mohammad ebrahim ghamarchehreh
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Background
Liver biopsy remain as the gold standard for diagnosing hepatic fibrosis; however, it has some limitations, such as life-threatening complications, low acceptance by the patients, and variations in the related sample. Therefore, there is a need for the development of non-invasive investigations for diagnosing hepatic fibrosis. Vibration-controlled transient elastography (VCTE) is one of these non-invasive methods.
MethodsThis study included 73 patients suffering from non-alcoholic fatty liver disease (NAFLD) who were older than 18 years. The patients underwent VCTE at the Baqiatallah and Firoozgar hospitals. Then, they underwent a liver biopsy by an experienced radiologist in the same hospital. A receiver operating characteristic (ROC) curve of different fibrosis stages was used to evaluate the VCTE verification.
ResultsVCTE could detect any fibrosis levels (stage 1 and higher) with an area under the ROC curve (AUROC) of 0.381. Moreover, it detected stage 2-4 fibrosis with an AUROC of 0.400, stage 3-4 fibrosis with an AUROC of 0.687, and stage 4 fibrosis with an AUROC of 0.984.
ConclusionThe VCTE has high clinical validity in diagnosing the advanced stages of fibrosis (stages 3, 4) and can be a suitable alternative to the invasive method of liver biopsy with high reliability.
Keywords: Fibrosis, Non-alcoholic fatty liver disease, Elasticity imaging techniques -
مقدمه
با تغییر الگوی مصرف مواد غذایی و زندگی ماشینی، اضافه وزن و چاقی رو به افزایش بوده و شیوع بیماری های قلبی عروقی و مرگ زودرس ناشی از آن بیشتر شده است. هدف از این مطالعه، تعیین تاثیر هشت هفته تمرینات هوازی تناوبی شدید بر شاخص توده بدنی و قند خون ناشتا در پرستاران بیمارستان بقیه الله (عج) بود.
روش کارمطالعه حاضر از نوع نیمه تجربی سه گروهه و از نوع کارآزمایی بالینی تصادفی بوده است. نمونه های مطالعه به صورت هدفمند در دسترس شامل 30 نفرپرستار بود که به صورت تصادفی به سه گروه ورزش های تناوبی نوع یک (10) نفر، ورزش های تناوبی نوع دو (10) نفر و گروه کنترل (10) نفر تقسیم شدند. قد ،وزن و قند خون ناشتای همه آزمودنیها قبل از شرکت در فعالیت ورزشی اندازه گیری شد. پس از هشت هفته فعالیت ورزشی، دوباره قد، وزن و قند خون ناشتای همه آزمودنیها اندازه گیری شد. برای تحلیل آماری از نرم افزارSPSS نسخه 22 و برای تحلیل استنباطی داده ها از آزمون Repeated measures) ANOVA) استفاده گردید. سطح معناداری در آزمون (p<0/05) در نظر گرفته شد.
یافته هامداخله 8 هفته فعالیت ورزشی منظم، باعث کاهش معنی دار مقادیر قند خون ناشتا و کاهش میزان توده بدنی آزمودنیها در دو گروه ورزشی گردید (p<0/05). بر این اساس، گروه آزمون یک (میانگین قند خون ناشتا قبل از مداخله 21±98 ، بعد از مداخله 11±90 و شاخص توده بدنی قبل از مداخله 1/59±26/68 ، بعد از مداخله 0/09±25/30) و گروه آزمون دو (میانگین قند خون ناشتا قبل از مداخله 6/06±99 ، بعد از مداخله 13±96 و شاخص توده بدنی قبل از مداخله 1/34±27/46 ، بعد از مداخله 0/08±26/27) بیشترین اثر کاهش در قند خون ناشتا را داشتند.
نتیجه گیریدر مجموع بر اساس یافته های پژوهش حاضر انجام برنامه های ورزشی منظم و با شدت معین که قابلیت اجرا در محل کار دارند، جهت کنترل و کاهش وزن و قند خون ناشتا افراد چاق که دارای جمعیتی رو به افزایش هستند، در مراکز بهداشت و سلامت جامعه کارایی مناسبی خواهد داشت.
کلید واژگان: پرستاران، شاخص توده بدنی، قند خون ناشتا، ورزشIntroductionWith the change in the feeding patterns and modern life style, overweight and obesity have been increasing and so, the prevalence of cardiovascular diseases and premature death caused by it has increased. The aim of this study was to determine the effect of eight weeks of intense intermittent aerobic exercise on body mass index and fasting blood sugar in the nurses of Baqiyatallah Hospital.
