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Driven by opioid use, HIV prevalence is high (15-27%) amongst injection drug users (IDU) in Iran. Harm reduction programmes are associated with a reduction in high risk injecting behaviours; however, Iran has a large number of non-injecting opioid users not immediately targeted by harm reduction programmes. The vast majority of heroin injectors tend to have a history of several years of smoking opium or heroin before transitioning to injection, and a small fraction may even start their drug career by injection of opioids, behaviours that can undermine the effectiveness of the harm reduction programmes. In this study, we have reviewed evidence on the HIV epidemic, extent and pattern of opioid use, and correlates of the transition to injection in Iran. We have concluded that harm reduction policies should also emphasize prevention of the transition to injection amongst high-risk non-injecting opioid users as an additional strategy against the spread of HIV infection in Iran. [ABSTRACT FROM AUTHOR]

Abstract HIV infection rates have reached epidemic proportions amongst injecting drug users (IDUs) in Iran. Although a number of community-based interventions have being implemented in the country, there is little information on the risk behaviors of IDU participants in these programs. This cross-sectional report aimed to compare the risk behaviors of injecting drug users with differential exposure rates to an HIV outreach program in Tehran, Iran. Results indicated that shared use of needle/syringe in the past month was significantly lower among IDUs who received estimated ≥ 7 syringes per week than those who did not [adjusted odds ratio (OR) = 14.36, 95% confidence interval (CI) 2.30–89.56]. While the effectiveness of this outreach program needs further evaluation through a longitudinal investigation, our preliminary findings suggest that the outreach program in Tehran may have been beneficial in reducing direct sharing among those who received more than several needles/syringes from the program.

Purpose: This study aimed to prepare, characterize, and in vitro and in vivo evaluate a novel nanostructured lipid carriers (NLCs) formulation containing two fractions of Glycyrrhiza glabra L. (licorice) extract for the treatment of hyperpigmentation., Methods: Two fractions, one enriched with glabridin (FEG) and the other enriched with liquiritin (FEL), were obtained by partitioning the methanol (MeOH) extract of licorice roots with ethyl acetate (EtOAc) and partitioning the EtOAc fraction with butanol (n-BuOH) and water. The quantities of glabridin (Glab) and liquiritin (LQ) in the fractions were determined by high-performance liquid chromatography (HPLC). FEG and FEL were loaded in different NLC formulations, and surface characterization and long-term stability were studied using Dynamic Light Scattering (DLS). The best formulation was chosen for further surface characterization, including Transmission Electron Microscopy (TEM), Differential Scanning Calorimetry (DSC), and Fouriertransform infrared (FTIR) spectroscopy. Moreover, entrapment efficiency percentage (EE%), in vitro drug release, in vivo skin penetration, cytotoxicity on B16F10 melanoma cells, effect on melanin production, and anti- tyrosinase activity were tested for the selected formulation., Results: Based on HPLC results, FEG contained 34.501 mg/g of Glab, and FEL contained 31.714 mg/g of LQ. Among 20 different formulations, NLC 20 (LG-NLCs) showed desirable DLS results with a Z-average size of 185.3±1.08 nm, polydispersity index (PDI) of 0.229±0.35, and zeta potential of -16.2±1.13 mV. It indicated good spherical shape, high EE% (79.01% for Glab and 69.27% for LQ), two-stage release pattern (an initial burst release followed by sustained release), efficient in vivo skin penetration, and strong anti-tyrosinase activity. LG-NLCs had acceptable physiochemical stability for up to 9 months and were non-cytotoxic., Conclusion: The LG-NLC formulation has revealed desirable surface characterization, good physiochemical stability, efficient drug release pattern and in vivo penetration, and high EE%. Therefore, it can be a suitable nanosystem for the delivery of licorice extract in the treatment of hyperpigmentation., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: It is hypothesized that fenugreek seeds are a rich source of fiber with anti-diabetic effects, which can help to lower blood glucose in patients with polycystic ovary syndrome (PCOS). In this study, the clinical and metabolic effects of fenugreek were compared to those of metformin in women with PCOS aged 16-40 years., Methods: In a randomized, triple-blind, parallel clinical trial, the efficacy of fenugreek 333 mg (n=55) was compared with metformin 500 mg (n=55), both administered three times a day in women with PCOS of reproductive age. Changes in some clinical outcomes and metabolic laboratory profile outcomes were evaluated at baseline and two months after the study., Results: By the end of the intervention period, all investigated factors improved significantly in patients of both groups (p<0.05). Reduction in biometric indices (body mass index and waist-hip ratio), fasting blood sugar (FBS), and insulin resistance was significantly higher after metformin consumption (p<0.001). Metformin also significantly improved irregular menstruation (p=0.02). In contrast, fenugreek significantly improved patients' lipid profiles, including low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) compared to metformin (p<0.001). Both interventions improved the patient's hair loss and hirsutism., Conclusion: Fenugreek cannot substitute metformin in PCOS treatment. However, regarding its lipid-lowering ability and low frequency of adverse effects, it can be used as an adjuvant treatment in PCOS, especially in PCOS patients with hyper-lipidemia and severe hair loss., Competing Interests: Conflicts of Interest There is no conflict of interest., (Copyright© 2024, Journal of Reproduction & Infertility.)

