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Background: Elderly population are at higher risk of malnutrition that can increase the morbidity and mortality among them. This study aimed to evaluate the nutritional status and the related factors among elderly nursing home residents.Methods: This descriptive cross-sectional study enrolled 1062 (439 males, 623 females) elderly living in the elderly nursing home residents in Mashad, Iran. The nutritional status of participants was assessed through a Mini Nutritional Assessment-Short Form scale and Nutrition Day questionnaires.Results: Among the study participants, 64 (18.5%) were malnourished,142 (31.9%) were at risk of malnutrition and 94 (49.6%) had no malnutrition. Moreover, elderly males were more susceptible to malnutrition (p=0.03). Furthermore, reduced food intake in the past three months was significantly correlated with malnutrition in elderly participants (p=0.001). Also, the lower number of nurses and people who care about nutritional status was significantly associated with the higher malnutrition rate in elderly participants (p=0.02, p=0.03, respectively).Conclusion: The present study showed that more than half of the elderly population living in elderly nursing homes were malnourished or at risk of malnutrition.

ABSTRACT Introduction Previous studies investigated the impact of weight‐related abuse (WRA) on eating pathology. However, the circumstances of such an effect are still unclear. Our study aimed to examine the relationship between verbal WRA and binge eating (BE) behavior via attentional bias (AB) to threat cues and difficulties in emotion regulation. Method We conducted a parallel mediation model. On the basis of the purposive sampling method, 183 individuals with obesity and overweight (70.5% female and 28.4% male; Meanage = 32.78), from February to June 2019, were recruited from a nutrition clinic in Tehran. The participants completed the BE scale (BES), the weight‐related abuse questionnaire (WRAQ), the difficulties in emotion regulation scale (DERS), and the dot probe task (DPT). Results AB to threat cues had a significantly negative association with verbal WRA and BE. Difficulties in emotion regulation showed a significant positive association with verbal WRA and BE. The parallel mediation model showed a direct effect of verbal WRA on BE. Moreover, the bootstrap analysis revealed that difficulties in emotion regulation could mediate the association between verbal WRA and BE. Conclusions Our findings suggest that experiences of verbal WRA can contribute to cognitive bias to negative emotion, maladaptive emotion regulation strategies, and behavioral problems like BE.

Background and Objectives: Failure to thrive (FTT) is a common developmental disorder in infants. Although the improvement effect of zinc supplementation in these patients was reported in some past studies, the results were conflicting. Accordingly, this study investigates the effect of zinc supplementation on factors related to growth in infants with FTT by conducting a meta-analysis. Methods: Medline, Web of Science, and Scopus databases were comprehensively searched to find randomized controlled trials investigating the effect of zinc on growth-related factors in infants with FTT. Eligible studies were extracted after screening their relevant information. The pooled effect size was estimated as a weighted mean difference with a 95% confidence interval (CI) using the random effect model method. Results: Out of 85 reviewed papers, 4 studies were eligible to enter this review. The present meta-analysis revealed that zinc supplementation in infants with FTT led to a significant increase in weight (weighted mean difference (MD)=-0.25 kg; 95% CI, 0.02%-0.49%), weight-for-age Z-score (weighted MD=0.16; 95% CI, 0.03%, 0.28%), and height-for-age Z-score (weighted MD=0.15, 95% CI, 0.001%, 0.30%), compared to control groups. In contrast, zinc supplementation had no significant effect on height and insulin-like growth factor 1 serum level. Conclusions: The findings of the current meta-analysis indicated the effectiveness of zinc supplementation in improving the developmental status of infants with FTT; however, due to the small number of included trials, it was impossible to draw definitive conclusions, and conducting randomized controlled trials with larger sample size and higher sensitivity is needed.

Abstract Background & objective Patients in the intensive care unit have a high prevalence of vitamin D deficiency (VDD). In the present study, clinical outcomes in the ICU were analyzed with vitamin D status. Materials and methods In this prospective, multicenter study, sampling was conducted on seven ICUs in three hospitals. Within the first 24 h of ICU admission, patient’s serum vitamin D levels were measured, and their disease severity was monitored using the scores of acute physiologic assessment and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA), and the modified Nutrition Risk in Critically ill (mNUTRIC) score. Results A total of 236 patients were enrolled in this study, of which 163 (69.1%) had lower vitamin D levels than 20 ng/ml upon ICU admission. The patients with VDD had higher APACHE II scores)P = 0.02), SOFA scores (P 30 ng/ml) had a shorter stay at ICU (P

Background: Sanctions are a type of forfeit aimed at forcing the subject to obey the desired political will. Since sanctions affect various components of the economic sectors. The purpose of this study is to investigate the effect of sanctions on food intake of households living in Khorasan Razavi province, Iran. Methods: To investigate the effect of sanctions on food intake of households living in Khorasan Razavi province, the survey data of the National Statistics Center of Iran (NSCI) on cost and income was used. 2129 households (number of households in 2017: 702, 2018: 726 and 2019: 701) were studied. In the N4 program, macronutrients and micronutrients were calculated. The studied variables were analyzed based on four income categories. In the SPSS software, quantitative variables of 2017 to 2019 were reviewed by ANOVA test and variables in pairs of the same period were reviewed by post hoc Tukey test. Results: The analysis showed that by intensifying sanctions, the cost of food has increased more than the average of income, and prices of all food groups spesifically healthy food groups have increased. The diet quality index has decreased significantly. The lower-income classes had the most insufficient dietary intake of micronutrients and the gap between dietary intake of different income classes increased during the study. Conclusion: Sanctions have affected the dietary intake due to the rise in the price of food expenditure and as a result people tend to consume cheaper and lower quality food. Corresponding Author:Abdolreza Norouzy View Orcid in Profile You can search for this author in PubMed Google Scholar Profile

Objective: Cinnamon is extracted from the inner bark of Cinnamomum trees. Recent studies have indicated that cinnamon is a safe and cost-effective treatment for improving body weight, lipid profiles, insulin resistance, and blood pressure. This systematic review aimed to summarize the effect of cinnamon supplementation on adipokines and appetite-regulating hormones.Materials and Methods: This comprehensive literature search was conducted using databases such as PubMed, Scopus, ISI Web of Science, and Google Scholar up to March 2022 without any limitation. The quality of eligible studies was evaluated through the Cochrane Collaboration’s tool for assessing the risk of bias.Results: This systematic review included six clinical trial studies (363 participants), among which, only one study was performed on children, and two investigations were conducted on obese participants. A decreasing effect was found in the level of leptin and visfatin after cinnamon supplementation. Two out of three studies examined adiponectin levels and revealed non-significant effects of cinnamon consumption on this parameter. Two studies evaluated ghrelin levels and found an increase after cinnamon supplementation. The result of cinnamon supplementation on other biomarkers such as glucose-dependent insulinotropic polypeptide, glucagon-like peptide 1, and resistin was inconsistent.Conclusion: The result of this systematic review indicated the increasing effect of cinnamon supplementation on ghrelin levels and decreasing effect on leptin and visfatin levels. However, more clinical data are required to clarify the beneficial effects of cinnamon on adipokines levels due to the controversial findings of the studies.