MethodsThe current study was a semi-experimental and a randomized clinical trial study of three groups. The population of study included 30 nurses who were randomly divided into three groups of intermittent exercise type one (10), intermittent exercise type two (10) and control group (10). The height, weight and fasting blood sugar of all the subjects were measured before and after the study. SPSS version 22 software was used for statistical analysis and ANOVA (repeated measurement) was used for inferential data analysis. The p<0.05 was considered as significance difference.
Results8 weeks of regular exercise activity resulted in a significant decrease in fasting blood sugar values and a decrease in the BMI in two exercise groups (p<0.05). also, group one (mean fasting blood sugar before intervention 98±21, after intervention 90±11 and BMI before intervention 26.68±1.59, after intervention 25.30±0.09) and group two (mean fasting blood sugar before intervention 99±6.06, after intervention 96±13 and BMI before intervention 27.46±1.34, after intervention 26.27±0.08 ) had the greatest reduction in fasting blood sugar.
ConclusionIn general, based on the findings of the present research, regular exercise programs with a certain intensity, which can be implemented at the workplace, will be effective in controlling weight and reducing fasting blood sugar in obese people, who have an increasing population.
Keywords: Nurses, body mass index, fasting blood sugar, exercise -
Introduction
Colorectal cancer (CRC) is one of the most widespread Cancers across the world. Notwithstanding the diagnoses and treatments developed over thepast four decades, patients' survival rate has improved moderately; and yet, it still has a 5-year survival rate of less than 50%.In this study, hypermethylation of the NDRG4 gene was evaluated as a biomarker in CRC screening.
Materials and Methods70samples were examined in this case-control study (45 CRC patients versus 25 healthy controls) totally, and Methylation-Specific PCR (Polymerase Chain Reaction) technique was used to investigate the NDRG4 methylation situation in plasma samples.
ResultsThe mean age in the control group and CRC patients was 58.4±3.4 years and 64.6±4.4 years, respectively. The male to female ratio in the control group and CRC patients was 1.5:1 and 1.1:1, respectively. Gastrointestinal disease history was positive in 12% and 33% of patients in the control group and CRC patients. In this study, NDRG4 gene hypermethylation was observed in 53.3% of patients, while it was shown in only 23.3% of healthy controls.
ConclusionThe results showed that NDRG4 could be a prognostic biomarker in CRC diagnosis and screen as a noninvasive blood-based biomarker
Keywords: olorectal Cancer, Methylation, Screening, NDRG -
Gastroenterology and Hepatology From Bed to Bench Journal, Volume:12 Issue: 3, Summer 2019, PP 190 -196AimThe aim of this study was to investigate the effects of eight weeks aerobic and resistance exercise on blood lipid profile in elderly with non-alcoholic fatty liver disease (NAFLD).BackgroundIncreased sedentary have a potential role in the development of NAFLD. Exercise training as an effective strategy to reduce NAFLD is presented.MethodsIn a randomized clinical trial study, thirty nine elderly patients with NAFLD were enrolled and were randomly divided in three groups. Aerobic groups (AG, n=13), resistance group (RG, n=13) and control group (CG, n=13). AG participated in an 8-week aerobic training (three 45-min sessions per week at 55-75% of HRR (heart rate reserve)). RG participated in an 8-week resistance exercises (three 45-min sessions per week at 50-70% of 1RM (one-repetition measure). Blood lipid profile of patients were evaluated baseline and after eight weeks.ResultsAt baseline, there were no differences between the two groups. In two group, cholesterol and low density lipoprotein (LDL) of blood of elderly follow eight weeks aerobic training with p=0.02 and p=0.02 were decreased, respectively. Also, High density lipoprotein (HDL) was improved follow aerobic training (p=0.008). However, the aerobic and resistance training were not effective on triglyceride (TG).Conclusionaerobic training was more effective than resistance training in improving the blood lipid profile in elderly with NAFLD and can role in management of this condition.Keywords: Aerobic training, Aging, Resistance training, Non-alcoholic fatty liver disease, Lipid profile.(Please cite as: Ghamarchehreh ME, Shamsoddini AR, Alavian SM. Investigating the impact of eight weeks of aerobic and resistance training on blood lipid profile in elderly with non-alcoholic fatty liver disease: a randomized clinical trial. Gastroenterol Hepatol Bed Bench 2019;12(3):190-96).Keywords: Aerobic training, Aging, Resistance training, Non-alcoholic fatty liver disease, lipid profile
