مجله تعالی بالینی
سال پنجم شماره 1 (پیاپی 10، تابستان 1395)

The health and wellness of human beings is largely dictated by the consumption of nutritious foods. Food bioactive compounds are natural components that have biological activity and in some instances provide nutritional value. They play an important role in the community health and safety due to confirmed roles in human growth and development, besides reducing disease risks. Consumption of biologically active ingredients in fruits and vegetables has been linked to helping combat diseases like cancer, CVDs, obesity and GI tract disorders. There has been much research activity recently on the types of food items and other natural products (mainly of plant origin) and their possibility of being sources of therapeutic and prophylactic agents. The types of foods in this regard are those functional foods that, when consumed regularly and appropriately, can result in beneficial health effects beyond their natural properties Manufacturers often cannot simply add a nutraceutical to a food when formulating functional foods that have acceptable sensory appeal as well as the desired health benefits. The appropriate application of encapsulation for stabilizing nutraceuticals enables their effective delivery through food. The careful design of the delivery system helps protect sensitive nutraceuticals from the environment and processing stresses encountered during food manufacture, and prevents undesirable interactions of the nutraceutical with components in the food matrix.The increased interest for these products could benefit both consumers and the industry, through contributions to improve consumers’ quality of life, adding value to industrial residues and generating more patents in these sectors.

The aim of this study is investigation cognitive and metacognitive theories and recent researches about obsessive - compulsive disorder (OCD). Salkovskis believes that critical cognitive component in OCD is inflated responsibility that a person has for her/him intrusive thoughts, this responsibility was caused naturalization behavior. In Rachman theory metacognitive bias such as thought- action fusion (TAF) has more important role. This bias increase responsibility and guilt. Also, this bias could increase compulsion for decreas those feeling. In Wells metacognitive theory is emphasized to metacognitive believes for example; lake of cognitive confidence, TAF, thought-event fusion and thought- object fusion. According to Clark cognitive thought control theory, existence some vulnerabilities such as anxiety trait, negative mood and metacognitive believes with interaction negative mood and events cause intrusive thoughts and unsuccessful try to control them intensify these thoughts. In sum, according to Obsessive Compulsive Cognitions Working Group (OCCWG) six cardinal cognitive pathology of OCD include: inflated responsibility, overestimation of threat and liklihood, TAF , overimportance and control thoughts, perfectionism and intolerance of uncertainty, that in this article the relation of these factors and their relation with OCD symptoms was studied.

Reported rates of awareness and observation of patient`s rights inside the country are very different. Likely in this regard, a systematic review can present a closer detail and coordination of subject to better decision-making and policy. So, this systematic review study was performed to determine the health services providers` viewpoint about the awareness and observation of patient`s rights in Iran.
Iranian prior related studies published in inner and outer databases were searched with keywords such as; patient`s rights, patient`s rights in Iran, patient bill of right, patient bill Iran and its equivalent Persian word and finally, relevant documents were entered to the study using systematic review studies criteria.
Health service providers` average awareness of patient`s rights was variable from 5.1 to 95.5 percent and also was variable for patient`s rights charter from 1.8 to 93 percent. In other words, health service providers` overall awareness rate was 34.5 percent in good level, 46 percent in moderate percent and 19.5 percent in weak level. Also, health service providers` overall observation rate was 72.5 percent.
Simple review of studied documents in this survey showed that average awareness of patient`s rights places in low level. So, the compilation of comprehensive educational program in the form of training employee must recurrently consider with the health policy makers till reach to the acceptable level in Iran.

In the past, it was more focused on the role of vitamin D in biological activities, such as maintaining mineral homeostasis and regulation of bone turnover. While recently the importance of this vitamin further enhanced by the identification of vitamin D receptors in various tissues including lymphocytes T, macrophages, thymus tissue and pancreatic beta cells. According to high prevalence chronic diseases and widespread vitamin D deficiency in the world, the present review study was to investigate the relationship between vitamin D and effective metabolism of biomarkers. In order to find the available studies on the role of vitamin D in inflammation, adiponectin, insulin resistance in chronic diseases and perform a review study search was done the databases Medline, Pub med, Science Direct. Recent evidence suggests that vitamin D plays an important role in regulating the inflammatory process involved in the development and progression of chronic diseases. Since the inflammatory process can interfere with normal glucose metabolism and insulin signaling pathways that affect insulin resistance, this hypothesis is whether vitamin D can be effective through the inflammatory process and adiponectin on glucose homeostasis. According to epidemiological and clinical data, the beneficial effects of vitamin D primarily by increasing insulin sensitivity and secretion and the subsequent impact on the inflammatory process. The need for further studies with emphasis on the role of anti-inflammatory vitamin D as a result of the relationship between vitamin D and chronic disease in cardiovascular disease and diabetes-related disorders seems to be necessary.

