The Efficacy of Licorice Root Extract in Decreasing Transaminase Activities in Non-alcoholic Fatty Liver Disease: A Randomized Controlled Clinical Trial

This study was performed to investigate the effects of licorice on non-alcoholic fatty liver disease (NAFLD). In this double blind randomized clinical trial, 66 patients were divided into case and control groups. All patients had elevated liver enzymes and had increased liver echogenicity (lipid accumulation) on sonography. The case group was treated with one capsule containing 2 g aqueous licorice root extract per day for 2 months while the control group was treated in the same manner with a placebo. Weight, body mass index (BMI) and liver transaminase levels were measured for each patient before and after the study. In the case group, the mean alanine aminotransferase (ALT) level decreased from 64.09 to 51.27 IU/mL and the aspartate aminotransferase (AST) level decreased from 58.18 to 4

Co-occurrence of upper respiratory tract disorders with gastrointestinal infections of helicobacter pylori in patients: a systematic review and meta-analysis

Background: Helicobacter pylori infection and respiratory tract infection at the same time cause pathogenicity increase and death. The aim of this study was to evaluate the co-occurrence of upper respiratory tract disorders and gastrointestinal infections of H. pylori. Methods: The present study was conducted as a systematic review and meta-analysis, from August 2019 to Agusut 2020, at Qazvin University of Medical Sciences. Articles in the international databases (April 2001-December 2018) on the coexistence of upper respiratory tract disorders with H. pylori gastrointestinal infections were examined. The random effect model with a 95% confidence level was used to analyze the data. Results: The highest prevalence of respiratory disorders co-occurrence associated with adenoid tissue (33%), nasal polyps (100%), chronic rhinosinusitis (71%) and gastrointestinal infections of H. pylori was reported in 2006 in Turkey, 2011 in Poland and 2015 in Egypt .Concurrent prevalence of the disease, according to the type of upper respiratory tract disorders in all studies, the estimated effect size according to the random model was 53% in chronic rhinosinusitis, 63% in nasal polyps, 62% in adenoid tissue and 60% in total, which was significant (P=0/000). The prevalence of co-occurrence of upper respiratory tract disorders with gastrointestinal infections of H. pylori in patients was estimated to be 61% at the age of more than 27 years and 60% at the age of fewer than 27 years. Pooled estimation of the concurrent prevalence of infection (in total) was estimated to be 60% and was significant among the studies (P=0/000). Conclusion: The concurrent prevalence of upper respiratory tract disorders with gastrointestinal infections of H. pylori was observed to be almost equal and significant in elderly and young patients. Due to the fact that the simultaneous occurrence of two types of infections and diseases in people is very dangerous, screening of patients with each of these infections is necessary to identify the other infection and prescribe appropriate drugs

Effects of Exosomes Derived From Helicobacter pylori Outer Membrane Vesicle-Infected Hepatocytes on Hepatic Stellate Cell Activation and Liver Fibrosis Induction

Liver fibrosis is a multifactorial disease with microbial and non-microbial causes. In recent years, Helicobacter pylori infection has been thought to play a critical role in some extragastrointestinal manifestations especially liver disorders. Outer membrane vesicles (OMVs) are one of the most important discussed H. pylori virulence factors. In the current study, four different clinical strains of H. pylori were collected and their OMVs were purified using ultra-centrifugation. To investigate their effects on liver cell exosomes, co-incubation with hepatocytes was applied. After a while, hepatocyte-derived exosomes were extracted and incubated with hepatic stellate cells (HSCs) to investigate the HSC activation and fibrosis marker induction. The expression of a-SMA, TIMP-1, b-catenin, vimentin, and e-cadherin messenger RNAs (mRNA) was assessed using real-time RTPCR, and the protein expression of a-SMA, TIMP-1, b-catenin, vimentin, and e-cadherin was evaluated by Western blotting. Our results showed that infected hepatocyte-derived exosomes induced the expression of a-SMA, TIMP-1, b-catenin, and vimentin in HSCs and e-cadherin gene and protein expression was downregulated. In the current study, we found that H. pylori-derived OMVs may aid the exosome alternation and modified exosomes may have a possible role in HSC activation and liver fibrosis progression

High level of resistance to metronidazole and clarithromycin among Helicobacter pylori clinical isolates in Qazvin province, Iran