As a basic infrastructure, sewers play an important role in the innards of every city and town to remove unsanitary water from all kinds of livable and functional spaces. Sewer pipe failures (SPFs) are unwanted and unsafe in many ways, as the disturbance that they cause is undeniable. Sewer pipes meet manholes frequently, unlike water distribution systems, as in sewers, water movement is due to gravity and manholes are needed in every intersection as well as through pipe length. Many studies have been focused on sewer pipe failures and so on, but few investigations have been done to show the effect of manhole proximity on pipe failure. Predicting and localizing the sewer pipe failures is affected by different parameters of sewer pipe properties, such as material, age, slope, and depth of the sewer pipes. This study investigates the applicability of a support vector machine (SVM), a supervised machine learning (ML) algorithm, for the development of a prediction model to predict sewer pipe failures and the effects of manhole proximity. The results show that SVM with an accuracy of 84% can properly approximate the manhole effects on sewer pipe failures., Competing Interests: The authors declare there is no conflict., (© 2024 The Authors This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits copying, adaptation and redistribution, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/).)

Mushrooms have been used as medicine by humans for more than 5000 years. They have had a successful role in treating immune deficiencies. Nowadays, some extracts and compounds obtained from medicinal mushrooms have increased a great prospect of treating many disorders by having a great role in modulation of immune system, cancer inhibiting, cardio-vascular health, antiviral, antibacterial, antioxidant and protective effects against hepatitis and diabetes. In this study, we evaluated the antioxidant effect of methanol and hot water extract of the Trametes gibbosa (Pers.) Fr. mushroom and hepatoprotective effect of the extract with the most radical scavenging potency. To assess the antioxidant properties of different extracts of the mushroom, DPPH method was used. For assessing the hepatoprotective properties, a seven-day experiment was designed, and liver toxicity was induced by carbon tetrachloride [intraperitoneal (ip) for 7 consecutive days, 0.5 mL/kg body weight (BW)]. Rats were simultaneously fed with aqueous extract of the mushroom with the dose of 250, 500, and 1000 mg/kg BW and silymarin (100 mg/kg BW) as positive control. At the end of the experiment, blood serums of the rats were collected for quantification of major liver factors (e.g., aspartate aminotransferase, alanine aminotransferase, alanine phosphatase, bilirubin, etc.). Tissue samples were obtained for pathological examination. Based on the results, the aqueous extract showed more potent radical scavenging activity (half-maximal inhibitory concentration = 414.33 μg/mL, compared with 936.92 μg/mL for methanolic extract). Indeed, hepatoprotective properties of the aqueous extract of the mushroom (500 and 1000 mg/kg BW) were comparable with those of silymarin and even showed superior protective effects in histopathological examination. It seems that with further complementary studies, T. gibbosa could be considered a potential candidate for hepatoprotection.

Raynaud's phenomenon is manifested clinically by demarcated color changes the skin of the digits or extremities, typically may be an early clue to the diagnosis of hypothyroidism. In this report, we describe the 8-year-old patient with diagnosed primary hypothyroidism presenting with ceasing the treatment for 1 month that presenting with Raynaud phenomenon., Competing Interests: Conflict of interestThe authors have no competing interests to declare that are relevant to the content of this article., (© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Evidence confirms that parents know that they should limit non-core foods for their children since these tend to be high in energy density (HED), fat, salt and sugar. However, it is unclear how knowledge of portion size limits, such as the 100 kcal guide from Public Health England are applied in practice. To observe in real-time children's home food environment related to portion control and to explore with parents their reported portion size strategies, a mixed methods study was designed. Families with children aged 1-5 years were recruited ( n  = 21) to a three-part study: (1) to complete questionnaires and interviews on household food intake and portion control; (2) to report daily food intake for 4 days ( n  = 13) for one parent and their child(ren); (3) to observe home-based food provisioning via videorecording during dinner, breakfast and snack time ( n  = 6). Although the problem of large portion sizes of HED foods was recognised by mothers, strategies to downsize portions were not necessarily applied at home, as revealed in home observations and diaries. A mismatch between what was observed at home, what was reported in food diaries and what was said in interviews became apparent for some families. Mothers reported the need for greater support and guidance to downsize HED foods since they relied on pre-packaging as a guide to intake. Education and engagement were identified as important parameters for downsizing by mothers. One strategy which could be explored and applied by manufacturers is packaging design to faciliate the 100 kcal guidance using physical and engaging ways to assist parents in downsizing HED foods for their children. To facilitate effective government communication, innovative packaging design can be used to convey clear guidance and to tailor portion size messages for children. Packaging design, alongside government recommendations, can support parents' goals to achieve healthy eating and can reinforce guidance for portion norms through innovation involving learning, playful engagement, and interaction., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Tang, Wang, Vazirian, Croden and Hetherington.)

