Infertility and physical activity: A cross-sectional study of women living in Yazd aged 20-49 yr, 2014-2015

Background: Changes in the state of energy balance owing to changes in physical activity (PA) may affect the reproductive system. Objectives: the aim of this study was to assess the association between PA and infertility of women living in Yazd 2014 - 2015. Materials and Methods: The study method was analytical cross-sectional on the Yazd Health Study (YaHS) data which was conducted on 10,000 people. We studied 2,611 women (20 and 49 yrs old), living in Greater Yazd area. PA information was collected using a physical activity questionnaire (IPAQ) short form. The standardized instruments were used for anthropometrics measurement. Results: Totally 135 cases of infertility were documented. The overall prevalence of infertility was 4.73% (95% CI: 3.94-5.59%). The median of PA scores (METs) in women was 746.66 and 25-75% interquartile range was 361.25-1277.25. The relationship according to the Chi-square test between infertility and PA, as categorized variables, was significant (p = 0.015). It showed over 90% of those who suffered from infertility had a low or moderate PA. Conclusion: The results of our study showed that there is a significant relationship between infertility and PA level in women living in Greater Yazd area. Also, women with infertility had lower activity levels, consistent with most previous studies. Key words: Women, Infertility, Physical activity, Yazd, Iran

Hypoglycemic Effect of Aqueous Shallot and Garlic Extracts in Rats with Fructose-Induced Insulin Resistance

The present study has been carried out to investigate the effect of aqueous extract of shallot (Allium ascalonicum) and garlic (Allium satium) on the fasting insulin resistance index (FIRI) and intraperitoneal glucose tolerance test (IPGTT) of fructose-induced insulin resistance rats. Male albino Wistar rats were fed either normal or high-fructose diet for a period of eight weeks. Fasting blood glucose level, fasting blood triglyceride level, FIRI, and the area under the glucose tolerance curve were significantly elevated in fructose-fed animals. Fructose-induced insulin resistance rats treated by aqueous shallot or garlic extract (500 mg/kg body weight/day, i.p.) for duration of eight weeks. Control animals only received normal saline (0.9%). The results showed that neither shallot nor garlic extracts significantly altered the FIRI and the IPGTT at the fourth week after treatment. The fasting blood glucose in fructose-induced insulin resistance animals has been significantly decreased in 8-week treated animals by both shallot and garlic extracts. Shallot extract administration, but not garlic extract, for a period of eight weeks can significantly improve the intraperitoneal glucose tolerance and diminish the FIRI. These results indicate that shallot and garlic extracts have a hypoglycemic influence on the fructose-induced insulin resistance animals and aqueous shallot extract is a stronger hypoglycemic agent than the garlic extract

Regression of nonalcoholic fatty liver disease detected by sonography: Results of a four years prospective adult population-based study

Background: Today, nonalcoholic fatty liver disease (NAFLD) has become a major health problem owing to its high prevalence. Literature evidence about regression of NAFLD are not as high as its development or progression. Objectives: This cohort study was conducted to reveal the factors influencing the regression of the NAFLD. Methods: A population-based study conducted in Shiraz, Iran. Adults older than 18 years were recruited by multistage randomized sampling in 2012, and then in 2017. Demographic, anthropometric, nutritional, and medical characteristics of each interviewee were entered into a valid and reliable questionnaire. Interviewees were categorized into three groups according to the changing of their NAFLD status between two stages of this study; no change, regressed and progressed. Results: Of the 537 participants, 163 (30.3%) showed regression of their NAFLD compared to 93 (17.3%) that their NAFLD was progressed. Multinomial regression showed that each unit of decrease in BMI (∆ BMI=-1 kg/m2 ) augmented the relative risk (RR) of improvement of NAFLD by 13.3% (RR: 0.867; 95% CI: 0.776-0.969; P = 0.012) and reduced the relative risk of NAFLD deterioration by 14.3% (RR: 1.143; 95% CI: 1.009-1.294; P = 0.035). Conclusions: A significant portion of patients showed regression of their NAFLD by decreasing their BMI. Therefore, BMI as a modifiable variable should be regarded in the management of NAFLD patients Keywords: Non-Alcoholic Fatty Liver, Regression, Progression, Cohort Stud

Unveiling the Fifth State of Matter: Insights into Ultra-Hot Plasma and its Applications