Background: The relation between long-term dietary intake and diseases is well known. There are several methods to determine long-term dietary intake. The food frequency questionnaire (FFQ) is used in studies to assess habitual dietary intake over a long term period. Dietary intake varies according to cultural differences, so an FFQ must be designed and validated for the target population. This protocol study aims to explain the development and validation of a semi-quantitative FFQ for the Iranian population that includes mixed dishes and single food items. Methods: The initial list of food items were extracted from interviews and expert opinion. An expert panel of ten nutritionists calculated the content validity ratio (CVR) and content validity index (CVI) of food items to finalize the FFQ. One hundred twenty eligible participants were included in the study. They completed the FFQ two times, with a ten month interval. They recorded their food intake for three days in the 2nd and 10th months of the study. In the 4th and 10th months, serum retinol and alpha-tocopherol, and 24-hour urinary potassium and nitrogen were measured. Result: Covering typical Iranian mixed dishes is the main advantage of this study. Given that the questionnaire is valid and reproducible, it can be used in epidemiologic studies. Conclusion: The current study developed a dish-based Iranian FFQ based on mixed food.

Abstract Background Critically ill patients must be monitored constantly in intensive care units (ICUs). Among many laboratory variables, nutritional status indicators are a key role in the prognosis of diseases. We investigated the effects of l-carnitine adjunctive therapy on monitoring variables in critical illness. Method A prospective, double-blind, randomized controlled trial was implemented in a medical ICU. Participants were 54 patients, aged > 18 years, with multiple conditions, randomly assigned to receive 3 g l-carnitine per day or placebo, along with enteral feeding, for 1 week. Primary outcomes included monitoring variables related to nutritional status. Result Of 54 patients randomly assigned, 51 completed the trial. Serum albumin (Alb) (P-value: 0.001), total protein (P-value: 0.003), and calcium (Ca) (0.044) significantly increased in the intervention vs. control group. Alanine transaminase (ALT) (0.022), lactate (

Abstract Background Time‐restricted feeding (TRF) is a kind of intermittent fasting defined as eating and drinking only during a certain number of hours in a day. It has been suggested that intermittent fasting may improve cardiovascular risk factors. This study evaluated the association of TRF and arterial stiffness, using pulse wave velocity (PWV), pulse wave analysis, and arterial age in metabolic syndrome participants. Methods A cohort study was carried out among metabolic syndrome adults who were followed over the Ramadan fasting period (used as a model of TRF since food was only allowed for about 8 h/day). The subjects were divided into Ramadan fasting and Ramadan nonfasting groups. The aortic PWV and central aortic pressure waveform were measured. Central systolic pressure, central pulse pressure, and indices of arterial compliance, such as augmentation pressure and augmentation index (AIx), were determined from waveform analysis. Results Ninety‐five adults (31.57% female, age: 45.46 ± 9.10 years) with metabolic syndrome (based on the International Diabetes Federation definition) participated in this study. Ramadan fasting and Ramadan nonfasting groups were including 80 and 15 individuals respectively. A significant reduction was seen in PWV (0.29 m/s), central systolic pressure (4.03 mmHg), central pulse pressure (2.43 mmHg), central augmentation pressure (1.88 mmHg), and central AIx (2.47) in the Ramadan fasting group (p = 0.014, p

Abstract Background Disease-related malnutrition is associated with adverse outcomes such as increased rates of morbidity and mortality, prolonged hospital stay, and extra costs of health care. This study was conducted to assess nutritional status among patients and to determine the risk factors for malnutrition in Iran university f. Methods Persian Nutritional Survey In Hospitals (PNSI) was a cross-sectional study that conducted in 20 university hospitals across Iran. All the patients with age range of 18 to 65 years, who were admitted or discharged, were assessed by subjective global assessment (SGA). Results In total, 2109 patients were evaluated for malnutrition. Mean values of age and body mass index were 44.68 ± 14.65 years and 25.44 ± 6.25 kg/m2, respectively. Malnutrition (SGA-B & C) was identified in 23.92% of the patients, 26.23 and 21% of whom were among the admitted and discharged patients, respectively. The highest prevalence of malnutrition was in burns (77.70%) and heart surgery (57.84%) patients. Multivariate analysis presented male gender (OR = 1.02, P

Introduction: Ramadan fasting (RF) is a model of calorie restriction similar to intermittent fasting, which is extensively practiced by a large population of Muslims. Limited and controversial studies have investigated the physiological changes induced by 30 days of RF. The present study aimed to evaluate the effects of Ramadan fasting on the resting metabolic rate and body composition of overweight and obese individuals. Methods: This study was conducted on 21 men and women aged 18-40 years. The subjects avoided eating and drinking for one month during the holy month of Ramadan (at least 20 days) and received a routine diet without an intervention between Iftar and dawn (Sahur). Before and after the study, the energy of the basal metabolic rate was measured via indirect calorimetry, and body composition was measured by bioimpedance (InBody s10). In addition, the physical activity of each participant was evaluated using a pedometer during one week. During the study, each participant received a 24-hour recall once a week. Results: Compared to the pre-study period and after four weeks of RF, body weight (77.91±11.83 vs. 77.01 ±11.75 kg; P

Introduction In traumatic brain injury (TBI) patients, inflammatory processes and oxidative stress have been linked to the development of neurodegenerative diseases, disability, increased rate of muscle catabolism, malnutrition, hospital stay and mortality. Previous in vitro and in vivo studies have shown that trehalose can decrease inflammatory and oxidative factors. Therefore, the present study was designed to evaluate the effect of oral trehalose consumption on this marker in critically ill TBI patients at intensive care unit (ICU).Methods and analysis This study is a pilot randomised, prospective and double-blind clinical trial. The study sample size is of 20 (10 patients in each group) TBI patients aged 18–65 years at ICU. Randomisation is performed by permuted block randomisation method. The allocation ratio is 1:1. An intervention group will receive 30 g of trehalose instead, as a part of the carbohydrate of daily bolus enteral feeding and the control group will receive standard isocaloric hospital bolus enteral feeding for 12 days. The inflammatory factors (C reactive protein, interleukin 6) and oxidative stress markers (glutathione, malondialdehyde, superoxide dismutase, pro-oxidant–antioxidant balance, total antioxidant capacity) will be measured at the baseline, at the 6th day, and at the end of the study (12th day). Sequential Organ Failure Assessment, Acute Physiology and Chronic Health Evaluation II, Nutrition Risk in the Critically ill scores, 28-day mortality, anthropometric assessments and the clinical and nutritional status will be measured. Each patient’s nutritional needs will be calculated individually. The statistical analysis would be based on the intention to treat.Ethics and dissemination The vice-chancellor of the research centre of Mashhad University of Medical Sciences is sponsoring this study. IR.MUMS.MEDICAL.REC.1400.113.Trial registration number Iranian Registry of Clinical Trials (IRCT) Id: IRCT20210508051223N1, Registration date: 26 July 2021.

