Cultural vs. State Borders: Plant Foraging by Hawraman and Mukriyan Kurds in Western Iran.

Plant foraging is a millennia-old activity still practiced by many people in the Middle East, particularly in the Fertile Crescent region, where several socioeconomic, ecological, and cultural factors shape this practice. This study seeks to understand the drivers of plant foraging in this complex region characterized by highly diverse linguistic, religious, and cultural groups. Our study aims to document the wild plants used by Kurds in Western Iran, identify similarities and differences among Hawraman and Mukriyan Kurdish groups in Iran, and compare our findings with a previous study on the Hawramani in Iraq. Forty-three semi-structured in-depth interviews were conducted in Kurdish villages of Western Iran. The results revealed the use of 44 wild food plant taxa, their preparation, and culinary uses. Among the reported taxa, 28 plant taxa were used by Mukriyani, and 33 by Hawramani. The study revealed a significant difference between the Hawraman and Mukriyan regions in Iran, whereas there is a high similarity between Hawramani Kurds in Iran and Iraq. We found that the invisible cultural border carries more weight than political divisions, and this calls for a paradigm shift in how we perceive and map the distribution of ethnobotanical knowledge.

A population-based prospective study on obesity-related non-communicable diseases in northern Iran: rationale, study design, and baseline analysis.

Background: Iran is facing an epidemiological transition with the increasing burden of non-communicable diseases, such as obesity-related disorders and cardiovascular diseases (CVDs). We conducted a population-based prospective study to assess the prevalence and incidence rates of CVDs and obesity-related metabolic disorders and to evaluate the predictive ability of various CVD risk assessment tools in an Iranian population. Method: We enrolled 5,799 participants in Amol, a city in northern Iran, in 2009-2010 and carried out the first repeated measurement (RM) after seven years (2016-2017). For all participants, demographic, anthropometric, laboratory, hepatobiliary imaging, and electrocardiography data have been collected in the enrollment and the RM. After enrollment, all participants have been and will be followed up annually for 20 years, both actively and passively. Results: We adopted a multidisciplinary approach to overcome barriers to participation and achieved a 7-year follow-up success rate of 93.0% with an active follow-up of 5,394 participants aged 18-90 years. In the RM, about 64.0% of men and 81.2% of women were obese or overweight. In 2017, about 16.2% and 5.2% of men had moderate or severe non-alcoholic fatty liver disease, while women had a significantly higher prevalence of metabolic syndrome (35.9%), and type 2 diabetes mellitus (20.9%) than men. Of 160 deceased participants, 69 cases (43.1%) died due to CVDs over seven years. Conclusion: The most prevalent obesity-related chronic disease in the study was metabolic syndrome. Across the enrollment and RM phases, women exhibited a higher prevalence of obesity-related metabolic disorders. Focusing on obesity-related metabolic disorders in a population not represented previously and a multidisciplinary approach for enrolling and following up were the strengths of this study. The study outcomes offer an evidence base for future research and inform policies regarding non-communicable diseases in northern Iran.

Antimicrobial and cytotoxic naphthoquinones from microbial origin: An updated review.

Naphthoquinones (NQs) are small molecules bearing two carbonyl groups. They have been the subject of much research due to their significant biological activities such as antiproliferative, antimicrobial, anti-inflammatory, antioxidant, and antimalarial effects. NQs are produced mainly by bacteria, fungi and higher plants. Among them, microorganisms are a treasure of NQs with diverse skeletons and pharmacological properties. The purpose of the present study is to provide a comprehensive update on the structural diversity and biological activities of 91 microbial naphthoquinones isolated from 2015 to 2022, with a special focus on antimicrobial and cytotoxic activities. During this period, potent cytotoxic NQs such as naphthablin B (46) and hygrocin C (30) against HeLa (IC50=0.23 µg/ml) and MDA-MB-431 (IC50=0.5 µg/ml) cell lines was reported, respectively. In addition, rubromycin CA1 (39), exhibited strong antibacterial activity against Staphylococcus aureus (MIC of 0.2 µg/ml). As importance bioactive compounds, NQs may open new horizon for treatment of cancer and drug resistant bacteria. As such, it is hoped that this review article may stimulates further research into the isolation of further NQs from microbial, and other sources as well as the screening of such compounds for biological activity and beneficial uses.

