---

This study aimed to determine the knowledge and attitudes to wards homeopathy among general practitioner and specialist physicians in Sari. Our results indicate Sari physicians had not sufficient knowledge obout homeopathy but they liked collaboration with homeopaths for treatment of their patients and have courses for homeopathy education.

---

Background and purpose: Older adults with chronic diseases are at higher risk for infectious diseases, especially COVID-19. The aim of this study was to investigate the clinical manifestations in aged people with COVID-19 in Mazandaran province between March 2020 and September 2021.
Materials and methods: In a retrospective descriptive study, we studied demographic information, symptoms, and clinical manifestations of all patients over 60 years of age with COVID-19 admitted to medical centers affiliated with Mazandaran University of Medical Sciences. The checklist provided by the Ministry of Health and Medical Education available in the Medical Care Monitoring Center (MCMC) of the province was used.
Results: Totally, 40804 older adults were hospitalized, including 21405 (52.36%) women. Most of the patients aged 60-75 years old (68%). In 49%, the time from the onset of symptoms to hospitalization was less than five days. Respiratory diseases (34%), heart disease and hypertension (25%), and diabetes (20.99%) were the most common underlying diseases. The main clinical symptoms were cough (26.43%), respiratory distress (26.33%), and fever (22.77%). The mortality rate was 12.08% (n= 4930).
Conclusion: According to this study, chronic diseases in older population worsens the symptoms of COVID-19, which is consistent with other age groups. Care and intervention measures, such as self-care education could be of great benefit in promoting the health of aged people.
 

---

Background and purpose: Hypoxia can lead to impairments in body function and is linked to the pathology of acute mountain sickness, cardiovascular disease, and stroke, all of which are leading causes of death in many countries. Silybum marianum is a plant known for its strong antioxidant properties. This research aims to investigate the anti-hypoxic effects of S. marianum and its major constituent, silymarin, in three experimental models of hypoxia in mice.
Materials and methods: The protective effects of the methanolic extract of S. marianum aerial parts and silymarin against hypoxia-induced lethality in mice were evaluated using three experimental models of hypoxia: asphyctic, haemic, and circulatory. In the asphyctic hypoxic model, phenytoin (50 mg/kg, i.p.) was used as the positive control, while in the haemic and circulatory models, propranolol (20 and 30 mg/kg, i.p.) served as the positive control. Normal saline (0.5 ml, i.p.) was used as the negative control. Analysis of variance (ANOVA), followed by Newman-Keuls multiple comparisons (performed using GraphPad Prism 8), was used to determine significant differences in means.
Results: The extract and silymarin exhibited significant protective effects by increasing the survival time of male mice, even at their lowest doses, across all tested models. Silymarin was effective in all models and demonstrated a comparable effect to propranolol and phenytoin, which were used as positive controls. Except in the asphyctic model, the extract at a dose of 62.5 mg/kg exhibited the same activity as silymarin at 12.5 mg/kg.
Conclusion: The presence of silymarin in the extract may be responsible for the antihypoxic activities observed in the plant extract. Both the methanolic extract and silymarin, when tested separately, demonstrated significant protective effects against hypoxia in all tested models, exhibiting similar activity to the positive controls.