Physical, psychological, and social experiences of women recovered from COVID-19 in Iran: A qualitative study.

BACKGROUND: This paper aims to examine the impact of COVID-19 on various health aspects of women recovered from this disease in Ardabil province, Iran. MATERIALS AND METHODS: This qualitative study using a content analysis approach was carried out through in-depth individual and focus group discussion using semi-structured interviews schedule in 26 women during June and August 2021. Interviews were recorded, transcribed, and MAXQDA six-stage analysis framework. RESULTS: Negative consequences of COVID-19 were generally categorized into five main themes (including increased self-conscious excitement, perceived social stigma, depression, changes in behavioral patterns, and reduced level of quality of life) and 13 subthemes. The positive consequences were the following five themes (including the development of the spiritual attitude, increasing the importance of personal health, the rise of perceived support, increased sense of altruism, and increased financial management) and four subthemes. CONCLUSION: Based on the findings, it is concluded that effective support by the government, society, and the medical staff could help to relieve people's psychological and social stress through providing financial aid, the right information, and training.

Inflammatory markers and noncoding-RNAs responses to low and high compressions of HIIT with or without berberine supplementation in middle-aged men with prediabetes.

This study compared the capacity of two different models of HIIT [high-(HC) and low-(LC) compression], with or without the use of berberine (BBR), on NOD-like receptor pyrin domain-containing protein-3 (NLRP3), H19, interleukin (IL)-1ß, high-sensitivity C-reactive protein (hs-CRP), and insulin resistance markers. Fifty-four middle-aged men with overweight or obesity and prediabetes [fasting blood glucose (FBG) 110-180 mg/dL] were randomly and equally assigned to the HC, LC, HC + BBR, LC + BBR, BBR, and non-exercising control (CON) groups. The HC (2:1 work-to-rest) and LC (1:1 work-to-rest) home-based training programs included 2-4 sets of 8 exercises at 80%-95% HRmax, twice a week for 8 weeks. Participants in the berberine groups received approximately 1000 mg daily. All exercise interventions led to a significant reduction in hs-CRP, IL-1ß, insulin, FBG, and insulin resistance index (HOMA-IR) versus CON. Notably, there was a significant reduction in FBG and HOMA-IR with the BBR group compared to the baseline. Both NLRP3 and H19 experienced a significant drop only with LC in comparison to the baseline. While both exercise protocols were beneficial overall, LC uniquely exhibited more anti-inflammatory effects, as indicated by reductions in H19 and NLRP3. However, the addition of berberine to the exercise programs did not demonstrate additional benefits.

Spirulina supplement and exercise training affect lipid droplets-related genes expression in visceral adipose tissue.

Objective: Disruption of lipid droplets (LDs) is associated with many metabolic diseases. Spirulina, as a natural bioactive dietary supplement, along with exercise training, may improve lipid metabolism; however, their effects on LDs-regulated genes in visceral adipose tissue are still unclear. This study aimed to investigate the effects of six-week Spirulina supplementation along with exercise training on LDs regulating gene expression. Materials and Methods: Fifty-six male Wistar rats were divided into six groups: saline (control), control+Spirulina (Spirulina), aerobic interval training (AIT), AIT+ Spirulina (AIT+Spirulina), resistance training and resistance+ Spirulina. The supplement groups consumed 500 mg/kg Spirulina five days per week. The training groups performed AIT (5 times per week) and resistance training (3 times per week) for 6 weeks. LDs regulating genes expression in visceral adipose tissue (Zw10, Bscl2, DFCP1, Rab18, Syntaxin 18, Acsl3, and Plin2) was analyzed by real-time PCR. Results: Spirulina and exercise training had no significant effects on the gene expression of Syntaxin18 (p=0.69) and DFCP1 (p=0. 84), ACSL3 (p=0.98), or BSCL2 (p=0.58). In addition, Spirulina was found to significantly attenuate the expression of Plin2 (p=0.01) and Rab18 (p=0.01) genes compared to the control, AIT, and resistance training groups. However, Plin2 gene expression was higher in the resistance training than the AIT. Furthermore, Spirulina decreased ZW10 (p=0.03) gene expression in visceral adipose tissue compared to the control, AIT, and resistance training groups. Unexpectedly, Spirulina supplementation decreased the expression of these genes even more when taken without exercise training. Conclusion: Spirulina supplementation and exercise training have significant effects on LDs-regulated genes in visceral adipose tissue.