In this work, we investigate the dissociation energy of the North (N) and South (S) poles of a quantum magnetic particle, incorporated within both classical and quantum mechanical perspectives. A simple model of a harmonic oscillator is employed to estimate the dissociation energy of the N-S poles, as well as the corresponding breakdown temperature and internal pressure. The results indicate that the separation of magnetic poles occurs in two states: (a) in an ultra-hot plasma medium with extremely high temperatures, such as in the core of a hot star, and (b) at extremely high pressures, such as between internal plates in complex superlattices of layered solids. The breakdown temperature is found to be of the order of $10^7$ to $10^8$ Kelvin, which is only achievable in an ultra-hot plasma environment, known as the fifth phase of matter. Based on this model, the possibility of dissociation of bonds between N and S magnetic poles for solid superlattices under very high pressures between crystal plates is also calculated. The results suggest that the presence of isolated magnetic monopoles in superlattices of solids under ultra-high-pressure conditions is possible. Consequently, the model proposes that the conductivity of magnetic monopole carriers can be applied to the manipulation of nanomaterials for the production of advanced devices, such as new generations of superconductors, new spin devices, and magnetic-electronics, advanced materials with magnetic monopoles, as well as super-dielectrics.Comment: 15 pages, 6 figures. Accepted for publication in the International Journal of Modern Physics

Koncept opstrukcije portalnog sustava u Aviceninu kanonu medicine

Historical literature on portal hypertension is mainly focused on the contemporary advances in therapeutic methods, especially surgical ones. However, it seems that the origin of the human knowledge on the portal system, its association with the caval system, obstructive pathologies in this system and the gastrointestinal bleeding due to hepatic diseases might be much older than previously believed. Avicenna provided a detailed anatomy of the portal venous system and its feeding branches in the Canon of Medicine. Soddat al-Kabed va al-Masarigha (liver and mesenteric occlusion) is also a disease presented by Avicenna with clinical, etiological and therapeutic descriptions suggesting the fact that Soddat al-Kabed va al-Masarigha has multiple similarities with the currently identified concept of “portal hypertension”. He presented sense of heaviness in the liver area with or without mild pain, anemia, pale and inappropriate body color, and loose stool which can be complicated with ascites, infection, fever and abdominal pain as clinical manifestations of this disease. He has also suggested therapeutic approaches including laxative and diuretic herbs to help excreting the obstructive material into stool or urine.Povijesna literatura o portalnoj hipertenziji uglavnom je usredotočena na suvremeni napredak u terapijskim metodama, posebice kirurškim. Čini se, međutim, da ljudsko znanje o portalnom sustavu, njegovo povezivanje sa sustavom šuplje vene, patologije opstrukcija u tom sustavu i gastrointestinalno krvarenje zbog bolesti jetre može biti znatno starije nego što se prije vjerovalo. Avicenna je dao detaljnu anatomiju portalnoga venskog sustava i njegovih grana u Kanonu medicine. Soddat al-Kabed va al-Masarigha (jetra i okluzija mesenterijskih žila) bolest je koju je Avicenna predstavio kliničkim, etiološkim i terapeutskim opisima koji upućuju na to da ima puno sličnosti s identificiranim pojmom “portalne hipertenzije”. Avicenna je istaknuo osjećaj težine u području jetre s blagom boli ili bez nje, anemiju, blijedu i neodgovarajuću boju tijela te mekanu stolicu koja se može zakomplicirati ascitesom, infekcijom, groznicom i bolovima u trbuhu kao kliničkim manifestacijama ove bolesti. Predložio je i terapeutske pristupe, uključujući laksativ i diuretičke trave, kako bi se izbjeglo izlučivanje opstruktivnih tvari u stolici ili urinu

Mucosal interleukin-21 mRNA expression level is high in patients with Helicobacter pylori and is associated with the severity of gastritis

Helicobacter pylori (H. pylori) infection is associated with gastritis and marked infiltration of the gastric mucosa by several cytokines secreting inflammatory cells. Different clinical forms of the infection may reflect distinctive patterns of cytokine expression. Interleukin (IL)-17, IL-21, IL-22, and IL-23 have been reported to be involved in H. pylori-induced gastric mucosal inflammation, but the details and relationship to different patterns of inflammation and virulence factors remain unclear. The present study was launched to analyse IL-6 expression in H. pylori-infected and uninfected gastric patients and to investigate its correlation with chronic gastritis among H. pylori-infected patients. Total RNA was extracted from the gastric antrum biopsies of 48 H. pylori-infected patients and 38 H. pylori uninfected patients. Mucosal IL-21 mRNA expression level in H. pylori-infected and uninfected gastric biopsy was determined by real-time PCR. The presence of vacA (vacuolating cytotoxin A) and cagA (cytotoxin associated gene A) virulence factors were evaluated using PCR. Interleukin-21 mRNA expression was significantly high in biopsies of H. pylori-infected patients compared to H. pylori uninfected patients, and the mucosal IL-21 mRNA level was positively correlated with the grade of chronic inflammation. There was no association between virulence factors and IL-21 mRNA expression. We believe that IL-21 might be involved in the pathogenesis of H. pylori and might be an index of the severity of chronic gastritis

