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OBJECTIVES: Substance abuse behaviors among university freshmen in Iran are poorly understood. This study aimed to identify, for the first time, subgroups of university freshmen in Iran on the basis of substance abuse behaviors. Moreover, it examined the effects of socio-demographic characteristics on membership in each specific subgroup. METHODS: Data for the study were collected cross-sectionally in December 2013 and January 2014 from 4 major cities in Iran: Tabriz, Qazvin, Karaj, and Khoramabad. A total of 5,252 first-semester freshmen were randomly selected using a proportional cluster sampling methodology. A survey questionnaire was used to collect data. Latent class analysis (LCA) was performed to identify subgroups of students on the basis of substance abuse behaviors and to examine the effects of students' socio-demographic characteristics on membership in each specific subgroup. RESULTS: The LCA procedure identified 3 latent classes: the healthy group; the hookah experimenter group; and the unhealthy group. Approximately 82.8, 16.1, and 2.1% of students were classified into the healthy, hookah experimenter, and unhealthy groups, respectively. Older age, being male, and having a family member or a close friend who smoked increased the risk of membership in classes 2 and 3, compared to class 1. CONCLUSIONS: Approximately 2.1% of freshmen exhibited unhealthy substance abuse behaviors. In addition, we found that older age, being male, and having a close friend or family member who smoked may serve as risk factors for substance abuse behaviors.
Subject(s)
Humans , Male , Friends , Iran , Risk Factors , Smoke , Smoking , Substance-Related DisordersABSTRACT
OBJECTIVES: Substance abuse behaviors among university freshmen in Iran are poorly understood. This study aimed to identify, for the first time, subgroups of university freshmen in Iran on the basis of substance abuse behaviors. Moreover, it examined the effects of socio-demographic characteristics on membership in each specific subgroup.METHODS: Data for the study were collected cross-sectionally in December 2013 and January 2014 from 4 major cities in Iran: Tabriz, Qazvin, Karaj, and Khoramabad. A total of 5,252 first-semester freshmen were randomly selected using a proportional cluster sampling methodology. A survey questionnaire was used to collect data. Latent class analysis (LCA) was performed to identify subgroups of students on the basis of substance abuse behaviors and to examine the effects of students' socio-demographic characteristics on membership in each specific subgroup.RESULTS: The LCA procedure identified 3 latent classes: the healthy group; the hookah experimenter group; and the unhealthy group. Approximately 82.8, 16.1, and 2.1% of students were classified into the healthy, hookah experimenter, and unhealthy groups, respectively. Older age, being male, and having a family member or a close friend who smoked increased the risk of membership in classes 2 and 3, compared to class 1.CONCLUSIONS: Approximately 2.1% of freshmen exhibited unhealthy substance abuse behaviors. In addition, we found that older age, being male, and having a close friend or family member who smoked may serve as risk factors for substance abuse behaviors.
Subject(s)
Humans , Male , Friends , Iran , Risk Factors , Smoke , Smoking , Substance-Related DisordersABSTRACT
OBJECTIVES@#Substance abuse behaviors among university freshmen in Iran are poorly understood. This study aimed to identify, for the first time, subgroups of university freshmen in Iran on the basis of substance abuse behaviors. Moreover, it examined the effects of socio-demographic characteristics on membership in each specific subgroup.@*METHODS@#Data for the study were collected cross-sectionally in December 2013 and January 2014 from 4 major cities in Iran: Tabriz, Qazvin, Karaj, and Khoramabad. A total of 5,252 first-semester freshmen were randomly selected using a proportional cluster sampling methodology. A survey questionnaire was used to collect data. Latent class analysis (LCA) was performed to identify subgroups of students on the basis of substance abuse behaviors and to examine the effects of students' socio-demographic characteristics on membership in each specific subgroup.@*RESULTS@#The LCA procedure identified 3 latent classes: the healthy group; the hookah experimenter group; and the unhealthy group. Approximately 82.8, 16.1, and 2.1% of students were classified into the healthy, hookah experimenter, and unhealthy groups, respectively. Older age, being male, and having a family member or a close friend who smoked increased the risk of membership in classes 2 and 3, compared to class 1.@*CONCLUSIONS@#Approximately 2.1% of freshmen exhibited unhealthy substance abuse behaviors. In addition, we found that older age, being male, and having a close friend or family member who smoked may serve as risk factors for substance abuse behaviors.
