Determination of phenolic compounds in Pinus eldarica by HPLC

The antioxidant components have been identified in some pine species. Antioxidant properties of proantocyanidins reduce free radicals induced by DNA fragmentation and lipid proxidation and also proanthocyanidines could curb lipid peroxidation. In this study, we analyzed different parts of Pinus eldarica [bark, seed and needle] and assessed their antioxidant contents. Pine specimens were collected from four different geographic locations in Tehran. The HPLC method [UV detector, C[18] reverse phase column, 4.6 mm [25 cm, and water/ H[3]PO[4]/ methanol/ acetonitril as eluant] were employed for evaluating total polyphenols. The wavelength for detection of polyphenolic compounds was 280 nm in this study. The highest range of total polyphenols was detected in the bark of this pine, specially reported a considerable amount of tyrosol in Pinus eldarica. Tyrosol stimulated resistance to oxidative stress and also has anti aging effect. The high amount of total phenolic compounds in P. eldarica bark might be attractive for future research considering its health benefits

code of ethics for nurses

Nurses are ever-increasingly confronted with complex concerns in their practice. Codes of ethics are fundamental guidance for nursing as many other professions. Although there are authentic international codes of ethics for nurses, the national code would be the additional assistance provided for clinical nurses in their complex roles in care of patients, education, research and management of some parts of health care system in the country. A national code can provide nurses with culturally-adapted guidance and help them to make ethical decisions more closely to the Iranian-Islamic background. Given the general acknowledgement of the need, the National Code of Ethics for Nurses was compiled as a joint project [2009-2011]. The Code was approved by the Health Policy Council of the Ministry of Health and Medical Education and communicated to all universities, healthcare centers, hospitals and research centers early in 2011. The focus of this article is on the course of action through which the Code was compiled, amended and approved. The main concepts of the code will be also presented here. No doubt, development of the codes should be considered as an ongoing process. This is an overall responsibility to keep the codes current, updated with the new progresses of science and emerging challenges, and pertinent to the nursing practice

Implementation of patient's rights charter: a report from ministry of health and medical education, Iran

At the aim of explaining the rights of health care recipients and upgrading ethical observance in the field of treatment -the most important field of health care-, the Patient's Rights Charter was declared by Ministry of Health and Medical Education to all medical universities in September 2009. This paper provides a report of strategic planning for implementation of Patient's Rights Charter and a summary of other projects

Health system vision of Iran in 2025

Vast changes in disease features and risk factors and influence of demographic, economical, and social trends on health system, makes formulating a long term evolutionary plan, unavoidable. In this regard, to determine health system vision in a long term horizon is a primary stage. After narrative and purposeful review of documentaries, major themes of vision statement were determined and its context was organized in a work group consist of selected managers and experts of health system. Final content of the statement was prepared after several sessions of group discussions and receiving ideas of policy makers and experts of health system. Vision statement in evolutionary plan of health system is considered to be: "a progressive community in the course of human prosperity which has attained to a developed level of health standards in the light of the most efficient and equitable health system in visionary region[1] and with the regarding to health in all policies, accountability and innovation". An explanatory context was compiled either to create a complete image of the vision. Social values and leaders' strategic goals, and also main orientations are generally mentioned in vision statement. In this statement prosperity and justice are considered as major values and ideals in society of Iran; development and excellence in the region as leaders' strategic goals; and also considering efficiency and equality, health in all policies, and accountability and innovation as main orientations of health system

Intersectoral collaboration to develop health equity indicators in Iran

Health equity is considered as one of the main objectives of health care systems. This study was carried out with the aim of determining health equity indicators in Iran. Through consideration of these indicators, differences in health status of different social groups and different geographical areas can be shown in different periods and based on that, effective interventions can be designed. This study is carried out through a main workshop and expert panels and final consensus on selected indicators. The first draft of indicators and inequity stratifying variables were prepared and then revised by working groups consisting of experts inside and outside Health system. Finally ideas were accepted or rejected after presenting enough reasons and deep examination through the Consensus-Oriented Decision-Making [COMD] model. Fifty two indicators have been determined as health equity indicators in five areas including health, social and human development, economic development, physical environment and infrastructure and governance. Furthermore, for each indicator the proper and practical stratifying variables of inequity were identified. By calculating such indicators, it becomes possible to determine differences in health status of different social groups and different geographical areas

