A prospective cohort study on the association between dietary fatty acids intake and risk of hypertension incident.

There are inconclusive results available on the association between dietary fatty acid intake and the risk of hypertension (HTN) incident. In this study, we investigate the relationship between baseline dietary fatty acids intake including polyunsaturated fatty acid (PUFA), trans fatty acids (TFA), monounsaturated fatty acid (MUFA), and saturated fatty acid (SFA), and the risk of first incidence hypertension. The current prospective cohort study was carried out from the Ravansar Non-Communicable Diseases (RaNCD) cohort. A food frequency questionnaire (FFQ) with 118 items was used for the assessment of dietary data. Cox proportional hazards analyses were done to estimate hazard ratios (HR) and 95% confidence intervals (CIs) of the highest versus lowest quartile intake of SFA, PUFA, MUFA, and SFA and risk of HTN. Out of 7359 eligible participants, 597 new cases of HTN were identified over an average of 6.4 ± 1.33 years of follow-up. No significant relationship was observed between the fourth compared to the first categories of dietary SFA (HR: 0.82, 95% CI 0.55, 1.21; P trend: 0.476), MUFA (HR: 0.71, 95% CI 0.48, 1.06; P trend: 0.252), PUFA (HR: 0.86, 95% CI 0.62, 1.19; P trend: 0.315) and TFA (HR: 0.99, 95% CI 0.76, 1.27; P trend: 0.675), and risk of HTN. However, a significant inverse association between each 1 g per day increase in dietary MUFA intake during 6.4 years of follow up and HTN incident (HR: 0.97; 95% CI 0.94, 0.99; P 0.044) was observed. In brief, our study revealed that higher dietary MUFA intake was protectively associated with HTN incident. Dietary MUFA-rich foods should be encouraged to improve blood pressure.

Triglyceride glucose-body mass index and hypertension risk in iranian adults: a population-based study.

BACKGROUND: Insulin resistance (IR) and obesity are risk factors for hypertension; triglyceride-glucose (TyG) is known as a surrogate for IR. The present study investigated the association between the triglyceride-glucose body mass index (TyG-BMI) index and the risk of hypertension in Iranian adults. METHODS: This study was conducted on a sample of 8,610 participants from the baseline phase of the Ravansar non- communicable diseases (RaNCD) in Iran. A logistic regression model was used to evaluate the relationship between TyG-BMI and hypertension. Receiver operating characteristic (ROC) curve analysis was conducted to estimate the predictive power of TyG-BMI for hypertension. RESULTS: A total of 4176 men and 4434 women with an average age of 46.74 years were examined. The anthropometric indices were significantly higher in hypertensive than normotensive subjects (P < 0.001). The level of physical activity was significantly higher in the bottom quartiles (P < 0.001). The odds of hypertension in the highest quartile and 3.10 (95% CI: 2.28, 4.16) times significantly higher than the bottom quartile of the TyG-BMI index. The discriminating ability of TyG-BMI to predict blood pressure was 61% (AUC: 0.61; 95% CI: 0.57, 0.63), and higher than BMI and TyG. CONCLUSION: The TyG-BMI index is associated with an increase in the odds of hypertension. Therefore, the TyG-BMI index can be a new clinical index for early diagnosis of hypertension. Lifestyle modifications such as weight control through physical activity and a healthy diet can help improve IR and prevent hypertension.

Association between dietary inflammatory index and infertility of women; Results from RaNCD Cohort Study.