Kidney transplantation is a preferred treatment and the 'last resort' in chronic kidney disease after end-stage renal disease. Considering the key role of nutrition in post-transplant recovery, the present study aimed to review the nutritional assessment and dietary requirements of kidney transplant patients. Relevant articles were retrieved via searching in databases such as PubMed, Medline, Google Scholar, Scopus, and Web of Science using various keywords and phrases, including kidney transplantation, end-stage disease, nutrition, dietary intake, nutritional assessment, and nutritional evaluation. According to the literature, medical nutrition therapy is essentially involved in the post-transplantation recovery of patients with kidney failure. Furthermore, it seems that nutritional and medical evaluation based on laboratory methods, vital signs, and anthropometric measurements are critical to improving the quality of nutritional interventions after kidney transplantation and may help decrease the risk of kidney transplant rejection. Therefore, the periodic evaluation and follow-up of these could yield beneficial outcomes.

Background Different studies have confirmed the role of nutritional factors in the etiology of Multiple sclerosis (MS). However, dietary patterns associated with the risk of MS remain unknown. Objectives This study aimed to investigate the possible relationship between the existing dietary patterns and the risk of MS. Methods This case-control study was conducted in Mashhad city, Iran in 2015. In total, 197 MS patients and 200 control subjects (matched in terms of age, gender, education level, and body mass index) were enrolled in this study. The required data were collected through interviews and questionnaire completion. Moreover, the data on the usual dietary intake of each participant during the past year were evaluated using a valid and reliable semi-quantitative food frequency questionnaire (160 items). Logistic regression analysis was applied to discover the associations between dietary patterns and the risk of MS. Results Four major dietary patterns were identified in this study, including Unhealthy, Western, Healthy, and Traditional. After adjustment for smoking habits, the family history of autoimmune diseases and the duration of breastfeeding, the highest tertile of Healthy dietary pattern was found to be associated with the reduced risk of MS by 74% (OR = .26; P < .001), whereas the Unhealthy dietary pattern was associated with a three-fold increased risk of MS (OR = 3.04; P < .001). However, no correlation was observed between the Western and Traditional dietary patterns and the risk of MS. Conclusion According to the results of this study, a healthy diet may reduce the risk of MS, whereas an unhealthy dietary pattern may.

Introduction: Sepsis is one of the major causes of high morbidity and mortality in intensive care units (ICU) and severe sepsis leads to some metabolic disorder. The previous studies indicate that l-carnitine deficiency in septic patients and causing mitochondria dysfunction and worsening metabolic disorder. Reducing mortality in sepsis by nutritional supplements may help mitigate the risk of clinical outcomes in sepsis patients. Methods: Our systematic search to find relevant studies was performed up to March 2020, using ISI Web of Science, Google Scholar, EMBASE, PubMed/MEDLINE and SCOPUS databases. In this systematic review, the aim was to assess whether l-carnitine or levocarnitine may reduce the risk of mortality in patients with sepsis. Result: 10 articles were included in our systematic review. The results of the review showed that plasma carnitine levels were significantly associated with the Sequential Organ Failure Assessment score (SOFA) (p

Abstract Background Traumatic brain injury (TBI) is the most common trauma worldwide and is a leading cause of injury-related death and disability. Inflammation is initiated as a result of the TBI, which is in association with severity of illness and mortality in brain trauma patients, especially in subdural hemorrhage and epidural hemorrhage cases. A high percentage of adults admitted to the intensive care unit with TBI are diagnosed with vitamin D deficiency; this deficiency may induce impaired immune responses and increase the risk of infections. Vitamin D intervention has been shown to modulate pro- and anti-inflammatory cytokines in non-critically ill patients, but to date, there is no substantial data on the effectiveness of vitamin D for the improvement of immune function in traumatic brain injury patients. Methods/design A randomized clinical trial (RCT) will be performed on 74 Iranian adults 18–65 years old with brain trauma and will be treated daily with vitamin D supplements (100,000 IU oral drop) or a similar placebo (1000 IU) for 5 days. Discussion If this randomized clinical trial demonstrates reductions in inflammatory cytokines, it would provide evidence for a multicenter clinical trial to evaluate the efficacy of vitamin D supplementation in neurocritically ill patients. Since vitamin D supplements are inexpensive and safe, this clinical trial could have the potential to improve clinical outcomes in traumatic brain injury patients through reduction of inflammation and infection-associated morbidity and mortality rates. Trial registration Iranian Registry of Clinical Trials, IRCT20180619040151N3 . Registered on 10 August 2019.

Background: Differentiated thyroid cancer (DTC) is the most prevalent endocrine cancer. Evidence showed a significant association between diet and DTC. Thus, this study aimed to assess the relationship between dietary intakes and DTC. Methods: This case-control study was accomplished among 300 adult patients and 300 matched (age and gender) controls in Mashhad city, Iran. Dietary assessment was conducted and the relationship between dietary intakes and DTC were examined by a validated food-frequency questionnaire and logistic regression analysis, respectively. Results: After adjusting for the confounders, a protective effect was observed for the highest tertile of low-fat dairy (OR=0.3, 95% CI=0.17-0.53, P < 0.001) and fruits' intakes (OR=0.28, 95% CI=0.15-0.52, P < 0.001) on DTC. However, the highest tertile of sugar intake was significantly related to greater DTC chance (OR=4.01, 95% CI=2.07-7.79, P < 0.001). A protective role was also found for vegetables in the second tertile of consumption (OR=0.3, 95% CI= 0. 0.17-0.54, P < 0.001) and for tea in the second and third tertiles (OR=0.2, 95% CI= 0.11-0.53, P < 0.001; OR=0.42, 95% CI=0.26-0.69, P = 0.001 respectively). However, the second and third tertiles of the roasted or fried meat consumption were significantly associated with higher DTC chance (OR=1.66, 95% CI= 1.007-2.76, P = 0.04; OR=1.92, 95% CI=1.07-3.42, P = 0.02 respectively). No significant association was detected for other dietary intakes. Conclusions: Consumption of low fat dairy, fruits, vegetables, and tea had a protective effect on DTC; whereas, roasted or fried meat and sugar consumption was significantly associated with higher DTC chance. Further studies are needed to confirm these results.

