Relationship between ureB Sequence Diversity, Urease Activity and Genotypic Variations of Different Helicobacter pylori Strains in Patients with Gastric Disorders

Association of the severity of Helicobacter pylori induced diseases with virulence entity of the colonized strains was proven in some studies. Urease has been demonstrated as a potent virulence factor for H. pylori. The main aim of this study was investigation of the relationships of ureB sequence diversity, urease activity and virulence genotypes of different H. pylori strains with histopathological changes of gastric tissue in infected patients suffering from different gastric disorders. Analysis of the virulence genotypes in the isolated strains indicated significant associations between the presence of severe active gastritis and cagA+ (P = 0.039) or cagA/iceA1 genotypes (P = 0.026), and intestinal metaplasia and vacA m1 (P = 0.008) or vacA s1/m2 (P = 0.001) genotypes. Our results showed a 2.4-fold increased risk of peptic ulcer (95% CI: 0.483–11.93), compared with gastritis, in the infected patients who had dupA positive strains; however this association was not statistically significant. The results of urease activity showed a significant mean difference between the isolated strains from patients with PUD and NUD (P = 0.034). This activity was relatively higher among patients with intestinal metaplasia. Also a significant associa­tion was found between the lack of cagA and increased urease activity among the isolated strains (P = 0.036). While the greatest sequencevariation of ureB was detected in a strain from a patient with intestinal metaplasia, the sole determined amino acid change in UreB sequence (Ala201Thr, 30%), showed no influence on urease activity. In conclusion, the supposed role of H. pylori urease to form peptic ulcer and advancing of intestinal metaplasia was postulated in this study. Higher urease activity in the colonizing H. pylori strains that present specific virulence factors was indicated as a risk factor for promotion of histopathological changes of gastric tissue that advance gastric malignancy

Actual Preoperative Fasting Time; A Report From Guilan Academic Hospitals: A Cross-sectional Study

Objectives: Traditional guidelines for preoperative fasting (POF) time lead to several complications in surgery patients. However, not enough attention has been paid to the issue. This aimed of this study was to investigate the management of fasting times in Guilan academic hospitals. Materials and Methods: In this descriptive cross-sectional study, individuals from five academic referral centers enrolled the survey and questionnaires including demographic characteristics, fasting hours for liquids and solids, POF recommenders, and patient’s knowledge regarding the definition of clear liquids were completed. Results: A total of 390 individuals candidate for elective surgeries enrolled in the study, the mean age of our cases were 46.61 years. The average POF time for solids and liquids was 11.43 and 9.70 hours, respectively. 95.38% of the participants did not know a correct definition of clear liquids, which was not related to their level of education (P=0.314). A positive association was observed between age and POF times for liquids and American Society of Anesthesiologists Classification for both solids (P=0.010) and liquids (P=0.0001). Conclusions: It was found that the real POF time in our hospitals was significantly longer than the modern guidelines, and needs to be corrected

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

Worldwide trends in underweight and obesity from 1990 to 2022 : a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

A list of authors and their affiliations appears online. A supplementary appendix is herewith attached.Background: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI 2 SD above the median). Findings: From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation: The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity.peer-reviewe

Patient safety culture in intensive care units from the perspective of nurses: A cross-sectional study

Background: One of the goals of nursing is providing safe care, prevention of injury, and health promotion of patients. Patient safety in intensive care units is threatened for various reasons. This study aimed to survey patient safety culture from the perspective of nurses in intensive care units. Materials and Methods: This cross-sectional study was conducted in 2016. Sampling was done using the convenience method. The sample consisted of 367 nurses working in intensive care units of teaching hospitals affiliated to Isfahan University of Medical Sciences. Data collection was performed using a two-part questionnaire that included demographic and hospital survey on Patient Safety Culture (HSOPSC) questionnaire. Data analysis was done using descriptive statistics (mean and standard deviation). Results: Among the 12 dimensions of safety culture, the nurses assigned the highest score to “team work within units” (97.3%) and “Organizational learning-continuous improvement” (84%). They assigned the least score to “handoffs and transitions”(21.1%), “non-punitive response to errors” (24.7%), “Staffing” (35.6%), “Communication openness” (47.5%), and “Teamwork across units” (49.4%). Conclusions: The patient safety culture dimensions have low levels that require adequate attention and essential measures of health care centers including facilitating teamwork, providing adequate staff, and developing a checklist of handoffs and transitions. Furthermore, to increase reporting error and to promote a patient safety culture in intensive care units, some strategies should be adopted including a system-based approach to deal with the error

