Estimating Nephron Number from Biopsies: Impact on Clinical Studies.

BACKGROUND: Accumulating evidence supports an association between nephron number and susceptibility to kidney disease. However, it is not yet possible to directly measure nephron number in a clinical setting. Recent clinical studies have used glomerular density from a single biopsy and whole kidney cortical volume from imaging to estimate nephron number and single nephron glomerular filtration rate. However, the accuracy of these estimates from individual subjects is unknown. Furthermore, it is not clear how sample size or biopsy location may influence these estimates. These questions are critical to study design, and to the potential translation of these tools to estimate nephron number in individual subjects. METHODS: We measured the variability in estimated nephron number derived from needle or virtual biopsies and cortical volume in human kidneys declined for transplantation. We performed multiple needle biopsies in the same kidney, and examined the three-dimensional spatial distribution of nephron density by magnetic resonance imaging. We determined the accuracy of a single-kidney biopsy to predict the mean nephron number estimated from multiple biopsies from the same kidney. RESULTS: A single needle biopsy had a 15% chance and virtual biopsy had a 60% chance of being within 20% of the whole-kidney nephron number. Single needle biopsies could be used to detect differences in nephron number between large cohorts of several hundred subjects. CONCLUSIONS: The number of subjects required to accurately detect differences in nephron number between populations can be predicted on the basis of natural intrakidney variability in glomerular density. A single biopsy is insufficient to accurately predict nephron number in individual subjects.

Mapping kidney tubule diameter ex vivo by diffusion MRI.

Tubular pathologies are a common feature of kidney disease. Current metrics to assess kidney health, in vivo or in transplant, are generally based on urinary or serum biomarkers and pathological findings from kidney biopsies. Biopsies, usually taken from the kidney cortex, are invasive and prone to sampling error. Tools to directly and noninvasively measure tubular pathology could provide a new approach to assess kidney health. This study used diffusion magnetic resonance imaging (dMRI) as a noninvasive tool to measure the size of the tubular lumen in ex vivo, perfused kidneys. We first used Monte Carlo simulations to demonstrate that dMRI is sensitive to restricted tissue water diffusion at the scale of the kidney tubule. We applied dMRI and biophysical modeling to examine the distribution of tubular diameters in ex vivo, fixed kidneys from mice, rats, and a human donor. The biophysical model to fit the dMRI signal was based on a superposition of freely diffusing water and water diffusing inside infinitely long cylinders of different diameters. Tubular diameters measured by dMRI were within 10% of those measured by histology within the same tissue. Finally, we applied dMRI to investigate kidney pathology in a mouse model of folic-acid-induced acute kidney injury. dMRI detected heterogeneity in the distribution of tubules within the kidney cortex of mice with acute kidney injury compared with control mice. We conclude that dMRI can be used to measure the distribution of tubule diameters in the kidney cortex ex vivo and that dMRI may provide a new noninvasive biomarker of tubular pathology.NEW & NOTEWORTHY Tubular pathologies are a common feature of kidney disease. Current metrics to assess kidney health, in vivo or in transplant, are generally based on urinary or serum biomarkers and pathological findings from kidney biopsies. Diffusion MRI can be used to measure the distribution of tubule diameters in the kidney cortex ex vivo and may provide a new noninvasive biomarker of tubular pathology.

Image analysis techniques to map pyramids, pyramid structure, glomerular distribution, and pathology in the intact human kidney from 3-D MRI.

Kidney pathologies are often highly heterogeneous. To comprehensively understand kidney structure and pathology, it is critical to develop tools to map tissue microstructure in the context of the whole, intact organ. Magnetic resonance imaging (MRI) can provide a unique, three-dimensional view of the kidney and allows for measurements of multiple pathological features. Here, we developed a platform to systematically render and map gross and microstructural features of the human kidney based on three-dimensional MRI. These features include pyramid number and morphology as well as the associated medulla and cortex. In a subset of these kidneys, we also mapped individual glomeruli and glomerular volumes using cationic ferritin-enhanced MRI to report intrarenal heterogeneity in glomerular density and size. Finally, we rendered and measured regions of nephron loss due to pathology and individual glomerular volumes in each pyramidal unit. This work provides new tools to comprehensively evaluate the kidney across scales, with potential applications in anatomic and physiological research, transplant allograft evaluation, biomarker development, biopsy guidance, and therapeutic monitoring. These image rendering and analysis tools could eventually impact the field of transplantation medicine to improve longevity matching of donor allografts and recipients and reduce discard rates through the direct assessment of donor kidneys.NEW & NOTEWORTHY We report the application of cutting-edge image analysis approaches to characterize the pyramidal geometry, glomerular microstructure, and heterogeneity of the whole human kidney imaged using MRI. This work establishes a framework to improve the detection of microstructural pathology to potentially facilitate disease monitoring or transplant evaluation in the individual kidney.