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Introduction: It is long known that vitamin D deficiency was common in patients with liver disease, but little is known on the therapeutic effects of vitamin D, especially in patients with chronic liver disease. In this study, we aimed to systematically review the literatures and study the evidences in which the effects of vitamin D supplementation had been investigated on the severity of chronic liver disease or liver cirrhosis
Methods: A systematic literature search was performed by using the following key terms "vitamin D supplementation" and "chronic liver disease" in the PubMed, Scopus and Google scholar to find relevant articles. After collecting the eligible documents, data were extracted and described based on the purpose of this review
Result: Of total 196 articles found, only 7 relevant documents with 518 studied patients were included. The results of this study showed that the levels of 25[OH] D were considerably lower in patients with chronic liver disease. Findings showed that vitamin D supplementation can rise up the mean serum level of 25[OH] D in patients with severe vitamin D deficiency, especially patients with liver cirrhosis
Conclusion: The results of this review showed that vitamin D deficiency is associated with the severity of liver disease and may have prognostic value in the assessment of liver disease. Also, it was shown that vitamin D supplementation may be helpful for the treatment of liver disease at least in certain groups of patients
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Background: atherosclerosis is involved in inflammatory diseases, and inflammation can be a valuable predictor of cardiovascular disease. On the other hand, an increase in intima-media thickness [IMT] is usually considered as a primary marker of atherosclerotic lesions.Hence, measurement of IMT may be useful for early detection of atherosclerosis in patients with inflammatory bowel disease [IBD]. The aim of this study was to systematically review the literature in which the IMT had been evaluated as diagnostic marker for the detection of atherosclerosis in patients with IBD
Materials and Methods: a systematic literature search was performed in PubMed, Scopus, and Google scholar using the following search method [[inflammatory bowel disease OR IBD OR Crohn's disease OR ulcerative colitis]] AND [intima OR intima media thickness OR intimal medial thickness OR IMT OR carotid intima-media thickness OR CIMT] to evaluate the association between IBD and IMT. After collecting the eligible documents, the desired data were extracted and analyzed
Results: of total 278 collected documents, only 14 relevant articles with total 1333 participants including 720 patients with IBD and 613 healthy controls were included for data assessment. The results of the articles did not support significant association between IMT and IBD. However, in some studies it was shown that IMT was elevated in patients with IBD
Conclusion: the results of this survey showed that there was no significant difference in IMT between the patients with IBD and healthy control groups; therefore, IMT cannot be considered as a predictor of atherosclerosis and future cardiovascular events in patients with IBD
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Background: Vitamin D deficiency is believed to cause variety of abnormalities such as liver stifihess and fibrosis. It is also shown that vitamin D deficiency may result in chronic liver disease or liver cirrhosis. In this study, we aimed to systematically review the literature wherein the relationship between vitamin D deficiency and the severity of chronic liver disease or liver cirrhosis had been investigated
Materials and Methods: PubMed, Scopus, and Google scholar were searched using the following search method [vitamin D deficiency OR vitamin D insufficiency OR insufficient vitamin D] AND [chronic liver disease OR chronic hepatitis OR cirrhosis OR liver cirrhosis] AND [severity OR intensity] to evaluate the role of vitamin D deficiency or vitamin D inadequacy in the occurrence and severity of chronic liver disease. Articles were collected and the data were extracted
Results: Totally, 641 articles were found through searching the databases and reference list scanning. Of the collected documents, only 19 articles with 4895 studied patients were included and analyzed. The results of this study showed that almost 80% of patients with chronic liver disease had severe vitamin D deficiency
