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Aim of the studyFew population-based studies have been conducted to report the prevalence of non-alcoholic fatty liver disease (NAFLD) and determine its risk factors in Iran, particularly in Shahrekord, southwest Iran. The main aim of this population-based, case-control study was to determine the prevalence of NAFLD and its potential risk factors in an Iranian population-based cohort study in Shahrekord, Iran.Material and methodsWe compared 1153 cases with NAFLD at 35 to 70 years to 1153 frequency-matched NAFLD-free controls from a population-based Shahrekord cohort study. Data collection and assessed risk factors (demographics, anthropometrics, clinical and biochemical factors, and laboratory tests) were performed based on the Shahrekord cohort study protocol. Chi-square test, stepwise selection with backward likelihood ratio, logistic regression and log-binomial regression model with 95% confidence interval were performed to determine risk factors with significant effects on NAFLD.ResultsIn this study, the mean (± standard deviation) age of the participants was 50.23 (±8.70) years. The prevalence of NAFLD and metabolic syndrome with 95% confidence interval were 16.47% (15.61-17.36%) and 32.74% (30.83-34.70%), respectively. There was a significant difference in the frequency of waist circumstance, triglycerides, body mass index, blood pressure, and alanine aminotransferase between cases and controls (p < 0.001). According to log-binomial model results, socioeconomic status, hypertension, diabetes, and physical activity were significantly associated with NAFLD.ConclusionsOur findings have important clinical and public health implications in southwest Iran for monitoring the prevalence of NAFLD and important risk factors to manage, screen, prevent, and reduce NAFLD and related factors.

Background Critical inter-provincial differences within Iran in the pattern of non-communicable diseases (NCDs) and difficulties inherent to identifying prevention methods to reduce mortality from NCDs have challenged the implementation of the provincial health system plan. The Shahrekord Cohort Study (SCS) was designed to address these gaps in Chaharmahal and Bakhtiari, a province of high altitude in the southwest of Iran, characterized by its large Bakhtiari population, along with Fars and Turk ethnicity groups. Methods This ongoing cohort, a prospective, large-scale longitudinal study, includes a unique, rich biobank and was conducted for the first time in Chaharmahal and Bakhtiari Province in Iran. SCS is a part of the PERSIAN (Prospective Epidemiological Research Studies in IrAN) cohort. The study began in 2015, recruited 10075 participants (52.8% female, 47.2% male) from both urban (n=7034) and rural (n=3041) areas, and participants will be annually followed up for at least 15 years. A cross-sectional analysis was conducted using baseline data from the SCS, using descriptive statistics and logistic regression. Data analysis was performed using Stata software. Results The prevalence of NCDs was 9.8% for type 2 diabetes, 17.1% for hypertension, 11.6% for thyroid disease, 0.2% for multiple sclerosis and 5.7, 0.9 and 1.3% for ischemic heart disease, stroke and myocardial infarction, respectively. The prevalence of multimorbidity (≥2 NCDs) was higher in women (39.1%) than men (24.9%). The means (standard deviations) of age, BMI, systolic blood pressure and fasting blood glucose were 49.5 (9) years, 27.6 (4.6) kg/m2, 115.4 (17.3) mmHg and 96.7 (27.3) mg/dL, respectively. Logistic regression models showed that older age, female gender, living in an urban area, non-native ethnicity, high wealth index, unemployment, obesity, low physical activity, hypertriglyceridemia, high fasting blood sugar, alkaline urine pH and high systolic and diastolic blood pressure were associated with increased prevalence of NCDs. Conclusions The SCS provides a platform for epidemiological studies that will be useful to better control NCDs in the southwest of Iran and to foster research collaboration. The SCS will be an essential resource for identifying NCD risk factors in this region and designing relevant public health interventions.

OBJECTIVESStillbirth is an undesirable outcome of pregnancy. In light of the increasing use of pesticides and growing concerns about the possible health effects of agricultural pesticides, we investigated the effect of exposure to pistachio pesticides on stillbirth in pregnant mothers.METHODSThis case-control study was conducted in Rafsanjan, Iran from 2011 to 2012. A total of 125 females who had a recent stillbirth were included as the case group, and 250 controls were selected from females who had a recent live birth. For each case, two controls with the nearest propensity score to the case were selected. Data were collected using a protocol developed by the researcher that involved interviewing respondents and reviewing their medical records. Conditional multivariate and univariate logistic regression analysis were performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.RESULTSThe ORs of stillbirth in mothers living in pistachio gardens and those who were exposed to sprayed pesticides, in comparison to the controls, were 14.1 (95% CI, 3.3 to 63.4) and 5.0 (95% CI, 1.2 to 28.6), respectively. No significant differences were found in stillbirth rates according to the distance between the mother’s residence and a pistachio garden or involvement in agricultural activities.CONCLUSIONSThe results of our study showed that exposure to pistachio pesticides during pregnancy may increase the likelihood of stillbirth in mothers.

Background: Pain control after every surgery, especially cesarean is very important, and physicians are striving to discover pain control methods using the least amount of opioid. Paracetamol is a non-opioid analgesic with few complications. The present study was aimed to investigate the analgesic effect of preoperative intravenous administration of paracetamol on post-cesarean pain. Methods: This randomized double-blind clinical trial was conducted on 240 pregnant women under spinal anesthesia who were candidate for elective cesarean. The patients’ weight, height, age and body mass index (BMI) were recorded, and patients were randomly divided into two equal groups (n=120). In the first group, 10 mg/kg paracetamol in 100cc normal saline (paracetamol group) and in the second group 100cc normal saline (control group) administered 15 minutes before surgery intravenously. Blood pressure, pulse rate, chills and nausea were recorded during and 1 hour after surgery, and pain visual analogue scale (VAS) and need for additional analgesic were recorded 1, 2, 4, 6, 12 and 24 hours after surgery. Results : The mean scores of pain were significantly lower in paracetamol group (4.01±2.22) than control group 6 hours (4.83±2.35) (p=0.008) and 24 hours (2.26±1.85 and 2.67±1.80 respectably) (p=0.038) after surgery. Mean meperidine consumed was lower in paracetamol group than control group but not significantly. No significant difference was found between the two groups in frequency of chills and nausea (p>0.05). Conclusions : Within the limitations of the current study, preoperative intravenous administration of paracetamol significantly reduced post-cesarean pain within 24 hours. Trial registration: The proposal of present study approved by the Research Council of Rafsanjan University of Medical Sciences with No. 841 on 2016-11-08 and by the ethics committee of Rafsanjan University of Medical Sciences, with code IR.RUMS.REC.1395.115 on 2016-11-08 (prospectively registered), and approved by the Iranian Registry of Clinical Trial (IRCT) with code IRCT20150519022320N17 on 2019-01-18 (retrospectively registered). https://www.irct.ir