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12This fear of childbirth prevents some women from becoming pregnant. This condition is common in women who have been raped. The present study investigates the causes of fear of childbirth in pregnant mothers.
Materials and Methods: This cross-sectional descriptive study was performed on 130 pregnant women referred to the staff hospital of Balkh Medical School between 1397-1397. The data collection tool was a questionnaire about fear of childbirth.
Results: The results showed that the most important causes of fear of childbirth in pregnant mothers were fear of labor pain and painful injections during childbirth. Also, the mean score of fear of childbirth in primiparous women was higher than multiparous women (p <0.001).
Conclusion: Considering the importance of fear of childbirth in increasing cesarean section, it is necessary for medical researchers to consider the reasons for this fear.
Keywords: Managment, Life, Specification, Limitations, Natural, Applicant, Giving birth, Usual, Study, Dispute.
Сведения об авторах:
Профессор доктор Абдулхаким (Хекмати) и доцент доктор Мирвайз Бахо, преподаватель медицинского факультета Балхского университета Афганистана. hkim.hekmati456@gmail.com
Information about authors:
Professor Dr. Abdulhakim (Hekmati) and Associate Professor Dr. Mirwayz Baho, Lecturer at the Faculty of Medicine, Balkh University of Afghanistan. hkim.hekmati456@gmail.com
THE ROLE OF WAR STRESS AND THE COMBINATION OF DIET AND BODY
MASS IN GASTROESOPHAGEAL REFLUX DISEASE
Abdolhakim Hekmati
Balkh University Nilofar Hekmati,
Rahnavard University
Introduction GASTROESOPHAGEAL REFLUX DIDEASE (GERD):
Mucosal damage due to abnormal reflux (return) of stomach contents (acidic substances) into the esophagus. Gastroesophageal reflux disease (GERD) is one of the most common diseases of the present century, which is diagnosed with specific symptoms of recurrent heartburn and regurgitation (return of stomach contents to the esophagus) (1, 2). According to epidemiological studies, the prevalence of GERD in Western countries is between 10-48%, in Asian countries (> 5%) (3) and in Iran 2.7% (4) in our country. As far as we estimated, these figures are 20%. . is. If left untreated, GERD can lead to esophageal lesions, including ulcerated esophagitis, Barrett's esophagus, and finally, esophageal adinocarcinoma (5). Identifying modifiable risk factors for GERD, including diet and BMI, can have potential effects on general health. The results of various studies on the relationship between diet and GERD are contradictory. Most studies have been performed physiologically to investigate the effect of lumen fat content on postpartum esophageal contact with acid (6, 7). Or focus on the motor function of the lower esophageal sphincter, LES (8 and 9). So far, few studies have been conducted to evaluate food intake in patients with GERD symptoms (10-12) with different results. The results of physiological studies on food volume and energy dissipation in GERD are also unclear. According to a study, the rate of gastroesophageal reflux due to the consumption of a meal is considered to depend on the volume of food rather than the amount and dissipation of its energy (13). On the other hand, it is suggested that the GERD treatment regimen should focus on reducing the caloric load of meals instead of the fat content of food (14). . Studies on the role of obesity as another risk factor for GERD indicate conflicting results (15). Therefore, due to the existing contradictions, the present study was conducted to investigate the relationship between diet and BMI and their interventional effect on GERD.
materials and methods
This study was performed on 217 patients referred to the Faculty of Medicine and Examination Hospital (age range 14-69 years with age and sex and positive and negative reflux symptoms) between 1994-95.
Individuals with symptoms of GERD (heartburn, return of gastric contents to the esophagus or both) during the last 12 months were selected as the affected group and individuals without the above symptoms as the control group. The evaluation of these symptoms was reliable for the diagnosis of GERD (16) and therefore, in this study, a checklist related to GERD symptoms was used for diagnosis.
This checklist included questions about the type and frequency (weekly or at least monthly) of symptoms.
Exclusion criteria: This study included gastric surgery, esophageal or gastric cancer, history of vagotomy, known peptic ulcer and use of LES pressure-modifying spices (such as calcium channel blockers and nitrates), proton pump inhibitors (PPIs) , H2 receptor antagonists (H2RAs), and contraceptives and hormones. If the patient was using antacids, he was discontinued one month before the diet.