Abstract Aims The purpose of this review was to investigate the effect of vitamin D supplements on hemoglobin concentration in subjects aged 17.5–68 years old; using randomized controlled trials (RCTs). Methods Relevant RCT studies were identified from January 2000 to January 2019 by using MeSH terms in PubMed, Embase, Cochrane Library, Clinical trials, Scopus databases and gray literature. The studies were reviewed systematically, and quality assessments were evaluated by the guidelines of the Cochrane risk of bias. The effect of vitamin D supplements (n = 14) on hemoglobin concentration was considered as primary outcome, while its effects on the levels of ferritin, transferrin saturation and iron status were derived as secondary outcomes. In total, 1385 subjects with age range of 17.5 to 68 years old were examined for 3 h to 6 months; Mean (standard deviation) or median interquartile changes in the hemoglobin concentration in each treatment group was recorded for meta-analysis. Results Fourteen RCTs met the inclusion criteria. Current study findings propose that vitamin D supplementation leads to a non-significant reduction in hemoglobin levels in subjects (17.5–68 years old) [std. mean difference (SMD): 0.01; 95% CI: − 0.28, 0.29; P = 0.95], also it has no significant effect on ferritin concentrations [std. mean difference (SMD): -0.01; 95% CI: [− 0.20, 0.18; P = 0.91]. However, vitamin D supplementation demonstrated positive effects on transferrin saturation [mean difference (MD): 1.54; 95% CI: 0.31, 2.76; P = 0.01] and iron status [std. mean difference (SMD): 0.24; 95% CI: − 0.09, 0.39; P = 0.002]. Conclusion Current review concluded that supplementation with vitamin D had no significant effect on hemoglobin and ferritin levels while positive effects on transferrin saturation and iron status were observed. Further clinical studies are required to determine the actual effect of this intervention on hemoglobin levels.

Abstract Background Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patients. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective The objective of this work is to survey the effect of pycnogenol on the clinical, nutritional, and inflammatory status of TBI patients. Methods This is a double-blind, randomized controlled trial. Block randomization will be used. An intervention group will receive pycnogenol supplementation of 150 mg for 10 days and a control group will receive a placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (malondialdehyde, total antioxidant capacity), at the baseline, at the 5th day, and at the end of the study (10th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. The Sequential Organ Failure Assessment (SOFA) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index, and body composition will be measured. All analyses will be conducted by an initially assigned study arm in an intention-to-treat analysis. Discussion We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients. Trial registration This trial is registered at clinicaltrials.gov (ref: NCT03777683) at 12/13/2018.

Background: Old world cutaneous leishmaniasis (CL) is known as a self-healing cutaneous parasitic infection. Host immunity has a fundamental role in the course of this infection. This study was designed to investigate the relationship between nutritional status and vitamin A intake with the clinical course of CL. Methods: Overall, 250 patients with CL attending a dermatology clinic in Imam Reza Hospital Mashhad, Iran, were enrolled from Apr 2011 to Aug 2012. For data gathering, a semi-quantitative 302-item food frequency questionnaire was utilized. They received routine treatment protocols for leishmaniasis and 1 year of follow-up Results: As for the 149 patients who completed the study, a deficiency of macro and micronutrients, particularly vitamin A, was significantly related to a chronic clinical disease course. Conclusion: Imbalanced or insufficient nutritional intake including vitamin A deficiency, may influence the clinical course of CL.

Background: Obesity is a common health problem associated with a number of diseases, such as hypertension, cardiovascular disease, hyperlipidemia, diabetes, gout, gall bladder and liver disease, cancer, and depression. The prevalence of obesity is dramatically increasing around the world, especially in the Asia Pacific region. omega-3 is a type of polyunsaturated fatty acids that have several beneficial effects on some diseases such as diabetes, hypertension, rheumatoid arthritis, bipolar disorder and asthma. Therefore, the main objective of the present study was to determine the levels of omega-3 fatty acids in subjects with different categories of BMI (healthy- weight, overweight, and obese) and WC (not at risk, increased risk, and substantially increased risk). Method: In the current study, a total of 151 individuals consist of 58 men and 93 women (aged 18-65 year) were randomly recruited from patients attending the nutrition clinics of Mashhad, Iran. Participants were divided into three groups according to body mass index (BMI) (healthy-weight, overweight, and obese) and WC categories (not at risk, increased risk, and substantially increased risk). Plasma levels of omega-3 fatty acids were analyzed in blood sample of all participants by gas chromatography apparatus equipped with a flame ionization detector (GC-FID). The protocol was approved by the Ethics Committee of the Mashhad University of Medical Science (MUMS) and written informed consent was obtained from all individuals. Results: Alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) were inverse association with increasing both overall (p

Compact FoodBars (CFB) are part of the diets that are named according to the purpose of use, Meal Ready-to-Eat (MRE) used during the maneuvers and military operations, Emergency Food Product (EFP) used in emergencies and crises such as natural disasters and warfare leading to the promotion of crisis management, and Ready-to-Use Therapeutic Food (RUTF) used for therapeutic purposes in malnourished individuals and AIDS patients. Some of the characteristics of CFB include high nutritional value, high nutrient content, high energy density, no need for preparation, ready to use, long lasting, low spoilage percentage due to low moisture content, low volume and weight and ease of transportation and distribution. The energy level, the type and amount of fat, protein, carbohydrates, fiber and micronutrients should be taken into account in the formulation of CFB . The main ingredients of these diets consist of cereal, skim milk, soy and its products, vegetable oil, sugar and plant nutrients. The products based on this purposes are very valuable to people in these circumstances. In fact, it should be noted that victims of war and natural disasters will have a new chance to live by eating the CFB . Therefore, it is essential to check and plan for the production of Compact Foodwith the described characteristics.

Background: Nutritional support of the burn patient is essential to optimize, host immune defenses and to promote prompt wound healing. Furthermore, the increased needs in calorie requirement of burned patients, the composition of proteins, carbohydrates and fats in their diet is important. The purpose of this study was to evaluate energy, macronutrient and micronutrient intake and comparing with Reference Daily Intake (RDI) in adult burn patients. Methods: Sixty thermally injured patients who were hospitalized in a burn care Imam Reza hospital in Mashhad, Iran, were included in this cross-sectional study. Information about actual intake was collected by ‘nutrient intake analysis (NIA) through direct observation. Individual nutritional intakes were assessed with the use of nutritionist 4 software and Data was analyzed by SPSS version 18. Results: The mean of energy, carbohydrate and protein intake was significantly lower than the mean total energy requirement and carbohydrate and protein RDA (p

Introduction: The present study aimed to evaluate the effects of hospitalization on the nutritional status and prooxidant-antioxidant balance (PAB) of the patients with myocardial infarction (MI).Methods: This study was conducted on 57 patients diagnosed with MI with the mean age of 58.44±12.80 years. The patients were admitted to the cardiac care unit (CCU) of Ghaem Hospital in Mashhad, Iran. Nutritional status of the patients was assessed using the nutritional risk screening (NRS-2002) questionnaire. In addition, anthropometric and biochemical parameters and their changes were evaluated. PAB was also assessed as an oxidative stress marker. In total, 15 patients stayed in the hospital for more than one week. The measurements were performed upon admission and discharge.Results: Upon admission, 49.1% of the patients were well-nourished, and 50.9% were at nutritional risk. As expected, the patients were overweight (36.8%) or obese (19.2%), and all the measures of adiposity were high. Well-nourished patients had lower serum PAB comparatively, while the difference was not statistically significant. The prevalence of the suboptimal nutrition index increased from 46.7% upon admission to 53.3% upon discharge. However, the increase was not considered significant due to the small sample size. Serum PAB increased within one week after admission, while the change was not significant (P=0.249).Conclusion: According to the results, the prevalence of suboptimal nutrition was high in the MI patients in Iran and increases during hospitalization.

