majid valizadeh

The aim of this study was to compare the effectiveness of group therapies that were based on acceptance and commitment, as well as schema on coping-avoidance style, in individuals who were obese or overweight and were experiencing emotional eating. The present study was a quasi-experimental design that included a control group and a pretest-posttest. The research population included all men and women between the ages of 21 and 50 who visited nutrition and obesity clinics in Tehran during the summer and autumn of 2019. A sample of 60 individuals was randomly assigned to three groups of 20 individuals (acceptance and commitment therapy, schema treatment, and control) using the cluster sampling method and based on entry and exit criteria. The subjects completed the Dutch Eating Behavior Questionnaire (DEBQ) and the General and Exclusive Avoidance Questionnaire (GASQ) in three stages: pre-test, on-test, and post-test. The data were analyzed using SPSS version 24 software, which included covariance analysis and Bonferroni's post hoc test. The results indicated that group therapies based on acceptance and commitment and schema therapy were effective in reducing the avoidance of coping styles in obese and overweight individuals with emotional excess. The experimental groups exhibited a lower level of avoidance compared to the control group. The results suggest that overweight and obese individuals can decrease their reliance on coping style avoidance through group therapy that is based on acceptance, commitment, and schema therapy.

The aim of this study was to investigate the effectiveness of mindfulness on emotional regulation and forgiveness of women affected by infidelity. The research method was quasi-experimental pre-test-post-test with a control group. The statistical population of the study were women affected by infidelity referring to welfare centers in Bojnourd in 2021, from which 30 people were selected as a sample by available sampling method and randomly divided into two experimental and control groups (15 in each group). were replaced. The experimental group underwent 8 sessions of 60-minute mindfulness treatment and the control group did not receive any intervention until the end of the study. The research instruments included Ray (2001) Forgiveness Questionnaire and Granfski & Kraj (2006) Emotion Regulation Questionnaire. Research data were analyzed by multivariate analysis of covariance using SPSS software version 24. The results showed that mindfulness treatment is effective on emotional regulation and forgiveness of women affected by infidelity (P<0.05). According to the findings of the study, it can be said that mindfulness treatment is an important and effective factor in increasing emotional regulation and forgiveness of women affected by infidelity.

Gamma rays are widely used in medicine despite their harmful effects on health. Our study evaluated the protective effects of melatonin on kidney, heart, and liver tissues.

Seventy-two adult male Wistar rats were categorized into nine groups. Groups 2 and 3 only received whole-body γ-ray irradiation (WBI) (2.0 Gy), no melatonin,  interval time (IT) 8hr and 24hr. Groups 4 and 5 received WBI (8.0 Gy, no melatonin, 8hr and 24hr). Groups 6 and 7 received melatonin at 60 minutes (min) before WBI(2.0 Gy). Groups 8 and 9 received melatonin before WBI(8.0 Gy). All the rats were sacrificed 8 or 24 h after the experiments for laboratory and histopathological analysis. Serum levels of Blood Urea Nitrogen(BUN), Creatinine (Cr), Lactate dehydrogenase (LDH), Potassium (K), Gamma-glutamyl Transferase (GGT), Serum Glutamic-Oxaloacetic Transaminase(SGOT), Serum Glutamic-Pyruvic Transaminase(SGPT), Alkaline Phosphatase(ALP), c-reactive protein(CRP), Troponine(TPO)  and histological features of liver, heart and kidney tissues were assessed. Statistical analysis was performed by One-Way ANOVA.

Our data did not indicate significant differences in BUN, Cr, K, and CRP between groups with or without melatonin treatment (P>0.05); but differences were significant for LDH, GGT, SGOT, SGPT, ALP, and TPO (P<0.05). The results showed that radiation-induced histopathological effects on the liver, heart, and kidneys were mitigated in the groups six to nine.

The existence of significant differences in serum levels of LDH, GGT, SGOT, SGPT, ALP, and TPO in groups(6 to 9) and amelioration of the histopathological effects of irradiation on the liver, heart, and kidneys in the groups six to nine showed that the melatonin(100 mg/kg)  is able to protect the body in gamma-radiation(2.0 Gy and 8.0 Gy).

Obesity has increasingly become a health threat in the Middle East and North Africa (MENA) countries. This study aimed to investigate the scientific publications on obesity in the MENA countries during 2008-2020.

