Publications by authors named "Mohammadreza Naghipour"

24 Publications

  • Page 1 of 1

High Prevalence of Metabolic Syndrome and Its Related Demographic Factors in North of Iran: Results from the PERSIAN Guilan Cohort Study.

Int J Endocrinol 2021 29;2021:8862456. Epub 2021 Mar 29.

Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.

Introduction: The prevalence of metabolic syndrome has increased in recent decades around the world and is currently reaching epidemic levels as it is a major public health and clinical concern. The aim of this study was to evaluate the prevalence of metabolic syndrome and its related demographic factors in a population-based study.

Methods: In this cross-sectional study, the target population consisted of 10520 individuals aged 35-70 years in Phase 1 of the Persian Guilan cohort study (Guilan site/Some'e Sara) that was conducted in 2014-2017. Demographic, anthropometric, blood pressure, and biochemical data were used in this study. The IDF definitions were used to diagnose the metabolic syndrome.

Results: The prevalence of the syndrome according to IDF and ATP definition was 42.87% (95% CI: 41.92-41.81) and 40.68% (95% CI: 39.74-41.62), respectively. The prevalence of components for central obesity, high triglyceride, HDL cholesterol, blood glucose, and hypertension components was 75.8%, 43.1%, 40.6%, 39.2% and 37.9%, respectively. All demographic variables were related to the syndrome, and among them age, gender, and residence were identified as independent and strong predictive variables in the regression model. More than 92% of the population had at least one component of the syndrome.

Conclusion: The results of the study show a high prevalence of metabolic syndrome risk factors. It is essential to educate healthy lifestyle behaviors and further health education in the high-risk groups identified in this study, especially the elderly, women, and rural residents.
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http://dx.doi.org/10.1155/2021/8862456DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024063PMC
March 2021

Epidemiologic Profile of Hypertension in Northern Iranian Population: The PERSIAN Guilan Cohort Study (PGCS).

Ann Glob Health 2021 02 12;87(1):14. Epub 2021 Feb 12.

Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.

Background: Estimates region-related prevalence of hypertension and attempts to identify its related factors at the district levels are required for prevention and management of hypertension.

Objective: The aim of this study was to investigate the epidemic features and related factors of hypertension and its awareness, treatment, and control rates among the northern Iranian population.

Methods: It was a community based cross-sectional study based on data from PERSIAN Guilan Cohort Study (PGCS). In total, 10,520 participants (aged 35-70 years) from the Guilan Province in northern Iran included in this study, between October 8, 2014, and January 20, 2017. Hypertension was defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg or a prior diagnosis of hypertension or being on antihypertensive medication. Potential correlates of hypertension and its awareness, treatment and control were analyzed by multivariate logistic regression adjusted for demographic factors, anthropometric characteristics, lifestyle variables, past medical history, and laboratory data.

Results: The prevalence of hypertension was 43.2% and the hypertension awareness, treatment, and control rate were 53.4%, 49.8%, and 73.7%, respectively. The multivariate logistic regression analyses revealed that older age, urbanization, lower education, overweight and obesity, lower physical activity, prediabetes and diabetes, cardiovascular disease, psychiatric disorder, positive family history of hypertension and raised serum creatinine were independently associated with presence of hypertension. Awareness of hypertension was greater in the female sex, older age, rural residency, higher education and patient with comorbidities. Older age, rural residency and comorbidities were associated with treatment of hypertension. Control of hypertension was better among younger age, higher education, normal weight and higher physical activity.

Conclusion: Hypertension is highly prevalent in the northern Iranian population. About half of affected persons are unaware of their disease and untreated. Modifying risk factors (such as weight lose and increase physical activity) and increasing hypertension awareness (by screening) is essential for primary and secondary prevention of high blood pressure in this population, especially in urban areas and among males, younger ages, and less educated.
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http://dx.doi.org/10.5334/aogh.3027DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879995PMC
February 2021

Comparison of anthropometric indices as predictors of the risk factors for cardiovascular disease in Iran: The PERSIAN Guilan Cohort Study.

Anatol J Cardiol 2021 02;25(2):120-128

Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences; Rasht-Iran;Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences; Rasht-Iran;GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences; Rasht-Iran.

Objective: This study was conducted to assess the prevalence of central and general obesity and compare nine anthropometric indices as predictors of the risk factors for cardiovascular disease (CVD) in Iranian adults.

Methods: A total of 10,520 adults between ages 35 and 70 years old who were referred to the PERSIAN Guilan Cohort Study were included in this study. Anthropometric indices, including body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), waist to hip ratio (WHR), conicity index, hip circumference (HC), waist to hip to height ratio (WHHR), body adiposity index, and a body shape index (ABSI), were measured using the standard methods. The risk factors for CVD (diabetes mellitus, hypertension, and out of range lipid profiles) were defined by laboratory tests and medical history. The odds ratio of the risk factors based on a unit increase in anthropometric indices was examined by an adjusted logistic model.