Background: The use of a neutropenic diet after hematopoietic stem cell transplantation (HSCT) was instituted more than 30 years ago. This diet was targeted toward preventing from infection with organisms colonizing the gastrointestinal tract and the food-borne pathogens, which are the most important cause of illness and death in developing countries. Regarding this, the present study aimed to evaluate neutropenic diet in patients undergoing bone marrow transplantation in a selected hospital. This study also sought to investigate the role of hospital foods in the transmission of clinically important bacteria to the hospitalized patients. Materials and Methods: This cross-sectional study was conducted on the specimens of the foods served in the Bone Marrow Transplant Department of Shariati Hospital, Tehran, Iran. The samples were evaluated in terms of bacterial contamination using the standard method ‎of American Public Health Association and Food and Drug Administration (FDA). Results: According to total bacteria and coliform counts, No contamination was detected in any of the tested specimens. Conclusion: As the findings indicated, the neutropenic diet, was found to be fully in line with the standards of the Ministry of Health and FDA both in terms of guidelines and food analysis.

Very-early-onset inflammatory bowel disease (VEO-IBD) has a distinct phenotype and should be considered a specific entity. VEO-IBD presents with very severe clinical pictures and is frequently known by an indeterminate colitis whose clinical remission is unmanageable. This study examines the case of a neonate with VEO-IBD, not responding to medical and surgical treatment. A 7-day-old Iranian female neonate presented with severe bloody diarrhea, poor feeding, abdominal distention, and dehydration suggesting severe proctocolitis due to an allergy to the protein in cow’s milk. The condition did not respond to the elimination of diet for 1 month. Infections, celiac disease, and cystic fibrosis were excluded. Immunological investigations were negative, but antineutrophil cytoplasmic antibodies were positive. Due to the neonate’s persistent symptoms and failure to thrive, upper and lower endoscopies were performed, showing ulcerative colitis. At the age of 4 months, she presented with signs and symptoms of toxic colitis and acute intestinal perforation, which prompted an emergency laparotomy. Due to the necrosis of the colon, hemicolectomy and colostomy were done. The patient was resuscitated and rehabilitated and was given glucocorticoid and mesalamine. We believe that the incidence of this problem is increasing, as is shown by the rise in the number of children under 10 years old being diagnosed. These patients require more aggressive therapeutic interventions than older IBD patients to achieve complete remission because they are more likely to have extensive colonic disease.

Background: Recently, nutrition support was implemented as a part of clinical services in hospitals. The implementation of nutrition support needs to be assessed for its improvement. Objective: This study aimed to develop and validate a questionnaire to assess the state of nutrition support in Iranian hospitals. Methods: A mixed method approach was used in this study. This study was performed in training hospitals of Iran in 2016. In the development stage, pre-determined keywords were searched on international electronic databases. Additionally, semi-structural interviews were performed with 13 key informants based on purposive sampling. Themes were extracted from articles and interviews by thematic analysis. A primary questionnaire was generated based on extracted themes. In the validating stage, the content validity ratio (CVR) and content validity index (CVI) were used. The reliability of the questionnaire was also computed through a pilot study using Cronbach’s alpha test. SPSS version 16.0 was used for data analysis. Results: Based on 16 items elicited from the content analysis, 110 questions were generated, out of which, 65 questions were selected. Then, 55 questions showing acceptable CVI and CVR were chosen for the pilot study. The Cronbach’s alpha coefficient of the questionnaire was found to be 0.80. This value remained stable for each item, even after an item was deleted. Conclusion: For the first time, a validated questionnaire for the assessment of the state of nutrition support in hospitals was developed in a methodological approach process with high validity and reliability indexes which intended to be comprehensive based on the mixed method approach.

Objective: Food waste is a progressive concern and is contributed to reduce energy and protein intake. The aim of this study is to investigate the amount of food waste in different wards of Qaem and Imam Reza hospitals of Mashhad. Design and subjects: This cross-sectional study was performed during one week in the Imam Reza and Qaem hospitals. The study population consisted of 425 patients in some wards of two hospitals. We selected participants non-randomly from patients who are hospitalized in two hospitals. The rate of food waste was measured just in lunch meal by using the food residual observational check list. All statistical analyses were done through SPSS version 16. Descriptive statistic was used to define baseline characteristics. Independent sample T-test was used for comparison of food waste between main course and appetizer, crosstab and chi-square test for comparing the main course and appetizer waste based on sex, hospitals and wards and ANOVA used for comparison of age between different degrees of food waste. Results: In this study 13.9% of the patients left their food in plate entirely. Food wastage in appetizer was significantly higher than main course (P < 0.001). Also less patients in Qaem hospital than Imam Reza left all of their food (27.84 vs 22%) (p=0.003). Food wastage in the Heart ward was significantly higher than other wards (P=0.006). Conclusion: Food waste vary by the different hospitals and wards, so in order to decrease the food waste, serving meals based on the wards and patient requirements is a good solution.

Background: Neonatal screening is a preventive medical measure to screen infants shortly after birth for treatable metabolic disorders and endocrinopathies. The present study aimed to evaluate and compare the accuracy of laboratory samples in the screening programs for metabolic diseases in Mashhad city, Iran with international guidelines.Methods: This observational study was conducted on all the patients referring to the health centers of Mashhad, Iran during two weeks. In total, 220 infants were enrolled in the study and divided into three groups of health center 1, 2, and 3. A checklist was prepared based on the international guidelines to evaluate the neonatal screening procedures.Results: In total, 220 neonates aged 3-14 days (90 girls and 130 boys) were enrolled in this study. Mean weight and height of the neonates was 3215.90±485.12 grams and 49.85±2.04 centimeters, respectively. In all the cases, mode of nutrition was breastfeeding, and sampling was performed within 36 hours after birth. Neonates had no history of corticosteroid administration, catecholamine administration, parenteral nutrition, and blood transfusion. Heels of the neonates had no contact with the filter paper, and the samples were dried away from direct sunlight and heat. Two of the health centers used disinfectants and dried the heels of infants afterwards prior to drawing the samples. Conclusion: According to the results, the studied health centers followed the protocol properly. However, two of the health centers used disinfectants in such way that we were not sure whether the heels of the neonates were dried completely

Introduction: Malnutrition is a prevalent problem in hospitalized patients, causing a wide range of negative clinical and economic challenges. Protected mealtimes (PM) aim to enhance the quality of mealtime experience, improve nutrient status in hospitalized patients, and limit all non-essential interruptions so that patients might eat in a clean, quiet, and safe environment. Materials and Methods: This study is a clinical audit and was conducted in Mashhad teaching hospitals in order to evaluate mealtime interruptions that occurred among non-nutritional staff and influenced their food intake. Data were collected by direct observation. Lunchtime was chosen for audit because medical interruptions were more likely to happen during this meal. Two researchers (one dietitian, student and one dietetic assistant) observed lunch mealtime. The mealtime environment was monitored, and every negative interruption was registered. Exclusion criteria included patients who were nil-by-mouth or received enteral or parenteral nutrition. Results:A total of 208 patients were involved in the audit. The recorded negative interruptions included medical round, educational round, nurses’ change-of-shift, and activities of environmental service workers. Among interruptions, both medical round and nurses’ change-of-shift were the most frequent. All mealtime interruptions summarized to medical round (2.5%) (including serum replace, drug injection, and IV replace), change-of-shift (2.5%), environmental-service-worker activities (2%), and educational round (2%). Conclusion: Our study demonstrated that non-urgent interruptions during mealtimes were not adhered to PM guidelines, indicating the importance of addressing mealtime related issues in hospitals.