Research materials and methods:
The height and weight of the subjects were measured (without shoes and with at least clothes) with a wall height gauge with a minimum of 0.1 cm and a weight measurement scale. Finally, the body mass index (BMI) of the weight division (kg) G) was calculated based on height squared (square meters) and BMI equal to or greater than 25 was defined as overweight or obese. In addition, each patient was provided with a three-day food registration form. This form included questions about the type of food, the ingredients and the amount consumed by the person, which after the necessary training and the written instructions that were given to them, Subsequently, face-to-face interviews were conducted to ensure that the amount and type of their usual meals were recorded. The amount and energy dissipation of foods was calculated as the energy per unit weight of food (kilocalories per gram) except drinking water and non-energy drinks.
Research problems: The lack of a standard hospital, the patient's lack of cooperation with the doctor and the war conditions in the country are the problems in our research.
The questions that this research answers: Does being overweight cause reflux? This illness lowers the quality of life. What are the side effects of this disease?
Aim and importance of the research: The main purpose of this study is to identify the relationship between basic food composition, amount and dissipation of energy, energy intake, volume and frequency of food consumption and BMI with GERD symptoms.
Importance of research: It is due to the adverse effects on the quality of life of patients and also the high cost of treatment due to the use of spices and frequent medical visits.
Literature review
Return of acid to the esophagus or gastroesophageal reflux disease or gastroesophageal reflux, popularly known as acid reflux, means mucosal damage and chronic symptoms due to abnormal return of stomach acid and contents to the esophagus. Common symptoms of gastroesophageal reflux disease include heartburn, chest pain, and bad breath. Literary evidence indicates that one-fifth of Iranians (especially Tehranians) suffer from gastritis, that is, they become acidic at least once or twice a week. [1]
A quarter of the population of our country, Afghanistan, suffers from this disease and does not realize the consequences. They consume a lot of animal fat and cholesterol. The prevalence of the disease is estimated to be about 25% in Western countries based on the symptoms of heartburn and acid regurgitation with a criterion of at least once a week (1). However, complications due to diseases such as inflammation and damage to the esophageal and esophageal lining are more common in men.
(3) Aging is an important factor in causing morbid complications (5, 4). Recent studies have reported the prevalence of the disease in different races, although the effects of the disease were higher in whites. [6]. This disease is one of the most common digestive diseases that its prevalence is increasing in recent years. The decline in Helicobacter pylori infection in recent years, which has
led to an increase in gastric acid production, is one of the possible reasons for this upward trend. Helicobacter pylori infection with simultaneous involvement of the antrum and gastric trunk (which contains acid-separating cells) can reduce gastric acid outflow. Another possible cause of the increase in this disease is the current obesity epidemic (8, 7).
The prevalence of tight wearable goods among women is more likely to cause this disease
The prevalence of the disease family and its complications have suggested a genetic role in the disease (10, 9). Oesophageal motility disorder (11)
The disease is also prevalent in Afghanistan, Pakistan, Uzbekistan, and Iran. In several studies in Iran, the prevalence of this disease has been between 10.7 and 25% daily with the criterion of burning of the back of the chest. (8-12)
Hernias are present in 54 to 94% of patients with reflux esophagitis due to reflux, which is more common in the general population. (4 and 2) The severity of esophagitis is related to the size of this hernia.
The time that the pH of the oesophagus stays below 4 is called the time when the acid clears from the oesophagus. Prolonged acid clearance occurs in half of patients with esophagitis. People with an oesophageal hernia from the diaphragm have the longest time to clear acid from the oesophagus. Perisaltic movements of the oesophagus clear the acid from the oesophagus. 5) Oesophageal motility disorders can cause esophagitis. It is not known whether esophagitis leads to oesophageal motility disorders or whether a musculoskeletal movement disorder predisposes a person to reflux disease.
The glaze of the mouth is a weak gland with a pH of 6.4 to 7.8, which can neutralize small amounts of acid remaining in the oesophagus, but is not effective in neutralizing large amounts of acid. (6)
Decreased glaze during sleep is the cause of nocturnal reflux episodes, which prolongs the time it takes for the acid to clear from the oesophagus.
