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Mo L, Li J, Lu H, Lu S, Fu H, Huang B, Zhao C. Aloe polysaccharides ameliorate obesity-associated cognitive dysfunction in high-fat diet-fed mice by targeting the gut microbiota and intestinal barrier integrity. Food Funct 2024. [PMID: 38989726 DOI: 10.1039/d4fo01844c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
Aloe polysaccharides (APs) display cognition-improving properties, but the underlying mechanisms remain unclear. Herein, AP supplementation for 24 weeks significantly improved cognitive behavioral disturbances caused by a high-fat diet. Moreover, APs notably reshaped the structure of the gut microbiota, which was manifested by increasing the relative abundance of Alloprevotella, Alistipes, Romboutsia, Turicibacter, Prevotellaceae_UCG-001, and Akkermansia while reducing the abundance of Parasutterella, Staphylococcus, Helicobacter, Enterococcus, and Erysipelatoclostridium. Notably, the gut barrier damage and LPS leakage caused by HF were recovered by APs. Additionally, with the improvement of intestinal barrier integrity, oxidative stress and inflammation in the brain and jejunum were significantly ameliorated. Furthermore, the expression of genes associated with cognitive impairment and the intestinal tract barrier was up-regulated (CREB, BDNF, TrkB, ZO-1 and occludin), while the expression of genes associated with inflammatory factors was down-regulated (IL-1β, IL-6, and TNF-α). Finally, we observed a significant correlation among cognition-related genes, gut microbiota, oxidative stress, and inflammation in the HF-AP group. Together, our findings suggest that altered gut microbiota composition and improved gut barrier integrity may be important targets for potentially improving high-fat diet-induced cognitive impairment.
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Affiliation(s)
- Ling Mo
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, School of Public Health, Guilin Medical University, Guilin 541199, China.
- Department of nutrition and food hygiene, School of Public Health, Guilin Medical University, Guilin, 541199, China
| | - Jingjing Li
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, School of Public Health, Guilin Medical University, Guilin 541199, China.
- Department of nutrition and food hygiene, School of Public Health, Guilin Medical University, Guilin, 541199, China
| | - Hangsun Lu
- Department of nutrition and food hygiene, School of Public Health, Guilin Medical University, Guilin, 541199, China
| | - Shaoda Lu
- Department of nutrition and food hygiene, School of Public Health, Guilin Medical University, Guilin, 541199, China
| | - Henghui Fu
- Department of nutrition and food hygiene, School of Public Health, Guilin Medical University, Guilin, 541199, China
| | - Bo Huang
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, School of Public Health, Guilin Medical University, Guilin 541199, China.
| | - Chaochao Zhao
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, School of Public Health, Guilin Medical University, Guilin 541199, China.
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Bawish BM, Rabab MA, Gohari ST, Khattab MS, AbdElkader NA, Elsharkawy SH, Ageez AM, Zaki MM, Kamel S, Ismail EM. Promising effect of Geranium robertianum L. leaves and Aloe vera gel powder on Aspirin ®-induced gastric ulcers in Wistar rats: anxiolytic behavioural effect, antioxidant activity, and protective pathways. Inflammopharmacology 2023; 31:3183-3201. [PMID: 37184667 PMCID: PMC10692037 DOI: 10.1007/s10787-023-01205-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/21/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Many drugs have been restricted in the treatment of gastric ulcers (GU). So, herbal medicines are now in great demand for their better cultural acceptability, compatibility, and minimal side effects. Therefore, our study aimed to assess the protective efficacy of Aloe vera gel and Geranium robertianum extracts against Aspirin®-induced GU in Wistar rats. METHODS Antioxidant activity and chemical composition of both herbs were analysed. Then, we divided forty female Wistar rats into five groups: a negative control group, a positive control group of Aspirin®-induced GU, and pretreated groups with Aloe Vera, geranium, and Famotidine (reference drug). The locomotor disability, anxiety-like behaviour, and ultrasonography were assessed. Ultimately, scarification of animals to determine gastric juice pH and ulcer index. Then the collection of stomach and liver for histopathological and immunohistochemical examinations, besides tracing the oxidative stress biomarkers and related genes. RESULTS High content of polyphenols was revealed in both extracts. The pretreatment with Aloe vera gel and geranium showed significant antioxidant activities with free radical scavenging and ferric-reducing power (FRAP). Moreover, they improved the stomach architecture and alleviated anxiety-like behaviour and motor deficits. They significantly reduced the expression of proinflammatory cytokine (TNF-α), inflammatory, and oxidative stress genes (NF-KB, HO-1, Nrf-2) while increasing the Keap-1 in gastric mucosa. CONCLUSION Data presented a significant protective effect of Aloe vera gel and geranium against Aspirin®-induced GU; they reduced gastric mucosal injury with potential anxiolytic effects through their anti-inflammatory and antioxidant properties. Therefore, they may be considered promising agents for preventing or treating gastric ulceration.