Relationship between Toxoplasma gondii infection and psychiatric disorders in Iran: A systematic review with meta-analysis.

BACKGROUND: Toxoplasma gondii, a ubiquitous parasitic protozoan, may be an important cause of neurological and psychiatric diseases. The present systematic review and meta-analysis, therefore, was conducted to investigate the scientific evidence regarding the potential association between T. gondii infection and psychiatric disorders in Iran. METHODS: We systematically reviewed articles from world-wide databases, including PubMed, Scopus, Science Direct, Web of Science, Google Scholar, and Iranian national databases up to July 30th, 2021. The Newcastle Ottawa Scale (NOS) was used to assess the quality of included studies. The common odds ratio (OR) was estimated using inverse variance and a random-effects model. Heterogeneity was assessed using the χ2-based Cochrane test (Q) and the I2 index. Also, sensitivity analyses and publication bias were calculated. Moreover, subgroup analysis was performed based on the type of disorder and quality score of different eligible studies. RESULTS: 16 studies were included in this meta-analysis. Our meta-analyses found that the OR of the risk of anti- T. gondii IgG and IgM in psychiatric patients compared to the control group was 1.56 (95% CI; 1.23-1.99) and 1.76 (95% CI: 1.19-2.61), respectively. Subgroup analysis based on the type of disorder showed that the OR of the risk of anti- T. gondii IgG in Iranian schizophrenia patients and other psychiatric disorders compared to the control group were 1.50 (95% CI; 1.09-2.07) and 2.03 (95% CI: 1.14-3.60), respectively, which are statistically significant. Also, the OR of the risk of anti- T. gondii IgM in Iranian schizophrenia and depression patients compared to the control group was 1.54 (95% CI; 0.9-2.64) and 1.03 (95% CI: 0.2-5.24), respectively, which are not statistically significant. Additionally, subgroup analysis based on quality scores showed no significant influence on the results according to the moderate quality studies. However, this association was significant according to the high quality studies. The obtained results of Egger's test were 1.5 (95% CI; -0.62-3.73, P = 0.15) and 0.47 (95% CI; -0.82-1.76, P = 0.45), respectively, indicating publication bias. The significant results of the heterogeneity analysis confirmed a high level of heterogeneity in the IgG test (P = 0.000, I2 = 66.6%). However, no significant results from the test of heterogeneity were detected in the IgM test (P = 0.15, I2 = 27.5%). The results of the sensitivity analysis showed that the impact of each study on the meta-analysis was not significant on overall estimates. CONCLUSIONS: Despite the limited number of studies, these outcomes supported a possible link between T. gondii infection and psychiatric disorders in Iran. However, more high-quality investigations are needed in the future.

The Psychometric Properties of the Fear of Progression Questionnaire (FoP-Q) for Cancer Patients in Iran.

PURPOSE: Fear of progression or recurrence is assumed as a rational response to the threat of cancers and types of cancer treatment. However, the elevated levels of fear in cancer patients can become dysfunctional. Therefore, a valid and reliable questionnaire is unquestionably required for this purpose. This study aimed to translate the Fear of Progression Questionnaire and evaluate its psychometric properties for patients with gastrointestinal cancers in Iran. METHODS: In this study with a methodological research design, a total number of 430 patients affected with gastrointestinal cancers referring to Northern Iran completed the 43-item Fear of Progression Questionnaire. The psychometric properties of the questionnaire were evaluated, including the face validity and content validity. Then construct validity was assessed using exploratory and confirmatory factor analyses. Finally, the reliability was assessed using internal consistency (Cronbach's alpha) and stability (intraclass correlation coefficient). RESULTS: Based on the result of the face and content validity, no items were revised and removed. The five extracted factors included were emotional response, employment, and loss of independence, economy/family, and coping. These factors explained 37% of the total variance of Fear of Progression Questionnaire. Reliability (by Cronbach's alpha) and stability (test retest was evaluated by intraclass correlation coefficient) were more than 0.7. CONCLUSION: The study results revealed that the Persian version of the Fear of Progression Questionnaire had acceptable reliability and validity for cancer patients in Iran. Emotional responses explained the most variance of the concept of fear of progression among cancer patients.