Results: The mean of all anthropometric indices was higher in women than in men (p<0.01). After adjusting for confounders, the risk of diabetes mellitus, hypertension, and hypertriglyceridemia increased with an increase in all anthropometric indices. The highest risk of diabetes mellitus and hypertriglyceridemia was found in higher WHHR. The highest risk of low high density lipoprotein cholesterol (HDL C) and high low density lipoprotein cholesterol (LDL C) was found in an increase in the WHR and ABSI, respectively.

Conclusion: Our findings emphasize higher levels of general and central obesity in adults in the north of Iran. The WHHR and WHtR seem to be more valuable indices than BMI and WC for predicting distinct risk factors for CVD. However, the WHR was the strongest index for the prediction of high LDL C/HDL C ratio.
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http://dx.doi.org/10.14744/AnatolJCardiol.2020.73557DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8114644PMC
February 2021

Epidemiologic profile of viral hepatitis B and C in North of Iran: results from PERSIAN Guilan Cohort Study (PGCS).

BMC Res Notes 2021 Feb 10;14(1):59. Epub 2021 Feb 10.

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

Objective: Hepatitis B (HB) and C (HC) are two severe viral infectious diseases with a deleterious impact on global health. This study aimed to evaluate the prevalence of HB and HC in the Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study using immunological and molecular methods.

Results: The blood samples were obtained from 10,520 enrolled participants. Complete biochemical and hematological tests, as well as urine analysis, were assessed. The presence of HBsAg, anti-HBs, anti-HBc, and anti-HCV antibodies for all participant and HBeAg and anti-HBe antibodies for HB-positive patients were evaluated. Moreover, HB genomic DNA and HC genomic RNA were extracted from serum samples of HB-positive patients. The real-time PCR assay was employed to quantify the gene copies of hepatitis B and C viruses. HC genotyping was also performed. The prevalence of HB and HC was 0.24% (95% CI 0.16-0.35) and 0.11% (95% CI 0.06-0.19), respectively. Rural participants were significantly more HB-positive than the urban people (P = 0.045), while males were significantly more HC-positive than the females (P = 0.013). The prevalence of HB and HC in this area were lower than those of other geographical locations of Iran, which may be due to different lifestyles or other unknown reasons.
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http://dx.doi.org/10.1186/s13104-021-05474-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877021PMC
February 2021

Exploratory factor analysis of gender-based metabolic syndrome components: Results from the PERSIAN Guilan cohort study (PGCS).

Clin Nutr ESPEN 2020 12 30;40:252-256. Epub 2020 Sep 30.

Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran; GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran; Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran. Electronic address:

Background: One of the important issues related to metabolic syndrome is the underlying factor that remains controversial. The purpose of this study was estimating exploratory factor analysis (EFA) to reveal underlying factors that may explain the observed variants of metabolic syndrome (MetS) components in a population-based study.

Methods: In this cross-sectional study, the target population consisted of 10,520 individuals aged 35-70 years from Phase 1 of the PERSIAN Guilan cohort study conducted between 2014 and 2017. Exploratory factor analysis (EFA) of components of the metabolic syndrome, including waist circumference (WC), systolic (SBP) and diastolic (DBP) blood pressure, triglyceride (TG), high-density lipoprotein (HDL) and fasting blood glucose (f-Glc) was performed across the population as well as by gender.

Results: EFA results in the whole population based on eigen values > 1 showed two factors that explain 55.46% of the total variance. Taking factor loadings above 0.3, the first factor included systolic blood pressure, diastolic blood pressure, and waist circumference - called the blood pressure factor. Also, the second factor included triglycerides, negative-loaded HDL, and fasting blood glucose, which was named as lipid factor. In terms of gender, the first factor was similar to the whole population pattern, but in the second factor, in addition to the two components of blood lipids, waist size for men and in fasting blood glucose for women was launched.

Conclusion: Hypertension and lipids were substantial factors, and obesity is an important factor in this study. Hypertension, having the highest factor load, can generally be a valuable screening parameter for cardiovascular and metabolic risk assessment.
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http://dx.doi.org/10.1016/j.clnesp.2020.09.011DOI Listing
December 2020

Validation of Omron HBP-1100-E Professional Blood Pressure Measuring Device According to the American Association for the Advancement of Medical Instrumentation Protocol: The PERSIAN Guilan Cohort Study (PGCS).

Med Devices (Auckl) 2020 3;13:231-236. Epub 2020 Sep 3.

Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.

Background: Blood pressure (BP) measurement accuracy is critical to the diagnosis and management of hypertension. The aim of the present study was to validate the Omron HBP-1100-E professional blood pressure measuring device in accordance with the American Association for the Advancement of Medical Instrumentation in Iranian adults.

