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1.  Synbiotic containing Bacillus coagulans and fructo-oligosaccharides for functional abdominal pain in children  
Aim: We evaluated the effectiveness of a synbiotic in the treatment of childhood functional abdominal pain (FAP).
Background: Probiotics are effective in the treatment of functional gastrointestinal disorders in adult patients, but there is lack of information in children.
Patients and methods: Children with FAP, based on the Rome III criteria (n = 115, aged 6-18 years), were randomized to receive either synbiotic (Bacillus coagulans, Unique IS-2, 150 million spore plus FOS, 100 mg) twice daily or placebo for four weeks. Treatment response was defined as ≥ 2-point reduction in the 6-point self-rated pain scale or “no pain”. Physician-rated global severity and improvement were also evaluated. Patients were followed for a total of 12 weeks.
Results: Eighty-eight patients completed the trial (45 with synbiotic). Response rate was higher with synbiotic than placebo after medication (60% vs. 39.5%, P = 0.044), but was not different between the two groups at week 12 (64.4% vs. 53.4%, P = 0.204). Difference between the two groups regarding the physician-rated global severity over the study period was not statistically significant (z = -1.87, P = 0.062). There was no significant difference between the two groups in physician-rated global improvement (week 4, P = 0.437; week 12, P = 0.111). Receiving synbiotic (OR 2.608, 95% CI: 1.01-6.68) and baseline pain score (OR 2.21, 95% CI: 1.19-4.10) were predictors of treatment response after medication.
Conclusion: The synbiotic containing Bacillus coagulans and FOS seems to be effective in the treatment of childhood FAP. Further trials are recommended in this regard.
PMCID: PMC4285933  PMID: 25584177
Abdominal pain; Child; Probiotic; Prebiotic; Synbiotic
2.  Mebeverine for Pediatric Functional Abdominal Pain: A Randomized, Placebo-Controlled Trial 
BioMed Research International  2014;2014:191026.
We evaluated the effectiveness of an antispasmodic, mebeverine, in the treatment of childhood functional abdominal pain (FAP). Children with FAP (n = 115, aged 6–18 years) received mebeverine (135 mg, twice daily) or placebo for 4 weeks. Response was defined as ≥2 point reduction in the 6-point pain scale or “no pain.” Physician-rated global severity was also evaluated. Patients were followed up for 12 weeks. Eighty-seven patients completed the trial (44 with mebeverine). Per-protocol and intention-to-treat (ITT) analyses were conducted. Treatment response rate in the mebeverine and placebo groups based on per-protocol [ITT] analysis was 54.5% [40.6%] and 39.5% [30.3%] at week 4 (P = 0.117 [0.469]) and 72.7% [54.2%] and 53.4% [41.0] at week 12, respectively (P = 0.0503 [0.416]). There was no significant difference between the two groups in change of the physician-rated global severity score after 4 weeks (P = 0.723) or after 12 weeks (P = 0.870) in per-protocol analysis; the same results were obtained in ITT analysis. Mebeverine seems to be effective in the treatment of childhood FAP, but our study was not able to show its statistically significant effect over placebo. Further trials with larger sample of patients are warranted.
PMCID: PMC4095832  PMID: 25089264
3.  Association of apolipoprotein B, apolipoprotein A, and the its ratio with body fat distribution 
To evaluate the association of apolipoprotein B (apoB), apolipoprotein A (apoA), and apoB/apoA ratio with the body fat indicators in patients with stable angina pectoris (SA).
Materials and Methods:
One hundred and twenty two participants aged 40-60 years old, with a mean age of 52.1 ± 7.2 years and SA, were recruited for the present study. Body weight, height, and waist circumference (WC) were measured, and waist to height ratio (WHtR) was calculated. After 12 hours of fasting, a blood sample was obtained and serum levels of apoB and apoA were measured and the apoB/apoA ratio was calculated. These patients underwent an abdominal computerized tomography scan (CTS) to assess visceral and subcutaneous adipose tissue (VAT, SAT). Linear regressions were computed to assess the relation of apoB, apoA, and their ratio with various measurements of adiposity (VAT, SAT, WC, and WHtR), with adjustment for age, sex, and BMI ≥ 25, WC ≥ 80 in women and WC ≥ 90 in men and WHtR ≥ 0.59.
From totally 123 patients with SA with a mean age of 52.1 ± 7.2 years, 44.7% male and 55.3% women were entered. Significant positive associations were found between visceral fat area and the apoB/apoA ratio (P = 0.02, β = 0.2), and significant negative correlations were observed between visceral fat area and apoA concentrations (P = 0.04, β = −0.2).