Comparing mental health status and COVID-19 event impact between survivors and the general population during the second wave of the pandemic in Iran.

BACKGROUND AND AIM: The coronavirus disease 2019 (COVID-19) pandemic has to date overwhelmed the survivors and the general population. The present study aimed to compare the mental health status and the COVID-19 event impact between the survivors and the general population in Mazandaran Province, Northern Iran. DESIGN: A web-based cross-sectional survey was used. METHODS: This study was performed using convenience sampling. RESULTS: In total, 1,766 participants were included in this study. The findings revealed that the posttraumatic stress disorder (PTSD) severity in both outpatient and hospitalized groups was significantly higher than that in the general population. Besides, the levels of anxiety and depression in the group receiving inpatient care and treatment had significantly elevated than those in the general population. CONCLUSION: Given the high prevalence rate of mental disorders, healthcare professionals are recommended to plan for various interventions and support services to boost community mental health status.

A new diterpenoid from Salvia santolinifolia boiss.

Phytochemical study of the Salvia santolinifolia root extract resulted in the isolation of one new quinone diterpenoid, aegyptinone E (1) as well as two known ones, aegyptinone A (2) and aegyptinone D (3). All the isolated compounds were reported for the first time from S. santolinifolia. Spectroscopic analyses including 1 D and 2 D NMR and HRESIMS were used to determine the chemical structures. Aegyptinone A (2) showed moderate antibacterial activity against Staphylococcus aureus, Staphylococcus epidermis, and Bacillus subtilis with MIC of 25 µg/mL.

LC-MS-based metabolite profiling of aqueous extract of Pergularia tomentosa L. and its anti-hyperglycemic effect.

Objectives: In this study, to find scientific evidence for the traditional use of Pergularia tomentosa as an anti-diabetic remedy, the effects of its aqueous extract on streptozotocin-induced diabetes mellitus in rats were evaluated. Materials and Methods: Wistar rats were fasted overnight and diabetes mellitus was induced using streptozotocin (50 mg/kg body weight). The rats were randomly and equally divided into four groups (n=5): group I (normoglycaemic control), group II (diabetic rats), group III (diabetic rats treated with 200 mg/kg BW of an aqueous extract of P. tomentosa), group IV (normoglycemic rats treated with 200 mg/kg BW of an aqueous extract of P. tomentosa). Chemical profiling of the aqueous extract was carried out using liquid chromatography coupled with electrospray ionization and multiple-stage linear ion-trap and orbitrap high-resolution mass spectrometry (LC-ESI/LTQOrbitrap/MS/MS). In addition, the quantitative determination of the main cardenolides in the extract was carried out by an analytical approach based on LC coupled to tandem mass spectrometry with ESI source and hybrid triple quadrupole-linear ion trap mass analyzer (LC-ESI/QTrap/MS/MS). Results: Aqueous extract of P. tomentosa showed a reasonable reduction in blood glucose level. Probably, the P. tomentosa effect on hyperglycemic and hyperlipidemic diabetic animals was associated with antioxidant properties, triglyceride levels, as well as liver enzymes. Meanwhile, LC-ESI/LTQOrbitrap/MS/MS analysis led to identification of double-linked cardenolides along with cardenolides and flavone glycosides as the main bioactive compounds. Conclusion: The extract decreased the glucose level and induced a beneficial effect on the lipid profile, probably due to the presence of cardenolide glycosides.

Profile of Cigarette and Drug Use Status in Population of Tabari Cohort Study.