Materials And Methods: Simultaneous blood pressure auscultator measurements were obtained by two observers using mercury sphygmomanometers as a reference, sequentially with a measurement by using the Omron HBP-1100-E device. Absolute device-reference blood pressure differences were categorized into three error categories (within 5, 10, and 15 mmHg), and mean device-reference blood pressure difference (standard deviation) was calculated and evaluated using the American Association for the Advancement of Medical Instrumentation criteria.

Results: A total of 85 participants (250 paired readings) were enrolled to the study. 26.8%, 55.6%, and 79.6% of the device-reference blood pressure differences agreed to within 5, 10 and 15 mmHg, respectively, for systolic blood pressure, and 39.6%, 69.2%, and 81.6% of measurements for diastolic blood pressure, respectively, and failed to pass the protocol criteria. The mean device-reference blood pressure difference was 8.0 ± 13.1 mmHg for systolic BP and 2.2 ± 11.3 mmHg for diastolic BP, and was >5.0 ± 8.0 mmHg (required criteria).

Conclusion: Omron HBP-1100-E professional blood pressure monitor is not desirable for measuring the BP for Iranian adults as it overestimates blood pressure in this population.
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http://dx.doi.org/10.2147/MDER.S253638DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478364PMC
September 2020

Naproxen, isosorbide dinitrate and co-administration cannot prevent post-endoscopic retrograde cholangiopancreatography pancreatitis: Randomized controlled trial.

Ann Hepatobiliary Pancreat Surg 2020 Aug;24(3):259-268

Caspian Digestive Disease Research Center, Rasht, Iran.

Backgrounds/aims: Acute pancreatitis is the most widespread complication of endoscopic retrograde cholangiopancreatography. Here, we investigated the efficacy of rectal suppository naproxen, sublingual isosorbide dinitrate and their co-administration in the prevention of post-ERCP pancreatitis.

Methods: This double-blind randomized clinical trial carried out from June 2015 to February 2016 at the Gastrointestinal and Liver Diseases Research Center in Rasht, Iran. A total of 585 patients were selected from candidates for diagnostic or therapeutic ERCP by using the simple sampling method. Patients divided into three groups. Group A received 500 mg naproxen, group B took 5 mg isosorbide dinitrate, and group C was co-administrated both agents before ERCP. The primary outcome measure was the development of pancreatitis onset of pain in the upper abdomen and increase of serum amylase activity more than 3 times over the upper normal limit (60-100 IU/L) within first the 24 h post-ERCP.

Results: Totally, 80 patients developed PEP included 29 (4.9%), 24 (4.1%), and 27 (4.6%) patients in groups A, B, and C, respectively (=0.845). Longer ERCP time (=0.041), using diazepam (=0.033), a higher number of pancreatic ducts cannulation (<0.001), pancreatic duct injection (=0.013), and using pancreatic stent (=0.004) were the predisposing factors for PEP.

Conclusions: Our findings indicated that prophylactic naproxen suppository or isosorbide dinitrate sublingually or co-administration had no significant difference in the prevention and severity of PEP, however, enhancing the endoscopist's skills can be effective. Departments and educational hospitals should develop their assessment and quality assurance measures for the training of fellows' not only technical training but also an understanding of the diagnostic and therapeutic roles of the procedure.
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http://dx.doi.org/10.14701/ahbps.2020.24.3.259DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452799PMC
August 2020

Vitamin D deficiency associated with reproductive factors in northern Iranian women: The PERSIAN Guilan Cohort Study (PGCS).

Clin Nutr ESPEN 2020 08 22;38:271-276. Epub 2020 Apr 22.

Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran. Electronic address:

Background: One of the public health concerns is Vitamin D deficiency. The aim of this study was to determine the prevalence of vitamin D inadequacy and to determine its reproductive factor correlates in northern Iranian women.

Methods: This study, conducted on 5096 females aged 35-70 years. The study was based on data from PERSIAN Guilan Cohort Study (PGCS), a prospective, population-based cohort study in Guilan, Iran. History of reproductive and gynecologic factors, including age at menarche, age at first marriage, number of pregnancies or live births, age at first pregnancy, duration of breastfeeding, number of abortions, age and type of menopause status, use of oral contraceptives or hormone replacement therapy, history of hysterectomy, tubectomy or oophorectomy and history of gestational diabetes and hypertension was collected. Serum 25(OH) vitamin D was measured.

Results: The mean 25(OH)-D concentration was 21.78 ng/mL, and 53.5% of women had vitamin D inadequacy. The multivariate analyses revealed that younger age (36-45 years) [>66 years adjusted odds ratio (aOR) = 2.1, 95% CI 1.7-2.7, 56-65 years aOR = 1.7, 95% CI 1.3-2.1 and 46-55 years aOR = 1.4, 95% CI 1.1-1.7], not consuming oral contraceptives [aOR = 1.1, 95% CI 1.05-1.3] and pre-menopausal status [aOR = 1.4, 95% CI 1.2-1.6] were significantly independently associated with vitamin D inadequacy.

