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Introduction: Infection due to hepatitis B virus (HBV) could be due to wild or mutant viruses. The HBeAg negative chronic hepatitis B (HbeAg-CHB) is unable to produce hepatitis B, e antigen (HbeAg), so that patients with this varient do not present with HBV characterized by HbcAg in the serum. HbeAg-CHB usually proceeds to serious liver disease. The prevalence of different viral forms in patients with chronic liver disease in Iran has not been established.
Materials and Methods: Seventy-six Hamadanian patients with over 6 months HBSAg positivity were enrolled. Patients with co-infection of HIV, HCV, past history of alcoholism, fatty liver, using of hepatotoxic drugs, autoimmune hepatitis and other metabolic liver disease were excluded. All patients were screened for Hhe Ag. HbeAb. HBV DNA by PCR, AST, ALT, ALK. pH and bilirubin.
Results: Eleven (14.5%) patients had HheAg-CHB (HbsAg +ve, HbeAg-ve / ve/anti HbeAb + ve, HBV DNA + ve and elevated AST, ALT) and 6 (8%) had normal transminases (AST and ALT) accompanied by the remaining criteria of HbeAg-CHB. 59 patients (77.5%) were infected with wild type HBV, ie: HBSAg + ve, HbeAg-ve, HbeAb + ve, HBV DNA- ve, and normal AST, ALT.
Conclusion: Frequency of HbeAg.CHB in Hamadan is 14.5% knowing of this varient of chronic hepatitis B is important since the HbeAg-CHB have worse prognosis than wild type and more better response to lamivudine than interferon.

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Introduction: Peptic ulcer is a mucosal lesion of stomach or deodenum in which acid and pepsin play major pathogenic roles. In general population, Helicobacter pylori (HP) plays an important role in peptic ulcer. Peptic ulcer is more common in chronic renal failure (CRF) but its etiology is unknown. Materials and methods: In a descriptive cross-sectional study, the prevalence of peptic ulcer in CRF patients was studied and its relationship with HP was evaluated. All patients were visited in Tajrish shohada hospital, Tehran. CRF was defined as a serum ceratinin concentration equal or more than 2 mg/dl at least for 3 months. Patients who stressful conditions, or were recieved immunosuppressive or NASID drugs, or drugs for eradication of HP were excluded. Upper GI endoscopy was performed for all patients by gastroentrologists to find out peptic ulcer. Biopsy was taken for HP identification by rapid ureas test. Results: The mean age of participants was 56 year and 51% of them had GI symptoms. Nineteen of 98 patients with CRF (19%) had peptic ulcer. That 5 of them were positive HP. HP was identified in 45 (46%) of patients. Conclusion: This study showed that HP is not more prevalent in CRF patients compared to general population. Additionally, peptic ulcer was more common in male patients with CRF than non-CRF subjects.

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Introduction: Hidden hepatitis B is a condition in which the surface antigen of hepatitis B in the patient's serum is negative but the DNA of the hepatitis B virus is detected in the serum or liver tissue. In this study, the prevalence of latent hepatitis B in chronic hepatitis C patients and their biochemical and histological changes were investigated.
method: In this descriptive study, target sampling was performed so that 27 chronic hepatitis C patients whose HBsAg was negative and during 2001 and 2002 to two hepatitis centers of Tehran and Research Center for Gastrointestinal and Liver Diseases of Shahid University of Medical Sciences Beheshti came in and underwent liver sampling. On the hepatic paraffinic block of these patients, polymerase chain reaction tests were performed for the presence of HBVDNA, as well as immunohistochemical tests for the presence and detection of HBsAg and central hepatitis B antigen.
Results: Of the 27 PCR samples examined, patients reported positive HBVDNA in 5 cases (19%). In all of these patients, IHC tests were reported to be negative for HBsAg and HBcAg. Histological changes of cirrhosis and irreversible cirrhosis symptoms were seen only in the HBVDNA group.
Conclusion: The prevalence of latent hepatitis B is relatively high in patients with hepatitis C. In these patients, latent hepatitis B can exacerbate liver damage and accelerate the progression of cirrhosis.

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Introduction: Chronic and relapsing abdominal pain is one of the most common reasons that bring children to pediatric clinics. About 20% of these children are suffering from idiopathic hypercalciuria. Since Hydrochlorothiazide is effective in relieving hypercalciuria, we assessed its effects on reducing these relapsing pains in girls with idiopathic hypercalciuria. Materials and Methods:In this single blind clinical trial study, 100 girls, aged 5-12 years old, with chronic relapsing abdominal pain and hypercalciuria were divided to two groups by random block design. All children and their parents were trained about consuming plenty of liquids and decreasing salt in foods. In addition to these measures, Hydrochlorothiazide (1 mg/kg/day) was also administered to children in the case group. The control group was assessed for the number of abdominal pain episodes for 3 months following the commencement of the diet and the case group for 3 months after becoming normocaciuric. The results were analyzed by T-test. Results: The mean number of pain episodes in Hydrochlorothiazide group in the first, second, and third months were 0.38, 0.4, and 0.26 respectively much lower than the corresponding months in the control group which were 1.60,1.94, and 1.84 in that order (p<0.001). Conclusion: It seems that single dose daily Hydrochlorothiazide is a safe and effective drug in the treatment of chronic relapsing abdominal pain in children with idiopathic hypercalciuria.