Magnetic resonance imaging accurately tracks kidney pathology and heterogeneity in the transition from acute kidney injury to chronic kidney disease.

Acute kidney injury (AKI) increases the risk for chronic kidney disease (CKD). However, there are few tools to detect microstructural changes after AKI. Here, cationic ferritin-enhanced magnetic resonance imaging (CFE-MRI) was applied to examine the heterogeneity of kidney pathology in the transition from AKI to CKD. Adult male mice received folic acid followed by cationic ferritin and were euthanized at four days (AKI), four weeks (CKD-4) or 12 weeks (CKD-12). Kidneys were examined by histologic methods and CFE-MRI. In the CKD-4 and CKD-12 groups, glomerular number was reduced and atubular cortical lesions were observed. Apparent glomerular volume was larger in the AKI, CKD-4 and CKD-12 groups compared to controls. Glomerular hypertrophy occurred with ageing. Interglomerular distance and glomerular density were combined with other MRI metrics to distinguish the AKI and CKD groups from controls. Despite significant heterogeneity, the noninvasive (MRI-based) metrics were as accurate as invasive (histological) metrics at distinguishing AKI and CKD from controls. To assess the toxicity of cationic ferritin in a CKD model, CKD-4 mice received cationic ferritin and were examined one week later. The CKD-4 groups with and without cationic ferritin were similar, except the iron content of the kidney, liver, and spleen was greater in the CKD-4 plus cationic ferritin group. Thus, our study demonstrates the accuracy and safety of CFE-MRI to detect whole kidney pathology allowing for the development of novel biomarkers of kidney disease and providing a foundation for future in vivo longitudinal studies in mouse models of AKI and CKD to track nephron fate.

Synthesis and Expression of a Targeted, Ferritin-Based Tracer for PET Imaging of Kidney Glomeruli.

Cationic ferritin (CF) has been developed as a multimodal, targeted imaging tracer to directly detect and map nephrons in the kidney in vivo. Direct detection of functional nephrons provides a unique, sensitive biomarker to predict or monitor kidney disease progression. CF has been developed to map functional nephron number from magnetic resonance imaging (MRI) or positron emission tomography (PET). Previous preclinical imaging studies have used non-human-derived ferritin and commercial formulations that must still be developed for translation to clinical use. Here we describe the reproducible formulation of CF (either derived from horse or from human recombinant ferritin) optimized for intravenous injection and radiolabeling by PET. The human recombinant heteropolymer ferritin is spontaneously assembled in liquid culture (Escherichia coli, E. coli) and modified to form human recombinant cationic ferritin (HrCF) to mitigate potential immunologic reactions for use in humans.

Effects of motion and b-value on apparent temperature measurement by diffusion-based thermometry MRI: eye vitreous study.