The COVID-19 global epidemic caused by coronavirus has affected the health and other aspects of life for more than one year. Despite the current pharmacotherapies, there is still no specific treatment, and studies are in progress to find a proper therapy with high efficacy and low side effects. In this way, Traditional Persian Medicine (TPM), due to its holistic view, can provide recommendations for the prevention and treatment of new diseases such as COVID-19. The muco-obstruction of the airway, which occurs in SARS-CoV-2, has similar features in TPM textbooks that can lead us to new treatment approaches. Based on TPM and pharmacological studies, Cinnamomum verum (Darchini)'s potential effective functions can contribute to SARS-CoV-2 infection treatment and has been known to be effective in corona disease in Public beliefs. From the viewpoint of TPM theories, Cinnamon can be effective in SARS-CoV-2 improvement and treatment through its anti-obstructive, diuretic, tonic and antidote effects. In addition, there is pharmacological evidence on anti-viral, anti-inflammatory, antioxidant, organ-o-protective and anti-depression effects of Cinnamon that are in line with the therapeutic functions mentioned in TPM.Overall, Cinnamon and its ingredients can be recommended for SARS-CoV2 management due to multi-targeting therapies. This review provides basic information for future studies on this drug's effectiveness in preventing and treating COVID-19 and similar diseases., (Copyright © 2021 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Although military body armor is an effective life saver, it considerably loads more weight on the warfighters, increasing the risk of musculoskeletal injury. This study investigated the immediate and prolonged effects of wearing body armor on timing aspect of lumbo-pelvic coordination during the toe-touch (TT) and two-legged-squat (TLS) tests. A cross-over study design was used wherein twelve asymptomatic and gender-balanced individuals completed two experimental sessions with and without body armor. A session included two similar sets of tests, before and after exposure to a treadmill walk, containing a TT and a TLS test with ten cycles of fast bending and return. Reflective markers were attached on the participants to capture the kinematics of body segments in conjunction with a motion capture system. The mean absolute relative phase (MARP) and deviation phase (DP) between the thorax and pelvis were calculated for each test. The pre-walk MARP in the return was significantly larger with versus without body armor (p = 0.022), while there were no significant effects of body armor on the other outcome measures. In addition, the pre-walk MARP and DP in the bending and return, as well as the walk-induced changes in the MARP in the bending phase were significantly larger in TLS versus TT (p < 0.026). Therefore, using a body armor immediately made the lumbo-pelvic coordination less in-phase during return, but no prolonged effects were found. Further investigation is necessary to specify chances wearing a body armor increases the risk of musculoskeletal injuries in the lower back and lower extremities joints., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to declare., (Published by Elsevier Ltd.)

Excessive production of reactive oxygen species (ROS) during semen cryopreservation can induce structural and functional changes in spermatozoa. It is well known that antioxidants can mitigate the effect of ROS. Moreover, the application of antioxidants in freezing media is an appropriate strategy for protecting spermatozoa against deleterious effects of ROS during the cryopreservation process. As an example, oregano is a medicinal plant with important activities, with antiseptic, antibacterial, antithrombotic, and antioxidant properties. This study aimed at evaluating the antioxidant effects of oregano extract on cryopreserved human spermatozoa. In the first phase, 13 semen samples with different concentrations of oregano extract (0.0, 50, 100, 150, 300, and 500 μg/mL) were cryopreserved to achieve an optimal dose of oregano extract. Then, motility, viability, and plasma membrane integrity were evaluated. In the second phase, 20 samples were cryopreserved in freezing media supplemented with or without the optimal concentration of oregano (100 μg/mL). After thawing, motility, the levels of ROS, lipid peroxidation, and translocation of phosphatidylserine (PS) were evaluated. The results showed that 100 μg/mL oregano extract significantly increased the total motility in frozen-thawed spermatozoa in comparison with the control group (28.2 ± 4.3 vs. 42.4 ± 1.6, p  < 0.05). This concentration significantly decreased the percentage of 2',7'-dichlorofluorescein-positive cells (25.53 ± 1.2 vs. 21.48 ± 1.2) and the malondialdehyde level (4.25 ± 0.7 vs. 0.82 ± 0.4 μM) ( p  < 0.05). In the oregano group, the percentage of vital spermatozoa without PS externalization was significantly higher than that in the control group (25.88 ± 1.6 vs. 16.8 ± 1.9, p  < 0.001), while the percentage of dead spermatozoa with PS externalization spermatozoa was significantly lower than that in the control group (51.65 ± 1.4 vs. 60.36 ± 1.9, p  < 0.05). In general, the addition of oregano extract to sperm freezing extender has protective effects against oxidative stress and apoptosis.

