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1.  Hyperhomocysteinemia as a potential contributor of colorectal cancer development in inflammatory bowel diseases: A review 
Homocysteine is an amino acid generated metabolically by the S-adenosylmethionine-dependent transmethylation pathway. In addition to being a well-known independent risk factor for coronary heart disease, is also a risk factor for cancer. Patients suffering from inflammatory bowel diseases (IBD) including ulcerative colitis and Crohn’s disease are at increased risk of developing colorectal cancer in comparison to healthy individuals. Furthermore, the risk of hyperhomocysteinaemia is significantly higher in IBD patients when compared with controls. In the present article, we review the mechanisms in which hyperhomocysteinemia may contribute to increased risk of colorectal cancer in IBD patients.
PMCID: PMC4306151  PMID: 25632180
Hyperhomocysteinemia; Colorectal cancer; Inflammatory bowel disease
2.  Consumption of spicy foods and the prevalence of irritable bowel syndrome 
AIM: To explore the association between consumption of spicy foods and prevalence of irritable bowel syndrome (IBS) among Iranian adults.
METHODS: In this cross-sectional study, data from 4763 Iranian adult participants were used. Consumption of spicy foods was estimated using a dietary habits questionnaire that included a question on spicy foods consumption: “how frequently do you use spicy foods (pepper, curry, ginger, cinnamon and turmeric) during a week?” Participants could respond to the question by choosing one of these choices: never, 1-3 times, 4-6 times, 7-9 times, or more than 10 times per week. A modified Persian version of the Rome III questionnaire was used to determine the prevalence of IBS.
RESULTS: IBS was prevalent in 21.7% (18.6% of men and 24.1% of women) of the study population. After controlling for potential confounders including dietary behaviors, those consuming spicy foods ≥ 10 times per week were 92% more likely to have IBS compared with those who never consumed spicy foods (OR = 1.92; 95%CI: 1.23-3.01, Ptrend < 0.01). The association remained significant even after taking lactose intolerance into account (OR = 1.85; 95%CI: 1.18-2.90, Ptrend < 0.01). Stratified analysis by gender revealed that the association between consumption of spicy foods and IBS was not significant in men; however, a significant association was found among women after taking potential cofounders, including meal regularity and lactose intolerance, into account. Women who consumed spicy foods ≥ 10 times per week were two times more likely to have IBS compared with those who never consumed spicy foods (OR = 2.03; 95%CI: 1.09-3.77, Ptrend = 0.02).
CONCLUSION: Consumption of spicy foods is directly associated with IBS, particularly in women. Further, prospective studies are warranted to (1) examine this association in other populations; and (2) evaluate whether dietary interventions, for example a reduction in spice consumption, would improve IBS symptoms.
PMCID: PMC3801318  PMID: 24151366
Spice; Diet; Condiments; Red pepper; Irritable bowel syndrome; Functional gastrointestinal disorders
3.  Bloating in Iran: SEPAHAN Systematic Review No. 4 
Bloating is a common and bothersome gastrointestinal symptom. Despite its high prevalence, associated costs, and effects on the quality of life, very few studies have reported the epidemiology of bloating in Iran. Through this systematic review, findings and limitations of the current research will be discussed.
In March 2012, we searched PubMed, Google Scholar, Scientific Information Database, IranMedex, and Magiran to find articles for inclusion in the study. Two of the authors screened the articles on the basis of titles and abstracts. The full manuscripts of these publications were then evaluated according to the predefined criteria.
Fifteen articles were included in the study, and data regarding the prevalence of bloating were extracted. The studies depict a prevalence of 1.5% to 8.8% for bloating in the Iranian population. Two studies reported the prevalence of functional bloating to be 1.5% and 10% according to the Rome III and Rome II criteria, respectively. Female to male ratio remains ≥1 for most of the studies criteria.
In Iran, data on the prevalence of bloating are limited, and have mostly been gathered from a highly selective population. The results of the present study advocate the necessity to perform further studies on the general population, which may help health policy makers in the allocation of the appropriate resources.
