The influence of ergonomic breastfeeding training on some health parameters in infants and mothers: a randomized controlled trial.

BACKGROUND: Breastfeeding is considered as a protective factor against non-communicable diseases in infants and mothers. The first aim of this study was to assess the influence of ergonomic breastfeeding training on the infants' growth. The second aim was to investigate the effectiveness of this training for improving musculoskeletal disorders in mothers. METHODS: In this randomized control trial, 104 participants who were referred to the health centers in Shiraz for breastfeeding care were randomly allocated into the intervention or comparison group using a size-four block sampling method. At birth, 2, 4, and 6 months later childbirth, Rapid Upper Limb Assessment was used to assess musculoskeletal disorders in participants, and the severity of their discomfort was measured with the Visual Analog Scale. During the 6 months of the study (March to September, 2017), the weight and height of the neonates were measured every 2 months. RESULTS: Significant differences were found between groups in the priority level for corrective action in mothers' postures determined by Rapid Upper Limb Assessment at 2, 4 and 6 months after childbirth (p < 0.001). Based on the Visual Analog Scale results in mothers at 6 months after childbirth, fewer back pain was reported by the intervention group (p = 0.03). No significant difference were found in the infants' weights and heights in boys and girls at all growing stages between the two study groups (p > 0.05). However, the mean height for age of the girl infants at age of 6 months was higher among intervention groups compared to the controls (p = 0.01). CONCLUSION: This study demonstrated that ergonomic breastfeeding training reduced the incidence of musculoskeletal disorders in mothers but seems not to have any significant and consistent impact on the infants' growth. TRIAL REGISTRATION: fa.irct.ir IRCT2014042317398N1.

Association between Angiotensinogen M235T Polymorphism and Preeclampsia in Iranian Pregnant Women.

OBJECTIVE: To determine the possible association between the M235T variant of angiotensinogen gene and preeclampsia in Iranian preeclamtic women with hypertension during pregnancy. MATERIALS AND METHODS: During a case control study, we used polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) analysis to investigate the association between M235T polymorphism in preeclamtic women compared to normotensive controls. RESULTS: The M235T polymorphism was significantly associated with increased preeclampsia risk in the studied population as supported by a p value of 0.017 and chi-square value of 8.12. The frequency of mutated allele and genotype distribution showed a significant difference between preeclamtic women and control groups. CONCLUSION: The result indicates that the AGT M235T polymorphism plays a significant role in preeclampsia observed in selected Iranian preeclamtic women, and it can be considered as a major risk factor for preeclampsia.

Effectiveness of topical curcumin for treatment of mastitis in breastfeeding women: a randomized, double-blind, placebo-controlled clinical trial.

OBJECTIVE: To determine the efficacy of topical curcumin in reducing breast inflammation in women suffering from lactational mastitis. METHODS: A randomized double-blind, placebo-controlled study including 63 breastfeeding women with lactational mastitis were randomly assigned to receive curcumin topical cream, one pump every 8 hours for 3 days (n=32) or topical moisturizer as placebo (n=31). Using an index for severity of breast inflammation, all of the patients had moderate breast inflammation before entering the study. The outcome of treatment was evaluated using the same index at 24, 48 and 72 hours of starting the treatment. RESULTS: There was no significant difference between two study groups regarding the baseline characteristics such as age (p=0.361) and duration of lactation (p=0.551). After 72-hour of therapy, patients in curcumin groups had significantly lower rate of moderate (p=0.019) and mild (p=0.002) mastitis. Patients in curcumin group had significantly lower scores for tension (p<0.001), erythema (p<0.001) and pain (p<0.001), after 72-hour of treatment. CONCLUSION: The results of the current study indicate that topical preparation of curcumin successfully decrease the markers of lactational mastitis such as pain, breast tension and erythema within 72 hours of administration without side effects. Thus, topical preparation of curcumin could be safely administered for those suffering from lactational mastitis after excluding infectious etiologies.

The preventive effect of pentoxifylline on contrast-induced nephropathy: a randomized clinical trial.