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Affiliation(s)
- Basma M Bawish
- Department of Veterinary Hygiene and Management, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Mariem A Rabab
- Faculty of Biotechnology, October University for Modern Sciences and Arts (MSA), 6th October City, 12573, Egypt
| | - Safaa T Gohari
- Department of Nutrition, Food Science and Home Economics, Faculty of Specific Education, Ain Shams University, Ain Shams, 11566, Egypt
| | - Marwa S Khattab
- Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Naglaa A AbdElkader
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Samar H Elsharkawy
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Amr M Ageez
- Faculty of Biotechnology, October University for Modern Sciences and Arts (MSA), 6th October City, 12573, Egypt
| | - Manal M Zaki
- Department of Veterinary Hygiene and Management, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Shaimaa Kamel
- Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - Eman M Ismail
- Department of Veterinary Hygiene and Management, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt.
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Structural and mechanistic insights into modulation of α-Synuclein fibril formation by aloin and emodin. Biochim Biophys Acta Gen Subj 2022; 1866:130151. [DOI: 10.1016/j.bbagen.2022.130151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 04/02/2022] [Accepted: 04/08/2022] [Indexed: 11/20/2022]
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Kaushik P, Ahlawat P, Singh K, Singh R. Chemical constituents, pharmacological activities, and uses of common ayurvedic medicinal plants: a future source of new drugs. ADVANCES IN TRADITIONAL MEDICINE 2021. [DOI: 10.1007/s13596-021-00621-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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5
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Jalali A, Firouzabadi N, Zarshenas MM. Pharmacogenetic-based management of depression: Role of traditional Persian medicine. Phytother Res 2021; 35:5031-5052. [PMID: 34041799 DOI: 10.1002/ptr.7134] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/26/2021] [Accepted: 04/10/2021] [Indexed: 12/11/2022]
Abstract
Depression is one of the most common mental disorders worldwide. The genetic factors are linked to depression and anti-depressant outcomes. Traditional Persian medicine (TPM) manuscripts have provided various anti-depressant remedies, which may be useful in depression management. This review has studied the bioactive compounds, underlying mechanisms, and treatment outcomes of the medicinal plants traditionally mentioned effective for depression from "The storehouse of medicament" (a famous pharmacopeia of TPM) to merge those with the novel genetics science and serve new scope in depression prevention and management. This review paper has been conducted in two sections: (1) Collecting medicinal plants and their bioactive components from "The storehouse of medicament," "Physician's Desk Reference (PDR) for Herbal Medicines," and "Google scholar" database. (2) The critical key factors and genes in depression pathophysiology, prevention, and treatment were clarified. Subsequently, the association between bioactive components' underlying mechanism and depression treatment outcomes via considering polymorphisms in related genes was derived. Taken together, α-Mangostin, β-carotene, β-pinene, apigenin, caffeic acid, catechin, chlorogenic acid, citral, ellagic acid, esculetin, ferulic acid, gallic acid, gentiopicroside, hyperoside, kaempferol, limonene, linalool, lycopene, naringin, protocatechuic acid, quercetin, resveratrol, rosmarinic acid, and umbelliferone are suitable for future pharmacogenetics-based studies in the management of depression.
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Affiliation(s)
- Atefeh Jalali
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Negar Firouzabadi
- Department of Pharmacology & Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad M Zarshenas
- Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.,Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Sørnes EØ, Risal A, Manandhar K, Thomas H, Steiner TJ, Linde M. Use of medicinal plants for headache, and their potential implication in medication-overuse headache: Evidence from a population-based study in Nepal. Cephalalgia 2021; 41:561-581. [PMID: 33435708 PMCID: PMC8047708 DOI: 10.1177/0333102420970904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background In Nepal, traditional treatment using medicinal plants is popular. Whereas
medication-overuse headache is, by definition, caused by excessive use of
acute headache medication, we hypothesized that medicinal plants, being
pharmacologically active, were as likely a cause. Methods We used data from a cross-sectional, nationwide population-based study, which
enquired into headache and use of medicinal plants and allopathic
medications. We searched the literature for pharmacodynamic actions of the
medicinal plants. Results Of 2100 participants, 1794 (85.4%) reported headache in the preceding year;
161 (7.7%) reported headache on ≥15 days/month, of whom 28 (17.4%) had used
medicinal plants and 117 (72.7%) allopathic medication(s). Of 46 with
probable medication-overuse headache, 87.0% (40/46) were using allopathic
medication(s) and 13.0% (6/46) medicinal plants, a ratio of 6.7:1, higher
than the overall ratio among those with headache of 4.9:1 (912/185). Of 60
plant species identified, 49 were pharmacodynamically active on the central
nervous system, with various effects of likely relevance in
medication-overuse headache causation. Conclusions MPs are potentially a cause of medication-overuse headache, and not to be
seen as innocent in this regard. Numbers presumptively affected in Nepal are
low but not negligible. This pioneering project provides a starting point
for further research to provide needed guidance on use of medicinal plants
for headache.