Estimating Hidden Population Size of COVID-19 using Respondent-Driven Sampling Method - A Systematic Review.

INTRODUCTION: Currently, the ongoing COVID-19 pandemic is posing a challenge to health systems worldwide. Unfortunately, the true number of infections is underestimated due to the existence of a vast number of asymptomatic infected individual's proportion. Detecting the actual number of COVID-19-affected patients is critical in order to treat and prevent it. Sampling of such populations, so-called hidden or hard-to-reach populations, is not possible using conventional sampling methods. The objective of this research is to estimate the hidden population size of COVID-19 by using respondent-driven sampling (RDS) methods. METHODS: This study is a systematic review. We have searched online databases of PubMed, Web of Science, Scopus, Embase, and Cochrane to identify English articles published from the beginning of December 2019 to December 2022 using purpose-related keywords. The complete texts of the final chosen articles were thoroughly reviewed, and the significant findings are condensed and presented in the table. RESULTS: Of the 7 included articles, all were conducted to estimate the actual extent of COVID-19 prevalence in their region and provide a mathematical model to estimate the asymptomatic and undetected cases of COVID-19 amid the pandemic. Two studies stated that the prevalence of COVID-19 in their sample population was 2.6% and 2.4% in Sierra Leone and Austria, respectively. In addition, four studies stated that the actual numbers of infected cases in their sample population were significantly higher, ranging from two to 50 times higher than the recorded reports. CONCLUSIONS: In general, our study illustrates the efficacy of RDS in the estimation of undetected asymptomatic cases with high cost-effectiveness due to its relatively trouble-free and low-cost methods of sampling the population. This method would be valuable in probable future epidemics.

The effect of foot bath on sleep quality in the elderly: a systematic review.

INTRODUCTION: Population aging is a problem that has affected most countries in the world. Poor-quality sleep is a common complaint among the elderly. Foot baths are a method of heat therapy and are performed as an independent nursing care in different departments. The present study was conducted with the aim of investigating the effects of foot baths with spa on improving the sleep quality of the elderly. METHODS: This research is a systematic review. We systematically searched six databases, including Google Scholar, PubMed, Web of Science, Scopus, Embase, and the World Health Organization databases, to retrieve the related articles based on the keywords used in our search strategy from 2010 to March 2023. RESULT: Finally, 10 articles were included in this study. All studies were randomized controlled trial (RCTs) and semi-experimental. In all 9 studies, the positive effects of the foot bath were reported. In 9 studies, the effect of foot baths with water above 40 degrees Celsius was reported. The PSQR questionnaire was used in most of the studies. CONCLUSION: The total findings of this study showed that due to the high prevalence of sleep problems in the elderly, foot baths with warm water can be used as an easy, simple, and safe nursing intervention to improve sleep quality. Therefore, it can be used in nursing homes and hospitals. It is also a non-pharmacological and inexpensive nursing intervention that can be implemented by the elderly themselves after training by community health nurses.

Design, development and evaluation of a mobile-based self-care application for patients with COVID-19 not requiring hospitalization; a study of Northwest of Iran.

