Tehran University Medical Journal

Background: Colorectal cancer is the second most common cancer in the world which is mainly caused by epigenetic and environmental factors. Among these epigenetic factors, gut microbiota is an important one. Although it has not been proved a unique group of bacteria correlated with colorectal cancer, these findings have generally demonstrated differences between healthy and disease gut microbiome in population. Actually, the identification and investigation of intestinal microbiota in early detection of colorectal cancer have been highlighted in new researches and studies. Herein, in the current study, we aimed to evaluate the number of selected gut bacteria including Lactobacillus and Escherichia coli and Prevotella in the fecal specimens of adenomatous polyposis patients, colorectal cancerous cases in compared to normal participants in terms of estimating important role of gut microbiota during colorectal cancer initiation and progression.
Methods: The current research was a case-control study. Fecal samples were provided from 31 healthy individuals, 42 adenomatous polyposis patients and 20 colorectal cancer cases that were referred to Taleghani Hospital, Tehran, Iran, from August 2016 to August 2017 for colorectal cancer screening tests. Fecal samples were collected to analyze intestinal bacteria including, Lactobacillus, Escherichia coli, and Prevotella by absolute quantitative real-time polymerase chain reaction (PCR). The number of these gut bacteria was precisely determined by this method of real-time PCR.
Results: Higher number of Prevotella with 24.6 CT number (P<0.005) and E.coli with 20.4 CT number (P<0.015) were achieved in colorectal cancer cases and adenomatous polyposis patients in contrast to samples from normal individuals. On the contrary, the opposite range was observed for the quantification of Lactobacillus and greater numbers of bacteria (CT=28.6) were detected in normal, compared to the colorectal cancer cases and adenomatous polyposis (P<0.001).
Conclusion: The gut microbiota composition of individuals with colorectal cancer and adenomatous polyposis differs from that of healthy individuals, and the higher numbers of pathogenic microbiota versus beneficial microbiota present in those with colorectal cancer and adenomatous polyposis. In contrast, healthy individuals have higher numbers of beneficial gut microbiota than pathogenic microbes. These findings need more experimental analysis and investigation to better clarify.

Chick embryos are a great historical research model in basic and applied sciences. Along with other animal models, avian and specifically chicken embryo has been attended, as well. Avian fertilized eggs as a natural bioreactor are an efficient tool for producing recombinant proteins and vaccines manufacturing. Due to the limitations of birds' eggs for viral replication, avian stem cells culture technologies access to safe methods as well as large-scale production of a variety of human and animal vaccines. Chicken pluripotent stem cells present the unique property of self-renewal and the ability to generate differentiated progeny in all embryonic lineages such as ectoderm, mesoderm, and endoderm in vitro. For the first time, chicken embryonic stem cells (cESCs) derived from the blastodermal cells of stage X embryos in vitro. Chicken ESC provides a great model of early embryo and they are useful for gene manipulation, virus proliferation, and the generation of transgenic birds. In addition to blastodermal cells, pluripotent cell lines can be produced by reprogramming of chicken fibroblasts into induced pluripotent stem cells (iPSCs) with transcription factors such as OCT4, NANOG, SOX2, KLF4, LIN28, and C-MYC that are well known to contribute to the reprogramming of somatic cells into an iPSCs. Similar to chicken ESCs, iPSCs have properties of unlimited self-renewal in vitro and the capacity for differentiation to all three embryonic germ layers. Chicken iPSCs have been a useful tool for the production of transgenic birds and viral vaccines. Despite the benefits and multiple applications of chicken pluripotent stem cells, the propagation of these cells is limited and some important challenges should be eliminated before their use in vaccine manufacturing. It is necessary to define the appropriate culture conditions for chicken pluripotent stem cells. For example, the presence of endogenous viruses in the avian species should be evaluated for human vaccine production. Currently, primary chicken fibroblast cells are still mainly used for vaccine production. This review covers the resources to achieve chicken derived cell lines for vaccine manufacturing.