A longitudinal analysis of 13 years (2008-2020) of bibliographic data from obesity-related articles was performed. Web of Science core collection (WoS) was searched for bibliographic data. The bibliometric indicators including overall productivity and collaboration along with the prevalence of obesity and socioeco-nomic status were used to assess and compare the context of obesity research efforts in the MENA region.

The overall obesity-related articles of the MENA countries cumulated to 23680 publications. The MENA region accounted for a 6.5% global publication share in obesity research. Turkey contributed the high-est rate of total publications (n=6162) followed by Iran (n=5302) and Israel (n=2847). Iran and Turkey had the lowest rates of international collaborations. The overall obesity research was not significantly associated with socio-demographic index (SDI) measure (r=-0.26, P=0.27). No significant association was found between Gross National Income (GNI) per capita and the overall production of obesity research (r=0.41, P=0.08). Ad-ditionally, obesity research was not significantly associated with the prevalence of obesity in the countries (r=0.24, P=0.30).

This study observed an increased share of scientific productivity in the field of obesity from the MENA countries. Neither SDI, GNI per capita, nor obesity prevalence was not significantly associated with the overall productivity of the region.

Today, obesity caused by emotional overeating has become a ubiquitous phenomenon with major side effects.

The present study aimed to compare the effectiveness of acceptance and commitment-based group therapy and group schema therapy in emotion regulation difficulties and body mass index (BMI) of obese people with emotional eating.

In this quasi-experimental study with a pretest-posttest, control group, follow-up design, the population included all men and women, aged 21-50 years, who were referred to the nutrition and obesity clinics of Tehran, Iran, from September 2020 to December 2020. The study sample included 45 obese people with emotional eating, who were selected through convenience sampling among individuals visiting Mehrdadi and Behpouyan nutrition and obesity clinics and randomly assigned to two experimental groups and one control group. The data collection tools were the Dutch Eating Behavior Questionnaire (1986), Difficulties in Emotion Regulation Scale by Gratz and Romer (2004), and BMI measurement. The collected data were analyzed using analysis of covariance and Bonferroni's post-hoc test in SPSS version 24.

Results from Covariance analysis showed that there was a significant difference between the scores of control and experimental groups. Compared to the control group, the experimental groups have improved emotion regulation and reduced body mass index. In addition to results indicated that acceptance and commitment-based group therapy and group schema therapy similarly improved emotion regulation and reduced the BMI of obese people with emotional overeating (P<0.05).

Acceptance and commitment-based group therapy and group schema therapy were effective methods in improving emotion regulation difficulties and reducing the BMI of obese people with emotional eating. So it's suggested to use these methods in the treatment of obese people suffering from emotional overeating.

To offer high-quality healthcare services, individuals need to utilize high-quality information. The present study aims to evaluate the data quality in the hospital information system (HIS) at a selected educational hospital.

This descriptive and cross-sectional study was conducted in 2018. The statistical population consisted of 202 users of the hospital HIS at Amir-al-momenin Hospital in Zabol.  The respondents were selected using stratified random sampling. Data were collected using a researcher-made questionnaire. Then, they were analyzed through SPSS-20 and descriptive statistics.

It was found that 45 of the respondents stated in the comprehensibility of the hospital information, while 76 considered the hospital information not very understandable. Moreover, 34.7% believed that the hospital information would be rapidly accessible when needed. The average scores of the dimensions were found to be 5-8.5, and there were significant, positive relationships between all the dimensions under the study (P-value<0.05).

Findings suggest that only a small number of staff had complete information on the HIS and associated subsystems. Other respondents lacked sufficient awareness of the HIS or were unaware of its existence. The authors suggest that the needs of users be evaluated before designing a HIS system in order to ensure that it will meet those needs. Despite the use of HIS subsystems in all the units of the hospital under study, respondents had insufficient information on how these subsystems could be used.

We aimed at evaluating the best body mass index (BMI) and percent body fat (PBF) cutoffs related to cardio-metabolic risk factors and comparing the discriminative power of PBF and BMI for predicting these risk factors.

In this cross-sectional study in phase V (2012-2015), 1271 participants (age ≥ 20 yr; 54.3% women) were enrolled. Bioelectrical impedance analysis (BIA) was used to estimate PBF. Joint Interim Statement criteria were used for defining metabolic syndrome (MetS). We compared PBF with BMI through logistic regression and area under the curve of the receiver operating characteristic (ROC) curve. Percent body fat cutoff points were > 25 in men and >35 in women.