BACKGROUND: Percutaneous coronary intervention provides a high-risk condition for incidence of CIN even in patients with normal renal function. Pentoxifylline (PTX) with a variety of mechanisms may prevent CIN. MATERIALS AND METHODS: Between April 5, 2011, and February 20, 2012, all consecutive eligible patients referred for elective percutaneous coronary intervention were asked to participate in the study (n = 199). Eligibility was defined as the age between 18 and 65 years and baseline serum creatinine ≤ 132.6 µmol/l (1.5 mg/dl). The patients were randomly allocated to two groups either receiving saline or saline plus pentoxifylline 400 mg orally three times a day for 48 h. Serum creatinine was measured 24 h prior to the procedure and 48 h thereafter. The primary endpoint was occurrence of CIN defined as 25 % rise in serum creatinine 48 h after the procedure. RESULTS: The overall incidence of CIN was 6 % in this study (6.2 % in the PTX group versus 5.9 % in the hydration group, P = 0.92). Absolute rise in serum creatinine was not also significantly different between the two groups (P = 0.97). In hypertensive patients, however, the incidence of CIN was lower among those receiving PTX: 5 % in the PTX group versus 8.7 % in the hydration group. Nevertheless, this difference was not statistically significant (P = 0.68). CONCLUSION: Short-term prophylaxis with pentoxifylline added to optimal hydration does not seem to reduce the risk of CIN in patients with normal renal function undergoing PCI. Further clinical trials in patients with renal impairment are warranted to define its role.

Comparative effects of silymarin and vitamin E supplementation on oxidative stress markers, and hemoglobin levels among patients on hemodialysis.

BACKGROUND: The incidence of accelerated atherosclerosis among patients on hemodialysis is very high and oxidative stress (OS) is a potentially major contributor to their morbidity and mortality. OBJECTIVE: To evaluate the effects of Silymarin and/or vitamin E on OS markers and hemoglobin levels in patients on hemodialysis. METHODS: Eighty patients on hemodialysis were randomized into four groups: Group 1 received silymarin 140 mg 3 times daily; Group 2 received vitamin E 400 IU/day; Group 3 received silymarin 140 mg 3 times daily and vitamin E 400 IU/day; and Group 4 was the control. Samples were obtained at baseline and on day 21 for measurement of malondialdehyde (MDA), red blood cell (RBC) glutathione peroxidase (GPX), and hemoglobin. RESULTS: Combination of silymarin and vitamin E led to a reduction in the MDA levels (7.84 ± 1.84 vs. 9.20 ± 2.74 nmol/mL; p = 0.008). There was a significant increase in RBC GPX levels in all treatment groups compared with controls after 3 weeks. This was more pronounced in the group receiving combination compared with the group receiving vitamin E or the control group (5.78 ± 3.51, 4.22 ± 1.63, and 3.16 ± 1.89 IU/grHb, respectively; p < 0.001). There was also a significant increase in mean hemoglobin of all treatment groups compared with the control. CONCLUSIONS: Oral supplementation with silymarin and vitamin E leads to reduction in MDA, increase in RBC GPX, and increase in hemoglobin levels in patients with end-stage renal disease. Studies with larger sample sizes and longer follow-up are required to investigate the effect of silymarin on cardiovascular outcomes and erythropoietin requirement.

Significance of serum and urine neuraminidase activity and serum and urine level of sialic acid in diabetic nephropathy.

BACKGROUND: Prospective studies have reported associations among various markers of inflammation and the incidence of diabetes, and it has been proposed that inflammation has a causal role in the development of diabetes. The objective of this study was to investigate the significance of serum and urine neuraminidase activity (NA) and serum and urine sialic acid (SA) level in patients with Diabetic nephropathy. METHODS: In a prospective study, 190 diabetic patients with established diabetic nephropathy, 30 type 2 diabetes patients without any diabetic related nephropathy, and 36 non-diabetic patients with diagnosed nephropathy were enrolled. Two hundred and forty healthy individuals without diabetes or kidney disease were also enrolled as control group. Fasting venous blood samples and urine samples were collected and checked for serum and urine NA and SA level. RESULTS: In the diabetic nephropathy group, the mean value of serum and urine NA was 64.6 ± 2.6 and 11.7 ± 1.2 mU/ml, respectively, and mean values of serum and urine SA were 93.2 ± 3.6 and 17.7 ± 1.4 mg/dl, respectively. Serum and urine NA and SA levels were significantly higher in patient with diabetic nephropathy when compared to the other groups (P < 0.001). CONCLUSIONS: Our study suggests that there is a strong association between elevated serum and urine NA and serum and urine SA levels with the presence of diabetic nephropathy in type 2 diabetic patients. Further investigations are needed on the diagnostic and prognostic significance of these two inflammatory markers.

