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

Effects of Self-Management Education on Self-Efficacy and Quality of Life in Patients with Ulcerative Colitis: A Randomized Controlled Clinical Trial

Background: Self-management (SM) as a dynamic process enables Ulcerative colitis (UC) patients to live with this chronic illness. The present study aimed to investigate the effect of SM education on self-efficacy (SE) and quality of life (QoL) in patients with UC. Methods: This randomized controlled clinical trial study was conducted on 64 patients with UC from December 2016 to February 2017 at Motahari clinic, Shiraz. Patients were randomly divided into two groups of intervention and control. The education program included six 90-minute sessions in 3 weeks and one month telephone follow-up. Before, immediately and one month after the intervention, the participants filled out the Strategies Used by People to Promote Health (SUPPH) for SE, and the Inflammatory Bowel Disease Questionnaire-9 (IBDQ-9) for Qol. Then, data were entered into SPSS 18.0 and analyzed using independent samples t-test, Chi-square, repeated measures ANOVA and Pearson’s correlation coefficient. Results: A significant increase was observed in terms of the overall mean score for SE and its dimensions in the intervention group (P<0.001). These scores were significantly higher than those of the control group (P<0.001), except for positive attitude (P=0.15). The scores for overall Qol and its dimensions significantly increased in the intervention group immediately and one month after the intervention (P<0.001), and the difference between the two groups was significant (P<0.001). There was a significant positive correlation between SE and Qol (r=0.32, P=0.01). Conclusion: SM improved the SE and Qol in patients with UC. SM educatoin is recommended in nursing care of patients with UC. Trial Registration Number: IRCT2016092429823N

Identifying and prioritizing the effective factors in the implementation of green supply chain management in the construction industry

In recent years, environmental protection and sustainability have become significant issues and have attracted everyone's attention. And many organizations are now interested in using it as their strategy to gain customer satisfaction and market share and outperform competitors. This article aims to identify and prioritize the main factors that implement green supply chain management (GSCM) in the construction industry. To achieve the goal, the integrated approach combining is fuzzy decision-making trial and evaluation laboratory (FDEMATEL) and fuzzy analysis network Process (FANP) developed. The parameters employed are in this approach identified through an extensive literature review, and validation is criteria introduced through the experts’ opinions to discuss data uncertainty. First, the FDEMATEL method sets up the interrelationships between the criteria, which used for determining are the most important factors in the GSCM approach. Then, the local weight of the criteria calculated using the FANP approach based on cause and effect relationships, and through the FDEMATEL method. The results of this study show that external factors are the most important and influential factors in the GSCM approach, Therefore, the findings of this study can guide managers to make better use of the GSCM approach in the Iranian construction industry

Successful interferon desensitization in a patient with chronic hepatitis C infection

Treatment of hepatitis C, even when absolutely necessary, is almost impossible when interferon cannot be administered for any reason. We report a 65-year-old patient with chronic hepatitis C virus (HCV) infection and fibrosis, who was unable to receive interferon because of systemic hypersensitivity. The patient was desensitized successfully through gradual incremental exposure to interferon, and HCV infection was eradicated after a complete course of treatment, with no further allergic reactions. This case report that describes successful eradication of hepatitis C in a patient with advanced liver disease after desensitization to interferon revealed that desensitization may not necessarily damage the therapeutic efficacy of the drug

COMBINED 24-HOURS ESOPHAGEAL PH MONITORING AND MULTICHANNEL INTRALUMINAL IMPEDANCE FOR COMPARISON OF GASTROESOPHAGEAL REFLUX IN CHILDREN WITH TYPICAL VERSUS ATYPICAL SYMPTOMS OF GASTROESOPHAGEAL REFLUX DISEASE

ABSTRACT Background - Gastroesophageal reflux disease is the most common esophageal disorder in pediatrics. Objective - The aim of this study was to compare reflux parameters of typical and atypical symptoms of gastroesophageal reflux disease using 24-hour esophageal pH monitoring and multichannel intraluminal impedance in pediatric population. Methods - In this prospective study, 43 patients aged less than 18 year with suspected gastroesophageal reflux disease were enrolled. The patients were divided into two groups based on the main presenting symptoms (typical versus atypical). Twenty four-hour pH monitoring and multichannel intraluminal impedance were performed in all the patients for comparing these two group regarding association of symptoms and reflux. Number of refluxes, pH related reflux, total reflux time, reflux more than 5 minutes, longest time of the reflux, lowest pH at reflux, reflux index were recorded and compared. Data comparison was done using SPSS. Results - The mean age of the patients was 5.7±3.4 years and 65.1% were male. Out of 43 patients 24 cases had typical symptoms and 19 had atypical symptoms. The mean reflux events detected by multichannel intraluminal impedance was more than mean reflux events detected by pH monitoring (308.4±115.8 vs 69.7±66.6) with P value of 0.037, which is statistically significant. The mean symptom index and symptom association probability were 35.01% ± 20.78% and 86.42% ± 25.79%, respectively in multichannel intraluminal impedance versus 12.73% ± 12.48% and 45.16% ± 42.29% in pH monitoring (P value <0.001). Number of acid reflux was 46.26±47.16 and 30.9±22.09 for atypical and typical symptoms respectively. The mean symptom index was 18.12% ± 13.101% and 8.30% ± 10.301% in atypical and typical symptoms respectively (P=0.034). Bolus clearance was longer in atypical symptoms compared typical symptoms(P<0.05). Conclusion - Symptom index was significantly higher in atypical symptoms compared to typical symptoms. Higher number of acid reflux was found in children with atypical symptoms of reflux. Longer duration of bolus clearance was found in group with atypical symptoms of reflux

Expression of a Recombinant Anti-HIV and Anti-Tumor Protein, MAP30, in Nicotiana tobacum Hairy Roots: A pH-Stable and Thermophilic Antimicrobial Protein.

In contrast to conventional antibiotics, which microorganisms can readily evade, it is nearly impossible for a microbial strain that is sensitive to antimicrobial proteins to convert to a resistant strain. Therefore, antimicrobial proteins and peptides that are promising alternative candidates for the control of bacterial infections are under investigation. The MAP30 protein of Momordica charantia is a valuable type I ribosome-inactivating protein (RIP) with anti-HIV and anti-tumor activities. Whereas the antimicrobial activity of some type I RIPs has been confirmed, less attention has been paid to the antimicrobial activity of MAP30 produced in a stable, easily handled, and extremely cost-effective protein-expression system. rMAP30-KDEL was expressed in Nicotiana tobacum hairy roots, and its effect on different microorganisms was investigated. Analysis of the extracted total proteins of transgenic hairy roots showed that rMAP30-KDEL was expressed effectively and that this protein exhibited significant antibacterial activity in a dose-dependent manner. rMAP30-KDEL also possessed thermal and pH stability. Bioinformatic analysis of MAP30 and other RIPs regarding their conserved motifs, amino-acid contents, charge, aliphatic index, GRAVY value, and secondary structures demonstrated that these factors accounted for their thermophilicity. Therefore, RIPs such as MAP30 and its derived peptides might have promising applications as food preservatives, and their analysis might provide useful insights into designing clinically applicable antibiotic agents