Tehran University Medical Journal

Background: One of the most important causes of chronic liver disease is hepatitis C virus (HCV), which causes liver cirrhosis and hepatocellular carcinoma. To control the prevalence of the disease, knowledge and information in risk factor of HCV are required. The aim of this study was to compare the risk factors of infection between HCV patients with genotypes 1a and 3a.
Methods: This is an observational analytical study. HCV patients who referred to the clinic of hepatology, Rasoul-e-Akram University Hospital from July 2015 to July 2017, were assigned to the genotype 1a and 3a. Demographic (age, sex, family history), clinical (cirrhosis, hepatocellular carcinoma) and laboratory data, history of intravenous drug and alcohol usage, and history of imprisonment were gathered and compared between two groups. All the patients completed the informed consent form. Data analysis was performed by SPSS software, version 22 (IBM SPSS, Armonk, NY, USA). P value less than 0.05 was considered statistically significant.
Results: Overall, 97 HCV patients were included in this study. Mean age was 45±12 years and 78 (80%) of patients were male. Among them, 58 (60%) and 39 (40%) had genotype 1a and 3a. respectively. History of injection drug usage was recorded in 34/39 (87%) of patients with genotype 3a, and significantly higher in genotype 3a as compared to genotype 1a [OR adj: 3.1, CI (1.3-6.2)]. Also, in this study, genotype 3a was significantly recorded in younger patients [OR adj: 1.7, CI (1.2-4.1)]. However, cirrhosis and hepatocellular carcinoma was more common in patients with genotype 1a as compared to genotype 3a [OR adj: 2.05, CI (1.6-5.4) and OR adj: 2.8, CI (1.3-5.7)] respectively.
Conclusion: According to the results of this study, hepatitis C virus transmission risk factors differed in genotypes 3a and 1a. Genotype 3a is found among young patients with a history of intravenous drug usage and genotype 1a in patients with cirrhosis and hepatocellular carcinoma.

Background: According to the previous studies, stress influences on eating behavior and is associated with unhealthy food selection. Furthermore, the research literature indicates that stress, anxiety, and depression can cause polyphagia and overweight. The purpose of present study is to investigate the relationship between depression, anxiety, and stress scales and dietary behavior in female high school students.
Methods: The cross-section study was carried out from April to December 2016 on high school female students of Tehran City by confirmation and protection of Nutrition Sciences and Food Technology Faculty at Shahid Beheshti Medical Sciences University, Tehran, Iran. 400 samples were selected by using multistage cluster sampling method. After receiving consent and recording socio-economic information, the data associated with stress, anxiety, and depression score were collected by a short questionnaire of Depression Anxiety Stress Scales 21 (DASS-21). In order to survey the dietary behavior of students, the 168-item semi-quantitative food frequency questionnaire (FFQ) was applied. In addition, to assess the association between dietary behavior and stress, anxiety and depression, chi-squared test and logistic regression model were employed.
Results: Based on the results of the present paper, 49.8 percent of students, studied in this research, had stress levels, 56.3 percent of them suffered from anxiety and 55.3 percent of them had depression levels. The salt intake amounts of students who had high stress, depression, and anxiety, were more than of normal ones (respectively P=0.01, 0.02, 0.006). Additionally, fast food consumptions of students, suffering from anxiety, were also higher than normal (P=0.07). Subjects, which were categorized in depressed group, rarely eat natural fruit juice (P=0.03), and, stressful students use few natural fruit juices (P=0.006) and few fresh fruits too (P=0.02).
Conclusion: Students with levels of stress, depression and anxiety in comparison to normal students, have more undesirable food habits, such problems may lead dietary behavior to unhealthy foods. More studies are required to clarify the relationships between dietary behavior and stress, depression and anxiety.

Background: Chronic inflammation and oxidative stress are the two essential factors determining ulcerative colitis (UC) onset and severity status. In present study, we aimed to investigate short-term effects of ginger (Zingiber officinale) as a well-known antioxidant and anti-inflammatory agent on the quality of life, disease activity index and some of inflammatory and oxidative stress factors in patients with active mild to moderate UC.
Methods: This study was a double blind placebo controlled randomized clinical trial conducted in nutrition and diet therapy clinic of Shahid Beheshti University of Medical Science, Tehran, Iran, from October 2017 to June 2018. Forty-six patients with active mild to moderate UC daily consumed four capsules of 500 mg dried ginger powder or similar placebo through eating their meals for 6 weeks. Before and after intervention, we analyzed patient´s scores of disease activity index, by simple clinical colitis activity index questionnaire (SCCAIQ) as well as their quality of life using inflammatory bowel disease questionnaire-9 (IBDQ-9). We also measured serum concentrations of total antioxidant capacity (TAC), malondialdehyde (MDA), tumor necrosis factor (TNF-α), high sensitive (hs)-CRP and nuclear factor κB (NF-κB) in fasted blood samples of each participant. Additionally, anthropometric and dietary intake values of energy, macro/micronutrients and minerals of all of participants were assessed at the same time.
Results: While the mean of anthropometric measures and dietary intake values remained unchanged during the study, MDA level decreased in ginger group (P=0.04) compared with placebo group. Additionally, ginger supplementation successfully lowered serum levels of TNF-α and disease activity index after 6 weeks of intervention compared with baseline in ginger consumer group, however the increase of quality of life score was not statistically significant in mentioned group versus baseline values. No significant change in other study outcomes was observed at the end of 6 weeks within and between groups.
Conclusion: Our data indicates that two grams per day supplementation with dried ginger powder can reduce oxidative stress level of patients with active mild to moderate UC.

