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Background: Diabetes and hepatitis are among the most common diseases in the world. Hepatitis C virus leads to extra-liver manifestations, including endocrine disease and diabetes. The prevalence of hepatitis C and B in diabetic patients and the prevalence of diabetes in hepatitis C and B patients are higher than those in normal populations, and if each is added to the other, the complications will be more and the consequences will be worse. Objectives: This study aimed to compare the frequency distribution of diabetes and serum lipid levels in hepatitis B and C patients and other people. Methods: In this retrospective case-control study, 80 patients with hepatitis B and C and 160 patients without hepatitis were included. In both groups, those with two glucose levels above 126 mg/dL were considered as diabetic subjects. Also, the tests for factors such as cholesterol, TG, LDL, HbA1c, HDL, and liver ultrasonography were performed for patients. Data were collected and entered into SPSS 23 software and analyzed using descriptive statistical tests (t test and chi-square or Fisher's exact test) at a significance level of α = 0.05. Results: A total of 240 patients [80 cases (hepatitis B or C positive) and 160 controls] were enrolled. Of them, 46.3% were females and most of them were in the age range of 45-55 years. Besides, 14 (5.8%) subjects had high fasting blood glucose levels of more than 126 mg/dl twice, and were considered to have diabetes. Among them, four (5.0%) cases (all having hepatitis B) and 10 (6.3%) controls were diabetics. Statistical analysis showed no significant difference in the mean serum lipids of cholesterol and LDL between the case and control groups (P < 0.1) but there was a significant association between HDL and TG in both groups (P = 0.02). Conclusions: All patients with hepatitis B and C should be screened for diabetes, and in addition to fasting blood glucose, we suggest that HbA1c be measured to confirm or rule out diabetes.

Background: Hemophilia is a rare inherited sex-linked disease caused by the deficiency or lack of some blood coagulation factors. The severity varies depending on the levels of these factors in the blood. Objectives: Therefore, this study aimed at determining the prevalence of metabolic syndrome and risk factors of cardiovascular disease in patients with hemophilia compared to a control group in 2015. Methods: A case-control study was done on all hemophilia patients referring to the Birjand University of Medical Sciences (n = 91). Healthy subjects with no hemophilia were selected using systematic random sampling from healthy individuals in Birjand City, who were matched in terms of age and sex. The data were entered into SPSS19 software. The significance level of less than 0.05 was considered in this study. Results: The mean age was 34.11 ± 14.68 and 33.72 ± 13.46 years in the case and control groups, respectively. The rate of metabolic syndrome was 12.1% in the control group and 4.4% in the hemophilia group. The results of Mann-Whitney U test showed a significant difference between the two groups in terms of TG (P = 0.016) and LDL (P < 0.001), and the waist circumference was significantly higher (P = 0.001) in the control group than in the hemophilia group. Conclusions: In the present study, the prevalence of metabolic syndrome was significantly lower among hemophilia patients than in the control group. The prevalence of diabetes and hypertriglyceridemia was significantly lower in hemophilia patients than in the control group (healthy subjects).

Background and Objectives: Regarding the high prevalence of the risk factors for human T-cell leukemia Virus (HTLV) in prison, including the high intravenous drug use and the higher chance of unprotected sexual behaviors, homosexuality, tattoos, and the probability of association between this disease and other sexually transmitted infections such as HTLV, this study compares the prevalence of HTLV-1 and its risk factors in intravenous and non-intravenous drug user prisoners in Birjand. Methods: This descriptive-analytical study was conducted in Birjand Prison during 2014-2015. The research community included all the prisoners of Birjand. Census method was used across intravenous drug users and simple random sampling for non-intravenous drug users’ group where sample size was considered to be 300 individuals (69 individuals in the case group and 231 individuals in the control group). Collected data were analyzed by descriptive statistics, Chi-square and Fisher's exact tests in SPSS software v.21 at siginificance level of 5%. Results: According to the results of the study, there was no case of HTLV-1 in either of the two groups. However, prevalence of smoking and history of common injection, non-sterile injections, suspected sexual contact, alcohol consumption, and tattoo in intravenous drug users were significantly higher than in non-intravenous drug users (P < 0.05). Conclusions: The results of this study suggested that although the prevalence of this disease was zero in the studied community, the prevalence of its risk factors was significant. This requires planning to reduce the risk factors associated with this disease in the target community.