PMCID: PMC3399290  PMID: 22826767
Bloating; abdominal distension; epidemiology; Iran; systematic review
4.  Dyspepsia in Iran: SEPAHAN Systematic Review No. 3 
Dyspepsia is an upper gastrointestinal tract syndrome presenting epigastric pain and discomfort, fullness sensation, early satiety, nausea, vomiting, and belching. The prevalence of dyspepsia has been reported to be high all over the world. In this study, we reviewed studies reporting the prevalence of dyspepsia in Iran and discussed the probable risk factors of dyspepsia to shed light on future research on this topic.
The four electronic databases of PubMed, Google Scholar, IranMedex, and Scientific Information Database were searched. The keywords for the electronic search were “dyspepsia” and “Iran”. A manual search of the reference lists of the selected articles was also carried out. Two reviewers reviewed and identified articles independently and selected relevant studies based on our inclusion and exclusion criteria.
Nine articles reporting the prevalence of dyspepsia in Iran were included. The reported prevalence ranged from 2.2% to 29.9%. The majority of studies have reported the prevalence of dyspepsia to be higher in women.
Dyspepsia seems to be highly prevalent in Iran. Considering the wide range of data reported in different studies, conducting further population-based studies is necessary to investigate the epidemiology and risk factors of dyspepsia among Iranians.
PMCID: PMC3399299  PMID: 22826763
Dyspepsia; epigastric pain; dyspepsia prevalence; Iran
5.  Constipation in Iran: SEPAHAN Systematic Review No. 5 
Constipation is physically and mentally troublesome for many patients and has adverse effects on their quality of life. The aim of the present study was to systematically review previous studies on the epidemiology of constipation in Iran.
Bibliographic databases including PubMed, Google Scholar, and Iranian databases including Scientific Information Database, Iran Medex, and Magiran were searched to select studies that reported the prevalence of constipation in Iran.
Overall, 10 articles met the inclusion criteria of the current study. The prevalence of constipation in Iran ranged from 1.4-37%, and the prevalence of functional constipation was reported to be 2.4-11.2%. Gender, age, socioeconomic status and educational level seem to have major effects on this condition.
The prevalence of constipation is high in Iran. There are very few data available regarding the natural history, quality of life and risk factors of constipation in our country. Conducting population-based studies is necessary to explore different epidemiological aspects of constipation in Iran.
PMCID: PMC3399301  PMID: 22826768
Constipation; epidemiology; Iran; systematic review
6.  Irritable Bowel Syndrome in Iran: SEPAHAN Systematic Review No. 1 
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder. Due to its high prevalence and absence of curative therapy, IBS has the potential to create tremendous burden on the health care system. Herein, we systematically reviewed the published literature to investigate the epidemiology of IBS in Iran.
Studies that were reviewed in this article were primarily identified through four online bibliographic databases including PubMed, Google Scholar, Iran Medex, and Scientific Information Database. Manual search of reference lists was carried out to identify any additional studies such as relevant abstracts and also recent review articles which may have been missed. Potentially related studies were retrieved and the selection criteria were applied. Eligible articles were reviewed.
From 4176 studies identified, 18 eligible studies were included. It was reported that in Iran, the prevalence of IBS was in the range of 1.1% to 25% and was more common in women. In addition, the difference in frequency of different age groups was minimal. There was a minimal difference in IBS prevalence within different age groups.
In Iran, the incidence of IBS was in the wide range. Since there are not enough population-based studies, researchers should focus on developing well-designed population-based studies to determine the epidemiology of IBS in Iran. Moreover, cohort studies should be conducted in order to investigate the natural history of IBS. Investigating the etiology of IBS and attempt to organize health promotion programs are highly suggested.
PMCID: PMC3399304  PMID: 22826748
Irritable bowel syndrome; functional gastrointestinal disorders; epidemiology; systematic review; Iran
7.  Gastroesophageal Reflux Disease in Iran: SEPAHAN Systematic Review No. 2 
Gastroesophageal reflux disease (GERD) is one of the most prevalent disorders affecting gastrointestinal tract with a wide range of frequency around the world. In this study, we aimed to review all of the published studies about GERD's prevalence in Iran systematically.