Dry mouth, which reduces the secretion of glaze, is associated with a prolonged period of oesophageal contact with acid and inflammation in the oesophagus. 8)
In addition, cigarette nicotine causes reflux by lowering the pressure in the lower oesophageal sphincter.
Delayed gastric emptying is an important cause of disease, especially in diabetic patients with autonomic neuropathy. In these patients, the discharge of solids is slow. (9)
Acid and pepsin are important factors in causing mucosal damage due to the return of gastric contents to the oesophagus.
Pregnancy increases reflux by lowering the pressure of the lower oesophageal sphincter as a result of the effects of oestrogen and progesterone, as well as the mechanical effects of the pregnant uterus. 30 to 80 percent of pregnant women complain of burning sensation in the back of the chest, especially in the first trimester of pregnancy. (3-8) which is relieved by taking antacids and milk.
Many scleroderma patients have reflux disease and its complications. Molasses muscle fibrosis in this disease reduces the pressure of the lower sphincter and normal or impaired oesophageal movements are lost (9).
Reflux disease and its complications are more common in Zollinger-Ellison disease due to excessive acid secretion and large volume of gastric secretions. (4)
Surgery to treat achalasia, placement of the nasogastric tube for long-term feeding, and obesity cause reflux disease due to interference with the normal function of the lower oesophageal sphincter.
Consumption of cigarettes, alcohol, bulky and fatty meals, chocolates, citrus fruits and beverages containing citric acid, spicy foods, eggplant compounds, coffee, tea, carbonated beverages, short time interval between food intake and strenuous exercise. Are reflux.
In various studies, mental disorders have been observed in people with GERD, especially in a subset of patients who do not have obvious mucosal damage on endoscopy. (4-5) In various studies, increased acid secretion during stress (5) is slow. Emptying the stomach with psychological stress during the fear and stress of war The conditions in Afghanistan and Afghanistan (8) and increasing
the sensitivity of the oesophagus (9) have been suggested as mechanisms involved in the occurrence of the disease.
Findings and Results: The mean age of our subjects in the northern parts of the country was 12.6 + _ 35.3 and 13.2 + _ 35.1 years in the group with reflux symptoms and without reflux symptoms (age range 14-69 years), respectively. 26.3% of them (12.5% in the case group and 13.8% in the control group) were men. The case group included 69 (65.1%) patients with at least weekly symptoms and 37 (34.9%) patients with monthly GERD symptoms. Demographic characteristics and BMI (Body mas index) of the subjects are shown in Table 1. In addition to age and sex, marital status, occupation, smoking and menopausal status did not show any difference between the two groups, which indicates that the two groups of affected and non-infected people are better matched. People with GERD symptoms had lower levels of education and higher BMI (P <0.001 in both cases) (Table 1). The dietary intake of the subjects is summarized in Table 2. Although the group of patients reported receiving more fat than the control group (mean, 68.6 vs. 66.9 g), but it was not significant in terms of numbers. Both groups had similar amounts of energy intake (average 1981's vs. 1982 4 4 kcal), carbohydrate grams (average 281.02 vs. 286.9 grams) and protein grams (average 64.6 vs. 68.6 grams). Had consumed.
The intake of other nutrients was similar between the two groups. So that the amount and dissipation of energy, total volume and number of meals consumed did not show a significant difference between the two groups. However, the mean protein content of energy intake in GERD patients was lower than healthy individuals (P = 0.06), indicating that low protein intake is likely to be associated with an increased incidence of GERD. Considering the intervening effect of BMI as a distorting factor in the incidence of GERD, the above relationship was observed in people with normal BMI, but not in people with high BMI. On the other hand, total fat and simple sugar after BMI control showed a significant positive relationship with overweight or obesity in the incidence of GERD (P = 0.04) in both cases (Table 3).