Several complications during childhood is associated with nutritional status of infants at birth. Therefore, nutritional status of newborns must be evaluated properly after birth. Assessment of the nutritional status of neonates based on anthropometric and physical indices is simple and inexpensive without the need for advanced medical equipment. However, no previous studies have focused on the assessment methods of the nutritional status of infants via anthropometric and physical indices. This study aimed to review some of the key methods used to determine the nutritional status of neonates using anthropometric and physical indices. To date, most studies have focused on the diagnosis of fetal malnutrition (FM) and growth monitoring. In order to diagnose FM, researchers have used growth charts and Ponderal index (PI) based on anthropometric indices, as well as Clinical Assessment of Nutritional (CAN) Score based on physical features. Moreover, in order to assess the growth status of infants, growth charts were used. According to the findings of this study, standard intrauterine growth curves and the PI are common measurement tools in the diagnosis of FM. Furthermore, CAN score is widely used in the evaluation of the nutritional status of neonates. Given the differences in the physical features of term and preterm infants, this index should be adjusted for preterm neonates. Longitudinal growth charts are one of the most prominent methods used for monitoring of the growth patterns of infants.

Objective: Achillea millefolium (A. millefolium) is known as an orexigenic herb in Iranian traditional medicine. In this study, the possible orexigenic effect of hydro-alcoholic extract of A. millefolium was investigated by measuring plasma ghrelin level.Materials and Methods: Thirty male Wistar rats were divided into five groups. Control group received water. Treatment groups received 50, 100 or 150 mg/kg of A. millefolium extract for 7 days via gavage. Before the intervention, daily amount of the food eaten by each rat was measured for 10 days. During the investigation, the amount of energy intake of each rat was also estimated 1, 2, 4, 6 and 24 hr after each intake, for 7 days. Later, the orexigenic dose of extract and distilled water was fed to two separate groups of 6 male Wistar rats. Plasma ghrelin level was measured 0.5, 1, 2 and 4 hr after extract intake.Results: The change in energy intake after treatment by 50 and 100 mg/kg of the extract was significantly higher than other groups (p

Introduction: A number of studies have shown the association between serum adiponectin level and the nutritional status. This study aimed to evaluate the relation between serum adiponectin and changes in nutritional status of head trauma patients. Methods: The current prospective cohort study was carried out on head trauma patients who were hospitalized in ICU of a General Teaching Hospital, Sulaimani, Iraq. Patients were divided into two groups based on their serum adiponectin level during the first 24 hours of admission (

An amendment to this paper has been published and can be accessed via the original article.

Oxidative stress is an important factor in the etiology of several chronic diseases that include cardiovascular disease (CVD), Type 2 diabetes (T2D), and rheumatoid arthritis (RA). Oxidative stress can lead to inflammation, and this can contribute to these chronic diseases. Reducing inflammation and oxidative stress may, therefore, be useful in the prevention and treatment of these conditions. One of the treatment options for chronic diseases is the use of traditional medicine and herbs, such as Nigella sativa. This is one of the herbs that have recently been assessed for its ability to reduce inflammation and oxidative stress. We have reviewed the reported effects of N. sativa on risk factors of chronic diseases (CVD, DM, and RA) with emphasis on molecular and cellular mechanisms in controlling inflammation and oxidative stress. Various mechanisms have been proposed to contribute to the beneficial properties of N. sativa, including a reduction of lipid peroxidation via its antioxidant properties; agonist of peroxisome proliferator-activated receptor gamma in adipose tissue; activation of AMP-activated protein kinase, increased antioxidants, inhibition of nuclear factor-kappa B pathway; increased in interleukin-10 expression, CD4+ T-cell percentage, T regulatory cell percentage (CD4+ CD25+ T-cell) in peripheral blood, and CD4+/CD8+ ratio, but to prove this claim, it is necessary to conduct experimental and well-designed clinical trial studies with a larger sample size on the effects of N. sativa on these chronic diseases.

Background: Food frequency questionnaires (FFQs) are inexpensive, easy to administer, and practical tools for dietary assessment in epidemiological studies. Several studies have investigated the validity and reproducibility of FFQs for the Iranian population. This systematic review aimed to assess the developed and validated FFQs for use in the Iranian population and compare their features and the validation studies in this regard. Materials and Methods: A comprehensive search was conducted in ISI Web of Knowledge, PubMed, Scopus, and Iranian databases without time constraints to retrieve the relevant English and non-English publications. Studies would be included if they were focused on the design and validation of FFQs in Iran. Results: In total, 782 articles were found, 22 of which met the eligibility criteria and evaluated 18 FFQs. Validation studies had been conducted on 18 out of 20 FFQs. The median of the correlation coefficients for the comparison of the FFQ intakes and the dietary reference method by nutrients varied within the range of 0.19–0.65, indicating reasonable validity. The median of the correlation coefficients for the comparison of two FFQs by nutrients was 0.28–0.85, showing appropriate reproducibility. However, low validity was observed in some nutrients and food groups, such as egg, legumes, iron, folate, and α-tocopherol. In seven studies, biomarkers were used for the assessment of nutrient intake using an FFQ with the median correlation coefficient of −0.07–0.42. In addition, the quality of methodology was evaluated in the FFQ validation studies, with 18 out of 20 studies reporting good and excellent quality. Conclusion: Although the FFQs used to assess the dietary intake of the Iranian population have different features, they have acceptable validity and reproducibility. Nevertheless, some food groups and nutrients have poor validity and must be considered attentively.

