty studies were included in this review. Of these 14 studies were randomized clinical trials and the rest were prospective pilot studies. Herbal treatment was reported for breast cancer-related lymphedema in most studies and coumarin was the most reported herb that used for lymphedema management. Edema volume reduction (17 out of 20) and symptoms improvement (15 out of 20) were the outcomes reported in most studies. CONCLUSION: Phytochemicals can be a promising pharmacotherapy for lymphedema management. However, further evidence is needed to establish definite effectiveness for the use of herbal remedies for lymphedema management.

Health-related quality of life in breast cancer patients: review of reviews from 2008 to 2018.

BACKGROUND: Breast cancer still is a topic. This overview of the literature aimed to update the current knowledge on quality of life in breast cancer patients. METHODS: A review of literature in MEDLINE, Cochrane Database of Systematic Reviews and Google Scholar were carried out to identify review papers on health-related quality of life in breast cancer during the 2008 to 2018. All publications were screened using the PRISMA guideline. The methodological quality of reviews was assessed using the AMSTAR. The findings were summarized and tabulated accordingly. RESULTS: Within over a decade, a total of 974 review papers were identified which according to the study selection criteria finally we have evaluated 82 reviews. Of these about 85% had a reasonable methodological quality. The findings were mainly summarized on several headings including instruments used to measure quality of life, treatment, supportive care, psychological distress, and symptoms. Questionnaires had a good performance to quantify quality of life in breast cancer patients. Most reviews were focused on the impact of treatment including endocrine therapy as well as integrating complementary and alternative medicine into the current practice. According to the reviews, yoga was the most recommended exercise to improve quality of life in breast cancer patients. CONCLUSION: Overall, the findings from this overview indicated that quality of life in breast cancer patients enhanced during the last decade. Several simple but effective interventions such as physical activity and psychosocial interventions proved to be effective in improving quality of life in this population. However, management of symptoms such as pain, and lymphedema, issues related to worry, sexual function especially for young patients, and the future outlooks all are among topics that deserve further consideration. Also, this overview indicated that methodological issues in measuring quality of life in breast cancer patients improved greatly, but still there is a long way to go to understand what really matter to patients.

The urgent need for integrated science to fight COVID-19 pandemic and beyond.

The COVID-19 pandemic has become the leading societal concern. The pandemic has shown that the public health concern is not only a medical problem, but also affects society as a whole; so, it has also become the leading scientific concern. We discuss in this treatise the importance of bringing the world's scientists together to find effective solutions for controlling the pandemic. By applying novel research frameworks, interdisciplinary collaboration promises to manage the pandemic's consequences and prevent recurrences of similar pandemics.

Comparison of the analgesic effect of oral sucrose and/or music in preterm neonates: A double-blind randomized clinical trial.

OBJECTIVE: To compare the analgesic effects of sucrose, music, and their combination on venipuncture's pain in preterm neonates. METHODOLOGY: A double-blinded randomized control trial conducted at a Neonatal Intensive Care Unit (NICU) affiliated to Tehran University of Medical Sciences (TUMS) in Tehran, Iran. One hundred and twenty preterm neonates were randomly allocated into three experimental (sucrose, music and combination of sucrose and music) and one control groups (n = 30 for each group). Two minutes before the venipuncture, 0.5 ml of oral 24% sucrose was provided for the sucrose and combination groups. The combination group additionally received lullaby music as same as the music group. The control group had headphones without playing music and received sterile water. Blinded assessment of the Premature Infant Pain Profile (PIPP) was performed before and during venipuncture, as well as 30 s and 10 min and 10 min after its completion. RESULTS: The pain scores during venipuncture in the sucrose and combination groups were significantly lower than the control group (p = .003, p < .001, respectively) but not in the music group. Thirty seconds after the end of the venipuncture, the pain score in the three intervention groups was significantly lower than the control group (sucrose, music and, combination group, p < .001, p = .009, p < .001, respectively). Ten min after the venipuncture, there was no significant difference in pain scores among the four groups. CONCLUSION: Music could relief pain 30 s after the venipuncture completion but not during the venipuncture. A more prolonged period of playing music is recommended to evaluate the analgesic effects of music in preterm neonates in future studies.