PURPOSE: To make noninvasive measurements of temperature in the posterior chamber (vitreous) of the eye using diffusion-based thermometry (DBT) magnetic resonance imaging (MRI) and to explain variability in these measurements due to choice of b-value and the effects of motion. METHODS: Phantom studies of human vitreous and distilled water were performed using b-values from 0 to 1500 s/mm2 to determine the liquid-specific calibration factor for vitreous as well as to determine the temperature offsets due to sampling the diffusion curve using three higher routine clinical b-values (b = 0, 500, 1000 s/mm2 ) or four lower b-values (b = 0, 200, 400, 600 s/mm2 ), thought to be optimized for fluids. Retrospective ROI-based measurements of apparent diffusion coefficient on single slices as well as multi-slice histograms of the eyes were made in six patients with peri-orbital cellulitis and 11 age-matched controls, to assess for temperature changes in the presence of peri-orbital inflammation. A prospective study of ten repeated measurements of eye temperature using both high and lower b-value sampling was performed in ten asymptomatic volunteers to determine the reproducibility of eye temperature measurements in-vivo as well as to estimate vitreous temperature in the absence of motion. RESULTS: The diffusion coefficient of vitreous (2,088 ± 13 × 10-6 mm2 /s) was significantly lower (-1.9%, P < 0.001) compared to distilled water (2,128 ± 12 × 10-6 mm2 /s). The calibration factor for temperature measurements of vitreous using DBT is +0.74 ± 0.06°C. Temperature offsets were smaller (<-0.2°C, P < 0.01) when using larger routine clinical b-values to estimate the diffusion coefficient compared to using a series of lower b-values (<-1.0°C, P < 0.001). Two-dimensional single-slice ROI-based measurement showed significant temperature differences (ΔTI-C  = 2.5 ± 1.2°C, P < 0.001) between the eyes of patient with peri-orbital cellulitis, higher on the side of inflammation. There was no significant difference in eye temperature when using the 3D histogram (which is likely due to motion averaging as significant slice-to-slice variation was present). However, significant differences in the 3D temperature histograms between the two eyes was observed in one out of six patients. Prospective eye temperature measurements in healthy volunteers showed significant intra- and inter-subject variability (33.8-41.6°C), which was caused by eye motion. This resulted in +2.4°C cohort-wide elevation in temperature when three b-values were used and +4.7°C when four b-values were used. Using a pattern of elevated temperature at the periphery of the eye to detect motion, eye temperature is the absence of motion was estimated to be 34.5 ± 0.4°C with three higher b-values and 34.6 ± 1.9°C with four lower b-values; this temperature corresponds with prior mathematical simulations of eye temperature as well as boundary conditions. CONCLUSIONS: Globe vitreous temperature has been measured noninvasively using DBT MRI. Using routine clinical b-values of b = 0, 500 and 1000 s/mm2 produces acceptable (<-0.2°C) temperature offsets. Although DBT measurements are highly susceptible to motion, methods such as temperature differences or regression can be used to reduce or eliminate the effects of motion. Using a single clinical diffusion-weighted MRI, globe temperature difference of 1.6°C is pathological. Using a series of ten measurements, globe temperature differences larger than 0.6°C are abnormal. This study suggests CSF flow likely artifactually increases core brain temperature measured by DBT MRI.

Mapping vascular and glomerular pathology in a rabbit model of neonatal acute kidney injury using MRI.

Acute kidney injury (AKI) in premature neonates is common due to the administration of life-saving therapies. The impact of AKI on renal morphology and susceptibility to further renal damage is poorly understood. Recent advances in radiological imaging have allowed integration of soft tissue morphology in the intact organ, facilitating a more complete understanding of changes in tissue microstructure associated with pathology. Here, we applied magnetic resonance imaging (MRI) to detect both glomerular and vascular changes in a rabbit model of neonatal AKI, induced by indomethacin and gentamicin. Using combined spin-echo MRI and cationic ferritin enhanced gradient-echo MRI (CFE-MRI), we observed (a) an increased cortical arterial diameter in the AKI cohort compared to healthy controls, and (b) focal loss of vascular density and glomerular loss in a circumferential band ~1 mm from the cortical surface. This combined use of vascular and glomerular imaging may give insight into the etiology of AKI and its impact on renal health later in life.

Spiritual Well-Being and Associated Factors with Relapse in Opioid Addicts.

INTRODUCTION: Opioid dependence relapse is a complex and multidimensional problem, and lack of spiritual well-being is a major concern in opioid addicts. AIM: This study was conducted to determine spiritual well-being and factors associated with relapse among opioid addicts. MATERIALS AND METHODS: This cross-sectional study was conducted from April 2015 to September 2015. According to purposive sampling, 312 eligible addicted patients were enrolled in the study. The patients had at least an attempt of detoxification in the past six months and referred to an outpatient detoxification clinic in Shahrekord (Southwest, Iran). They completed Paloutzian and Ellison's Spiritual Well-being Scale. A researcher-developed questionnaire consisting of demographic characteristics and 20 questions about associated factors with relapse was administered. Data were analysed by version 16.0 (SPSS Inc.,Chicago, IL) using one-way ANOVA, Pearson's correlation test, chi-square, Friedman test, and student's t-test. RESULTS: The most important factors associated with opioid dependence relapse consist of relation with an addict friend, unemployment, living expenses, family conflicts, and somatic pain. In the present study, 157 patients had never experienced relapse while the mean of relapse in the rest participants was (3.25±1.53) times. Furthermore, the addicted patients with relapse had significantly lower scores of spiritual well-being and its subscales compared with non-relapse patients (p<0.001). CONCLUSION: The findings of the present study indicate the necessity of paying attention to spiritual well-being, family and economical, personal, and occupational factors as crucial factors in opiate addiction relapse.