Background: The study of the smoking and drug use profile of the Tabari cohort enrolment phase, the outcomes of which will be evaluated in the coming years, has proper comprehensiveness. Therefore, the present study aimed to determine the cigarette and drug use status in the population of the Tabari cohort study (TCS). Methods: In this study, the profile of cigarette and drug use in the TCS was evaluated. Data analysis was performed in SPSS version 24 using percentage, mean, and standard deviation, chi-square, and independent t test. Findings: The frequency of daily smoking in the entire population was 9.1%, and the frequencies in men and women were 21.5% and 0.6%, respectively (P<0.001). The frequency of exposure to smoking in the home, at present or in the past, in the entire population was 30.5%, and in the populations living in urban and mountainous areas were 35.4% and 19.8%, respectively (P<0.001). The mean age at first use of cigarettes in the entire population was 20.50±7.61, whereas the mean age of regular smoking was 23.19±8.02. Furthermore, the frequency of experiencing drug abuse in the total population was 6.1%, and the frequencies in men and women were 14.1% and 0.7%, respectively. Conclusion: According to the results of this study, cigarette smoking and drug use are significant in men, and overall exposure of the Tabari cohort population to tobacco and drugs in the home is high. If effective prevention is not on the agenda, a significant proportion of the future outcomes in this population may be attributable to these risk factors.

Association between blood pressure and parameters related to sleep disorders in Tabari cohort population.

BACKGROUND: Insomnia and other sleep disorders can cause an increase in blood pressure, thereby resulting in premature death. Regarding this, the present study was conducted to investigate the relationship between hypertension and parameters related to sleep disorders in Tabari cohort population. METHODS: In this cross-sectional study, the data from the enrollment phase of the Tabari cohort study were adopted. Tabari cohort is a part of the PERSIAN (Prospective Epidemiological Research Studies in Iran) cohort study. Data analysis was performed using descriptive and inferential statistics. RESULTS: Out of 10,255 patients enrolled in the Tabari cohort, 2,281 patients (22.2%) had hypertension. According to the results of univariable logistic regression test, the odds ratio of high blood pressure in patients with insomnia and hypersomnia is 1.22 (95% confidence interval [CI], 1.06-1.40) and 1.22 (95% CI, 1.01-1.47) times higher than normal sleep. This odds ratio was not significant after adjusting the effect of sex, age, body mass index, waist circumference, area residence, high-density lipoprotein cholesterol, triglyceride, and total cholesterol variables with multivariable logistic regression. Frequency of routine hypnotic medication usage (14.6% vs. 5.7%, P < 0.001), involuntary napping (25.3% vs. 19%, P < 0.001), and leg restlessness during sleep (14.8% vs. 11.7%, P < 0.001) was higher in hypertensive individuals than in nonhypertensive cases. CONCLUSIONS: This study showed that sleep disorders prevalence are higher in hypertensive patients than nonhypertensive patients. Also, routine use of hypnotics was significantly higher medication in patients with hypertension compared to that in the nonhypertensive patients.

Motor Exercises Effect on Improving Shoulders Functioning, Functional Ability, Quality of Life, Depression and Anxiety For Women With Breast Cancer.

PURPOSE: This research aimed to study the effects of motor exercises on improving shoulder functioning, functional ability, quality of life, depression, and anxiety in patients. PATIENTS AND METHODS: A randomized clinical trial in which 70 eligible patients referred to the oncology ward participated in two intervention and control groups. The intervention group (N=35) had been doing motor exercises for five weeks. Before the surgery, two days, and five weeks after surgery, shoulder Range Of Motion (ROM) was measured with a goniometer, and the functional capacity level was measured by the 6-Minute-Walk-Test. Quality of life, depression, and anxiety were measured using the EORTC QLQ-C30 and QLQ-BR23; and HADS questionnaires, respectively, at baseline and five weeks after surgery. Descriptive statistics, the T-test, and the Chi-Square t-hotelling model were used to analyze the data. RESULTS: The results showed that motor exercises had a significant statistical increase in the distance of 6MWT (P<.001) and ROM (P≤.001) compared to the control group. Moreover, there were significant differences in dimensions of patients' quality of life, depression, and anxiety in the intervention group, compared to the control group (P<.05). CONCLUSION: Motor exercises had positive effects on improving physical functioning, shoulder ROM, and decreasing patients' anxiety and depression symptoms, consequently enhancing the quality of life.