Controversy According to epidemiological studies, the prevalence of GERD in Western countries is between 10-48%, in Asian countries (> 5%) (3) and in Iran 2.7%4 In our country, as far as we estimated, these figures are 20%. On Eid al-Adha, we saw a 35% increase in this illness due to the high consumption of animal fat and sacrificial meat at this time of year. The cause of this condition is the use of cholesterol-rich fats, which are used extensively. They swallow food without excitement. Excitement between meals, talking between meals. They swallow food with greed and craving along with the air. Eventually, they become ill. The main purpose of this study was to identify the relationship between basic food composition, amount and dissipation of energy, energy intake, volume and frequency of food consumption and BMI with GERD symptoms. The present study showed that among the dietary factors, only the share of protein in energy intake was significantly implicitly associated with GERD symptoms (Table 2). After controlling BMI as a distorting factor, increasing the protein share of energy intake somewhat reduced the risk of GERD. Protein is thought to reduce GERD through its effect on increasing LES pressure (17) and stimulating gastrin secretion and subsequently promoting gastric emptying (18). Because there seems to be a pathophysiological relationship between LES pressure reduction (19), gastric emptying delay (20) and GERD.
Table 1 Demographic characteristics (age, sex, occupation, level of education) and BMI in
people with and without GERD symptoms_
Variable of people with GERD symptoms (n = 106) Non-people with GERD symptoms (n = 111)
Average and standard deviation Average and standard deviation_
_Average and standard deviation Average and standard deviation
Age (years) 12/6± 13/2 3.35 ±35/1
BMI (kg / m2) 5/6+ 3/7 27/7 ±25/3_
Gender n (%) n (%)_
Male 30 (13/8) 27 (12/5)
Female 81 (37/3) 79 (36/4)_
Occupational status_
Unemployed 80 (72/1) 81 (76/4) Unemployed 2 (1/8) 2 (1/9) Convinced 8 (7/2) 3 (2/8)
Housewife 46 (41/4) 62 (58/5) Learned 2 (21/7) 14 (13/2) Employed 31 (27/9) 25 (23/6) Employee 20 (18) 17 (16)
Free 11 (9/9) 8 (7/6)
Level of Education illiterate 8 (3/7) 20 (9/2) Literate 64 (28/5) 67 (31) Higher Education 39 (18/8) 19 (8/8) marital statu
Single 25 (11/5) (7/15) 34
Married 77 (35/5) 81 (37/3)_
Menopausal status Yes sir 9 (5/7) 14 (8/9)
No 70 (44/6) 64 (40/8)_
Non-smoking 110 (50/7) 103 (47/5)
Table 2: Comparison of food intake in patients with and without GERD symptoms_
Variable People with GERD symptoms Non-GERD people
Mean and standard deviation Mean and standard deviation_
Total energy (kcal / day) 574/38± 628/23 1982/41 ±1981/25
Percentage of total energy from carbohydrates 8/18±/80 56/31 6±56/36
Percentage of total energy from fat 7/85 ± 6/96 30/85 ±30/03
Percentage of total energy of protein 2/77± 3/07 12/90 ±13/68
Carbohydrate (gram) 96/33 ± 89/25 281/02 ±286/90
Simple sugar (grams) 12/32± 16/55 22/09 ±24/87
Protein (gram) 24/16± 23/58 64/67 ±68/65
Fat (gram) 140/48± 26/31 231/88 ±69/95
Cholesterol (mg) 650/84± 529/66 2062/26 ±1956/22
Food volume (grams) 650/84± 529/66 2062/26 ±1956/22
Amount and energy dissipation of food (kcal) 0/25± 0/32 0/99 ±1/04_
Table 3: Interventional effect of BMI and type of food among people with and without GERD symptoms_
Types of food People with GERD symptoms Non-GERD people_
Number: 31 people Number: 63 people_
Total energy (kcal / day)
Total energy from: Carbohydrate% 556/97± 568/13 1950/06 ±2095/86
Fat 8/53 ± 6/51 55/74 ±55/53
Protein 8/25± 6/92 32/00 ±31/09
Consumption: Carbohydrate 2/32± 2/69 12/25 ±13/39
Simple sugar (grams) 10/33± 13/59 20/29 ±21/92_
BMI<25 Protein (gram) 20/26± 22/86 58/79 ±70/50 Fat (grams) 29/14± 27/41 68/25 ±72/10 Cholesterol (grams) 137/29± 122/19 240/70 ±238/74
Food volume (grams) 621/18± 548/51 1857/39 ±1978/42_
Amount and dissipation of food energy (kcal / gram 0/27+ 0/35 1/07 +1/10
Number of meals consumed 0/42± 0/49 5/87 ±5/82_
Número: 75 personas Numero: 48 personas_
Energía total (kcal / día) 656/36+ 553/59 2012/74 ±1833/50 Energía total de: Carbohidrato% 8/07+ 7/09 56/54 ±57/43 Fat 7/68+ 6/83 30/38 ±28/64 Protein 2/91+ 3/50 13/17 ±14/06