The effects of an individual, multistep intervention on adherence to treatment in hemodialysis patients.

PURPOSE: The present study was conducted to investigate the effect of individual, multistep intervention on adherence to treatment in hemodialysis patients referred to a hemodialysis center in Shahrekord, Iran. METHOD: In this interventional study, hemodialysis patients referring the center of the study were randomly assigned into two control and intervention groups (each 33). The control group received routine treatment, recommended dietary and fluid restrictions. The intervention group participated in eight individual interventional sessions accompanied routine treatment. At the beginning and the end of the study, routine laboratory tests and end-stage renal disease-adherence questionnaire were filled out for patients in both groups. The data were analyzed using Mann-Whitney and Wilcoxon tests. RESULTS: At the end of the study, the two groups showed a significant difference in all domains of adherence except adherence to diet and adherence was better in the intervention group (p < 0.05). In demographic characteristic, only age indicated a positive correlation with adherence to dialysis program (p = 0.04, r = 0.254). After intervention, serum phosphorus decreased significantly in the intervention group (p < 0.05). CONCLUSIONS: Adherence to treatment is one of the major problems in hemodialysis patients; however, comprehensive interventions are required in view of individual condition. Implications for Rehabilitation Adherence to treatment means that all patients' behaviors (diet, fluids and drugs intake) should be in line with the recommendations given by healthcare professionals. There is evidence on the association between adherence to treatment and decreased risk of hospitalization in dialysis patients. Individual structured programs are most likely to be successful in encouraging adherence to treatment.

Prevalence of Nosocomial Diarrhea Due to Adenoviruses 40 and 41 in a Paediatric Ward in Iran.

BACKGROUND: Enteric adenoviruses 40 (Ad40) and adenovirus 41 (Ad41) have been shown to be a significant cause of paediatric gastroenteritis worldwide, but no data are available for nosocomial diarrhea due to adenovirus in Iran. AIM: The present study was performed to determine the incidence of Ad40 and Ad41 in children less than five years with nosocomial diarrhea in Shahrekord, southwest Iran. MATERIALS AND METHODS: Adenovirus was detected by polymerase chain reaction (PCR) in stool samples collected during one year (2010-2011) from children less than five years with nosocomial diarrhea admitted to a paediatric center in Shahrekord, Iran. Nosocomial diarrhea was defined as those occurring more than 72 hours after admission to hospital for non-diarrheal causes. PCR technique was used for investigation of Ad40 and Ad41. RESULTS: In total of 100 samples, Ad40 and Ad41 DNA was found to be positive in 14/100 (14%), and 8/100 (8%) of diarrheic patients less than five years, respectively. CONCLUSION: Ad40 and Ad41 are important causes of nosocomial diarrhea in less than five-year, hospitalized Iranian children.

Learning theories application in nursing education.

