Adiposity trajectories and cardiovascular disease risk in women: a population-based cohort study with a focus on menopausal status.

Objectives: A single measurement of adiposity indices could predict the incidence of cardiovascular disease (CVD); nonetheless their long-term pattern and its association with incident CVD are rarely studied. This study aimed to determine distinct trajectories of adiposity indices among participants of Tehran Lipid and Glucose Study (TLGS) and their association with incident CVD. Furthermore, this study aimed to investigate whether this association differed among individuals according to their menopausal status. Method: A total of 6840 women participated in TLGS, aged 20 years and older were included in this study; they were followed for a median of 16 years. Body mass index (BMI), waist circumference (WC), conicity index (CI) and body roundness index (BRI) were included in the analysis as adiposity indices. The cohort outcome panel of medical specialists identified the CVD outcomes. Trajectory analyses were used to identify homogeneous distinct clusters of adiposity indices trajectories. The association between the trajectory group membership and incident CVD were explored by Cox proportional hazard models, with unadjusted and adjusted model for baseline age, physical activity, smoking status, menopause and family history of CVD. Results: Three BMI trajectory groups of low, medium, and high and two trajectories for WC, BRI and CI were identified. Adjusted cox proportional hazard models revealed significant associations between the hazard of CVD experience and the high trajectory group of the BMI (HR: 2.06, 95% CI: 1.38-3.07), WC (HR: 2.71, 95% CI: 1.98-3.70), CI (HR: 1.87, 95% CI: 1.26-2.77) and BRI (HR: 1.55-95% CI: 1.12-2.15), compared to the low trajectory group. Subgroup analysis based on the menopausal status of participants showed that the HR of CVD incidences for all of trajectories adiposity indices, except BMI, was statistically significant. Adjusted cox proportional hazard models, in those women not reached menopause during study, revealed that the HR (95% CI) of CVD incidences for high trajectory of BMI, WC, CI and BRI were 2.80 (1.86-7.05); 2.09 (1.40-6.16); 1.72 (1.42-5.61), and 3.09 (1.06-9.01), respectively. These values for those were menopause at the initiation of the study were 1.40 (1.11, 2.53); 1.65 (1.04-2.75); 1.69 (1.01-2.87), and 1.61 (0.98-2.65), respectively. Conclusion: Our findings suggest that adiposity trajectories, particularly central adiposity index of CI, could precisely predict the CVD risk. Consequently, preventive strategies should be tailored accordingly.

Association Between Insulin Resistance Indices and Liver Function Parameters Among Women With Polycystic Ovary Syndrome.

OBJECTIVE: This study aimed to investigate whether polycystic ovary syndrome (PCOS) status changes the association between insulin resistance (IR) indices and liver function parameters among women. METHODS: This is a cross-sectional, population-based study. We selected 1101 subjects aged ≥20 years from participants of Tehran Lipid and Glucose Study (TLGS). All of them had known the status of PCOS, and all variables were related to the IR indices and liver function parameters. The main outcome measures were TG/HDL-C and triglyceride-glucose (TyG) and liver function parameters (hepatic steatosis index [HSI], alanine transaminase [ALT] and aspartate transaminase [AST]). RESULT: In the present study, there was no significant difference between the PCOS and the non-PCOS regarding the presence of liver function abnormalities. A model adjusted by age and BMI showed that the upper tertile of TyG index was positively associated with high AST (OR = 3.04 [95% CI: 1.20-7.68], p < 0.05), high ALT (4.76 [3.07-7.36], p < 0.05) and high HSI (8.44 [1.82-39.17], p < 0.05). Although the history of diabetes had a positive impact on elevated AST (1.66 [1.15, 2.40], p < 0.05), the third tertile of TG/HDL-C was associated with increased odds of elevated ALT (3.35 [2.21-5.06]) and HSI (6.55 [1.17-36.46]), whereas the second tertile of TG/HDL-C (OR = 2.65, CI 95%: 1.74-4.03) was also positively associated with elevated ALT. PCOS had no significant association with elevated liver function tests. CONCLUSION: The highest tertile of TyG index and the TG/HDL-C ratio as a surrogate of IR might play a role in detecting abnormalities of liver function parameters among women. However, PCOS status cannot change the association between IR and liver dysfunction.

Substance Abuse and Sleep Quality in University Students.