High incidence and mortality rate of pulmonary thromboembolism urge physicians to be aware of its occurrence and treatment. Pulmonary thromboembolism (PE) typically manifests itself with acute dyspnea and tachycardia and may occur along with deep vein thrombosis. However, syncope, chest pain and heart failure decompensation in previously stable patients might be another presenting signs and symptoms.  Although there are several guidelines about PE prophylaxis both in medical and surgical patients, guideline adherence is not good enough. The most important reasons are; inappropriate PE risk scoring, insufficient prophylaxis dosage and the fear of probable bleeding. Both unfractionated and low-molecular-weight heparin has been suggested as prophylactic agents. The role of echocardiography in the diagnosis of PE has been challenged; however, it is mandatory to do an echocardiogram to define the prognosis and also the proper treatment approach. Based on the severity of right ventricular dysfunction, biomarker levels and hemodynamic status of the patients, they will be categorized as low, moderate and high-risk. Moderate to high risk patients should be planned for more invasive treatments such as thrombolytic therapy. In conclusion, PE is the third common cardio-vascular acute condition after myocardial infarction and cerebrovascular accident. The most important reason for death in PE is right-side heart failure. Besides, PE is the most preventable fatal disease in hospitalized patients. Long hospital stay, inappropriate thromboembolic prophylaxis and baseline comorbidities predispose patients to this fatal event. Sometimes, the fear of probable bleeding precludes guideline-based thromboprophylaxis, especially in post-operative patients. If PE occurs; it will be hard to manage and treat. New oral anticoagulants are advised as fixed-dose which does not need to be closely monitored. Drug and food interaction is significantly lower in New oral anticoagulants (NOACs). Thrombo-prophylaxis is better than mechanical thrombo-prophylaxis. Post-discharge thromboprophylaxis is also advised in orthopedic patients. It is mandatory to advise patients to walk after discharge and avoid long-term bedrest if possible. A too early discharge may also be an important risk factor and prone patients to PE at home.

Background: Due to multiple roles of albumin in the body, injection of its medicinal product as one of the therapeutic or management strategies under conditions such as severe bleeding, burns, liver failure, and neonatal hemolytic diseases is on the physicians' agenda. Considering that albumin is the most abundant plasma protein, designing an appropriate method to purify it is highly important. There are several methods such as human plasma fractionation, chromatographic, or Salting-out methods for the isolation and purification of the human albumin. The present study investigates a direct and combined ion-exchange chromatography approach for purification of albumin from human plasma and compares the quality of the final products obtained by both ion-exchange chromatographic methods.
Methods: This study was carried out from January 2019 to October 2019 at the Blood Transfusion Research Center, High institute for research and education in transfusion medicine, affiliated with the Iranian Blood Transfusion Organization. For this study, 10 human plasma bags were randomly collected. After thawing, all 10 human plasma bags were pooled, and in order to separate cryo paste, it was centrifuged at 4000 g for 10 minutes at the temperature of 1 Centigrade degree. Then the obtained cryo poor plasma was used to purify the albumin protein by direct and combined methods of ion-exchange chromatography. The purity of the final products was compared by cellulose acetate electrophoresis and SDS-PAGE tests. The sample obtained by the combined approach was pasteurized and HPLC analysis was performed to investigate any polymer aggregates.

Background: Mycoplasma pneumoniae is one of the causes of upper and lower respiratory tract infections especially in children, and antibiotics affecting the cell wall do not affect this type of infection. This study aimed to evaluate the prevalence of Mycoplasma pneumoniae and macrolide resistance in children with community-acquired pneumonia in Kerman city.
Methods: This cross-sectional study was conducted in a selected teaching hospital in Kerman city from July 2018 to July 2019. Fifty-one children hospitalized in the pediatric ward were diagnosed with bacterial pneumonia acquired from the community. These children were included in the study by census method. The data collection tool was a standard checklist. The checklist was completed by parents. Pharynx and nasal swab samples were taken from all patients. PCR was used to identify mycoplasma.

Background: mechanical bowel preparation (MBP) is a common practice before laparoscopic gynecologic surgeries but the role and efficacy of preparation have been questioned. this study assesses visualization and bowel handling in a group of patients who receive MBP and the control group and thereafter; compares the results.
Methods: We designed and conducted this randomized, single-blinded and controlled trial on patients who underwent advanced gynecologic laparoscopic surgeries. This clinical trial was carried out between July 2020 and January 2021. The patients were enrolled from l the laparoscopic office. 120 women aged 18-65 years undergoing level 2 and 3 benign gynecologic laparoscopic surgeries were randomized to bowel preparation with a normal saline enema (n=60) or non-bowel preparation (n=60) groups. Our patients underwent level 2 and 3 of benign laparoscopic gynecologic surgeries with or without MBP. The visualization and bowel handling were assessed by the primary surgical team and a questionnaire was later obtained. The outcomes included intraoperative surgical view and bowel handling, preoperative and post-operative patient signs and symptoms. The patients were also assessed in respect to discomfort prior and after the surgery, this assessment was obtained using a questionnaire. The gathered data was analyzed using IBM’s SPSS v26 software.