A Comparative Study between Transcutaneous Electrical Nerve Stimulation and Fentanyl to Relieve Shoulder Pain during Laparoscopic Gynecologic Surgery under Spinal Anesthesia: A Randomized Clinical Trail.

Background: Traditionally, laparoscopic procedures have been performed under general anesthesia. Spinal anesthesia is an effective alternative to general anesthesia. However, one of the intraoperative complications of performing laparoscopic surgery under spinal anesthesia is shoulder pain. This study aimed to compare the effect of transcutaneous electrical nerve stimulation (TENS) with fentanyl on pain relief in patients who underwent gynecologic laparoscopy under spinal anesthesia. Methods: We conducted a prospective randomized clinical trial from May 2016 to March 2017. A sample of patients who underwent gynecological laparoscopy under spinal anesthesia was recruited. If they had shoulder pain, they randomly received either transcutaneous electrical nerve stimulation (TENS) or 50 mg of fentanyl. Pain intensity was measured using the single item visual analogue scale (VAS-10 cm) immediately before and 5, 10, 20, and 30 minutes after treatment. Also, the effect of higher doses of analgesia on pain relief was analyzed. Results: In all, 80 patients (40 patients in each group) were entered into the study. The mean pain intensity score was 9.02 ± 1.32 in the TENS group and 8.95 ± 1.33 in the fentanyl group at baseline (P = 0.80). Repeated measures analysis of variance indicated that there was no significant difference on overall pain scores between the two treatment groups adjusted for age, BMI, total analgesia used, and baseline pain score (F (1, 74) = 1.44, P = 0.23). The use of analgesic drugs in the TENS group was significantly higher than the fentanyl group (P = 0.01). In addition, we found that nine patients (22.5%) complained of nausea/vomiting in the TENS group compared to thirteen patients (32.5%) in the fentanyl group (P = 0.31). Conclusions: The findings indicated that TENS was not superior to fentanyl for pain relief in laparoscopic surgery. It seems that the correct use of TENS parameters might merit further investigation. This trial is registered with: IRCT2016031216765N3.

Effect of zinc sulfate supplementation on premenstrual syndrome and health-related quality of life: Clinical randomized controlled trial.

AIM: The purpose of study was to assess the effect of zinc sulfate (ZS) supplementation on premenstrual syndrome (PMS) and health-related quality of life (QoL). METHODS: This was a double-blind randomized and placebo-controlled trial using the parallel technique conducted between June 2013 and May 2014. A total of 142 women (age, 20-35 years) with PMS were allocated to either the ZS or placebo group. The women in the intervention group received ZS 220-mg capsules (containing 50 mg elemental zinc) from the 16th day of the menstrual cycle to the second day of the next cycle. Data were collected using the Premenstrual Symptoms Screening Tool (PSST) and 12-item Short-Form Health Survey Questionnaire. RESULT: The prevalence of moderate to severe PMS in the ZS group significantly decreased throughout the study period (9.5% in the first, 6% in the second and 2.6% in the third month of the study, P < 0.001), but in the control placebo group this reduction was seen only in the first month of the study (14.2% in the first, 13.7% in the second and 13.5% in the third month, P = 0.08). Also, ZS improved the PSST component scores throughout the study period. The mean scores of QoL in physical and mental components were significantly improved in the ZS intervention group. However, the differences were statistically significant only 3 months after the intervention. CONCLUSION: Zinc sulfate, as a simple and inexpensive treatment, was associated with improvement of PMS symptoms and health-related QoL. Additional studies are warranted to confirm these findings.

Effects of infant massage on state anxiety in mothers of preterm infants prior to hospital discharge.

