Effect of vitamin D on gastrointestinal symptoms and health-related quality of life in irritable bowel syndrome patients: a randomized double-blind clinical trial.

BACKGROUND: Low-grade mucosal inflammation and immune activation are involved in the pathogenesis of irritable bowel syndrome (IBS). Furthermore, IBS symptoms are associated with a significantly higher prevalence of psychological distress, which in itself results into an impaired quality of life (QoL). Vitamin D could ameliorate the symptoms of patients suffering from IBS through its beneficial effects on psychological factors and inflammation. METHODS: A total of 90 IBS patients participated in this double-blind, randomized, placebo-controlled study. Participants were randomly selected to receive either 50 000 IU vitamin D3 or a placebo fortnightly for a period of 6 months. Patients reported their IBS symptoms at the baseline and monthly during intervention periods. The IBS severity score system (IBSSS) and IBS-specific QoL questionnaires were used at the baseline and postintervention. KEY RESULTS: Over the 6-month intervention period, a significantly greater improvement in IBS symptoms such as abdominal pain and distention, flatulence, rumbling, and overall gastrointestinal (GI) symptoms (except dissatisfaction with bowel habits) was observed in the patients receiving vitamin D as compared to the placebo group. The IBSSS and the IBS-QoL scores in the vitamin D group significantly improved compared to the placebo group postintervention (mean IBSSS score change: -53.82 ± 23.3 vs -16.85 ± 25.01, p < 0.001, respectively; mean IBS-QoL score change: 14.26 ± 3 vs 11 ± 2.34, p < 0.001, respectively). CONCLUSIONS & INFERENCES: Vitamin D seems to be an effective and safe option to improve QoL and symptoms of IBS. ClinicalTrials.gov (NCT02579902).

Socioeconomic status and prevalence of self-reported diabetes among adults in Tehran: results from a large population-based cross-sectional study (Urban HEART-2).

INTRODUCTION: Diabetes mellitus is an important public health challenge worldwide. The prevalence of type 2 diabetes varies across countries. The aim of this study is to estimate the prevalence of type 2 diabetes and to determine related factors including socioeconomic factors in a large random sample of Tehran population in 2011. METHODS: In this cross-sectional study, 91,814 individuals aged over 20 years were selected randomly based on a multistage, cluster sampling. All participants were interviewed by trained personnel using standard questionnaires. Prevalence and Townsend deprivation indexes were calculated. Principal component analysis (PCA) was used to construct wealth index. Logistic regression model was used in multivariate analysis. RESULTS: The estimated prevalence of self-reported diabetes was 4.98 % overall, 4.76 %in men and 5.19 % in women (P < 0.003). In multivariate analysis, age, marital status (married and divorced/widow) and BMI were positively associated with the prevalence of self-reported diabetes. Of the socioeconomic variables, educational level and wealth status were negatively and Townsend Index was positively associated with diabetes. CONCLUSION: Our study findings highlight low reported prevalence of diabetes among adults in Tehran. Subjects with low socioeconomic status (SES) had a higher prevalence of type 2 diabetes. Weight gain and obesity were the most important risk factors associated with type 2 diabetes. Wealth index and educational level were better socioeconomic indicators for presenting the inequality in diabetes prevalence in relation to Townsend deprivation index.

Seroprevalence of pertussis antibodies in 6-17-year-old students in Ahvaz, south-west Islamic Republic of Iran.

Although pertussis is a vaccine-preventable infection, vaccine-induced immunity is not lifelong and booster doses are recommended according to national disease epidemiology. The aim of this study was to evaluate pertussis-IgG levels in school-aged students in Ahvaz, south-west Islamic Republic of Iran. In a descriptive, cross-sectional study, blood samples were obtained from 640 students (382 boys and 258 girls) aged 6-17 years during 2010-2011. All students had received a full course of pertussis whole-cell vaccination at ages 2, 4, 6 and 18 months and 4-6 years. Using a Bordetella IgG ELISA kit, pertussis-IgG was detected in 301 (47.0%) students. No statistically significant differences in pertussis-IgG levels were found between girls and boys or across different age groups. The findings show that the overall level of pertussis-IgG seropositivity was unacceptable. Booster vaccination with an acellular pertussis vaccine should be considered in adolescents and/or adults in our region.

Effect of temperature changes on the occurrence of congenital hypothyroidism.

OBJECTIVES: To investigate an association between seasonal changes in temperature and the prevalence of congenital hypothyroidism (CH) in the Southwest of Iran. METHODS: A prospective two-year study conducted from March 2007 to March 2009 during the nationwide screening programme for CH in Ahvaz, the biggest city in southwest Iran. Blood samples were taken from almost all newborns by heel-stick and used in a thyroid-stimulating hormone (TSH)-enzyme-linked immunosorbent assay (ELISA). Serum thyroxine (T4) and TSH were measured if the ELISA-TSH was >5 mIU/L (suspicious cases). Infants were considered to have CH with T4 <6.0 µg/dL and TSH > 10 mIU/L, or with normal T4 values and persistent high TSH values for >2 months (subclinical hypothyroidism). Date of birth and sex were recorded. Detailed temperature data were obtained from the meteorological organization. The relationship between the monthly incidence of CH and the average monthly temperature was investigated. RESULTS: From 47,075 (50.92% male) newborns, 1131 were referred (recall rate = 2.4%) and 142 infants (51.4% male) were confirmed to have CH. The seasonal distribution of CH cases was 32.4% in the warm period and 67.6% in the cold period of the year (19%, 13.4%, 32.4% and 35.2% in spring, summer, fall and winter, respectively; P = 0.001). A statistical difference was seen between mid-summer (2.8%, warmest time) and early winter (15.5%, coldest time). The above-mentioned difference was the same for suspicious individuals (P < 0.001). The odds of being affected were increased by 4% for each fall of 1°C. CONCLUSION: The prevalence of CH has a significant negative correlation with the temperature in the tropical area of Iran.

Efficacy of sulfasalazine in the treatment of generalized lichen planus: randomized double-blinded clinical trial on 52 patients.

BACKGROUND: Oral sulfasalazine has been reported to be effective in patients with idiopathic cutaneous lichen planus (LP). OBJECTIVES: Our purpose was to evaluate the efficacy of this drug in the treatment of generalized cutaneous lichen planus (GLP). In this study, we evaluated the effectiveness of the anti-inflammatory drug sulfasalazine for the treatment of GLP. METHODS: A total of 52 patients with GLP presenting at the outpatient clinic were enrolled in this double-blind, randomized, placebo-controlled, prospective study. Of these patients, 44 completed the period of study. The patients were randomly divided into two groups. One group received placebo and the other was given sulfasalazine maximum 2.5 g/day. The patients were evaluated at the third and sixth weeks of treatment for improvement rate and occurrence of complications. RESULTS: After 6 weeks of treatment, the rate of cutaneous lesions improvement was 9.6% (two patients) in the placebo group and 82.6% (19 patients) in the sulfasalazine group. The improvement rate of pruritus was 14.3% in the placebo group and 91.3% in the sulfasalazine group. Side-effects which were mild and tolerable were detected in 30.7% of patients, but three patients left the study because of side effects. Most of the reported side-effects included gastrointestinal upset and headache. CONCLUSIONS: Statistically, sulfasalazine was more effective than placebo in reducing cutaneous lesions and improving pruritus after 6 weeks of treatment. According to our study, sulfasalazine is a relatively safe and effective treatment option and may be an alternative therapy for the treatment of generalized lichen planus.