Health in the 5[th] 5-years development plan of Iran: main challenges, general policies and strategies

Access to the right to the highest attainable level of health is a constitutional right that obliges governments and other players to take step to increase all individuals' chances of obtaining good health. At the least, health and education are two crucial requirements for this as well. Iran's vision 2025 is going to lead the country to a developed state with the highest rank of economic, scientific and technological status in the region. Enjoying health, welfare, food security, social security, equal opportunities, etc, are also considered as part of characteristics of Iranian society in 2025. Although health system of Iran has many achievements in providing health services specially for the poor following the Islamic Revolution of 1979, but the evidences gathered to develop the 5[th] 5-years economical, social and cultural plan [5[th] 5YDP:2011-2015], listed a variety of main challenges in stewardship, financing, resources generation and service provision functions of the existing health system. Thus, to overcome the main challenges, about 11% of general policies of 5[th] 5YDP are directly address health related issues with emphasizing on healthy human and comprehensive health approach with considering: Integration of policy making, planning, evaluation, supervision and public financing; Developing both quantity and quality of health insurance system and reducing out-of-pocket expenditures for health services to 30% by the end of the 5[th] plan. The strategies of 5[th] 5YDP adopted by the parliament as an Act will change the health system fundamentally through tuning the main drivers; so, its implementation needs brave leaders, capable managers, motivated technical staff and social mobilization

Iranian health research networks and vision of Iran by 2025: a case of virtual health network in EMRI

The present paper aims to explore the role of Health Research Networks [HRN] in facilitating and expedite achieving the prospects for goals of health research based on the visions of Iran by 2025. Aiming to the main function of HSR to achieve the targeted conducting of health sciences research; more cooperation and coordination between health science researchers; avoid parallel investigations; and optimum utilization and appropriate distribution of resources, in 2000 the deputy of Research and Technology of Ministry of Health and Medical Education defined and developed a comprehensive HRN. There are currently 27 research networks operating under the supervision of the Deputy of Research and Technology at MOHME. All of the HRN policies are following based on their strategic planning's which are extracted from national visions of Iran by 2025. Promoting the current position needs a reliable and feasible new strategies. The present article introduces the lessons learned of our experience in virtual web-based health research networking in Endocrinology and Metabolism Research Institute [EMRI]

Health observatories in Iran

The Islamic Republic of Iran, in her 20 year vision by the year 2025, is a developed country with the first economic, scientific and technological status in the region, with revolutionary and Islamic identity, inspiring Islamic world, as well as effective and constructive interaction in international relations. Enjoying health, welfare, food security, social security, equal opportunities, fair income distribution, strong family structure; to be away from poverty, corruption, and discrimination; and benefiting desirable living environment are also considered out of characteristics of Iranian society in that year. Strategic leadership towards perceived vision in each setting requires restrictive, complete and timely information. According to constitution of National Institute for Health Researches, law of the Fifth Development Plan of the country and characteristics of health policy making, necessity of designing a Health Observatory System [HOS] was felt. Some Principles for designing such system were formulated by taking following steps: reviewing experience in other countries, having local history of the HOS in mind, superior documents, analysis of current production and management of health information, taking the possibilities to run a HOS into account. Based on these principles, the protocol of HOS was outlined in 3 different stages of opinion poll of informed experts responsible for production on management of information, by using questionnaires and Focus Group Discussions. The protocol includes executive regulations, the list of health indicators, vocabulary and a calendar for periodic studies of the community health situation

Waist circumference, weight, and body mass index of Iranians based on national non-communicable disease risk factors surveillance