BACKGROUND: Given the effective role of a mobile applications in disease management, disease monitoring, and self-care in patients with COVID-19 disease, we aimed to design, development and evaluation of a self-care Mobile app for COVID-19 patients not requiring hospitalization. METHODS: The design, development and evaluation the usability of the self-care and education mobile app for patients with COVID-19 disease were conducted in two main phases at 2021 in Northwest of IRAN; (1) Determine the features and capabilities and (2) Design, development and evaluation of self-care mobile App. JAVA programming languages and Android Operating System were used and selected to design and development of a mobile app. There were 25 participants who conducted evaluations of the mobile app's usability and impact using the mobile health app usability a Questionnaire of User Interface Satisfaction was administered to assess the usability of the developed application. The results were analyzed via Excel 2013. RESULTS: The model of developing a mobile app as an Information System was the Waterfall model. The smartphone application based on a set of capabilities and features was designed and consists of two main parts: the login screen for user registration, and the main home menu. The user interface includes three main pages or activities; (a) Main Menu for quick access to all of the pages, (b) Symptom management and monitoring to monitor the signs and symptoms during the illness, and (c) Set Reminders and Alarms to notify patients. The users' mean score of the application usability was calculated as 7.91 out of 9 indicating a good level of satisfaction. CONCLUSION: This app can be a guideline and a useful tools for managing and monitoring symptoms, reminding medications, and implementing self-care instructions in outpatients. The authors suggest evaluating the efficacy and functionality test of mobile-based applications for COVID-19 in clinical trial studies.

Hearing loss and COVID-19: an umbrella review.

INTRODUCTION: COVID-19 can result in an extensive range of extrapulmonary, and neurological signs and symptoms such as olfactory and/or taste dysfunction, and otologic symptoms. The aim of this study was to investigate the hearing loss manifestation from COVID-19. METHODS: The goal of this umbrella review was to examine hearing loss associated with COVID-19 disease. English literature published until October 15, 2022 in online databases including PubMed, Scopus, Web of Science, and Embase was considered for this purpose. Eligibility of the articles for subsequent data extraction was evaluated in a two-step selection process with consideration to an inclusion/exclusion criterion. This review followed the PRISMA protocol and the Amstar-2 checklist for quality assessment. RESULTS: A total of four treatment strategies were used by different studies which included oral corticosteroids, intratympanic corticosteroids, combined oral and intratympanic corticosteroids, and hyperbaric oxygen therapy. Five studies investigated corticosteroid use in the forms of oral or intratympanic injection; four studies reported (complete or partial) hearing improvements after steroid treatment, while one study stated no significant improvement in hearing function. One study reported that oral corticosteroid monotherapy alone was not effective, while vestibular symptoms were ameliorated by a combination of oral prednisone, intratympanic dexamethasone injection, and hydroxychloroquine. CONCLUSION: The findings suggest that despite being one of the rare complications of COVID-19, hearing loss can impact a patient's quality of life. The most common type reported was sensorineural hearing loss, which can be diagnosed with variable techniques.

Exercise-induced expression of SARS-CoV-2 entry receptors: impact of mask modality, sex, and exercise intensity.

BACKGROUND: Wearing a facemask affects physiological responses to exercise. We explored how exercising with a facemask affects the expression of SARS-CoV-2 entry receptor (angiotensin-converting enzyme 2 [ACE2]) and some associated genes (angiotensin type-1 receptors [AT1R]; Mas receptor [MasR]; hypoxia-inducible factor 1α [HIF-1α]; endothelial nitric oxide synthase [eNOS]) among healthy males and females. METHODS: One hundred forty-four apparently healthy individuals (72 females; age: 30±6) were allocated to three mask groups of 48 (N95, Surgical, No Mask) with two exercise subgroups for each mask for both sexes. Participants in each experimental group performed either a submaximal (walking with no grade) or maximal (a modified Bruce Protocol) treadmill exercise test. Blood samples were collected before and after each exercise test and used to analyze the mRNA expression of the genes studied. RESULTS: The post-exercise expression of genes examined were comparable between Surgical, N95, and No Mask (P>0.05). ACE2 was significantly greater in Surgical and N95 against No Mask at baseline and following moderate-intensity exercise (P<0.05). Whilst similar expressions were noted for MasR and eNOS (P>0.05), AT1R was greater in N95 than Surgical following high-intensity exercise (P<0.05). HIF-1α following either exercise intensity was significantly lower in N95 than Surgical (P<0.05). AT1R and HIF-1α were similar between Surgical and N95 against No Mask (P>0.05). ACE2 and AT1R were significantly higher in either mask modality than No Mask in males at baseline and postexercise (P<0.05). HIF-1α, MasR, and eNOS expressions were comparable between all mask groups in either sex (P<0.05). CONCLUSIONS: Our findings suggest that wearing a facemask does not differentiate the gene expression of SARS-CoV-2 entry receptor following exercise among both sexes.