The treatment of patients with Helicobacter pylori infection has many limitations, especially because of antibiotic resistance. We aimed to investigate the prevalence and mechanism of antibiotic resistance to metronidazole and clarithromycin in H. pylori isolates collected from patients with gastrointestinal symptoms in Qazvin, Iran. In this cross-sectional study, antibiotic susceptibility testing to clarithromycin and metronidazole was performed among 80 clinical strains isolated from H. pylori-positive dyspeptic patients referred to Qazvin hospital from July 2018 to November 2018. Polymerase chain reaction (PCR) and sequencing tests were performed to determine the type of mutations in the rdxA gene in metronidazole-resistant isolates, and the 23SrRNA gene in clarithromycinresistant isolates. Thirteen (40.6%) and Twenty-one (65.6%) isolates were resistant to clarithromycin and metronidazole, respectively. 37.5% and 59.4% of clarithromycin and metronidazole resistant isolates had MIC>256. In clarithromycin-resistant isolates, mutations in the 23SrRNA gene was seen at A2143G (15.6%), A2142G (9.4%), C2195T (6.3%), C2244T (3.1%), and G2212A (3.1%) locations. In one isolate, three simultaneous mutations were recorded in locations A2143G, G2110A, and C2121T. Mutations in the rdxA gene in metronidazole-resistant isolates, were missense. High resistance to metronidazole and clarithromycin antibiotics were seen in H. pylori isolates in Qazvin province. This is the frst report of new mutation sites G2212A, G2110A, and C2121T on the 23SrRNA gene in clarithromycin-resistant isolates. It is necessary to evaluate the current situation in terms of resistance and identify the mechanisms involved in its occurrence for the successful treatment of infections caused by this organism

Prevalence of foodborne and zoonotic viral pathogens in raw cow milk samples

Foodborne and zoonotic viral pathogens are responsible for substantial morbidity and mortality worldwide. These viruses can be transmitted through foods such as dairy products to humans and cause several acute and chronic diseases. This study aimed to investigate the prevalence and profile of different foodborne and zoonotic viruses in raw cow milk samples. We collected 492 raw cow milk samples from local dairy markets in Qazvin, Iran. Then, we evaluated the presence of hepatitis A virus, noroviruses, rotavirus, astrovirus, bovine leukaemia virus (BLV), and tick-borne encephalitis virus (TBEV) in samples using conventional and nested RT-PCR methods. We found that 34.95, 7.72, 25.81, 14.63, 66.86, 12.80, and 21.34% of raw milk samples were contaminated with norovirus GI, norovirus GII, hepatitis A virus, rotavirus, astrovirus, BLV and TBEV viruses, respectively. Interestingly, the samples collected from the city's south area revealed a higher prevalence of foodborne and zoonotic viruses. Astrovirus and its combination with norovirus GI were the most prevalent virus profiles. Also, the highest correlations were observed among the presence of rotavirus and hepatitis A viruses (0.36) and TBEV and norovirus GII (0.31). Considering the prevalence rate and virus profiles of different foodborne and zoonotic viruses in raw milk samples, hygiene practices and the pasteurization process are strongly suggested to be conducted throughout the cow milk production chain and in dairy industries to prevent infections with these pathogens

Global incidence of helminthic contamination of vegetables, cucurbits and fruits: A systematic review and meta-analysis

ABSTRACT Accidental ingestion of infective stages of helminths through consumption of contaminated vegetables and fruits causes a wide range of food-borne diseases in humans. This systematic review and meta-analysis evaluated the global incidence of helminthic contamination of vegetables, cucurbits and fruits. Several databases (Science Direct, Web of Science, PubMed, Scopus, and Google Scholar) were searched for literature published prior to November 2020. Overally, 184 articles (32 countries) met the inclusion criteria. Among these, 137 studies documented helminthic contamination in vegetables, 46 in cucurbits and 9 were in fruits. The pooled incidence (95% confidence interval) was 31% (26%–37%) for vegetables, 20% (14%–27%) for cucurbits and 20% (8%– 37%) for fruits. The highest incidence rate was found in the Western Pacific WHO region (54%; 9%–95%). The most prevalent parasitic agents were Ascaris lumbricoides eggs (12%; 9%–15%) and Strongyloides stercoralis larvae (12%; 8%–16%) in vegetables, S. stercoralis larvae (10%; 5%–15%) and Toxocara spp. eggs (10%; 3%–21%) in cucurbits, and Trichuris trichiura eggs (9%; 1%–22%) in fruits. The highest incidence rate was found to be associated with lower-middle income countries (34%, 28%–41%) and regions with a tropical rainforest climate (50%, 10%–91%). The potential role of vegetables, cucurbits, and fruits in the spread of helminthic parasites was revealed. Utilizing clean water for irrigation, proper washing and cooking of vegetables and improved sanitary practices can decrease the public health hazard regarding the consumption of vegetables, cucurbits, and fruits. Keywords: Vegetable Cucurbits Fruits Helminthic contamination Public health Food safet

