Effects of alpha lipoic acid on iron overload, lipid profile and oxidative stress indices in ß-thalassemia major patients: A cross-over randomised controlled clinical trial.

AIMS: ß-Thalassemia major (ß-TM) is associated with iron overload, abnormal lipid levels and oxidative stress. Alpha lipoic acid (ALA) showed anti-oxidant and iron chelating properties, but its effect in ß-TM patients is unclear. We investigated the effects of ALA on iron levels, lipid profile and oxidative stress. METHODS: In this cross-over randomised clinical trial, 26 ß-TM patients were assigned to receive 600 mg/d ALA or placebo (corn starch), for 8 weeks with a 21-days washout period. Serum ferritin, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), LDL-C/HDL-C, total antioxidant capacity, malondialdehyde (MDA) and MDA/LDL-C were assessed at baseline and the end of each intervention phase. RESULTS: Twenty-two patients completed the study. Serum ferritin (P = .004), MDA (P = .025) and MDA/LDL-C ratio (P =.002) were decreased and HDL-C (P =.035) increased significantly during ALA consumption. In comparison with placebo, ALA decreased the serum ferritin significantly (P = .02). Also, the changes in serum ferritin between ALA and placebo (-123.1 ± 40.0 vs -34.3 ± 21.0, P =.03) was significant in women subgroup. ALA had no significant effects on the other biomarkers. CONCLUSION: The results of this study indicated that supplementation with 600 mg/d ALA may decrease serum ferritin in ß-TM. Further studies are needed to confirm the findings.

Effects of Alpha-Lipoic Acid Supplementation on Cardiovascular Disease Risk Factors in ß-Thalassemia Major Patients: A Clinical Trial Crossover Study.

AIM: Thalassemia is one of the most common genetic diseases, and cardiovascular disease (CVD) has been considered as the leading cause of mortality in more than 50% of ß-thalassemia patients. The aim of this study was to determine the effects of alpha-lipoic acid (ALA) on CVD risk factors in ß-thalassemia major patients. METHODS: Twenty ß-thalassemia major patients participated in this randomized crossover clinical trial study. Participants were randomly assigned to ALA (600 mg/day) or placebo groups for two 8-wk interventions that were separated by a 3-wk washout period. The CVD risk factors including serum osteoprotegerin (OPG), homocysteine, lipoprotein-associated phospholipase A2 and trimethylamine N-oxide were measured at the beginning and the end of each intervention phase according to the standard protocol. RESULTS: Serum OPG reduced significantly in the ALA group in all participants (5.38 ± 2.79 to 3.27 ± 2.43 ng/mL, P= .003) and in the male subgroup (5.24 ± 2.56 to 3.13 ± 2.5 ng/mL, P= .015); this reduction was significant in comparison with the placebo group (P= .013). The changes in other CVD risk factors were not significant. CONCLUSION: The results of this study showed that after 8-wk of ALA consumption, the serum OPG reduced significantly in ß-thalassemia major patients. Therefore, controlling the serum OPG level with ALA consumption can be an important complementary therapeutic option to prevent the progression of CVD in ß-thalassemia major patients.

Attitude of pregnant women towards Normal delivery and factors driving use of caesarian section in Iran (2016).

BACKGROUND: Normal delivery is a natural and physiological process with numerous benefits for mother and baby. Giving birth by Caesarean Section (CS) should be limited to the cases in which normal delivery is not possible. The purpose of the study was to determine the attitudes of pregnant women towards Normal Delivery and factors driving the use of Caesarian Section in Kermanshah, Iran. METHODS: This analytical-descriptive study was conducted on 410 pregnant women referred to the PHC centers in Kermanshah in western Iran. They had been selected through a multi-stage sampling method, including clustering, randomized, and proportional sampling, from among all eligible women. Data was collected using a questionnaire standardized by previous studies. The level of 0.05 was considered significance association, whenever applied. RESULTS: The mean and standard deviation for participant age was 27.65 ± 5.37 years. The median score for participant attitude was 60.7 ± 9.5 (range from 22 to 85). Generally, 21.5% had a negative attitude toward normal delivery and preferred CS. Participant attitude was negatively correlated with a pregnant woman's age, lower age, and a more positive attitude towards vaginal childbirth. The attitude of women with a history of normal delivery was 63 ± 9 and for those with a history of CS was 56.7 ± 9.3, significantly different. CONCLUSION: Most women had a positive attitude towards normal delivery, particularly those who had experienced normal delivery in their previous childbirth. Although only a quarter of the participants had a negative attitude toward normal delivery, this figure still was of utmost significance, therefore educational interventions, specifically encouraging women with history of normal delivery to consult their peers, are recommended.

A Comparative Study of the Efficacy of Cognitive Group Therapy and Aerobic Exercise in the Treatment of Depression among the Students.

BACKGROUND: Depression is one of the most common mental disorders. Finding effective treatments for such a disorder with higher efficiency lower side effects and affordability is an active area of research in psychiatry. This study aimed to comparatively analyze the effects of the cognitive group therapy and aerobic exercises on depression, automatic negative thoughts and dysfunctional attitudes of students at Kermanshah University of Medical Science. METHODS: In this clinical trial, 46 associate and undergraduate students at Kermanshah University of Medical Science were randomly divided into three groups: cognitive therapy, aerobic exercise, and control. The data was gathered both before and 8 weeks after the intervention. Beck Depression Inventory (BDI-II), automatic negative thoughts (ATQ), and the Dysfunctional Attitude Scale (DAS) were used as the data collection instruments. The data were analyzed with SPSS version 15 using paired samples T-test, chi-square test, Kruskal-Wallis test, and analysis of variance (ANOVA). RESULTS: Cognitive therapy caused a significant decrease in depression, belief in automatic negative thoughts, and dysfunctional attitudes in comparison to the control group (p<0.05). Although aerobics compared to the control group causes more reductions in the variables, however, It was only meaningful for the depression variable (p=0.049). Cognitive therapy also reduced the variables more than the aerobic exercise, but the decrease was not statistically significant. CONCLUSIONS: Cognitive group therapy and aerobic exercise are effective in treating depression. For treating depression, aerobic exercise can be used as a therapy itself or along with cognitive-behavioral therapy and pharmacotherapy.