Learning theories are the main guide for educational systems planning in the classroom and clinical training included in nursing. The teachers by knowing the general principles of these theories can use their knowledge more effectively according to various learning situations. In this study, Eric, Medline, and Cochrane databases were used for articles in English and for the Persian literature, Magiran, Iran doc, Iran medex, and Sid databases were used with the help of keywords including social cognitive learning, learning theory, behavioral theory, cognitive theory, constructive theory, and nursing education. The search period was considered from 1990 to 2012. Some related books were also studied about each method, its original vision, the founders, practical application of the training theory, especially training of nursing and its strengths and weaknesses. Behaviorists believe that learning is a change in an observable behavior and it happens when the communication occurs between the two events, a stimulus and a response. Among the applications of this approach is the influence on the learner's emotional reactions. Among the theories of this approach, Thorndike and Skinner works are subject to review and critique. Cognitive psychologists unlike the behaviorists believe that learning is an internal process objective and they focus on thinking, understanding, organizing, and consciousness. Fundamentalists believe that learners should be equipped with the skills of inquiry and problem solving in order to learn by the discovery and process of information. Among this group, we will pay attention to analyze Wertheimer, Brunner, Ausubel theories, Ganyeh information processing model, in addition to its applications in nursing education. Humanists in learning pay attention to the feelings and experiences. Carl Rogers support the retention of learning-centered approach and he is believed to a semantic continuum. At the other end of the continuum, experiential learning is located with the meaning and meaningful. It applies the minds and feelings of the person. From this group, the main focus will be on the works of Rogers and Novels. Finally, it could be concluded that the usage of any of these theoriesin its place would be desired and useful.

Molecular characterization of nosocomial Clostridium difficile infection in pediatric ward in Iran.

Clostridium difficile is recognized as a major cause of nosocomial acquired antibiotic-associated diarrhea and pseudomembranous colitis. It is a significant financial burden on modern healthcare resources. This study aimed to assess the molecular characterization of C. difficile strains isolated from children under 5 years old suffered from nosocomial diarrhea. One hundred diarrheic and 130 non-diarrheic fecal samples were collected from pediatrics less than 5 years old. Samples were cultured and C. difficile isolates were subjected to the PCR technique to study the distribution of ribotypes of C. difficile using P3 and P5 primers. Fifty-two out of 100 samples (52 %) were positive for C. difficile. The prevalence of bacterium in healthy children was 4.61 %. Total prevalence of C. difficile in diarrheic girls and boys were 48.9 and 54.7 %, respectively. Thirteen to twenty-four month age children had the highest prevalence of C. difficile. The most commonly detected ribotypes in the C. difficile isolates of Iranian pediatrics were RT027 (11.52 %), R1 (9.61 %) and R13 (7.68 %). The ribotypes of all of the six bacterial isolates of healthy children was not diagnosed. According to the presence of C. difficile and R27 ribotype, a continued genotype surveillance of this bacterium is necessary to monitor changes in the prevalence of certain strains and to identify the emergence of new strains that could affect future vaccine strategies.

Prevalence and molecular characterization of rotaviruses as causes of nosocomial diarrhea in children.

Rotaviruses have been confirmed as causative agents of nosocomial gastroenteritis in children, but limited data exist concerning the epidemiology of nosocomial rotavirus gastroenteroentritis in Iran. The aim of this study was to determine the prevalence and molecular characteristics of rotavirus in children less than five years old with nosocomial diarrhea in Shahrekord (southwest of Iran).This cross-sectional study was conducted between December 2010 and October 2011. The study population consisted of children aged 6 to 60 months who were hospitalized in the pediatric ward of Hajar Hospital in Shahrekord, Iran, due to diseases other than diarrhea. Nosocomial diarrhea was defined as that occurring more than 48 hours after admission to the hospital for non-diarrheal causes. Rotavirus and G genotypes were determined by seminested reverse transcriptase polymerase chain reaction in 100 stool samples. In these 100 samples, the prevalence of rotavirus infection was 30%; the most common genotyes were G1 (20%) and G9 (20%). According to the findings of the study, genotyping of rotavirus is necessary to monitör changes in strain prevalence. Identifying strains over time could affect future vaccine strategies and detect any regional differences of genotype prevalence.

The effect of spouses' educational classes held for primiparous women referring to Hajar hospital on their quality of life and pregnancy outcomes.