Background: Substance abuse remains a challenging public health issue, especially among young people. It has been shown that poor sleep and substance abuse may have mutual intensifying effects. This study aimed to evaluate the rates of substance abuse, cigarette smoking, and alcohol consumption and their association with sleep disturbances among university students in 2021. Methods: The participants were the students of the Faculty of Sciences, University of Guilan, Iran in 2021. Data were collected through a researcher-made demographic questionnaire, the first two questions of the translated version of the World Health Organization (WHO) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), and the Pittsburgh Sleep Quality Index (PSQI). Findings: A total of 222 students entered the study from March to August 2021. The rates of substance abuse in the past three months and lifetime were 35.6% and 45.5%, respectively. The most common type of substance abuse was related to the 'other substances' category. Substance abuse was significantly higher in students living in dormitories and those with a family history of substance abuse. Poor sleep was found in 34.2% of the students, and substance abuse and alcohol consumption both in the past three months and lifetime were significantly associated with lower sleep quality. Conclusion: This study showed that substance abuse was significantly associated with sleep disturbances. The study results also illustrated an upward trend of substance abuse in recent years among students in Rasht, which may be related to economic issues in the country and/or the effects of the COVID-19 pandemic. Considering the rising prevalence of substance abuse and its impacts on society, policymakers are highly recommended to pay special attention to its risk factors.

To what extent the weight changes impact the risk of hypertension among menopausal women: insights from Tehran lipid and glucose study.

BACKGROUND & AIM: The association between weight change and incident hypertension (HTN) in menopausal women has not been well characterized. This study aimed to determine whether weight changes after menopausal years make a difference in incidents of hypertension. MATERIALS & METHODS: This population-based study was performed using data collected from Tehran Lipid and Glucose Study cohort (1999-2018). Women who had natural and early menopause were followed up every 3 years. Data gathering was performed through the standard protocol of the study. Statistical analysis was performed using multivariable Cox hazard regression analysis. We used the 'survival' package in the R software version 3.6.0 to fit survival models. RESULTS: A total of 487 menopausal women met the inclusion criteria; 62.6% had natural menopause and remained had early menopause. Among the participants, 65.5% experienced HTN. The highest proportion of participants had > 5% weight gain, while the lowest had 3-5% weight gain. Either losing body weight (lost > 5%: HR: 0.44; CI 95%, 0.32, 0.62; p < 0.001), (lost 3-5%; HR: 0.47; CI 95%, 0.26, 0.84; p = 0.01), and weight gain > 5% (HR: 0.69; CI 95%, 0.51, 0.91; p = 0.01), were associated with decreased risk of HTN after adjustment for confounders. In this study, weight loss and gain have a protective impact on the development of HTN in subjects. For incident HTN, age (HR: 1.04 (1.01, 1.08), p = 0.004), fasting blood glucose (HR: 1.01, CI 95%:1.00, 1.01; p < 0.001), body mass index (1.02 (1.00, 1.05), p = 0.03) and smoking (1.70 (1.11, 2.58), p = 0.01) were positively associated with HTN. CONCLUSIONS: Our study indicates the significant association of weight change with hypertension risk in later life among menopausal women.

Microbial community response to biostimulation and bioaugmentation in crude oil-polluted sediments of the Persian Gulf.

The Persian Gulf is a transit point for a lot of crude oil at the international level. The purpose of this research is to compare two methods of biostimulation and bioaugmentation for degradation of sediments contaminated with crude oil in the Persian Gulf. In this research, six types of microcosms were designed (Sediments from Khark Island). Some indicators such as: the quantity of marine bacteria, enzyme activity (Catalase, Polyphenol oxidase, Dehydrogenase), biodiversity indices and the percentage of crude oil degradation were analyzed during different days (0, 20, 40, 60, 80, 100 and 120). The results of this research showed that the highest quantity of heterotrophic and crude oil-degrading bacteria was found in the sixth microcosm (SB). This microcosm represents a combination of two methods: bioaugmentation and biostimulation (3.9 × 106 CFU g-1). Following crude oil pollution, the activity of catalase and polyphenol oxidase increased and the dehydrogenase enzyme decreased. The bioaugmentation microcosm exhibited the highest activity of enzymes among all the microcosms studied. Predominant bacteria in each microcosm belonged to: Cellulosimicrobium, Shewanella, Alcanivorax and Cobetia. The highest degradation of crude oil is related to the Stimulation-Bioaugmentation microcosm (SB). The statistical results of this research proved that there is a significant relationship between the type of method chosen for biodegradation with the sampling time and the quantity of marine bacteria. The results of this research confirm that crude oil pollution in the Persian Gulf sediments can be reduced by choosing the proper bioremediation method.