Percent body fat and BMI cutoff points for predicting MetS were 25.6% and 27.2 kg/m2 in men and 36.2% and 27.5 kg/m2 in women, respectively. There were no significant differences between BMI and PBF area under the ROC curves for predicting MetS and its components, except for abdominal obesity in men and low high-density lipoprotein (HDL) in women in favor of BMI. Logistic regression analysis indicated that BMI in women was better for predicting MetS and its components, except for abdominal obesity. Moreover, BMI was equal or superior to PBF in men, except for low HDL and high triglyceride levels.

Comparison of PBF with BMI showed that the use of PBF is not significantly better than BMI in predicting cardio-metabolic risks in the general population.

Obesity is an increasing health problem worldwide, accounting for many comorbidities. Many experts believe that preventive and therapeutic strategies cannot be practical if obesity is not recognized as a disease. Accordingly, a majority of organizations and authorities agree with classifying obesity as a disease. However, it is not really known whether obesity is a disease. There is no doubt that excessive obesity is a disease; however, this debate focused on milder classes of obesity, which are more common and involve varying degrees. The study dealt with this issue by adopting three different approaches, showing the impossibility of answering this question based on scientific and legal approaches. In the utilitarian approach, it is necessary to first examine areas affected by this issue and then consider the specific conditions of each country, including the healthcare system's approach, in each area. Experts in various fields need to comment on the benefits and harms of labeling obesity a disease, depending on the specific circumstances of each community, to determine whether it is benefical to the greater good to accept obesity as a disease. Therefore, this issue will remain open for discussion.
This article is the counterpart of another article (Is Obesity a Disease? Yes) in this issue.

Today, energy consumption is on the rise due to population growth, growing human needs, and rising global temperatures. One of the major consumers of energy is buildings with an infrastructure of more than 2,000 square meters. Therefore, reducing energy consumption in buildings should be given much attention. In other words, the purpose of this paper is to control the cooling system in summer and to control the heating system in winter so that the current temperature and humidity of the room are taken into account.

In this study, fuzzy logic control for building air conditioning system to increase energy efficiency and provide a comfortable environment has been investigated. A theoretical model is extracted from the fan coil unit and the heat transfer between the air and the cooling fluid. The control variables are room temperature and relative humidity and control results, the percentage of cooled and heated water flow rate in summer and the percentage of hot water flow rate and injection steam in winter.

In this study, we found that by using an intelligent controller and compatible with the fuzzy system, up to 90% of energy loss can be prevented.

Fuzzy control results are compared with conventional proportional-integral-derivative control. Fuzzy controllers are proven to be more efficient and consume less energy than PID controls.

Context:

 Growing evidence highlights the importance of physical activity as a critical element for the prevention and control of diabetes. However, there is no clinical practice guideline focusing on the different aspects of exercise in patients with diabetes, especially for the Iranian population.

 We aimed to prepare and adopt a clinical practice guideline to provide well-defined, simple, and concise responses to certain questions related to physical activity and exercise in all patients with diabetes, including type 1, 2, and gestational diabetes mellitus (GDM).

Evidence Acquisition:

 A multidisciplinary team of experts in various fields (sports medicine specialists, endocrinologists, and cardiologists) developed the guideline. This group did the task in four stages: (1) identifying and refining the subject area using 17 clinical questions; (2) appraising evidence through a systematic review of the literature; (3) extracting recommendations from evidence and grading them as A, B, C, or D based on the quality, quantity, and consistency of existing evidence; and (4) subjecting the guideline to external review and finally selecting the recommendations with high scores of appropriateness and agreement. The final version was evaluated and approved by the National Deputy for Curative Affairs - Ministry of Health and Medical Education and has also been endorsed by the Iran Endocrine Society (IES) and Iranian Association of Sports and Exercise Medicine (IASEM).

 The guideline consists of 52 recommendations addressing 17 important questions concerning different aspects of exercise prescription in Iranian patients with diabetes.

 The guideline provides evidence-based information that may help physicians to prescribe exercise for Iranian patients with diabetes safely and effectively.