We searched bibliographic databases including PubMed and Google Scholar and local databases (Scientific Information Database and Iran Medex) to achieve all relevant articles to our subject and included them based on predefined inclusion criteria.
Twenty-two articles were included in the study to estimate the prevalence of GERD in Iran. Based on these articles, the prevalence of GERD in Iran was within the range of 1.9 to 52%.
Due to the differences between studies, such as characteristics of the sampled population and the diagnostic criteria, the reported prevalence of GERD was remarkably different in the reviewed studies. Nonetheless, because of the high prevalence of GERD in Iran, conducting large-scale epidemiological studies should be considered to determine factors associated with the prevalence of GERD to prevent and control it.
PMCID: PMC3399310  PMID: 22826749
Gastroesophageal Reflux Disease; Heartburn; Acid Regurgitation; Iran; Systematic Review
8.  Association between Serum Ferritin and Goitre in Iranian School Children 
Despite long-standing supplementation of iodine in Iran, the prevalence of goitre among general people remains high in some regions. The study investigated the role of iron status in the aetiology of goitre in school children in Isfahan, Iran. Two thousand three hundred and thirty-one school children were selected by multi-stage random sampling. Thyroid size was estimated by inspection and palpation. Urinary iodine concentration (UIC) and serum ferritin (SF) were measured. Overall, 32.9% of the children had goitre. The median UIC was 195.5 μg/L. The mean±SD of SF in the goitrous and non-goitrous children was 47.65±42.51 and 44.55±37.07 μg/L respectively (p=0.52). The prevalence of iron deficiency in goitrous and non-goitrous children was 9.6% and 3.1% respectively (p=0.007). Goitre is still prevalent in school children of Isfahan. However, their median UIC was well in the accepted range. Iron deficiency is associated with goitre in a small group of goitrous children. The role of goitrogens should also be investigated in this region.
PMCID: PMC2980875  PMID: 20411676
Cross-sectional studies; Goitre; Iodine; Iron deficiency; Serum ferritin; Iran
9.  What's the role of perceived social support and coping styles in depression and anxiety? 
Due to the excessive and pathologic effects of depression and anxiety, it is important to identify the role of protective factors, such as effective coping and social support. This study examined the associations between perceived social support and coping styles with depression and anxiety levels.
Materials and Methods:
This cross sectional study was part of the Study on the Epidemiology of Psychological, Alimentary Health and Nutrition project. A total 4658 individuals aged ≥20 years was selected by cluster random sampling. Subjects completed questionnaires, which were used to describe perceived social support, coping styles, depression and anxiety. t-test, Chi-square test, pearson's correlation and Logistic regression analysis were used in data analyses.
The results of Logistic regression analysis showed after adjusting demographic characteristics for odd ratio of anxiety, active copings such as positive re-interpretation and growth with odds ratios; 95% confidence interval: 0.82 (0.76, 0.89), problem engagement (0.92 [0.87, 0.97]), acceptance (0.82 [0.74, 0.92]) and also among perceived social supports, family (0.77 [0.71, 0.84]) and others (0.84 [0.76, 0.91]) were protective. In addition to, for odd ratio of depression, active copings such as positive re-interpretation and growth (0.74 [0.69, 0.79]), problem engagement (0.89 [0.86, 0.93]), and support seeking (0.96 [0.93, 0.99]) and all of social support types (family [0.75 (0.70, 0.80)], friends [0.90 (0.85, 0.95)] and others [0.80 (0.75, 0.86)]) were protective. Avoidance was risk factor for both of anxiety (1.19 [1.12, 1.27]) and depression (1.22 [1.16, 1.29]).
This study shows active coping styles and perceived social supports particularly positive re-interpretation and family social support are protective factors for depression and anxiety.