Evaluation Factors Affecting on Recurrence, Metastasis, and Survival of Breast Cancer in Iranian Women by Multi-State Model Approach.

Background: We used the multistate model to investigate how prognostic factors of breast cancer are seen to affect the disease process. Methods: This cohort study was conducted at Motamed Cancer Institute of Tehran, Iran on 2363 breast cancer patients admitted from 1978 to 2017, and they were followed up until 2018. We applied the multistate models, including four states: diagnosis, recurrence, metastasis, and final absorbing mortality state. Results: Age over 50 years, positive lymph nodes and tumor size intensified the hazard of transition from diagnosis to metastasis (P=0.002, P<0.001 and P=0.001 respectively) and they also intensified the hazard of transition from diagnosis to mortality (P=0.010, P<0.001 and P<0.001 respectively). At the same time, the educational level decreased the hazard of mentioned transitions (P<0.001). Positive estrogen receptors reduced the hazard of transition from diagnosis to metastasis (P=0.007) and positive lymph nodes also intensified the hazard of transition from metastasis to mortality (P=0.040). Tumor size had an increasing role in the transitions from diagnosis to recurrence, recurrence to metastasis, and metastasis to mortality (P=0.014, P=0.018 and P=0.002 respectively). Conclusion: Multistate model presented the detailed effects of prognostic factors on progression of breast cancer. Implementing early diagnosis strategies and providing informational programs, especially in younger ages and lower educational level patients may be helpful in reducing the hazard of transition to higher states of breast cancer and increasing the survival of Iranian women with breast cancer by controlling tumor size growth, lymph nodes involvements and estrogen receptor status.

Polycystic ovary syndrome and body image concerns during adolescence.

PURPOSE: This study aimed to compare body image concerns in adolescents with and without PCOS. DESIGN AND METHODS: This cross-sectional study included 1076 adolescents, including 344 with PCOS and 732 without PCOS. The participants were asked to complete a comprehensive questionnaire that included demographic and reproductive parameters and the body image concerns inventory (BICI) which comprised two factors (1-dissatisfaction and embarrassment about one's appearance and 2-social function due to appearance concerns). Linear regression analysis was conducted to evaluate the effect of hyperandrogenism and/or abnormal uterine bleeding (AUB) and/or obesity on BICI and its domains both before and after adjustment for potential confounders. RESULTS: The result showed that adolescents with PCOS had a worse total BICI score and its domains (p < 0.05). In multivariable-adjusted regression models, adolescents with PCOS were more likely to have a high body image concern (ß = 0.05, P < 0.001), while those with high household income were less likely to have body image concern (ß = -0.08, P = 0.004). Considering hyperandrogenism status, those with high household income were also less likely to have high body image concern (ß = -0.08, P = 0.004), and age of menarche (ß = -0.01, P = 0.013) were also inversely associated with total BICI score. Likewise, considering obese status, only high household income (ß = -0.08, P = 0.004) was inversely associated with total BICI score. Also, considering menstrual irregularity status, high household income (ß = -0.08, P = 0.005), and age of menarche (ß = -0.01, P = 0.01) were inversely associated with the total BICI score. CONCLUSION: Adolescents with PCOS had higher body image concerns. Apart from the being PCOS label, abnormal uterine bleeding was also a predictor of body image concern. PRACTICAL IMPLICATIONS: Clinicians should pay attention to the greater influence of the PCOS label on altered body image in adolescents.

Stimulation of ACE inhibitory and improving α-amylase and α-glucosidase and antioxidant activities of semi-prepared and dry soup by incorporating with date kernel powder.