The presence of the antibodies against the main thyroid antigens, which include thyroid peroxidase (TPO) or microsomal antigen, thyroglobulin (Tg) as well as thyrotropin receptor or Thyroid Stimulating Hormone Receptor (TSH-R), is a hallmark and symbol of the autoimmune thyroid diseases (AITDs) as one of the most common autoimmune diseases (AD) around the world. The prevalence of the thyroid peroxidase antibodies (anti-TPO antibody) and the thyroglobulin antibodies (anti-Tg antibody) is considerably higher in patients suffering from Graves’ disease (GD) and Hashimotochr('39')s thyroiditis (HT, chronic autoimmune thyroiditis, autoimmune hypothyroidism). While the TSH receptor antibodies (TRAbs) are common in the patients suffering from GD, they are relatively rare and infrequent in HT patients. This fact may indicate that TRAbs are more specific than other antibodies. In fact, TRAbs as one of the most important autoantibodies against the different thyroid antigens, are a set of the heterogeneous group of antibodies that based on the function, fall into three categories, including TSHR-stimulating antibodies (TSAbs), TSHR-blocking antibodies (TBAbs), and the neutral antibodies (no effect on receptor). TSAbs and TBAbs result in overproduction and reduction of intracellular cAMP respectively. Therefore the induction of the relevant signaling pathways can be the cause of different clinical symptoms in the form of hyperthyroidism or hypothyroidism consecutively. The extra-thyroidal effects of TRAbs as the extra-thyroid GD manifestations, such as ophthalmopathy and dermopathy, often have an effect on the eyes as well as the skin with the relatively well-known immunological mechanisms of the antibodies functions. Hashimoto encephalopathy is an extra-thyroidal effects of anti-TPO that provokes the central nervous system. On the other hand, anti-TPO like anti-Tg can affect the reproductive organs of women and lead to infertility by an unknown mechanism. Moreover, the circulating antibodies against the thyroid antigens can also be detected in other autoimmune diseases such as rheumatoid arthritis (RA), type I diabetes (T1DM) and celiac disease (CD). In this review article, the most important types of thyroid autoantibodies, their essential immunological processes in AITD as well as the main and important clinical extra-thyroidal manifestations of them have been discussed and reviewed.

Obesity is steadily growing around the world and is one of the most important threats to human health in the 21st century. It not only increases the incidence of obesity-related disorders, but also impairs the health-related quality of life (QOL). This study aimed to evaluate the health-related QOL in severely obese women after bariatric surgery.

A total of 476 patients, aged ≥18 years, attending Tehran Obesity Treatment Center, were enrolled in this study. Anthropometric and biochemical information of the participants was obtained before and one year after surgery. Health-related QOL was assessed using the Iranian version of the Short-Form Health Survey (SF-36).

The mean age of the patients undergoing bariatric surgery was 38.7±10.9 years. The body mass index (BMI) before bariatric surgery was 45.1±6.0 kg/m2, which decreased to 30.2±4.8 kg/m2 after one year of follow-up (P<0.001). The mean scores of anthropometric and metabolic indices improved one year after bariatric surgery. The mean score of the physical dimension of QOL improved from 227.6±54.3 to 316.6±63.2, and the mean score of the mental dimension also increased from 236.7±70.9 to 288.6±62.9 (P<0.001). The overall mean scores of QOL in the physical and psychological dimensions were not significantly different after one year of follow-up in the two groups of sleeve gastrectomy and gastric bypass.

QOL greatly improved at one year after bariatric surgery. The improvements were comparable after sleeve gastrectomy and gastric bypass.

Context: 

Gestational diabetes mellitus (GDM) is an important endocrine disorder in perinatology, associated with several maternal and neonatal complications. Development of national guidelines can inform clinicians, health policymakers, and researchers about the most recent evidence and practical issues of diagnosis and management of GDM.

 We aimed to develop clinical practice guidelines for the diagnosis and management of GDM in Iranian pregnant women.
Evidence Acquisition: The Iranian Endocrine Society constituted a task force, consisting of obstetrician-gynecologists, endocrinologists, a clinical nutritionist, a clinical epidemiologist, and a librarian, to review the published literature and propose national guidelines for the diagnosis and management of GDM. The consensus was reached on all recommendations in several group meetings with a majority decision. The evidence and recommendations were graded according to the American College of Physicians’ Guideline Grading System.

 The proposed guidelines included recommendations for screening, diagnosis, and management of GDM in Iran.