Conclusion: Vitamin D inadequacy is common in northern Iranian women. The reproductive factors that independently correlated with vitamin D statues are oral contraceptive consumption and menopausal statue.
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http://dx.doi.org/10.1016/j.clnesp.2020.03.022DOI Listing
August 2020

Decomposing socioeconomic inequality in poor mental health among Iranian adult population: results from the PERSIAN cohort study.

BMC Psychiatry 2020 05 13;20(1):229. Epub 2020 May 13.

Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: Socioeconomic inequality in mental health in Iran is poorly understood. This study aimed to assess socioeconomic inequality in poor mental health among Iranian adults.

Methods: The study used the baseline data of PERSIAN cohort study including 131,813 participants from 17 geographically distinct areas of Iran. The Erreygers Concentration index (E) was used to quantify the socioeconomic inequalities in poor mental health. Moreover, we decomposed the E to identify factors contributing to the observed socioeconomic inequality in poor mental health in Iran.

Results: The estimated E for poor mental health was - 0.012 (95% CI: - 0.0144, - 0.0089), indicating slightly higher concentration of mental health problem among socioeconomically disadvantaged adults in Iran. Socioeconomic inequality in poor mental health was mainly explained by gender (19.93%) and age (12.70%). Region, SES itself, and physical activity were other important factors that contributed to the concentration of poor mental health among adults with low socioeconomic status.

Conclusion: There exists nearly equitable distribution in poor mental health among Iranian adults, but with important variations by gender, SES, and geography. These results suggested that interventional programs in Iran should focus on should focus more on socioeconomically disadvantaged people as a whole, with particular attention to the needs of women and those living in more socially disadvantaged regions.
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http://dx.doi.org/10.1186/s12888-020-02596-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218818PMC
May 2020

Association of Serum Levels of Vitamin D with Blood Pressure Status in Northern Iranian Population: The PERSIAN Guilan Cohort Study (PGCS).

Int J Gen Med 2020 11;13:99-104. Epub 2020 Mar 11.

Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.

Background: Evidence in the last decades has indicated an association between vitamin D and cardiovascular risk factors including blood pressure. The present study aimed to determine whether serum 25-hydroxyvitamin D is independently associated with blood pressure in a large population-based study.

Methods: The study was based on subjects from PERSIAN Guilan Cohort Study (PGCS), a prospective, population-based cohort study in Guilan, Iran. In 9520 men and women, aged 35-70 years, serum 25-hydroxyvitamin D, systolic and diastolic blood pressure were measured. Multiple logistic and linear regression analyses were conducted with adjustments for demographic factors (age and gender), anthropometric characteristics (waist circumference and body mass index), lifestyle variables (physical activity, alcohol, and smoking consumption), and renal function (serum creatinine).

Results: Fully adjusted linear regression analyses revealed a weak but statistically significant negative association between serum 25-hydroxyvitamin D levels and systolic blood pressure (β = -0.02, 95% CI= -0.052 to -0.0001, P-value=0.04), whereas vitamin D status was not significantly associated with diastolic blood pressure (β = -0.01, 95% CI= -0.026 to 0.009, P-value=0.3). Serum 25-hydroxyvitamin D status showed no significant association with the presence of hypertension (OR 1.09, 95% CI=0.94 to 1.25 for the lowest (25OHD <12 ng/mL) versus the highest (25OHD ≥20 ng/mL) category).

Conclusion: Lower serum vitamin 25 (OH) D levels were associated with higher systolic blood pressure; however, it was not associated with diastolic blood pressure and presence of hypertension.
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http://dx.doi.org/10.2147/IJGM.S244472DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073441PMC
March 2020

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

Open Access Maced J Med Sci 2019 Oct 14;7(19):3313-3318. Epub 2019 Sep 14.

Gastrointestinal & Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.

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.
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http://dx.doi.org/10.3889/oamjms.2019.647DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953935PMC
October 2019

Biochemical markers and lipid profile in nonalcoholic fatty liver disease patients in the PERSIAN Guilan cohort study (PGCS), Iran.

J Family Med Prim Care 2019 Mar;8(3):923-928

Department of Gastroenterology, Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.

Background And Aim: Nonalcoholic fatty liver disease (NAFLD) is a global epidemic that is often asymptomatic and silent, and progresses slowly. This study aimed to determine the biochemical markers and lipid profile among NAFLD patients and their possible relationship with degrees of fatty liver.

Methods: This is analytical cross-sectional study, in which, 950 individuals referred to the PERSIAN Guilan cohort study were included through sequential sampling method. The demographic information and blood pressure of the subjects were taken and the blood sample was prepared to investigate the biochemical markers and lipid profile. Also, abdominal ultrasonography was performed to investigate NAFLD and its grades. For data analysis, independent sample -test, one-way ANOVA, and logistic regression model were used, where < 0.05 was considered significant.

