Molecular mechanisms of protection by dietary polyphenols against free fatty acid-induced mitochondrial dysfunction and endoplasmic reticulum stress in an in vitro model of non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is a public health burden. Steatosis as the “first hit”, and oxidative stress, inflammation, mitochondrial dysfunction, and endoplasmic reticulum stress as the “second hits” are the main contributors of the progression of fatty liver to non-alcoholic steatohepatitis (NASH). Dietary polyphenols have shown promise in protecting the liver against NAFLD. The relative effectiveness and mechanisms of different polyphenols however is mostly unknown. In this thesis HepG2 hepatocytes exposed to oleic or palmitic acid were used as a model system to explore the ability of selected polyphenols (resveratrol, quercetin, catechin, cyanidin, cyanidin-3-glucoside, berberine) from different classes to protect against molecular aspects of NAFLD and NASH. In an investigation of the “first hit” (Chapter 3), different polyphenols protected similarly against oleic acid-induced intracellular lipid accumulation, but differed in their effects on the expression of genes and proteins involved in lipogenesis, fatty acid oxidation, mitochondrial biogenesis, and bioenergetics. In an investigation of “second hits” (Chapter 4), most of the polyphenols decreased reactive oxygen species (ROS), prevented the decrease in uncoupling protein 2 (UCP2) mRNA, prevented the increase in tumor necrosis factor alpha (TNFα) mRNA, reversed decreases in mitochondrial biogenesis and increased expression of mitochondrial respiratory complexes and manganese superoxide dismutase (MnSOD). The anthocyanins were unique in decreasing ROS without inducing mitochondrial biogenesis or Mn-SOD mRNA expression. In investigations with palmitic acid (Chapter 5), exposure of HepG2 cells to palmitic acid induced endoplasmic reticulum (ER) stress evidenced by upregulated mRNA for the ER chaperones glucose-regulated protein 94 and 78 (GRP94, GRP78) and oxygen-regulated protein 150 (ORP150), cochaperone endoplasmic reticulum-localized DnaJ homologue 4 (ERdj4), and proapoptotic CCAAT-enhancer-binding protein homologous protein (CHOP). A few of the polyphenols (quercetin, catechin, cyanidin) protected against these changes. In a comparison of flavonoids with their phenolic breakdown/digestion products (Chapter 6), the polyphenols 2,4,6-trihydroxybenzaldehyde, protocatechuic acid, and caffeic acid protected similarly to quercetin and cyanidin against oleic and palmitic acid-induced steatosis and ROS generation. Moreover, in a short-term 1 h exposure (to limit spontaneous degradation in the medium), only breakdown/digestion products prevented an oleic acid-induced decrease of mitochondrial biogenesis. In conclusion, different classes of dietary polyphenols were all able to protect against steatosis and ROS generation in this in vitro model of NAFLD. Part of the mechanism for some polyphenols was through effects on mitochondrial biogenesis and function, bioenergetics, and ER stress. Phenolic breakdown/digestion products of flavonoids were shown to contribute to the protective effects of parent polyphenols

Complementa ry and alternative therapies to relie ve labor pain: A comparative stud y between music therapy and Hoku point ice massage

Background & aim: Pain is a comm on exper ience for women during labor. I n the present stu dy, w e compa red the effec t o f two types of non- pharm acologi cal pain relief metho ds “music therapy” and “Hok u point ice massage” on t h e severity of labor pain. Meth ods: This prospective, randomized, controlled trial wa s condu cted in Shah rekord, Iran, from September 2013 to June 2014 . We randomly assigne d 9 0 pri miparous women who expec ted a norma l chil dbirth into three groups: group “A” received mu sic therapy, group “B ” received Hoku point ice mass age, and group “ C” received usu al lab or care. At the beginn ing of the active phase (4 cm cerv ical dilation ) and before and af ter each in tervention (at dil ations 4, 6, and 8 cm), the intensities of lab or pain were meas ured using Visual An alogue Scale (VAS). Results: At the beginn ing of the ac tive pha se, the mean VAS scores were 5.58 ± 1.29, 5.4 2 ± 1. 31, and 6.13 ± 1. 37 in t h e women in groups “A,”“B,” and “C, ” respectively ( P > 0.05). Af ter the intervention , the mean pain scores were sign ifi cantly lower a t all of the time point s i n groups “ A” and “ B” than in group “C ” women (P 0.0 5). Conclu sions: Music therapy and Hoku point ice ma ssage are easily avail able an d i n expensive meth ods and have a si milar effect in relieving labo r pain. © 2015 Els evier Ltd. Al l rights reserved