BACKGROUND: With regard to the importance of quality of life in pregnant women, the present study aimed to determine the effect of spouses' educational classes held for primaparous women referring to Hajar hospital on women's quality of life and pregnancy outcomes. MATERIALS AND METHODS: This clinical trial was conducted from September 2011 to June 2012 in the clinic of the Hajar university center in Shahrekord. Eligible primiparous women who registered for physiologic delivery educational classes were randomly assigned to study (n = 31) and control (n = 27) groups. In the control group, eight physiologic delivery educational sessions were held. In the study group, in addition to attendance of pregnant women, their husbands also attended the third and the eighth sessions of these classes. Women's quality of life was investigated with SF36 questionnaire and pregnancy outcomes after delivery were investigated. Data were analyzed by t-test and Chi-square test. RESULTS: Before intervention, there was no significant difference between scores of quality of life and demographic characteristics (P > 0.05). After intervention, there was a significant difference only in the dimensions of mental health, hugging time, kissing, and breast feeding between the study and control groups (P < 0.05). There was no significant difference in gestational age, gravida, number of miscarriages, pregnancy outcomes, and spouses' age (P > 0.05). CONCLUSIONS: Educational classes held for the pregnant women's husbands during pregnancy can be efficient in promotion of pregnant women's quality of life, especially in improving their mental health.

A comparison of the efficacy of amoxicillin and nasal irrigation in treatment of acute sinusitis in children.

PURPOSE: The efficacy of antibiotic therapy for acute sinusitis is controversial. This study aimed to compare the efficacies of amoxicillin with nasal irrigation and nasal irrigation alone for acute sinusitis in children. METHODS: This randomized, double-blind, controlled study included 80 children aged 4-15 years with a clinical presentation of acute sinusitis. Patients were randomly assigned to receive either amoxicillin (80 mg/kg/day) in 3 divided doses orally for 14 days with saline nasal irrigation (for 5 days) and 0.25% phenylephrine (for 2 days) or the same treatment without amoxicillin. Clinical improvements in their initial symptoms were assessed on days 3, 14, 21, and 28. RESULTS: On day 3, patients in the amoxicillin with nasal irrigation group showed significant clinical improvement (P=0.001), but there was no significant difference in the degree of improvement between the amoxicillin with nasal irrigation and nasal irrigation alone groups during follow-up (P>0.05). In addition, no significant differences were seen in age, sex, and degree of improvement between groups (P>0.05). CONCLUSION: High-dose amoxicillin with saline nasal irrigation relieved acute sinusitis symptoms faster and more often than saline nasal irrigation alone. However, antibiotic treatment for acute sinusitis confers only a small therapeutic benefit over nasal irrigation.

Occupational therapy for inpatients with chronic schizophrenia: a pilot randomized controlled trial.

AIM: People with schizophrenia tend to experience difficulties in social and cognitive function, self-care, residual negative symptoms, high rates of unemployment, and social exclusion. Occupational therapy has contributed to the treatment and rehabilitation of people with severe mental health problems. Therefore, this study investigated the effects of occupational therapy on symptoms of patients with schizophrenia. METHODS: This survey was an experimental study in which positive and negative symptoms of patients with schizophrenia were assessed with a scale for the assessment of positive and negative symptoms (SANS, SAPS, respectively). The study was conducted in Sina Hospital, Shahrekord, Iran. The samples consisted of patients with schizophrenia who were divided randomly into intervention and usual treatment groups (30 patients in each group). The occupational therapy was performed in the intervention group for 18 h/week for 6 months. SANS and SAPS were assessed at the beginning and after 6 months of treatment. RESULTS: The groups were homogeneous in demographic variables, SANS and SAPS scores at baseline. The occupational therapy group showed significant improvement in the total score for the SANS and SAPS at 6 months (P<0.001), but the control group did not show any significant improvement. CONCLUSION: The results of this study indicated that occupational therapy combined with medications can improve the symptoms of schizophrenia.

Selenium and leptin levels in febrile seizure: a case-control study in children.

PURPOSE: Febrile seizures (FS) are seizures that occur between the age of 6 and 60 months, but its pathophysiology still is not fully understood. There is limited information about the correlation between levels of selenium and leptin with FS. This study aimed to determine the relationship between serum levels of selenium and leptin in children with FS. METHODS: This case-control study was conducted in a University Hospital in Shahrekord, Iran, in 2011. The serum levels of selenium and leptin of 25 children with simple febrile seizure (case group) were compared with 25 febrile children without seizure (control group) in acute phase and after three months. The levels of serum selenium and leptin were measured by flame atomic absorption spectrophotometer and enzyme-linked immunosorbent assay method, respectively. RESULTS: In acute phase, the mean serum level of selenium in case and control groups were 95.88±42.55 and 113.25±54.43 µg/dL, respectively, and difference was not significant (P=0.415), but after three months, this level had a significant increase in both groups (P<0.001). In acute phase, the mean serum leptin level in case and control groups were 0.94±0.5 and 0.98±0.84 ng/mL, respectively, but difference was not significant (P=0.405). After three months, serum leptin level had no significant change in both groups (P=0.882). CONCLUSION: These observations suggest that serum levels of selenium and leptin have not specific relation with FS but overllay is lower, however, further study is recommended. Also selenium level in stress and acute phase was significantly lower than recovery phase.

