Background: Leishmaniasis covers a range of clinical manifestations. Estimation of the burden of leishmaniasis may help guide healthcare management personnel and policy-makers in applying effective interventions. The present study aimed to calculate the incidence and burden of cutaneous and visceral leishmaniasis in Iran in 2013. Methods: To evaluate the epidemiological aspects of the disease in Iran, published studies over the past 20 years were searched and the viewpoints of relevant specialists in Iran were obtained. Data were collected from the Ministry of Health and from the Tehran University of Medical Sciences. To calculate years of life lost due to premature death, standard expected years of life lost was used. Standard life table of Global Burden of Disease (GBD) 2010 with the life expectancy of 86.02 years for both sexes was used to calculate the remaining potential years of life at any age from death. Results: The overall incidence of cutaneous and visceral leishmaniasis was calculated as 22 and 0.092 per 100000 population of Iran, respectively. The burden of leishmaniasis was 99.5 years: 95.34 and 4.16 years for cutaneous and visceral, respectively. Sensitivity was analyzed and deaths predicted by the Institute of Health Metrics and Evaluation added, the burden of visceral leishmaniasis was 726 years. Conclusion: The share of leishmaniasis burden in Iran is lower than the global burden of the disease. GBD 2010 standard method is recommended to calculate the burden of leishmaniasis in different countries and set local priorities on the basis of these measures. Keywords: Incidence, Disability-adjusted life years, Cutaneous leishmaniasis, Visceral leishmaniasis, Iran

Background. Different effects of cinnamon and its oil in traditional medicine in the treatment of diseases, including gastrointestinal diseases, were reported. The aim of this study is to evaluate the efficacy and safety of cinnamon oil (Cinnamomum zeylanicum) in patients with functional dyspepsia in a double-blind, randomized placebo-controlled trial. Methods. Soft gelatin capsule was made using the rotary die process, and the final capsule was standardized based on its cinnamaldehyde amount and analyzed by high-performance liquid chromatography (HPLC) method. Sixty-four patients with symptomatic functional dyspepsia were randomized to receive cinnamon oil soft capsule (n = 29) or sesame oil soft capsule as placebo (n = 35) for 6 weeks. The primary efficacy variable was the sum score of the patient’s gastrointestinal symptom (five‐point scale). Secondary variables were the scores of each dyspeptic symptom including severity of vomiting, sickness, nausea, bloating, abdominal cramps, early satiety, acidic eructation/heartburn, loss of appetite, retrosternal discomfort, and epigastric pain/upper abdominal pain, as well as any reported adverse events. Results. The results showed that, after 6 weeks of treatment, the cinnamon oil and placebo groups significantly decreased the total dyspepsia score compared to the baseline at the endpoint ( ). However, there was no significant difference between the cinnamon oil and placebo groups in terms of the baseline and endpoint values of the outcome variables ( and , respectively). Two patients in the cinnamon oil group complained of rashes, and three patients in the placebo group complained of nausea. Conclusion. This study showed significant improvements in gastrointestinal symptom score in both treatment and placebo groups. However, there was no significant difference between the cinnamon oil and sesame oil groups in terms of the baseline and endpoint values of the outcome variables. This study was registered as https://clinicaltrials.gov/ct2/show/IRCT20170802035460N2, 29 December 2017, in the Iranian Registry of Clinical Trials with https://www.IRCT.ir.

Reza Tahvilian, Mohammad Amin Golesorkhi, Farajollah Parhoudeh, Fatemeh Heydarpour, Hossein Hosseini, Hojjat Baghshahi, Hossein Akbari, Mohammad Reza Memarzadeh, Mehdi Mehran, Hosna Bagheri. J Pharmacopuncture 2024;27:82-90. https://doi.org/10.3831/KPI.2024.27.2.82