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IntroductionThe staging of gastric cancer has an important role in the management of tumors. Surgeons & oncologists may use many diagnostic tests to measure the stage of tumors. There is a need of study about the reliability of diagnostic endosonography as one of the most important tests for evaluating tumoral stages. The aim of current study is to determine the efficacy of endosonography (EUS) for the staging of gastric tumors pre-operatively.MethodsThis cross-sectional study was performed on 120 patients with gastric cancer who underwent gastrectomy operation and admitted to a tertiary hospital between 2014 and 2015. At the beginning, the tumors were staged by using endosonography. Also, the tumors re-staged after surgery by histopathologic studies. The results of the two methods were compared. Diagnostic indicators such as sensitivity, specificity, accuracy, positive predictive value and negative predictive value were compared between the two methods and the level of 0.05 was considered as statistically significant.ResultsMean age of the patients was 65.44±12.3 years. Of the total patients, 87 patients (72.5%) were male and 33 (25.5%) were female. The accuracy of endosonography method was 82.5% for tumor size. Also, the accuracy of evaluating lymph node involvement by endosonography was 79.2% and for metastasis was 25.0%.ConclusionEndosonography is a precise method for evaluating tumoral invasion and lymph node involvement with a high accuracy in our hospital and is recommended to be used forpre-operative staging of gastric cancers.Keywords: Endosonography, Pathology, Gastric neoplasms
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BackgroundHepatitis B (HB) vaccination is a recommended procedure in all dialysis patients, but its efficacy has not been perfect. In the current study, we aimed to conduct a comprehensive review of the literature to find and pool data of the randomized trials evaluating the impact of serum albumin levels on the immunogenicity of HB vaccination in dialysis patients.MethodsLiterature searches were conducted by the Medline and Google Scholar. The key words used included Hepatitis B, Vaccine, Dialysis, Hemodialysis, and Albumin. Data of serum albumin levels regarding seroresponse to HB vaccine in clinical trials have been achieved and analyzed. Finally, data from 17 clinical trials have been pooled and analyzed.ResultsOne thousand six hundred eighty-two dialysis patients (1212 seroconverted) were included in the meta-analysis. Analysis of response to HB vaccination in our dialysis population showed a significant relationship to their serum albumin levels (pConclusionThe data showed a significant effect for the levels of serum albumin on the immunogenicity of HB vaccine in dialysis patients. Moreover, stratification of data upon dialysis mode showed that this association is only available for hemodialysis patients, and not those on peritoneal dialysis.Keywords: Hepatitis B virus_vaccination_serum albumin_dialysis patients_ESRD_efficacy_immunogenicity
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BackgroundNonalcoholic fatty liver disease (NAFLD) has different prevalence rates in various parts of the world and is a risk factor for diabetes and cardiovascular disease that could progress to nonalcoholic steatohepatitis, cirrhosis, and liver failure..ObjectivesThe current study aimed to investigate the effect of Aerobic Training (AT) and resistance training (RT) on hepatic fat content and liver enzyme levels in Iranian men..Patients andMethodsIn a randomized clinical trial study, 30 men with clinically defined NAFLD were allocated into three groups (aerobic, resistance and control). An aerobic group program consisted of 45 minutes of aerobic exercise at 60% - 75% maximum heart rate intensity, a resistance group performed seven resistance exercises at intensity of 50% - 70% of 1 repetition maximum (1RM) and the control group had no exercise training program during the study. Before and after training, anthropometry, insulin sensitivity, liver enzymes and hepatic fat were elevated..ResultsAfter training, hepatic fat content was markedly reduced, to a similar extent, in both the aerobic and resistance exercise training groups (P ≤ 0.05). In the two exercise training groups, alanine amino transferase and aspartate amino transferase serum levels were significantly decreased compared to the control group (P = 0.002) and (P = 0.02), respectively. Moreover, body fat (%), fat mass (kg), homeostasis model assessment insulin resistance (HOMI-IR) were all improved in the AT and RT. These changes in the AT group were independent of weight loss..ConclusionsThis study demonstrated that RT and AT are equally effective in reducing hepatic fat content and liver enzyme levels among patients with NAFLD. However, aerobic exercise specifically improves NAFLD independent of any change in body weight..Keywords: Exercise Trainig, Nonalcoholic Fatty Liver Disease, Resistance, Aerobic