Conclusion: Vitamin D deficiency is associated with the occurrence of chronic liver disease. The severity of liver cirrhosis is also associated with the level of 25 [OH] in progressive liver disease
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Background: Duodenal biopsy is required for diagnosis of celiac disease in adults, although some studies have suggested adequate accuracy of serology alone
Objective: We aimed to assess the correlation between anti-tissue transglu-taminase [tTG] titer and pathological findings and to define the specific level of tTG for predicting celiac disease in adults without the need for biopsy sampling
Methods: This descriptive study was done on 299 participants
The tTG titer and pathological findings of duodenal biopsy samples were used for this study Analysis of Receiver operating characteristic [ROC] curve was used to find a cut-off point of anti-tTG antibody for mucosal atrophy
Results: Mean tTG titers was significantly higher in patients graded as Marsh III>/= 3 [p=0.023]. ROC curve analysis showed 89.1% sensitivity for cut-off point>/=76.5 lU/mL of anti-tTG. For Marsh>/= II, specificity was 28% and positive predictive value was 91%
Conclusion: There is a linear correlation between increasing tTG level and Marsh I to III. Specificity of tTG titer more than 200 was 100% for Marsh >2.
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Introduction: Colorectal cancer [CRC] is the third leading cause of cancer deaths in the world, and hereditary factors and family history are responsible for the incidence and development of the disease in 20 to 30% of cases. Lynch syndrome, or hereditary nonpolyposis colorectal cancer [HNPCC], is the most common hereditary form of CRC that is inherited in an autosomal dominant manner. This study consisted of a systematic literature review of research articles that described the prevalence of HNPCC in Iranian patients with CRC
Methods: A systematic literature search was conducted in the PubMed, Scopus, IranMedex, and Google Scholar databases to identify relevant articles that describe HNPCC or Lynch syndrome in patients with CRC in Iran. For this purpose, a keyword search of the following terms was employed: [[[Hereditary nonpolyposis colorectal cancer OR HNPCC OR Lynch syndrome]] AND [colorectal cancer OR familial colorectal cancer OR colon cancer OR rectal cancer OR bowel cancer]] AND IRAN. All eligible documents were collected, and the desired data were qualitatively analyzed
Result: Of the 67 articles that were found via the initial database search, only 12 were deemed to be of relevance to the current study. These articles included a total population of 3237 and this sample was selected and qualitatively analyzed. The findings of the review revealed that the frequency of mutation in MLH1, MSH2, PMS2, and MSH6 genes varied between 23.1% and 62.5% among the studied families. This indicated that HNPCC is linked with up to 5.5% of the total cases of colorectal cancers in Iran
Conclusion: The results of this study revealed that the hereditary form of HNPCC or Lynch syndrome is significantly high among patients with CRC in Iran
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To identify primary sclerosing cholangitis [PSC] predisposing factors in order to prevent inflammatory bowel disease [IBD] progression to PSC. IBD is commonly associated with PSC and there is no effective therapy for PSC except for liver transplantation. This retrospective study was conducted on 447 IBD patients from IBD Clinics of Ghaem and Emam Reza Hospitals. Data were collected by interview and through a review of the patients' medical records. Patients were divided into two groups: those with IBD and PSC [IBD-PSC] and those without PSC. Variables were compared between two groups and those with statistically significant differences in IBD-PSC group were considered as predictive factors for the development of PSC. The frequency of PSC in IBDs was 4.3% and all were ulcerative colitis. The mean age of patients with PSC was 39.1 +/- 11.33 years. The male to female proportion in PSCs was 3.8:1 and in IBDs was 0.9:1. There were statistically significant associations between PSC and gender, IBD duration and UC extension, mucocutaneous involvement, oral contraceptive pills [OCP] consumption, history of surgery and history of PSC in the first- degree relatives. PSC frequency among IBD patients in North-East of Iran was 4.3%. It is recommended to limit OCP consumption in IBD patients. Identification and modification of probable predisposing risk factors, as well as early diagnosis of PSC are necessary
