Association between liver enzymes and metabolic syndrome: results of the enrollment phase of Tabari cohort.

BACKGROUND: The association between liver enzymes and metabolic syndrome (MetS) has been evaluated in several studies with different results. The purpose of this study is to determine the association between the serum levels of these liver enzymes and MetS in Tabari cohort population. METHOD: In this case-control study, data collected from the enrolment phase of the Tabari cohort population have been used. MetS was defined based on IDF (international diabetes federation) standards. Then, 476 patients with MetS (case group) and 476 age-sex matched controls were selected randomly. RESULTS: Mean aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were higher in case group than control group (20.59 vs. 19.99 respectively, p = 0.339 and 24.64 vs. 20.16 respectively, p < 0.001). The chance of having MetS, high triglyceride, and fasting blood glucose (FBG) was significantly higher in people with ALT ≥ 40 (1.63, 2.35, and 2.02, respectively). The chance of having MetS in people with AST ≥ 40 was 1.45 times higher than that among those with normal AST level (p > 0.05). CONCLUSION: This study showed that there is an association between liver enzymes and MetS as well as some of its components. Liver enzymes, especially ALT, can be used as an early indicator of MetS in the at risk population.

The role of spiritual intelligence in predicting the empathy levels of nurses with COVID-19 patients.

AIM: Given the prolongation of the newly emerging COVID-19 pandemic and the significance of caring for the patients by nursing staff, investigating and planning for the different psychological dimensions of this group is of paramount importance. Hence, this study investigated the role of spiritual intelligence in predicting nurses' empathizing with COVID-19 patients. METHODS: This descriptive-correlation study was conducted in 2021 on nurses caring for COVID-19 patients in three public hospitals. The researchers used two standard questionnaires, including the Jefferson Scale of Empathy (JSE) and Spiritual Intelligence (SI), for data collection. The collected data were analyzed in SPSS16 using descriptive statistics and the following: The Mann-Whitney U test, Kruskal-Wallis test, Regression, chi-square test, and Pearson and Spearman correlations. RESULTS: The statistical population consisted of 338 nurses with an average age of 34 and ten years of work experience. There was a significant positive relationship between the empathy scores and spiritual intelligence scores of the nurses caring for COVID-19 patients (P < 0.05). It was also concluded from the regression analysis that, spiritual intelligence affect empathy. Mean score of empathy was higher in hospitals where more nursing staff had MSc degrees. There was a significant difference between the empathy scores of the three hospitals (P < 0.05). CONCLUSION: The results indicated that there is a positive relationship between empathy and spiritual intelligence. Therefor improving spiritual intelligence is the appropriate strategy to ameliorate empathy during the COVID19 pandemic. At the same time, study indicated attention to the issue of nurses' mental health. Hence, it was suggested to incorporate these issues in the training programs and national/international decisions.

Decomposing socioeconomic inequality in dental caries in Iran: cross-sectional results from the PERSIAN cohort study.

BACKGROUND: The current study aimed to measure and decompose socioeconomic-related inequalities in DMFT (decayed, missing, and filled teeth) index among adults in Iran. METHODS: The study data were extracted from the adult component of Prospective Epidemiological Research Studies in IrAN (PERSIAN) from 17 centers in 14 different provinces of Iran. DMFT score was used as a measure of dental caries among adults in Iran. The concentration curve and relative concentration index (RC) was used to quantify and decompose socioeconomic-related inequalities in DMFT. RESULTS: A total of 128,813 adults aged 35 and older were included in the study. The mean (Standard Deviation [SD]) score of D, M, F and DMFT of the adults was 3.3 (4.6), 12.6 (10.5), 2.1 (3.4) and 18.0 (9.5), respectively. The findings suggested that DMFT was mainly concentrated among the socioeconomically disadvantaged adults (RC = - 0.064; 95% confidence interval [CI), - 0.066 to - 0.063). Socioeconomic status, being male, older age and being a widow or divorced were identified as the main factors contributing to the concentration of DMFT among the worse-off adults. CONCLUSIONS: It is recommended to focus on the dental caries status of socioeconomically disadvantaged groups in order to reduce socioeconomic-related inequality in oral health among Iranian adults. Reducing socioeconomic-related inequalities in dental caries should be accompanied by appropriate health promotion policies that focus actions on the fundamental socioeconomic causes of dental disease.