 By using an evidence-based approach, these national GDM guidelines can address important clinical issues in the diagnosis and management of Iranian women with GDM.

The study aimed to compare the Modification of Diet in Renal Disease Study (MDRD) and the Epidemiology Collaboration (CKD-EPI) equations for the detection of cardiovascular risk.

Data of 9,970 Tehranian participants aged ≥ 20 years were analyzed. The prevalence of cardiovascular disease (CVD), its risk factors, and 10-year atherosclerotic cardiovascular disease (ASCVD) risk were compared across the categories of glomerular filtration rate based on the MDRD and CKD-EPI equations. Chronic kidney disease (CKD) was defined as the estimated Glomerular Filtration Rate (eGFR) < 60 mL/min/1.73 m2 according to each equation.

The prevalence of CKD weighted to the 2016 Tehranian urban population was 11.0% (95% confidence interval: 10.3 - 11.6) and 9.7% (9.1 - 10.2) according to the MDRD and CKD-EPI equations, respectively. Besides, 8.3% and 1.5% of the participants with CKDMDRD and non-CKDMDRD were reclassified to non-CKDCKD-EPI and CKDCKD-EPI categories, respectively. Participants with CKDCKD-EPI but without CKDMDRD were more likely to be male and older, and more frequently had diabetes, hypertension, dyslipidemia, and CVD, when compared to those without CKD according to both equations; they were also more likely to be male, older, and smokers, and had less dyslipidemia and more CVD, when compared to those with CKD by using both equations. In multivariate logistic regression analysis, compared to CKDMDRD, the odds of CKDCKD-EPI were significantly higher for older age and lower for the female gender.

Compared to MDRD, the CKD-EPI equation provides more appropriate detection of cardiovascular risk, which is caused by the reclassification of older individuals and fewer females into lower eGFR categories.

A rise in the global prevalence of severe obesity (body mass index; BMI of ≥35 kg/m2 ) has been reported. In this study, we investigated the trends in the prevalence of severe obesity among Tehranian adults over the past two decades.

A representative sample of 10,045 Tehranians aged ≥19 years were followed from 1999 to 2017. The trends in the prevalence of severe obesity were investigated over six cross-sectional phases with 3.6-year intervals using generalized estimating equations.

In this cohort, the overall prevalence of severe obesity increased from 4.6% (1.8% in males and 6.7% in females) in 1999 to 10.1% (4.7% in males and 14.3% in females) in 2017. The persisted rising in prevalence in the youngest age-group in both genders, with the most rapid increase among females aged 19–29 years, plateaued in the older ages and remained unchanged among males aged over 50 years. After age-sex standardized analysis by using Tehranian urban population data, the prevalence rates of severe obesity in Tehranian men and women were estimated to be 1.9% and 5.7% in 1996, and 4.5% and 10.9% in 2016, respectively.

There was a significant and continuous increase in the prevalence of severe obesity in Tehranian adults over the past two decades. Preventive interventions should be focused on the younger and middle-aged population, to mitigate the subsequent burden of severe obesity on Tehranian population and the healthcare system.

This paper introduces a new exclusive binary search (EBS) algorithm to solve the economic dispatch problem (ED). This new algorithm converges to the best possible solution, corresponding to the precision requirements of the problem with a systematic search structure. The most essential purpose of economic dispatch is the optimal allocation of each generator's load sharing and the cost reduction of the active units in the power system. In this article, nonlinear factors and constraints are considered, including inlet steam valves’ effect, Valve-Point Effect (VPE), generation and load balances in the system, prohibited operating zones (POZs), power generation limits, ramp rates limits, and line losses. According to these constraints, the complexity of computation increases. However, the proposed algorithm will be able to find the optimal solution. This algorithm is implemented on three standardized 13, 15, and 40-unit test systems considering different operating conditions. Simulation results indicate the capability of this algorithm to solve ED problems.

We aimed to investigate the trend of childhood obesity in Tehranian population during a median follow-up of 10 years.

Within a prospective cohort study, using data collected from Tehran Lipid and Glucose Study (TLGS), 1406 participants, aged 3-11 yr were selected and monitored in 4 phases: phase I (1999-2001), phase II (2002–2005), phase III (2006–2008) and phase IV (2009–2011).