BACKGROUND: In recent decades, more and more attention has been paid to the influence of nutrition on reproductive health. Nevertheless, the imminent association between diet-related inflammation and the risk of infertility has not yet been established. The aim of the current study was to investigate the ability of the Dietary Inflammatory Index (DII) to estimate infertility incidence in women. METHODS: This cross-sectional study was conducted using data from Ravansar non-communicable diseases (RaNCD) cohort study on 4437 participants. The DII was calculated based on the reported consumption of up to 31 food parameters measured via a validated and reproducible 118-item food-frequency questionnaire (FFQ). Multiple logistic regression analysis was applied to estimate the multivariable odds ratio (OR) adjusted for potential confounding variables. RESULTS: Out of all participants, 411 women (9.26%) were infertile. The mean ± SD age and weight of infertile women were 43.67 ± 7.47 years and 72.86 ± 13.02 kg, respectively. Statistical analyses showed the odds ratio of infertility in the fourth quartile (pro-inflammatory diet) was 1.76 times higher than in the first quartile (anti-inflammatory diet) of DII (95% CI: 1.57-2.02). CONCLUSIONS: The findings of this study provide compelling evidence about the association between infertility and the quality of diet in women. Therefore, interventions and programs aimed at promoting a healthy lifestyle and using healthy diets can be considered as one of the effective approaches in the prevention and treatment of infertility in women.

The Association Between Dietary Acidity and Clinical Symptoms in Patients With Rheumatoid Arthritis.

This study aimed to investigate the relationship between dietary acidity load and clinical symptoms in the patients with rheumatoid arthritis (RA). This case-control study examined 55 patients with RA and 215 healthy individuals in a Ravansar non-communicable diseases (RaNCDs) cohort study, Iran. Participants' food intakes were assessed using a validated food frequency questionnaire. The dietary acidity was calculated using potential renal acid load (PRAL), net endogenous acid production (NEAP), and dietary acid load (DAL) scores. The patients with RA were identified based on the self-reporting, medications history, and the approval of the cohort center physician following patients' examination. The odds ratio (OR) of joint stiffness in fully adjusted model was greater in the upper median of dietary acidity than in the lower median (PRAL: odds ratio [OR], 1.18; 95% confidence interval [CI], 0.59-2.36), but there was no statistically significant difference. The OR of joint pain in the upper median of dietary acidity was less than in the lower median in fully adjusted model (PRAL: OR, 0.70; 95% CI, 0.46-1.29), but the difference was not statistically significant. After adjusting potential confounders, people in the upper median of dietary acidity had a higher OR of developing RA than those in the lower median (PRAL: OR, 1.39; 95% CI, 0.70-2.76); however, it was not statistically significant. There was not any statistically significant relationship among dietary acidity and the odds of joint pain, joint stiffness, and developing RA.

Higher Odds of Type 2 Diabetes for Some Blood Groups.

BACKGROUND: Diabetes is one of the most common metabolic diseases in humans that cause disruption in glucose and fat metabolism. The determination of the ABO blood group system is hereditary and both diabetes and blood groups have a genetic basis. OBJECTIVES: The aim of this study was to investigate the odds of type 2 diabetes for some blood groups. METHODS: This case-control study was conducted in hospitals of Kermanshah in 2018. The case group consisted of patients with diabetes admitted to hospital and the control group of nondiabetic patients hospitalized in the surgical ward. Information such as age, sex, BMI, family history of diabetes and blood group is collected and analyzed by the univariate and multivariate logistic regression method. RESULTS: A total of 750 patients were enrolled in this study. The number of participants in both groups was 375. The average ages of the participants were 50.51 and 51.62 years, respectively. 67.5% of the patients in the case group were female in comparison with 73.6% of those in the control group. The value of Rh+ in the case and control groups was 94.4 and 93.6%, respectively (p = 0.645). The chance of having diabetes for patients with blood group A was 76% higher than for those with blood group O (p = 0.006). CONCLUSION: According to the results of this study, the odds of type 2 diabetes for people in blood group A was higher than for those in other blood groups. It is recommended that blood group A be considered as a risk factor in the screening of type 2 diabetes.

Molecular Mechanisms Underlying Cancer Preventive and Therapeutic Potential of Algal Polysaccharides.