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It is important to differentiate whether isolated anti-HBc is due to false positive results or the prior exposure to hepatitis B virus, because individuals with false-positive anti-HBc can benefit from vaccination and their blood can be safely transfused. To distinguish between these two conditions, we evaluated the serologic response to hepatitis B vaccine. Ninety subjects with isolated anti-HBc [cases] and 100 subjects with totally negative hepatitis B serologic markers [controls]] were recruited to receive three doses of hepatitis-B [HB] vaccine. Thirty days after the first dose of the vaccine, anti-HBs titers were checked and individuals with anti-HBs titer >50 mlU/mL did not receive additional doses of the vaccine. However, others completed the vaccination course, and another blood sample was collected 30 days after the third dose to measure anti-HBs level. Nineteen [21.1%] cases and three [3%] controls had no sero-conversion [anti-HBs titers <10 mlU/mL] 30 days after the third dose [p<0.000l]. Primary response, defined as the development of anti-HBs antibody titers >10 mlU/mL 30 days after the third dose, was observed in 43 [47.8%] cases and 92 [92%] controls [p<0.000l]. Also, 31.1% of cases developed anti-HBs titers > 50 mlU/mL 30 days after the first dose of vaccine, but the rate was significantly lower [5%] in the control group [P<0.0001]. Furthermore, half of the individuals with positive isolated anti-HBc developed protective levels of anti-HBs after three doses of HB vaccination. More than 75% of individuals with positive isolated anti-HBc can benefit from vaccination and can be included in donor pool. Also, one fifth seemed to have occult HBV infection. So HB vaccination may be used as a diagnostic tool for clarifying the situation of the subjects with isolated anti-HBc
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Patients with ulcerative colitis [UC] carry autoantibodies such as perinuclear antineutrophil cytoplasmic antibodies [p-ANCA]. The aim of the present study was to evaluate the target antigens for p-ANCA in Iranian patients with UC. p-ANCA target antigens including elastase, lactoferrin, cathepsin G, myeloproxidase, lysozyme, and bactericidal permeability increasing protein [BPI] were determined in 113 patients with UC using enzyme-linked immunosorbent assay [ELISA]. 59.2% of the patients were positive for at least one antigen and p-ANCA directed against lactoferrin, elastase, lysozyme, cathepsin G, Bactericidal permeability increasing protein, and myeloproxidase in 31.5%, 25.9%, 8.3%, 7.4%, 5.6%, and 0% of the patients, respectively. The highest prevalence of p-ANCA was observed against lactoferrin and elastase. Also, myeloproxidase was not an antigen for p-ANCA among our patients
Subject(s)
Animals, Laboratory , Animals , Insecta , Antibodies, Antineutrophil Cytoplasmic , Antigens , Pancreatic Elastase , Lactoferrin , Cathepsin G , Peroxidase , MuramidaseABSTRACT
Recent studies have shown a critical role for HLA-DQ2 and HLA-DQ8 in the pathogenesis of celiac disease. No study has been performed on the prevalence of these two HLA types in Iranian celiac patients. We enrolled 24 celiac patients and 37 first-degree relatives in whom the diagnosis of celiac was excluded by sero-logic tests. HLA typing for HLA-DQ2 [DQB1*02], HLA-DQ8 [DQB1*03], HLA-DQ B1*05 and HLA-DQ B1*06 was performed using polymerase chain [PCR] reaction. Twenty two [91.7%] celiac patients and twenty seven [73%] controls were positive for the HLA-DQ2 and/or HLA-DQ8 heterodimers. There was no significant difference between the two groups p=0.068]. However, celiac patients were statistically more positive for homozygote HLA-DQ2, whereas non-celiac participants were more positive for homozygote HLA-DQ8 [p<0.05]. The total prevalence of HLA-DQ2 and/or HLA-DQ8 allels did not significantly differ between the two groups. Hence, first-degree relatives of celiac patients appear to be more susceptible for developing celiac disease. On the other hand, the higher prevalence of homozygote HLA-DQ2 in celiac patients shows its stronger role in disease pathogenesis. Further studies on larger populations are needed in Iran.