Consumption: Carbohydrate 103/06+89/77 286/84 ±275/17 BMI>25 Simple sugar (grams) 25/33+ 24/52 67/09 ±66/22 Protein (gram) 28/42+ 23/38 68/74 ±60/18 Fat (grams) 142/53+ 132/91 228/24 ±213/47 Cholesterol (grams) 647/88+ 508/11 2146/94 ±1927/08 Food volume (grams) 0/23+ 0/26 0/95 ±0/97
Amount and energy dissipation of food (kcal / gram) 0/39+ 0/68 5/85 ±5/70 Number of meals consumed
Consistent with the findings of the present study, in the study of Nandurkar et al. (11) with a study of 212 patients, no significant relationship was found between diet and GERD, while with increasing BMI, the risk of GERD increased. According to a study by Becker et al.,
Recommending a low-fat diet to the general GERD patients is an inappropriate treatment approach (7). In contrast to the present study in a cross-sectional study by L-Serag et al. (10), which used a food frequency questionnaire to assess food intake, it was shown that high saturated fat intake, cholesterol and high fat intake were associated with an increased incidence of GERD symptoms. . However, this association was negligible when controlling BMI.
However, it is not clear whether the fat effects of food are independent of the effects of obesity. In this study, no association was found between other food intake (protein and carbohydrate) and GERD symptoms. In another study (12) was obtained on 60 patients with GERD. However, there was no association between BMI and reflux. It should be noted that in this study, the number of subjects was low and there was no group of patients. While the present study has enough power to identify the difference in food intake between the two groups and also has a control group. In the present study, there was a large variability in the reported amounts of food intake (Table 2). In addition, it is not known whether patients with GERD changed their diet significantly during the study and subsequent dietary record; This is because patients with severe GERD are often advised to adjust their eating habits by reducing their intake of high-fat meals or eliminating annoying foods. Nevertheless, some of the patients studied with mild GERD were reluctant to change their diet. It is also unclear whether patients had symptoms of GERD at the time of food registration, and if so, whether it affected the type and amount of food they ate. However, the above factors can lead to not considering the relationship of some important dietary factors with GERD. In our current study, a strong positive association was found between high BMI and GERD symptoms. This association remained significant even after controlling the distorting factors. Obesity can be due to various mechanisms such as increased intra-abdominal pressure (1-2). Decreasing LES pressure and increasing the frequency of transient relaxations of the lower oesophageal sphincter (2) lead to increased oesophageal contact with gastric acid and eventually GERD.
Final conclusion The results of the present study indicate the possible supportive role of the protein's share of energy intake and exposure to war and stress conditions in the severity of GERD symptoms. On the other hand, lower BMI and stress relief can reduce the incidence of GERD. According to the results of the present study, there is no direct correlation between fat and simple sugar with GERD symptoms and on the other hand, the effect of BMI intervention on the incidence of this disease, it is likely that the above compounds indirectly through non-reflux genic mechanisms of Increase BMI, increase the risk of developing GERD. However, due to the increase in the number of overweight and obese patients with GERD, appropriate dietary intervention studies
are necessary to prevent and treat GERD symptoms. Proposal: In the context of our country Afghanistan, we make the following proposal. We suggest lifestyle changes for the better
2. Lifestyle changes may be effective in mild cases of reflux or condition-dependent or nutritional reflux.
1- We suggest reducing life stress or avoiding it
3- One of these cases is raising the head of the bed during sleep, especially in cases where there is nocturnal reflux.
4 - Avoid wearing tight clothing, weight loss if GERD is associated with obesity, not consuming alcohol and cigarettes, diet changes, especially when the symptoms of GERD are exacerbated by the use of certain substances, avoid lying down immediately after consumption Food, he pointed out.