PMCID: PMC4274570  PMID: 25538777
Anxiety; coping styles; depression; perceived social support
10.  A cross-sectional population-based study on the association of personality traits with anxiety and psychological stress: Joint modeling of mixed outcomes using shared random effects approach 
Previous studies have showed some evidences about the relationship between personality traits particularly neuroticism and extroversion, separately, with psychological stress and anxiety. In the current study, we clarified the magnitude of joint interdependence (co-morbidity) of anxiety (continuous) and Psychological stress (dichotomous) as dependent variables of mixed type with five-factor personality traits as independent variables.
Materials and Methods:
Data from 3180 participants who attended in the cross-sectional population-based “study on the epidemiology of psychological, alimentary health and nutrition” and completed self-administered questionnaires about demographic and life style, gastrointestinal disorders, personality traits, perceived intensity of stress, social support, and psychological outcome was analyzed using shared random effect approach in R Free software.
The results indicated high scores of neuroticism increase the chance of high psychological stress (odds ratio [OR] = 5.1; P < 0.001) and anxiety score (B = 1.73; P < 0.001) after adjustment for the probable confounders. In contrast, those who had higher scores of extraversion and conscientiousness experienced lower levels of anxiety score (B = −0.54 and −0.23, respectively, P < 0.001) and psychological stress (OR = 0.36 and 0.65, respectively, P < 0.001). Furthermore, higher score of agreeableness had significant negative relationship with anxiety (B = −0.32, P < 0.001).
The present study indicated that the scores of neuroticism, extraversion, agreeableness and conscientiousness strongly predict both anxiety and psychological stress in Iranian adult population. Due to likely mechanism of genetic and environmental factors on the relationships between personality traits and psychological disorders, it is suggested to perform longitudinal studies focusing on both genetic and environmental factors in Iranian population.
PMCID: PMC4268191  PMID: 25535497
Anxiety; psychological stress; personality traits; shared random effect model; mixed outcomes
11.  Protein-energy Malnutrition in Goitrous Schoolchildren of Isfahan, Iran 
Some studies have shown the possible role of protein-energy malnutrition (PEM) in persistence of endemic goiter in iodine replenished areas. The present study was conducted to assess the association between PEM and goiter in schoolchildren of Isfahan, Iran.
In a cross-sectional study using multistage cluster random-sampling, 2331 schoolchildren with age ranged from 6-13 years old with a female to male ratio of 1.60 were enrolled. Thyroid size was examined by two endocrinologists for goiter detection. Children were considered goitrous if they had palpable or visible goiters according to World Health Organization (WHO)/United Nations children's Fund/International Council for the Control of Iodine Deficiency criteria. Weight and standing height were measured using the standard tools and anthropometric indices were calculated using the WHO AnthroPlus software developed by the World Health Organization. Height-for-age Z-scores (HAZ), weight-for-age Z-scores (WAZ) and body mass index (BMI) for age were calculated for each child. Children with a HAZ, WAZ or BMI-for-age of Z-score < –2.0 were classified as stunted, underweight or thin, respectively. Blood samples were drowned to measure serum thyroid hormones.
Overall, 32.9% of subjects were classified as goitrous. Weight, height, BMI, WAZ and BMI-for-age Z-score were significantly lower in children with goiter than in children who did not have goiter (P < 0.05). The prevalence of goiter in thin children was higher than that in non-thin ones (48.4 vs. 31.6%, odds ratio [OR]: 2.02, 95% confidence interval [CI]: 1.52-2.69, P < 0.001). Although 33.4% of non-stunted children were goitrous, 31% of stunted ones had goiter (P = 0.5). According to the logistic regression model taking sex and age as covariates, the only significant parameter affecting palpable goiter detection was thinness (OR = 2.13, 95% CI: 1.22-3.69, P < 0.001).
In the present study, we found a high prevalence of goiter in children who were malnourished. It seems that PEM may play a role in the still high prevalence of goiter in this region.