Circulating endocannabinoid levels in pregnant women with gestational diabetes mellitus: a case-control study.

BACKGROUND: The role of the Endocannabinoids (ECs) in insulin resistance, and their association with visceral obesity and metabolic profile have been studied extensively. Since the association between ECs and metabolic factors in Gestational Diabetes Mellitus (GDM) are not clear, we aimed to evaluate the levels of N-Arachidonoylethanolamide (AEA) and 2-Arachidonoylglycerol (2-AG) and their association with C-reactive protein (CRP), glycemic indices, blood pressure, and anthropometric indices in pregnant women with GDM. METHODS: The present case-control study was conducted among 96 singleton pregnant women aged 18-40 years, including 48 healthy pregnant women (control group) and 48 women with a positive diagnosis of GDM (case group). Odds Ratios (ORs) and 95% Confidence Intervals (CIs) for GDM were checked according to endocannabinoids and anthropometric indices using Multivariable Logistic Regression. RESULTS: AEA was significantly associated with increased risk of GDM in models 1, 2 and 3 (OR = 1.22, 95% CI: 1.06-1.41; OR = 1.54, 95% CI: 1.19-1.97; OR = 1.46, 95% CI:1.11-1.91). A positive but no significant association was found for AEA in model 4 (OR = 1.38,95% CI: 0.99-1.92). Similar to AEA, 2-AG was also positively associated with the likelihood of GDM in Models 1, 2, and 3 but the association attenuated to null in model 4 (OR = 1.25; 95% CI: 0.94- 1.65). CONCLUSIONS: Our findings showed that levels of ECs were significantly higher in pregnant women with GDM compared to healthy ones. Also, ECs levels were associated with the likelihood of GDM, independent of BMI and weight gain.

Effect of date palm pollen supplementation on female sexual function in non-menopausal women: A double blind randomized clinical trial.

Objective: Despite numerous experimental studies in the literature, there are few clinical trials regarding the effect of date palm pollen (DPP) supplementation on sexual function improvement. In the present study, we sought to evaluate the impact of DPP on female sexual function in Iranian non-menopausal women. Methods: Between October 2019 and December 2019, health centers in the city of Khalkhal, volunteers meeting the inclusion criteria were recruited in randomized clinical trials. Sixty-eight women were randomly stratified and assigned to one of the two study groups: placebo group (n = 35) and palm pollen group (n = 35), and received a starch or palm pollen capsule (300 mg per day), respectively, for 35 d. The Female Sexual Function Index (FSFI) instrument was used to assess female sexual function. Results: After DPP supplementation, the increase in desire, lubrication, and the overall score, was statistically significant compared to the placebo group (P = 0.002, P = 0.000, and P = 0.042; respectively); Whilst there was no significant differences in the remaining domains (arousal: P = 0.763; orgasm: P = 0.370; satisfaction: P = 0.474; pain: P = 0.259). There was a statistically significant positive correlation between the coitus and preintervention levels of desire (r = 0.298, P = 0.038), arousal (r = 0.328, P = 0.021), lubrication (r = 0.361, P = 0.011), orgasm (r = 0.320, P = 0.025), satisfaction (r = 0.327, P = 0.022), and overall scores (r = 0.338, P = 0.018). Conclusion: This study suggests that DPP (300 mg supplementation for 35 d), given to non-menopausal women, could improve the lubrication and desire domains of FSFI.

Does wearing a mask while exercising amid COVID-19 pandemic affect hemodynamic and hematologic function among healthy individuals? Implications of mask modality, sex, and exercise intensity.