Obesity is an important and life-threatening disease, associated with different chronic conditions such as cardiovascular disease, diabetes, and dyslipidemia. We sought to address the paucity of information on the trends of anthropometric indices such as weight, waist circumference, and body mass index in the adult population of Iran. We drew upon data from the First Non-communicable Disease Survey in Iran in 2005. In total, 79,611 participants between 20 and 64 years old were selected via the random multistage cluster sampling. The Lambda Median Scale method was applied to construct normal curves for anthropometric indices. The mean of waist circumference in both genders increased with age and in all the age groups except those between 20 and 24 years old was higher in the women. The mean of body mass index was higher in all the age brackets in the women, but the means of weight and height were higher in the men. The association of theses indices with diabetes, hypertension, and dyslipidemia was stronger in men. The ranges of waist circumference and body mass index in Iranian population are different from those of other countries. The higher body mass index and waist circumference in females and the direct association between obesity and chronic diseases, is advisable that the effects of this phenomenon be fully investigated and due heed be paid to the importance of lifestyle modification

Association between anthropometric measures and bone mineral density: population-based study

Osteoporosis is a major public health concern around the world. It has been shown that bone mineral density is correlated to anthropometric measures like height and weight, but this association may vary depending on ethnic and environmental factors. The aim of this study was to identify probable relations between anthropometric measures and bone mineral density. In this population-based study, we compiled the data collected from Iranian Multicenter Osteoporosis Study to assess the possible associations between different anthropometric indices and bone mineral density at femur and lumbar spine. The gathered data was analyzed using t-test and one way ANOVA. Data was available for 4445 subjects, consisting 1900 males [42.7%] and 2545 females [57.3%]. We observed statistically significant correlations between bone mineral density and height, weight, waist circumference, hip circumference, waist to hip ratio and body mass index [BMI]. Based on the result of linear regression modeling studies, BMI could be considered an independent predictor of bone mineral density. Iranian population shows similar measures compared to analogous studies in other populations. Lower weight should be carefully considered as a predisposing factor for bone loss and osteoporosis

Association of physical activity with risk of type 2 diabetes

Physical activity has shown to prevent type diabetes 2. However, the type, intensity and amount of effective physical activity as well as individuals' needs according to level of their risk for type 2 diabetes have not been clarified comprehensively. This study investigated a relation between moderate aerobic physical activity >/= 150 minuets/week with decreased risk of type 2 diabetes among obese and non-obese residents of south of Tehran, Iran. This study, which was a part of the Cardiovascular Risk Factors Survey in Tehran population Lab region, was designed and conducted based on MONICA/WHO project. Totally, 1552 adult inhabitants of 17[th] district of Tehran were enrolled in this cross-sectional study. Physical activity was assessed by MONICA Optional Study of Physical Activity questionnaire. Diabetes was defined as a history of a prior diagnosis of diabetes or fasting serum glucose >/= 126 mg/dl. All data analyses were conducted using SPSS 17 software for Windows. In a multivariate model, moderate aerobic physical activity >/= 150 minuets/week was significantly associated with decreased risk of type 2 diabetes in all and non-obese subjects [OR= 0.56; 95%CI: 0.35-0.91 and OR= 0.50; 95%CI: 0.26-0.94, respectively]. There was no significant relation between the physical activity and type 2 diabetes risk in obese subjects [OR=0.64; 95%CI: 0.30-1.39]. Moderate aerobic physical activity >/= 150 minuets/week was significantly associated with decreased risk of type 2 diabetes in non-obese people and could be an acceptable exercise goal for these individuals. However, obese people should be investigated more to produce a tailored exercise guideline to this population at high risk of type 2 diabetes

Effects of semelil [ANGIPARS[TM]] on diabetic peripheral neuropathy: a randomized, double-blind Placebo-controlled clinical trial