Hashimoto's thyroiditis presenting as a single toxic adenoma (A case report).

BACKGROUND: Hashimoto's thyroiditis can be present with a localized palpable nodule though presentation as a hyperfunction "nodule" is extremely rare. The first case of Hashimoto's thyroiditis and hot nodule was reported in 1971 by Warner. CASE PRESENTATION: We reported a 26-year-old hypothyroid woman in Hashimoto's thyroiditis background with a hyperactive thyroid nodule in both 99mTc and I131scintigraphy. The nodule disappeared after eight months of sufficient thyroid hormone replacement therapy. CONCLUSION: Toxic adenoma in hypothyroid patients can be resolved after levothyroxine (L-T4) replacement therapy.

Tabari Cohort Profile and Preliminary Results in Urban Areas and Mountainous Regions of Mazandaran, Iran.

BACKGROUND: The Tabari cohort study (TCS), part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN), is a large longitudinal prospective cohort designed to better understand the risk factors associated with major non-communicable diseases (NCDs) across two urban and mountainous regions in north of Iran. METHODS: The enrollment phase of TCS started in June 2015 and ended in November 2017. During this phase, individuals aged 35-70 years from urban and mountainous regions of Sari township (Mazandaran province) were invited to the cohort center by health volunteers (urban regions) and Behvarz (mountainous areas) using census information. Data was collected based on the PERSIAN cohort study protocols. Hypertension was defind as systolic blood pressure ≥140 mm Hg or a diastolic blood pressure ≥90 mm Hg or history of diagnosis with hypertension or taking antihypertensive medications among participants free from cardiovascular diseases. Diabetes was defined as fasting blood sugar ≥126 mg/dL or a history of diagnosis or taking glucoselowering medications among all participants. RESULTS: A total of 10,255 participants were enrolled in TCS, 59.5% of whom were female. Among the total population, 7,012 participants were urban residents (68.4%). The prevalence of daily smoking in the total population was 9.1%. Body mass index in 75.9% of participants was ≥25 kg/m2. The prevalence of hypertension, diabetes, and thyroid disorders were 22.2%, 17.2%, and 10.5%, respectively. CONCLUSION: The Tabari cohort is different from other cohorts in terms of levels of risk factors associated with NCDs. This study has certain important strengths including its population-based design and large sample size that provides a valid platform for conducting future investigations and trials. A biobank that has been designed to store blood, nail, hair and urine samples for future research is another strength of this study. Researchers who are interested in using the information can refer to the following web page: http://persiancohort.com.

Relationship between beta-globin gene carrier state and insulin resistance.

OBJECTIVE: To assess the relationship between being beta globin gene carrier and developing insulin resistance. METHODS: This study was conducted on 164 subjects including 82 healthy ones and 82 patients with beta thalassemia minor (microcytosis (MCV <80 fl) and hypochromia (MCH <25 pg) and HbA2 ≥ 3.5% using HPLC). Fasting blood glucose (FBS) values of 100-125 mg/dl were considered as impaired fasting glucose, and above 125 mg/dl as diabetes mellitus. Two hours After 75 gram glucose load(GTT), blood sugar level of 140-199 mg/dl was considered as impaired glucose tolerance and above 199 mg/dl as diabetes mellitus. Insulin resistance was diagnosed based on homeostasis model assessment method (HOMA). RESULTS: According to FBS and BS2hPG values, the percentages of diabetes mellitus, pre diabetes, and normal glucose tolerance in case group was 8.5%, 9.8% and 81.7%, respectively. There was no case of diabetes mellitus in control group and 6.1% of this group were pre diabetic and 93.9% of them had normal glucose tolerance test (P = 0.02). Relative risk for diabetes mellitus and insulin resistance in the cases with minor thalassemia was 2 (95% CI: 1.8-2.5) and 2.02 (95% CI: 1.7-2.4), respectively. CONCLUSION: The risk of developing diabetes and insulin resistance in patients with thalassemia minor is two times greater than the general population. Considering the high serum levels of CRP in these cases, the inflammation noted in liver cells could be considered as the underlying cause of insulin resistance, impaired glucose tolerance and diabetes in these patients.