BACKGROUND: Algal polysaccharide and oligosaccharide derivatives have been shown to possess a variety of therapeutic potentials and drug delivery applications. Algal polysaccharides contain sulfated sugar monomers derived from seaweed including brown, red, and green microalgae. Here, in this review, the recent progress of algal polysaccharides' therapeutic applications as anticancer agents, as well as underlying cellular and molecular mechanisms was investigated. Moreover, recent progress in the structural chemistry of important polysaccharides with anticancer activities were illustrated. METHODS: Electronic databases including "Scopus", "PubMed", and "Cochrane library" were searched using the keywords "cancer", or "tumor", or "malignancy" in title/abstract, along with "algae", or "algal" in the whole text until July 2018. Only English language papers were included. RESULTS: The most common polysaccharides involved in cancer management were sulfated polysaccharides, Fucoidans, Carageenans, and Ulvan from different species of algae that have been recognized in vitro and in vivo. The underlying anticancer mechanisms of algal polysaccharides included induction of apoptosis, cell cycle arrest, modulation of transduction signaling pathways, suppression of migration and angiogenesis, as well as activation of immune responses and antioxidant system. VEGF/VEGFR2, TGFR/Smad/Snail, TLR4/ROS/ER, CXCL12/ CXCR4, TGFR/Smad7/Smurf2, PI3K/AKT/mTOR, PBK/TOPK, and ß-catenin/Wnt are among the main cellular signaling pathways which have a key role in the preventive and therapeutic effects of algal polysaccharides against oncogenesis. CONCLUSION: Algal polysaccharides play a crucial role in the management of cancer and may be considered the next frontier in pharmaceutical research. Further well-designed clinical trials are mandatory to evaluate the efficacy and safety of algal polysaccharides in patients with cancer.

Efficacy and safety of a standardized extract from Achillea wilhelmsii C. Koch in patients with ulcerative colitis: A randomized double blind placebo-controlled clinical trial.

BACKGROUND: Using Achillea wilhelmsii as a dietary supplement for gastrointestinal disorders is common in Persian traditional medicine. Its anti-inflammatory, anti-spasmodic and antibacterial properties have been proven by different in vitro and in vivo studies, yet it has not been evaluated in a controlled clinical trial. AIM: This study intended to evaluate the efficacy and safety of A. wilhelmsii in patients with mild to moderate active ulcerative colitis in a randomized, double-blinded, placebo-controlled clinical trial. The hydroalcoholic extract of A. wilhelmsii was standardized based on caffeic acid. METHODS: Forty-nine patients were randomly received A. wilhelmsii capsules or placebo, twice daily for 4 weeks in a 1:1 ratio. The disease activity index (DAI) (Partial Mayo Score), haemoglobin, platelet count, erythrocyte sedimentation rate (ESR) and serum level of C-reactive protein (CRP) were measured at the entry and the end of the treatment. To standardize the extract, caffeic acid was detected and measured in the plant extract using high performance liquid chromatography (HPLC). RESULTS: Of 49 patients who entered the trial, 40 patients completed the study. In both treatment and placebo groups, significant reductions were observed in stool frequency, rectal bleeding, physician global assessment and partial mayo score. There was no significant difference in stool frequency (P = 0.176), rectal bleeding (P = 0.523), physician global assessment (P = 0.341) and partial mayo score (P = 1) in the treatment versus the placebo groups. Laboratory variables including hemoglobin, platelet count, ESR and CRP showed no significant difference between the treatment and the placebo group. Of all participants, only one patient in the treatment group complained about skin rash (grade 1 based on the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0). CONCLUSION: Oral administration of A. wilhelmsii powder for 4 weeks did not create a clinical response more than placebo. It seemed to be safe in UC patients. Further studies are obligatory to evaluate the therapeutic potential of A. wilhelmsii in the form of extract in UC patients.

Validity of Self-reported Hypertension and Factors Related to Discordance Between Self-reported and Objectively Measured Hypertension: Evidence From a Cohort Study in Iran.