Diabetic neuropathy is the most common diabetic complication that often is accompanied by significant morbidity, mortality and economic burden. The purpose of this study was evaluation of effect of Semelil [ANGIPARS[TM]], a new herbal drug for treatment of diabetic foot ulcers or diabetic peripheral neuropathy. In this double blind clinical trial, 49 type 2 diabetes patients with different degrees of neuropathy were evaluated in two groups [ANGIPARS[TM] and placebo groups]. All patients were assessed at the start and 12 weeks after treatment, with laboratory tests, United Kingdom screening test, Michigan neuropathy screening score, Michigan diabetic neuropathy score, vibration perception thresholds, nerve conduction study, monofilament test and visual analog scale. Michigan diabetic neuropathy score was decreased notably in ANGIPARS[TM] group. In the nerve conduction study, appropriate meaningful changes were observed in the distal latency and amplitude in the motor ulnar nerve in ANGIPARS[TM] group. The results showed limited evidence of efficacy of ANGIPARS[TM] in diabetic neuropathy treatment and more studies with a larger sample size and longer duration are required

[ effect of trans-chalcone on amylase activity, blood glucose and lipid levels in diabetic and non diabetic rats]

Alpha amylase is the most important decomposing enzyme in starch. Digestion and absorption of starch in the intestine can be prevented and also the blood sugar levels can be controlled by restrain and control of alpha amylase. The aim of this study was to evaluate the effect of trans-chalcone on amylase activity, blood glucose and lipid levels in diabetic and non diabetic rats. This experimental study was conducted in 1388 at Tehran University of Medical Sciences. Sixty rats were randomly divided to ten equal groups: non diabetic control, diabetic control, four non diabetic experiments and four diabetic experiments. Control groups received grape seed oil and experimental groups received 2, 8,16 and 32 mg/kg of body weight in a period of 24 days with a gastric cannula. Blood sugar, every two days, serum insulin levels in days 0,12, and 24 and at the end of the experiment, lipoproteins and alpha amylase activity were measured. The data were analyzed by one way analysis of variance, ANOVA, followed by Turkeys test with SPSS soft ware. On average Chalcone reduced 25.5% of blood sugar in normal and diabetic rats. IT also decreased the serum insulin level. On average, chalcone decreased 34.9% of alpha amylase activity in normal and diabetic rats. Following disturbances in lipids metabolism caused by diabetes, this drug improved lipoproteins metabolism and reduced water, food and urine volume. This study shows that trans-Chalcone reduces blood sugar and body weight via inhibition of alpha amylas. Moreover, improvement of lipoprotein metabolism may happen via the inhibitory effect of this drug on hydroxyl methyl glutaryl -COA reductase and phosphodiesterase

Patients' perspectives on factors that influence diabetes self-care

Although diabetes mellitus is of high concern in Iran, and the level of control is unacceptable, few qualitative studies have been carried out to reflect the experiences of patients on the barriers and motivators to self-care. This study aimed to explore a culturally based experience of Iranian diabetic patients regarding the personal and environmental barriers to and facilitating factors for diabetes self-care. Six focus groups were conducted among type 2 diabetic patients in the Charity Foundation for Special Diseases' diabetes clinic. Purposeful sampling was used. Newly diagnosed patients [less than six months] and all type 1 diabetic patients were excluded. Three focus groups were held on for each sex. A total of 43 patients participated in the study. Framework analysis was used to extract the themes from the data. Data analysis showed five main barriers: physical barriers [such as physical effects of diabetes]; psychological barriers [such as health beliefs]; educational barriers [such as lack of knowledge about diabetes]; social barriers [such as group pressure]; and care system barriers [such as service availability]. Along with the barriers, there were some motivators that the participants mentioned as a stimuli to control their diabetes. They include beliefs about diabetes, perceived responsibility for family, religious beliefs, and the views of significant others. Culturally based interventions are needed to improve diabetes care management in Iran. In addition to personal factors, diabetes health educators should pay attention to the environmental factors when they develop programs

