Prevalence and Clinical Significance of Hepatitis B Basal Core Promoter and Precore Gene Mutations in Southern Iranian Patients

Background and Aims: To investigate the prevalence and pattern of PC and BCP mutations and their clinical significance in patients with genotype D chronic hepatitis B infection in the Fars province of southern Iran. Materials and Methods: From January 2007 to March 2008, we evaluated 44 patients with chronic hepatitis B infection who were referred to our hepatology clinics affiliated with the Shiraz University of Medical Science. All Patients were HBeAg Negative and HBeAb positive. Basal core promoter and precore mutations in these patients were evaluated with clinical phenotype and laboratory tests. Results: The mean age of the patients was 37.21 ± 10.54 years. Twenty-seven patients (61.4) had no mutations, whereas 17 patients (38.6) had mutations in the precore or basal core promoter regions or both. The mean serum ALT level in mutation-free patients was 59.74 ± 55.86 IUL, whereas patients with PC and BCP mutations had a mean serum ALT level of 71.35 ± 59.49 IUL. The mean serum AST level in patients with mutations was higher than for patients without mutations (59.53 ± 41.35 IUL vs. 40.65 ± 25.21 IUL, respectively). There was no statistically significant difference between the mutation and mutation-free groups in terms of age, sex, and liver enzyme levels (P > 0.05). Fourteen of the 44 patients (31.8) had mutations in the precore region (G 1896A). 17 patients (38.6) had mutations in basal core promoter region. Conclusion: This study revealed a high prevalence of precore and basal core promoter mutations in southern Iran. Although no statistically significant difference was noted in liver enzymes, patients with mutations had igher liver enzymes in comparison with mutation-free patients

Dietary pattern of adolescent girls in relation to socio-economic factors; A comparison between North and South Tehran

Comparing dietary pattern and related socio-economic factors among adolescent girls in the North and South of Tehran, the capital of Iran. This cross-sectional and analytical study 210 adolescent girls, aged 14-17 years, from high schools in the North district of Tehran (n=105; high socio-economic level) and the South district (n=105; low socio-economic level) were selected by the two-step, cluster random sampling method. Demographic data, including mothers´ and fathers´ educational levels and parents´ occupation were gathered, using a validated self-administered questionnaire. Three questionnaires of food frequency, one-day 24-hour food recall and one-day 24-hour food record were used for assessing dietary pattern. The results showed that the frequency consumption of certain fatty foods, including dairy products and meat group, and fats in district 1 are higher than in district 19 adolescent girls; based on many differences such as life style and food accessibility. This indicated that there is a significant difference in the quality pattern of fat intake between the two districts. It is suggested to design and implement nutritional intervention programs for adolescent girls, particularly in the low socio- economic districts

Interstitial cells of Cajal: A novel hypothesis for the pathophysiology of irritable bowel syndrome

Irritable bowl syndrome (IBS) affects a large proportion of the world’s population, and accounts for a considerable number of visits to gastroenterologists and general practitioners. Despite its high prevalence, the precise mechanism of IBS has not been identified to date. The interstitial cells of Cajal (ICC) participate in the production of slow waves and the regulation of their propagation through the gastrointestinal system; thus, they are important components of gastrointestinal motility. The present review proposes that ICC play a central role in the pathophysiology of IBS. This hypothesis is based on many links between ICC and currently proposed mechanisms of IBS pathophysiology. It appears that ICC may be involved in almost all of the previously explained pathogenic mechanisms of IBS. If proven, this hypothesis may provide a key to solving the IBS mystery

Hepatic Computed Tomography Volumetry for Noninvasive Detection of Hepatic Steatosis and Steatohepatitis in Living Liver Donors

OBJECTIVESDetection of hepatic steatosis in donors is an important step for selection of a suitable liver allograft in living-donor transplant. This study aimed to investigate the role of hepatic computed tomography volumetry as a noninvasive method for detection of hepatic steatosis in living liver donors. MATERIALS AND METHODSIn a cross-sectional study, individuals who had undergone liver biopsy as a pretransplant checkup before living-donor liver transplant were included. The segmental liver volumes were measured by computed tomography scan with intravenous contrast enhancement. RESULTSOur study included 179 individuals. Mean total volume of the liver was 1705.2 ± 256.5 cm³ in those with steatohepatitis and 1419.4 ± 241.2 cm³ in those without steatohepatitis (P < .001). Higher total volume of the liver (odds ratio of 1.005; 95% confidence interval, 1.001-1.010; P = .012) and total liver volume-to-standard liver volume ratio (odds ratio of 1.090; 95% confidence interval, 1.021-1.163; P = .009) were independent predictors of steatohepatitis. A cutoff value of 1531 cm³ for total liver volume was a predictor of presence of steatohepatitis in liver biopsies of donors (sensitivity = 83%; specificity = 71%; area under the curve = 0.809; P < .001). CONCLUSIONSComputed tomography volumetry may be considered as an auxiliary noninvasive method for estimation of hepatic steatosis/steatohepatitis and may be used as a guide to select donor candidates for liver biopsy