AIMS AND OBJECTIVES: This study evaluated the effect of infant massage on anxiety in mothers of preterm infants who discharged from the neonatal intensive care unit. BACKGROUND: Birth of preterm infants commonly leads to great levels of distress and anxiety in mothers. Although various methods have been suggested to help mothers cope with such stressful conditions, the effects of infant massage have not been adequately studied in mothers. DESIGN: This was a quasi-experimental clinical trial. METHODS: Overall, in 70 mothers and their preterm infants who scheduled to be discharged within 24 hours, State-Trait Anxiety Inventory scale (Spielberger) was completed for mothers in both groups in the morning of the day before discharge. The experimental group received eight minutes of massage including two standard similar parts (each part four minutes). The massage was repeated in two parts on the day of discharge, and then, state anxiety was re-measured using Spielberg's scale for all mothers. The control group received no intervention. RESULTS: The results showed that on the day of discharge, there was a significant difference in the overall mean score of maternal state anxiety between the two groups (p < 0·002), although not in the severity of maternal state anxiety. In both groups, the mean score of maternal state anxiety was significantly decreased on the day of discharge (p < 0·001). CONCLUSIONS: The findings provide evidence that infant massage by mother has an effect on the state anxiety of mothers of preterm infants, so it is recommended that mothers apply massage for preterm infants to improve their mental health. RELEVANCE TO CLINICAL PRACTICE: Mothers of preterm infants can promote mental health by continuing massage of their infants at home.

The Mother-Newborn Skin-to-Skin Contact Questionnaire (MSSCQ): development and psychometric evaluation among Iranian midwives.

BACKGROUND: Despite the benefits of mother-newborn skin-to-skin contact immediately after birth, it has not been universally implemented as routine care for healthy term neonates. Midwifes are the first person to contact the neonate after birth. However, there is evidence that many midwives do not perform mother-newborn skin-to-skin contact. The aim of this study was to develop and psychometrically evaluate an instrument for measuring factors associated with mother-newborn skin-to-skin contact (MSSCQ) based on the PRECEDE-PROCEED model. METHODS: This was a two-phase qualitative and quantitative study. It was conducted during 2010 to 2012 in Tehran, Iran. In the qualitative part, 150 midwives working in labor room participated in 19 focus group discussions in order to generate a preliminary item pool. Then, content and face validity were performed to provide a pre-final version of the questionnaire. In the quantitative phase, reliability (internal consistency and test-retest analysis), validity and factor analysis (both exploratory and confirmatory) were performed to assess psychometric properties of the instrument. RESULTS: A 120-item questionnaire was developed through the qualitative phase. It was reduced to an 83-item after content validity. The exploratory factor analysis loaded fifteen-factors and three constructs (predisposing, enabling and reinforcing) containing 82 items (38, 18, and 26 statements, respectively) that jointly accounted for 60.61% of observed variance. The Confirmatory factors analysis determined a model with appropriate fitness for the data. The Cronbach's alpha coefficient showed excellent internal consistency (alpha = 0.92), and test-retest of the scale with 2-week intervals indicated an appropriate stability for the MSSCQ (ICC = 0.94). CONCLUSION: The Mother-Newborn Skin-to-Skin Contact Questionnaire (MSSCQ) is a reliable and valid theory-based measurement and now can be used in clinical practice, midwifery and nursing studies.

Towards a Holistic Approach to Healthy Diet: Evidence from Iranian Health Perception Study.

BACKGROUND: The aim of present study was to investigate the relation between the perception of population on healthy diet and lifestyle related behaviors. METHODS: As part of national study on Iranian Health Perception, a cross-sectional study was carried out in Iran, 2010. A multistage sampling approach was applied to include a representative sample of population aged between 18 and 65 in the study. To collect data a designed questionnaire was administered. RESULTS: In all 27,883 individuals (50.4% women, 48.8% men) were included in the study. The mean age of participants was 34.6 years (SD = 12.8) and most were married (61%). The findings indicated that Iranian population often pay attention to healthy diet (39.5%), never smoke (74.9%), sometimes were doing exercise (29.5%), felt happy to some extent (39.5%), often care about themselves (47.1%) and rated their health as good (54.5%). Further analysis of the data showed that increased paying attention to healthy diet was associated with reduced smoking, more exercise, more self-care and happiness, and a better self-rated health status. CONCLUSION: The findings suggest that a healthy diet and other determinants of lifestyle are very integrated into each other. The efforts for changing any components of lifestyle can potentially change all individual related lifestyle behaviors. Indeed, one of effective strategies in fostering healthy diet is fostering other healthy lifestyles. This holistic approach might help decision-makers to design appropriate interventions in order to influence diet behaviors of people.

