Non-alcoholic Steatohepatitis in a Sample of Iranian Adult Population: Age is a Risk Factor.

OBJECTIVES: Non-alcoholic Steatohepatitis (NASH) is a cause of cirrhosis. Detecting its preventable causes could be useful in decreasing the disease and its complications. This study aimed to assess the prevalence of NASH in adult population living in Isfahan city as a sample of Iranian population. METHODS: Blood samples of 2030 individuals referring to Dr. Shariati Hospital for routine health checkup were collected. All individuals with high liver enzymes [aspartate aminotransferase (AST) and/or Alanine aminotransferease (ALT)] were included in the study. Known causes of altered liver enzymes were excluded. Second blood samples were obtained 6 months later and those cases with persistent enzyme elevation were surveyed with ultrasonography. RESULTS: In the first survey, 234 individuals (11.5 %) had ALT levels of more than 40 U/L. By rechecking samples after 6 months, 50% of all high serum ALT individuals remained at high level. After conducting complementary biochemical tests, 3.3% of the population was considered to have NASH; 20% of NASH cases did not have any abnormal findings in ultrasonography. Hypercholesterolemia was the most coexisting risk factor in NASH cases. We found a reverse correlation between ALT level and age (P = 0.02). CONCLUSIONS: The prevalence of NASH was comparable with other countries. According to the significantl correlation between ALT level and age, preventive interactions in younger individuals would decrease the incidence of NASH.

Azithromycin effect on helicobacter pylori eradication: double blind randomized clinical trial.

BACKGROUND/AIMS: To evaluate the efficacy of one- and two-week regimen of quadruple therapy containing azithromycin for Helicobacter pylori infection eradication. METHODOLOGY: A total of 84 H. pylori-infected patients, were randomized into three groups: First group (n=31): 6 g AzOAB: Azithramycin 500 mg twice daily for 6 days and Omeprazole 20 mg, Amoxicillin 1 g, Bismuth 240 mg all twice daily for 2 weeks. Second group (n=28): 3 g AzOAB: Azithramycin 500 mg twice daily for 3 days and Omeprazole 20 mg, Amoxicillin 1 g, Bismuth 240 mg all twice daily for 1 week. Third group (n=25): 1.5 g AzOAB: Azithromycin 250 mg twice daily for 3 days and Omeprazole 20 mg, Amoxicillin 1 g, Bismuth 240 mg all twice daily for 1 week. Eradication was defined as a negative urea breath test, four weeks after the end of treatment. RESULTS: The eradication rate in the first, second and third group was 92% (95% CI: 84-99.8%), 88.46% (95% CI: 84.47-84.74%), 80% (95% CI: 79.88-80.11%) respectively, based on per-protocol analysis. There was no significant difference between eradication rates (P=0.44). The frequency of drug side effects in the study groups was respectively 19.23%, 7.6% and 0%. There was no statistically significant difference between the three regimens (P=0.06). However, frequency of drug side effects between 6 g AzOAB and 1.5 g AzOAB was statistically significant (P=0.02). CONCLUSIONS: According to the results of these 3 regimens, it seems that one week quadruple regimens of 3 g Azithromycin may be more favorable for H. pylori eradication.

Association of long polyglycine tracts (GGN repeats) in exon 1 of the androgen receptor gene with cryptorchidism and penile hypospadias in Iranian patients.

Hypospadias (a urethral orifice located along the ventral side of the penis) and cryptorchidism (failure of the testes to descend into the scrotal sacs) are the 2 most common congenital malformations in males, affecting 0.3%-0.7% and 2%-4%, respectively, at birth. To study the association of CAG/GGN trinucleotide repeats in the androgen receptor gene with cryptorchidism and hypospadias in an Iranian population, we performed a case-control study of 76 cryptorchid and 92 hypospadiac (divided into subgroups of glanular, penile, and penoscrotal hypospadias) Iranian males. The length of the CAG/GGN repeat segment was evaluated by using polymerase chain reaction (PCR) sequencing in exon 1 and PCR-single-strand conformation polymorphism (PCR-SSCP) in exons 2-8. There were no significant differences in CAG lengths between the cases and controls, but GGN numbers were found to be significantly higher (median, 24 vs 22) among both subjects with penile hypospadias (P = .018) and those with a history of cryptorchidism (P = .001) compared with controls. In addition, the GGN numbers among subjects with penile hypospadias were significantly different compared with the 2 other subgroups of hypospadias (P = .001). We were able to identify 12 different CAG alleles and 8 different GGN alleles in the cryptorchid group. Although further studies are needed to elucidate the possible role of specific CAG/GGC combinations as a susceptible factor, our data suggested the possible association between polyglycin tract polymorphism in androgen receptor gene and cryptorchidism.

Two novel missense and one novel nonsense CFTR mutations in Iranian males with congenital bilateral absence of the vas deferens.

Congenital bilateral absence of the vas deferens (CBAVD) is a frequent cause of obstructive azoospermia. Nearly 75% of men with CBAVD have at least one detectable common cystic fibrosis (CF) transmembrane conductance regulator (CFTR) mutation. To study the involvement of CFTR mutations in the Iranian population with presumed low CF frequency, we analysed 112 Iranian CBAVD males. Three Iranian CBAVD males with no clinical CF phenotype indicated by a normal karyotype, normal pancreatic function and sweat chloride concentration and no Y chromosome microdeletions were studied for CFTR mutations, IVS8-5T mutations and M470V exon 10 missense polymorphism. The entire coding sequence of each gene was analysed using a combination of the denaturing gradient-gel electrophoresis or by single-strand conformation analysis and direct DNA sequencing. Also, 52 fertile males were tested as controls to rule out polymorphism. This approach allowed us to detect one novel nonsense mutation (K536X) in the nucleotide-binding domain 1 (NBD1) region and two novel missense mutations (Y122H and T338A) in the M2 and M6 regions of CFTR gene in our studied population, which were not reported previously. Also, the conservation of changed nucleotide and amino acid in mutated regions was analysed by aligning with nine different species. K536X nonsense mutation (transversion) was found in the first NBD (NBF1), which plays an important regulatory role in CFTR function. It was, therefore, considered as a severe allele responsible for elevated sweat chloride levels and obstructive azoospermia. Because Y122H and T338A mutations were compound heterozygote with the IVS8-5T, it is difficult to judge the severity of these mutations and their role in the CBAVD phenotype.