Offering large portions of high energy dense (HED) foods increases overall energy intake in children, a potentially important contributing factor to childhood overweight and obesity. Packaging offers a simple heuristic to encourage healthy eating for nutrient dense foods and to downsize portions of HED foods. However, it is not clear how parents use packaging for portion control, nor how packaging might be used as a solution to offset large portions. Therefore, the aim of the present study was to investigate mothers' portion strategies and how they use packaging to facilitate portion control for children. 21 mothers of 25 children aged 1-5 years participated in semi-structured interviews to identify strategies used by mothers for portioning snack and meal items. Mothers reported feeling confident in amounts offered to their children, and were unaware of, or did not apply, recommendations for age-appropriate portions of meal items and snacks. Mothers portioned according to child appetite, needs and characteristics, not necessarily age. They reported that their child was able to determine for themselves how much to consume. However, mothers also applied restrictions to some foods. No differences in considerations and strategies were found between different ethnic groups of British and Chinese mothers. Mothers reported that packaging was an important determinant of preferences and a useful, convenient means of portion control. To promote appropriate consumption norms in children, a packaging design concept is described to aid downsizing for a highly liked HED food. Future studies should examine how creative packaging solutions influence parents' feeding practices and how this might influence dietary quality through user testing., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Trachyspermum ammi (Apiaceae) plants have several medicinal and condimentary applications and are considered an aphrodisiac agent in Iranian Traditional Medicine. Thus, the present study aims to evaluate the effects of oil from Iranian T. ammi plants on the viability of spermatogonial stem cells in vitro. The essential oil of T. ammi fruits was extracted by hydrodistillation, and the amount of thymol was calculated by a gas-chromatography method. Spermatogonial stem cells were isolated from the testes of mice using enzyme digestion. Real-time polymerase chain reaction (RT-PCR) was applied to assess the gene expressions of promyelocytic leukemia zinc finger protein ( Plzf ), DNA-binding protein inhibitor ( ID-4 ), tyrosine-protein kinase ( c-Kit ), B-cell lymphoma 2 ( Bcl2 ) and Bcl2-associated X protein ( BAX ). The number and diameter of colonies were also measured in the treated cells. The amount of thymol in the oil was 130.7 ± 7.6 µg/mL. Flow cytometry analysis showed that 92.8% of all cells expressed stimulated by retinoic acid 8 ( Stra8 ), a spermatogonial stem cell marker. Expression of Plzf and ID-4 genes significantly increased in the treatment groups, while c-Kit and BAX decreased, and Bcl2 increased in the presence of essential oil. The numbers and diameters of cells were also improved by the application of the plant oil. These data indicated that monoterpenes from the oil of T. ammi improved the quality and viability of spermatogonia cells in the cell culture.

Centaurea bruguierana subsp . belangerana was extracted by 80% ethanol. The total extract was then partitioned into four fractions including chloroform, ethyl acetate and methanol. Cytotoxic effect of fractions was examined by MTT assay in K562 (chronic myelogenous leukemia), AGS (gastric adenocarcinoma), MCF-7 (breast adenocarcinoma) and SW742 (colon adenocarcinoma) cell lines. The Chloroform fraction, with the lowest LC 50 against K-562 cell lines, was partitioned into 14 subfractions and subjected to further purification by reversed-phase (C18) silica gel and sephadex LH-20 column chromatography. Three flavonoids including cirsimaritin, cirsilinelol and eupatilin were isolated for the first time from the species and the structures were confirmed by spectroscopic data. The high selectivity index of the purified flavonoids indicates valuable components with potential few side effects for normal cell lines. However, solubility tests for isolated components indicates the need for novel pharmaceutical dosage forms, in the case for using natural flavonoids as chemotherapeutic agents.

Adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) is a heterotrimeric enzyme which monitors cellular energy status and regulates metabolism with energy balance. AMPK activation, as a master regulator of metabolism, plays role in key tissues like liver, skeletal muscles, and heart as well as central nervous system (CNS). Activation of the enzyme by indirect activators attracts scientific attentions to treat diabetes, obesity, cancer, and other related metabolic disorders like physiological and pathophysiological states in CNS. A number of hormones and pharmacological agents have been reported to activate AMPK including paroxetine, metformin, thiazolidinediones, adiponectin, leptin, interleukin-6, and etc. AMPK activity is prominent in regulation of glucose, lipid, and proteins metabolism as well as mitochondrial biogenesis and autophagy. Activation of AMPK in the liver decrease blood glucose and in skeletal muscles stimulates glucose uptake independently of insulin through modulation of activity of several downstream substrates. Activation of AMPK inhibits synthesis and induces oxidation of fatty acids, which may reduce ectopic lipid accumulation and improve insulin action. The enzyme activation promotes cardiovascular homeostasis by ensuring optimum redox balance of heart and vascular tissue. In addition, AMPK signaling may link to cancer development via regulation of checkpoints of cell cycle. Numerous of conventional drugs have been derived from natural resources, while the application of this fruitful source of chemical structures have not been explored in depth. A number of these compounds are discussed in this review that exhibit beneficial effects in metabolic disorders through AMPK activation., (Copyright © 2018. Published by Elsevier Ltd.)

: In this article, we describe a middle-aged woman with a history of addiction to opioid medications who eventually became dependent on kratom. Her kratom-related withdrawal symptoms responded to a trial of buprenorphine-naloxone. Subsequently, she was maintained on this medication.