PMCID: PMC4050673  PMID: 24932384
Body mass index-for-age Z-score; goiter; height-for-age Z-score; Iran; protein-energy malnutrition; weight-for-age Z-score
12.  Edentulism and Tooth Loss in Iran: SEPAHAN Systematic Review No. 6 
Tooth loss appears to have an important role in the loss of mastication and esthetics. The aim of this systematic review was to investigate the prevalence of tooth loss and edentulism in the Iranian population.
Studies reviewed in this article were primarily identified via search of the online bibliographic databases including PubMed and Iranian Biomedical Journals, by using “tooth loss”, “edentulism”, “epidemiology”, and “Iran” as keywords. Studies potentially related to this topic were retrieved and the selection criteria applied. From the chosen studies the eligible articles were reviewed.
Of the studies identified after conducting the search, 10 eligible studies were extracted. The prevalence of tooth loss ranges between 0.3% in 3 to 5-year-old children to 70.7% in adults over 65. There is a lack of well-designed epidemiological studies on edentulism and tooth loss in Iran. The prevalence of tooth loss is high and it increases by aging.
It seems that the prevalence of tooth loss is high among adults in Iran. It is highly suggested that population-based studies should be established to investigate the epidemiology and risk factors of tooth loss in Iran. The results of such studies will be useful in the adoption of appropriate preventive strategies.
PMCID: PMC3399303  PMID: 22826769
Tooth loss; Edentulism; Prevalence; Iran
13.  Mental disorder prevention and physical activity in Iranian elderly 
Mental disorders such as depression, anxiety and dementia are common in elderly. However, physical activity is suggested to be effective in preventing such aging-related disorders. The aim of this study was to investigate the role of physical activity on mental health in later life.
Four hundred elderly people were randomly divided into the intervention and control groups. The intervention consisted of exercise twice a week for two months. Mental health status before, just after, and three months after the study was assessed with the 28-item General Health Questionnaire (GHQ-28).
The mean of the GHQ-28 total scale decreased in the case group and this change remained significant after three months (before: 8 ± 5.5, after three months: 5.6 ± 4.6, p < .001). GHQ subscales including somatization, anxiety, social dysfunction, and depression decreased significantly in the case group just after and three months after the intervention.
Physical activity significantly prevents mental disorder in older adults. Although it has effects on anxiety, social dysfunction, and depression, the greatest influence is on improving the somatization symptoms.
PMCID: PMC3399311  PMID: 22826772
Aging; GHQ-28; mental health; physical activity
14.  A 10-year performance trajectory of top nutrition journals’ impact factors 
Background and Aim:
This study was performed to evaluate the impact factors (IFs) and total citations of ISI-indexed nutrition journals in a 10-year period from 1999 to 2008 in order to assess the quality of nutrition journals.
Materials and Methods:
For this retrospective study, the IF and total citation data from 1998 to 2008 were collected through Journal Citation Reports of Thomson Scientific Corporation Web of Knowledge. We selected five highly cited journals in the “nutrition and dietetics” category for our analysis. These journals include Annual Reviews in Nutrition (ANNU REV NUTR), American Journal of Clinical Nutrition (AJCN), Progress in Lipid Research (PROG LIPID RES), Journal of Nutrition (J NUTR), and International Journal of Obesity (INT J OBESITY)
All five selected journals were ranked as one of the top ten “nutrition and dietetics” journals between 1999 and 2008 in ISI database. Most of selected journals’ IF had an upward trend during the 10-year period with fluctuation in some cases. AJCN consistently received the greatest number of total citations during the study period, although its IF was not the highest among the five journals studied.
The IF illustrated changes in relative rankings of five highly cited journals included in the “nutrition and dietetics” category of the Web of Knowledge. Rank according to the absolute number of citations received, however, did not correlate with rank according to IF.
PMCID: PMC3525028  PMID: 23264784
Impact factor; nutrition and dietetics; total citation
15.  Thyroid Disorders in Children and Adolescents with Type 1 Diabetes Mellitus in Isfahan, Iran 
Iranian Journal of Pediatrics  2011;21(4):502-508.
