Background and Aims: Vitamin D deficiency is common among patients with inflammatory bowel disease, even when the disease is in remission. This study was designed to evaluate the serum levels of 25-hydroxy vitamin D [25(OH)-D3] in patients who suffered from ulcerative colitis and the control group in Golestan province in the northeast of Iran. Methods: In this case-control study, 60 patients with a definite histopathological diagnosis of ulcerative colitis were included. The control group was selected from healthy blood donors. The serum levels of 25(OH)-D3 were measured by the ELISA method (ids- UK). Data were entered into the SPSS-16 software and were analyzed by t-test and Chi-square test. Results: The mean serum level of vitamin D in the patients was significantly lower as compared to that in the control group (P-value <0.01). The differences in the levels of 25-OH-D3 were statistically significant between the two sexes, in both groups. A normal vitamin D level was seen in all cases with proctitis, in 20% of cases in the rectosigmoiditis group and in no cases in the pan-colitis group. The difference was statistically significant (p-value <0.01). Conclusions: It can be concluded that the serum levels of vitamin D in the patients with ulcerative colitis are low and that inflammatory bowel disease can be a target for the specific vitamin D therapy.
Background: The role of immune system in natural course of viral hepatitis has been drawn some attention. One of the main diagnostic markers of the immune system function in different diseases might be the ratio of CD4+ to CD8+ T lymphocytes (CD4+/CD8+ ratio). Objectives: This research aimed to measure and compare CD4+/CD8+ ratio in the patients with chronic hepatitis B (CHB) and control group. Methods: In this cross-sectional study, thirty-three CHB patients and thirty age and sex-matched healthy controls were included. Immunophenotyping of isolated T cells was performed using specific anti-CD4 and anti-CD8 antibodies by flow cytometry. Consequently, CD4+, CD8+ and the ratio of CD4+/CD8+were counted and compared between the two groups. Results: CD4+ counts (%) were considerably reduced in patients with CHB compared to the healthy controls (51.22 ± 10.5 vs. 63.14 ± 9.9, P = 0.00), whereas CD8+ counts (%) were higher in the patients with CHB than healthy controls (48.8 ± 10.5 vs. 36.85 ± 9.86, P = 0.00). Moreover, CD4+/CD8+ ratio remarkably decreased in the patients with CHB (1.15 ± 0.5) than healthy controls (1.93 ± 0.9) (P = 0.00). Area under curve (AUC) of 0.79 (SE = 0.06, CI = 0.68 - 0.90, P value = 0.05) was reported for CD4+/CD8+ ratio with a sensitivity of 72.73% and specificity of 73.33% in 1.35 cut-off (likelihood ratio = 2.72). Conclusions: The research indicated an impaired balance between T cell subsets associated with a higher proportion of CD8+ T cells and a lower proportion of CD4+ T cells and CD4+/CD8+ ratio in patients with CHB.
Studies on oral anti-hyperglycemic drugs have been shown in some studies to help and treat type 2 diabetic patients.The present study was designed to evaluate and compare the effect of different doses of metformin tablets on metabolic syndrome components in type 2 diabetic women in Gorgan, South East of Caspian Sea.Forty type 2 diabetic patients received 500 mg/day and 1000 mg/day metformin tablets for 12 months and forty healthy women were included in this study.The ATP III criteria were used to determine metabolic syndrome components, and lipid profiles, HbA1c and insulin were measured.Significant differences were found between blood sugar, triglycerides, high-density lipoprotein (HDL)-cholesterol, hemoglobin A1c (HbA1c) and insulin of the patients received 500 mg/day and 1000 mg/day metformin monotherapy.The blood sugar, triglycerides and insulin were significantly lower in patients received 500 and 1000 mg/day metformin than control groups.In both groups, HDLcholesterol was higher than control groups, but HbA1c was significantly higher and lower in patients received 500 and 1000 mg/day metformin than control groups, respectively.In both study groups, positive significant correlation was found between blood glucose and HbA1c and, blood glucose and triglyceride levels.Our study showed the efficacy of the 1000 mg/day metformin monotherapy on better control of blood sugar, HbA1c, triglyceride and HDLcholesterol levels, but Metformin had no effect on waist circumference and blood pressure.Treatment with this dose of metformin may be more beneficial for type 2 diabetic patients than those other doses.