Background: Fluctuations in blood pressure after induction of general anesthesia have played a significant role in complications of surgery. Therefore, the present study was performed by identifying the causes of blood pressure fluctuations after induction of anesthesia, predicting and preventing them.
Methods: For this study which is a retrospective cohort, data mining methods in the data set including the information related to 3150 patients who underwent anesthesia and surgery from April 2018 to September 2019 in Imam Khomeini Hospital in Kermanshah were used. The data set included patients aged 18 years and older (age range of 18 to 96) who underwent a general anesthesia induction test using Propofol and subsequently endotracheal intubation for non-cardiac surgery. If patients did not have intubation, data were missing, or patients underwent intubation after repeated trials, they got excluded. In total, 2640 patients were included in this analysis. Preoperative patient clinical information was collected from pre-anesthesia evaluation records. Intraoperative data were obtained from computer anesthesia records. This data from the patient monitoring system and the anesthesia machine was automatically stored in the anesthesia files, while drug doses and anesthesia techniques were recorded manually. The data were then pre-processed using SPSS software, version 26 (IBM SPSS, Armonk, NY, USA).

The vagus nerve (VN), the longest cranial nerve and an essential part of the parasympathetic system, connects the central nervous system to respiratory, cardiovascular, immune, gastrointestinal, and endocrine systems and is involved in the maintenance of homeostasis by controlling these systems. Vagus nerve stimulation (VNS) is related to any method that would stimulate the vagal nerve via electrical stimulation. VNS is a Food and Drug Administration (FDA)-approved treatment for medication-resistant depression, drug-resistant epilepsy, and migraine. However, VNS has also been studied for various other conditions, such as Alzheimer's disease and tinnitus, by targeting the VN in the neck and ear. Currently, there are two methods for VNS: a) invasive-VNS (iVNS), which requires surgical implantation of a pulse generator under the anterior chest wall, that is linked through a wire to an electrode cuff that wraps around a cervical vagus nerve, b) non-invasive transcutaneous VNS which is separated into cervical transcutaneous vagal nerve stimulation (ctVNS) and auricular transcutaneous vagal nerve stimulation (atVNS). The non-invasive transcutaneous VNS techniques are well tolerated and have no significant side effects, making them effective in clinical research for brain diseases. Because with these newer methods, the electrical stimulation is carried out through the skin.
The results of this study were collected using the advanced search in Scientific Information Database (SID), Google Scholar, PubMed, and Scopus between 2011 to 2021. Out of 671 articles surveyed, we used 53 articles in the study after the evaluation. Medical Subject Headings (MeSH) and Keyword Searching was carried out through the MeSH database. VNS has been shown to alter neural activity in multiple areas of the brain related to the regulation of the affective states. However, the precise mechanism of VNS action on the clinical consequences is still unknown. This study aimed to review the therapeutic effect of both methods of VNS in neuropsychiatric and neurological disorders such as depression, migraine, seizure, tinnitus and Alzheimer's disease and discuss several hypotheses on the mechanism of VNS, as a new approach, in the treatment of such disorders. It considers that a brain-mapping approach is needed to discover the therapeutic mechanisms of VNS in brain diseases.

Background: According to numerous research related to learning styles and also the difference of these styles in students, this study was designed in order to determine the status of learning styles in medical students in Iran.
Methods: This study was conducted as a systematic review and meta-analysis. Searching for articles in this study was done from September 24 to October 15, 2022 in databases: Proquest, PubMed, Iran medex, Scopus, Sid, Magiran, Google Scholar, Eric and medical education journals. The research environment of Iran has been Mashhad. Using the PICOTS model, the keywords: learning styles, clubs, medical students were used to search the mentioned databases. OR, AND operators and possible combinations of keywords were used when searching for articles in databases. The extracted articles were first evaluated in terms of the research title, then the abstract of the article, and finally the text of the article using the "PRISMA Checklist". In each stage, repetitive articles and articles that did not mention the percentage of learning styles were excluded from the study, and the articles that met the inclusion criteria were stored in the (EndNote software, version 20, Clarivate, USA), and at the end, 53 articles were analyzed.