prevalence of diabetic peripheral neuropathy and related factors

Diabetic peripheral neuropathy [DPN] accounts for 80% of diabetic foot ulceration; therefore neurologic examination plays a critical role in screening at risk patients. Our objective was assessment the prevalence of DPN and related factors based on clinical findings. This cross-sectional study was conducted on 124 diabetics who were randomly recruited from Diabetes Clinic of Dr. Shariati University Hospital [Tehran/Iran] in 2004. After gathering demographic data and blood sampling for fasting blood sugar [FBS], the questionnaires United Kingdom [UK], Michigan, Diabetic Neuropathy Score [DNS], and 10-g monofilament testing were administered. Analysis tests were chi-square, pearson correlation and logistic regression. The patient's age ranged 17-75 years; with 44% male. Ninety one percent suffered from type two diabetes and the mean duration of diabetes was 10 years. The mean FBS level was 181.5 mg/dl. While the prevalence of DPN based on Michigan, DNS, and monofilament testing was about 32-28%, some 54% were diagnosed by UK test. Tingling in the lower extremity was the most frequent complaint [42%]. The strongest linear correlation was reported between Michigan and DNS [r=0.7], and then between monofilament test and DNS [r=0.6]. The age >50 years, length of diabetes > 10 years, and FBS >200 mg/dl were the main risk factors for DPN based on DNS. It seems that the combination of Michigan and monofilament test can provide an accurate screening tool for detecting DPN. In addition, tight glucose control, regular assessment of the lower extremity, and to educate diabetics is urged in elderly diabetics, longer duration of diabetes, and those with high FBS

Heme oxigenase 2 gene polymorphisms as genetic risk factor in atherosclerosis in Iranian patients

Heme oxygenase 2 [HMOX2] is an important antioxidative stress enzyme found in the endothelial cells of blood vessels and adventitial nerves. This enzyme in collaboration with heme oxygenase 1 metabolizes heme molecules into ferrous iron, carbon monoxide [CO] and biliverdin while the later is further converted to bilirubin. Both biliverdin and bilirubin are potent antioxidants, reducing the chance of atherosclerosis. HMOX2 also induces endothelial relaxation by synthesizing CO. Heme oxygenase 2 gene mutations were studied in 137 patients with atherosclerosis and in 100 normal controls. Pairs of primers were designed to amplify 2[nd], 3[rd] and 5[th] exons of HMOX2 gene. These products were analyzed by single strand conformation polymorphism [SSCP] analysis and the shifted fragments were separated from SSCP polyacrylamide gel for further sequencing. Two sequence variations were observed among 13 patients with atherosclerosis, consisting of C to A substitution in codone A70D [GCC to GAC] which was reported for the first time and A to G substitution in codone K89E [AAG to GAG]. A significant association was noticed between A to G mutation in codon K89E of hemoxygenase 2 gene and the risk of atherosclerosis was supported with p=0.01 and chi[2]>6.82. However, no significant associations were observed among C to A substitution in codon A70D, p=0.11 and chi[2]>2.97 and the risk of atherosclerosis. Our findings denoted to the importance of K89E mutation in the development of atherosclerosis in Iranian cases. Further studies are required to show the importance of hemoxygenase 2 gene mutation in other populations

Adrenal insufficiency in patients admitted to intensive care unit with moderate to severe traumatic brain injury