The Effects of Lavandula Angustifolia Mill Infusion on Depression in Patients Using Citalopram: A comparison Study.

BACKGROUND: Many herbs have been used to treat psychiatric disorders including anxiety and depression in traditional medicine. OBJECTIVES: This study was carried out to determine the effect of using Lavandula angustifilia infusion on depression in patients taking Citalopram. PATIENTS AND METHODS: Among all patients referred to the Hajar Hospital psychiatric clinic, Shahrekord, Iran, 80 patients who met the criteria of major depression according to the structured interviews and the Hamilton questionnaire for Depression were included in the study. They were randomly assigned into two groups of experimental treatment group and standard treatment group at this study. In standard treatment group, the patients were given Citalopram 20 mg. In experimental treatment group, the patients took 2 cups of the infusion of 5 g dried Lavandula angustifilia in addition to tablet Citalopram 20 mg twice a day. The patients were followed up for four and eight weeks of the study onset using Hamilton Scale questionnaire and treatment side effects form. Data were analyzed using student t-test, pair t-test and chi square. RESULTS: After four weeks of the trial onset, the mean depression score according to the Hamilton Scale for Depression was 17.5 ± 3.5 in the standard treatment group and 15.2 ± 3.6 in the experimental treatment group (P < 0.05). After eight weeks, it was 16.8±4.6 and 14.8±4 respectively (P < 0.01). In addition, the most commonly observed adverse effects were nausea (12.8 %) and confusion (10%). In terms of side effects, there were no significant differences between two groups. CONCLUSIONS: Considering the results of this study, Lavandula angustifilia infusion has some positive therapeutic effects on depressed patients most importantly decreases mean depression score and might be used alone or as an adjunct to other anti-depressant drugs.

The relationship between mental health and social solidarity among apartment residents in shahrekord, iran.

OBJECTIVE: To examine the relationship between psychological well-being and social solidarity of apartment residents in Shahrekord, Iran. METHODS: A sample of 200 apartment dwellers was selected randomly. Fessler Social Solidarity Inventory and General Health Questionnaire were used to gather data. RESULTS: Using partial correlation test and having controlled the effect of age, sex and education, we found significant relationship between mental health and social solidarity (r = 0.47; p= 0.023). After controlling education and marital status, it was also revealed that women were in a better solidarity situation compared to men (p< 0.05). CONCLUSION: There is a relation between the mental health and social solidarity of apartment residents in Sharekord. Good mental health accompanied with better social solidarity.

Citrus aurantium blossom and preoperative anxiety.

BACKGROUND AND OBJECTIVES: Reducing anxiety is very important before operation. Preoperative visit and use of premedication are popular methods to achieve this goal, but the role of anxiolytic premedication remains unclear and postoperative side-effects may result from routine premedication. Citrus aurantium is used as an alternative medicine in some countries to treat anxiety, and recently the anxiolytic role of this medicinal plant was established in an animal model study. The aim of this study was to assess the anxiolytic effect of Citrus aurantium blossomon preoperative anxiety. METHODS: We studied 60 ASA I patients undergoing minor operation. In a randomized double-blind design, two groups of 30 patients received one of the following oral premedication two hours before induction of anesthesia: 1) Citrus aurantium blossom distillate 1mL.kg(-1) (C-group); 2) Saline solution 1mL.kg(-1) as placebo (P-group). Anxiety was measured before and after premedication using the Spielberger state-trait anxiety inventory (STAI-state) and the Amsterdam preoperative anxiety and information scale (APAIS) before operation. RESULTS: After premedication, both the STAI-state and the APAIS scales were decreased in C-group (p<0.05); while exhibiting no significant changes in P-group. CONCLUSIONS: Citrus aurantium blossom may be effective in terms of reduction in preoperative anxiety before minor operation.