Effects of medicinal herbs on osteoporosis: a systematic review based on clinical trials

Osteoporosis is rapidly turning into a global epidemic, leading to high rates of morbidity and mortality due to the resulting complications such as osteoporotic fractures in older people. Therefore, this review investigated the findings of clinical trials regarding the effects of medicinal herbs on osteoporosis. To this end, several keywords were used to search for relevant articles indexed in the Institute for Scientific Information and PubMed, including "Osteoporosis" or "Bone loss" AND "medicinal plant" or "phyto*" or "herb*". Finally, 43 articles were included in the review. There are several mechanisms for anti-osteoporosis effects. Estrogen-like effects, especially soy phytoestrogenic compounds and other herbal compounds and formulations, can enhance bone formation markers, as well as antioxidant and anti-inflammatory capacity, while decreasing bone resorption biomarkers. Therefore, they can be used as complementary medicine for osteoporosis, especially in postmenopausal older women. However, for more reliable evidence, further studies are still needed because most studies have addressed soy, and the number of randomized controlled trials conducted on other herbal drugs is small. The plants possess the androgen-like properties that play an important role in the promotion of bone health. In addition, herbal treatments are supportive and slow-acting and thus such treatments are suggested for prevention and maintenance purposes rather than fast-acting treatments. Keywords: Medicinal herbs, Osteoporosis, Bone loss, Phytoestroge

Improving the capabilities of the physicians working in health care centers of Chaharmahal va Bakhtiari province for doing applied researches

زمینه و هدف: خارج کردن پژوهش از مرز دانشکده ها و انحصار دانشگاهیان و گسترش آن در میان پزشکان، کارشناسان و کاردان ها همواره مورد دغدغه خاطر مدیران سلامت بوده است. این مطالعه با هدف توانمند سازی پزشکان در انجام تحقیقات کاربردی انجام گرفت. روش بررسی: در این مطالعه نیمه تجربی 60 پزشک عمومی استخدام رسمی شاغل در مراکز بهداشتی درمانی استان چهارمحال و بختیاری انتخاب شدند (30 پزشک گروه شاهد 30 پزشک گروه مورد). با شرکت دادن گروه مورد در کارگاه های آموزشی، پزشکان با نحوه شناسایی و تعیین اولویت‌‌‌‌‌‌‌‌‌های بهداشتی و درمانی و تدوین یک پروژه تحقیقاتی مداخله‌‌‌‌‌ای آشنا شدند. پس از بدست‌‌‌‌ ‌‌‌‌آوردن آمادگی لازم برای اجرای پروژه تدوین شده در بازگشت به محل کار خود با اجرای پروژه ها مجدداً در کارگاه مرحله دوم شرکت نموده و ضمن ارایه نتایج‌‌ ‌‌‌‌‌‌‌‌‌‌پژوهش های انجام شده با نحوه‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌‌ نگارش مقاله علمی و سخنرانی و تهیه پوستر و انتشار نتایج آشنا شدند. قبل و پس از هر مرحله کارگاه از طریق پرسشنامه سنجش آگاهی هر دو گروه مورد و شاهد در مورد تدوین و اجرای پروژه تحقیقاتی (مرحله اول) و نحوه نگارش مقاله علمی تهیه پوستر و سخنرانی (در مرحله دوم) صورت گرفت. پس از اجرای طرح های فوق عملکرد دو گروه به کمک آزمون های مستقل و زوجی با همدیگر مقایسه گردید. یافته ها: میانگین نمره آگاهی گروه مورد قبل و بعد از مداخله در مورد تدوین و اجرای پروژه تحقیقاتی به ترتیب 24/0±23/6 و 35/2±97/12 بود (05/0

Effect of phenobarbital on nitric oxide level in term newborn infants with perinatal asphyxia

