Dairy products are nutritious drink and can play a significant part in a healthy diet. The safety of dairy products decreases with increasing concentration of toxic compounds and environmental pollutants (especially heavy metals). In the present study, the contamination of Al, Sn, As, Cd, Hg and Pb in dairy products (pasteurized milk, yogurt, yogurt drink, cheese) consumed in Arak, Iran, 2013 was evaluated using inductively coupled plasma mass spectrometry (ICP-SFMS) method. To meet the aim, 60 samples of 5 different brands, consisting of pasteurized milk, yogurt, yogurt drink, cheese (n = 15) were selected and analyzed for heavy metals content. 100% of the samples were positive regarding the total average and range concentration of Al, Sn, As, Cd, Hg and Pb in dairy products was 168.25 ± 92.2 (30.6 -356.5), 5.9 ± 4 (1.1 -16), 3.2 ± 1.95 (0.4 -8.1), 4.55 ± 2.6 (0.6 -10.6), 23.15 ± 10.4 (6.8 -50.2) and 15.4 ± 8.53 (3.1 -40.2) µg/kg, respectively. 28.3% (17 of 60 samples) of dairy products samples had lead (Pb) greater than EU limit and national Iranian standard (20 µg/kg). Statistical analysis indicated except about As in pasteurized milk and cheese there was no significant difference between products in terms of heavy metals content.
Objective
Bipolar Disorder (BD) is one of the most common mental disorders associated with depressive symptoms and impairment in executive functions such as response inhibition. This study aimed to investigate the effectiveness of medication therapy combined with Transcranial Direct Current Stimulation (tDCS) on depression and response inhibition of patients with BD.
Method
This is a double-blinded randomized clinical trial with pretest, posttest, and follow-up design. Participants were 30 patients with BD randomly assigned to two groups of Medication+tDCS (n = 15, receiving medications plus tDCS with 2 mA intensity over dorsolateral prefrontal cortex for 10 days, two sessions per day each for 20 min) and Medication (n = 15, receiving mood stabilizers including 2–5 tables of 300 mg (mg) lithium, 200 mg sodium valproate, and 200 mg carbamazepine two times per day). Pretest, posttest and 3-month follow-up assessments were the 21-item Hamilton Depression Rating Scale (HDRS) and a Go/No-Go test. Collected data were analyzed in SPSS v.20 software.
Results
The mean HDRS score in both groups was reduced after both interventional techniques, where the group received combined therapy showed more reduction (P < 0.01), although their effects were not maintained after 3 months. In examining response inhibition variable, only the combined therapy could reduce the commission error of patients under a go/no-go task (p < 0.05), but its effect was not maintained after 3 months. There was no significant difference in the group received medication therapy alone.
Conclusion
Medication in combination with tDCS can reduce the depressive symptoms and improve the response inhibition ability of people with BD.
Trial registration
This study was registred by Iranian Registry of Clinical Trials (Parallel, ID: IRCT20191229045931N1, Registration date: 24/08/2020).
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