Date kernel as a functional food component has a special importance due to its rich nutritional profile, low price, and ease of access. For this, in this research, the sub-product was used for formulation of semi-prepared dry soup (SPDS); the effect of adding 0 (S1 = control), 2 (S2), and 4 (S3) %w/w date kernel powder (DKP) on physicochemical, nutritional, and organoleptic properties and beneficial effects of SPDS samples were evaluated. The results revealed that S2 and S3 samples were different from the control sample in some physicochemical properties so that viscosity increased 1.27 and 1.52 times and a* raised 5.6 and 8.5 times, respectively, while L* decreased 0.94 and 0.88 times and b* reduced 0.92 and 0.8 times, respectively. The nutritional properties of S2 and S3 samples compared with the control sample improved. Also, differences were observed in the beneficial effects of S2 and S3 compared with the control sample as total polyphenol content (TPC) increased 1.06 and 1.11 times, respectively (p < .05); antioxidant activities (AA) of S2 and S3 samples were 8.04 and 6.01 mg/ml and angiotensin-converting enzyme (ACE) inhibitory activities were measured to be 8.2 and 7.86 mg/ml, respectively; also, α-amylase and α-glucosidase inhibitory activities of S2 and S3 samples were observed 4.48% and 5.70%, and 4.59% and 6.36%, respectively. From the organoleptic aspect, S3 had the highest acceptability. Generally, it is concluded that with the addition of DKP (maximally 4%w/w) to SPDS formulation, a functional soup could be produced considering the rich nutritional profile of DKP.

Bone Health after Bariatric Surgery: Consequences, Prevention, and Treatment.

One of the most critical complications of bariatric surgery (BS), which has been widely discussed recently, is its adverse effects on the health of the bones and skeletal system. Studies show that bone mineral density (BMD) decreases significantly in the early years after BS Nutritional deficiencies are a common complication of BS that can last for months to years after surgery. For example, calcium absorption will significantly reduce after BS The role of gut hormones, endocrine factors, and adipokines in altering bone metabolism should never be overlooked. The available information and guidelines emphasize the periodic evaluation of BMD in patients undergoing BS The method of measuring BMD after BS is essential. DXA and quantitative computed tomography (QCT) are two convenient methods for measuring BMD. Many studies indicate a more detailed study of microarchitecture and cortical and trabecular bone mass with the help of QCT. The overall risk of fractures increases years after BS There are some recommendations for overcoming the adverse effects of BS on bone health. Endurance and resistance exercise after BS can help to mitigate BMD reduction and bone changes. In this review, we will explain each of these points in detail.

Peroneus Longus Tendon Autograft versus Hamstring Tendon Autograft in Anterior Cruciate Ligament Reconstruction: A Comparative Study with a Mean Follow-up of Two Years.

Background: Peroneus longus tendon can be a suitable alternative autograft for anterior cruciate ligament reconstruction (ACLR). The present study aimed to compare the clinical outcome and donor site morbidity in ACLR using peroneus longus tendon autograft versus hamstring tendon autograft. Methods: In a comparative cross-sectional study, ACLR was performed with quadrupled hamstring tendon autograft in 65 patients between 2017 and 2018, and in another group, peroneus longus tendon autograft was used for ACLR in 65 patients between 2018 and 2019. The same surgical technique, fixation method, and postoperative protocol were used in both groups. The knee functional outcomes were assessed according to the Lysholm score and the International Knee Documentation Committee scale at preoperative and at the end of at least 2 years after the procedure. Moreover, graft diameter was measured intraoperatively. Thigh circumference, the American Orthopedic Foot and Ankle Score (AOFAS), The Foot & Ankle Disability Index (FADI), and ankle range of motion (ROM) were used to evaluate ankle donor site morbidities. Results: A total of 130 patients (65 patients in each group) were evaluated with a minimum follow-up of 2 years (range 24-31 months). Both groups showed no significant differences in clinical outcomes and knee stability. The peroneus longus graft diameter was significantly larger than the hamstring diameter (P<0.001). Assessment of AOFAS, FADI, and ankle ROM showed no apparent ankle joint dysfunction in the peroneus longus tendon group. Conclusion: Faster knee extensions, less anteromedial knee pain, and thigh hypotrophy were observed in peroneus longus tendon patients. Peroneus longus tendon autograft can be an appropriate autograft for ACLR due to its strength, larger graft diameter, and avoiding potential complications of hamstring autograft obtained from the knee region.

Betanin alleviates oxidative stress through the Nrf2 signaling pathway in the liver of STZ-induced diabetic rats.