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Background: Nucleostemin plays a critical role in controlling proliferation and self-renewal of stem cells and cancer cells. Thus, inhibition of nucleostemin expression could be a potent therapeutic approach in cancer treatment. In the present study, the effects of nucleostemin gene silencing in K562 cell line were studied. Materials and Methods: In this experimental study, after transfecting NS-specific siRNA into K562 cells, changes in nucleostemin gene expression pattern were determined by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Trypan blue exclusion test, MTT assay, and fluorescent microscopy were used to evaluate the growth inhibition and apoptosis of K562 cells, respectively. Flow-cytometery was utilized for evaluating the effects of nucleostemin gene silencing on cell cycle. Results: The results showed the high expression of nucleostemin gene in K562 cells. NS-siRNA transfection into K562 cells at 200 nM inhibited the nucleostemin mRNA level up to 55% after 48 hours when compared to corresponding control cells. Forty eight hours after transfection, the cell growth decreased up to 33.7%. In addition, the silencing of nucleostemin induced G1 cell cycle arrest. Furthermore, fluorescent microscopy assays indicated that apoptosis occurred 48 hours after silencing nucleostemin gene expression. Conclusion: Noticing the potent growth inhibitory and apoptotic effects of nucleostemin siRNA in human myeloid leukemia K562 cells, silencing this gene can be a potential target for inhibiting K562 cells as the stem cell model of chronic myeloid leukemia.

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Background: A lot of research has been done on the post-traumatic stress, but few studies have investigated the effect of chronic stress disorders on physical and psychological health. This study investigated the combined interactive effects of chronic stress disorders and mental disorders on somatoform disorders reporting among employees at Isfahan Steel Company. Materials and Methods: In this correlational study, 189 employees in Isfahan Steel Company wwere selected according to the stratified random sampling method and completed demographic characteristics, chronic stress disorders of Cohen, Karmark, and Mermelstein, and mental disorders and somatoform disorders of Barling, Loughlin, and Kelloway questionnaires in 2011. Data were analyzed using Pearson correlation coefficient and hierarchical regression. Results: Results showed significant internal correlations among chronic stress disorders, mental disorders, and somatoform disorders (p<0.01). In addition, by controlling for demographic variables, the results of hierarchical regression analysis showed the interactive effect of chronic stress disorders and mental disorders on reporting somatoform disorders to be significant (p<0.05). Conclusion: This study showed that chronic stress disorders have a positive relationship with reporting somatoform disorders both in experiencing and not experiencing psychological disorders however, this relationship was stronger when employees in addition to chronic stress disorders experienced psychological disorders.

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Background: Nucleos(t)ide analogues, such as lamivudine and adefovir, are effective drugs for treatment of hepatitis B patients. However, long-term treatment with these drugs leads to the emergence of the nucleos(t)ide analogue resistant strains. The impact of nucleos(t)ide analogues on the emergence of HBsAg escape mutations is not clarified. Hence, the aim of this study was to determine HBsAg escape mutations in chronic hepatitis B patients treated with nucleos(t)ide analogues. Materials and Methods:A cross-sectional study was performed on 50 patients with chronic hepatitis B under treatment with nucleos(t)ide analogues (lamivudine and/or adefovir) and 50 naive chronic hepatitis B patients. HBV DNA was extracted from plasma and S gene of virus was amplified by Nested-PCR followed by direct sequencing. HBsAg gene sequence of the samples was evaluated for detection of HBsAg escape mutations. Results: Among the 100 patients, the following HBsAg escape mutations were identified: sQ101H, sG119R, sP120S, sP127S, sA128V, sG130N, sG130R, sT131I, sM133I, and sY134N. The frequency of HBsAg escape mutations in patients under treatment of nucleos(t)ide analogues was 16% and in naïve patients was 6% (p=0.2, OR=2.98). Conclusion:According to the obtained results, there seems to be no association between using nucleos(t)ide analogues and emergence of HBsAg escape mutations.

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Background: Brucellosis is a highly contagious zoonotic disease between humans and animals known for high frequency of relapsing and ability to cause chronic infection. The function of immune system plays an important role in induction of chronic diseases. However, the role of immune system response is not completely studied. Therefore, this study designed to investigate the cytokine profile of the patients suffering from chronic and acute brucellosis.