Many of the treatment regimens available for hepatitis C include sofosbuvir. Unfortunately, sofosbuvir has not been recommended for use in patients with severe renal impairment leaving these group of patients with very few options. Nevertheless, there are many reports in which these patients have been treated with sofosbuvir-containing regiments without important adverse events. This study aims at determining the safety and effectiveness of a sofosbuvir-based treatment in patients with severe renal impairment, including those on hemodialysis.We enrolled subjects with hepatitis C and estimated glomerular filtration rate under ml/min/1.73m2 from 13 centers in Iran. Patients were treated for 12 weeks with a single daily pill containing 400-mg sofosbuvir and 60-mg daclatasvir. Patients with cirrhosis were treated for 24 weeks. Response to treatment was evaluated 12 weeks after end of treatment (sustained viral response [SVR]). ClinicalTrials.gov identifier: NCT03063879.A total of 103 patients were enrolled from 13 centers. Seventy-five patients were on hemodialysis. Thirty-nine had cirrhosis and eight were decompensated. Fifty-three were Genotype 1, and 27 Genotype 3. Twenty-seven patients had history of previous failed interferon-based treatment. Three patients died in which cause of death was not related to treatment. Six patients were lost to follow-up. The remaining 94 patients all achieved SVR. No adverse events leading to discontinuation of medicine was observed.The combination of sofosbuvir and daclatasvir is an effective and safe treatment for patients infected with all genotypes of hepatitis C who have severe renal impairment, including patients on hemodialysis.
Successful treatment of cancer remains a challenge, due to the unique pathophysiology of solid tumors, and the predictable emergence of resistance. Traditional methods for cancer therapy including radiotherapy, chemotherapy, and immunotherapy all have their own limitations. A novel approach is bacteriotherapy, either used alone, or in combination with conventional methods, has shown a positive effect on regression of tumors and inhibition of metastasis. Bacteria-assisted tumor-targeted therapy used as therapeutic/gene/drug delivery vehicles has great promise in the treatment of tumors. The use of bacteria only, or in combination with conventional methods was found to be effective in some experimental models of cancer (tumor regression and increased survival rate). In this article, we reviewed the major advantages, challenges, and prospective directions for combinations of bacteria with conventional methods for tumor therapy.
Abstract Background : Hepatitis C virus (HCV) is among the highest priority diseases in custodial settings; however, the diagnosis remains suboptimal among people in custody. This study aimed to validate a short survey for identifying people with HCV infection in a provincial prison in Iran. Methods : Between July and December 2018, residents and newly admitted inmates of Gorgan central prison completed a questionnaire, including data on the history of HCV testing, drug use, injecting drug use, sharing injecting equipment, and imprisonment. Participants received rapid HCV antibody testing, followed by venipuncture for RNA testing (antibody-positive only). Each enrollment question (yes/no) was compared with the testing results (positive/negative). Results : Overall, 1892 people completed the questionnaire, including 621 (34%) who were currently on opioid agonist therapy (OAT); 30% of participants had been tested for HCV previously. About 71% had a history of drug use, of whom 13% had ever injected drugs; 56% had ever shared injecting equipment. Prevalence of HCV antibody and RNA was 6.9% (n=130) and 4.8% (n=90), respectively. The antibody prevalence was higher among people on OAT compared to those with no history of OAT (11.4% vs. 4.0%). History of drug use was the most accurate predictor of having a positive HCV antibody (sensitivity: 95.2%, negative predictive value: 98.9%) and RNA testing (sensitivity: 96.7%, negative predictive value: 99.5%). Sensitivity of the drug use question was lowest among people with no OAT history and new inmates (87% and 89%, respectively). Among all participants, sensitivity and negative predictive value of the other questions were low and ranged from 34% to 54% and 94% to 97%, respectively. Conclusions: In resource-limited settings, HCV screening based on having a history of drug use could replace universal screening in prisons to reduce costs. Developing tailored screening strategies together with further cost studies are crucial to address the current HCV epidemic in low- to middle-income countries.