Background and Objectives: Hepatitis B is associated with different physical and psychological complications. This study sought to evaluate the effects of cognitive behavioral therapy on the quality of life among patients with hepatitis B. Methods: In this quasi-experimental study, 60 patients with hepatitis B were conveniently recruited from a private infectious disease clinic in Birjand, Iran. The patients were randomly allocated to either a control (n = 30) or an intervention (n = 30) group. Patients in the intervention group received cognitive behavioral therapy in eight 45-minute sessions while their counterparts received no cognitive behavioral therapy. All patients completed the 36-item Short Form Survey both before and after the intervention. The SPSS software (v. 15.0) was used to analyze the data by running the paired-sample t, independent-sample t, Wilcoxon signed-rank, and Mann-Whitney U test at a significance level of less than 0.05. Results: In the intervention group, the scores of the social functioning and general health domains of quality of life significantly decreased while the score of the emotional well-being domain significantly increased after the intervention (P 0.05). Moreover, in the control group, the scores of quality of life and its social functioning and general health domains significantly decreased (P 0.05). The groups did not significantly differ from each other respecting the pretest-posttest mean scores of the quality of life and its domains (P > 0.05). Conclusions: This study suggests that cognitive behavioral therapy has no significant effect on the quality of life but significantly improves emotional well-being among patients with hepatitis B.

Background: Hepatitis C is among the greatest global health challenges. It is a major risk factor for serious liver diseases. Stigmatization of hepatitis C by healthcare providers is one of the main barriers to its early diagnosis and effective treatment. The aim of this study was to assess hepatitis C knowledge and stigmatization among the students and the staff of Birjand University of Medical Sciences, Birjand, Iran. Methods: This descriptive-analytical epidemiological study was undertaken on 200 students, 100 nurses, 50 physicians, and 50 administrative staff affiliated to Birjand University of Medical Sciences, Birjand, Iran. A researcher-made hepatitis C knowledge and stigmatization questionnaire was used for data collection. The collected data were entered into the SPSS software (v. 18) and analyzed using the one-sample t-test and Pearson correlation analysis at a significance level of less than 0.05. Results: Participants were 278 women (69.5%) and 122 men (30.5%). The mean score of hepatitis C stigmatization was 82.33 ± 12.81 (out of a total possible score range of 28 - 140). This score was significantly lower than the possible mean score of the stigmatization questionnaire. Most participants obtained a low stigmatization score (63.8%) and a high knowledge score (66%). Hepatitis C stigmatization by participants was inversely correlated with their hepatitis C knowledge (r = -0.2; P < 0.001). Compared to other healthcare providers, physicians obtained the lowest hepatitis C stigmatization score and the highest hepatitis C knowledge score. Conclusion: People with greater knowledge about hepatitis C are less likely to stigmatize patients with hepatitis C. Therefore, educational interventions are needed to improve healthcare providers’ knowledge about hepatitis C in order to reduce the risk of hepatitis C stigmatization by them.

Background: There are 350 million carriers of hepatitis B virus (HBV) around the world. HBV can be associated with type II diabetes mellitus. The aim of this study was to evaluate the prevalence and risk factors for type II diabetes mellitus among patients with HBV. Methods: This community-based, cross sectional, descriptive, correlational study recruited participants above 13 years, who resided in Esfandiar rural area, Tabas, Iran. A blood sample was collected from each participant for serological and biochemical tests. A researcher-made questionnaire was used to collect data on the participants’ demographic characteristics, HBV risk factors, and diabetes mellitus risk factors. Independent sample t test, Chi square test, and Fisher’s exact test were applied in SPSS v. 22.0 at a significance level of 0.05). Conclusions: This study suggests that HBV can be a risk factor for type II diabetes mellitus. Therefore, continuous monitoring for diabetes mellitus is essential for patients with HBV infection, particularly those above 50 years, those with a body mass index above 25 kg/m2, and those with a positive family history of type II diabetes mellitus.

Background and Aim: Sexual transmission is one of the routes of hepatitis B transmission. This study aimed at assessing the prevalence of hepatitis B among the spouses of patients with hepatitis B. Methods: This cross-sectional descriptive-analytical study was done on 397 spouses of chronic carriers of hepatitis B, who had referred during years 2003 to 2014 to a private clinic of infectious diseases in Birjand, Iran. Serological tests for hepatitis B surface antigen and anti-core antigen antibody were performed for all participants. Data were entered in the SPSS software (v. 19.0) and analyzed through the Chi-square and Fisher’s exact tests at a significance level of less than 0.05. Results: The prevalence of hepatitis B among participants was 8.3%. Resolved hepatitis B was observed in 40.6% of the participants. The prevalence of hepatitis B surface antigen positivity and hepatitis B core antigen antibody positivity among participants whose spouses had shown hepatitis B e-antigen positivity was 15.8% and 70.2%, respectively. This rate among participants whose spouses had shown hepatitis B e-antigen negativity was 7% and 36.3%, respectively. Hepatitis B e-antigen positivity among participants’ spouses was significantly correlated with transmission of hepatitis B core antigen antibody positivity (odds ratio = 4.18; 95% confidence interval: 2.08 - 8.38; P < 0.001). Conclusions: This study suggests the high risk of hepatitis B interspousal transmission, particularly among patients with hepatitis B e-antigen positivity. Therefore, public education about hepatitis B and emergency vaccination against it are essential for spouses of infected patients, to prevent interspousal transmission.