Results: The systolic blood pressure (SBP) ( < 0.001), diastolic blood pressure (DBP) ( < 0.001), hepatic enzymes (aspartate aminotransferase [AST], < 0.001, alanine aminotransferase [ALT], < 0.001; gamma-glutamyle transferase [GGT], < 0.001; AST/ALT ratio, < 0.001), lipid profile (triglyceride [TG], < 0.001; total cholesterol [TC], = 0.008; high density lipoprotein [HDL], < 0.001; LDL-C/HDL-C (ratio), = 0.003; TC/HDL-C (ratio), < 0.001); and fasting blood sugar [FBS], < 0.001 correlated with NAFLD. However, there was no relationship between age ( = 0.34), alkaline phosphatase [ALP] ( = 0.26) and low-density lipoprotein [LDL] ( = 0.72). Further, a significant relationship was observed between AST ( < 0.001), ALT ( < 0.001), and GGT ( = 0.004) and NAFLD degrees based on the ultrasonography.

Conclusion: Biochemical markers and lipid profile are associated with NAFLD. Thus, it is recommended to investigate NAFLD in clinical settings in cases in which their changes are observed in patients through ultrasonography.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_243_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482810PMC
March 2019

The role of anthropometric indices in the prediction of non-alcoholic fatty liver disease in the PERSIAN Guilan Cohort study (PGCS).

J Med Life 2018 Jul-Sep;11(3):194-202

Gastrointestinal & Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.

Non-alcoholic fatty liver disease (NAFLD) is an obesity-associated health problem that causes other liver diseases for the patient. Four anthropometric indices: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were analyzed as NAFLD predictors in the present study. From the total number of individuals who referred to the PERSIAN Guilan Cohort study (PGCS) located in the north of Iran during the period of study, a total of 960 people were enrolled in the present study. NAFLD was diagnosed using through an abdominal ultrasound exam. Height, weight, WC, BMI, WHR and WHtR were later calculated. Chi-square, ANOVA and logistic regression analyses were used to analyze the risk factors. Out of the 960 individuals who were enrolled in the study, 597 (62.2%) were male and 363 (37.8%) were female (with an average age of 47.21 ± 7.29 years). There was a significant relationship between weight and NAFLD (P<0.001). There was also a significant relationship between BMI (OR= 8.41; 95% CI = 5.59-12.75), WC (OR= 2.67; 95% CI = 2.05-3.48), WHR (OR= 3.84; 95% CI = 2.26-6.52), WHtR (OR= 28.53; 95% CI = 6.94-117.31) and NAFLD (P<0.001). The results of the logistic regression analysis showed that WHtR, BMI and WC were effective predictors for the risk of NAFLD while WHtR played a more important role in the prediction of NAFLD. Anthropometric indices, especially WHtR, as a simple screening tool, seem to be an important criterion for the detection of NAFLD.
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http://dx.doi.org/10.25122/jml-2018-0031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6197514PMC
December 2018

Needlestick Injuries among Healthcare Workers: Why They Do Not Report their Incidence?

Iran J Nurs Midwifery Res 2018 Sep-Oct;23(5):382-387

Caspian Digestive Diseases Research Center (CDDRC), Guilan University of Medical Sciences (GUMS), Rasht, Iran.

Background: Needlestick injuries (NSIs) among healthcare workers (HCWs) pose an important health challenge and several pieces of evidence show that in many cases HCWs do not report the injury.

Materials And Methods: This multicenter descriptive cross-sectional study was performed in eight teaching hospitals of Rasht, Iran. Using consecutive sampling methods, 1010 nurses were enrolled from October 2014 to January 2015. A three-part self-administered questionnaire was used. It included questions on demographic features, NSI-related questions, and questions on the knowledge of hepatitis B and C viruses (HCV, HBV).

Results: Among the 1010 participants, 580 (57.42%) showed a positive history of NSI; the total number of occurrences of NSI was 914. The major item causing NSI was the syringe with needle (315; 34.47%). In this way, NSIs occurred most frequently during recapping and injection [339 (37.10%) and 147 (16.10%), respectively]. Only 92 (10.07%) of all NSI positive participations had referred to the infection control units of their hospitals. The others mostly answered the question of "Why did you not report the incident?" with being too busy at work at the time of injury (140; 27.58%). The results showed that among participants with <5 years elapsed since their vaccination, the risk of NSI reduced to 60% [p < 0.02, odds ratio (OR) = 0.40, 95% confidence interval (CI) = 0.20-0.80].

Conclusions: It seems that NSI is still a major problem among nurses. Correspondingly, HCWs do not take the reporting system seriously and training them requires an ongoing activity in all hospitals.
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http://dx.doi.org/10.4103/ijnmr.IJNMR_74_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111658PMC
September 2018

Effectiveness of spinal anesthesia combined with obturator nerve blockade in preventing adductor muscle contraction during transurethral resection of bladder tumor.

Turk J Urol 2017 Dec 1;43(4):507-511. Epub 2017 Dec 1.

Urology Research Center, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.

Objective: To determine whether spinal anesthesia combined with obturator nerve blockade (SOB) is effective in preventing obturator nerve stimulation, jerking and bladder perforation during transurethral resection of bladder tumor (TURBT).