Total prevalence of obesity in children increased from 5.5% to 9.4% from phase I to IV. Performing GEE (Generalized Estimating Equation) analysis, relative risk of obesity was calculated, comparing each phase to its previous phase: phase II in reference to phase I (RR=1.06, CI=1.04-1.08), phase III in reference to phase II (RR=1.01, CI=1.00-1.03) and phase IV in reference to phase III (RR=0.96, CI=0.94-0.98). Between group difference was significant in all subgroups (age, gender, parental obesity) except parental education. Test of interaction for effect of time was insignificant in all subgroups except for the age group. For children younger than 7 yr old at phase I, trend of obesity throughout the study was higher compared to those with 7 yr of age and older at phase I.

During a decade of follow-up, trend of obesity was rising in this Tehranian children in both genders, especially in younger children. Any preventive interventions for stopping this trend should focus on early stages of childhood.

To develop body mass index (BMI) cut-offs for overweight and obesity based on international obesity task force (IOTF) definition, in children in Tehran, and to compare these values with those of center for disease control (CDC) for local pediatric subjects in discriminating cardiometabolic risk factors. Anthropometric and biochemical information of 1555 participants, aged 5 - 18 years, from phase IV of the Tehran lipid and glucose study (TLGS), were used to obtain local IOTF and CDC cut-offs. We used the LMS method to develop BMI curves matching the adult cut-offs at the age of 18 years for defining obesity and overweight based on the IOTF definition. Using the CDC growth curves, overweight was defined as 85th ≤ BMI < 95th percentile, and obesity as a BMI ≥ 95th percentile. The overall prevalence of overweight was 22.2, 23.9 and 10.5%; and that of obesity was 7.8, 9.0 and 4.2% using international IOTF, local IOTF and local CDC criteria, respectively. IOTF curves better discriminated the presence of all cardiometabolic risk factors, compared with local CDC curves. Local IOTF cut-offs for children in Tehran are in agreement with international IOTF values and better discriminate the cardiometabolic risk factors in children compared with local CDC cut-offs.

Context: The prevalence of overweight and obesity are increasing worldwide and have frequently been associated with health risks. This review highlighted several studies regarding obesity, outlining contributions of over a span of almost two decades in the Tehran Lipid and Glucose Study (TLGS). Evidence Acquisition: A systematic review was undertaken to retrieve articles related to all aspects of obesity from the earliest available date up to January 30, 2017. Prevalence of excess weight, including overweight and obesity were 20.8 and 63.6% among those aged below and above 20 years, respectively. TLGS found a high incidence of obesity with higher incidence in women among Tehranian adults; the cumulative incidence of obesity was 31.3, 38.1 and 23.4% for the whole population, women, and men, respectively. In children and adolescents, younger non-obese 7 - 9 years old, compared to 10 - 11 year olds are at greater risk of obesity. Prevalences of abdominal obesity in men and women were 52.8% and 44.4% respectively. Similar to generalized obesity, a high incidence of abdominal obesity was observed; the total cumulative incidence of abdominal obesity was 76.0% (83.6% for men and 70.9% for women). Metabolically healthy obese (MHO) and metabolically healthy abdominal obese (MHAO) are two important obesity phenotypes. People with these phenotypes have different risks for cardiovascular disease (CVD), type 2 diabetes (T2DM), and mortality. In the TLGS participants, MHO was found in 2% and 7.7% of the whole and obese population, respectively, whereas MHAO phenotype was reported in 12.4% and 23.5% of the whole and abdominal obese population. In these unstable conditions, during the long term follow up the metabolic risks developed in nearly half of the individuals. During a 12-year follow-up, incident CVD did not increase in the MHO phenotype compared to metabolically healthy normal weight (MHNW) individuals, but the risk of CVD events had increased in all metabolically unhealthy phenotypes. However in another report, over a 10-year follow-up, MHAO phenotype had an increased risk for CVD in comparison to the reference group, metabolically healthy non-abdominal obese (MHNAO) individuals. The TLGS studies bridged the significant gap in knowledge regarding prevalence, incidence, trends, morbidities and mortalities for obesity among Iranian population.