Traumatic brain injury is a cause of death in adult populations. Adrenal insufficiency has a great impact on the prognosis of patients with traumatic brain injury. However there is a lack of consensus regarding the diagnostic criteria of adrenal insufficiency. Our aim was to assess adrenal function in patients with moderate to severe traumatic brain injury. In a multicenter case-series study, 50 patients, aged 15 to 70 years, with moderate to severe traumatic brain injury were enrolled from 4 intensive care units in Tehran. Adrenal function was assessed using the 1 and 250 microg ACTH stimulation tests. The incidence of adrenal insufficiency in the first 10 days after traumatic brain injury varied from 34% to 82%, based on various definitions of adrenal insufficiency. More cases of adrenal insufficiency were detected by 1microg ACTH stimulation test compared to the basal cortisol and 250 microg ACTH tests. Since the gold standard insulin stimulation test is regarded as potentially dangerous in the acute phase of post traumatic brain injury, the sensitivity and specificity of the stimulation tests could not be assessed. Kappa test showed no agreement between the two tests [Kappa=0.17]. The incidence of hypotension and vasopressor requirement was higher in patients diagnosed by the 250 microg ACTH test. Baseline cortisol had linear correlation with the 60-minute cortisol of both the 1 and 250microg ACTH tests [P < 0.0001]. The prevalence and associated morbidity of adrenal insufficiency in patients with traumatic brain injury warrant early diagnosis of subclinical cases by dynamic stimulation tests and judicious corticosteroid therapy

Evaluating of VDR gene variation and its interaction with immune regulatory molecules in osteoporosis

To evaluate VDR gene variation and its interaction with immune regulatory molecules in osteoporosis. Totally 205 pre and postmenopausal women were recruited in the study. After an overnight fast, peripheral blood was taken and centrifuged to sprat serum for measurement of serum parathyroid hormone, 25 hydroxyvitamin D, osteocalcin and cross laps. The Fok I polymorphism in exon 2 of the VDR gene was detected by PCR-RFLP. Expression of osteoprotegrin, vitamin D receptor [VDR] and beta-actin genes were quantified by quantitative real-time reverse transcriptase. To design the experimental model we randomly selected five participants of each genotype groups. PBMC were cultured and induced with vitamin D. At several times, cells were harvested and total RNA was extracted. Then expression of target genes evaluated by real time PCR. The frequencies of Ff, FF and ff genotypes were 34.2%, 56.5% and 9.2%. The mean of bone mineral density in FF genotype was higher than other genotypes. Also in this genotype, mean of serum inflammatory cytokines was lower than other genotypes. The expressions of the VDR and osteoprotegrin were up regulated by 1, 25 [OH] 2D3 in PBMC from participants with FF genotype. PBMC from healthy control comparison to osteoporotic patients had a clearly better response to vitamin D3 incubation. Inflammation may important role in osteoporosis whereas osteoporotic patients have elevated pro-inflammatory profile. This cytokine profile and gene expressions of VDR and Osteoprotegrin were different in VDR genotype groups

[ effect of Nigella sativa extract on biochemical bone markers in osteopenic postmenopausal women]

The extract of the seeds of Nigella sativa [Ns] has been used therapeutically for centuries as a safe herbal medicine, and has been reported to have beneficial effects in the treatment of diabetic osteopenia and bone healing in animal models. In the present study, we examined the effect of Ns seed oil extract on biochemical bone markers in osteopenic postmenopausal women. In a placebo controlled clinical trial, 30 osteopenic postmenopausal women, aged 49-72 years, were randomized to either 3-month Ns [oil] treatment [3cc, 0.05 cc/kg/day p.o.] or placebo groups. In all subjects, calcium-D supplements [1 tab per day] were administered during the 3 month study period. At baseline and after 3 months CBC diff, liver and kidney function tests, and serum levels of calcium and phosphate and plasma levels of bone markers [including CTX, Osteocalcin and Bone-ALP] were measured. Twenty-two participants completed the 3 month study period [9 in the Ns group and 13 in the placebo group]. Women in the placebo group had relatively higher BMI in comparison with those in the Ns group. Other characteristics and bone markers levels were similar between two groups at the baseline. Plasma levels of bone markers including CTX, Osteocalcin and Bone ALP did not differ significantly between the Ns and placebo groups at the end of the 3 months neither did changes in bone markers over the course of study show statistically significant differences between the two groups. Although Ns oil was safe, no reports of adverse reactions were observed in this study, we found no beneficial effect of Ns treatment on bone turnover markers. Based on our results, we do not recommend it for the prevention or treatment of bone loss. However this needs to be further investigated in the long-term clinical trials and with larger sample sizes