The Lifestyle Characteristics in Non-Alcoholic Fatty Liver Disease in the PERSIAN Guilan Cohort Study

BACKGROUND: Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common cause of chronic liver disease worldwide. Since the effect and safety of pharmacotherapy for NAFLD are unknown, the proper management of lifestyle is crucial. AIM: The present study was conducted to determine the status of food, Physical Activity (PA), and sleep in patients with and without NAFLD. METHODS: In this analytical- cross-sectional study, 630 clients with 36-60 years old who referred to the PERSIAN Guilan cohort study were included through simple non-random sampling. The developed questionnaire and lifestyle characteristics, including the status of nutrition, physical activity, and sleep, were completed for all samples. BMI was also calculated by determining weight and height, and fatty liver was confirmed based on abdominal ultrasound. RESULTS: The prevalence of NAFLD in this study was by 43.7% (275 / 630). Smoking, alcohol consumption, BMI, and weight loss over the past six months, regular exercise and exercise intensity, sedentary living, speed of eating, consuming fatty food, red meat, sweets beverages, and use of saturated fatty acid (SFA), and consuming fruits and vegetables were associated with presence of NAFLD (all p < 0.05). However, no significant relationship was observed between the parameters of sleep duration, the interval between dinner and night sleep, consuming breakfast and snack during the day and NAFLD (All p > 0.05). CONCLUSION: The onset and progression of NAFLD are associated with lifestyle. Therefore, dietary therapy solutions, physical activity, and sleep and rest situations should be paid attention for people with or at risk of NAFLD

Clinical Validation of an Office-Based 14C-UBT (Heliprobe) for H. pylori Diagnosis in Iranian Dyspeptic Patients

Background. We encountered repeatedly, in our clinical practice, discordant results between UBT and histopathology about H. pylori infection. Goal. To study the diagnostic accuracy of Heliprobe 14C-urea breath test (14C-UBT) for detection of H. pylori infection in an Iranian population. Study. We enrolled 125 dyspeptic patients in our study. All of them underwent gastroscopy, and four gastric biopsies (three from the antrum and one from the corpus) were obtained. One of the antral biopsies was utilized for a rapid urease test (RUT), and three others were evaluated under microscopic examination. Sera from all patients were investigated for the presence of H. pylori IgG antibodies. The 14C-UBT was performed on all subjects using Heliprobe kit, and results were analyzed against the following gold standard (GS): H. pylori infection considered positive when any two of three diagnostic methods (histopathology, RUT, serology) are positive. Results. According to data analysis, the Heliprobe 14C-UBT had 94% sensitivity, 100% specificity, 93% negative predictive value (NPV), 100% positive predictive value (PPV), and 97% accuracy, compared with GS. Conclusion. The Heliprobe 14C-UBT is an easy-to-perform, rapid-response, and accurate test for H. pylori diagnosis, suitable for office use

Frequency of Celiac Disease in Patients with Hypothyroidism

Background. Celiac disease (CD) is closely associated with other autoimmune endocrine disorders, particularly autoimmune thyroid disease. The aim of this study was to find the frequency of celiac disease in patients with hypothyroidism in Guilan province, north of Iran. Methods. A total of 454 consecutive patients with hypothyroidism underwent celiac serological tests antiGliadin antibodies (AGA), antitissue transglutaminase antibodies (IgA-tTG) and antiendomysial antibodies (EMA-IgA). Small intestinal biopsy was performed when any of celiac serological tests was positive. Results. Eleven (2.4%) patients were positive for celiac serology, and two patients with documented villous atrophy were diagnosed with classic CD (0.4%; 95%). Two patients with classic CD had Hashimoto's thyroiditis (HT) (0.6%; 95%). Six (54.5%) of 11 were suffering from overt hypothyroidism and 45.5% from subclinical hypothyroidism. Six (54.5%) had HT, and 45.5% had nonautoimmune hypothyroidism. Conclusions. In this study, prevalence of CD was lower than other studies. Most of the patients with CD were suffering from HT, but there was no significant statistical relation between CD and HT

Correlation between Certain Klotho Gene Polymorphisms and IGF-1 Levels of Colorectal Cancer Patients in Northern Iran

Background: Colorectal cancer susceptibility may correlate with the Klotho gene G-395A and C1818T polymorphisms. This study aims to evaluate the relationship between a Klotho single nucleotide polymorphism and IGF-1 with risk of colorectal cancer. Methods: This study enrolled 60 colorectal cancer patients and 60 age-matched healthy persons who referred to Razi Hospital, Rasht, and Northern Iran in September 2013. Patients enrolled under supervision of a gastro-intestinal specialist and according to the ethics right. G-395A and C1818T polymorphisms were genotyped with polymerase chain confronting two pair primer technology. IGF-1 and certain biochemistry analytes were assayed. Statistical analysis was used to compare appropriate relationships. Results: There were different base pair partitions for G395A and C1818T. Odds ratio and 95% confidence interval were used to analyze the correlation of genotypes and haplotypes with colorectal cancer susceptibility. The AA (odds ratio: 1.437, 95% confidence interval: 0.596) and GA (odds ratio: 1.958, 95% confidence interval: 1.133- 3.385) genotypes of the G-395A polymorphisms showed a slight relationship to the risk of colorectal cancer. The A allele had a much higher frequency in the case group (31.2%) compared with the control group (17.6%). There was no significant relationship with the C1818T polymorphism between the case and control groups. Conclusion: The Klotho gene polymorphism did not significantly increase the risk of colorectal cancer. Therefore, these genotypes might not have a correlation with IGF-1