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Affiliation(s)
- Elise Øien Sørnes
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Ajay Risal
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.,Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Kedar Manandhar
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.,Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Hallie Thomas
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Timothy J Steiner
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Division of Brain Sciences, Imperial College London, London, UK
| | - Mattias Linde
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
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Salehi B, Albayrak S, Antolak H, Kręgiel D, Pawlikowska E, Sharifi-Rad M, Uprety Y, Tsouh Fokou PV, Yousef Z, Amiruddin Zakaria Z, Varoni EM, Sharopov F, Martins N, Iriti M, Sharifi-Rad J. Aloe Genus Plants: From Farm to Food Applications and Phytopharmacotherapy. Int J Mol Sci 2018; 19:E2843. [PMID: 30235891 PMCID: PMC6163315 DOI: 10.3390/ijms19092843] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 09/14/2018] [Accepted: 09/15/2018] [Indexed: 12/20/2022] Open
Abstract
Aloe genus plants, distributed in Old World, are widely known and have been used for centuries as topical and oral therapeutic agents due to their health, beauty, medicinal, and skin care properties. Among the well-investigated Aloe species are A. arborescens, A. barbadensis, A. ferox, and A. vera. Today, they account among the most economically important medicinal plants and are commonly used in primary health treatment, where they play a pivotal role in the treatment of various types of diseases via the modulation of biochemical and molecular pathways, besides being a rich source of valuable phytochemicals. In the present review, we summarized the recent advances in botany, phytochemical composition, ethnobotanical uses, food preservation, and the preclinical and clinical efficacy of Aloe plants. These data will be helpful to provide future directions for the industrial and medicinal use of Aloe plants.
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Affiliation(s)
- Bahare Salehi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran 88777539, Iran.
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran 22439789, Iran.
| | - Sevil Albayrak
- Department of Biology, Science Faculty, Erciyes University, Kayseri 38039, Turkey.
| | - Hubert Antolak
- Institute of Fermentation Technology and Microbiology, Faculty of Biotechnology and Food Science, Lodz University of Technology, Wolczanska 171/173, 90-924 Lodz, Poland.
| | - Dorota Kręgiel
- Institute of Fermentation Technology and Microbiology, Faculty of Biotechnology and Food Science, Lodz University of Technology, Wolczanska 171/173, 90-924 Lodz, Poland.
| | - Ewelina Pawlikowska
- Institute of Fermentation Technology and Microbiology, Faculty of Biotechnology and Food Science, Lodz University of Technology, Wolczanska 171/173, 90-924 Lodz, Poland.
| | - Mehdi Sharifi-Rad
- Department of Medical Parasitology, Zabol University of Medical Sciences, Zabol 61663-335, Iran.
| | - Yadav Uprety
- Research Centre for Applied Science and Technology (RECAST), Tribhuvan University, P.O. Box 1030 Kirtipur, Kathmandu, Nepal.
| | - Patrick Valere Tsouh Fokou
- Antimicrobial and Biocontrol Agents Unit, Department of Biochemistry, Faculty of Science, University of Yaounde 1, Ngoa Ekelle, Annex Fac. Sci, P.O. Box 812 Yaounde, Cameroon.
| | - Zubaida Yousef
- Department of Botany, Lahore College for Women University, Jail Road Lahore 54000, Pakistan.
| | - Zainul Amiruddin Zakaria
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia.
- Integrative Pharmacogenomics Institute (iPROMISE), Level 7, FF3 Building, Universiti Teknologi MARA, Puncak Alam 42300, Malaysia.
| | - Elena Maria Varoni
- Department of Biomedical, Surgical and Dental Sciences, Milan State University, via Beldiletto 1/3, 20100 Milan, Italy.
- National Interuniversity Consortium of Materials Science and Technology, via G. Giusti 9, 50121 Firenze, Italy.
| | - Farukh Sharopov
- Department of Pharmaceutical Technology, Avicenna Tajik State Medical University, Rudaki 139, Dushanbe 734003, Tajikistan.
| | - Natália Martins
- Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.
- Institute for Research and Innovation in Health (i3S), University of Porto, 4200-135 Porto, Portugal.
| | - Marcello Iriti
- National Interuniversity Consortium of Materials Science and Technology, via G. Giusti 9, 50121 Firenze, Italy.
- Department of Agricultural and Environmental Sciences, Milan State University, via G. Celoria 2, 20133 Milan, Italy.
| | - Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran 11369, Iran.