BACKGROUND: Continuing hyperglycemia causes and exacerbate oxidative stress. Betanin as the principal pigment of red beet root has antioxidant, anti-inflammatory, and anti-diabetic properties. The purpose of this study was to investigate the potency of betanin on antioxidant defense in STZ-induced diabetic rats' livers. METHODS: STZ at a single dose of 60 mg/kg body weight was intraperitoneally injected and betanin (10, 20, and 40 mg/kg/day) was administered orally for 28 days. Malondialdehyde (MDA), total antioxidant capacity (TAC), protein carbonyl (PC) levels, and the enzyme activity of superoxide dismutase (SOD), catalases and glutathione peroxidases (GPx) were evaluated in the liver. Furthermore, gene expression of Nrf2 and mentioned antioxidant enzymes were measured by Real-time PCR. RESULTS: Betanin (10 and 20 mg/kg) significantly reduced PC levels and increased antioxidant enzyme activity in diabetic rats compared to the control diabetic group (P < 0.01). In comparison to the diabetic control group, all studied genes expression in diabetic rats were increased significantly with betanin at doses of 10 and 20 mg/kg (P < 0.02). The increase in gene expression at 20 mg/kg of betanin was significantly stronger than others (P < 0.015) except for the catalase (P = 0.201), that was almost the same. Moreover, treatment of diabetic rats with 20 mg/kg of betanin could significantly increase TAC levels (P < 0.05) and decrease MDA levels (P < 0.001) compared to diabetic control group. CONCLUSIONS: Betanin could increase the antioxidant capacity of liver tissue associated with the Nrf2-mediated pathway in a dose-dependent manner.

Evaluation of antibiotic prophylaxis for gastrointestinal surgeries in a teaching hospital: An interventional pre-post study.

Surgical site infections are related to a high morbidity, mortality and healthcare costs. Despite ample evidence demonstrating the effectiveness of antimicrobials to prevent surgical site infections, inappropriate timing, antibiotic selection and excessive continuation of antibiotics are common in practice. In this study, we compare the appropriateness of antibiotic prophylaxis in gastrointestinal surgery, before and after an evidence-based guideline implementation. One hundred patients were evaluated in each group. The implementation of the guideline resulted in significant reduction of incorrect use of antibiotics from 55% to 18% (P = 0.002). It also reduced duration of prophylactic antibiotics (43% vs. 23%, P = 0.025). Inappropriate doses diminished but not significantly (8% vs. 5%, P = 0.321). Based on our results, in more than half of of these cases patients received incorrect antibiotic prophylaxis regimens for gastrointestinal surgery in this hospital. Local guideline implementation can result in reduction of antibiotic use, dose and duration errors.

Single nucleotide polymorphism rs5029937 in TNFAIP3 gene is correlated with risk of rheumatoid arthritis.

Background: Rheumatoid arthritis (RA) is a progressive and common autoimmune disease with multifactorial etiology. Several pieces of research show that genetic factors play a major role in the incidence of RA. Several genome-wide association studies (GWAS) have identified the tumor necrosis factor alpha inducible protein 3 (TNFAIP3) genes as one of the candidate loci. The TNFAIP3 gene encoding ubiquitin-editing protein A20 witch restricts B cell survival and prevents autoimmunity. Previous studies have indicated that single nucleotide polymorphisms (SNPs) in the TNFAIP3 gene are correlated with several autoimmune disorders. In the present study, we assessed the possible association between SNP rs5029937 (intronic variant) in the TNFAIP3 gene with RA risk in the Iranian population. Methods: A case-control study using 50 RA patients and 50 control subjects was undertaken to evaluate rs5029937 (G>T) genotypes using real-time PCR high resolution melting method (HRM). The SPSS22 was used for statistical analyses and the significance level was set at P<0.05. Results: Logistic regression analysis demonstrates that homozygous TT + heterozygous TG genotypes compared with GG genotype increase the risk of RA (TT+TG vs GG; P= 0.004, OR= 3.46; 95%CI [1.492-8.075]). Also, individuals with allele T were more frequently affected with RA than subjects with G allele (T vs G; P= 0.004, OR= 2.61; 95%CI [1.382-4.919]). Conclusion: Our findings propose a substantial correlation between rs5029937 (G>T) polymorphism and RA risk in Iranian population.

The relationship between use of aluminum-containing anti-perspirant and hair color with breast cancer.