BACKGROUND The combination of sofosbuvir and daclatasvir is a potent, pangenotypic regimen suitable for mass-scale hepatitis C treatment, especially in resource-limited countries where newer, expensive combinations are not available. This combination has been widely tested on genotype 4. However, Phase III trials of this combination in other genotypes have been cost prohibitive. With the introduction of generic, low-cost sofosbuvir and daclatasvir, large-scale studies in resource-limited countries are now possible. METHODS Sofosbuvir at 400 mg and daclatasvir at 60 mg were coformulated into a fixed-dose combination (FDC) tablet (Sovodak, Rojan Pharma, Tehran, Iran). Patients from 46 centers were dosed for 12 or 24 weeks with or without ribavirin, in line with existing guidelines. Responses to treatment were evaluated 12 weeks after the end of treatment (for a sustained virological response at Week 12; SVR12). RESULTS There were 1361 patients recruited. Overall, the patients were 21% female, with a mean age of 50 years; 39% were cirrhotic; 22% were treatment-experienced; 47% were genotype 1, 41% were genotype 3, and 2% were other genotypes. The genotype was not known in 10% of the patients. The intention-to-treat and per-protocol SVR12 rates were 94.7% and 98.8%, respectively. The safety profile was unremarkable, treatment was well tolerated, and compliance with the single-tablet regimen was excellent. CONCLUSIONS The treatment with FDC of sofosbuvir and daclatasvir achieved high SVR12 rates, equivalent to those seen in Phase III trials of other pangenotypic options, and has been conducted at a similar scale in a representative, real-world population at a cost of under $100 per patient, which makes this combination suitable for elimination protocols in resource-limited countries. CLINICAL TRIALS REGISTRATION NCT03200184.
Background: The purpose of the present study was to investigate the age- and gender-related serum level of interleukin 18 (IL18) in male and female Iranian Fars ethnic group with metabolic syndrome components. Methods: The study included 226 native Iranian Fars ethnic groups. One hundred sixteen females and 110 men were selected. There were 60 females and 50 males with metabolic syndrome and 56 females and 60 males without metabolic syndrome. The serum fasting blood glucose (FBS), lipid profiles, and IL18 were measured. The National Cholesterol Education Program Adult treatment Panel III criteria were used to determine metabolic syndrome components. Results: There were significant differences between the males and females [except high-density lipoprotein (HDL)] with and without metabolic syndrome for the mean body mass index, FBS, HDL-cholesterol, waist circumference (WC), triglyceride (TG), and IL18 levels in all age groups. Serum IL18 was the highest in males and females in age groups 61–70 and 41–50 years with metabolic syndrome, respectively. Serum IL18 levels significantly correlated with TG and waist WC in males (and also correlated with HDL) and females with the metabolic syndrome. There were significant correlations between IL18 and TG and WC in males (and also correlated with HDL) in ages 61–70 years and females in ages 41–50 years with the metabolic syndrome. Conclusions: The increased IL18 level in both gender and different ages may have an important role in the alteration of some metabolic syndrome components. These alterations may be made to happen in different related metabolic diseases. IL18 seems to be a useful biomarker for the management of metabolic syndrome components and the risk factors of cardiovascular disease.
Pancreatic cancer (PC) is one of the most malignant cancers with a poor prognosis. Despite advances in the diagnosis and management of PC, the survival rate remains low. In Iran, the incidence of PC is increasing, with mortality rates nearly doubling over the past 25 years. Therefore, this study was designed to assess the temporal variations and incidence of PC in Golestan province, as a prominent hub for gastrointestinal cancers in Iran.
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