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Background: Pharmaceutical medications are considered an important component of healthcare delivery and there is a need for its rational use; although there have been major improvements in the pharmaceutical sector in the recent past, inappropriate medication use is considered a major threat to patients' health. Therefore, the pattern of medication use should be monitored routinely. The aim of this study was to investigate the population‐based prevalence of polypharmacy and the patterns of medication use in southwestern Iran. We also investigated correlates between polypharmacy and patterns of medication use. Methods: Data from the Khuzestan Comprehensive Health Study (KCHS) which consists information of 30 506 with age range to 20 to 65 years were used. Crude and age‐standardized prevalence of polypharmacy and their 95% confidence intervals were estimated for different subpopulations. Multivariable Poisson regression modeling was applied, and adjusted prevalence ratios and their 95% confidence intervals were estimated. The Anatomical Therapeutic Chemical classification system (first and second levels) was used for drug classification in different groups based on age, gender, and socioeconomic status. Results: Out of 30 506 adults, 93.3% were not on any medications, and age‐ and gender‐standardized prevalence of polypharmacy was 0.24%. The lowest estimated prevalence was among Arab participants (0.13%). The prevalence of polypharmacy was 1.57% among elderly people, and 4.78% among patients with heart diseases. Socioeconomic status was not associated with polypharmacy (prevalence ratio: 0.95; p = 0.573) but was significantly associated with patterns of medications use for alimentary tract and metabolism and nervous system diseases. The most common drug classes were cardiovascular system (3.93%), alimentary tract and metabolism (2.79%), nervous system (1.01%), systemic hormonal preparations (0.69%), and blood and blood‐forming organs (0.38%). Conclusions: The prevalence of polypharmacy is very low in Khuzestan province, especially in the Arab population. Future research is needed to investigate the causes of medication underuse in this population. [ABSTRACT FROM AUTHOR]

Background and Aim: Many of the treatment regimens available for hepatitis C include sofosbuvir. Unfortunately, sofosbuvir has not been recommended for use in patients with severe renal impairment leaving these group of patients with very few options. Nevertheless, there are many reports in which these patients have been treated with sofosbuvir‐containing regiments without important adverse events. This study aims at determining the safety and effectiveness of a sofosbuvir‐based treatment in patients with severe renal impairment, including those on hemodialysis. Method: We enrolled subjects with hepatitis C and estimated glomerular filtration rate under ml/min/1.73m2 from 13 centers in Iran. Patients were treated for 12 weeks with a single daily pill containing 400‐mg sofosbuvir and 60‐mg daclatasvir. Patients with cirrhosis were treated for 24 weeks. Response to treatment was evaluated 12 weeks after end of treatment (sustained viral response [SVR]). ClinicalTrials.gov identifier: NCT03063879. Results: A total of 103 patients were enrolled from 13 centers. Seventy‐five patients were on hemodialysis. Thirty‐nine had cirrhosis and eight were decompensated. Fifty‐three were Genotype 1, and 27 Genotype 3. Twenty‐seven patients had history of previous failed interferon‐based treatment. Three patients died in which cause of death was not related to treatment. Six patients were lost to follow‐up. The remaining 94 patients all achieved SVR. No adverse events leading to discontinuation of medicine was observed. Conclusions: The combination of sofosbuvir and daclatasvir is an effective and safe treatment for patients infected with all genotypes of hepatitis C who have severe renal impairment, including patients on hemodialysis. [ABSTRACT FROM AUTHOR]

Objective This study was aimed to determine the prevalence of celiac disease (CD) in irritable bowel syndrome (IBS) and its subtypes in a group of Iranian patients. Methods From March 2007 to June 2009, 465 consecutive patients who were referred to the gastroenterology clinic of Jundishapur University of Medical Sciences and fulfilled the Rome III criteria for IBS were included. Immunoglobulin A (IgA) anti-tissue transglutaminase (IgA-tTG) and anti-gliadin antibody ( AGA) levels were measured. CD was confirmed by gastroduodenoscopy and biopsy in patients with abnormal antibodies. Results Five patients had only elevated IgA-tTG, 26 with only elevated AGA, and in 16 patients abnormal results for both antibodies were reported. Duodenal biopsies from these 47 patients confirmed CD in 13 (2.8%, 95% CI 1.6-4.0%) according to the Marsh criteria. Two CD patients had normal IgA-tTG concentrations while only one patient with normal AGA was proven to have CD. CD was most prevalent in unsubtyped IBS (4.9%, 95% CI 1.1-8.7%), followed by mixed IBS (4.7%, 95% CI 0.3-9.1%). In multiple comparison, CD was less common in diarrhea-predominant IBS than in unsubtyped IBS, although this did not reach statistical significance (1.0% vs 4.9%, P = 0.057). Conclusions CD in unsubtyped IBS had a growing trend to be more common than in diarrhea-predominant IBS. Evaluation of IBS patients for CD is advisable. [ABSTRACT FROM AUTHOR]