OBJECTIVES: We investigated how wearing a mask - and its modality (surgical vs. N95) - affect hemodynamic and hematologic function in males and females across two exercise intensities (submaximal (SUB) and maximal (MAX)). METHODS: 144 individuals participated in the present study and were randomly allocated to three mask groups of 48 (N95, SURGICAL, and NO MASK) with two exercise subgroups for each mask group (MAX, n = 24; SUB, n = 24) for both sexes. Participants in each experimental group (N95SUB, N95MAX; SURSUB, SURMAX; SUB, MAX) were assessed for their hemodynamic and hematologic function at baseline and during recovery after exercise. RESULTS: No significant differences were noted for either hemodynamic or hematologic function at post-exercise as compared to baseline with regard to mask modality (P > 0.05). Heart rate (HR) for maximal intensity were significantly greater at 1 min post-exercise in N95 as compared to SURGICAL (P < 0.05). No differences were noted for hemodynamic and hematologic function with N95 and SURGICAL compared to NOMASK for either intensity (P > 0.05). Females showed significantly greater HR values at 1 min post-exercise in N95 as compared to NO MASK, but no significant differences were noted for hematological function between sexes (P > 0.05). CONCLUSION: Our findings show that wearing a face mask (N95/surgical) while exercising has no detrimental effects on hemodynamic/hematologic function in both males and females, and suggest that wearing a mask, particularly a surgical mask, while exercising during the ongoing pandemic is safe and poses no risk to individual's health. Future studies examining physiological responses to chronic exercise with masks are warranted.

Interaction of miR-146a-5p with oxidative stress and inflammation in complications of type 2 diabetes mellitus in male rats: Anti-oxidant and anti-inflammatory protection strategies in type 2 diabetic retinopathy.

OBJECTIVES: This study aimed to evaluate the role of miR-146a-5p in the pathogenesis of diabetic retinopathy and its interaction with oxidative stress and inflammation in the ocular tissue of rats with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: Twenty adult male Sprague Dawley rats (220 ±20 g) were randomly assigned to control and diabetic groups. A high-fat diet was used for three months to induce T2DM which was confirmed by the HOMA-IR index. After that, the levels of glucose and insulin in serum, HOMA-IR as an indicator of insulin resistance, the ocular level of oxidative markers, TNF-α, IL-1ß, MIPs, and MCP-1 along with ocular gene expression of NF-κB, Nrf2, and miR-146a-5p were evaluated. RESULTS: The level of lipid peroxidation along with metabolic and inflammatory factors significantly increased and the antioxidant enzyme activity significantly decreased in diabetic rats (P<0.05). The ocular expression of NF-κB and TNF-α increased and Nrf2, HO-1, and miR-146a-5p expression decreased in diabetic rats (P<0.05). In addition, a negative correlation between miR-146a-5p expression with NF-κB and HOMA-IR and a positive correlation between miR-146a-5p with Nrf2 were observed. CONCLUSION: It can be concluded that miR-146a-5p may regulate Nrf2 and NF-κB expression and inflammation and oxidative stress in the ocular tissue of diabetic rats.

Ginger (Zingiber officinale roscoe) extract could upregulate the renal expression of NRF2 and TNFα and prevents ethanol-induced toxicity in rat kidney.

OBJECTIVE: Ginger has protective effects on the kidney, however the molecular mechanism of this effect has not yet been fully elucidated. Therefore, this work studied molecular mechanisms of ginger effects on ethanol-induced kidney injury. MATERIALS AND METHODS: Twenty-four male Sprague-Dawley rats were randomly divided into four groups: control, ginger (1 g/kg/day ginger extract by oral gavage), ethanol (4 g/kg/day ethanol by oral gavage) and ginger-ethanol group and treated daily for 28 days. Kidney function, expression of nuclear factor erythroid 2-related factor 2 (NRF2) and tumor necrosis factor (TNF)-α genes and oxidative stress parameters in kidney tissue, were evaluated. Total phenolic content (TPC) and 2, 2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity of ginger extract were also evaluated. RESULTS: Hydroethanolic extract of ginger showed a good level of DPPH scavenging activity and TPC. In the ethanol group, serum level of urea, creatinine and uric acid and the expression of NRF2 and TNF-α significantly increased compared to control group, while co-treatment with ginger in ginger+ethanol group significantly ameliorated them compared to the ethanol group. Ethanol exposure significantly reduced the activity of superoxide dismutase  (SOD), glutathione peroxidase (GPx) and catalase (CAT) compared to the control values ,while the level of malondialdehyde (MDA) significantly increased. Ginger significantly ameliorated the level of MDA and activity of SOD, GPx and CAT in the ginger-ethanol group compared to the ethanol group. CONCLUSION: The results showed that ginger's protective effects against ethanol renotoxicity were mediated via enhancing the NRF2 and TNF-α expression.