As abdominal fat accumulation is associated with other risk factors such as apolipoproteins in ischemic patients, then we most focus on control of these factors.
PMCID: PMC3793379  PMID: 24124431
Apolipoprotein A; apolipoprotein B; apolipoprotein B/apolipoprotein A; cardiovascular disease; intra-abdominal fat
4.  Association of helicobacter pylori infection with severity of coronary heart disease 
ARYA Atherosclerosis  2012;7(4):138-141.
There are few literatures evaluating the association between cytotoxin-associated gene A (CagA) positive strains of Helicobacter pylori (HP) and the severity of coronary heart disease (CHD). This study was designed to investigate this association.
Medical and drug history of 112 consecutive patients who were candidate for coronary angiography were taken. Fasting blood samples were obtained to measure C-reactive protein (CRP), anti Helicobacter pylori immunoglobulin G (anti-HP IgG), anti-CagA antibody (Ab) and interlukine-6 (IL6). According to angiography reports, participants were divided into patients with mild (n = 69) and with sever CHD (n = 36). To measure the association between CagA positive strains of HP with the severity of CHD, multivariate logistic regression tests were used by adjusting age, sex, history of diabetes mellitus (DM), dyslipidemia (DLP), and/or hypertension (HTN), CRP status and IL-6 level.
The analysis was concluded on 105 subjects. HP infection and CagA Ab were not significantly higher compared to the patients with severe and mild CHD (P = 0.28 and P = 0.68, respectively). Colonization of CagA positive HP did not significantly associate with severity of CHD (OR 1.05, 95% CI 0.33–3. 39).
Colonization of CagA positive HP was not an independent risk factor for severe coronary heart disease.
PMCID: PMC3413081  PMID: 23205045
Helicobacter Pylori; CagA; Coronary Heart Disease; Severity
5.  Psychological Status and Quality of Life in relation to the Metabolic Syndrome: Isfahan Cohort Study 
Objective. Current study was designed to investigate the association of metabolic syndrome (MetS) with depression, anxiety, psychological distress, and quality of life (QoL). Design. Two hundred and fifteen contributors with MetS and 253 participants without MetS were randomly selected from 2151 participants of Isfahan Cohort Study who were residents of Isfahan city. Measurements consisted of fasting blood samples, anthropometrics, and self-reported data of 12-item General Health Questionnaire, Hospital Anxiety and Depression Scale, and European Quality of Life-5 Dimension. Binary logistic regression analysis was used to find the association between MetS and four psychological factors. Results. Participants mean age was 56.3 ± 9.8 years. Male/female ratio was 0.86 (217/251). Mean score of depression (P = 0.003), anxiety (P = 0.018), distress (P = 0.047), and QoL (P ≤ 0.001) was significantly higher in MetS group. There were significant increasing relationships between depression (OR 1.10, 95% CI 1.03–1.22), anxiety (OR 1.03, 95% CI 1.05–1.11), and QoL (OR 1.13, 95% CI 1.05–1.23) and MetS when associations were adjusted for other risk factors, but it was not the case for distress (OR 1.03, 95% CI 0.99–1.08). Conclusion. It might be better to consider MetS as a combination of biological and psychological risk factors. Thus, a person with metabolic disease should be recognized as a patient with these factors and be screened for all of them.
PMCID: PMC3363984  PMID: 22675350
6.  Is helicobacter pylori infection a risk factor for coronary heart disease? 
ARYA Atherosclerosis  2012;8(1):5-8.
There is still controversy about association of Helicobacter pylori (H. pylori) infection with coronary heart disease (CHD). This study designed to evaluate this association in a sample of Iranians Population.
Medical and drug history as well as fasting blood samples of 112 consecutive patients who were candidate for coronary angiography were taken on catheterization day. Fasting blood samples were used to measure C-reactive protein (CRP), anti H. pylori immunoglobulin G (anti H. pylori IgG) and interlukine-6 (IL6). According to angiography reports, participants were divided into patients with (n = 62) or without CHD (n = 43). To compare the association between H. pylori infection with CHD, multivariate logistic regression tests were used by adjusting sex and age, age and sex plus history of diabetes mellitus (DM), Dyslipidemia (DLP), and/or hypertension (HTN), CRP status and IL-6 level.
Sixty two patients with CHD and 43 participants without CHD were enrolled in the present study. The mean ages of patients with and without CHD were 62.4 261 9.5 and 59.0 261 10.5 years respectively. Multivariate logistic regression analysis after adjusting for history of DM and/or DLP and/or HTN plus CRP status and IL-6 level showed significant association of H. pylori infection with CHD (OR 3.18, 95%CI 1.08-9.40).