OBJECTIVES: Self-reporting can be used to determine the incidence and prevalence of hypertension (HTN). The present study was conducted to determine the validity of self-reported HTN and to identify factors affecting discordance between self-reported and objectively measured HTN in participants in the Ravansar Non-Communicable Diseases (RaNCD) cohort. METHODS: The RaNCD cohort included permanent residents of Ravansar, Iran aged 35-65 years. Self-reported data were collected before clinical examinations were conducted by well-trained staff members. The gold standard for HTN was anti-hypertensive medication use and blood pressure measurements. The sensitivity, specificity, positive and negative predictive values, and overall accuracy of self-reporting were calculated. Univariate and multivariate logistic regression were used to examine the discordance between self-reported HTN and the gold standard. RESULTS: Of the 10 065 participants in the RaNCD, 4755 (47.4%) were male. The prevalence of HTN was 16.8% based on self-reporting and 15.7% based on medical history and HTN measurements. Of the participants with HTN, 297 (18.8%) had no knowledge of their disease, and 313 (19.9%) had not properly controlled their HTN despite receiving treatment. The sensitivity, specificity, and kappa for self-reported HTN were 75.5%, 96.4%, and 73.4%, respectively. False positives became more likely with age, body mass index (BMI), low socioeconomic status, and female sex, whereas false negatives became more likely with age, BMI, high socioeconomic status, smoking, and urban residency. CONCLUSIONS: The sensitivity and specificity of self-reported HTN were acceptable, suggesting that this method can be used for public health initiatives in the absence of countrywide HTN control and detection programs.

Mortality from aluminum phosphide poisoning in Kermanshah Province, Iran: characteristics and predictive factors.

OBJECTIVES: Aluminum phosphide (ALP), also known in Iran as rice tablets, is one of the most effective rodenticides used to protect stored grain. However, ALP poisoning regularly causes mortality in humans. The aim of this study was to evaluate the characteristics and predictive factors of mortality from ALP poisoning. METHODS: This study evaluated all patients with ALP poisoning referred to Imam Khomeini Hospital in Kermanshah Province, Iran from 2014 to 2015. For each patient, the following information was recorded: age, sex, the number of tablets consumed, the number of suicide attempts, the time elapsed from consumption to treatment, blood pressure, blood pH, HCO3 levels, and PCO2 . Differences between the survivors and non-survivors of ALP poisoning were analyzed using univariate logistic regression and multivariate analysis. RESULTS: In this study, 48 patients were male and 29 patients were female (total: 77 patients). The average age of the survivors and non-survivors was 28.7 and 31.3 years, respectively. All cases (100%) of ALP poisoning were intentional, with the goal of committing suicide. The main predictive variables of mortality from ALP poisoning were blood pressure, blood pH, and time elapsed from consumption to treatment. CONCLUSIONS: The likelihood of mortality in patients with ALP poisoning can be predicted using blood pressure, blood pH, and time elapsed from consumption to treatment. These findings may help healthcare providers take more effective measures to treat patients with ALP poisoning.

Evaluation of low-dose thalidomide as induction and maintenance therapy in patients with multiple myeloma not eligible for stem cell transplantation.

BACKGROUND: The role of thalidomide in induction and long-term maintenance therapy in patients with multiple myeloma not eligible for stem cell transplantation remains unclear. The aim of the present study was to evaluate the effect of low-dose thalidomide as induction therapy and as maintenance therapy for 24 months in patients with a complete remission after the induction chemotherapy and to monitor the survival and relapse rates. METHODS: Between October 2005 and September 2013, 50 patients with multiple myeloma received six courses of Cyclophosphamide-Vincristine Adriamycin and Dexamethazone (c-VAD) and pamidronate, and thalidomide 100 mg daily during induction, then thalidomide 100 mg daily for 24 months as maintenance. The effects of thalidomide were assessed objectively and subjectively. Whenever necessary, electromyography and nerve capacity volume were performed monthly for 6 months, then once every 3 months until the end of treatment. RESULTS: Primary response was 96% (CR or very good PR in 48/50 patients). Fifteen out of the remaining 48 patients relapsed during the follow-up period. Nine out of the 15 patients who relapsed showed very good partial response to treatment and four patients showed partial response. Survival rate was 81% in these patients. The primary outcome measures showed a mean and median progression-free survival of 33 and 27 months, respectively, and a mean and median overall survival of 43 and 39 months, respectively. CONCLUSION: Low-dose thalidomide during induction therapy combined with conventional chemotherapy and a 2-year maintenance may be effective in preventing the relapse and improving the overall survival.