Introduction: During Ramadan, adult Muslims abstain from drinking and eating from sunrise to sunset. This religious practice influences individuals’ lifestyle factors such as eating behavior, meal schedule, and sleep pattern. These changes may affect endocrine and neuroendocrine circadian patterns, and consequently, cardiovascular indices. This study was performed to investigate the effects of Ramadan fasting on serum high-sensitivity C-reactive protein (Hs-CRP) and homocysteine as the risk factors for cardiovascular disease and body composition in the Iranian population. Methods: Healthy volunteers who fasted at least during 20 days of Ramadan were included in the study. Body composition and biochemical markers were measured pre- and post-Ramadan fasting. For normally distributed parameters, paired samples t-test was performed for analyzing the differences between the results, and Wilcoxon Signed Ranks test was run for non-normally distributed parameters. All the data was analyzed by SPSS, version 11.5. Results: Fifty-one healthy participants with the mean age of 36±10 years were enrolled in this study. Our analyses showed a reduction in body mass index (BMI) and fat mass pre- and post-Ramadan fasting. However, lean body mass and total body water remained unchanged by fasting. Variation in the serum Hs-CRP and homocysteine were not statistically significant. The results were the same across genders. Conclusion: Our study demonstrated that Ramadan fasting may lower fat mass in fasting volunteers with no adverse effects on inflammatory biomarkers of cardiovascular disease.

Background: Energy deficit is a common and serious problem in pediatric intensive care units. Parenteral nutrition, either alone or in combination with enteral nutrition, can improve nutrient delivery in critically ill patients by preventing or correcting the energy deficit and improving the outcomes. Intralipid 10% and 20% are lipid emulsions, widely used in parenteral nutrition. Despite several clinical advantages, intravenous Intralipid therapy has been associated with several complications.In this study, we aimed to investigate the effects of Intralipid 10% and 20% on peripheral intravenous catheter ablation in children receiving Intralipid in a pediatric intensive care unit. Methods: In this observational study, 96 patients were recruited through simple non-random sampling over six months. In total, 48 patients received intravenous Intralipid 10%, while 48 patients were administered Intralipid 20% as part of their parenteral nutrition plan. Through separate peripheral intravenous catheters, 0.5-3 g/kg/day of Intralipid was administered at an infusion rate of 0.5 g/kg/h. Length of hospital stay and intravenous catheter ablation were compared between the two groups. Results: Age of the patients ranged between two days and eight years. Esophageal atresia was the most common condition among patients receiving intravenous Intralipid infusion (8.3%). The mean duration of catheter survival was significantly shorter in patients receiving Intralipid 20% (28.77 vs. 68.23 h, P

Background: Few cases of persistent hyperinsulinemic hypoglycemia of infancy (PHHI) have been reported, so far. The main concern in the management of PHHI is to prevent severe hypoglycemia, which can lead to coma, brain damage and mental retardation. Total or subtotal pancreatectomy is normally required for the infants, despite the availability of medical therapies. Case report: In this report, we present the case of a three-day-old male infant with hypoglycemia and seizure, admitted to a hospital in Mashhad with the diagnosis of PHHI. Further evaluations revealed multiple congenital disorders including dextrocardia, posterior communicating aneurysm, atrial septal defect, ventricular septal defect, situs inversus and asplenia. Maximal doses of diazoxide, octreotide and intravenous glucose were prescribed for the infant. The patient was referred to our hospital and subtotal pancreatectomy was performed. In addition, due to frequent hypoglycemic episodes, a near-total pancreatectomy was conducted six days after the first surgery. The patient died eight months after total pancreatectomy at the age of nine months with no follow-ups. Conclusion: Infants with PHHI are at a high risk of severe neurological damage due to severe hypoglycemia, unless immediate and adequate medical interventions are carried out. Considering the co-occurrence of different congenital anomalies and PHHI in the present case, further assessment of concomitant congenital disorders is highly recommended in PHHI patients.

Objectives: We have investigated the effect of a saffron supplement, given at a dose of 100 mg/kg, on prooxidant-antioxidant balance (PAB) in individuals with metabolic syndrome. Materials and Methods: A randomized, placebo-controlled trial design was used in 75 subjects with metabolic syndrome who were randomly allocated to one of two study groups: (1) the case group received 100mg/kg saffron and (2) the placebo control group received placebo for 12 weeks. The serum PAB assay was applied to all subjects before (week 0) and after (weeks 6 and 12) the intervention. Results: There was a significant (p=0.035) reduction in serum PAB between week 0 to week 6 and also from week 0 to week 12. Conclusion: Saffron supplements can modulate serum PAB in subjects with metabolic syndrome, implying an improvement in some aspects of oxidative stress or antioxidant protection.

Over a billion of Muslims fast worldwide during Ramadan each year. Through this religious custom, fasting contributes to their health as well as their spiritual growth. However, available evidence regarding the health-benefits of Ramadan fasting is scarce and highly contentious. Although Islam exempts patients from fasting, many fast conceivably, and their clinical condition is prone to deteriorate due to persistent gap between current expert knowledge and conclusive strong evidence regarding the pathophysiologic and metabolic alterations of fasting and the consensus that should be taken into account to implements guided managing of various patient groups during Ramadan fasting among health care professionals. In this article, we summarized the results of initial studies regarding the effects of Ramadan fasting on some clinical conditions including alterations of body composition and clinically important outcomes of patients with a previous history of cardiovascular disease, asthma and renal colic disease. Our studies have shed light on several outcomes in favor of Ramadan fasting, and encourage those with mentioned diseases to consult their physicians and follow medical and scientific recommendations. In this review we aimed to present a piece of relevant evidence, clarify future scope and provide suggestions for future investigations.

The present study aimed to evaluate the effects of Ramadan fasting on the level of sex hormones in girls between 9-13 years before age at menarche.This study was conducted on a sample of 58 subjects (age range: 9-13 years), who were divided intotwo groups of fasting (N=31) and non-fasting (N=27). The levels of follicle-stimulating hormone(FSH), luteinizing hormone (LH), progesterone and estradiol were measured in all the subjectsbefore and after Ramadan. Measurements were carried out three days before the start of Ramadan,and one day afterwards.In this study, FSH levels significantly increased in the non-fasting group (P=0.01), and the level ofDehydroepiandrostenedione (DHEA) had a significant decrease during the time of study in bothgroups (P=0.001, P=0.006). In addition, serum levels of LH significantly increased in the non-fastinggroup after Ramadan (P=0.006), and estradiol significantly increased in both groups (P=0.008,P=0.004).Given the similar changes in the levels of DHEA, progesterone and estradiol in both study groups, itcould be concluded that fasting has no effects on these parameters, and the changes in LH and FSHlevels could be due to other contributing factors.

