Background: Depression and anxiety are among the most common mental disorders before and after surgery. Aromatherapy is a treatment that has grown substantially in recent years in comparison with other complementary and alternative medicines (CAM) to relieve anxiety. Objectives: This study investigated the effect of inhaling lavender essence on the physiological and psychological status of patients who are candidates for coronary artery bypass graft (CABG) surgery. Methods: This randomized clinical trial was performed on 60 patients who were undergoing CABG surgery at the hospitals of Artesh Jomhory Eslami (AJA) University of Medical Sciences in Iran. Patients who met specific inclusion criteria were selected and randomly allocated into two groups: a control group that inhaled room air and an experimental group that inhaled from a piece of cotton impregnated with two drops of lavender essence. This intervention was done on the morning of surgery. To evaluate these measures, a Depression Anxiety Stress Scale (DASS) questionnaire was filled out by the patient before and after the intervention. The data collected were analyzed using descriptive and analytic statistics. Results: After the intervention, the study results showed statistically significant differences between the two study groups in heart rate (mean = 78.83, P = 0.02) and anxiety level (mean = 6.63, P = 0.02). However, the differences between the two groups were not significant regarding stress level (mean = 8.63, P = 0.55) and other physiological variables. Conclusions: Inhalation aromatherapy is an effective method for reducing the heart rate and the level of anxiety in patients before CABG surgery. Given that the physiological and psychological health of patients are important responsibilities for nurses, aromatherapy can be considered a safe and effective relaxation method before invasive interventions. Learning this method is recommended for students and nurses.

Paranonylphenol (p-NP) is an environmental pollutant that causes oxidative stress. The purpose of this study was to evaluate the protective effect of N-acetylcysteine (NAC) as an antioxidant on sperm parameters and testis in mice after treatment with p-NP. Adult mice were randomly divided into four groups (n = 6, each group) including 1-control, 2- p-NP (250 mg kg day ), 3- NAC (150 mg kg day ) and 4- p-NP + NAC. After 35 days of oral treatment, the mean of spermatogenic index (p < 0.02), sperm count (p < 0.01), daily sperm production (p < 0.01), sperm tail length (p < 0.02), progressive movement (p < 0.04), normal morphology (p < 0.04) and viability (p < 0.01) of spermatozoa and also serum testosterone level (p < 0.04) were significantly reduced in p-NP group when compared to other groups. While the count of the positive TUNEL cells in the seminiferous tubules (p < 0.01) and level of the malondialdehyde (MDA) in testis (p < 0.02) and serum (p < 0.01) significantly increased. In the histopathologic assay in the p-NP group, apoptosis, atrophy, oedema, reduction in sperm density in lumens and vacuoles were observed. The findings of this study indicate that NAC as a potent antioxidant be able to compensate the adverse effects of p-NP in spermatogenesis, testis and levels of testosterone and MDA in the p-NP + NAC group significantly compared to the p-NP group.

Cadmium is known as an oxidative stress‐inducing factor. Silymarin extracted from Silybum marianum is regarded as a potent antioxidant. The present study investigated the preventing effects of silymarin on cadmium chloride‐induced toxicity in terms of testis histopathology and serum testosterone level as well as oxidative stress indicators in mice. In addition, the activities of antioxidant defence enzymes was evaluated. Adult male mice were divided into four groups (n = 6 in each group): (a) control; (b) cadmium chloride; (c) silymarin + cadmium chloride and (d) Silymarin. In this study, cadmium chloride significantly decreased the diameter and wall thickness of the seminiferous tubule, diameter of the spermatogonia nucleus and serum testosterone levels compared to the control group. Furthermore, in mice treated with this pollutant, a significant increase in malondialdehyde was observed while ferric reducing antioxidant power level, and the activity of catalase, superoxide dismutase and glutathione peroxidase were significantly reduced in the testis. In the silymarin + cadmium chloride group, silymarin could significantly reverse the toxic effects of cadmium chloride. The findings of this study showed that silymarin, as a potent antioxidant, can compensate the adverse effects of cadmium chloride on testis histopathology, testosterone level, oxidative stress indicators and antioxidant defence enzymes in mice.

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Infertility is one of the problems of today's society which has created psychological and therapeutic difficulties for couples (Makker et al., 2009). According to global statistics, about 10-15 per cent of couples are infertile (Fanaei et al., 2014). Asthenoteratozoospermia is one of the reasons for infertility in men (WHO, 2010). Sperm parameters of these patients have motility less than 40% and abnormal morphology more than 96% (WHO, 2010). Previous studies have shown that semen of asthenoteratozoospermic men compared to normal men produces high levels of ROS (Ghafarizadeh et al., 2018). This extra ROS can be caused by a decrease of semen antioxidants levels and mitochondrial dysfunction that was created during incomplete spermatogenesis and also originated from the NADPH oxidase system (Fanaei et al., 2014; WHO, 2010). Fatty acid peroxidation in the plasma membrane is the most important cause hurt to spermatozoa by oxidative stress induction (Lenzi et al., 1996), and it is worth mentioning that polyunsaturated fatty acids (PUFA) are one of the significant factors in the risk of ROS attack (Lenzi et al., 1996). In addition to the semen of asthenoteratozoospermic men that has sperm abnormality, preparing and maintaining of sampling also in these patients in the laboratory for ART may take several hours (Nabi et al., 2014; WHO, 2010). During this stage, due to the imbalance between antioxidant capacity and ROS production, spermatozoa are damaged and their function is reduced (Jeulin et al., 1982; Nabi et al., 2014). Cause the inherent property of antioxidants to ROS scavenging, VE can be recommended as a potent antioxidant to asthenoteratozoospermia in sperm preparation.