Development and Diagnostic Evaluation of Loop-Mediated Isothermal Amplification Using a New Gene Target for Rapid Detection of Helicobacter pylori.

BACKGROUND: Helicobacter pylori cause chronic gastritis and subsequent diseases like gastric and duodenal ulcers and gastric adenocarcinoma. Current methods for detecting H. pylori have several disadvantages and it is of utmost importance to develop a simple, quick, accurate, and cost-effective diagnostic test. OBJECTIVES: The aim of this study was to set up and evaluate a diagnostic value of loop- mediated isothermal amplification (LAMP) for detecting H. pylori. PATIENTS AND METHODS: The analytical sensitivity values (limit of detection) of LAMP and polymerase chain reaction (PCR) were determined using serial dilutions of H. pylori DNA. Analytical specificity of the methods using new designed primers targeted ureC gene was also determined. RESULTS: The detection limits of the LAMP and PCR assay were similar and were 10 fg of pure DNA of H. pylori, which is equal to 6 copy numbers of H. pylori genome. Analytical specificity of the tests was 100% because the tests were positive only with H. pylori DNA. CONCLUSIONS: The analytical sensitivity of LAMP and PCR methods, using the designed primers, was 8 times more than any other reported methods. The designed methods are specific and sensitive for detection of H. pylori in different clinical and environmental samples.

Loop-Mediated Isothermal Amplification as a Fast Noninvasive Method of Helicobacter pylori Diagnosis.

BACKGROUND: Helicobacter pylori infection is etiologically associated with some important health problems such as gastric cancer. Because of the high clinical importance of H. pylori infection, development of a noninvasive test for the detection of H. pylori is desirable. METHODS: In this study, a loop-mediated isothermal amplification (LAMP) targeted ureC of H. pylori was evaluated on 100 stool specimens and compared with a stool antigen test. Culture and rapid urease test were considered as gold standards. RESULTS: The overall detection rate of the fecal antigen test and LAMP was 58% and 82%, respectively. The analytical sensitivity of the fecal antigen test and LAMP was 500 and 10 H. pylori cells/g and 10 fg DNA/reaction, which is equal to six H. pylori genome. CONCLUSION: LAMP technique has been characterized by high sensitivity and low detection limit for the detection of H. pylori in stool specimen. Clinical diagnostic performance of LAMP was better than the stool antigen test.

Self-induced subcutaneous facial emphysema in a prisoner: report of a case.

Subcutaneous cervicofacial emphysema is a rare condition that results from various causes. Initially it might be misdiagnosed and managed as other clinical entities, such as angioedema. We report a case of self-induced subcutaneous facial emphysema in a prisoner who sought better living conditions by simulating an emergency.

Crimean congo hemorrhagic fever infection simulating thrombotic thrombocytopenic purpura.

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease that may also be transmitted through person-to-person transmission by exposure to infected body fluids. Despite its wide geographic distribution in animals, CCHF virus is rarely associated with recognized human diseases. We report the first case of CCHF in Kermanshah province, Iran. Clinical presentation was characterized by fever, myalgia, and hemorrhage. The levels of liver enzymes, creatinine phosphokinase, and lactate dehydrogenase were elevated, and bleeding markers were prolonged.