Nurses' attitudes towards euthanasia: a cross-sectional study in Iran

Aim: Nurses have an important role in caring for terminally ill patients. They are often confronted with euthanasia but little is known about their attitudes towards it. The present study aimed to examine Iranian Muslim nurses' attitudes towards euthanasia. Methods: In this exploratory cross-sectional study, all qualified registered nurses working in two teaching hospitals (Kashani and Hajar hospitals) in Iran were invited to participate. The Euthanasia Attitude Scale (EAS) was used to assess the nurses' attitude towards euthanasia. Of 266 nurses who fit the criteria, 190 participated in the study (response rate 72.9%); 91.1% (n=173) were female and 8.9% (n=17) were male. Results: In total, 57.4%, 3.2% and 39.5% of nurses reported a negative, neutral and positive attitude to euthanasia respectively. Nurses reported their most negative attitude to the domain `practical consideration' with mean of 2.36 +/- 0.9 and most positive attitude to the domain `treasuring life' with a mean EAS score of 2.85 +/- 0.4. Conclusion: The majority of Muslim nurses were found to have negative attitudes to euthanasia. We recommend that future studies should be conducted to examine Muslim nurses' attitudes to euthanasia in different cultures to determine the role of culture and religious beliefs in attitude to euthanasia

Comparison Between Effects of Home Based Cardiac Rehabilitation Programs Versus Usual Care on the Patients’ Health Related Quality of Life After Coronary Artery Bypass Graft

Abstract Background & Aim: To compare home-based cardiac rehabilitation with usual care on the patients’ Health Related Quality of Life (HRQoL) after coronary artery bypass graft in patients with coronary artery bypass graft (CABG) surgery. Methods: In a randomized controlled clinical conducted from March 2013 to June 2013, 110 patients with CABG surgery were randomly assigned into two groups. While patients in group I, were received usual care and patients in group II, in addition to the usual care were received home-based cardiac rehabilitation programs. The 27-item MacNew Heart Disease HRQoL questionnaire was used to evaluate the patient’s HRQoL under and over 2 months after intervention. Results: At the time of 0, mean score of HRQoL was 67.86±7.5 and 64.76±8.4 in patients in group I and group II, respectively (P> 0.05). Although mean score of HRQoL in all patients in both groups increased two month after intervention, but this increase in patients in group II were higher than patients in group I (154.93±4.6 vs 134.20±8.2). This difference were statistically significant (P< 0.05). Conclusion: Quality of Life (QoL) can be considered as a quality indicator of health care systems. Results of present study showed that home-based cardiac rehabilitation program improved patients HRQoL after CABG surgery. Keywords: cardiovascular disease, chronic disease, home based rehabilitation program, health related quality of life, developing countr

Effect of dignity therapy model on stress, anxiety and depression of hemodialysis patients

A B S T R A C T Aim: Dignity therapy is a novel therapeutic approach to the treatment of psychological problems in patients under maintenance hemodialysis. The aim of this study was to determine the effects of dignity therapy model on stress, anxiety and depression of patients under maintenance hemodialysis. Methods: In a randomised controlled trial conducted from December 2013 to March 2014 in one hemodialysis center in Iran, 42 patients under maintenance hemodialysis were randomly assigned into two groups (control and intervention group). Patients’ level of stress, anxiety and depression were measured with using DASS-21 questionnaire before and one week after dignity therapy protocol implantation. Results: Before implementation of dignity therapy protocol, level of stress, anxiety and depression were high and similar in patients in both groups (p > .05). After implementation of dignity therapy protocol, level of stress, anxiety and depression significantly decreased in patients in dignity therapy group (p > .05) but not in patients in control group (p > .05). Conclusions: Level of stress, anxiety and depression among hemodialysis patients is high. Dignity therapy is an effective intervention for decreasing stress, anxiety and depression in this group of patients. Key Words: Dignity therapy, End stage renal disease, Maintenance hemodialysis, Psychological disorder

Sexual Self-concept and Its Relationship to Depression, Stress and Anxiety in Postmenopausal Women.

OBJECTIVES Women in menopause have the more mood swings than before menopause. At the same time seem to sexual self-concept and sexual aspects of self-knowledge has a great impact on their mental health. This study aimed to investigate the sexual self-concept and its relationship to depression, stress and anxiety in postmenopausal women's. METHODS In this descriptive correlation research, 300 of postmenopausal women referred to healthcare and medical treatment centers in Abadeh city were selected by convenience sampling method. The information in this study was collected by using questionnaires of multidimensional sexual self-concept and depression anxiety stress scale 21 (DASS-21). For data analysis, SPSS/17 software was used. RESULTS The results showed the mean score positive sexual self-concept was 41.03 ± 8.66 and the average score of negative sexual self in women's was 110.32 ± 43.05. As well as scores of depression, stress, and anxiety, 35.67%, 32.33% and 37.67% respectively were in severe level. Positive and negative sexual self-concept scores with scores of stress, anxiety, and depression, of post-menopausal women in the confidence of 0.01, is significantly correlated (P < 0.05). CONCLUSIONS Being stress, anxiety, and depression in severe level and also a significant correlation between increased stress, anxiety and depression with negative and weak self-concept of women's, it is necessary to devote more careful attention to mental health issues of women's and have appropriate interventions