Studies in different populations have shown great variation in the prevalence of thyroid diseases in patients with type 1 diabetes mellitus (T1DM). Our aim was to study the prevalence of thyroid disorders such as autoimmunity of thyroid (AIT), thyroid dysfunction, and goiter in children and adolescents with T1DM, compared with age- and sex-matched healthy controls in Isfahan.
One hundred patients with T1DM who were referred to Isfahan Endocrine and Metabolism Research Center and 184 healthy schoolchildren matched for age and sex were included. They were examined for goiter by two endocrinologists. Thyroid function test and serum thyroid antibodies (anti-TPO Ab and anti-Tg Ab) were measured.
The prevalence of subclinical hypothyroidism was high in both groups (18%). T1DM patients had lower frequency of goiter (21% vs. 38%, P=0.001), and higher prevalence of positive AIT (22% vs. 8%, P=0.001), anti-TPO Ab positivity (19.3% vs. 5.3%, P=0.000), and anti-Tg Ab (11.1% vs. 6.4%, P=0.1) in comparison with the control group. Being positive for AIT in diabetic patients meant an odds ratio of 5 (CI 95%: 1.5-15.6) for thyroid dysfunction. There was no association between age, sex, duration of diabetes and HbA1C with serum anti-TPO Ab and anti-Tg Ab concentrations in this group.
Our results demonstrated the high prevalence of AIT and thyroid dysfunction in patients with T1DM. We suggest regular thyroid function and antibody testing in these patients.
PMCID: PMC3446149  PMID: 23056839
Type 1 diabetes mellitus; Autoimmune thyroid disease; Thyroid dysfunction disease; Goiter; Thyroid antibody
16.  Association between food intake and oral health in elderly: SEPAHAN systematic review no. 8 
Dental Research Journal  2011;8(Suppl1):S15-S20.
Dental status may influence food intake. The aim of this review was to summarize the earlier investigations on the association between food intake and dental status. We searched the electronic databases of PubMed and the Cochrane library for articles published until 30 February, 2012. To reach the related published articles, Medical Subject Heading (MeSH) terms of ‘oral health,’ ‘masticatory performance,’ ‘dental status,’ and ‘eating’ or ‘food intake’ were used. We included all research articles in the English language that (1) had used the random sampling method, and (2) had investigated the association between dental status and nutrient intake in elderly, non-denture wearer individuals, with no systemic illness. The findings of the seven original research articles had a great variation. Four of them supported a strong association between dietary intake and dental status and three of them found that there was no association between these variables. Most investigations found a significant relationship between the oral health status and nutrient intake; however, longitudinal studies were required for a better understanding of the diet-oral health relations.
PMCID: PMC3556278  PMID: 23372590
Dental status; dietary intake; eating; food intake; masticatory performance; oral health
17.  Gastroesophageal reflux disease and tooth erosion: SEPAHAN systematic review no. 10 
Dental Research Journal  2011;8(Suppl1):S9-S14.
Many systemic diseases affect oral health. The aim of this research was to conduct a systematic review on the association between dental erosion (DE) and gastroesophageal reflux disease (GERD) and the effect of saliva's flow rate, buffering capacity and oral microbial changes caused by GERD. All descriptive, analytical studies up to December 2011 that have relevant objectives, proper sampling method and sufficient results were included by searching PubMed and Scopus electronic data bases. Fifteen studies were selected according to our inclusion criteria (10 in adult and 5 in children population). There was a strong association between DE and GERD in the adult population, and the relationship in the children population was found to be of less importance. Early diagnosis and treatment of refluxed acid in both age groups through lifestyle changes and medications can prevent further damage and tooth loss.
PMCID: PMC3556282  PMID: 23372604
Dental erosion; gastroesophageal reflux disease; saliva; systematic review
18.  The role of Helicobacter pylori in the development of recurrent aphthous stomatitis: SEPAHAN systematic review no. 9 
Dental Research Journal  2011;8(Suppl1):S2-S8.