Subject(s)
Humans , HLA-DQ Antigens , Genotyping Techniques , HLA Antigens , Polymerase Chain ReactionABSTRACT
Worldwide, the incidence of inflammatory bowel disease [IBD] is increasing. This study aims to evaluate the diagnostic value of two serological markers, atypical perinuclear anti-neutrophil cytoplasmic antibodies [atypical-P-ANCA] and anti-Saccharomyces cerevisiae antibodies [ASCA], with the intent to determine their relationship to ulcerative colitis [UC] and Crohn's disease [CD], in addition to the location and extent of bowel involvement. There were 97 patients enrolled in this study, 72 diagnosed with UC and 25 with CD. The control group consisted of 40 healthy individuals. ASCA was determined by enzyme-linked immunosorbent assay [ELISA] and atypical-P-ANCA by indirect immunofluorescence assay [IIF]. For data analyses, we used the chi-square and independent t-tests. Significance was considered to be p<0.05. For CD, the sensitivity of ASCA was 16% and its specificity was 97%. ASCA had a specifity of 90% in UC patients. The atypical P-ANCA test had a sensitivity of 44% and specificity of 86% for UC. The positive predictive value [PPV] for atypical P-ANCA in UC patients was 78% and for the negative predictive value [NPV], it was 58%.There was no correlation between ASCA and atypical P-ANCA results and the location of gastrointestinal [GI] involvement in CD [p=0.61] and UC [p=0.28] patients. According to the results, ASCA and atypical P-ANCA markers are not useful for IBD screening. Our study suggests that atypical P-ANCA is a useful parameter to differentiate UC from CD. However, ASCA is of limited value for screening and differentiating UC from CD
Subject(s)
Humans , Female , Male , Saccharomyces cerevisiae/immunology , Antibodies, Antineutrophil Cytoplasmic , Diagnosis, DifferentialABSTRACT
Drug abuse as a frequent high risk behavior accompanies many different gastrointestinal complications. In this study we tried to evaluate the prevalence of gastrointestinal reflux among opium addicts. Using a historical cohort design, 62 cases with dyspepsia as the chief complaint entered the study: 30 cases with history of regular use of opium over the last year [exposed group] and 32 cases with no history of addiction at all [unexposed group]. Upper GI tract endoscopy was accompanied by 3 biopsy specimens taken from body and antre of stomach was performed for all the cases. 2 cases in the exposed group and 3 cases in the unexposed group left the study with the diagnosis of malignancy. Mean age of the remaining cases in the exposed group was 48.1 +/- 13.2 and in the unexposed group, it was 37.8 +/- 13.9 years [p= 0.006]. 16 cases [57.1%] in the exposed group and 5 cases [17.2%] in the unexposed group had endoscopic evidence of bile reflux into the stomach [p= 0.003]. Pathologic evidence of bile gastritis including foveolar elongation was reported in 7 cases [25.0%] of the exposed group in comparison with 1 case [3.4%] of the unexposed group [p = 0.025]. The frequency of "helicobacter pylori free gastritis" was 50% in the exposed group and 17.2% in the unexposed group [p = 0.012]. Duodenogastric reflux is not restricted to cases with a history of GI tract surgery and it seems that this problem is common among opium addicts
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With respect to the importance of hepatitis B vaccination of high-risk groups such as prisoners, this study was performed to assess the comparability of a short-course double-dose vaccination schedule with the standard 3-dose schedule. Within a randomized clinical trial, a short-course vaccination [at months 0 and 1] with 20 microgram [double-dose] doses of the vaccine was compared to the standard method of hepatitis B vaccination [at months 0, 1 and 6, with 10-microgram doses] in 100 prisoners in Zahedan city in Iran in 2009. We made sure the sera from all the individuals were negative for markers of previous hepatitis B infection. Subsequently serum from all the participants was tested for anti-HBs antibody 1, 2 and 7 months after the first dose of vaccination. Seroconversion rates [HBsAb>10 mIU/ml] 1, 2 and 7 months after the first dose of vaccination were similar in the routine [11%, 79% and 94%, respectively] relative to the double-dose group [26%, 95% and 93%, respectively]. The mean values of anti-HBs antibody titers were similar in the 1st and 2nd months for the two groups but it was significantly higher [P=0.002] in the routine dose [514 mIU/ml] versus the double-dose group [130 mIU/mL], in the 7th month. Demonstrating comparable results with the standard 3-dose schedule, it seems that short-term double-dose vaccination for hepatitis B is a safe and acceptable method for use in high-risk groups such as prisoners