Material And Methods: In this clinical trial, 30 patients were randomly divided into two groups: spinal anesthesia (SA) and SOB. In SA group, 2.5 cc of 0.5% bupivacaine was injected intrathecally using a 25-gauge spinal needle and in SOB after spinal anesthesia, a classic obturator nerve blockade was performed by using nerve stimulation technique.

Results: There was a statistically significant difference between jerking in both groups (p=0.006). During the TURBT, surgeon satisfaction was significantly higher in SOB group compared to SA group (p=0.006). There was no significant correlation between sex, patient age and location of bladder tumor between the groups (p>0.05).

Conclusion: Obturator nerve blockade by using 15 cc lidocaine 1% is effective in preventing adductor muscle spasms during TURBT.
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http://dx.doi.org/10.5152/tud.2017.96992DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5687216PMC
December 2017

Can laser treatment improve quality of life of hirsute women?

Int J Womens Health 2017 19;9:777-780. Epub 2017 Oct 19.

Dermatology Department, School of Medicine, Guilan University of Medical Sciences.

Background: Hirsutism can have negative impacts on psychosocial aspects of women's lives and reduce their quality of life (QOL). The aim of this study was to assess the QOL of these women during laser treatment.

Patients And Methods: Eighty-eight women with unwanted facial hair underwent laser therapy. Each patient completed a questionnaire consisting of a modified Dermatology Life Quality Index (DLQI) and visual analog scale (VAS) before the first, third, and fifth sessions of laser therapy. Interval between the sessions was 4-6 weeks. Statistical analyses were done using SPSS software version18.

Results: The DLQI scores before treatment, and at third and fifth sessions were 7.75±2.36, 5.55±1.88, and 4.14±0.64, respectively (<0.0001). Also, VAS scores had a decreasing trend between the first and second treatment sessions as the mean patient VAS score fell from 10±0.04 to 5.53±2.41 (<0.0001). The DLQI scores were significantly different according to areas of hair growth and number of involved areas. There were no significant differences with regard to response to treatment and mean of DLQI score according to the level of education, marital status, and employment status.

Conclusion: Hair removal with laser therapy can improve the QOL in hirsute women. Also, socioeconomic status does not affect the satisfaction rate of laser therapy for hair removal.
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http://dx.doi.org/10.2147/IJWH.S137910DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655156PMC
October 2017

Statin therapy and hepatotoxicity: Appraisal of the safety profile of atorvastatin in hyperlipidemic patients.

Adv Biomed Res 2014 19;3:168. Epub 2014 Aug 19.

Department of Internal Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Background: Statins are one of the most frequently prescribed medications to reduce the risk of cardiovascular events. Statins appear to be safe however, there are contradictory data regarding their adverse effects, which might be due to genetic variation in their metabolism. Hence, this prospective study was aimed to evaluate the effects of atorvastatin on liver transaminase changes in a clinical setting, in north Iran.

Materials And Methods: This prospective semi-experimental study was performed on hyperlipidemic adults in 2010-2011. Patients received atorvastatin (5-40 mg/d) based on the American National Cholesterol Education Program guidelines. Liver aminotransferases were measured in three occasions of baseline, 8 and 16 weeks period.

Results: A total of 206 patients were included in the study. Of which 178 were female and 30 were male. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were in normal range before intervention in the majority, except in 25 (12.1%) and 16 (7.8%) of patients, respectively. In general, ALT and AST remained in normal range over the study period (23.3 IU/L and 21.8 IU/L, respectively). There was found no relationship between different doses of atorvastatin prescribed and ALT/AST changes in the patients. The males' ALT means at baseline (26.9 IU/L), 8 weeks (30 IU/L) and 16 weeks (28.8 IU/L) after statin therapy were significantly higher than females (22 IU/L, 22.2 IU/L and 22.1 IU/L, respectively; P < 0.05 for all).

Conclusion: The absence of any hepatic adverse effect in the present study supports safety of atorvastatin and emerging opinion that routine screening of liver function tests is not necessary in patients on statins.
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http://dx.doi.org/10.4103/2277-9175.139133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4162033PMC
September 2014

Modeling seasonal variation in rotavirus hospitalizations for use in evaluating the effect of rotavirus vaccine.

J Med Virol 2010 Aug;82(8):1468-74

Program for Asian and African Research Centers, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.