H. pylori infection is one of the probable risk factors for CHD independent of history of DM, DLP, HTN, CRP status and IL-6 level.
PMCID: PMC3448393  PMID: 23056092
Helicobacter Pylori; Coronary Heart Disease; Angiography
7.  Barriers and facilitators of weight management in overweight and obese people: Qualitative findings of TABASSOM project 
Since weight management is affected by various factors, including social and behavioral ones, this study aimed to explore the peoples’ experience of barriers and facilitators of weight management.
Materials and Methods:
This qualitative content analysis was conducted as the initial step of TABASSOM Study. Participants, who tried to reduce their weight at least once, were selected by purposeful sampling method from aerobic fitness clubs, parks, and public offices in Isfahan in 2010. Data saturation was reached after indepth unstructured interviews with 11 participants. Data analysis was done by conventional content analysis method.
The participants have intermittently followed weight loss program. Barriers such as physical problems, lack of motivation, lack of work and family support and lack of time have resulted in their failures and outages. The main facilitator to start or restart after stopping such programs for a while was positive psychologic effect.
Discussion and Conclusion:
Findings showed that many problems could prevent weight loss. It is important to identify obstacles that hinder weight management and regimen programs and to discuss them with people before planning for their weight management.
PMCID: PMC3696212  PMID: 23833613
Obesity; overweight; qualitative study
8.  Ejection Fraction and Mortality Rate of Patients with Isolated Acute Inferior Myocardial Infarction Reperfused by Streptokinase 
ARYA Atherosclerosis  2011;7(2):54-57.
This study aimed to evaluate the effects of streptokinase on left ventricular ejection fraction and mortality rate of patients with inferior acute myocardial infarction (AMI) without right ventricular myocardial infarction (RVMI).
Fifty five consecutive patients with the diagnosis of inferior AMI without RVMI in the coronary care unit (CCU) of Shariati Hospital in Isfahan were selected for this study. Patients who had a history and/or electrocardiogram (ECG) evidence of previous myocardial infarction, evidence of bundle branch block, historical or clinical findings of valvular or other non-coronary heart diseases or heart failure were excluded. Participants were divided into two groups. Group one (n=28) had no contraindication for taking thrombolytic therapy and group two (n=27) had at least one contraindication for this treatment. Patients in group one took 1,000,000 units streptokinase for one hour. Three days later, LVEF of all participants was measured by an experienced cardiologist using 2-dimentiona1 echocardiography. Patients were followed up until four weeks to assess the mortality rate.
One death in the first 24 hours was reported in group one. However, no death was reported in any group until four weeks after discharge. There was no significant difference in mortality rate during the first 24 hours and four weeks after discharge between the two groups. Mean LVEF in the two groups did not show any significant difference (P=0.21).
Probably streptokinase has no effects on one-month mortality rate and LVEF in patients with inferior AMI without RVMI. Therefore, streptokinase side effects must be taken into consideration when being administered for this group of patients.
PMCID: PMC3347851  PMID: 22577446
Inferior Acute Myocardial Infarction; Left Ventricular Ejection Fraction; Streptokinase; Mortality Rate
9.  Non-alcoholic Steatohepatitis in a Sample of Iranian Adult Population: Age is a Risk Factor 
Non-alcoholic Steatohepatitis (NASH) is a cause of cirrhosis. Detecting its preventable causes could be useful in decreasing the disease and its complications. This study aimed to assess the prevalence of NASH in adult population living in Isfahan city as a sample of Iranian population.
Blood samples of 2030 individuals referring to Dr. Shariati Hospital for routine health checkup were collected. All individuals with high liver enzymes [aspartate aminotransferase (AST) and/or Alanine aminotransferease (ALT)] were included in the study. Known causes of altered liver enzymes were excluded. Second blood samples were obtained 6 months later and those cases with persistent enzyme elevation were surveyed with ultrasonography.
In the first survey, 234 individuals (11.5 %) had ALT levels of more than 40 U/L. By rechecking samples after 6 months, 50% of all high serum ALT individuals remained at high level. After conducting complementary biochemical tests, 3.3% of the population was considered to have NASH; 20% of NASH cases did not have any abnormal findings in ultrasonography. Hypercholesterolemia was the most coexisting risk factor in NASH cases. We found a reverse correlation between ALT level and age (P = 0.02).
The prevalence of NASH was comparable with other countries. According to the significantl correlation between ALT level and age, preventive interactions in younger individuals would decrease the incidence of NASH.
PMCID: PMC3063465  PMID: 21448401
Non-alcoholic steatohepatitis; Population-based study; Liver enzyme; Iran

Results 1-9 (9)