Background: Historically, there has been a restrictive approach toward outpatient parenteral antimicrobial therapy (OPAT) in patients with injection drug use (IDU) due to the fear that they might utilize the intravenous catheter to inject illicit substances., Objective: We tested the hypothesis that patients with current IDU on OPAT would have less favorable treatment outcomes compared to those without current IDU., Methods: In this retrospective cohort chart review study of Cleveland Clinic OPAT registry, we identified patients with current IDU by both electronic and manual review. For each patient with current IDU, we identified 3 matched controls among those on OPAT and without current IDU, by propensity score matching on age, sex, OPAT year, and OPAT diagnosis. We compared treatment failure, infection relapse, line infection, hospital readmission, number of emergency room visits, and 90-day mortality, for patients with current IDU and their matched controls., Results: We identified 39 patients with current IDU and 117 matched controls. Most patients with current IDU (82%) were discharged to skilled nursing facilities, whereas the majority of the control group (74%) was treated at home (p < 0.01). There was no significant difference in the examined treatment outcomes between the 2 groups., Conclusions: Patients with current IDU on OPAT did not have less favorable treatment outcomes compared to those without current IDU. Although the reason for this finding could potentially be related to difference in disposition, more studies need to be done to assess safety of home disposition among these patients., (Copyright © 2018 Academy of Consultation-Liaison Psychiatry. Published by Elsevier Inc. All rights reserved.)

Background: Malaria, a mosquito-transmitted disease, is still a major human health problem all over the world. Larviciding is a component of comprehensive control program to overcome the disease. Negative aspects of synthetic insecticides application, such as environmental safety concerns, have favored use of natural insecticides., Methods: Larvicidal activity of essential oil, extracts and fractions of a wild grown and a cultivated type of Bunium persicum fruits against malaria vector Anopheles stephensi was assessed according to the method described by WHO., Results: Bunium persicum showed remarkable potency against An. stephensi larvae. LC 50 values for essential oil, total extract, petroleum ether fraction and methanol fraction were 27.4284, 64.9933, 85.9933 and 255.7486ppm for wild type, and 21.3823, 63.2580, 62.7814 and 152.6357ppm for cultivated one., Conclusion: The results of this study suggest B. persicum as a valuable source of natural insecticides against malaria vector Anopheles stephensi .

Ischemic stroke is an important cause of death and disability in the world. Brain ischemia causes damage to brain cell, and among brain neurons, pyramidal neurons of the hippocampal CA1 region are more susceptive to ischemic injury. Recent findings suggest that neurotrophic factors protect against ischemic cell death. A dietary component of Rosa damascene extract possibly is associated with expression of neurotrophic factors mRNA following ischemia, so it can have therapeutic effect on cerebral ischemia. The present study attempts to evaluate the neuroprotective effect of Rosa damascene extract on adult rat hippocampal neurons following ischemic brain injury. Forty-eight adult male Wistar rats (weighing 250±20 gr and ages 10-12 weeks) used in this study, animals randomly were divided into 6 groups including Control, ischemia/ reperfusion (IR), vehicle and three treated groups (IR+0.5, 1, 2 mg/ml extract). Global ischemia was induced by bilateral common carotid arteries occlusion for 20 minutes. The treatment was done by different doses of Rosa damascena extract for 30 days. After 30 days cell death and gene expression in neurons of the CA1 region of the hippocampus were evaluated by Nissl staining and real time PCR assay. We found a significant decrease in NGF, BDNF and NT3 mRNA expression in neurons of CA1 region of the hippocampus in ischemia group compared to control group (P<0.0001). Our results also revealed that the number of dark neurons significantly increases in ischemia group compared to control group (P<0.0001). Following treatment with Rosa damascene extract reduced the number of dark neurons that was associated with NGF, NT3, and BDNF mRNA expression. All doses level had positive effects, but the most effective dose of Rosa damascena extract was 1 mg/ml. Our results suggest that neuroprotective activity of Rosa damascena can enhance hippocampal CA1 neuronal survival after global ischemia.

Context: As an alternative approach, administration of phytotherapeutic agents in management of benign prostate hyperplasia (BPH), is rapidly growing each day. Different authors have indicated effectiveness of Viola odorata L. (Violaceae), Echium amoenum Fisch. & C.A.Mey. (Boraginaceae) and Physalis alkekengi L. (Solanaceae) in treatment of BPH. However, none have reported the beneficial outcomes of the mixture yet., Objective: This study evaluates the therapeutical effects of V. odorata, E. amoenum and P. alkekengi mixture on symptomatic BPH patients., Materials and Methods: Eighty six symptomatic BPH patients with International Prostate Symptom Score (IPSS) of more than 13 and prostate volume of more than 30 cm 3 were randomly allocated to receive a two-week course of placebo (control group) or 1 mL of mixed hydro-alcoholic solution of P. alkekengi, E. amoenum and V. odorata extracts (1.5, 1 and 1.5% respectively) (treatment group)., Results: IPSS score of incomplete urination (42.3 ± 2.04%), frequency of urination (20.08 ± 1.02%), intermittency (40.78 ± 2.16%), urgency (60.91 ± 3.14%), weak stream (50.58 ± 2.14%), straining (55.67 ± 2.53%) and nocturia (40.14 ± 1.89%) in treatment group were significantly decreased after treatment compare to placebo receiving group. Furthermore, the prostate volume (16.92 ± 0.89%) and extant urine volume (28.12 ± 1.36%) also significantly decreased in treatment group compared to control group. No significant side effects or abnormalities in biochemical tests and urinalysis were observed throughout the study., Discussion and Conclusions: Based on results, mentioned mixture is safe and effective in improving life quality of patients suffering from BPH.