Context: Chronic kidney disease (CKD), is correlated with a substantial upsurge in mortality and morbidity worldwide. In this review, we aimed to review the 20-year-findings on CKD of the Tehran lipid and glucose study (TLGS). Evidence Acquisition: We conducted a systematic review of all studies on CKD that had been performed in the context of TLGS. Age adjusted prevalence of CKD, according to estimated glomerular filtration rate (eGFR) assessed with the two abbreviated equations of the modification of diet in renal disease (MDRD) and the CKD epidemiology collaboration (CKD-EPI) were 11.3% (95% confidence interval (CI): 10.7, 12.0) and 8.5% (95% CI: 7.9, 9.1), respectively. Using MDRD equation, over a mean follow up of 9.9 years, the incidence density rates of CKD were 285.3 person years in women and 132.6 per 10000 person-years in men. Studies on the TLGS population documented that abdominal adiposity defined as waist circumference (WC) categories (P for trend < 0.02) and waist gain in men (hazard ratio (HR) = 1.7, CI: 1.3, 2.2) significantly affected CKD development. Also, CKD had a significant effect on coronary heart disease (CHD) only in participants with low body mass index (HR = 2.06; CI: 1.28, 3.31 and HR = 2.56; CI: 1.04, 6.31 in men and women, respectively). Moreover, CKD was among the strongest independent predictors of stroke (HR = 2.01, CI: 1.22, 3.33). Also, compared to diabetic patients, an abnormal ECG was more prevalent in moderate CKD (P = 0.02). Increased waist circumference and waist gain (only in men) were associated with developing CKD in the TLGS population. CKD was an independent predictor of CHD (in lean individuals) and stroke.

Non-alcoholic fatty liver disease (NAFLD) has become a leading cause of chronic liver disease worldwide. We aimed to study this condition and liver fibrosis in bariatric patients at baseline using ultrasound, NAFLD fibrosis score (NFS), and fibrosis index-4 (FIB-4).
Adult patients with morbid obesity without other possible causes of liver pathology were evaluated. Liver biopsy was performed in a subset of patients. Diagnostic accuracy of tests was assessed using area under the receiver operating-characteristic curve (AUROC).
Overall, 1944 patients with mean age of 38.3 ± 10.8 years and body mass index of 44.6 ± 6.4 kg/m2 comprised the study population. Liver Biopsy showed features of NAFLD in 70%; 60.3% had nonalcoholic fatty liver and 9.6% steatohepatitis. Older age and higher transaminase levels were associated with higher NAFLD activity score. Fibrosis was present in 23.3% with the majority having F1. Ultrasound detected steatosis in 76.8%, with two-thirds having grade I to II fatty liver. Metabolic syndrome, hemoglobin A1c, age, and alanine transaminase were the strongest risk factors for fatty liver. Ultrasound showed an AUROC of 0.75 (95% confidence interval 0.63-0.86) for NAFLD with a sensitivity and specificity of 72.5% and 68.2%, respectively (cutoff of grade II). For diagnosis of fibrosis, FIB-4 had an AUROC of 0.72 (0.58-0.86) with 93.3% sensitivity and 43.1% specificity (cutoff of 0.50). NFS failed to show a significant AUROC curve for diagnosing fibrosis.
Our findings confirmed a high prevalence of NAFLD in morbidly obese patients. Despite this high prevalence, fibrosis was uncommon and low-grade. This study questions the use of current cutoffs for NFS and FIB-4 in all patients.

Amine compounds are believed to have acceptable results regarding their use as clay swelling inhibitor and corrosion inhibitor additives in drilling fluids. It is crucial to know the capability of amine compounds to enhance the thermal stability of drilling fluid; herein, a water-based fluid composed of biopolymer and other additives as the proper representatives of muds used in the pay zone section of a well is used. In order to enhance drilling fluid thermal stability to 250 °F (which is about 200 °F for starch in common drilling fluids), the compatibility of four amine compounds (mono ethanolamine, 1,6-diaminohexane, polyamine, and choline chloride) with three polymers (starch-green, poly-anionic cellulose, and starch-high temperature) is investigated; one of the named polymers is also chosen to examine its thermal stability performance along with the mentioned amine compounds at 250 °F. Two percent by volume concentration (2 Vol.%) of the mentioned amines were used. For these purposes, the rheological and filter loss properties were studied. The results showed that the starch-green is almost compatible with four amines. Moreover, mono ethanolamine and 1,6-diaminohexane acted better in terms of thermal stability at elevated temperatures.

