NAFLD is the most common cause of persistently elevated serum ALT level among the general population of Iran.

Background:Viral hepatitis is a major health problem worldwide. Change in transmission patterns of hepatitis B makes it necessary to re-evaluate its prevalence and risk factors.Objectives:We aimed to determine the prevalence of HBV infection and its related risk factors in Amol city, Northern Iran.Patients and Methods:As a population based study, a cluster sampling approach was used and 6146 individuals from the general population of urban and rural areas of Amol, Iran, from both genders and different ages were enrolled. Inclusion criteria were willingness to participate in the study, being a lifelong resident in Amol city or its surrounding areas with Iranian nationality. Ten milliliters (10 mL) of blood was taken from each study subject and checked regarding hepatitis B markers including HbsAg, HBsAb and HBcAb using a third generation ELISA. The prevalence of HBV infections and its potential risk factors were recorded.Results:The prevalence of HBsAg, HBsAb and HBcAb were estimated as 0.9%, 30.7% and 10.5%, respectively. The mean age of all participants was 43.9 (95% CI: 43.4, 44.3) in females and 55.6 in (n = 3472) males. In our study, there was a significant association between family history of hepatitis, rural residency and presence of HBsAg. There was also a positive correlation between HBcAb and family history of hepatitis, history of other types of hepatic diseases, history of tattooing, traditional phlebotomy, male gender and age. In backward logistic regression, a significant association was found between history of hepatitis in first-degree family members (OR = 13.35; 95% CI: 6.26, 28.47) and place of residence (OR = 2.32; 95% CI: 1.27, 4.22) with presence of HBsAg. There was also a positive correlation between history of hepatitis among first-degree family members (OR = 2.49; 95% CI: 1.52, 4.08), history of tattooing (OR = 2.13; 95% CI: 1.33, 3.42), history of previous hepatitis (OR = 1.87; 95% CI: 1.06, 3.28), male sex (OR = 1.36; 95% CI: 1.12, 1.66) and age (OR = 1.03; 95% CI: 1.03, 1.04) with presence of HBcAb.Conclusions:The prevalence of hepatitis B in Amol City and its surrounding areas was about one percent, a lower rate than other reports from Iran.

BACKGROUND Reflux disease is a common gastrointestinal problem. The association between reflux disease and gastritis pattern is controversial. AIM: To determine the association between reflux disease and gastritis pattern in patients with Helicobacter pylori (H. pylori) infection. METHODS 470 patients with dyspepsia and reflux disease were enrolled in this study. The inclusion criteria were willing to participate in the study, age over 40 years, and having the criteria of ROME III for at least 3 months. Patients with history of H. pylori eradication therapy during the 3 months before the study, a history of gastric surgery, and gastric cancer were excluded. All of the participants underwent upper endoscopy and two biopsy samples were taken from antrum, body, and fundal areas. RESULTS H. pylori infection rate was 367 (78.1%) with mean age of 59.8 ± 11.4 years. Of them 131 patients (35.7%) were male. Reflux disease was detected in 273 (74.4%) patients. 216 (58.9%) and 102 (27.8%) patients had non-erosive reflux disease (NERD) and gastroesophageal reflux disease (GERD), respectively. Corpus predominant and antral predominant gastritis were seen in 72 (19.6%) and 129 (35.2%) patients, respectively. Antral gastritis was significantly associated with GERD (p<0.01). In regression analysis, antral predominant gastritis had a significant association with GERD (OR=1.92; 95%CI: 1.22- 3.12). The same result was observed in mild to moderate antral and greater curvature gastritis (OR= 1.26; 95%CI: 0.25-6.40 and OR= 3.0; 95%CI: 0.63-14.17, respectively). CONCLUSION According to these finding ,we could suggest that the pattern of gastritis could be associated with reflux disease and GERD.

Although the main impacts of COVID-19 (coronavirus disease 2019) are considered in the pulmonary system, recent studies highlight the liver as the mainly affected organ. Studies show that a significant percentage of COVID-19 patients suffer from hepatic injury, especially patients with critical or severe forms of COVID-19. Major reported pathological changes consist dilatation in the sinusoidal system, infiltration of lymphocytic cells in the sinusoidal system, multifocal hepatic necrosis, Kupffer cell hyperstimulation, and cholestasis. 1 Some fundamental mechanisms have been described for a hepatic malfunction that important causes include lowered blood oxygen saturation due to pneumonia, compromise of cardiac function, direct potential hepatotoxicity from therapeutic drugs (e.g., non-steroidal anti-inflammatory drugs (NSAIDs), hydroxychloroquine, and azithromycin), and cellular injury due to direct viral invasion, and micro and macrovascular changes from hypercoagulability. 2 Aberration in liver function test (LFT) occurs in 14%-53% of COVID-19 patients. 3 Most of these abnormalities in the LFT return to normal condition without specific treatment. Nevertheless, hepatic injuries occur when the LFT is thrice or higher than the normal limit, which may need attentive management. 2 A recent meta-analysis showed that liver vascular thrombosis and portal inflammation occurred in 29.4% and 13.2% of patients with a severe form of This study also showed that progressive ischemic injury in the liver biliary system might rapidly develop in some patients with severe illness, similar to the symptoms seen in the primary sclerosing cholangitis. This