In this study, in vitro evaluation of cholinesterase inhibitory (ChEI) activity of various plants including betel nuts (Areca catechu L.), clove buds (Syzygium aromaticum L.), aerial parts of dodder (Cuscuta chinensis Lam.), common polypody rhizomes (Polypodium vulgare L.) and turpeth roots (Ipomoea turpethum R. Br.) which were recommended for the treatment of AD symptoms in Iranian Traditional Medicine (ITM) is reported. Among them, aqueous extract of A. catechu L. was found as the most potent anti-AChE (IC 50  = 32.00 μg/mL) and anti-BChE (IC 50  = 48.81 ± 0.1200 μg/mL) agent.

Age-related differences in lumbar contribution to the trunk motion in the sagittal plane were investigated. Sixty individuals between 20-70 years old in five gender-balanced age groups performed forward bending and backward return with slow and fast paces. Individuals older than 50 years old, irrespective of the gender or pace, had smaller lumbar contribution than those younger than this age. The lumbar contribution to trunk motion was also smaller in female participants than male participants, and under fast pace than under the slow pace. Age-related differences in lumbar contributions suggest the synergy between the active and passive lower back tissues is different between those above and under 50 years old, differences that are likely to affect the lower back mechanics. Therefore, detailed modelling should be conducted in future to find the age-related differences in the lower back mechanics for tasks involving large trunk motion. Practitioner Summary: Lumbar contribution to the sagittal trunk motion was observed to be smaller in individuals above 50 years old than those below this age. This could be an indication of a likely change in the synergy between the active and passive lower back tissues, which may disturb the lower back mechanics.

Alterations in the lumbo-pelvic coordination denote changes in neuromuscular control of trunk motion as well as load sharing between passive and active tissues in the lower back. Differences in timing and magnitude aspects of lumbo-pelvic coordination between patients with chronic low back pain (LBP) and asymptomatic individuals have been reported; yet, the literature on lumbo-pelvic coordination in patients with acute LBP is scant. A case-control study was conducted to explore the differences in timing and magnitude aspects of lumbo-pelvic coordination between females with (n=19) and without (n=19) acute LBP. Participants in each group completed one experimental session wherein they performed trunk forward bending and backward return at preferred and fast paces. The amount of lumbar contribution to trunk motion (as the magnitude aspect) as well as the mean absolute relative phase (MARP) and deviation phase (DP) between thoracic and pelvic rotations (as the timing aspect) of lumbo-pelvic coordination were calculated. The lumbar contribution to trunk motion in the 2nd and the 3rd quarters of both forward bending and backward return phases was significantly smaller in the patient than the control group. The MARP and the DP were smaller in the patient vs. the control group during entire motion. The reduced lumbar contribution to trunk motion as well as the more in-phase and less variable lumbo-pelvic coordination in patients with acute LBP compared to the asymptomatic controls is likely the result of a neuromuscular adaptation to reduce painful deformation and to protect injured lower back tissues., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Glaucoma represents several optic neuropathies leading to irreversible blindness through progressive retinal ganglion cell (RGC) loss. Reduction of intraocular pressure (IOP) is known as the only modifiable factor in the treatment of this disorder. Application of exogenous cannabinoids to lower IOP has attracted attention of scientists as potential agents for the treatment of glaucoma. Accordingly, neuroprotective effect of these agents has been recently described through modulation of endocannabinoid system in the eye. In the present work, pertinent information regarding ocular endocannabinoid system, mechanism of exogenous cannabinoids interaction with the ocular endocannabinoid system to reduce IOP, and neuroprotection property of cannabinoids will be discussed according to current scientific literature. In addition to experimental studies, bioavailability of cannabinoids, clinical surveys, and adverse effects of application of cannabinoids in glaucoma will be reviewed., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Forward bending and backward return of the human trunk in the sagittal plane are associated with a specific lumbopelvic rhythm, which consists of magnitude and timing aspects. In this study, the age-related differences in the timing aspect of lumbopelvic rhythm were investigated using the continuous relative phase method. Specifically, the mean absolute relative phase (MARP) between the thoracic and pelvic motions as well as variation in MARP under repetitive motions, denoted by deviation phase (DP), were characterized in sixty participants between 20 and 70years old. MARP and DP were determined for trunk forward bending and backward return tasks with self-selected slow and fast paces. The MARP and DP were both smaller (p=0.003, p<0.001 respectively) in the older versus younger age participants with no gender-related difference. In fast versus slow pace task, the MARP was smaller (p<0.001) only in forward bending, whereas the DP was smaller (p<0.001) in both the forward bending and backward return. A more in-phase and more stable lumbopelvic rhythm denoted respectively by smaller MARP and DP in older versus younger individuals maybe a neuromuscular strategy to protect the lower back tissues from excessive strain, in order to reduce the risk of injury., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: Gharikon is a well-known medicinal mushroom in Iranian traditional medicine and mentioned several times in different kinds of authentic literature. Considering both traditional and modern literature, the aim of this study is to present a review of its biological activities., Methods: Using online databases (e.g. PubMed, Scopus, and Google Scholar) as well as reviewing traditional medicinal literature (e.g. Makhzan-ul-Adwiah, Al-Qanun fi al-Tibb); we reviewed the published literature on the pharmacological effects of Laricifomes officinalis (the most common species considered as "Gharikon")., Results: Laricifomes officinalis (Polyporus officinalis) is a wood-rotting fungus that grows on different hosts such as conifers. The mushroom is native to Europe, Asia, and North America. According to the judgment of traditional medicine, its temperament is warm and dry. It has been used since the ancient times to treat sciatica, weakness of muscles, bronchitis, constipation, stomach and uterus pain, jaundice, fever and insect bites. It also has diuretic and emmenagogue effects. In recent decades, several research studies have been performed on L. officinalis. The results showed that the biological effects of L. officinalis are anti-viral (especially against smallpox, H5N1 influenza, and hepatitis C virus), anti-tuberculosis, boosting the immune system, treating dysmenorrhea, hemorrhoids, cough, rheumatoid arthritis and anticoagulant activity. A survey revealed that L. officinalis is a well-known medicinal mushroom with some formulations as dietary supplements on the market., Conclusion: Considering traditional literature and recent findings on biological activities that in most cases corroborate each other, it seems that Laricifomes officinalis needs more attention in new investigations, including more pharmacologic assays and clinical trials, which may lead to the development of new natural products.