بررسی اشعار شاعران قرن ششم هجری در حیطه گیاه دارویی خشخاش

Background and Aim: The sixth century poems are usually considered as "technical poems". The poets of this era put aside simplicity and fluency of the poetry of the previous periods and used similes and metaphors in poetry to describe scientific information of that era such as astronomy, mysticism, music, medicine and especially herbal medicines, in a manner that one cannot comprehend the meaning and concept of poetry without having knowledge of these sciences. Medical information and common healing properties of plants have a wide reflection in poetry of this period. One of these medicinal herbs (herbal medicines) is poppy, whose active ingredients have been known to people and used by them through centuries under different names such as poppy, coke, opium and... The poets of this era attempted to create themes for medicinal and sleep inducing characteristics of the extract of this plant and used its taste, color and properties as the bases of advice, lyric, praise and mysticism. Methods: The present library based research study is undertaken to utilize descriptive and analytical approaches to extract medicinal reflections of opium from Khaghani, Sanai, Anvri and Khamsa Nizami divans, and then make an exploratory and investigative analysis based on the therapeutic properties listed in scientific articles, authentic traditional medicine books as well as books on modern medicinal plants. Ethical Considerations: In this research, the ethical aspects of library study, including the authenticity of texts, honesty and trustworthiness, have been observed. Results: The sedative, hypnotic and antidote medicinal properties of poppy correspond to its current usage. Conclusion: Opium was used therapeutically in the 6th century and was obtained from two plants of "poppy" and "wild lettuce". Poppy opium was referred to as "poppy" and lettuce opium was called "koke". Nowadays, there is not any "koke" opium, but wild lettuce is still used as a hypnotic agent in traditional medicine and herbal medicine books confirm its hypnotic properties. Please cite this article as: Mesbah M, Poordargahi E, Farzi HR, Pasbaneslam B. Scrutinizing the Poems of the Sixth Century (AH) Poets in the Area of the Herbal Medicines; Poppy. Tārīkh-i pizishkī, i.e., Medical History. 2022; 14(47): e28.زمینه و هدف: شعر قرن ششم، «شعر فنی» است. شاعران این دوره سادگی و روانی شعر دوره‌های قبل را کنار گذاشته و اطلاعات علمی رایج در آن دوره، از قبیل نجوم، کلام، عرفان، موسیقی، طب و به ویژه گیاهان دارویی را در قالب تشبیه و استعاره‌های دیر‌یاب وارد شعر کرده‌اند، به نوعی ‌که بدون آشنایی با این علوم نمی‌توان مفهوم شعر را درک کرد. اطلاعات طبی و خواص درمانیِ رایج گیاهان، بازتاب ‌گسترده‌ای در شعر این دوره دارد. یکی از این ‌گیاهان دارویی، خشخاش است که از مواد مؤثره آن در طیّ قرون با نام‌های مختلف مانند کوکنار، کوک، افیون و تریاک یاد و استفاده شده ‌است. شاعران این دوره، از خاصیّت ‌دارویی و خواب‌آوری عصاره این گیاه، مضمون‌آفرینی‌کرده و طعم و رنگ و خواص ‌آن را دستمایه پند، مدح، تغزّل و عرفان ساخته‌اند. روش: این پژوهش‌کتابخانه‌ای بر آن است‌ که با استفاده از روش توصیفی ـ تحلیلی بازتاب دارویی افیون و تریاک را از دیوان ‌خاقانی، سنایی، انوری و خمسه نظامی استخراج کند و بر اساس خواص درمانی مندرج در مقالات ‌علمی، کتب معتبر طب سنتی و همچنین کتاب‌های ‌گیاهان دارویی امروزی، به بررسی و تحلیل بپردازد. ملاحظات اخلاقی: در این تحقیق جنبه‌های اخلاقی مطالعه کتابخانه‌ای شامل اصالت متون، صداقت و امانتداری رعایت شده است. یافته‌ها: خواص ‌داروییِ مسکّن، منوّم و پادزهری خشخاش با کاربرد امروزی ‌آن مطابقت دارد. نتیجه‌گیری: افیون در قرن ششم کاربرد درمانی داشته و از دو گیاهِ «خشخاش» و «کاهوی ‌وحشی» به ‌دست می‌آمده ‌است. افیون خشخاش را «کوکنار» و به افیون کاهو «کوک» می‌گفتند. امروزه خبری از افیون کوک نیست، با این حال کاهو هنوز هم در طب سنتی و کتاب‌های گیاهان دارویی به عنوان خواب‌آور شناخته می‌شود. لفظ «تریاک» نیز در شعر قرن ششم به طور مطلق در معنی پادزهر به کار رفته است

The effect of long-term strength training on serum levels of betatrophin and irisin in elderly men with type 2 diabetes

Background. The irisin and betatrophin hormones are involved in insulin resistance. Considering the muscle weakness of elderly diabetics, this study aimed to investigate the effect of 21 weeks of strength training on betatrophin and irisin serum levels in type 2 diabetic elderly men. Methods. This semi-experimental study was conducted on type 2 diabetic men with an average age of 70.85±2.90 years. The strength training protocol was performed twice a week for 21 weeks. The exercises consisted of three stages: 1- muscle endurance, 2- muscle hypertrophy, and 3- maximum strength training. Fasting blood glucose levels and serum levels of insulin, betatrophin, and irisin were measured in two phases before and after the exercises. Results. The serum levels of insulin, irisin, and betatrophin in the diabetes control group were lower than in the healthy group (P<0.05) and 21 weeks of strength training increased the serum levels of insulin, irisin, and betatrophin, and decreased body weight and fasting blood glucose levels in elderly diabetic men compared to the control group (P<0.05). Conclusion. Strength training improved metabolic disorders in diabetics and increased secretion of irisin and betatrophin following exercise which indicated that exercise may have a protective mechanism in diabetes. Practical Implications. Stationary movements by performing strength activities, through the development of skeletal muscles of diabetics, improve insulin sensitivity and harvest more glucose in the body. In addition, these exercises can be a protective mechanism to prevent or delay the complications of type 2 diabetes by increasing irisin and betatrophin levels