INTRODUCTION: Sleep hygiene was found as an important predictor for sleep quality. People’s sleep hygiene can have a major role in their daily function. The purpose of the study was to determine sleep hygiene patterns and sleep hygiene behaviors and factors affecting them in the general population of Kermanshah, Iran.MATERIAL & METHODS: In this cross-sectional study, 1829 men and 1262 women were selected randomly from 50 clusters of different parts of the city. The inclusion criteria were age between 12 and 65 years and living in Kermanshah. The exclusion criteria were psychiatric disorder and known general medical conditions that affecting sleep. The data collection instruments were demographic questionnaire and Sleep Hygiene Questionnaire, consisted of 13 items about biological rhythm and bed room environment and behaviors that affecting sleep. Data were analyzed by using SPSS version 16 software.RESULTS: The highest percentage was obtained for irregular woke and went up from day to day or at weekend and holidays (74.8%). Only 213 (6.9%) participants were classified as having good sleep hygiene (score 12-14). The mean age of very poor, poor, moderate, and good sleepers was 34.8 ± 14.4, 33.7 ± 17.4, 36.5 ± 13.8, and 35 ± 13.7years, respectively. There were significant differences between the age of poor and moderate sleepers and also sleep hygiene patterns with respect to sex, education level and job.CONCLUSION: Poor sleep hygiene were more frequent in Iranian peoples and the major problem in sleep hygiene in our study was inappropriate sleep schedule.

Brain tissue in Alzheimer's patients is exposed to oxidative stress. Silymarin is an adjunct drug that has anti-inflammatory and antioxidant properties. This study aimed to evaluate the effect of silymarin on biomarkers of oxidative stress, inflammation, and disease severity in Alzheimer's patients. This randomized, single-blind clinical trial study was performed on 33 patients with Alzheimer's disease (AD) whose disease was confirmed by DSM-5 criteria and by brain imaging. Patients in the case group received three 250 mg silymarin capsules daily (each containing 150 mg silymarin), as an adjunctive medication in addition to the routine medication regimen. In the placebo group (control), patients received the same amount of placebo. All patients underwent Mini Mental State Exam (MMSE) and a panel of blood tests including malondialdehyde, neopterin, catalase, paraoxonase-1, total oxidative status, and total antioxidant capacity to reevaluate the changes pre/postintervention at the end of the trimester. The catalase and MDA serum levels after the adjunctive silymarin treatment decreased significantly (Catalase_{before silymarin}= 9.29 ± 7.02 vs Catalase_{after silymarin}= 5.32 ± 2.97, p = 0.007 and MDA_{before silymarin}= 4.29 ± 1.90 vs MDA_{after silymarin}= 1.66 ± 0.84, p < 0.001) while MMSE increased notably (MMSE_{before silymarin}= 10.39 ± 6.42 vs MMSE_{after silymarin}= 13.37 ± 6.81, p < 0.001). Silymarin can be effective as an adjunct drug and a powerful antioxidant in reducing oxidative stress and improving the course of AD.

Background: Acute kidney injury (AKI) commonly occurs in critically ill patients. Estimation of renal function and antibiotics dose adjustment in patients with AKI is a challenging issue.Methods: Urinary creatinine clearance was measured in a 6-hour urine collection from patients with acute kidney injuries. The correlations between different formulas including the modified Cockcroft-Gault, modification of diet in renal disease, chronic kidney disease-epidemiology collaboration, Jelliffe, kinetic-glomerular filtration rate (GFR), Brater, and Chiou formulas were considered. The pattern of the prescribed antimicrobial agents was also compared with the patterns in the available resources.Results: Ninety-five patients with acute kidney injuries were included in the research. The mean age of the participants was 63.11±17.58 years old. The most patients (77.89%) were in stage 1 of AKI according to the Acute Kidney Injury Network criteria, followed by stage 2 (14.73%) and stage 3 (7.36), respectively. None of the formulations had a high or very high correlation with the measured creatinine clearance. In stage 1, Chiou (r=0.26), and in stage 2 and 3, kinetic-GFR (r=0.76 and r=0.37) had the highest correlation coefficient. Antibiotic over- and under-dosing were frequently observed in the study.Conclusions: The results showed that none of the static methods can predict the measured creatinine clearance in the critically ill patients. The dynamic methods such as kinetic-GFR can be helpful for patients who do not receive diuretics and vasopressors. Further studies are needed to confirm our results.