Perinatal asphyxia (PA) is very significant in perinatal medicine due to the involvement of the central nervous system. This study was conducted to investigate the biochemical, clinical, and paraclinical changes associated with phenobarbital administration in neonates with PA. Methods: In this prospective, case-control study, 30 neonates with PA in two groups of 15 each (case and control) were investigated. The case group received 20 mg/kg intravenous phenobarbital within six hours of birth, and the control group did not receive phenobarbital. Serum concentrations of nitric oxide (NO) were measured at enrollment and one week after birth in the two groups. Clinical, electroencephalography, and magnetic resonance imaging findings of the two groups were compared. Results: At enrollment, the two groups did not differ in clinical severity, seizure incidence, or NO concentration. After one week, NO concentration was significantly lower in the case group (p < 0.050), but there was no significant difference in other variables between the two groups. Conclusions: Early administration of phenobarbital in term neonates with PA could protect them against encephalopathy

Effect of a participatory intervention to reduce the number of unnecessary cesarean sections performed in Shahrekord, Iran

چکیده: زمینه و هدف: در سال های اخیر در کل جهان و از جمله ایران روند رو به رشد سزارین به چشم می خورد. در شهرکرد در سال 1380 سزارین 49 زایمان ها را به خود اختصاص داده است. در دنیا رویکرد جدیدی جهت کمک گرفتن از نیروهای مردمی در حل مشکلات سلامتی بوجود آمده است. در این تحقیق نقش مشارکت گروههای مردمی در کاهش میزان سزارین مورد بررسی قرار گرفته است. روش بررسی: در یک مطالعه میدانی (فیلد تریال) 171 زن باردار که سابقه قبلی سزارین نداشتند و کمتر از 3 بار زایمان داشته اند از زنان باردار به صورت تصادفی انتخاب شدند. ساختار یک گروه مردمی متشکل از پزشکان، ماماها، پرستاران علاقمند، زنان خانه دار، معلمین، رابطین بهداشتی، پرسنل بهداشت خانواده، خانم های فروشنده و نمایندگانی از سازمان های غیر دولتی فعال شهر شکل گرفت. این گروه، زنان باردار انتخاب شده را از طریق آموزش ترغیب به انجام زایمان طبیعی نمود. رضایت زنان باردار از آموزش ها و فراوانی سزارین قبل و بعد از مداخلات جمع آوری و با استفاده از آزمون های آماری t زوجی و مک نمار تجزیه و تحلیل گردید. یافته ها: در این مطالعه 70 زنان باردار از آموزش های ارائه شده راضی بودندو فراوانی سزارین از63 قبل از اجرای طرح به 52 بعد از انجام مداخلات کاهش داشت (05/0

Vitamin D and bone minerals status in the long-term survivors of childhood acute lymphoblastic leukemia

Background: Low vitamin D and diminished bone minerals with the potential for fractures are one of the nonapparent late effects of acute lymphoblastic leukemia (ALL). Chemotherapy and radiation were known as two important risk factors. We evaluated these late effects in ALL survivors who were treated with chemotherapy or chemo plus cranial radiation therapy. Methods: In a case-control study, 33 of ALL survivors who were treated with chemotherapy (Group A), and 33 subjects who were treated with chemoplus cranial radiation (Group B) were compared against 33 matched age, sex, and pubertal stage of their healthy siblings (Group C). Standard anthropometric data were collected as well as Tanner staging for puberty, number of fractures since treatment, serum calcium (Ca), phosphorus (P), magnesium (Mg), alkaline phosphatase, parathyroid hormone, and 25-hydroxyvitamin D (25(OH) D). The independent t-test, one-way ANOVA, Chi-square test, and Tukey′s test were used to analyze the data. Results: The findings indicated that the mean serum levels of 25(OH) D in ALL survivors (i.e. Groups A and B) with age mean score of 11.2 years and 12.3 years, average treatment length: 3.25 years and average time after treatment completion: 4 years, was lower compared to the controls group (12.94 ± 6.69, 14.6 ± 8.1, 20.16 ± 10.83, respectively, P 0.05). Other clinical and laboratory parameters had no significant differences between the survivors and control. Vitamin D deficiency (<20 ng/ml) was observed in 27% of group A and 24% of group B and vitamin D insufficiency (20-30 ng/ml) in 72.7% and 69.6% survivors of Group A and B and 48.5% of controls group (P = 0.003). Conclusions: ALL treatment is associated with the increase in prevalence of vitamin D insufficiency in the childhood ALL survivors and since the low vitamin D level potentially increases the risk of low bone density, subsequent malignancies, and cardiovascular disease in the survivors, close follow-up of such patients are highly recommended to prevent the stated complications