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In the present study, we examined the relationship between family history of cardiovascular diseases (CVD), dyslipidemia, hypertension, and diabetes with laboratorial abnormalities and syndromes in Iranian patients with non-alcoholic fatty liver disease (NAFLD). A total of 332 NAFLD patients from our outpatient clinic were consecutively entered into analysis. Exclusion criteria were having diabetes mellitus and fasting blood glucose over 126, active hepatitis B virus infection, having HCV positive serology, and to be under corticosteroid therapy. Family history of CVD, diabetes, dyslipidemia, and hypertension were taken from patients and related to the study variables. Family history of cardiovascular diseases (CVD) was associated with low HDL levels (P=0.05). Patients with positive family history of diabetes mellitus were significantly more likely to have AST/ALT levels proportion of higher than one (P=0.044). Family history of dyslipidemia was a predictor for hypertriglyceridemia (P=0.02), higher prothrombin time levels (P=0.013), lower albumin (P=0.024) and T4 (P=0.043) levels. Family history of hypertension was associated with dysglycemia/diabetes (P=0.038), high ALT (P=0.008), and low TIBC (P=0.007) and albumin levels (P=0.001). Family history for CVD, diabetes, dyslipidemia, and hypertension were of clinical importance in the Iranian patients with NAFLD. We therefore recommend that physicians should precisely get family history of main disorders in all NAFLD patients; and to pay more attention to those having the mentioned family histories. Further studies with larger patient population and prospective approach are needed for confirming our findings.Keywords: Family history, NAFLD, Non alcoholic fatty liver disease
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Background
There are insufficient data available on utilization and health care costs of non-alcoholic fatty liver disease. The cost data for different health conditions and services is a major gap in Iranian health system. So this study is the primary or first step towards filling this gap..
ObjectivesThis study aims to estimate the diagnosis and treatment costs of Non-alcoholic Fatty Liver..Patients and
MethodsThis cross-sectional study was conducted on 528 subjects. The subjects had been diagnosed with non-alcoholic fatty liver. All the subjects had been referred to the Tehran Fatty Liver Clinic, a clinic of the Baqiyatallah Research Center for Gastroenterology and Liver Diseases, in 2009 and they had been observed for 2 years to determine the frequency of health care utilization (physician visit, laboratory tests, medication and cost of sonography). The costs of diagnosis and treatment for each person were estimated in Purchasing Power Parity dollars (PPP$)..
ResultsThe average total cost was 5,043 PPP$ per person in the 2 years of observation. Majority of these 528 patients (87.9%) had a BMI ≥ 25 (kg/m2). Also, 33.9% were diagnosed with comorbid diseases such as Diabetes Mellitus (DM), Coronary Artery Disease (CAD), hypertension (HTN) and hypothyroidism (HYPO)..
ConclusionsThe results confirmed that the total costs for non-alcoholic fatty liver among the Iranian adult urban population alone exceeded 1 billion PPP$ per year. These costs can be saved or reduced by effective disease management and early prevention..
Keywords: Non, alcoholic Fatty Liver Disease, Costs, Cost Analysis, Delivery of Health Care, Utilization -