Safflower seed oil improves steroidogenesis and spermatogenesis in rats with type II diabetes mellitus by modulating the genes expression involved in steroidogenesis, inflammation and oxidative stress.

ETHNOPHARMACOLOGICAL RELEVANCE: Diabetes mellitus (DM), as a multiorgan syndrome, is an endocrine and metabolic disorder that is associated with male reproductive system dysfunction and infertility. Safflower (Carthamus tinctorius L.) as an herbal remedy improves DM and infertility-related disorders. The anti-hypercholesterolemic, anti-inflammatory, and antioxidative properties of this herb have been well documented, but its role in testosterone production, male reproductive system and zinc homeostasis has not been fully illustrated. AIM OF THE STUDY: This study aimed to investigate the preventive and therapeutic properties of different doses of safflower seed oil against reproductive damage caused by type II DM by investigating zinc element homeostasis, inflammation and oxidative damage in testis tissue and their relationship with testosterone production and sperm parameters. MATERIALS AND METHODS: Eighty adult male Sprague-Dawley rats were randomly divided into eight groups and treated daily for 12 and 24 weeks in protective and therapeutic studies, respectively. Type II DM was induced by a High Fat Diet (HFD) in normoglycemic rats for three months. At the end of each study, serum level of glucose, testosterone, gonadotropins, TNF-α, insulin, and leptin were measured. Moreover, antioxidant enzymes activity, lipid peroxidation, zinc and testosterone along with the expression of Nrf-2, NF-κB, TNF-α, StAR, P450scc, and 17ßHSD3 genes in the testis were detected. RESULTS: After the intervention, the activity of antioxidant enzymes and the level of testosterone and gonadotropins significantly decreased in the rats with DM in comparison to the others. However, lipid peroxidation and serum level of insulin, leptin and TNF-α increased and the testicular level of zinc significantly changed in the rats with DM compared to the control groups (p < 0.05). The gene expression of NF-κB and TNF-α were also significantly increased and the gene expression of Nrf2, StAR, P450scc and 17ßHSD3 were decreased in the testis of diabetic rats (p < 0.05). The results showed that pretreatment and treatment with safflower seed oil could improve these parameters in diabetic rats compared with untreated diabetic rats (p < 0.05). CONCLUSION: HFD could impair the production of testosterone and sperm, and reduce gonadotropin by increasing the serum level of leptin and inducing insulin resistance, oxidative stress and inflammation. However, safflower oil in a dose-dependent manner could improve testosterone level and sperm parameters by improving the level of leptin, zinc and insulin resistance, and the genes expression involved in testosterone synthesis, inflammation and oxidative stress.

Covid-19 effects on the workload of Iranian healthcare workers.