Objectives: weight loss as a consecution of losing appetite in post-operative patients and those suffering from HIV, cancer, cachexia and inflammatory diseases are the main inducements of morbidity and mortality. There is an increasing demand for more efficacious and endurable appetite stimulating treatment for patients with cachexia. Health economics is influenced by the malnutrition which was accounted for 5% of Iranian populations in 2011. Artemisia absinthium is known as an orexigenic herb in Iranian traditional medicine. Little evidence is available about its orexigenic effect and mechanism. So, the present study evaluated the possible effect on appetite of hydroalcoholic extract of Artemisia absinthium. Materials and Methods: Thirty male Wistar rats were randomly divided into five groups. Vehicle group received 0.5 ml water per day, control group did not receive anything and other 3 groups received 50, 100 and 150 mg/kg of Artemisia absinthium for 7 days respectively. The daily amount of the food eaten by each rat was measured for 10 consecutive days. The amount of energy intake for each rat was also calculated for 7 days during the intervention. The difference in energy intake was calculated and compared between groups. Results: The results suggest that there was no significant (p>0.05) differences in energy received before and during intervention between three case groups compared with the control group. The energy intake in 1-2 hours after extract injection in all groups, and energy intake after 24 hours interval in third case group (receiving 150 mg/kg extract) is higher compared to other intervals, but it is not significant (p>0.05). So, it can be stated that there was no significant differences between energy intake of 3 case groups and control group. Conclusion: Artemisia absinthium had no positive and dose-related effects on appetite of rats. Future studies are needed to evaluate the orexigenic effect of this plant.

Introduction: Malnutrition is a general problem in hospitalized patients. Enteral feeding in Intensive Care Unit (ICU) has been stated to decrease the metabolic response to stress, decline bacterial translocation, and preserve gut mucosal integrity. To assess the efficacy and complications of Nutrika supplement for enteral feeding in Intensive Care unit. Materials and Methods: Nutrika is an enteral nutritional supplement. 12 patients (six male, six female) who received Nutrika supplement through Nasogastric Tube (NGT) in ICU department of Ghaem Hospital were studied. Evaluating gastrointestinal tolerance, biochemical tests, daily calorie intake and the measurement of arm circumference were done daily. Mean admission duration of these hospitalized patients was ten days and it should be noted that the average amount of received gavage was 200 ml/2h. Results: four patients (two male, two female) had diarrhea when they received this supplement in consecutive meals. Two patients (female) experienced abdominal pain after consuming this supplement; however the prevalence of all gastrointestinal intolerance symptoms among patients were not statistically significant (P=0.25, P=0.50, P=0.50). Albumin and Urea level alter significantly during supplementation (P=0.001, P=0.002). Rest of the laboratory values did not change significantly. In two patients (one male, one female) who were completely intolerant to this solution, arm circumference had two cm decrease. Conclusion: Although this supplement has some complication including distension and diarrhea, however it is strongly suggested to use due to severe malnutrition in ICU ward and plays a significant role in improving general condition of these patients.

Background: Advances in information technology and data collection methods have enabled high-speed collection and storage of huge amounts of data. Data mining can be used to derive laws from large data volumes and their characteristics. Similarly, fuzzy logic by facilitating the understanding of events is considered a suitable complement to scientific data mining. Materials and Methods: The present study used clustering to identify the independent characteristics of data. Related fuzzy sets, linguistic variables, and data classifications were defined, and the index was introduced based on the characteristics extracted from useful results. By considering the disease risk factors, the results were analyzed. Results: Two factors contributing to the health improvement or deterioration were defined: ‘age’ and ‘the appropriateness or inappropriateness between insulin level and blood sugar’. In addition, according to the results, fasting had a positive effect on fatty substances of the blood (cholesterol and triglycerides). Conclusion: The results can help us determine whether or not an individual with a cardiovascular disease should fast in the month of Ramadan. However, due to variations in some features such as blood pressure throughout the day, there are uncertainties in some input data; therefore, the results could be far from reality. If it is possible to generate fuzzy data, then we can obtain more accurate results.

Background: Previous studies have indicated that Ramadan fasting has beneficial effects on cardiovascular risk factors, specially blood pressure and heart rate (1). In the present study, the effect of Ramadan fasting on 24-hour ambulatory blood pressure and heart rate has been investigated. Materials and Methods: This prospective observational study was conducted on two groups of individuals. Six patients under hypertension treatment were allocated to the case group and 12 healthy individuals were selected as the control group. Twenty-four-hour blood pressure monitoring was carried out during four periods: prior to Ramadan, during the first ten days and the last ten days of Ramadan, and one month after it. All patients continued their medication, which was administered twice per day. Twenty-four-hour mean blood pressure, weight, body mass index (BMI), and waist circumference were compared among the groups. Results: In the case group, there was a significant reduction in subjects’ weight during the third period of the experiment; also, a significant improvement was observed in the heart rate during the second and third periods in the case group (P

Objective(s):Hyperglycemia worsens the neuronal death induced by cerebral ischemia. Previous studies demonstrated that diabetic hyperglycemia suppressed the expression of heat shock protein 70 and 60 (HSP70 and 60) in the liver. IgG antibody titres against heat shock protein 27 (anti HSP27) were measured to determine whether hyperglycemia exacerbates ischemic brain damage by suppressing the expression of heat shock protein 27 (HSP27) in the brain. Materials and Methods: A randomized controlled study of traumatic brain injury ICU patients treated either by intensive insulin treatment (IIT) or by conventional glucose control (CGC) was conducted. Patients received at least 50% of their estimated daily energy requirements parenterally. Serum anti HSP27 antibody concentration was assessed at baseline, day 7 and day 14. Results: Twenty-six out of 29 patients (n=13 in each group) completed the study. At baseline, there were no differences between the two groups. On day 14, there was a significant reduction in anti HSP27 titre concentration in the IIT compared to the GCG group (0.47±0.27 mg/dl vs 0.60±0.15 mg/dl, P=0.03). Conclusion: In this study, intensive control of traumatic brain injury patients on parenteral nutrition reduced anti HSP27 titre, possibly suggesting a reduction in stress.

Background: Parenteral nutrition (PN) is a valuable life saving intervention, which can improve the nutritional status of hospitalized malnourished patients. PN is associated with complications including hyperglycemia. This study was conducted to compare two methods of blood glucose control in traumatic brain injury patients on PN. Materials and Methods: A randomized, open-label, controlled trial with blinded end point assessment was designed. Traumatic brain injury patients (GCS = 4-9) on PN, without diabetes, pancreatitis, liver disease, kidney complication, were participated. Patients were randomly assigned to receive continuous insulin infusion to maintain glucose levels between 4.4 mmol/l (80 mg/dl) and 6.6 mmol/l (120 mg/dl) (n = 13) or conventional treatment (n = 13). Patients in the conventional group were not received insulin unless glucose levels were greater than 10 mmol/l (>180 mg/dl). These methods were done to maintain normoglycemia in ICU. The primary outcome was hypo/hyperglycemic episodes. Other factors such as C-reactive protein, blood electrolytes, liver function tests, lipid profile and mid-arm circumference were compared. Results: Mean glucose concentration were significantly lower in IIT group (118 ± 28 mg/dl) vs conventional group (210 ± 31 mg/dl) (P < 0.01). No hypoglycemic episode occurred in two groups. Triglyceride (P = 0.02) and C-reactive protein (P = 0.001) was decreased in the IIT group, significantly. There were also significant differences in the electrolytes, with magnesium and phosphorus being lower in the IIT group (P = 0.05). Conclusion: In this pilot study, blood glucose level, CRP and TG were lower in IIT group. Further data collection is warranted to reach definitive conclusions.