INTRODUCTION: Breast cancer is one of the most important and common types of cancer in most countries of the world and its incidence are increasing in Iranian women. Understanding its contributing factors is important in planning for prevention. This study was conducted to investigate the association between aluminum-containing antiperspirant and hair color use with breast cancer. METHODS: In this observational cross-sectional descriptive study, 384 patients with breast cancer referred to selected hospitals of Tehran University of Medical Sciences in 2017 and 384 person as control group were randomly selected. The anti-perspiration use of aluminum-containing and hair color was compared. In this study, data were collected and descriptive and inferential statistics were used to analyze them. Absolute and relative frequency distribute tables, mean, and standard deviation were used to descriptive statistics. Chi-square and independent t-tests were used for data analysis. RESULTS: The use of antiperspirant was similar in this study, with 23.2% of breast cancer patients and 22.4% of control group using antiperspirant (P = 0.796). Frequency distribution of the use of hair color was similar among the studied subjects and 35.9% of breast cancer patients and 32% of control group consumed hair color (P = 0.253). CONCLUSION: Based on the results, it can be concluded that there is no significant relationship between the use of aluminum-containing anti-perspiration and hair color with breast cancer.

Food Addiction Disorder 2 Years After Sleeve Gastrectomy; Association with Physical Activity, Body Composition, and Weight Loss Outcomes.

PURPOSE: Food addiction (FA) following bariatric surgery (BS) has received a burst of attention in recent years due to its important contribution to obesity. Therefore, this study was conducted to explore the prevalence of FA disorder and its predictors 2 years after laparoscopic sleeve gastrectomy (LSG) and assess its relationship with physical activity (PA), body composition, and weight outcomes. MATERIALS AND METHODS: Four hundred fifty individuals who had undergone LSG 2 years prior to the study were enrolled. FA was diagnosed using the Yale Food Addiction Scale (YFAS). The collected data included body composition (fat mass (FM), fat-free mass (FFM)), PA, and nutritional intakes. RESULTS: Eighty-nine subjects (about 20%) met the criteria for FA disorder. FA patients had significantly lower PA (p = 0.04) and higher weight (p < 0.001), BMI (p < 0.001), FM, and FFM (p = 0.01) compared to those without FA. Regarding weight and body composition changes, the finding reveals that FA patients (vs. non-FA) had a significantly less excess weight loss (EWL%) (p < 0.001) and total weight loss (TWL%) (p = 0.05) as well as a higher FFM loss (kg) (p = 0.04) (linear regression analysis). A younger age (p trend = 0.01), higher BMI (p trend = 0.04), and more excess weight (p trend = 0.03) were related to higher odds of FA disorder at second year after LSG (logistic regression analysis). CONCLUSION: The results showed that FA was highly prevalent 2 years after LSG. In addition, FA disorder was associated with negative long-term outcomes following LSG. Younger individuals with more excess weight and higher BMI at baseline are more vulnerable to FA.

Clinicopathological, Immunohistochemical, and PMS2 Gene Expression Profiling of Patients with Sporadic Colorectal Cancer.

BACKGROUND: The DNA mismatch repair (MMR) system is one of the molecular pathways involved in colorectal cancer (CRC) carcinogenesis that consists of several genes, including MLH1 (MutL homolog 1), MSH6 (MutS homolog 6), MSH2 (MutS homolog 2), and MSH3 (MutS homolog 3). The protein encoded by PMS2 (post-meiotic segregation 2) is also essential for MMR. Here, we address the correlation between immunohistochemical and transcriptional expression of PMS2 with the tumor grade and clinical stage of non-hereditary/sporadic CRC disease. METHODS: This study retrospectively analyzed 67 colorectal resections performed for 38 male and 29 female patients. Random biopsies were taken by a gastroenterologist from patients referring to three hospitals in the cities of Zanjan, Urmia and Qazvin (Iran) during 2017-2019. All specimens were examined and classified for localization of tumor, pathological stage and grade. The PMS2 protein expression was studied immunohistochemically and analysis of mRNA expression was performed in the same tissue sections. RESULTS: Immunohistochemistry and quantitative real-time polymerase chain reaction (PCR) analysis showed a decrease in PMS2 expression compared with paracancerous tissue (P<0.001), which correlated with tumor stage. In addition, reduced PMS2 expression was correlated with the tumor differentiation grade, underlining a connection between downregulation of PMS2 and progression of CRC. Comparing the PMS2 mRNA levels in different groups showed the following results: 0.92 ± 0.18 in patients with Stage I CRC tumor, 0.86 ± 0.38 in Stage Ⅱ, 0.50 ± 0.29 in Stage Ⅲ, and 0.47 ± 0.23 in Stage Ⅳ. CONCLUSION: These findings suggest that PMS2 may provide a potential reliable biomarker for CRC classification by combined immunohistochemical and mRNA analysis.