Sleep profile status based on substance use, lipids and demographic variables in Tabari cohort study.

Background: This study aims to investigate the situation of sleep profile and its related factors in the Tabari Cohort Tabari (TCS) population. Methods: The information of 10255 of the Tabari cohort population in the enrolment phase was used in this study. The sleep profile data was collected and recorded by trained questioners. The sleep duration in day & night, the time interval between going bed and falling asleep, continuous use of sedatives, involuntary nap, limb hypermobility during sleep and shift working were determined for each person. Data analysis was performed by independent T test and Pearson correlation coefficient. Results: Mean, standard deviation, median, minimum and maximum of sleep duration in this population were 7.6, 1.6, 7.5, 0.5 and 17 h. Frequency of sleeping less than 6 h, 6-10 h and more than 10 h were 1168(11.4%), 8463(82.5%) and 624(6.1%) respectively. Prevalence of sleeping more than 10 h among men and women were 5% and 6.8% respectively (P < 0.001). Prevalence of sedative routine use among men and women were 4.7% and 9.6% respectively (P < 0.001). There were significant relationships between sleep duration and area residence, age group (P < 0.001), education level (P < 0.001), socioeconomic level (P < 0.001), triglyceride (P = 0.002), HDL-cholesterol (P = 0.013) and Cholesterol total (P = 0.021). There was a negative correlation between age and sleep duration (r = -0.062, P < 0.001). Conclusion: The results showed the association of the quality and quantity of sleep with personal, social, environmental and biological factors such as gender, age, economic status, educational status, and lipid profile. Therefore without proper intervention, the incidence of outcomes associated with these risk factors can be predicted in TCS In later years.

Sertraline-induced rectal bleeding and anal pain (a rare case presentation).

BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) have proven more problematic in terms of some side effects than the original clinical trials suggested. Sertraline may displace warfarin from plasma proteins and may increase the prothrombin time. The aim of this study was to report a rare case of the sertraline- induced severe anal pain and rectal bleeding without concurrent of taking any other drugs including non-steroidal anti-inflammatory drugs (NSAIDs). CASE PRESENTATION: Here we report a case of a 31 -year old married man who referred to a psychiatrist with depressive disorder and started to take sertraline up to 400 mg daily, thereafter the patient reported severe anal pain and bleeding. Other etiologies of this side effect were evaluated with Naranjo evaluation scale and rolled out. The patient did not report any anal pain or bleeding after eight months of stopping sertraline. CONCLUSION: Reported from sertraline, the psychiatrists must be more cautious when prescribing sertraline and monitor the patient properly for a long time to ensure these rare adverse effects and complications do not happen.

Ethnopharmacological study of medicinal plants in Sarvabad, Kurdistan province, Iran.