Results: The results of the study showed that the most used learning styles among students of medical sciences in Iran was convergent learning style (32% with 95% confidence interval). In the investigation of the adaptive learning style in the fields of basic sciences during the years 2006 to 2021, the percentage of using this style increased and this trend was statistically significant (P=0.0078). Conclusion: According to the findings of the study, the most used learning style in medical sciences in Iran is convergent learning style, and considering the characteristics of convergent people, it is necessary to provide effective and efficient training in medical sciences to Students' learning styles should be given special attention so that training can be guided based on their learning styles.

Background: Breast cancer is the most common type of cancer in many countries, accounting for over 18% of all cancers in females. There are more than one million new cases of breast cancer each year. Most women diagnosed with breast cancer are over the age of 50, but younger women can also get breast cancer. About one in seven women are diagnosed with breast cancer during their lifetime. There's a good chance of recovery if it's detected at an early stage. In Iran, breast cancer is the most common cancer among women, making up 21.4% of all female cancers. The mortality rate of this cancer is 4.33 for every 100,000 people. The purpose of this research is to see how often different kinds of early breast cancer come back and how long people live after being diagnosed.
Methods: This retrospective study evaluated the medical records of 500 breast cancer patients at two hospitals in Mashhad, Iran during April 2006 to March 2016. We used SPSS software, version 16 (SPSS Inc., Chicago, IL, USA) to analyze data. A P value less than 0.05 means that the results are considered statistically significant.

Results: We included 230 women with breast cancer. The average overall survival was 130.7 months, with 83.2% of people surviving for five years and 78.8% surviving for 10 years. The stage of the disease is strongly linked to the recurrence (P=0.000). Additionally, the specific type of disease is also strongly related to disease recurrence (P=0.01) or metastasis (P=0.01). Patients who have the triple-negative subtype had the highest chance of the cancer spreading and recurrence compared to patients with other subtypes. Conclusion: The different types of breast cancer are strongly linked to the disease recurrence or metastasis. Patients with triple-negative subtypes had the most cases of cancer spreading to other parts of the body and coming back again, compared to other subtypes. Our findings also showed that patients with the triple-negative disease had the worst overall and disease-free survivals.

Background: The success of labor induction depends on the condition of the cervix at the time of delivery. This study examines the effect of labor induction with an intra-cervical Foley catheter and oxytocin compared to a Foley catheter and misoprostol on cervical preparation and delivery rate in the first 24 hours after induction.
Methods: In a randomized clinical study, pregnant women with a singleton pregnancy and a gestational age of more than 40 weeks, with a Bishop score less than 4 and an intact amniotic sac referred to Umm al-Binin Hospital in Mashhad from 2017 to 2018 were included in the study. They were randomly divided into two groups of Foley catheter and oxytocin (1) or Foley catheter and misoprostol (2). In the first group, immediately after placing the Foley catheter; Oxytocin was started with a dose of 2 milliunits per minute, and every 20 minutes, 2 milliunits were added to reach the maximum dose of 30 milliunits per minute (induction method with a low dose). In the second group, after Foley catheter insertion, sublingual misoprostol was prescribed at a dose of 25 micrograms every 4 hours up to a maximum of 6 doses.

Results: 74 pregnant women were randomly evaluated in two groups of 37 people. There is no statistically significant difference in the demographic variables in the two groups. There was a significant difference in the labor rate in the first 24 hours, and it was higher in the oxytocin group (P=0.009). Bishop's score after 24 hours of induction was not significantly different in the two groups. Reaching the active phase was significantly shorter in the oxytocin group. (P=0.01). The time of catheter removal in both groups and the rate of cesarean section and the occurrence of complications were the same in both groups. Conclusion: The use of oxytocin with a Foley catheter inside the cervix can accelerate the preparation of the cervix and increase the chance of labor in the first 24 hours, but it does not affect labor complications.