Association of zinc deficiency and depression in the patients with end-stage renal disease on hemodialysis.

INTRODUCTION: Depression is a common psychological symptom in patients undergoing chronic hemodialysis. In the general population, low serum zinc level is associated with major depression. The current study surveys the possible relationship between the prevalence of depression and plasma level of zinc in patients on hemodialysis (HD). PATIENTS AND METHODS: A total of 135 patients with end-stage renal disease (ESRD) on HD were enrolled in the study. The severity of depression was assessed using Beck Depression Inventory (BDI). Plasma zinc level was measured from fasting samples. RESULTS: Mean age of the patients was 52.45 (standard deviation: 15.33) years. In all, 76% of the patients had some degree of depression according to BDI scoring system (BDI >14). The mean level of plasma zinc in the depressed patients was significantly lower than the rest of the patients (67.46 ± 29.7 vs. 85.26 + 40.05). DISCUSSION: Zinc deficiency may be a reversible cause which might contribute to the increased rate of depression in HD patients. This is the first study reporting the association of zinc deficiency with the presence of depression in HD patients; therefore, these findings need further investigations.

Senior-Loken syndrome in an Iranian family.

Senior-Loken syndrome is a rare entity that combines familial juvenile nephronophthisis with retinal dystrophy. Herein, we report Senior-Loken syndrome in six members of an Iranian family with progressive blindness and renal failure since childhood. Although, this syndrome was reported from other parts of the world, report of six members of one family with this syndrome is rare. To the best of our knowledge, this is the first report from Iran.

Impact of oral zinc therapy on the level of sex hormones in male patients on hemodialysis.

BACKGROUND: Sexual dysfunction in chronic renal failure patients undergoing hemodialysis is common. It is demonstrated that the zinc level is significantly lower in the hemodialysis patients. OBJECTIVE: In this clinical trial, we investigate the effect of zinc supplement therapy on the serum levels of sexual hormones in hemodialysis male patients. PATIENTS AND METHODS: We carried out a clinical trial study including 100 of our male patients with end-stage renal disease on hemodialysis. Testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and zinc plasma level were measured in all of the patients. The patients received zinc supplement (zinc sulfate, 250 mg/day) for 6 weeks, and sex hormones and zinc plasma level were checked again. RESULTS: Serum level of FSH and prolactin did not have any significant changes before and after intervention, but serum level of testosterone, LH, and zinc increased significantly. DISCUSSION: These results suggest that although zinc administration did not have a definite effect on hemodialysis patients with sexual dysfunction, it can cause increase in the serum level of sex hormones which may improve the sexual function of the patients in some aspects.

Captopril and combination therapy of captopril and pentoxifylline in reducing proteinuria in diabetic nephropathy.

Chronic kidney disease is a worldwide health problem. Type II diabetes mellitus is now a major cause of end stage renal disease. The effect of diabetes mellitus through the dysregulation of the innate immunity results in increased tumor necrosis factor-alpha. This can lead to an increasing protein trafficking through the glomerular capillary, which can have an intrinsic renal toxicity. Seventy-four patients with type II diabetes mellitus with overt proteinuria were included in the study. They were randomly assigned to two groups of 37 patients (group 1: captopril 25 mg three times a day, group 2: captopril 25 mg and pentoxifylline 400 mg each three times per day). In the course of the study, two patients were excluded from each group. Daily urinary protein excretion was assessed at baseline and at two and six months. The reduction of urinary protein to creatinine clearance ratio in group 2 was 15.16 points more than in group 1 from baseline to the end of the study (p = 0.001). The difference in reduction only started after two months of pentoxifylline use. The differences in HbA1c and duration of diabetes mellitus at baseline in the two groups had not adversely affected the outcome of the study. There was a modest decrease in systolic blood pressure in group 2 as well (p = 0.041). Combining an angiotensin-converting enzyme inhibitor and pentoxifylline can lead to a greater reduction in proteinuria.