 Materials and Methods: This descriptive- analytical study was performed on 22 patients with acute brucellosis (mean age 38±17), 21 patients with chronic brucellosis (mean age 43±10) and 21 healthy people (mean age 26±4) with the same age and sex as patients. The serum IFN-&gamma, IL-17, IL-5 and TGF- &beta levels were measured using ELISA method.

 Results: The mean IFN-&gamma serum level in acute and chronic brucellosis patients group was significantly higher than control group (p=0.045). The mean IL-17 serum level in acute brucellosis patients was significant decreased once compared with control group and in chronic patients was significantly decreased when compared with control group (p=0.024). In addition, the mean IL-5 and TGF-&beta serum levels of acute brucellosis patients group were significantly decreased as compared to chronic patients (p=0.001).

 Conclusion: The results of current study indicate that cytokine profile of chronic brucellosis patients is more related to Th2 immune response. Hence, Th2 immune response inhibition would be an appropriate way to treat and prevent disease to become chronic.

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Background: Hydatid disease is a zoonotic infestation by a tapeworm of the genus of Echinococcus that characterized by cystic lesions in the liver and lungs but rarely in other parts of the body.

Case: Known case of chronic Lymphocytic leukemia was a 56-years old man with several hydatid cysts of liver and lungs that was hospitalized because of ascites and abdominal pain. The patient received albendazol and surgical operation with diagnosis of peritonitis and complicated hydatid cyst in lungs and liver and Peritoneum. Patient expired with DIC and sepsis.

Conclusion: This case report provides evidence that complicated hydatid cysts in immunocopromised patients have a bad prognosis and can not be safely treated by medication and surgery.

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  Background: In spite of designing and applying an effective vaccine against Hepatitis B virus (HBV), chronic infection with this virus is still one of the most important health problems worldwide. Host genetic background including single nucleotide polymorphisms play a significant role in chronicity or clearance of the infection. The final product of programmed cell death 1 gene (PDCD1) is expressed frequently on T-cells and in chronic viral infections, prevent the virus-specific T-cell response against the virus. In this study, the association of a single nucleotide polymorphism (+7146A/G) in intron 4 of PD1 gene with chronic hepatitis B infection in Iranian population has been assessed.

  Materials and Methods: 212 chronic HBV patients and 208 healthy controls were analyzed in this case-control study. Genomic DNA of the studied individuals was extracted and after performing polymerase chain reaction (PCR), polymorphism of +7146 was determined via RFLP method.

  Results: Frequencies of GG, GA and AA genotypes on position 7146 of the intron 4 of PD1 gene were 77.4%, 20.7% and 1.9% in patient group and 80.8%, 15.4% and 3.8% in control group, respectively. After statistical analysis, No significant difference was observed between patient and control groups (p=0.198).

  Conclusion: Genotype frequencies in the studied population are in accordance with the results of previous studies. Results of the present study suggest that there is not any association between A/G single nucleotide polymorphism in intron 4 of PD1 gene and susceptibility to chronic hepatitis B in Iranian population.

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Background: Hepatitis B virus (HBV) is a member of hepadenaviridae family, which is infectious for humans and a few animal species. Successful clearance and elimination of infection from the body or development of HBV infection to chronic disease depend on the host genetic background in immune system genes. Interleukin-12 (IL12) and also Interleukin-12 Receptor B1 (IL 12 RB1) are the key factors in the spontaneous clearance of viral infections, especially HBV. The aim of the present research is to investigate the association between Interleukin-12 receptor B1 gene polymorphism (rs11575934 A/G) and susceptibility to chronic Hepatitis B virus infection.

Materials and Methods: In this case-control study, genomic DNA of 150 chronic HBV infected patients and 150 healthy controls were extracted from peripheral blood cells. Single nucleotide polymorphism (rs11575934 A/G) was genotyped using polymerase chain reaction/restriction fragment length polymorphism (PCR-RFLP).

Results: The frequency of GG, AG, AA genotypes was 6.7%, 40.7%, and 52.7% in chronic patients and 12.7%, 41.3%, and 46% in control group, respectively. No statistically significant difference between case and control groups has been observed (p=0.176).

Conclusion: In the present study, no significant correlation between rs11575934 A/G single nucleotide polymorphism of the IL12RB1 gene and susceptibility to chronic hepatitis B virus infection has been observed. According to the study, this polymorphism does not affect the susceptibility to chronic HBV infection.

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Background: Brucella is an intracellular bacterium that causes chronic infection in humans and domestic animals. The underlying mechanisms that cause prolonged illness are complex and not fully understood. Immune responses may have an important role in the chronicity of infection. Here, we evaluated the lymphocyte proliferation responses in patients with chronic and acute brucellosis.