Methods: The present research was conducted from September 2022 to March 2023 in the specialized physical training laboratory of Ferdowsi University of Mashhad. The statistical population was twenty one adult male Syrian mice with an average weight of twenty three grams. The sports activity protocol was adopted for fifty-six days using the special video recorder for rodents. The intense interval training program was carried out in the form of ten one-minute repetitions and two-minute active rest, so that the total daily training time for each person was thirty minutes.The vaccination protocol includes the daily vaccination of somatropin injected intraperitoneally. Results: The PGC1α levels were significantly higher in both the HIIT (P=0.02) and H- GH (P=0.03) groups collationed to the witness team. Moreover, the levels of SOD were considerably increased, in both the HIIT (P=0.05) and H-GH (P=0.005) team s compared to the witness team. Moreover, the levels of MDA were considerably decreased, in both the HIIT (P=0.007) and H-GH (P=0.04) teams compared to the witness team. The decrease in insulin resistance was significant only in the HIIT (P=0.05) team compared to the witness team and slightly increased in the H-GH (P=0.36) team but was not considered. The difference between HIIT and H-GH team (P=0.03) was also significant.The proportion of ALT/AST in both HIIT (P=0.02) and H-GH (P=0.03) teams had a significant decrease compared to the witness team. LDL/HDL proportion evidenced considered decrement at just in the HIIT team (P=0.01). Conclusion: Intense intermittent sports activity was able to produce a more optimal response compared to GH peptide in improving NAFLD-related indices. Injection of this hormone single may have adverse outcomes on some indexes of this abnormality.

Conclusion: High body mass index of the mother and weight gain during pregnancy can cause complications in the mother and the fetus. Therefore, prenatal care should be done more carefully and health care providers should place mothers who have abnormal body mass index and inappropriate weight gain in pregnancy in the high-risk group and under special care to minimize maternal and fetal complications.

Background: Choosing a specialty in medicine is an important decision for the individual. It is also important decision for the health system. This study aimed to investigate the factors affecting the interest of specialized assistants to continue studying in subspecialized fields.
Methods: This descriptive cross-sectional study investigated the factors affecting the interest of 261 specialized assistants to continue their studies in subspecialized fields from March 2021 to March 2022. All the specialized assistants of Kerman University of Medical Sciences (KMU), whose assistantship continued until the end of March 2022, were included in the study by census method. The data collection tool was a 4-part questionnaire. 1) demographic information including 13 questions (age, gender, marital status, city where the family lives, place of residence to complete the residency course, specialized field, level of education, grade point average, parents' education, parents' occupation and having first-degree relatives with subspecialized degrees), 2) the willingness or unwillingness to continue studying in subspecialized fields and the field of interest, 3) the reasons for the assistants' interest in continuing their education, included 14 questions, and 4) the reasons for the assistants' lack of interest in continuing their education, included 14 questions.

Results: The average age of the assistants was 31.53±3.90 years old. Most of the assistants were women (57.9%). 57.5 percent of the assistants were interested in continuing their studies in subspecialized fields. The most important reason for residents' interest in continuing their studies was "increasing practical-clinical knowledge" (80.1%). The most interest in continuing education was observed in internal assistants (17.33%). The assistant's age, specialist field and having first-degree relatives with a subspecialist degree had a significant relationship with the interest of the assistants to continue studying in subspecialist fields. Conclusion: The results showed that a significant percentage of assistants were interested in continuing their studies in subspecialized fields. Age, the assistant's specialty and having first-degree relatives with a subspecialist degree had a significant effect on this interest.

Background: Postoperative nausea and vomiting (PONV) is a common challenge in cesarean surgeries, on the other hand, the use of dexamethasone has been proposed as an effective prophylaxis in the management of these complications. This study evaluated the effect of dexamethasone in reducing PONV.
Methods: This study was conducted as a randomized and double-blind clinical trial from April 2022 to September 2023 at Razi Hospital of Jundishapur University of Medical Sciences, Ahvaz. Elective cesarean section patients under spinal anesthesia were divided into two groups of 30 people. In this research, there were two groups: a group that received 0.1 mg/kg dexamethasone (Iran company) and a placebo group that received normal saline. The injections were done before the start of anesthesia, and both groups had received 500 cc of normal saline serum before drug injection. During the surgery and after that at specific time intervals, parameters such as blood pressure, heart rate, and the occurrence of nausea and vomiting were recorded through the V&N scoring table and shivering through the shivering scoring table. Recorded 1/2/4/6/12 after surgery.