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Hepatitis C virus [HCV] is an etiological agent responsible for occurrence of post-transfusion hepatitis in thalassemic patients. This study identified hepatitis C genotypes in pediatric and adolescent thalassemic patients and their correlation with age, blood transfusion, HCV RNA viral titer and liver function. This study considers cross-sectional data from the Center for Thalassemia in Zahedan [Iran] carried out between August 2005 and September 2007, Twenty multitransfused patients suffering from p-thalassemia major and chronic HCV infection [13 males, 7 females] were included in the study, Patients were considered eligible for the study if they were seropositive for HCV RNA polymerase chain reaction [PCR] before initiation of evaluation. Blood sample was taken for HCV genotype and viral titer as well as biochemical markers. Type specific primer and real-time RT-PCR HCV were used for determination of viral genotype and HCV-RNA titer. There was a significant positive correlation between serum HCV RNA titer and genotypes [P<0001]. Serum HCV RNA levels were found higher in genotype 3a than in others. The most prevalent genotype in thalassemic patients was genotype 3a [40%] followed by 1b [25%], unclassified [20%] and 1a [15%]. There was no meaningful relationship between genotype, Alanine aminotranferease, ferritin and alkaline phosphatase. Age, serum HCV RNA titer and number of transfusions were the only significant factors associated with genotypes [P<015, P<0.0001 and P<0.001 respectively]. This study showed that HCV genotype and viral titer are related to the number of blood transfusions received by thalassemic patients. Screening donated blood in blood banks would prevent the occurrence of hepatitis C in this high-risk group
Subject(s)
Humans , Male , Female , Child , Adolescent , Genotype , Viral Load , beta-Thalassemia/virology , Cross-Sectional Studies , Polymerase Chain ReactionABSTRACT
Viral hepatitis represents one of the most significant public health challenges. The institutionalization itself is an important factor influencing the risk and frequency of exposure and further spread of HBV and HCV infections. This study was carried out to determine the frequency of HBV and HCV serological markers in residents of Guilan nursing home. Demographic data and history of exposure to known risk factors were collected by interview and through medical records available at the nursing home; clinical information was obtained via examination. All residents were screened for markers of HBV and HCV. HBsAg or HCVAb positive cases were examined for HBeAg, HBcAb, and HCV-RNA, respectively; and complementary tests including AST, ALT, ALP, bilirubin, serum albumin, and prothrombin time [PT] were done. 383 residents of Guilan nursing home including 243 females [63.4%] with mean age of 58.4 +/- 21.9 years were investigated. The average duration of residency was 6.0 +/- 5.7 years. Nine cases [2.3%] including 6 males [4.2% of all males] were anti-HCVAb positive. Out of these 9 cases, 5 individuals were HCV-RNA positive. All of these 5 cases were male. The average duration of residency in HCV positive cases was 1.5 +/- 1.8 years in comparison with 6.1 +/- 5.8 years in negative cases. There was a significant reverse relationship between residency duration and HCV positivity in logistic regression. Residency in nursing home is not an important risk factor for viral hepatitis transmissions. However; we recommend precise and complete viral hepatitis screening on admission to nursing home and HBV vaccination for HBV negative cases