ETHNOPHARMACOLOGICAL RELEVANCE: Traditional medicine has a long history and plays an important role in the Kurdish community in Sarvabad county, Kurdistan province, Iran. Despite the great diversity of medicinal plants, cultural history, and variety of herbal medicine uses among Kurdish tribes, very few cohesive ethnopharmacological studies of this unique region are available in the scientific literature. Our study tried to gather medicinal plant species and document the associated indigenous knowledge of the ethnic groups in the Sarvabad district for the first time. MATERIALS AND METHODS: Ethnobotanical data were collected from 92 local informants through semi-structured questionnaires, open interviews, and field surveys during a period of two years (2018-2020). The statistical analysis included use reports (UR) for each species, and informant consensus factor (FIC) to evaluate the data. RESULTS: In the present study a total of 156 plant species belonging to 58 botanical families, were recorded for the treatment of 16 diseases categories. The most represented families were Lamiaceae, followed by Asteraceae, and Apiaceae. The most frequently cited plant species with the highest use report (UR) were Pistacia atlantica (161), Hymenocrater longiflorus (128), Melissa officinalis (124), Cyperus rotundus (114), Thymus transcaspicus (112), and Quercus brantii (109). Psychological (ICF = 0.96), musculoskeletal (ICF = 0.94), and digestive (ICF = 0.93), followed by respiratory problems (ICF = 0.92) showed the highest informant consensus factors among all ailment categories. Most herbal remedies were consumed as decoction. Leaves (28.5%) were the most widely used plant parts, followed by flowers (18.7%), aerial parts (14.5%), seeds (13.2%), and terrestrial parts (8.41%). Some interesting new medicinal uses for native and common species were reported. Species such as Cyperus rotundus, Hymenocrater longiflorus, Anthriscus nemorosa, Pistacia atlantica and Quercus brantii would be interesting targets for drug discovery and are suggested for further investigations. CONCLUSION: The plant use reports, and quantitative data analyzed demonstrate that the relative importance of plant species and shared knowledge of herbal therapies among Kurdish communities of the Sarvabad county is still rich. A systematic study and evaluation of the biological activity of highly consumed plants, could identify the possible mechanism of action.

Paternal postpartum depression's relationship to maternal pre and postpartum depression, and father-mother dyads marital satisfaction: A structural equation model analysis of a longitudinal study.

BACKGROUND: Fathers' depression is an understudied subject, and the increasing participation of fathers on the care of their children, this is an issue of great importance. This study aimed to determine the relationship of paternal postpartum depression with prenatal and postpartum depression of mothers and their marital satisfaction. METHODS: This longitudinal study was conducted among 352 expecting couples in 28-40 weeks of pregnancy and 6-8 weeks after delivery from April to September 2019. Eligible participants were selected from primary health care centers in northern Iran using a two-stage sampling method. Socio-demographic information, Edinburgh Postpartum Depression Scale, and ENRICH Couple Scale were used for data collection. The primary basis of data analysis was cross-lagged structural equation modeling to explore the underlying mechanism for paternal postpartum depression. RESULTS: The results showed that a) maternal prenatal depression indirectly (ßstand = 0.32, p = 0.004); b) maternal postpartum depression directly (ßstand = 0.56, p <0.001); c) paternal prenatal depression indirectly (ßstand = 0.11, p = 0.028) were associated with paternal postpartum depression. Also, marital satisfaction directly (ßstand = -0.19, p = 0.002) and indirectly (ßstand = -0.11, p = 0.007) had a relationship to paternal postpartum depression. LIMITATIONS: Culturally-sensitive measures of marital satisfaction, especially in conservative context of developing countries, along with self-reported data of psychological problems may lead to under-reported findings. CONCLUSION: The major contribution of marital satisfaction and maternal depression during prenatal period on the paternal postpartum depression, emphasizes on the prenatal period as the ideal time for fathers' mental health improvement.

Zolpidem withdrawal seizure in an Iranian young woman: A case presentation.

BACKGROUND: Zolpidem is a non-benzodiazepine drug, approved by FDA for sleep induction. Zolpidem is thought to be a safer drug than benzodiazepines (BZD) because of no evidence of abuse or dependence potential, but several case reports of zolpidem abuse and dependence have been published along with a small number of cases demonstrating seizures after sudden zolpidem withdrawal. CASE PRESENTATION: A 32-year-old unmarried woman suffering from major depressive disorder had been taking zolpidem for insomnia for more than 1 year. She began to take zolpidem alone without mixing other kinds of hypnotics, and 50 mg of zolpidem used to be initially effective in treating her insomnia. In some days the dose increased up to 100 mg per day. In the end, she had to discontinue zolpidem abruptly because she could not afford it anymore. After 2 days, she suddenly showed facial spasm, mouth opening, tonic-clonic seizure, and loss of consciousness for about 1-2 minutes. Post-ictal confusion with clouded consciousness, psycho-motor retardation, persisted in 1 day. EEG in wakefulness revealed intermittent, generalized, diffused alpha wave and diffused sharp waves, and suggested seizure waves in the patient. CONCLUSION: Our case suggested that the potential of zolpidem dependence and withdrawal seizure are also present in the Iranian population. The female-gender, high dosage and long-term use of zolpidem might be risk factors for the development of adverse effects.