Background: Psychosocial issues and quality of life are important components at the patients diagnosed with chronic hepatitis B and C. Hepatitis is a chronic liver disease that can affect quality of life of patients. In this study, we compared the quality of life between patients with hepatitis B and C and finally presented a structural model about it.
Methods: In a prospective analytic study, 86 patients with hepatitis B and 86 with hepatitis C who referred to the Rasoul-e-Akram Hospital in Tehran from April 2015 to April 2018 were compared regarding the quality of life and health-related quality of life. The clinical and radiographic data of patients were extracted from their medical records. The 36-item short-form health survey (SF-36) was used for the evaluation quality of life and health-related quality of life. The questionnaire consisted of 36 questions in eight sub-scales (physical performance, physical role, physical pain, general health, vitality, social role, emotional role, and mental health).
Results: Generally, the quality of life score was significantly lower in patients with hepatitis C (34.13±9.37) than patients with hepatitis B (51.5±10.5) (P=0.001). Except for the physical role and vitality, all other SF-36 subscales were significantly lower in the HCV patients group (P>0.05). Based on the results of logistic regression, the emotional dimension of patients was reported as most important effect on the quality of life in patients [(OR=9.15, 95% CI=(4.11-15.41), P=0.001)]. Based on the results of linear analysis, hepatitis type [(B=4.21, P=0.001)], patient income [(B=2.57, P=0.001)], the level of education [(B=2.9, P=0.014)] and the gender of patients [(B=2.77, P=0.023)] were reported as most important factors affecting the quality of life of patients, respectively. There was no significant difference between age, body mass index and smoking reported in patients' quality of life (P>0.05).
Conclusion: According to the results of this study, the quality of life in patients with hepatitis C was significantly lower than the quality of life in patients with hepatitis B.

Background: Hepatitis is among the major health problems, especially in developing countries. During past decades, the association between type of blood group (ABO) and hepatitis B and C virus has always been discussed. This study was designed to investigate the possible association between type of ABO blood group and chronic hepatitis B and C infection.
Methods: In the present analytical study, frequency of blood groups and their relationship with hepatitis B and C were evaluated in three groups: group A (patients with hepatitis B), group B (patients with hepatitis C) and group control (subjects with non-hepatitis B and C). The study was done from October 2016 to October 2018 on patients who referred to Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Demographic and laboratory data of all participants were extracted and collected from their medical records.
Results: Overall, 196 and 103 patients in group A, B and three hundred control were included in this study, respectively. The baseline demographic data of patients were not significantly different between treatment groups. The mean age of participants was 35.1±13 years. The O blood group was significantly higher in patients with hepatitis B (46.4%) and hepatitis C (41.9%) compared to control group (34%) (P=0.001). The risk of hepatitis B and C infection were significantly higher among patients with O blood group (OR = 3.9, 95% CI 2.1-5.9; P = 0.001) and (OR = 2.7, 95% CI 1.7-5.6; P = 0.02), respectively] while, the risk of hepatitis B infection was significantly lesser in participants with blood group A (OR = 0.4, 95% CI -1.2-0.8). Rh positive participants significantly were at higher risk of hepatitis (B and C) than Rh negative participants. (P<0.05).
Conclusion: Participants with blood group O were at higher risk for chronic hepatitis B and C B infection and antigen (Rh) positive. Hepatitis B infection was reported lesser in participants with blood group A.

Background: Gastric cancer (GC) is one of the most common malignancies and is considered as one of the leading causes of cancer deaths worldwide. Despite considerable progress in the disease's control and treatment, the patients' survival rate is relatively low. Different factors can affect the survival rate of GC patients. The current study aims to evaluate the association of demographic and pathological characteristics with the survival rate of GC patients.
Methods: This descriptive-analytical study was conducted on Fifty-six patients with gastric cancer from October 2015 to October 2016, who were referred to the gastroenterology clinic of Imam Khomeini and Rasoul Akram Hospitals in Tehran province and followed up for five consecutive years. The survival rate of the patients was measured using Kaplan-Meier method. Moreover, the Log-rank test and the COX regression model were used to determine the association of the survival rate with the demographic and pathological characteristics, including gender, age, tumor location, tumor type, tumor differentiation, metastasis, tumor staging, and Helicobacter pylori status. Data analysis was performed via SPSS version 22, and a P<0.05 was considered statistically significant. 

Results: A total of 56 patients were studied; 73% were men, and 27% were women. Our results showed that gastric cancer is more common in males and older people. Patients' one-year, three-year, and five-year survival rates were 67%, 35%, and 26%, respectively. Also, the survival rate of participants over 60 and in advanced stages of GC was lower than others. The Log-rank test showed that age, tumor type, tumor differentiation, metastasis, and tumor staging could affect the survival rate. However, in the COX regression model, age, metastasis, and tumor staging influenced the survival rate of patients. Conclusion: The results indicated that the survival rate of gastric cancer patients was relatively low, and the early diagnosis of GC could be a substantial factor in increasing the patients' survival rate. Therefore, an appropriate screening program is necessary to increase the survival rate of GC patients.