Background: Hepatitis B is a serious liver infection and one of the 5 leading causes of death around the world. Chronic hepatitis B has a variant natural history. Around one-third of patients with chronic hepatitis may eventually develop cirrhosis or hepatocellular carcinoma. The aim of this study was to follow-up chronic hepatitis B carriers. Methods: This cross-sectional descriptive-analytical study was done on 235 chronic hepatitis B carriers, who referred to an infectious disease and tropical medicine clinic, in Birjand, Iran. All chronic hepatitis B carriers, who had referred to the study settings from 2005 to 2013, were approached. Data were entered in the SPSS software (v. 21.0) and analyzed via the Chi-square and the Fisher’s exact tests at a significance level of less than 0.5. Results: The majority of participants were male (132 cases, 56.2%) and married (193 cases, 82.1%) and were aged 33.3 ± 0.7. The follow-up mean time was 5 years with a range of 3 to 9 years. During this follow-up period, 10 individuals (4%) experienced seroconversion from hepatitis B surface antigen (HBsAg) positivity to negativity, 35 (15%) developed active hepatitis, 8 (3.5%) developed cirrhosis, and 2 (1%) developed liver cancer. The remaining 180 participants (76.5%) had inactive hepatitis. Among participants, 45 (19%) were hepatitis B e antigen-positive, 24.5% of whom experienced positivity to negativity seroconversion. Conclusions: Most chronic hepatitis B carriers are primarily asymptomatic. However, 15% developed serious liver disease over time. Therefore, careful lifelong follow-up assessments are needed for early diagnosis and prevention.

Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is a major threat for public health around the world. Objectives: This study aimed at investigating the prevalence of HIV/ADIS high risk behaviors and necessity of prevention in the population of Birjand, East of Iran. Methods: This population-based study was conducted on 5235 subjects from Birjand, East of Iran, during years 2013 to 2014. Subjects were asked to complete a checklist including gender, marital status, and history of drug injection, tattooing, unsafe sexual contact, imprisonment, dental surgeries, bloodletting, and blood transfusion. All subjects were tested by commercially available enzyme-linked immunosorbent assay (ELISA) kits to detect Anti-HIV antibodies (HIVAb; Genscreen® plus HIV Ag-Ab, Bio-Rad, Matnes la coquette, France). The chi-square test was performed and P < 0.05 was considered statistically significant. Results: Prevalence of HIV was zero. Also, result of the study showed that 9 (0.2%) subjects had a history of drug injection, 81 (1.5%) history of tattooing, 44 (0.8%) unsafe sexual contact, 39 (0.7%) history of imprisonment, 1709 (32.6%) history of dental surgeries, and 802 (15.3%) history of bloodletting. History of drug injection, history of tattooing, unsafe sexual contact, history of imprisonment, and history of dental surgeries showed a significant relationship with gender. Conclusions: It is recommended to increase knowledge about HIV/AIDS behaviors especially in low risk populations to prevent the occurrence of new cases.

Background Smoking is amongst unhealthy behaviors that endangers public health and can impose significant costs on the society. We aimed to investigate the prevalence of cigarette smoking and related factors in Birjand city, Eastern Iran, during year 2014.Methods This cross-sectional study was conducted on 5235 participants in Birjand city, east of Iran, during year 2014. We analyzed comprehensive data from Birjand study. Researchers asked participants to complete a check-list, which contained demographic questions and infectious disease risk factors. Binary logistic regression model was performed and P Results Prevalence of smoking was 7.0% (2.0% in females and 12.7% in males). No history of cigarette smoking (OR = 0.02, P Conclusions The prevalence of cigarette smoking was lower than similar studies in Iran. This study showed that males smoked cigarettes more than females. The results showed that it is better to plan for the future to control cigarette smoking and its related factors.

Background: Fatty liver is one of the most common liver diseases across the world. Fatty Liver is characterized by deposition of fat in liver cells. Therefore, the aim of this study was to determine the prevalence of fatty liver and some related factors in Birjand, Iran. Methods: This was a cross sectional study and was performed on 520 individuals in Birjand, Iran. Ultrasonography, cholesterol (CHOL), low density cholesterol (LDL), high density cholesterol (HDL), triglyceride (TG), fasting blood sugar (FBS), and tests of liver enzymes were performed. Results were analyzed using SPSS version16 software by Mann-Whitney, chi-square (Fischer exact test) and Kruskal-wallis with significance level of α = 0.05. Results: The mean age of participants was 41.6 ±13.7 (15 - 70). Males made up most of the subjects. Prevalence of fatty liver was estimated as 47.5% in Birjand. Results showed that fatty liver was associated with age, education, and marital status. People with primary education had a higher prevalence of fatty liver. Also, with elevated grade of fatty liver, Alanine aminotransferase (ALT) level had a significant increase (34.89 ± 29.3). Conclusions: Several factors were associated with fatty liver that should be considered effectively. Also, increased awareness of the general population about non-alcoholic fatty liver is recommended.