The prevalence of low back pain (LBP) increases with age, yet the underlying mechanism(s) responsible for this remains unclear. To explore the role of biomechanical factors, we investigated age-related differences in lower-back biomechanics during sagittally-symmetric simulated manual material handling tasks. For each task, trunk kinematics and mechanical demand on the lower back were examined, from among 60 participants within five equal-sized and gender-balanced age groups spanning from 20 to 70 years old. The tasks involved lowering a 4.5 kg load from an upright standing posture to both knee height and a fixed height and then lifting the load back to the initial upright posture. During these tasks, segmental body kinematics and ground reaction forces were collected using wireless inertial measurement units and a force platform. Overall, older participants completed the tasks with larger pelvic rotation and smaller lumbar flexion. Such adopted trunk kinematics resulted in larger peak shearing demand at the lower back in older vs. younger participants. These results suggest that older individuals may be at a higher risk for developing lower back pain when completing similar manual material handling tasks, consistent with epidemiological evidence for higher risks of occupational low back pain among this cohort., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Age-related differences in trunk intrinsic stiffness, as an important potential contributor to spinal stability, were investigated here because of: (1) the role of spinal instability in low back pain (LBP) development; (2) the increasing prevalence of LBP with age, and (3) the increasing population of older people in the workforce. Sixty individuals aged 20-70 years, in five equal-size age groups, completed a series of displacement-controlled perturbation tests in an upright standing posture while holding four different levels of trunk extension efforts. In addition to examining any age-related difference in trunk intrinsic stiffness, the current design assessed the effects of gender, level of effort, and any differences in lower back neuromuscular patterns on trunk intrinsic stiffness. No significant differences in trunk intrinsic stiffness were found between the age groups. However, stiffness was significantly larger among males and increased with the level of extension effort. No influences of differences in neuromuscular pattern were observed. Since the passive contribution of trunk tissues in the upright standing posture is minimal, our values of estimated trunk intrinsic stiffness primarily represent the volitional contribution of the lower back musculoskeletal system to spinal stability. Therefore, it seems unlikely that the alterations in volitional behavior of the lower back musculature, caused by aging (e.g., as reflected in reduced strength), diminish their contributions to the spinal stability., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Lumbopelvic rhythm during trunk forward bending and backward return has been widely investigated to have a better understanding of the pattern of trunk motion, as used in research on low back disorders. Considerable differences in the methods used to measure, and approaches used to characterize the lumbopelvic rhythm hinder the integration of findings of those studies for further research in the future. Thus, the purpose of this review was to summarize the methods for kinematic measurement as well as their characterization approaches for the lumbopelvic rhythm. PUBMED and CINAHL databases were searched for relevant studies. Several types of instruments were found to be used in the reviewed studies, mostly using markers or sensors, which were placed on different parts of spine, with different definitions to measure the lumbar and pelvic motion. Also, various characterization approaches were found to be used, of which some related to the magnitude, while the others to the timing aspects of lumbopelvic rhythm. Such a characterization was either qualitative or quantitative. In addition, the specified characterization approaches were applied on a sample of trunk kinematics data from our lab to demonstrate differences in the outcomes of these approaches., Competing Interests: Competing interests The authors declare that they have no competing interests.