BackgroundThere are several studies in the literature investigating factors which can induce non-alcoholic fatty liver disease (NAFLD) in different populations. However, the existing literature lacks powerful studies addressing the factors which may predict the severity of NAFLD..ObjectivesIn the current study, we aimed to evaluate factors independently associated with liver echogenicity in an Iranian NAFLD patient population..Patients andMethodsA total of 393 patients attending as outpatients at the Hepatology Clinic of Baqiyatallah University of Medical Sciences were entered into this analysis. Univariate and multivariable linear regression models were performed to evaluate the effects of the study variables on the NAFLD grade, defined by ultrasound hepatic echogenicity..ResultsUnivariate linear analyses revealed a significant relationship between; the ultrasonographic grading of NAFLD and body weight (P < 0.001), abdominal girth (P = 0.007), pelvic girth (P = 0.032), fasting blood glucose (FBS) (P = 0.005), serum insulin (P = 0.035), hemoglobin A1c (HbA1c) (P = 0.012), triglycerides (P = 0.049), aspartate aminotransferase (AST) (P = 0.015), alanin aminotransferase (ALT) (P = 0.026), and homeostasis model assessment (HOMA) (P = 0.002). Multivariable linear regression models left only; HbA1C (P = 0.011, β = 0.133), body weight (P = 0.001; β = 0.176) and serum triglyceride (P = 0.034; β = 0.112) as factors independently associated with liver echogenicity..ConclusionsDiabetic patients can reduce liver damage of NAFLD with control of their HbA1C through the lower ranges. Hypertriglyceridemia and body weight are the other implicated factors, which worsen hepatic echogenicity in the NAFLD patient population. We recommend future prospective studies and clinical trials to confirm our findings..Keywords: Ultrasonography, Non, Alcoholic Fatty Liver Disease
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سابقه و هدفبا توجه به این که تشخیص نئوپلاسم های کولورکتال غیرپولیپوئیدی و سرطان های برخاسته از آنها با کولونوسکوپی های معمولی بسیار مشکل است و امکان عدم تشخیص آنها وجود دارد، ما از کولونوسکوپی با بزرگ نمایی (high-magnify colonoscopy) استفاده کردیم تا فراوانی ضایعات Flat و Depressed کولورکتال را در آنها به دست آوریم.روش بررسیدر این مطالعه توصیفی در بیمارانی که به دلایل طبی اندیکاسیون کولونوسکوپی داشتند و به بیمارستان طالقانی در سال 1385 مراجعه کرده بودند، کولونوسکوپی انجام شد. تمام ضایعات ابتدا براساس نمای ماکروسکوپی و تقسیم بندی Paris شناسایی شدند. تمامی آنها تا 100 بار بزرگ نمایی شدند و خصوصیات الگوی Pit آنها با طبقه بندی های استاندارد مورد بررسی قرار گرفت. تمامی ضایعات مشاهده توسط دو پاتولوژیست مجرب بطور مشترک از نظر خصوصیات بافت شناسی مورد بررسی قرار گرفتند.یافته هادر 100 بیمار با میانگین سنی 1/16 ± 3/44، 18 بیمار (18 درصد) 27 ضایعه غیرطبیعی یافت شد که 17 مورد آن از نوع پولیپوئید و 10 مورد آن از نوع غیرپولیپوئید بود. بیشترین ضایعه مورد نظر از نوع Pedunculated (9 مورد) بود. 8 مورد ضایعه Flat و 2 مورد ضایعه Slightly elevated یافت شد. هیچ موردی ضایعه Depressed مشاهده نشد. در بررسی بافت شناسی ضایعات، 21 مورد آدنوم (8/77 درصد) یافت شد که سهم آدنوم توبولر بیش از همه و به میزان 12 مورد (4/44 درصد) بود. یک مورد آدنوکارسینوم یافت شد. در بزرگ نمایی ضایعات در بررسی الگوی Pit بیشترین مورد مشاهده شده مربوط به Pit pattern II در 17 مورد (63 درصد) بود.نتیجه گیریبا توجه به وجود نئوپلاسم های غیرپولیپوئیدی در ایران، انجام کولونوسکوپی با بزرگ نمایی در بیمارانی که نماهای مشکوک در کولونوسکوپی معمولی دارند یا موردی در آنها کشف نمی شود، توسط کولونوسکوپیست های آموزش دیده توصیه می شود.
Medical Science Journal of Islamic Azad Univesity Tehran Medical Branch, Volume:18 Issue: 2, 2008, P 113BackgroundNon-polypoid colorectal neoplasms and related malignancies are difficult to be detected using traditional colonoscopy. In this study, we attempted to evaluate frequency of flat and depressed colorectal neoplasms using high-magnifying colonoscopy.Materials And MethodsPatients with medical indication of colonoscopy who referred to Talaghani hospital in 1385 were evaluated. After preparation, total colonoscopy (Olympus, CF-Q240TL, Japan) was performed up to cecum. Lesions were classified according to macroscopic presentation and Paris classification, and then they were evaluated regarding pit patterns after 100-fold magnification. Pathologic findings of lesions were studied by two expert pathologists.ResultsOne hundred patients with mean age of 44.3 ± 16.1 were studied. In total 27 lesions (17 polypoid, 10 non-polypoid) were found in 18 patients. Peduculated polyps (9 polyps) were the most common lesions. We found 8 flat and 2 slightly elevated polyps. There was no depressed lesion. In pathologic examination, there were 21(77.8%) adenomas, mostly tubular (12, 66.6%). One adenocarcinoma was also detected. Pit pattern II was the most common pattern found.ConclusionAs non-polypoid neoplasms are frequent lesions in Iran, we recommend performing high-magnifying colonoscopy in patients with suspected presentations in traditional colonoscopy.
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