5. Reducing the volume of meals, reducing the fat content of food, reducing the consumption of substances containing colours and chocolate in some cases is helpful. Some patients complain of irritation of the back of the chest after consuming acidic beverages such as citrus fruits and spicy foods and consuming compounds containing eggplant, as well as reflux after drinking coffee, tea, and carbonated beverages.
6- In some cases, raising the head of the bed, especially in people with nocturnal reflux, alleviates the patient's symptoms.
7. Antacids neutralize stomach acid and also increase the pressure of the lower oesophageal sphincter. Symptoms of irritation of the back of the chest can be relieved by taking antacids, but it should be used frequently every 1 to 3 hours after a meal to relieve symptoms. 8- Excitement of war conditions should be reduced in time of war illness.
9- We suggest using boiling water instead of tea and coffee during the war.
Article summary in English : Gastroesophageal reflux disease (GERD), also known as acid reflux, is a long-term condition where stomach contents come back up into the oesophagus resulting in either symptoms or complications.[4][5] Symptoms include the taste of acid in the back of the mouth, heartburn, bad breath, chest pain, vomiting, breathing problems, and wearing away of the teeth.[4] Complications include esophagitis, oesophageal strictures, and Barrett's oesophagus.[4]
Risk factors include obesity, pregnancy, smoking, hiatus hernia, and taking certain medicines.[4] Medications involved include antihistamines, calcium channel blockers, antidepressants, and sleeping medication. It is due to poor closure of the lower oesophageal sphincter (the junction between the stomach and the oesophagus). Diagnosis among those who do not improve with simpler measures may involve gastroscopy, upper GI series, oesophageal pH monitoring, or oesophageal manometer. Treatment is typically via lifestyle changes, medications, and sometimes surgery. Lifestyle changes include not lying down for three hours after eating, losing weight, avoiding certain foods, and stopping smoking. Medications include antacids, H2 receptor blockers, proton pump inhibitors, and prokinetics. Surgery may be an option in those who do not improve with other measures. In the Western world, between 10 and 20% of the population are affected by GERD. Gastroesophageal reflux (GER) once in a while, without significant symptoms or complications, is more common The condition was first described in 1935 by the American gastroenterologist Asher Winkelstein. The classic symptoms had been described earlier in 1925. Certain foods and lifestyle are considered to promote gastroesophageal reflux, but most dietary interventions have little supporting evidence Avoidance of specific foods and of eating before lying down should be recommended only to those in which they are associated with the symptoms. Foods that have been implicated include coffee, alcohol, chocolate, fatty foods, acidic foods, and spicy foods. Weight loss and elevating the head of the bed are generally useful. A wedge pillow that elevates the head may inhibit gastroesophageal reflux during sleep. Stopping smoking and not drinking alcohol do not appear to result in significant improvement in symptoms. Although moderate exercise may improve symptoms in people with GERD, vigorous exercise may worsen them.
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9- - Stanghellini V: Three-month prevalence rates of gastrointestinal symptoms and the influence of demographic factors. Results from the Domestic/International Gastroenterology Surveillance Study (DIGEST). Scand J Gastroenterol 34(Suppl 231):20, 1994
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11 - Richter JE, Falk GW, Vaezi MF: Helicobacter pylori and gastroesophageal reflux disease: The bug may not be all bad. Am J Gastroenterol 93:1800, 1998.
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РОЛЬ ВОЕННОГО СТРЕССА И СОЧЕТАНИЕ ДИЕТЫ И МАССЫ ТЕЛА ПРИ БОЛЕЗНИ ЖЕЛУДОЧНО-ПИЩЕВОДНОГО РЕФЛЮКСА
Предпосылки и цели. Патогенез гастроэзофагеальной рефлюксной болезни (ГЭРБ) до конца не изучен. Однако в патогенезе ожирения есть несколько факторов риска ожирения, включая диету и избыточный вес. Из-за противоречивых результатов различных исследований в этой области, это исследование было проведено для изучения влияния диеты и индекса массы тела (ИМТ) и их интервенционного воздействия на гастроэзофагеальную рефлюксную болезнь.