Objectives: Abnormalities of lumbopelvic coordination have been suggested to relate to risk of developing low back pain. The objective of this study is to review and summarize the findings of studies that have implemented and reported on lumbopelvic rhythm during trunk forward bending and backward return., Methods: The PUBMED and CINAHL databases were searched for studies related to LPR using appropriate keywords. The references of each study from the database search were further investigated to identify any missed study., Results: The findings includes results related to lumbopelvic rhythm, and how it varies due to participant characteristics such as age, gender, and presence of low back pain as well as due to variations in the experimental procedures such as pace of motion, presence of external load, and muscle fatigue., Conclusion: In general, the magnitude of lumbar contribution is smaller in people with low back pain, in the elderly and females, as well as with greater pace of motion, but is larger with greater external load or back muscle fatigue. The compiled data in this review are expected to serve as a foundation for implementation of this kinematic-based measure in the conduct of future research.

It is well known that innate immunity in fish can be activated by many synthetic and natural immunos-timulants; several natural substances induced immunity in fish in previous surveys. This study discussed data regarding the effect of Ganoderma applanatum aqueous extract on the defense mechanisms of rainbow trout in feeding trials. Fish were fed 250, 500, and 1000 mg extract/kg diet 4 times daily. Growth, humoral parameters, lysozyme activity, and serum protein concentrations were assessed after a period of 45 days. The results indicated that dietary supplementation with the mushroom extract did not positively affect the growth of fish compared with the control group. The numbers/amounts of red blood cells, hemoglobin, hematocrit, white blood cells, monocytes, and neutrophils increased significantly in the treated fish. Other red cell indices, including mean corpuscular volume, mean corpuscular hemoglobin concentration, and mean corpuscular hemoglobin values, indicated no significant differences among all groups. The values of immunologic parameters in the all treatment groups were elevated, especially with a concentration of 1000 mg mushroom extract/kg diet: lysozyme activity, 50.00 ± 1.15 U/mL; total protein, 4.40 ± 0.12 g/dL; albumin, 2.40 ± 0.23 mg/dL; total immunoglobulin, 23.50 ± 0.76 mg/dL. These findings suggested the potential ability of G. applanatum aqueous extract to activate immunologic parameters in rainbow trout.

Objectives: Several novel synthetic amphetamines have been marketed worldwide as "bath salts." The use of bath salts is associated with severe medical consequences resulting in a US federal ban over the last 3 years on the more common substances found in this group. Bath salts intoxication has a relatively nonspecific presentation, and urine toxicology confirmation in emergency departments (EDs) is impractical because the turnaround time is several days. Emergency clinicians must therefore rely heavily on patients' self-reports to verify the diagnosis. We performed an online survey of emergency clinicians to determine their degree of exposure to bath salts-intoxicated patients, the clinically relevant features of such patients, and the typical emergency management., Methods: We invited 124 physicians and physician assistants in 7 Cleveland Clinic EDs to participate in an online survey., Results: From a total of 43 of the 124 respondents, 77% did not specifically ask patients about bath salts use. Sixty percent had encountered a bath salts-intoxicated individual. Most respondents reported that the majority of patients were male, were between 19 and 29 years old, and used other drugs in addition to bath salts. Agitation, aggression/violence, and hallucinations were reported to be the most common presentations, and intravenous/intramuscular tranquilization was reported as the most often used management. Most patients were discharged home from the ED., Conclusions: Despite the lack of toxicology screening in EDs, about two thirds of the surveyed emergency clinicians encountered bath salts-intoxicated individuals. Our study demonstrates the need for increased screening of bath salts intoxication in EDs, especially in agitated patients.

Echinacea purpurea (Asteraceae) is a perennial medicinal herb with important immunostimulatory and anti-inflammatory properties, especially the alleviation of cold symptoms. The plant also attracted scientists' attention to assess other aspects of its beneficial effects. For instance, antianxiety, antidepression, cytotoxicity, and antimutagenicity as induced by the plant have been revealed in various studies. The findings of the clinical trials are controversial in terms of side effects. While some studies revealed the beneficial effects of the plant on the patients and no severe adverse effects, some others have reported serious side effects including abdominal pain, angioedema, dyspnea, nausea, pruritus, rash, erythema, and urticaria. Other biological activities of the plant such as antioxidant, antibacterial, antiviral, and larvicidal activities have been reported in previous experimental studies. Different classes of secondary metabolites of the plant such as alkamides, caffeic acid derivatives, polysaccharides, and glycoproteins are believed to be biologically and pharmacologically active. Actually, concurrent determination and single analysis of cichoric acid and alkamides have been successfully developed mainly by using high-performance liquid chromatography (HPLC) coupled with different detectors including UV spectrophotometric, coulometric electrochemical, and electrospray ionization mass spectrometric detectors. The results of the studies which were controversial revealed that in spite of major experiments successfully accomplished using E. purpurea, many questions remain unanswered and future investigations may aim for complete recognition of the plant's mechanism of action using new, complementary methods.