Determinant components of newly onset versus improved metabolic syndrome in a population of Iran

This study aimed to determine the risk factors related to regression and progression of metabolic syndrome, in a 4-year cohort study. A total of 540 individuals (≥ 18 years old) participated in both phase of the study. Participants were categorized into 3 categories of regressed, progressed and unchanged metabolic syndrome (MetS). Demographic, anthropometric and biochemical parameters were assessed for each individual in both phase. Variables differences (delta: Δ) between the two phase of study were calculated. Unchanged group was considered as baseline category. Based on IDF, MetS had been regressed and progressed in 42 participants (7.7%) and 112 (20.7%) participants respectively, in the second phase. More than 47% of people, whose MetS regressed, experienced also NAFLD regression. Results of multiple variable analysis revealed that increased age, positive Δ-TG, and Δ-FBS, significantly increased the odds of MetS progression based on IDF and ATP III definitions, while negative Δ-HDL and Δ-neutrophil to lymph ration increased the odds of progression. On the other hand, negative Δ-TG and positive Δ-HDL significantly increased the odds of Mets regression based of both IDF and ATP III. Management of hypertriglyceridemia, hyperglycemia, and HDL is a critical, non-invasive and accessible approach to change the trend of Met

Violence against Nurses: A Neglected and Health-threatening Epidemic in the University Affiliated Public Hospitals in Shiraz, Iran.

BACKGROUND: Nurses are more likely to be exposed to violence at their workplace in comparison with other employees. OBJECTIVE: To determine various aspects of violence against nurses in Shiraz public hospitals. METHODS: This cross-sectional study was conducted from 2017 to 2018, using a multistage random sampling method. Violence including verbal threats, verbal abuse, physical and sexual abuse as well as ethnical types, violence from patients, patients' companions and coworkers, and causes of violence were investigated using a checklist. RESULTS: 405 nurses with a mean age of 30.2 (SD 7.1) years and female to male ratio of 4.2 were interviewed. 363 (89.6%) nurses had experienced at least one kind of violence; 68.4% suffered from more than one type of violence. Verbal abuse (83.9%), verbal threats (27.6%), physical violence (21.4%), sexual abuse (10.8%), and ethnical harassment (6.1%) were the most common types of violence experienced by the nurses. Patients' companions, patients, and physicians were reported as the sources of violence in 70.6%, 43.1%, and 4.1% of cases, respectively. Nurses with non-official employment status and non-Farsi ethnicity, having a disease, with non-evening shift work, and those with short or long employment period were more affected. Unrealistic expectations by patients' companions and long working hours were the most common attributing factors. CONCLUSION: Violence against nurses, as a strenuous and health-threatening crisis, has become epidemic in public hospitals in our region. Effective interventions are warranted to sort out these problems. KEYWORDS: Hospitals; Nurses; Patients; Physicians; Violenc

The challenges of urban family physician program over the past decade in Iran: a scoping review and qualitative study with policy-makers

Introduction: Despite all the advantages of urban family physician program (UFPP), there is still a gap between UFPP and what is actually achieved by the community after its implementation in Iran. In response, this study attempted to review published studies related to the barriers to the implementation of the UFPP in Iran as well as potential solutions to improve it. Further, a qualitative study was conducted to learn the perspectives of experts at the national level and in the Fars province in order to better understand the program's challenges. Methods: This study was conducted in two phases. First, a scoping review was done, aiming to identify the common barriers and potential solutions to implementing UFPP in Iran. Second, a qualitative study using semi-structured interviews was conducted to investigate the views of decision- and policy-makers regarding barriers to and solutions for implementing the UFPP in the Fars province over the last decade. The findings were classified using the five control knobs framework (Organization, financing, payment, regulation, and behavior).  Results: The most common barriers to UFPP were: 1) organization (ununited stewardship function of the Ministry of Health, weak management and planning, inadequate training of human resources, and a weak referral system); 2) financing (fragmented insurance funds, insufficient financial resources, and instability of financial resources); 3) payment (inappropriate payment mechanisms and delay in payments); 4) regulation (cumbersome laws and unclear laws); and 5) behavior (cultural problems and conflict of interests). On the other hand, several solutions were identified to improve the implementation of UFPP, including: enhancing the role of government; improving the referral system; providing comprehensive training for UFPP providers; considering sustainable financial resources; moving towards mixed-payment mechanisms; employing appropriate legal and regulatory frameworks; enhancing community awareness; and elevating incentive mechanisms. Conclusion: Our research found that, despite the UFPP having been in place for a decade in Iran, there are still significant challenges in all five components. Therefore, the promotion of this program requires solving the existing implementation challenges in order to achieve the predetermined goals. The ideas in this study can be used to improve the current program in Fars Province and bring it to other cities in Iran