Results: In this study the investigated variable is postoperative nausea and vomiting (PONV), since the investigated variable is a qualitative/nominal variable, to calculate the sample size from the formula P1- P2 ∕√P(1-P) used. The significance level of the tests is considered to be less than 0.05 and data analysis was done with SPSS type 23 software. Although no significant difference was observed between dexamethasone and placebo in the first hour after the operation, in the following hours, dexamethasone significantly reduced nausea and vomiting, on the other hand, heart rate and blood pressure decreased faster in the groups receiving dexamethasone. Conclusion: Dexamethasone is significantly effective in reducing nausea and vomiting after cesarean surgery. It also has a positive role in reducing the heart rate and blood pressure and This drug is particularly effective in controlling complications after spinal anesthesia after the operation.

Results: The average age of patients was 59.59±11.75 and most of them (74.3%) were women. Most patients (75.71%) with a normal to mild FIB-4 index stage had a normal to mild elastography stage. of patients had normal to mild liver fibrosis. FibroScan grade were not related to the age, gender, body mass index, methotrexate dose and duration of the disease (P>0.05). The average FIB-4 was 1.25±0.6, which was not significantly related to gender, body mass index, disease duration and methotrexate dose but directly related to the age of patients (P<0.001, (CL95%, 0.51-0.53)).The correlation between FIB-4 and FibroScan grade of the patients showed a positive association, which was not statistically significant (P=0.594, r=0.06, CL95%, -0.24-0.4). The FIB-4 in normal to mild grade was 85% rejecting the moderate to severe grade in FibroScan but none of them were statistically significant (P=0.146). Conclusion: Overall, the FIB-4 was incapable of predicting the FibroScan result. On the contrary, this case was also inconclusive and the results of FibroScan did not justify FIB-4 results of the patients. The FIB-4 cannot replace in RA patients. It is recommended to conduct future studies with a larger sample size in RA patients.

Background: Although the respiratory system is the main element involved in the disease of COVID-19, nevertheless, there are reports of the involvement of other organs and their lesser symptoms. This study was conducted with the aim of investigating the frequency of gastrointestinal symptoms in patients with COVID-19.
Methods: This cross-sectional descriptive study was conducted on all patients diagnosed with COVID-19 hospitalized in Imam Khomeini Hospital from April to September 2021 by census method. The data was collected using a checklist that included demographic information. After the data was collected, it was entered into SPSS software, version 18 (IBM SPSS, Armonk, NY, USA) and analyzed with the help of descriptive statistics.

Results: In this study, the results showed that out of 2580 hospitalized patients, 54% were women and 46% were men. And the average age of the patients was 58.67±17.68. The highest frequency of people was in the age range of 40-59 years (925 people). 64% of patients had at least one gastrointestinal symptom, Each of the symptoms had a different prevalence, Anorexia 40% with a preference for men (57%) and the highest frequency in the age range of 40-59 years (430 people), gastrointestinal bleeding 10% with a preference for men (80%), And the highest frequency in the age range of 60-79 years (112 people), abdominal pain 8% with preference for women (65%) with preference for frequency in the age range of 40-59 years (65 people), vomiting 3% with preference for women (51%) with abundance in the age range of 80-99 years (58 people), diarrhea 1.5% with preference in men (51%) with abundance in the age range of 60-79 years (18 people) and constipation in 0.2% with preference Women (67%), all of whom were over 60 years old. Conclusion: The findings of this study showed that the COVID-19 disease can not only involve the respiratory system but also the digestive system in the course or beginning of the disease.

Results: In the study of baseline variables in the elderly with and without pain with diabetes, it was found that women reported more pain with 54.4% than men with 45.6% that there is a significant difference between the two sexes (P=0.0001). Education level was also associated with having pain so that 67.8% of the elderly with having pain were illiterate and this relationship was significant (P=0.006). 82.5% of the elderly with higher physical activity had less pain than the elderly with less physical activity. This indicates the effect of physical activity in reducing pain and the observed relationship was significant (P=0.001). Triglyceride levels and history of underlying disease were lower in painless elderly (P=0.009 and P=0.002). Physical activity in the elderly without pain was higher than the elderly who had pain and this significant difference was reported (P=0.002).
Conclusion: The results of this study indicate a high prevalence of chronic pain in the elderly in Amirkola. In the elderly without chronic pain, there were lower triglyceride levels, more physical activity and fewer underlying diseases. Attention to chronic pain features among elderly to identify vulnerable groups and providing better care can increase the quality of life in this group.