A Case Series of Severe Hyperammonemia Encephalopathy Related to Valproate: Can Antipsychotics Increase the Risk?

Valproate-induced hyperammonemia is a common side effect of valproate, which may occur either without any symptoms or may rarely cause symptoms of encephalopathy. Different risk factors have been defined for this side effect, including some nutritional deficiencies and polypharmacy (eg, other anticonvulsants). Three cases with psychiatric disorder who showed symptoms of severe hyperammonemia encephalopathy and had taken valproate with antipsychotics, especially risperidone, are presented here. In all cases, the symptoms were improved by discontinuation of valproate. Administration of antipsychotic may be considered as a risk factor for hyperammonemic encephalopathy related to valproate, specifically in some prone populations.

Comparison of atherogenic index and lipid profiles in candidates for coronary artery bypass graft surgery versus normal people.

Information on incidence and risk factors of cardiovascular disease (CVD) is rare in the Middle East. This study aims to compare Iranian candidates for coronary artery bypass graft (CABG) surgery and healthy controls in terms of lipid profile, atherogenic index of plasma (AIP), and atherosclerosis index (ASTI). The individuals recruited in this study were 135 CVD patients before CABG surgery and 135 healthy subjects matching in age with the cases. Lipid profiles of the two groups were analyzed with a commercial kit. The AIP and ASTI indexes were calculated with related formula. The TC, TG, LDL-C and HDL-c parameters were dramatically changed (p<0.01) between study groups. AIP and ASTI indexes were significantly higher in patients than in healthy people (p=0.001). In individuals with CVD, it is suggested to measure these indexes in order for effective diagnosis before CABG surgery.

Overview of Risk Factors for Age-Related Macular Degeneration (AMD).

Age related macular degeneration (AMD) is the leading cause of blindness in individuals older than 65 years of age. It is a multifactorial disorder and identification of risk factors enables individuals to make life style choices that may reduce the risk of disease. This review discusses the role of genetics, sunlight, diet, cardiovascular factors, smoking, and alcohol as possible risk factors for AMD. Genetics plays a more significant role in AMD than previously thought, especially in younger patients, histocompatibility locus antigen (HLA) and complement system genes being the most significant. Whether the risk of AMD is increased by exposure to sunlight, cardiovascular risk factors, and diet is more controversial. Smoking is the risk factor most consistently associated with AMD. Current smokers are exposed to a two to three times higher risk of AMD than non-smokers and the risk increases with intensity of smoking. Moderate alcohol consumption is unlikely to increase the risk of AMD. Optometrists as front-line informers and educators of ocular health play a significant role in increasing public awareness of the risks of AMD. Cessation of smoking, the use of eye protection in high light conditions, dietary changes, and regular use of dietary supplements should all be considered to reduce the lifetime risk of AMD.

Relationship Between Sleep Quality and Spiritual Well-Being/Religious Activities in Muslim Women with Breast Cancer.

For determining relationship between quality of sleep and spiritual well-being/religious activities in Muslim women with breast cancer (WBC), we conducted a cross-sectional study on 80 WBC who presented at all chemotherapy clinics in Qom, Iran, in 2012. We used Pittsburgh Sleep Quality Index (PSQI), spiritual well-being scale (SWBS), and religious activities (RA) questionnaire. Global PSQI score and its seven components score were not significantly correlated with total score of SWBS and its two subscales. Global PSQI score was not significantly correlated with total score of RA questionnaire (P = 0.278), but its "sleep latency" (r = 0.235, P = 0.044) and "use of sleep medications" (r = 0.237, P = 0.040) components were significantly correlated with total score of RA. Global PSQI was significantly correlated with "I don't get much personal strength and support from my God," "I believe there is some real purpose for my life" questions in SWBS, and "Attendance in mosque or religious places" subscale of RA.