Alteration in the composition of the gut microbiota can lead to a number of chronic clinical diseases. Akkermansia muciniphila is an anaerobic bacteria constituting 3–5% of the gut microbial community in healthy adults. This bacterium is responsible for degenerating mucin in the gut; its scarcity leads to diverse clinical disorders. In this review, we focus on the role of A. muciniphila in diabetes, obesity and atherosclerosis, as well as the use of this bacterium as a next-generation probiotic. In regard to obesity and diabetes, human and animal trials have shown that A. muciniphila controls the essential regulatory system of glucose and energy metabolism. However, the underlying mechanisms by which A. muciniphila alleviates the complications of obesity, diabetes and atherosclerosis are unclear. At the same time, its abundance suggests improved metabolic disorders, such as metabolic endotoxemia, adiposity insulin resistance and glucose tolerance. The role of A. muciniphila is implicated in declining aortic lesions and atherosclerosis. Well-characterized virulence factors, antigens and cell wall extracts of A. muciniphila may act as effector molecules in these diseases. These molecules may provide novel mechanisms and strategies by which this bacterium could be used as a probiotic for the treatment of obesity, diabetes and atherosclerosis.

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Offering strategies to prevent tiredness and reduce the related fatigue complications.

Introduction: Despite the proven risks associated with not breastfeeding, few mothers exclusively breastfeed their babies for six months as recommended by the World Health Organization. This study was conducted to compare the effect of breastfeeding promotion interventions on exclusive BMF among primiparous women. Methods: This quasi-experimental study was conducted on a sample of 93 primiparous women who were referred to health care centres, Mashhad, Iran, in 2010. Health care centres were selected by multistage sampling method, and then randomly allocated into two intervention groups (peer support group and health care provider's education group) and one control group. Primigravidae aged 18-35 years old, with singleton pregnancy, with gestational age of 35-36 weeks, and intending to breastfeed their children were randomly selected out of health care centres. The peer support group participants received supports from their peers four times and education group's participants received 4 training sessions by health care providers. The control group received only routine cares. Exclusive BMF duration and rate assessed at 4 and 8 weeks postpartum and collected data were analysed using SPSS (ver.11.5) software.

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INTRODUCTION:Each mother has the legal right to decide about her delivery, but this decision should be made based on scientific knowledge. Instructions during pregnancy help to choose the proper type of delivery. This study conducted aimed to compare two instructional methods of role playing and lecture on primigravida decision about type of delivery.SUBJECTS AND METHODS:In this single-blind clinical trial 67 primigravida, 34–36 week were selected using multi-stage sampling and assigned into two groups randomly. Decision-making (before, 2-week after, and at admission in maternity department) was tested by a questionnaire. In role-playing group, advantages and disadvantages of two type delivery were presented by role-playing in 90-min by three scenarios. In lecture group, it was also presented in a 90-min lecture. Data were analyzed by mean difference test, Fisher test, independent and paired t-test.RESULTS:Two groups showed a significant difference in terms of decision at admission to maternity department (P = 0.000). 75% of lecture group and 100% of role-playing group selected normal delivery. Postintervention knowledge score in lecture group was 18 ± 5.3 and in role-playing group 17.1 ± 4.0. Percent of change in knowledge scores in two groups was significant (P = 0.001). Participants’ attitude, before and after the intervention, in both groups was significant (P < 0.05). Mean difference of pre- and post-test in relation to two groups’ knowledge and attitude scores was not significant (P > 0.05).CONCLUSION:In this research, lecture was more effective in raising knowledge level, and role playing was more effective in raising decision to vaginal delivery and reducing elective caesarean section. It is therefore suggested to use both teaching methods altogether for pregnant women to decrease the rate of unnecessary cesarean.

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