Microbial factors may play a role in the pathogenesis of recurrent aphthous stomatitis (RAS). Because of similarities in the characteristics of peptic ulcers and oral aphthous ulcers, it seems reasonable to hypothesize that Helicobacter pylori (H. pylori) could play a role in the development of RAS. The aim of the present study was to determine the relationship between H. pylori and RAS using the results obtained in other related studies. In the present systematic review, all of the relevant papers up to December 2011 were screened. The search was done using PubMed and the Cochrane library and out of 33, 9 articles were selected via the keywords of stomatitis, aphthous and H. pylori. Nine of the studies met the inclusion criteria. Among the selected articles, 6 were inconsistent with the association of H. pylori infection and RAS and 3 agreed to this assumption. The results of the literature indicate that there is no association between H. pylori infection and recurrent aphthous stomatitis.
PMCID: PMC3556289  PMID: 23372591
Aphthous stomatitis; Helicobacter pylori; Oral cavity; Pathogenesis
19.  The predictive role of histopathological findings in renal insufficiency and complete remission in a sample of Iranian adults with primary focal segmental glomerulosclerosis 
Primary focal segmental glomerulosclerosis (FSGS) is defined by the presence of proteinuria, often in nephrotic range and pathologically by segmental scars (SS). The aim of this study is to identify the possible predictors of complete remission or progression to chronic kidney disease in Iranian adults with primary focal segmental glomerulosclerosis.
In this historical cohort study, pathological findings of 50 patients with primary FSGS were reviewed by single renal pathologist without knowing about patients’ identities or outcomes. Patients were divided based on their histopathological findings and outcomes were compared among these groups.
There were significant differences in the complete remission rate in subjects with and without mesangial hypercellularity (p < 0.05), and in patients with and without hyalinosis (p < 0.05). According to the cut off points based on ROC curve analysis for the quantitative data, there was significant difference in renal insufficiency between the patients with and without global scars more than 12% (p < 0.05). Also multiple logistic regression analysis strongly suggests the association of mesangial hypercellularity and global scar with no complete remission and progression to renal insufficiency, respectively.
In the studied patients, presence of mesangial hypercellularity and hyalinosis has been suggested as prognostic factors for lower remission rate. According to multivariate analysis, only mesangial hypercellularity and global scar were found to act as independent prognostic predictors of lower complete remission rate and progression to renal insufficiency in patients with FSGS, respectively.
PMCID: PMC3082788  PMID: 21526053
Focal Segmental Glomerulosclerosis; Mesangial Hypercellularity; Hyalinosis; Global Scar; Renal Insufficiency; Remission
20.  Zinc status in goitrous school children of Semirom, Iran 
Iodine deficiency produces the spectrum of iodine deficiency disorders (IDDs) including endemic goiter, hypothyroidism, cretinism and congenital anomalies. Other factors, including goitrogens and micronutrient deficiencies may influence the prevalence and severity of IDDs and response to iodine supplementation. An association between zinc and goiter has previously been reported.
A cross sectional study investigating an association between goiter and serum zinc status was performed in 2003 in a mountainous region of Iran. One thousand eight hundred twenty-eight children were selected by multistage cluster sampling. Goiter staging was performed by inspection and palpation. Serum zinc, total thyroxine, thyroid stimulating hormone and urinary iodine concentration were measured in a group of these children.
Thirty six and seven tenth percent of subjects were classified as goitrous. Serum zinc level in goitrous and nongoitrous children was 82.80 ± 17.85 and 83.38 ± 16.25 μg/dl, respectively (p = 0.81). The prevalence of zinc deficiency (serum zinc ≤65 μg/dl) in goitrous and nongoitrous children did not differ significantly (9.3 % vs. 10.8%, p = 0.70).
Goiter is still a public health problem in Semirom. According to the present study zinc status may not play a role in the etiology of goiter in Semirom school children. However, the role of other goitrogens or micronutrient deficiencies should be investigated in this region.
PMCID: PMC3129056  PMID: 21772878
Goiter; Iodine Deficiency; Zinc Deficiency; Child

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