Instability of shale formations is one of the major challenges during a drilling operation. Shale swelling is a time-dependent process in which water gradually infiltrates the shale structure. Due to very low permeability of shales (10-6 - 10-12 D) and relatively large size of solid materials of drilling mud compared to shale pore throats (3-100 nm), filter cake is not capable of hindering this process. As a result, mud filtrate continuously seeps into shale, concurrently increasing pore pressure and reducing mechanical strength of the formation, where it may result in wellbore caving. One remedy to this hazard is the use of Nano-materials to block the entrance of mud filtrate into shale formations. Using nano-particle additives is one of the methods to reduce the entrance of mud filtrate into the shale formations. The present research investigates the application of Nano ZnO in controlling shale swelling. This nano particle benefits size adequacy as well as suitable interfacial properties in controlling mud filtration. The impact of adding nano ZnO to reduce water seepage into shale is investigated using PPT apparatus. This test shows the increase in pore pressure in the formation due to mud filtrate invasion, hence enabling us to study the effect of different additives on stability of shales. The results show that Nano ZnO particles reduces shale’s wettability effectively, and thereby reducing water penetration, due to their sizes and other chemo-physical properties; such as, specific surface area, electric charge. Using 0.25, 0.5 and 0.75 weight/volume percentage of Nano-ZnO mixture shows respectively %60 ,%87, and %96 reduction in pore pressure transmission compared to a sea water sample.

Hypovitaminosis D has been associated with the development of gestational diabetes mellitus (GDM) in many observational studies..
We report the first study of the impact of prenatal vitamin D supplementation on postpartum dysglycemia in GDM patients in a randomized clinical trial..
Patients and Women with GDM at 12 - 32 weeks of gestation were assigned randomly to either the intervention group (in which serum 25-hydroxy vitamin D [25OHD] levels were measured immediately, n = 48) or the control group (in which the serum was stored and assayed at 6 - 12 weeks post-partum, n = 48). Participants with initial serum 25OHD The mean ± SD of serum 25OHD in the intervention group raised dramatically from 14.6 ± 6.3 to 32.4 ± 14.4 ng/mL, whereas no significant change occurred in the control group (from 17.7 ± 6.1 to 19.3 ± 9.6 ng/mL, P Although the high vitamin D supplementation dose in the present study (compared to the 400 IU/day dose usually recommended for pregnancy) safely increases the serum 25OHD, in GDM cases, the higher dose does not affect the plasma glucose level or insulin resistance at short term follow-up after delivery..

Gestational diabetes mellitus (GDM) affects nearly 5% of pregnancies. Significant proportion of the women with previous GDM develops type 2 diabetes mellitus (T2DM) in the next years, which indicates a higher risk in them than in the general population.. We conducted this study to determine the risk factors and incidence of abnormal glucose level and metabolic syndrome (MetS) in women with a history of GDM in a long period after delivery in our region..Patients and We extracted the demographic characteristics of 110 women with GDM who had delivered during 2004 - 2010 in three main hospitals of Zanjan City, Iran. The patients were recalled to perform oral glucose tolerance test (OGTT) and other necessary tests for MetS diagnosis. Anthropometric measurements were recorded of all the participants.. In this study, 110 women with a history of GDM were studied at one to six years since delivery. Among these women, 36 (32.7%) developed T2DM and 11 (10%) had impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). Moreover, 22 women (20%) had developed MetS. among those with abnormal results in glycemic test, 93.6% had fasting blood sugar (FBS) ≥ 95 mg/dL (≥ 5.27 mmol/L)at the time of GDM diagnosis in the index pregnancy that was significantly higher than the normal glycemic test (NGT) group with 42.9% being affected (OR, 19.55; P < 0.0001). There was a significant difference between those with abnormal results and NGT group in interval between delivery and performing laboratory tests (27 ± 18.8 and 18.5 ± 17.7 months, respectively; OR, 1.02; P = 0.02). No insulin use during pregnancy was discovered as a protective factor in women with a history of GDM (OR, 0.35; P = 0.01). Those with abnormal results were significantly different from NGT group in the number of parities (2.61 ± 1.4 vs. 2.05 ± 1.1, respectively; OR, 1.4; P = 0.03). The most common component of MetS among women with a history of GDM was FBS > 100 mg/dL (> 5.55 mmol/L).. Regarding the high incidence of the T2DM and MetS among women with a history of GDM, they should be screened at a regular interval for diabetes and other cardiovascular risk factors..