The impact of kangaroo care and music on maternal state anxiety.

OBJECTIVE: The effect of kangaroo care (KC) has not been adequately studied in mothers. This present study was undertaken to determine if music during KC has a greater effect than KC alone, on maternal state anxiety (MSA) in the early postpartum period. DESIGN AND SETTING: In a randomized controlled trial, 90 Iranian women who were scheduled for a repeat Cesarean-section, were randomized into three groups: KC, music during KC, and a control group. Mothers' pain scores were evaluated using a visual analog scale (VAS). If the VAS score was ≤3, then MSA was measured by using the State-Trait Anxiety Inventory (STAI) Scale (Spielberg). Interventions were 30 min KC for mother-infant dyads, or playing music for the mothers during KC. Six hours later, in cases where the VAS was ≤3, the MSA was re-measured using Spielberg's scale for all mothers. RESULTS: Six hours post intervention, there was no significant difference in the overall mean scores of MSA between the groups, but the severity of MSA in the two experimental groups was less than in the control group (P=0.02), although not between the two experimental groups. CONCLUSIONS: The findings of this study provide evidence that KC has an effect on the severity of MSA in mothers who were delivered by C-section, however, music during KC had no more effect than KC alone. More research is needed to document the effectiveness of selected or familiar music during KC on state anxiety in early postpartum.

Coping strategy in adolescents with premenstrual syndrome: application of the construal level theory and the precaution adoption process model.

This study aimed to apply the construal level theory (CLT) to increase the relaxation adoption as a coping behavior in adolescents with premenstrual syndrome (PMS). The theory offers a framework that assumes decision-making about adoption of any given behavior depends on perceived temporal distance from the desired or recommended behavior and thus individual might perceive any information or intervention, at two levels (low or high). In doing so, a trial was conducted on 1578 high school students suffering from PMS. The precaution adoption process model was applied to categorize students in six stages, based on their intention to adopt a behavior. The focus of this study was on students who were in stage 3 of the model (undecided to adopt a behavior that was relaxation). Overall, 411 students were identified and randomly assigned to the three study groups: group 1 (n = 98) who received a CLT-driven intervention containing detailed information about relaxation (low-level construal, LLC); group 2 (n = 150) who received a CTL-driven intervention containing general information about relaxation (high-level construal, HLC); and group 3 (n = 163) who received nothing (control group). The progression from stage 3 toward stage 6 (action) was considered as the desired outcome and it was hypothesized that LLC intervention would be more effective than HLC intervention. Compared to participants in the control group, participants in the high and low construal groups were significantly more likely to advance to the action stage (P < 0.001). In addition, students in the low construal group had made an apparent higher stage progression as compared to the high construal group, although this difference was not statistically significant (P = 0.33). The findings suggest that, for people who are undecided to adopt a new health action, LLC intervention might be more effective.

Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial.