Every year rotavirus epidemic repeats in cooler months of the year in temperate countries, but the size of the epidemic may often vary. Such seasonal variation needs to be considered when the effect of rotavirus vaccine is predicted before vaccine introduction or it is evaluated after vaccine introduction. A computer program based on a stochastic decision tree model was developed to produce stochastic variation, which was used as a proxy for seasonal variation, in the number of rotavirus hospitalizations. When the model was applied to a hypothetical community with a birth cohort of 1,000 children in Japan, it predicted the occurrence of up to 29% of stochastic variation from the average number of rotavirus hospitalizations. Then, the model was applied for use in evaluating the effect of rotavirus vaccine in two different scenarios regarding vaccine use in the community: a scenario where rotavirus vaccine was introduced only into the private sector, and another where it was incorporated into the universal immunization program. In the former scenario, an average of 23% reduction in the number of rotavirus hospitalizations was predicted, but this level of reduction would be obscured due to seasonal variation. In the latter scenario, an average of 74% reduction was predicted, which would be beyond seasonal variation. This model will be useful to inform stakeholders and policymakers how vaccine introduction will change the burden of rotavirus disease under different scenarios of vaccine implementation.
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http://dx.doi.org/10.1002/jmv.21806DOI Listing
August 2010

Recurrence of Helicobacter pylori infection 1 year after successful eradication: a prospective study in Northern Iran.

Med Sci Monit 2010 Mar;16(3):CR144-148

Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Razi Hospital, Sardar-jangle Ave., P.O. box 41448-95655, Rasht, Iran.

Background: The aim was to investigate the H. pylori recurrence rate one year after successful eradication in dyspeptic patients in Guilan province, northern Iran.

Material/methods: Patients with chronic dyspepsia were enrolled in our gastroenterology clinic. Gastric biopsies were obtained by endoscopy and H. pylori infection was diagnosed using the Rapid Urease Test (RUT). Patients with H. pylori infection were prescribed clarithromycine-based quadruple therapy for 10 days. The (13)C urea breath test ((13)C-UBT) was used to assess H. pylori status 10 weeks after completing H. pylori therapy. Patients who H. pylori-negative had a second (13)C-UBT after 1 year to establish the recurrence rate.

Results: Of 269 dyspeptic patients with RUT positivity for H. pylori in endoscopy who were treated with the quadruple regimen for 10 days, 240 had negative (13)C-UBT 10 weeks after the end of therapy, with an eradication rate of 89.2% (95%CI: 82.2-97.2%) by per-protocol analysis. Of this group, 153 patients (63.8%) were female. The (13)C-UBT at 1 year was positive in 12 (5.0%) of the 240 patients. A mean age of >35 year, being female, living in an urban area, and a household size of more than 5 person were more frequent in the (13)C-UBT-positive patients at 1 year, but they were not statistically significant. In this study there was also no significant relationship between, job, educational status, and the source of domestic water with recurrence of H. pylori infection.

Conclusions: According to these data, the H. pylori recurrence rate in our region is 5% after successful eradication.
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March 2010

Relationship between serum HBV DNA level and liver histology in HBV carriers with normal ALT in Guilan province, Iran.

Med Sci Monit 2010 Mar;16(3):BR97-101

Gastrointestinal and Liver Diseases Research Center (GLDRC), Medical Sciences, Guilan University, Iran.

Background: Chronic hepatitis B virus (HBV) infection remains a major health problem. The aim of this study was to determine the serum HBV DNA levels in HBeAg-negative HBV patients and look for a relationship between serum HBV DNA level and liver histology.

Material/methods: In a cross-sectional study, 70 patients with positive serum hepatitis B surface antigen (HBsAg) and normal ALT for at least 6 months were enrolled. Quantification of HBV DNA was performed by real-time PCR. Liver biopsy specimens were performed for grading and staging of chronic hepatitis.

Results: Fifty-four patients (34 males, 20 females) were included. Mean + or - SD serum HBV DNA level was 282,280.46 + or - 1,474,295 copies/ml, fibrosis (0-6) 2.37 + or - 1.263, necroinflammation (0-18) 0.33 + or - 0.476, and BMI 26.65 + or - 4.9. The mean serum HBV DNA level had significant differences between grade <4 and grade > or = 4 cases (P<0.05). The relationship between serum HBV DNA level and liver grade was confirmed by the Kendall test (P<0.05). No significant relationship between serum HBV DNA level and liver histological stage, gender, age, BMI, or HBeAg was observed in these patients (P>0.05).

Conclusions: It is advantageous to measure serum HBV DNA level quantitatively in patients who are inactive carries of hepatitis B. If they have HBV DNA levels > or = 104 copies/ml, it will be necessary to perform a liver biopsy and apply therapy accordingly.
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March 2010

Adenovirus infections within a family cohort in Iran.

Pediatr Pulmonol 2009 Aug;44(8):749-53

Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK.

Background: Adenovirus is one of the most frequent viruses associated with acute respiratory infections (ARI). There is limited information of its transmission within the community.

Methods: Cohorts of 50 families with > or =two children were visited weekly for 2 months to ascertain the presence ARI in Rasht, Iran. Nasopharyngeal swabs were obtained from symptomatic participants and at 3-4-day intervals to assess the duration of adenovirus shedding. Adenoviruses were identified by PCR and adenovirus positive amplicons were subjected to DNA sequencing.