Homocysteine is a sulfur-containing amino acid, which is derived from demethylation of methionine. Current evidences have shown that elevated serum levels of homocysteine can lead to migraine, and exacerbate the severity and frequency of migraine attacks. Some investigations have indicated that vitamin supplementations with vitamin B6, B9 and B12 can decrease serum levels of homocysteine, and be effective in alleviating of severity and frequency of migraine attacks. So, this study aimed to review evidences on association of serum homocysteine levels with migraine and effects of vitamin supplementations with vitamin B6, B9 and B12 on it. This review was done by searching on PubMed, Scopus, Science Direct and Web of Science by entering migraine, headache, homocysteine, vitamin B6, vitamin B9, folic acid and “vitamin B12 as keywords. In this study, clinical trial, cross-sectional, retrospective and prospective studies which were published during 2000 to 2015 were reviewed. We included studies that were diagnosed migraine based on international headache society criteria and were done on human, and excluded non-English language articles and studies that investigated pulsating headaches as the main aim. In most evaluated studies, homocysteine levels were significantly higher in patients with migraine, especially migraine with aura, compared to control group and healthy subjects. Vitamin supplementations with B6, B9 and B12 decreased the homocysteine levels, severity attacks and its related disabilities; however, results on frequency of migraine attacks were inconsistent. Based on results, it seems that low levels of homocysteine with vitamin supplementations with B6, B9 and B12 can decrease severity and disabilities of migraine, although more studies are suggested due to few studies in this regard.

Fasting in holy month of Ramadan is an important obligation of Muslims and increases their physical and mental health. Fasting has no negative effect on incidence and course of most of neurological diseases, but results are controversial regarding few disorders. This systematic review aimed to investigate neurologic diseases, their etiology and the way to prevent them in Ramadan. In this systematic review, PubMed, ScienceDirect, Google scholar, Magiran, IranMedex and SID databases were searched by relevant keywords for time interval of 2000-2014. Based on results, fasting has no effect on hemorrhagic and arterial ischemic strokes. The incidence of cerebral venous thrombosis increases in Ramadan with the main etiology of taking oral contraceptive pills(OCPs). Fasting has no adverse effect and probably improve the quality of life in mildly disabled multiple sclerosis patients. But it is not recommended in patients with severe disability. The effect of fasting on seizure and headache has controversial results. Incorrect medication use by patients, taking OCPs and absence of appropriate medical advices are the most common underlying factors of increased incidence of neurologic diseases during fasting. Therefore, rise of public awareness and reasonable medical advices could be helpful in prevention of neurologic diseases during fasting.

Cancer-related fatigue is one of the most common and most distressing side effects of cancer and its treatment. Non-pharmacological interventions may have lower side effects. The aim of this study was to evaluate non-pharmacological approaches to treat cancer related fatigue. We searched the databases of ISI, Medline, Google scholar, SID, Magiran and Iranmedex, The literature search was conducted between the years 1980-2014. The results of 87 full text relevant articles were evaluated. Most evidence, suggests the effectiveness of exercise and acupuncture on reducing cancer-related fatigue during and after cancer treatments. Studies on psychosocial support, sleep and nutrition promotion, and some of complementary and alternative medicine, such as massage, touch, herbal medicine, yoga, relaxation and meditation are possibly useful and effective to reduce or eliminate the cancer-related fatigue. All treatments discussed in this study were noninvasive(except acupuncture), low risk and relatively inexpensive methods, which can be used with current treatments or even be replaced for drugs. It is hoped that these studies will be used for evidence-based practice to reduce fatigue in cancer patients.

Nowadays, Population growth is associated with trauma to the face and mouth and consequently tooth fractures are common events in societies. During trauma to the mouth and dental fracture, damage to the upper and lower jaw, cervical spines and soft tissues of the throat also can occur. Dental fractures are classified based on their severity. Each type of dental fracture has specific diagnostic and therapeutic approaches and sometime the management only limited to supportive techniques. Delay in diagnosis and failure in the use of proper therapies can lead to severe side effects and high costs. Herein we ought to review the kinds of dental fractures and the diagnostic and therapeutic approached.