Autoimmune hepatitis is a necroinflammatory process of liver, featuring interface hepatitis by T cells, macrophages and plasma cells that invade to periportal parenchyma. In this process, a variety of cytokines are secreted and liver tissues undergo fibrogenesis, resulting in the apoptosis of hepatocytes. Autophagy is a complementary mechanism for restraining intracellular pathogens to which the innate immune system does not provide efficient endocytosis. Hepatocytes with their particular regenerative features are normally in a quiescent state, and, autophagy controls the accumulation of excess products, therefore the liver serves as a basic model for the study of autophagy. Impairment of autophagy in the liver causes the accumulation of damaged organelles, misfolded proteins and exceeded lipids in hepatocytes as seen in metabolic diseases. In this review, we introduce autoimmune hepatitis in association with autophagy signaling. We also discuss some genes and proteins of autophagy, their regulatory roles in the activation of hepatic stellate cells and the importance of lipophagy and tyrosine kinase in hepatic fibrogenesis. In order to provide a comprehensive overview of the regulatory role of autophagy in autoimmune hepatitis, the pathway analysis of autophagy in autoimmune hepatitis is also included in this article.

Background:Population aging and more prevalent westernized lifestyle would be expected to result in a markedly rising burden of colorectal cancer (CRC) in the future years. The aim of this study is to estimate the limited-time prevalence of CRC in Iran between 2015 and 2020.Materials and Methods:Aggregated CRC incidence data were extracted from the Iranian national cancer registry (IR.NCR) reports for 2003–2009 and from GLOBOCAN-2012 database for 2012. Incidence trends were analyzed by age groups, genders, histopathologic, and topographic subtypes to estimate annual percentage changes. Incidence was projected for 2020. The prevalence was estimated applying an adopted version of a previously introduced equation to estimate limited–time prevalence based on the incidence and survival data. Monte Carlo sensitivity analyses were applied to estimate 95% uncertainty levels (ULs). In each scenario, incidence, survival, annual percentage changes, and completeness of case ascertainment at IR.NCR were replaced under pre-assumed distributions.Results:Number of estimated within 1, 2-3 and 4-5-year CRC patients in 2015 were 13676 (95% UL: 10051–18807), 20964 (15835–28268), and 14485 (11188–19293), respectively. Estimated 5-year prevalence for 2020 (99463; 75150–134744) was 2.03 times of that for 2015. Highest 5-year prevalence was estimated in ages 55–59 for females and 75 + for males. Adenocarcinoma (41376; 31227 55898) was the most prevalent histologic subtype. The most prevalent tumor location was colon (30822, 23262–41638).Conclusion:A substantial growth in the prevalence of CRC survivors is highly expected for future years in Iran. Establishment of specialized institutes is highly recommended to provide medical and especially social supports for Iranian CRC survivors.

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Background: One unprecedented year after the coronavirus disease 2019 (COVID-19), the pandemic is no longer a short-term stressor; the unremitting/chronic effects of COVID-19 disease is likely to cause impaired physical and mental health upon population and the implemented public health and social measures to limit transmission and reduce mortality and morbidity from COVID-19 expose many people to social isolation, job loss, and economic recession. This study aims to compare mental status and four mental symptoms (somatization, anxiety, depression, and social functions) between two periods during the first year of the COVID-19 pandemic. Materials and Methods: Current study consists of two cross-sectional mental health surveys on the Iranian adult population carried out in two periods of March to April 2020 and December 2020 to February 2021 in two important Provinces of Iran (Fars and Khorasan Razavi). In the first survey, 1337 individuals participated in the study and completed the General Health Questionnaire-28, while in the second survey, 1205 participants completed the same questionnaire. Results: Among 1337 participants of the first survey, there were 876 (65.5%) females and 461 (34.5%) males with an average age of 37.41±10.58 years. In the second survey, there were 1205 participants with mean age of 33.79±19.57 years. The rates of females and males were 57.7% and 42.3%, respectively. Compared to the first survey, the second one showed that poor mental health condition that was 1.40 (95% confidence interval: 1.17-1.67) times higher based on the age, sex, education, marital status, economic, alcohol, cigarette, water-pipe, and sedative (P<0.001). Conclusion: Poor mental health status has increased during the first year of the COVID-19 pandemic. These results revealed that the COVID-19 pandemic was a chronic stressor faced by people every day; therefore, more robust mental health-related considerations must be implemented. [GMJ.2021;10:e2199]

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