BACKGROUND: In this study, we aimed to evaluate the impact of the COVID-19 epidemic on the workload and mental health of Iranian medical staff using the General Health Questionnaire (GHQ-12) and NASA -Task Load Index (NASA-TLX) Questionnaire between March and April 2020, respectively. METHODS: The present cross-sectional study was conducted from March 5th to April 5th, 2020. To evaluate the workload and mental health of participants NASA-TLX and GHQ-12 online questionnaires were distributed. Data were entered into software SPSS (Version 23) and T-test, ANOVA, Regression methods were used for data analysis. RESULTS: Health workers who encountered COVID- 19 patients, were subjected to more task load compared to those who had no contact with COVID- 19 patients at the workplace (p <  0.001). In terms of the subscale score of NASA-TLX, nurses had more scores in mental pressure, physical pressure, time pressure (temporal), and frustration compared to the other jobs (p <  0.05). Moreover, nurses had significantly more workload compared to the other jobs. CONCLUSIONS: Type of job, the shift of work, educational level, and facing COVID-19 affected the score of NASA-TLX. NASA-TLX scores were higher in nursing compared to the scores of other health staff groups. The results of this study indicate that the scores of NASA-TLX and GHQ-12 among staff who had contact with COVID-19 patients were significantly higher than those who did not face COVID-19 patients. We suggested that a comprehensive assistance should be provided to support the well-being of healthcare workers especially nurses and healthcare workers who treated COVID-19 patients.

Footbath as a safe, simple, and non-pharmacological method to improve sleep quality of menopausal women.

Due to the adverse effects of medication we decided to provide a safe, economic, and easy intervention to decrease sleep problems in menopausal women. This trial aimed to determine the effect of footbath on sleep disturbance in postmenopausal women. One hundred menopausal women were randomly stratified using a permuted block randomization procedure by Random Allocation Software, and assigned to one of two study groups: control (without intervention, n = 50) and intervention (footbath, n = 50). The footbath group was asked to lie their feet into the warm water for 20 min in a container with a depth of 10 cm one hour before the usual sleeping time for 6 weeks. To assess sleep quality, we used the Pittsburgh sleep quality index (PSQI). To evaluate severity of menopause symptoms, the Greene scale was applied. Before the intervention, 96% of the subjects in the footbath group and 94% in the control group were poor sleepers. The results of analysis of covariance showed significant improvement in sleep quality and decrease in severity of menopause signs in the footbath group compared to the control group. At the baseline, there was a statistically significant correlation between the severity of menopause signs and the global score of PSQI in all study individuals (p ≤ .001, r = .464). The present study findings showed that footbath intervention enhanced sleep quality in menopausal women. Thus, footbath as a safe, simple, and non-pharmacological application can improve quality of life in postmenopausal women and inhibit problems due to inadequate sleep quality.

Ginger (Zingiber officinale Roscoe) extract can improve the levels of some trace elements and total homocysteine and prevent oxidative damage induced by ethanol in rat eye.

OBJECTIVE: Acute and chronic ethanol consumption cause oxidative stress and ginger improves suchconditions. In this study, the protective effects of ginger were studied on indices of oxidative stress, total homocysteinelevel and the level of the some of the oxidative stress-associated trace elements against toxicity induced by ethanol in rat eye. MATERIALS AND METHODS: Twenty-four adult male Sprague-Dawley rats were randomly allocated into four groups and treated daily for 28 days as follows: group I: control;group II: ginger (1g/kg/day ginger extract by oral gavage); group III: ethanol (4g/kg/day ethanol by oral gavage) and group IV: ginger+ethanol. At the end of the experimental period, eye tissue sera were used for determination of different parameters. Furthermore, in vitro antioxidant potential and total phenol content of ginger extract were determined. RESULTS: In ethanol group, significant changes in oxidative stress markers and levels of homocysteine and some trace elements, compared to other groups, were observed (p<0.05 for all cases). However,these parameters significantly ameliorated with pretreatment with ginger in ginger+ethanol group (p<0.05 for all cases), and had no significant differencesinthese parameters betweenginger and control group were found. CONCLUSION: It can be concluded that ginger extract has protective effects against toxicity induced by ethanol in the eye of male rat.

Exercise protects against ethanol-induced damage in rat heart and liver through the inhibition of apoptosis and activation of Nrf2/Keap-1/HO-1 pathway.