BACKGROUND: Zingiber officinale R. rhizome (ginger) is a popular spice that has traditionally been used to combat the effects of various inflammatory diseases. The aim of this study was to evaluate the effects of ginger on pain relief in primary dysmenorrhea. METHOD: This was a randomized, controlled trial. The study was based on a sample of one hundred and twenty students with moderate or severe primary dysmenorrhea. The students were all residents of the dormitories of Shahed University. They were randomly assigned into two equal groups, one for ginger and the other for placebo in two different treatment protocols with monthly intervals. The ginger and placebo groups in both protocols received 500 mg capsules of ginger root powder or placebo three times a day. In the first protocol ginger and placebo were given two days before the onset of the menstrual period and continued through the first three days of the menstrual period. In the second protocol ginger and placebo were given only for the first three days of the menstrual period. Severity of pain was determined by a verbal multidimensional scoring system and a visual analogue scale. RESULTS: There was no difference in the baseline characteristics of the two groups (placebo n = 46, ginger n = 56). The results of this study showed that there were significant differences in the severity of pain between ginger and placebo groups for protocol one (P = 0.015) and protocol two (P = 0.029). There was also significant difference in duration of pain between the two groups for protocol one (P = 0.017) but not for protocol two (P = 0.210). CONCLUSION: Treatment of primary dysmenorrhea in students with ginger for 5 days had a statistically significant effect on relieving intensity and duration of pain. TRIAL REGISTRATION: IRCT201105266206N3.

Muslim breast cancer survivor spirituality: coping strategy or health seeking behavior hindrance?

We explored the role of religiosity and spirituality on (i) feelings and attitudes about breast cancer, (ii) strategies for coping with breast cancer, and (iii) health care seeking behaviors among breast cancer survivors in Iran. We conducted in-depth semistructured interviews with 39 breast cancer survivors. We found that spirituality is the primary source of psychological support among participants. Almost all participants attributed their cancer to the will of God. Despite this, they actively have been engaged with their medical treatment. This is in surprising contrast to Western cultures in which a belief in an external health locus of control diminishes participation in cancer screening, detection, and treatment. These findings can help researchers to provide a framework for the development of appropriate and effective culturally sensitive health interventions.

Quality of life in opium-addicted patients with coronary artery disease as measured with WHOQOL-BREF.

OBJECTIVE: Several factors can influence the quality of life in patients with coronary artery disease (CAD). The goal of this research was to measure quality of life in opium-addicted patients with CAD in order to assess the effect of CAD risk factors on their quality of life. METHOD: The WHOQOL-BREF questionnaire was completed through interviews with 275 patients who underwent isolated coronary artery bypass surgery in Tehran Heart Centre between May and September 2006. RESULTS: No significant differences were found in the mean scores of the four domains of quality of life between the addicted and non-addicted patients. Furthermore, the evaluation of QOL in the groups with CAD risk factors showed that the mean QOL domains were statistically similar between opium addicted and non-opium addicted patients. In the addicted group, men had a higher psychological health score than women. A previous history of myocardial infarction reduced the psychological score in this group. Also, in the addicted patients with a history of diabetes mellitus, social functioning was better than that of the non-diabetics. CONCLUSIONS: The different domains of quality of life in our opium-addicted and non-addicted patients with CAD were similar; and among all the major risk factors for coronary artery disease, only female gender and a previous history of myocardial infarction could influence quality of life in the opium-addicted patients.

Depression and the use of complementary medicine among breast cancer patients.

This was a cross-sectional study to examine the association between anxiety, depression and quality of life and the use of complementary and alternative medicine. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS), and quality of life was measured using the global quality of life subscale selected from the European Organization for Treatment and Research of Cancer (EORTC) quality of life core questionnaire (QLQ-C30). In all, 177 breast cancer patients were studied, and 32% (n=57) reported that they used or were using complementary medicine. Users and nonusers did not differ significantly in almost all variables studied, with the exception of duration of their diagnosis. The most commonly used complementary medicine was prayer and spiritual healing (n=45, 73.8% of responses). Performing the logistic regression analysis controlling for age, marital status, educational level, knowledge of diagnosis, time since diagnosis, global quality of life, depression, and anxiety scores, the results indicated that the use of complementary medicine among breast cancer patients was associated with sever depression (odds ratio 2.49, 95% CI 1.06-5.89, P 0.04). The other variables studied did not show any significant results. The study findings confirm that the use of complementary medicine is more common among depressed breast cancer patients and might be a marker of greater psychological distress in this group of patients.