Symptomatic reinfection with COVID-19: A case-report study in Iran

Coronavirus disease 2019 (COVID-19) resulted in a worldwide concern. The role of the immunity system and memory cells in this disease and their ability in preventing a secondary infection is a controversial issue. Here we presented a case of reinfection with this virus eight months after the first episode. A twenty-one-year-old man was referred to our local hospital on 19 February 2020 with symptoms of viral infection. COVID-19 infection was confirmed by RT-PCR. He got hospitalized for 5 days. Eight months later on 4 October 2020, he was again referred with symptoms of viral infection and para-clinical tests confirmed COVID-19 infection. He got hospitalized for 6 days in the second episode. Although the immunity system plays important role in COVID-19 infection through the presence of memory cells it doesn’t guarantee permanent immunity to this virus. Reinfection with COVID-19 is possible and has been reported in some other studies.

Prevalence of Gastrointestinal Symptoms among Individuals with and without Diabetes: A Cross-Sectional Study from the PERSIAN Guilan Cohort Study

Objective: Gastrointestinal (GI) symptoms are the most common complaint among individuals with diabetes. This study investigated the prevalence of upper, lower, and general GI symptoms in individuals with and without diabetes among the Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan Cohort study (PGCS) population. Materials and methods: This cross-sectional study of PGCS was conducted on 2669 participants, 1364 with diabetes and 1305 without diabetes. The first part of the questionnaire collected demographical and clinical data, and the second part collected GI symptoms. A 4-point Likert Scale was used for each question. Data were analyzed using SPSS software version 16, and the significance level was considered < 0.05. Results: The mean age of the participants was 52.24 ± 8.75 years, and 55.5% were female. Patients with diabetes have an increased incidence of upper GI symptoms (adjusted odds ratio [aOR] = 1.19, 95% confidence interval [CI]: 1.00–1.42, p = 0.045) compared to individuals without diabetes. The most common upper GI symptom in patients with diabetes compared to those without diabetes was eructation (18.6% vs. 14.9%, p = 0.009). Conclusions: The prevalence of GI symptoms was high in patients both with and without diabetes, and the chance of developing GI upper symptoms was higher in patients with diabetes

Prevalence and predictors of low back pain among the Iranian population: Results from the Persian cohort study

Background and objectives: Low back pain (LBP) is a common health condition in populations. Limited large-scale population-based studies evaluated the prevalence and predictors of LBP in developing countries. This study aimed to evaluate the prevalence and factors associated with LBP among the Iranian population. Methods: We used baseline information from the Prospective Epidemiological Research Studies in Iran (PERSIAN), including individuals from 16 provinces of Iran. LBP was defined as the history of back pain interfering with daily activities for more than one week during an individual's lifetime. Various factors hypothesized to affect LBP, such as age, sex, marital status, educational status, ethnicity, living area, employment status, history of smoking, body mass index (BMI), physical activity, sleep duration, wealth score, history of joint pain, and history of morning stiffness in the joints were evaluated. Results: In total, 163770 Iranians with a mean age of 49.37 (SD = 9.15) were included in this study, 44.8% of whom were male. The prevalence of LBP was 25.2% among participants. After adjusting for confounders, the female gender [OR:1.244(1.02-1.50)], middle and older ages [OR:1.23(1.10-1.33) and OR:1.13(1.07-1.42), respectively], being overweight or obese [OR:1.13(1.07-1.19) and OR:1.21(1.16-1.27), respectively], former and current smokers (OR:1.25(1.16-1.36) and OR:1.28(1.17-1.39), respectively], low physical activity [OR:1.07 (1.01-1.14)], and short sleep duration [OR: 1.09(1.02-1.17)] were significantly associated with LBP. Conclusion: In this large-scale study, we found the lifetime prevalence of LBP to be lower among the Iranian population in comparison to the global prevalence of LBP; further studies are warranted to evaluate the causality of risk factors on LBP

Prevalence, awareness, treatment, and control of hypertension based on ACC/AHA versus JNC7 guidelines in the PERSIAN cohort study

In this cross-sectional population-based study, we used the baseline data of the Prospective Epidemiologic Research Studies in IrAN cohort study collected in Iran from 2014 to 2020. The main outcomes were the prevalence of hypertension and proportion of awareness, treatment, and control based on the 2017 ACC/AHA guideline compared to the seventh report of the Joint National Committee (JNC7). Of the total of 163,770 participants, aged 35–70 years, 55.2% were female. The sex-age standardized prevalence of hypertension was 22.3% (95% CI 20.6, 24.1) based on the JNC7 guideline and 36.5% (31.1, 41.8) based on the ACC/AHA guideline. A total of 24,312 participants [14.1% (10.1, 18.1)] were newly diagnosed based on the ACC/AHA guideline. Compared to adults diagnosed with hypertension based on the JNC7 guideline, the newly diagnosed participants were mainly young literate males who had low levels of risk factors and were free from conventional comorbidities of hypertension. About 30.7% (25.9, 35.4) of them (4.3% of the entire population) were eligible for pharmacologic intervention based on the ACC/AHA guideline. Implementation of the new guideline may impose additional burden on health systems. However, early detection and management of elevated blood pressure may reduce the ultimate burden of hypertension in Iran