Методы: это исследование было выполнено на 217 человек с подозрением на ГЭРБ (106 с симптомами и симптомами (поражены) и 111 (без симптомов и симптомов) не затронуты, с точки зрения возраста и пола), направленных в больницу для персонала и на домашний осмотр. Данные были собраны с использованием общей анкеты, контрольного списка для диагностики ГЭРБ и трехдневной регистрационной формы для оценки потребления пищи. Были измерены вес и рост, а также рассчитан индекс массы тела (ИМТ). ИМТ, равный или превышающий 25, считался избыточным весом или ожирением.
Результаты: средний ИМТ испытуемых составлял 26,5 ± 26,5 кг / м2. Среди диетических факторов только доля белка в потребляемой энергии показала различия между пациентами с ГЭРБ и здоровыми людьми.
Но потребление других пищевых соединений было одинаковым между двумя группами. Количество и рассеивание энергии, общий объем и количество потребленных приемов пищи не показали значительной разницы между двумя группами; В то время как частота симптомов ГЭРБ была выше у людей с высоким ИМТ. Учитывая промежуточный эффект
ИМТ, из набора диетических факторов общее содержание жира и простой сахар показали значительную положительную взаимосвязь с избыточным весом или ожирением в частоте возникновения ГЭРБ.
Заключение: результаты этого исследования указывают на возможную и поддерживающую роль содержания белка в потребляемой энергии в развитии симптомов ГЭРБ. С другой стороны, с увеличением ИМТ распространенность ГЭРБ увеличивается. Простое ожирение и глюкоза, по-видимому, косвенно участвуют в развитии симптомов ГЭРБ через нерефлюксные механизмы, включая увеличение ИМТ.
Ключевые слова: диета, жир, масса тела, рефлюкс, нижний сфинктер пищевода.
THE ROLE OF WAR STRESS AND THE COMBINATION OF DIET AND BODY MASS IN GASTROESOPHAGEAL REFLUX DISEASE
Background and Aims: The pathogenesis of Gastro-esophageal reflux disease (GERD) is not fully understood. However, there are several risk factors for obesity in the pathogenesis of obesity, including diet and overweight. Due to the contradictory results of different studies in this field, this study was conducted to investigate the effect of diet and body mass index (BMI) and their interventional effect on gastroesophageal reflux disease.
Methods: This study was performed on 217 people suspected of having GERD (106 with symptoms and symptoms (affected) and 111 (without symptoms and symptoms) not affected, in terms of age and sex) referred to the staff hospital and home examination. Data were collected using a general questionnaire, checklist for GERD diagnosis and a three-day food registration form to assess food intake. Weight and height were measured and body mass index (BMI) was calculated. BMI equal to or greater than 25 was considered overweight or obese.
Results: The mean BMI of the subjects was 26.5 + _ 26.5 kg / m2. Among dietary factors, only the protein share of energy intake showed differences between GERD patients and healthy individuals.
But the intake of other dietary compounds was similar between the two groups. The amount and energy dissipation, total volume and number of meals consumed did not show a significant difference between the two groups; While the incidence of GERD symptoms was higher in people with high BMI Considering the intervening effect of BMI, from the set of dietary factors, total fat content and simple sugar showed a significant positive relationship with overweight or obesity in the incidence of GERD.
Conclusion: The results of this study indicate the possible and supportive role of protein content of energy intake in the development of GERD symptoms. On the other hand, with increasing BMI, the prevalence of GERD increases. Simple obesity and glucose appear to be indirectly involved in the development of GERD symptoms through non-reflux mechanisms, including increased BMI.
Keywords: Diet, Fat, Body mass, Reflux, Lower esophageal sphincter
GREEN CHEMISTRY AND ITS ROLE IN HUMAN LIFE
Pohanmal (Assistant Professor) Mr. Noor Ahamd Qaitmas Faryab University
Introduction
There is no doubt that the economic growth of any country depends on the scientific progress of the people of that society. Therefore, the school curriculum, especially the school chemistry curriculum, should be based on the needs of individuals and the scientific needs of the world. Although chemistry has played a fundamental role in the development of human civilization and its place in economics, politics and life has become more colorful day by day. Covers a wide range of chemical products including spices, foodstuffs, baby chemicals, dyes and more. Clearly, we can