PROPOSE: Understanding the protective effect of exercise against ethanol-induced toxicity through the oxidative stress signaling pathway, apoptosis, and cholesterol metabolism is important to prevent development of cardiovascular diseases. METHODS: Thirty-two male Wistar rats were randomly divided into four equal groups as follow: control, exercise training (ET), ethanol (4 g/kg of body weight/day) and ET + ethanol. The ET and ET + Ethanol groups ran on the treadmill at 65% maximum running speed for 60 min for five sessions per week for eight weeks. The ethanol and ET + Ethanol groups received ethanol for eight weeks. At the end of the study, animals were anesthetized and blood and tissues were sampled to examine the biochemical and molecular evaluation. RESULTS: The results showed that the antioxidant enzymes activity decreased and MDA levels increased in the heart and liver of animals in ethanol group compared to control group. The levels of these oxidative biomarkers improved by ET in ET + Ethanol group compared to ethanol group. It showed that ET could protect the heart and liver against oxidative damage induced by ethanol through up-regulating the expression of the Nrf2/Keap-1/HO-1 pathway. ET could exert a cardioprotective effect on ethanol-induced apoptosis through down-regulating the Bax and the caspase-3 and via up-regulating the Bcl-2 expression in the heart. ET could also improve the impairment of cholesterol metabolism induced by ethanol. CONCLUSION: Exercise can protect against ethanol-induced toxicity through moderating the expression of genes which are involved in oxidative status, apoptosis and cholesterol metabolism.

Challenges Faced by Nursing Students to Work with Nursing Personnel: A Qualitative Study.

PURPOSE: Nursing is a practice-based discipline. Clinical education is one of the most important parts of nursing education; nurses play an important role in the learning of nursing students. This study was carried out to unveil the challenges of nursing students' learning through working with nurses. METHODS: A qualitative design was used to conduct the study in city of Khalkhal, Ardabil province, Iran. In order to collect data through purposive sampling, twenty students were interviewed using in-depth semi-structured individual techniques. Data analysis was done using MAXODA 12. RESULTS: Challenges of nursing students' learning were generally categorized into three main themes including inappropriate social norms, inadequate organizational atmosphere, and inadequate resources. CONCLUSION: It seems that inappropriate organizational culture in the clinical setting and wrong distribution of resources will lead to disruption of student-nurse relationships and ultimately disruption of clinical education.

Thyme oxymel by improving of inflammation, oxidative stress, dyslipidemia and homeostasis of some trace elements ameliorates obesity induced by high-fructose/fat diet in male rat.

OBJECTIVE: Thyme oxymel is a mixture of vinegar, sugar and thyme which is traditionally used in many folk medicines as syrup to treat metabolic disorders. The molecular mechanisms of anti-hyperlipidemic and anti-inflammatory and antioxidant effects of thyme oxymel or oxymel and its role on homeostasis of trace elements are not fully understood. The aim of this study was to evaluate the anti-inflammatory, antioxidant and anti- hyperlipidemic effects of different doses of thyme oxymel and oxymel on obesity induced by high-fat/-fructose diet (HFFD) in male rat. METHODS: Eighty adult male Sprague-Dawley rats were randomly divided into eleven groups and treated daily for 24 weeks. At the end of the study, serum levels of liver enzymes, lipid profiles, blood glucose, insulin, antioxidant enzymes and lipid peroxidation and TNF-α were measured. The hepatic oxidative biomarkers and the genes expression of SREBP-1c, CPT-1, Nrf-2 and NF-κB were also studied to determine the molecular mechanism involved in this disease. RESULTS: The results showed that HFFD could significantly change the level of oxidative biomarkers, lipid profiles, TNF-α, liver enzymes, leptin, insulin and the levels of some trace elements in obese rats compared to control group (p < 0.05), while pretreatment and treatment with thyme oxymel and oxymel in obese rats could significantly ameliorate them and bring some of them back to normal (p < 0.05).The molecular results also showed that HFFD significantly up-regulated the expression of SREBP-1c and NF-κB and down-regulated CPT-1 and Nrf-2 expression(p < 0.05). While, pretreatment and treatment with thyme oxymel or oxymel in obese rats could significantly ameliorate them (p < 0.05). CONCLUSIONS: It can be concluded that thyme oxymel or oxymel can alleviate HFFD-induced obesity through improving oxidative stress, inflammation, lipid metabolism, homeostasis of some trace elements, and weight-regulating hormones.