- Department of Chemistry, Richardson College for the Environmental Science Complex, The University of Winnipeg, 599 Portage Avenue, Winnipeg, MB R3B 2G3, Canada.
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Tabatabaei SRF, Ghaderi S, Bahrami-Tapehebur M, Farbood Y, Rashno M. Aloe vera gel improves behavioral deficits and oxidative status in streptozotocin-induced diabetic rats. Biomed Pharmacother 2017; 96:279-290. [DOI: 10.1016/j.biopha.2017.09.146] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/21/2017] [Accepted: 09/26/2017] [Indexed: 12/20/2022] Open
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Akaberi M, Sobhani Z, Javadi B, Sahebkar A, Emami SA. Therapeutic effects of Aloe spp. in traditional and modern medicine: A review. Biomed Pharmacother 2016; 84:759-772. [PMID: 27716590 DOI: 10.1016/j.biopha.2016.09.096] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 09/24/2016] [Accepted: 09/24/2016] [Indexed: 10/20/2022] Open
Abstract
Traditional medicine is a useful guide in medical sciences. In the Islamic Iranian traditional medicine, the medicinal properties of many plants have been mentioned that could be exploited in drug discovery. We aimed to explore the nature and properties of Aloe spp. As described in some major Islamic traditional texts including Ferdows al-Hekmah fi'l-Tibbe (The Paradise of Wisdom in Medicine), Al-Hawi fi'l-Tibb (Comprehensive Book of Medicine), Kamel al-Sanaat al-Tibbyyah (Complete Book of the Medical Art), Al-Qanun fi'l-Tibb (Canon of Medicine), Zakhireh Kharazmshahi (Treasure of Kharazmshah), and Makhzan al-Adwiah (Drug Treasure), and assess the conformity of traditional medicine instructions with the findings of modern pharmacological studies. Gastrointestinal activities, hepato-protective properties, beneficial effects against skin problems such as wounds, injuries, and infective diseases are among the most frequently mentioned properties of Aloe spp. Several activities of Aloe spp. described in traditional medicine have been the subject of recent in vitro and in vivo studies as well as clinical trials. Owing to the positive findings, different preparations of Aloe spp. are now present in pharmaceutical markets such as Aloe cosmetic products. On the other hand, there are many traditional therapeutic effects of Aloe spp. which have not been studied and require confirmatory experimental or clinical investigations. It is hoped that the present study could stimulate further research on the unexplored aspects of the medicinal properties of Aloe spp.
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Affiliation(s)
- Maryam Akaberi
- Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Sobhani
- Department of Traditional Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behjat Javadi
- Department of Traditional Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Seyed Ahmad Emami
- Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Traditional Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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Shahraki MR, Mirshekari H, Sabri A. Aloe vera Aqueous Extract Effect on Morphine Withdrawal Syndrome in Morphine-Dependent Female Rats. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2014; 3:e11358. [PMID: 25593890 PMCID: PMC4286921 DOI: 10.5812/ijhrba.11358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 11/12/2013] [Accepted: 05/25/2014] [Indexed: 04/13/2023]
Abstract
BACKGROUND Aloe vera is a medicinal herb used as an anti-inflammatory and sedative agent. OBJECTIVES The current study aimed to evaluate the effect of Aloe vera aqueous extract on morphine withdrawal symptoms in morphine-dependent female rats. PATIENTS AND METHODS The current research was performed on 40 female Wista-Albino rats which were made dependent on morphine using Houshyar protocol and were randomly divided into five groups (A, B, C, D, and E). Group A did not receive any agent in the period of handling but other groups (B, C, D and E) received 5, 10, 20 and 40 mg/kg of Aloe vera aqueous extract by gavage, three times daily for a week, respectively. Withdrawal symptoms, stool form, agitation, disparity, floppy eyelids, and body mass variations were checked for 10 days. The obtained data were analyzed using SPSS v.11 software, and Friedman, Kruskal-Wallis, and Mann-Whitney statistical tests. Statistical difference was considered significant (P < 0.05). RESULTS The results of the present study showed that agitation, disparity, and floppy eyelids in group E were significantly higher than those of others groups; however, these symptoms in group C were significantly lower than those of the other groups. CONCLUSIONS The results of the present study revealed that the Aloe vera aqueous extract had various effects on morphine withdrawal syndrome in morphine-dependent female rats .
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Affiliation(s)
- Mohammad Reza Shahraki
- Department of Physiology, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Corresponding author: Mohammad Reza Shahraki, Department of Physiology, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-5413414552-5, Fax: +98-5413414563, E-mail:
| | - Hamideh Mirshekari
- Zahedan Health Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Azame Sabri
- Mashhad Health Service Center, Mashhad University of Medical Sciences, Mashhad, IR Iran
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