Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 8 3 2023 07 19 230 232 Mahdi Saravani Golestan Research Center of Gastroenterology and Hepatology, Department of Persian Medicine, School of Persian Medicine, Golestan University of Medical Sciences, Gorgan, Iran Fatemeh Kolangi Counseling and Reproductive Health Research Centre, Department of Persian Medicine, School of medicine, Golestan University of Medical Sciences, Gorgan, Iran 2022 11 05 2022 11 24 No Abstract No Abstract No Abstract https://jtim.tums.ac.ir/index.php/jtim/article/view/871

Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 8 3 2023 07 19 233 242 Mohammad Mehdi Gravandi Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran Seyede Zahra Hosseini Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran Seyede Darya Alavi Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran Seyed Mohammad Reza Jafari Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran Mohsen Zhaleh Department of Medical Laboratory Sciences, School of Paramedicine, Kermanshah University of Medical Sciences, Kermanshah, Iran Mohammad Hossein Farzaei Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran 2022 11 05 2023 04 16 Inflammatory bowel disease (IBD) has two subtypes called ulcerative colitis (UC) and Crohn's disease (CD). They have the same tissue damage processes; however, differ in the initial procedures and immune regulatory aberrations. Tumor necrosis factor-alpha (TNF-α) appears to have an important function and a key pathogenic role in CD and UC. In this paper, we evaluated the protective impact of the extract of Ailanthus altissima (Mill.) Swingle (tree of heaven), Simaroubaceae, in acetic acid-induced UC. Ferric-reducing capacity of plant extract, total phenols, and total flavonoid contents were measured in A. altissima ethanolic extract. Thirty male rats were randomly divided into six groups including control, normal, mesalazine 300 mg/kg (positive control) and 3 treatment groups with doses of 50, 100, and 200 mg/kg for 7 days. Except for the normal group, all animals received 2 mL of 4% acetic acid infusion into the large intestine. Upon 48 h after the last gavage, the animals were euthanized. Acetic acid intracolonic administration resulted in a severe acute inflammation in the colonic tissue, which was improved by A. altissima extract at all examined doses in both microscopic and macroscopic aspects. In comparison to the control, TNF-α was considerably lower in the mesalazine and 200 mg/kg A. altissima extract groups. Conclusively, the valuable effects of the extract in the treatment of UC were confirmed by TNF-α levels, histological data, and macroscopic observations, especially at 200 mg/kg dosage. Future studies are recommended to further clarify the action mechanisms of this plant. https://jtim.tums.ac.ir/index.php/jtim/article/view/869

Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 8 3 2023 08 06 243 248 Sara Pourshahidi Department of Oral Medicine, Dental Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Houman Ebrahimi Dental Branch, Azad University of Medical Sciences, Tehran, Iran Zahra Zeraat School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran Mohammad Parvizi Molecular Dermatology Research Center, Shiraz University of Medical Sciences , Shiraz, Iran Hajar Zolfaghari Department of Oral Medicine, Dental Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran 2022 11 07 2023 06 05 Oral lichen planus and lichenoid reactions are autoimmune chronic inflammatory diseases. Since the inflammatory system is the main pathological process in these lesions, some etiological roles for inflammatory cytokines and personal temperaments (Mizaj) are proposed. In this preliminary study, establishing such an association between personal temperaments with oral lichen planus and lichenoid reactions would develop new horizons for better preventive programming to prevent or control the disease course in affected patients. This case-control study was carried out among  384 patients referred to the oral medicine department of dental school, Tehran University of Medical Sciences, from 2000 to 2017. They were categorized into three groups as follows: oral lichen planus (128),  oral lichenoid reactions (128), and healthy control group (128). The temperament was assessed by Mojahedi et al. validated questionnaire, and the results were compared across the groups. Warm temperament was significantly higher in the lichen planus group (P=0.0001). The dry temperament was higher in oral lichen planus and lichenoid groups. In these groups, the intermediate group had the least rate, but in the control group, the moist temperament was less common. No statistically significant difference existed between groups in this era (P=0.210). However, among mixed temperaments, the warm and moist temperament was the same across the groups (P=0.195); the warm and dry temperament was significantly more common in cases with oral lichen planus (P < 0.001); and the cold and dry temperament (P=0.017) and cold and moist temperament (P <0.001) were significantly more common in the control group. The only difference between the two groups of control and lichenoid reactions was cold and dry temperament (P=0.008). This study revealed that warm temperament is related to oral lichen planus. Reestablishing this matter in future studies would help develop some evidence-based preventive strategies to reduce the burden of oral lichen planus. https://jtim.tums.ac.ir/index.php/jtim/article/view/874

Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 8 3 2023 07 24 249 255 EN Reza Ahmadi Department of Family, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Hossein Mohammadzadeh-Moghadam Department of Public Health, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran Reza Esmaeili Department of Public Health, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran Abdoljavad Khajavi Department of Community Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran Maryam Ghahramany Department of Health Education and Promotion, school of Health, Mashhad University of Medical Sciences, Iran AND Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Davoud Salarbashi Department of Food Science, Nutrition and Clinical Biochemistry, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran AND Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Mahdieh Bahramizadeh Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran Sepideh Elyasi Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran 2022 11 18 2023 04 08 Sesame oil (SO) or so-called Tahini has been traditionally used for management of various conditions including burns and wounds and relief of pain, fever, and inflammation n Persian Medicine. It poses anti-inflammatory, antioxidant, and anti-carcinogenic activities; then it could be used in various inflammatory conditions. A triple-blind randomized placebo-controlled clinical trial was carried out to examine the efficacy of a Persian natural topical medicine based on sesame oil in outpatients suffering mild and moderate coronavirus disease-19 (COVID-19). The participants were 101 COVID-19 patients who met the inclusion criteria. The participants were allocated randomly to treatment (n = 51) group who received topical Sesame oil formulation five times daily on the chest and back skin for 1 week or the placebo (n = 50) group. The symptoms were examined at admittance and over a follow-up course and the results were compared in the two groups after 3 and 7 days. After three days, fever (7.84 vs. 20.41%, P=0.05), chills (3.92 vs. 16.33%, P=0.03), cough (severe 0 vs. 8.6, intermediate 50.98 vs. 65.31%, P=0.007) and headache (mild 7.84 vs. 30.61, moderate 5.88 vs. 0, P=0.004) had a significant lower prevalence in the treatment group. However, after 7 days, all symptoms had insignificant difference between two groups (P>0.05). No significant adverse reaction reported in both groups. As the results indicated, topical formulation consisting of sesame oil and cow butter, rubbing on the chest and back of the mild-to-moderate COVID-19 patients five times daily could significantly improve cough, fever, chills and headache, in 3 days. But it could not be effective on final outcome of the patients. More works covering a larger sample size are needed. https://jtim.tums.ac.ir/index.php/jtim/article/view/885

Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 8 3 2023 07 25 256 268 Putra Santoso Biology Department, Faculty of Mathematics and Natural Sciences, Andalas University, Padang, West Sumatra, Indonesia Syafruddin Ilyas Department of Biology, Faculty of Mathematics and Natural Sciences, University of Sumatera Utara, Medan, Indonesia Yurnadi Midoen Department of Medical Biology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia Alfi Yuniarti Biology Department, Faculty of Mathematics and Natural Sciences, Andalas University, Padang, West Sumatra, Indonesia 2022 12 20 2023 05 28 Diabetes mellitus is profoundly associated with various detrimental outcomes including sexual dysfunction and infertility in males. On the other hand, a medicinal plant namely Vitis gracilis Wall (Vitaceae) has been used as a traditional medicine to enhance vitality. This present study aimed to investigate the protective effect of V. gracilis leaf decoction against diabetes-induced sexual dysfunction and testicle histopathology in adult male mice. The experiment was composed of five different groups namely the control (non-diabetic) group, the diabetes group (without any treatments), and the diabetes treated with V.gracilis decoction at the doses of 25, 50, and 100 g/ L, respectively. In addition, the phytochemical constituents of leaf decoction were determined by using Ultra performance-liquid chromatography-mass spectroscopy (UPLC-MS). Our data demonstrated that, despite failing to improve blood glucose profile and body weight, V.gracilis leaf decoction sustained intense sexual behaviors including face and genital kissing, genital licking, and mount toward estrous females. Moreover, lower doses of decoction (25 and 50 g/ L) attenuated the diabetes-induced reduction of testis weight and precluded malondialdehyde accumulation in the testicle tissue. The decoction at the lower doses also ameliorated histopathological alterations in the testis, particularly the wall thickness of tubulus seminiferous and the number of necrotic cells. V. gracilis decoction also improved hematological values including hemoglobin (Hb), red blood cell count and hematocrit (HTC) level. In addition, UPLC-MS analysis revealed a total of 26 phytochemical compounds with seven predominant substances. In conclusion, leaf decoction of V. gracilis, particularly at lower doses but not at a higher dose, exerted a protective effect on sexual vitality, testicle tissue, and hematological value under diabetic condition. The beneficial effects of V.gracilis decoction might be associated with its various bioactive compounds. Therefore, V. gracilis leaves may be a future candidate as a potent natural drug for male sexual vitality and testicle protection against diabetes.  https://jtim.tums.ac.ir/index.php/jtim/article/view/917

Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 8 3 2023 07 26 269 274 EN Soghra Mohammadi Colorectal Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mohsen Masoodi Colorectal Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Mohammad Sabzikarian Colorectal Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Atefeh Talebi Colorectal Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Marjan Mokhtare Colorectal Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Abolfazl Akbari Colorectal Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Amirhossein Faghihi Kashani Colorectal Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran 2022 12 25 2023 02 21 Due to the lack of favorable response to synthetic drugs, the tendency to use traditional medicine to treat inflammatory bowel disease has risen. We aimed to assess the effect of Cichorium intybus L., Trigonella foenum-graecum L., and Foeniculum vulgare L. on the control of recurrent ulcerative colitis (UC) symptoms. This randomized clinical trial was performed on 60 patients suffering from mild-to-moderate UC. Patients were randomly assigned to control and intervention groups. Patients in both groups were treated with a standard dose of oral mesalazine (3 g daily) for eight weeks. In addition, the intervention group was given a mixture of 200 mg C. intybus, 350 mg T. foenum-graecum, and 1.5 mg F. vulgare (three times a day). The disease activity was evaluated before and 60 days after the intervention using a simple clinical colitis activity index (SCCAI). The baseline mean SCCAI score was similar in both groups. Although the SCCAI score significantly reduced in both groups 60 days after the initial assessment, this reduction was significantly higher in the group receiving the herbal combination than in the control group. The intervention-related side effects, such as bloating and dyspepsia, were well tolerated. The use of C. intybus, T. foenum-graecum, and F. vulgare can effectively control UC symptoms and thus, can be used as an effective and safe medication for treating UC. https://jtim.tums.a09 The diverse geographical regions of Iran have tribes with different cultures and customs in the medicinal use of plants in the control, prevention and treatment of diseases, and on this basis, to collect valuable ethnobotanical information in the field of medicinal plants, more studies are needed among different tribes. It is so that in the event of the death of people with this knowledge, their historical and experimental knowledge will not be forgotten. In this ethnobotanical and systematic study in the city of Ilam (western Iran), an attempt has been made to identify and report the use of medicinal plants native to this region in the treatment of back pain. Traditional therapeutic information about medicinal plants effective on back pain is done by ethnobotanical questionnaire. The complete list of herbal druggists in Ilam city was obtained from the Food and Drugs deputy, and the interviewer collected the required information personally by visiting each and every herbal druggists in Ilam city. The questionnaire included personal information and the names of native plants, the organ used, the method of use, and the effect of traditional treatment for back pain. Data analysis shows that 16 medicinal plants from 15 plant families are used in the treatment of back pain in Ilam. Medicinal plants Pistacia khinjuk, Amygdalus communis, Achillea biebersteinii, Amygdalus arabica, Pistacia atlantica, Thymbra spicata, Capsicum annuum, Biebersteinia multifida, Nigella sativa, Salvia rosmarinus, Hypericum helianthemoides, Calendula persica, Citrullus colocynthis, Zingiber officinale, Elaeagnus angustifolia, Nerium oleander, Myrtus communis and Ricinus communis are medicinal plants that are used in Ilam city to treat back pain. Based on the obtained results, it was found that the medicinal plant Achillea biebersteinii with usage report index (UR) of 14, relative frequency of citation (RFC) of 0.73 and percentage of frequency of use (PFU) of 53.8% is the most used in the treatment of back pain. Asteraceae plant family is the most used plant family. Leaf with 37% was the most used organ and decoction with 35% was the most traditional way of use. The presence of rich plant flora and medicinal species in Ilam city provides a suitable field for pharmacological research for better use and production of medicines and herbal products against back pain. https://jtim.tums.ac.ir/index.php/jtim/article/view/1317

Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 9 3 2024 09 28 298 307 Zahra Ayati Department of Traditional Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran AND NICM Health Research Institute, Western Sydney University, Sydney, Australia Seyed Ahmad Emami 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 Shokoufeh Aalinezhad Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran Leila Mohtashami Department of Pharmacognosy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran Zahra Boghrati Department of Traditional Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran Amirmahdi Taleb Health and Graduate’s Education, Treatment and Medical Sciences, Ministry of Health, Tehran, Iran Mohammad Reza Abbaspour Department of Pharmaceutics, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran AND Targeted Drug Delivery Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran 2023 11 30 2024 04 21 The fruit of Rosa canina L., commonly known as rosehip, has a long history of use in treating various disorders such as osteoarthritis and cardiovascular diseases. However, like many other herbal extracts, rosehip dried extract presents challenges due to its hygroscopic and sticky properties. This poses difficulties in developing solid pharmaceutical dosage forms utilizing rosehip extract. Hence, the objective of this study was to formulate and standardize a tablet containing rosehip extract. To achieve this goal, a novel wet granulation method was employed in this study to develop a tablet formulation of rosehip extract. This method utilized rosehip concentrated extract as a granulation liquid, and double granulation was employed to optimize the content of the extract. Various formulations were systematically evaluated to determine the optimal composition and ratio of excipients. Subsequently, the final formulations underwent rigorous assessment of their physicochemical properties and stability. Rosehip extract and its tablets were standardized based on ascorbic acid and total polyphenol content, using HPLC and Folin-Ciocalteu methods accordingly. To the best of our knowledge, this is the first study to report the double-wet-granulation method in a tablet formulation design along with an examination of its impact on the total polyphenol content of the extract. The key advantage of employing this method lies in its capability to incorporate liquid extract into a solid formulation, thereby facilitating the accommodation of escalating dosages of extract in each tablet. However, it is important to note that this method does come with certain limitations. Primarily, the extended formulation process necessitates prolonged exposure of active ingredients to heat and oxygen, which may potentially affect their stability and efficacy. https://jtim.tums.ac.ir/index.php/jtim/article/view/1303

Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 9 3 2024 09 28 308 317 EN Aastha Pahuja Division of Food Science and Nutrition, Banasthali Vidyapith, Rajasthan, India Monika Jain Division of Food Science and Nutrition, Banasthali Vidyapith, Rajasthan, India Kritika Rawat Division of Food Science and Nutrition, Banasthali Vidyapith, Rajasthan, India 2023 11 16 2024 04 20 Throughout history, herbalists and traditional healers have wielded the power of plant-based remedies, an ancient practice now embraced by modern science. Delving into the therapeutic properties of conventional herbs and spices is a recent pursuit. Galactogogues, compounds known for their ability to heighten prolactin levels by modulating dopamine receptors, stand as agents amplifying milk production—a vital function for lactation. This study endeavors to meticulously explore medicinal spices and herbs recognized for their remarkable capacity to augment breast milk production. Methodologically, information pertaining to medicinal herbs and spices recognized for promoting lactation was extracted from reputable literature. A meticulous exploration across multiple academic databases, encompassing PubMed, Science Direct, Scopus, Google Scholar, and Web of Science, was undertaken to authenticate the impacts of these medicinal plants on lactation, considering their identified pharmacological properties. The findings underscored the potency of Trigonella foenum-graecum L., Asparagus racemosus W., Zingiber officinale Roscoe, Moringa oleifera L., Cuminum cyminum L., and Trachyspermum ammi L., contribute to increased lactation. They achieve this through mechanisms such as phytoestrogenic effects, vasodilation, stimulation of mammary growth, and facilitation of breast milk production. In conclusion, the fusion of traditional wisdom with contemporary scientific inquiry offers a promising avenue for discovering potent phyto pharmaceuticals that effectively boost breast milk production. Leveraging this amalgamation may yield impactful advancements in maternal health and lactation support. https://jtim.tums.ac.ir/index.php/jtim/article/view/1293

Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 9 3 2024 09 29 318 338 Steven Alvianto Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, North Jakarta, Indonesia Nicolas Daniel Widjanarko Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, North Jakarta, Indonesia Stevan Kristian Lionardi Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, North Jakarta, Indonesia Erlangga Saputra Arifin Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia 2024 03 12 2024 05 22 Ganoderma is a mushroom renowned for its medical attributes, encompassing hepatoprotective, hypocholesterolemic, antioxidant, anti-inflammatory, hypoglycemic, and immunomodulatory activities. This study aimed to evaluate the effect of Ganoderma lucidum supplementation on metabolic profile in adult populations. Articles were retrieved from MEDLINE, ScienceDirect, ProQuest, and Google Scholar databases until the year 2023. Inclusion criteria were all published trials examining the effect of G. lucidum supplementation on metabolic profile in adult populations. The quality assessment and meta-analysis was performed. A total of 13 studies (two in populations with metabolic syndrome, two in type 2 diabetes mellitus, one in fibromyalgia patients, six in healthy populations, and two patients with coronary arterial disease) were included in this study, and seven studies met the eligibility criteria for meta-analysis. G. lucidum was mostly administered as capsules. There were no significant differences among outcomes in between group comparisons of high-density lipoprotein, low-density lipoprotein, total cholesterol, and fasting plasma glucose in the metabolic syndrome population (p value=1.00, 0.90, 0.78, and 0.33, respectively). Within group comparisons among the healthy population, only serum glutamic-pyruvic transaminase (p=0.03) and total cholesterol (p<0.0001) exhibited significant changes. In conclusion, we observed significant reductions in serum glutamic pyruvic transaminase and total cholesterol levels among healthy individuals following G. lucidum supplementation. However, despite promising preliminary findings, greater sample numbers with a more diverse demographic studies are required to fully understand and uncover any capabilities of G. lucidum in a therapeutic role. https://jtim.tums.ac.ir/index.php/jtim/article/view/1497

Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 9 3 2024 09 29 339 346 Farzaneh Zare Department of History of Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran Mohammad Mahd Parvizi Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran AND Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran AND Universal Scientific Education and Research Network (USERN), Tehran, Iran AND Smart University of Medical Sciences, Tehran, Iran Mehrdad Karimi Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran Amir Mohammad Jaladat Department of Traditional Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran 2023 07 24 2024 05 21 Gastrointestinal disorders are one of the most common conditions among people in many societies. On the other hand, evidence shows that the prevalence of usage of complementary and alternative medicine (CAM) has increased in recent years to treat many chronic and acute conditions, which might be due to testimonies of the safety, effectiveness, and affordability of CAM. In Persian medicine (PM), medical barley water (MBW) has been known as a helpful remedy for treating some digestive illnesses. This study aimed to review the properties of MBW in Avicenna’s Canon of Medicine for the treatment of gastrointestinal disorders. So, Avicenna’s Canon of Medicine was reviewed with keywords related to this remedy. Furthermore, various databases, including PubMed, Scopus, Web of Science, Google Scholar, and SID, were searched with the keywords “barley water," “non-alcoholic beer," and “alcohol-free beer." This study showed that Avicenna’s Canon of Medicine recommends MBW for the treatment of various gastrointestinal disorders. Avicenna prescribed barley water for the treatment of bowel obstruction disease, bowel mass, intestinal ulcers, and jaundice. Oral consumption of MBW was the most frequently used method for disease improvement. Meanwhile, recent studies have also shown the therapeutic effects of non-alcoholic beer in the treatment of various disorders, such as gastrointestinal inflammatory disease, cardiovascular disease, and diabetes, possibly due to its anti-inflammatory effect. Given the high importance of MBW in Avicenna’s Canon of Medicine, the results of this review and recent clinical studies can introduce MBW as an effective and less harmful gastrointestinal drug. We suggest conducting further clinical trials to assess the effectiveness of MBW in managing gastrointestinal conditions. https://jtim.tums.ac.ir/index.php/jtim/article/view/1146

Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 9 3 2024 09 29 347 356 Hanieh Tahermohammadi Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Mahdi Hosseini Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Mahdi Bahrami Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Scienc