Ethnobotany of the medicinal plants used by the ethnic communities of Kerman province, Southeast Iran.

BACKGROUND: Traditional medicine is a major component in the primary healthcare system in the southeast of Iran, which has a rich floral diversity. However, there is no comprehensive report on the use of medicinal herbs in this specific region. This traditional usage of medicinal plants by local communities could serve as a source for pharmacological and phytochemical studies. The main objective of this study was to identify ethnopharmacological knowledge on medicinal plant species and their local healing applications by the folk communities of Kerman province in the southeast of Iran. METHODS: In this cross-sectional study, data were collected from 217 herbal healers using semi-structured questionnaires, open interviews, and field surveys. Factors including use reports (UR) for each species, frequency of citation (FC), and informant consensus factor (ICF) were used to analyze the data. Plant species were identified by botanists through standard taxonomic methods. RESULTS: A total of 402 medicinal plants were used in healing practices by the local communities of Kerman province. These species belong to 273 genera of 73 families, among which 367 species are dicotyledons, 27 are monocotyledons, 7 species are cryptogam, and one species is gymnosperm. An important implication from the current study is the identification of the traditional medicinal use of 292 plant species in this region for the first time. Asteraceae, Apiaceae, Lamiaceae, and Fabaceae were the dominant medicinally utilized plant families, respectively. Leaf, flower, fruit, and seed were the most common plant parts used. Generally, crude drugs were used in the form of decoction, followed by poultice and infusion forms. Moreover, oral route is considered as the most common administration route followed by topical route. Endocrine (diabetes), dermatological, gastrointestinal, and respiratory problems were ranked as the most frequent ailment categories for which medicinal plants in this region were applied, respectively. Our findings suggested dominant use of Asteraceae and Apiaceae plants for the treatment of gastrointestinal disorders, Lamiaceae plants for respiratory and gastrointestinal ailments, and Apocynaceae plants for dermatological problems. CONCLUSION: Our findings suggested that Asteraceae and Apiaceae plants were used for the treatment of gastrointestinal disorders, Lamiaceae plants for respiratory and gastrointestinal ailments, and Apocynaceae and Euphorbiaceae plants for dermatological problems. Among the medicinal plants with high UR and new ethnobotanical uses, Rhazya stricta was used for wound healing, Calotropis procera, Clematis ispahanica and Euphorbia spp. for eczema, Cionura erecta for the treatment of cough, Launaea acanthodes for the treatment of gastrointestinal parasites, Berberis integrrima as an antidiabetic medicinal herb, Dracocephalum polychaetum and Rydingia persica for various types of chronic diseases, Citrus limon and Citrus aurantium for the treatment of ocular diseases and making the traditional kohl, Calendula officinalis for the treatment of pterygium and Prosopis farcta for preventing nasal bleeding. The identified medicinal plants can be further evaluated for their pharmacological activity and underlying mechanisms of action.

Prevalence of elimination disorders and comorbid psychiatric disorders in Iranian children and adolescents.