Materials and Methods: This descriptive - analytical study was performed on 22 patients with acute brucellosis, 21 patients with chronic brucellosis and 21 healthy people with the similar age, sex and genetic background as control group. Peripheral lymphocytes were isolated using Ficoll and the cellular proliferation was quantified in presence of antigen and phytohemaglutinin-A by MTT method.

Results: The brucella antigen-specific stimulation index in patients with chronic brucellosis was significantly lower than the acute brucellosis patients (p=0.001). Also, stimulating the lymphocytes with phytohemaglutinin-A has shown that proliferative response in patients with chronic brucellosis was lower than the other groups (p=0.04).

Conclusion: The results indicated that chronic brucellosis inhibits lymphocyte proliferation. This inhibition of lymphocyte proliferation may be due to the induction of anergy.

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Background: Chronic kidney disease as an important risk factor is associated with some disorders which are key causes of death and disability in older people. Therefore, the aim of this study was to assess the combined effect of regular aerobic exercise with garlic extract on renal apoptosis regulatory factors in aged rats with chronic kidney disease.

Materials and Methods: In this experimental research, 42 aged male Wistar rats(48-52 weeks) were selected and randomly divided into 6 groups: control, doxorubicin, doxorubicin-salin, doxorubicin- garlic, doxorubicin - exercise, doxorubicin –garlic-exercise(combined). Chronic kidney disease was induced by a single subcutaneous injection 8.5 mg/kg of doxorubicin. Swimming training was programmed 3 days /week, 30 min/day for 8 weeks. Both the doxorubicin garlic and combined groups with garlic extract were administered by garlic gavage at a dose of 2.5 g/kg. The renal Bax and Bcl-2 levels were evaluated by ELIZA method. A one-way analysis of variance was used to data analysis (p<0.05).

Results: The results showed that induced chronic kidney disease was associated with a significant increase on Bax and a decrease on Bcl-2 in aged rats. Also, 8 weeks swimming training, garlic supplementation and the combined intervention significantly reversed these changes. Furthermore, no significant difference have been observed in the effect of these interventions on Bax and Bcl-2 in aged rats with chronic kidney disease.

Conclusion: It seems that the use of non-pharmacological treatment methods such as exercise training, garlic extract supplement, and combination of the both interventions may be effective in reducing apoptosis resulted from chronic kidney disease in aged rats.

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Background: Parvovirus 4 (PARV4) was first discovered in 2005, in a hepatitis B virus–infected injecting drug user (IDU). To date, the best evidence about PARV4 transmission is parenteral roots and comes from IDU individuals. It seems that the prevalence of the virus in the normal population is very low. In this study, we investigated the prevalence of PARV4 virus among patients with chronic HCV infection compared with healthy controls and related risk factors among these groups.

Materials and Methods: A total of 206 patients, including 103 patients with chronic HCV infection and 103 healthy controls, were studied by use of nested-PCR and also real-time PCR techniques.

Results: AST enzyme levels with a mean of 40.45+34.84 and 18.58+5.9 in patients and healthy group respectively and the amount of enzyme ALT among patients with a mean of 40.45+35.75 and 21.50+11.35 in patients and healthy group respectively, were reported. Finally, after screening all DNA samples from patients and controls, we discovered that none of these people are infected with the PARV4 virus.

Conclusion: This study is the first to investigate the occurrence of PARV4 among HCV patients in Iran. The results show that, the virus is not important in Iranian population, even in patients with blood born infections such as HCV and further studies in other areas and various groups are required.

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Introduction: Since dermatologic diseases are relatively high prevalent in the society and are associated with various psychological consequences, the present study was conducted to compare the difficulties in emotion regulation, psychological flexibility and quality of life in dermatologic patients with Lichen Simplex Chronicus and normal population.
Methods: The study design was causal-comparative, and the statistical population included all men and women with dermatologic diseases who referred to skin clinics in Tehran, Karaj and Qom cities. A convenience sampling method was employed to select 199 patients as the study sample. In addition, for the comparison group 200 normal individuals were selected from normal population. All participants assessed by the Difficulties in Emotion Regulation Scale (DERS), Acceptance and Action Questionnaire-II (AAQ-II), and Short Form-36 Quality of Life (SF-36). Data were analyzed by Multivariate Analysis of Covariance (MANCOVA). This study was approved by Research Ethics Committee of University of Kurdistan (Code: IR.UOK.REC.1401.015).
Results: Results showed that there was significant difference between two groups in terms of difficulties in emotion regulation, psychological flexibility and quality of life. The mean scores of difficulties in emotion regulation scale and psychological flexibility were higher in the patient group and lower in quality of life than the healthy group.
Conclusions: According to the present results, psychological factors of emotional dysregulation and psychological inflexibility may play a role in the persistence of skin problems of Lichen Simplex Chronicus. Since psychological underlying factors are often involved in the development and maintenance of dermatologic diseases, it is suggesting to use psychological interventions for these patients at the same time.