Results: Thirty-three (35%) of 94 ARI episodes in children and 8 (27%) of 30 episodes in adults were due to adenovirus (not significant, NS). 25/50 (50%) families had adenovirus infections. Children had more infections than adults, were more likely to develop symptoms if there was a symptomatic case within the household and episodes had a longer duration (P < 0.05). Adenoviruses were recovered for a median of 11 (interquartile range 5-26) days of follow up in children and 7 (2-20) days in adults (NS). Adenovirus-7 was the most frequent serotype (12 families), followed by adenovirus-6 (5 families), adenovirus-1 and 2 (4 families each), and adenovirus-5 (3 families). Both adenovirus-5 and 7 amplicons fell into two clusters. No mutations were observed during transmission within a family.

Conclusion: A substantial proportion of ARI in the community are due to adenovirus with further transmission within the family. Children > or =2 years experienced a higher proportion of infections than younger children and adults. Viral shedding was more prolonged in children and adenovirus-7 and 5 predominated with several clusters co-circulating in the same season.
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http://dx.doi.org/10.1002/ppul.20785DOI Listing
August 2009

Issues with reducing the rotavirus-associated mortality by vaccination in developing countries.

Vaccine 2008 Jun 24;26(26):3236-41. Epub 2008 Apr 24.

Division of Molecular Epidemiology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.

More than 65% of the global rotavirus deaths were estimated to occur in 11 countries in Asia and Africa, claiming 345,000 children less than 5 years of age in 2004. While efficacious rotavirus vaccines are at hand, inequity in health delivery system within and between these countries was found to be the major hurdle against achieving the goal of rotavirus vaccine. When the coverage of currently used vaccines was applied to a rotavirus vaccine, a maximum of 202,550 deaths would be averted. Even if the coverage reached 80%, there would remain 96,841 children dying because of rotavirus diarrhea in these 11 countries. Studies are therefore encouraged to develop comprehensive strategies to resolve inequity in health delivery system enabling the increase in the immunization coverage.
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http://dx.doi.org/10.1016/j.vaccine.2008.04.004DOI Listing
June 2008

Human bocavirus in Iranian children with acute respiratory infections.

J Med Virol 2007 May;79(5):539-43

Liverpool School of Tropical Medicine, Liverpool, UK.

Human bocavirus (HBoV), a virus discovered in Sweden in 2005, has been associated with acute respiratory infections in young children and subsequent reports suggest that HBoV may have a worldwide distribution. This report describes the frequency and clinical presentation of HBoV in 261 Iranian children<5 years old with acute respiratory infections attending two regional hospitals in Rasht, Iran in the winter of 2003-2004. Polymerase chain reaction (PCR) and reverse transcription PCR (RT-PCR) were used for the detection of HBoV and other respiratory pathogens from nasopharyngeal specimens. HBoV was detected in 21 (8%) children. Fifteen (12%) of these children were identified among 122 children admitted to hospital and 6 (4%) from 139 outpatients (P < 0.05). Most children with HBoV were less than 2 years (17/21, 81%) and 7 (33%) were less than 1 year old. Although HBoV was identified in all ages it affected slightly older children than the respiratory syncytial virus (RSV). The frequency of the virus varied from 1 (3%) in 40 patients in November to 7 (12%) of 61 in February, suggesting a seasonal pattern during the autumn and early winter. Seven children had co-infections with RSV, adenovirus or influenza A. The relatively high frequency of HBoV suggests that the virus may contribute substantially to acute respiratory infections in children.
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http://dx.doi.org/10.1002/jmv.20815DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7166854PMC
May 2007

Contribution of viruses, Chlamydia spp. and Mycoplasma pneumoniae to acute respiratory infections in Iranian children.

J Trop Pediatr 2007 Jun 7;53(3):179-84. Epub 2007 Feb 7.

Guilan University of Medical Sciences, Namdjoo Avenue, Rasht, Iran.

The study reports the frequency and clinical presentation of respiratory syncytial virus (RSV), human metapneumovirus, influenza (Inf V), parainfluenza, adenovirus (Adv), Chlamydia spp. and Mycoplasma pneumoniae in children with acute respiratory infections (ARI) in Rasht, Iran. Nasopharyngeal aspirates and swabs were collected from 261 children in 2003 and 2004. Pathogens were detected using polymerase chain reaction (PCR) and reverse transcription-PCR (RT-PCR), confirmed with sequence analysis. Ninety-three pathogens were detected in 83 children. RSV was present in 39 (15%), Adv in 37 (14%), Inf A in 11 (4%), C. trachomatis in 4 (2%) and M. pneumoniae, in 2 (1%) children. Neither parainfluenza nor metapneumovirus were detected. RSV, Inf A and C. trachomatis were more frequent in children with lower respiratory infections. Adv presented more frequently as upper respiratory infection. All pathogens, except M. pneumoniae, were detected in children with severe pneumonia. Viruses play a significant role in Iranian children with community-acquired ARI.
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http://dx.doi.org/10.1093/tropej/fml089DOI Listing
June 2007