Global prevalence of intestinal protozoan contamination in vegetables and fruits: A systematic review and meta-analysis

A B S T R A C T Environmental contamination of vegetables and fruits with intestinal protozoan trophozoites, cysts and oocysts is a means of transmitting parasitic agents of public health importance. The purpose of this systematic review and meta-analysis was to determine the global prevalence of intestinal protozoan parasite contamination in vege- tables and fruits. Several databases (Web of Science, PubMed, Scopus, ProQuest and Google Scholar) were searched for literature published up to August 2021. Pooled prevalence was determined using the meta-package in R (version 3.6.1). Out of 90,404 publications, 189 articles (202 datasets) met the inclusion criteria. Among these, 183 investigations documented protozoan contamination in vegetables and 20 in fruits. The pooled prevalence (95% confidence interval) was 20% (16%–24%) for vegetables and 13% (7%–21%) for fruits. The highest pooled prevalence was found in South-East Asian WHO region 37% (6%–76%). The most prevalent protozoan parasite in vegetables was Cryptosporidium spp. (11%, 7%–15%). As well, Entamoeba histolytica was the most common agent found in fruits (9%, 4%–14%). Furthermore, the unwashed samples had the highest pooled prevalence of contamination (22%, 3%–49%). Our data suggest a possible risk of protozoan infection in humans via unwashed vegetables and fruits. Accidental ingestion of protozoa occurs through consumption of contami- nated vegetables and fruits that have been improperly washed and prepared under poor sanitation. Using san- itary irrigation water, consuming properly cleaned and cooked vegetables, and practicing good hygiene can all assist to reduce the risk of protozoa infection Keywords: Vegetables Fruits, Protozoan contamination, Public health, Food-borne, disease

Clinicopathological Findings of the Cardia and Gastroesophageal Junction in Adult Candidates for Endoscopy in Qazvin, Iran

Background: Chronic inflammation and intestinal metaplasia lead to gastric and esophageal adenocarcinoma. Past research has provided controversial findings about the etiology of inflammation and intestinal metaplasia in the cardia and the Z-line. Objectives: The aim of this study was to evaluate clinicopathological findings of the cardia and gastroesophageal junction in adult candidates for endoscopy in Qazvin, Iran. Methods: Biopsy was performed for 124 ambulatory adult patients without any evidence of cancer. Specimens were obtained from the antrum and the cardia of the stomach, the Z-line, and 2 cm above the Z-line. A comparison was made between the histological, clinical and endoscopic data obtained from the patients. Results: Helicobacter pylori were significantly related to active inflammation in the antrum and the cardia, but not in the Z-line. Another finding was that active carditis was related to active antritis and active Z-line inflammation. A further observation was the positive correlation between cardiac and Z-line metaplasia. Finally, a relationship was observed between the type of cardiac mucosa and the presence of metaplasia in the cardia and the Z-line. Conclusions: The study revealed thatinflammationin the cardia and, to a lesser extent, the Z-line is related to H. pyloriandantral gastritis and that the metaplasia of these areas is related to gastroesophageal reflux disease. Lastly, both H. pylori and gastroesophageal reflux disease are important in the pathology of these areas. Keywords: Cardia, Z-Line, Gastroesophageal Reflux Disease, Histopathology, Helicobacter pylor

Treatment Outcome in Chronic Hepatitis C Infection: A Four Years Survey Among Iranian Patients

Abstract Background: Hepatitis C virus (HCV) infection is universal. Side effects of its treatment are observed in many patients. The present study was designed to evaluate treatment outcome and side effects of the treatment in chronic HCV infection. Materials and Methods: The current study was conducted prospectively on patients with hepatitis C infection. They had been treated with the standard drug regimen, if indicated. They were followed for treatment response, side effects of therapy, and its related factors. Findings: From ninety one patients, eighty four persons finished their treatment course. They comprised 71 (84.5%) males and 13 (15.5%) females. Their mean age was 41.5± 11.90 years (20-69 years). Genotype 3 was the most common virus genotype (51.2%). Sustained virologic response (SVR) was 84.5% for genotype 3 and 47.5% for genotype 1. Decrease in hemoglobin (43%), weakness and fatigue (26%), neutropenia (13%), and thrombocytopenia (13%) were the most common side effects of the treatment. Seven patients can not finish their treatment course, because of the side effects. Conclusion: Genotype 3, viral load less than 600000, and more than 3- fold rise in AST are associated with higher SVR. Early administration of the added drugs such as erythropoietin and G-CSF to not reduce the drug doses were also influential. Keywords: chronic hepatitis C, SVR, Peg-interferon, α-2a pegaferon, ribavirin, treatmen