PURPOSE: Currently, there is a paucity of studies on the prevalence of Elimination Disorders among Iranian children and adolescents. Due to the ongoing need to monitor the health status of these children and adolescents, the present study aims to investigate the prevalence of Elimination Disorders and comorbid disorders in Iranian children and adolescents. METHODS: In this cross-sectional study, 29,781 children and adolescents age 6 to 18 years old were selected and studied from all the provinces in Iran. The sampling was carried out by employing a multistage cluster sampling method, and several clinical psychologists using semi-structured interviews collected the data. Furthermore, clinical psychologists collected demographic information (including information about gender, age, place of residence, education level, and parental education level). The collected data were analyzed using SPSS version 20. RESULTS: Generally, the prevalence of Elimination Disorders was found to be 5.4% covering both enuresis (p= 5.4, 95% CI = 5.1-5.7) and encopresis (p= 0.13, 95% CI = 0.09-0.2). The total prevalence of comorbid disorders was 38%, and among the comorbid disorders, Attention Deficit Hyperactivity Disorder (ADHD) (p= 11, 95% CI = 9.5-12.7) and Separation Anxiety (p= 10.6, 95% CI = 9.1-12.2) were the most prevalent. CONCLUSION: The prevalence of Elimination Disorders in Iranian children and adolescents is moderate compared to similar studies elsewhere. As for comorbid disorders, ADHD and Separation Anxiety were found to be the most prevalent disorders. Since Elimination Disorders coexist with psychiatric disorders in children, further studies of these comorbidities may give better insight into the treatment and prognosis of Elimination Disorders.

Evaluation of sleep quality and duration in pregnancy and risk of gestational diabetes mellitus: A prospective follow-up study.

BACKGROUND AND OBJECTIVES: Sleep disorders during pregnancy may be linked an increase risk of adverse pregnancy outcomes. This study aimed to evaluate the relationship between sleep quality and duration in pregnancy and risk of gestational diabetes mellitus (GDM). MATERIALS AND METHODS: This prospective follow-up study was performed on 240 pregnant women with a gestational age between 20 to 24 weeks, who were referred to Imam Khomeini Hospital in Sari from 2018 to 2019 for prenatal care. The sleep quality of all eligible women were evaluated with the Pittsburgh Sleep Quality Index (PSQI). During the 26 to 28 weeks of gestation, 1-hour and 2-hour oral glucose tolerance test (OGTT) was done for all women. RESULTS: The results showed that women with poor sleep quality had a significantly higher mean BMI and 1-hour and 2-hour OGTT results (P < 0.05). Compared to women with good sleep quality, women with poor sleep quality (PSQI >5) had a greater risk of developing GDM (OR = 2.99, 95% CI 1.77 to 5.06). In women with sleep duration of less than 7 and more than 9 hours, the frequency of GDM was significantly higher than women with the 7-9 hour sleep duration (P < 0.05). Also, the frequency of GDM in women with three or more than three times of snoring in a week (63.44%) was significantly higher than women with once a week (30.61%) (P-value <0.001). CONCLUSION: It seems that sleep disorders and poor sleep quality can be a risk factor in developing GDM. Therefore, sleep characteristics should be considered in pregnancy care; especially in women with higher risk of GDM.

Prevalence, comorbidity and predictors of anxiety disorders among children and adolescents.

Childhood anxiety may lead to serious health consequences in later life. The present study provides the prevalence, comorbidity, and predictors of anxiety disorders among children and adolescents. This was a cross-sectional national project that was implemented on 28,698 children and adolescents in Iran. Participants entered the study by multistage cluster sampling with an equal number of each gender and three age groups (6-9, 10-14, and 15-18 years) within each cluster. The tools used in this research were the demographic questionnaire and K-SADS-PL. To analyze the data logistic regression and chi-square tests were used in SPSS (ver. 16). The prevalence of anxiety disorder in children and adolescents was 13.2 in boys and 15.1 in girls. Furthermore, gender, age, place of residence and history of psychiatric hospitalization of parents could predict anxiety disorders. Anxiety disorders had comorbidity with behavioral disorders, neurodevelopmental disorders, mood disorders, psychotic disorders, substance abuse disorders, and elimination disorders. According to our findings in this study, anxiety disorders affect the performance, health and life of children and adolescents, identifying the childhood anxiety, as well as finding diseases that are associated with anxiety disorders, can help in the prevention of the disorder.