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Caroli disease is characterized by bile duct ectasia without other liver abnormalities. In contrast, Caroli syndrome is characterized by bile duct dilatation with congenital liver fibrosis. Caroli disease is rarer than Caroli syndrome. This paper introduces a 32-yearold man with vitiligo and asymptomatic Caroli disease who was accidentally diagnosed following a fall from a height. [ABSTRACT FROM AUTHOR]

Background: Liver cancer is the fifth most common cancer worldwide. Currently, because of increased risk factors and life expectancy, the prevalence of this cancer has increased. Therefore, health care systems should focus more on liver cancer. Evaluation of efficacy and side effects of therapeutic methods can identify potential problems in such patients and provide a good basis for patient care plans. This is an effective step to increase patient satisfaction and subsequently increase treatment success. This review study aimed to evaluate the side effects and efficacy of treatment modalities in patients with liver cancer. Materials and Methods: This study was based on the method presented by Cronin and colleagues (2008), which has five stages. The articles in the timeframe of 2018-2012 were searched. 20 paper have been selected and studied which are more relevant to the topic, and each of them has at least two keywords. Results: The treatment modalities for liver cancer are classified into two groups: surgical (hepatic resection, liver transplantation), and nonsurgical (microwave, radiofrequency, trans arterial chemoembolization, ethanol injection, and chemotherapy). Their complications are divided into physical and psychological sections. The more invasive these methods (surgical) or the more systemic side effect they have (chemotherapy), the greater the physical and psychological complications will be. This study shows that the incidence of adverse events in chemotherapy and hepatic resection was higher than the other treatments, while microwave and radiofrequency had fewer side effects. Adverse effects are the determinants of survival, health-related quality of life, and efficacy of therapeutic modalities. This study shows that the efficacy of microwave and radiofrequency therapies were more than the other therapeutic modalities. Conclusion: Treatment modalities in liver cancer are classified into two groups, surgical and non-surgical. Their consequences are categorized as physical and psychological. By assessing the complications of treatments the survival rate and quality of life in patients with liver cancer are determined. Although in many situations because of patient's conditions and the stages of the disease, it is not possible to choose treatments with low side effects, increasing the awareness of the benefits and potential side effects of each treatment, can help in planning for prevention and appropriate action. Also, increasing the patients’ knowledge about the side effects of the therapeutic methods will lead to the patients’ informed involvement in the treatment process, which will have a significant positive effect on reducing anxiety and depression in affected patients, and promote the quality of medical and nursing care, and can reduce the financial burden of the community. [ABSTRACT FROM AUTHOR]

Background: Bleeding after endoscopic retrograde cholangiopancreatography (ERCP) is a serious complication that requires identification of its underlying factors. We aimed to investigate the incidence and predictors of this complication in our center. Materials and Methods: We conducted a descriptive cross-sectional study on 500 patients who underwent ERCP for any indication at Firoozgar Hospital in 2020-2021. We collected data on demographic characteristics, medical history, medications, preoperative hemoglobin, and indication for ERCP from the hospital records. We also measured intraoperative bleeding, sphincterotomy, and hemoglobin levels at 6 hours and one week after ERCP. We used SPSS software for data analysis and considered P< 0.05 statistically significant. Results: The mean ± SD age of the patients was 60.37 ± 16.37 years, and 50.8% were male. The incidence of acute and delayed bleeding after ERCP was 4.2% and 0.6%, respectively, and the rate of acute and delayed moderate to severe hemoglobin drop was 7.8% and 13%, respectively. There was no difference in demographic information, medical history, and medications between patients with and without acute and delayed hemoglobin drop. However, patients with a history of diabetes mellitus had a higher rate of mild delayed bleeding, and patients with smoking and clopidogrel use had a higher rate of moderate to severe hemoglobin drop (P< 0.05). Sphincterotomy, precut, peri-ampullary anatomy, and common bile duct (CBD) size did not affect the incidence of acute and delayed bleeding and hemoglobin drop. Conclusion: Diabetes mellitus was the only risk factor for delayed bleeding, and smoking and clopidogrel were risk factors for moderate to severe hemoglobin drop. Due to the discrepancy between overt and laboratory bleeding in this study, we recommend regular hemoglobin monitoring as a more accurate indicator of bleeding after ERCP. [ABSTRACT FROM AUTHOR]

Background: Shigellosis is an acute infection in the intestine and leads to bloody diarrhea. Children under 5 years old, the elderly, and immunocompromised people are at a higher risk of contracting this disease. Therefore, the aim of this systematic review and meta-analysis was to determine the prevalence of shigellosis in Iranian children. Materials and Methods: This study is a systematic review and meta-analysis by examining the Scientific Information Database (SID), Medline (PubMed), Science Direct, and Google Scholar until August 2023. Extracted data were analyzed using comprehensive meta-analysis software (version 2). Results: In the review of 15 studies with a sample size of 18336 children, the I2 heterogeneity test showed high heterogeneity (I2: 99.07), and based on this, the random effects method was used to analyze the results. Based on the meta-analysis, the prevalence of shigellosis in Iranian children was 13.4 (95% CI: 7.6-22.7). Conclusion: There The results of the present study show that the prevalence of shigellosis in Iranian children is high and requires more information and care of children through health measures and health education, as well as control of children's nutrition through the cooperation of the Ministry of Health and Education. [ABSTRACT FROM AUTHOR]

Background: Liver transplantation is a critical treatment option for end-stage liver disease, albeit associated with potential complications. Among the most common post-transplant complications are biliary issues, including leaks, strictures, and obstructions. Endoscopic retrograde cholangiopancreatography (ERCP) is frequently employed to manage these complications despite its inherent risks. While the complications of ERCP in the general population are well-documented, specific risks and protective factors for liver transplant recipients have not been extensively studied. Materials and Methods: We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines. In order to find relevant studies published between 1/1/2011 and 1/3/2023, two independent researchers conducted searches (MT, I SH). A literature search of English language publications was conducted using MEDLINE through PubMed, EMBASETM through Ovid, the Cochrane Library, and Trip. In addition to Magiran and SID, we searched KoreaMed and LILACS for literature published in other languages. Endoscopic retrograde cholangiopancreatography OR ERCP, OR liver Transplantation, OR Complication are terms used in the search strategy. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies, and data were independently extracted by two researchers. Results: A total of 274 studies were selected. After analyzing their correspondence with the required criteria, a final review of eleven studies was conducted. Our meta-analysis identified several risk and protective factors for complications following ERCP in liver transplant patients. Protective factors included male sex and intraoperative stenting, which were associated with reduced complications. Conversely, high serum bilirubin and creatinine levels and a history of hepatitis B were found to increase the likelihood of complications or failure after ERCP. Factors such as age, history of diabetes, serum Alanine Aminotransferase (ALT) level, steroid administration, Mammalian Target of Rapamycin (mTOR) inhibitor use, and sphincterotomy did not significantly impact ERCP outcomes and complications. Conclusion: This systematic review and meta-analysis provide valuable insights into the risk and protective factors associated with complications following ERCP in liver transplant recipients. These findings can inform clinical decision-making and guide healthcare providers in optimizing the management of post-transplant biliary complications. [ABSTRACT FROM AUTHOR]

Background: One of the most sensitive periods of a person's life, which has a great impact on his future health, is the fetal period, while the risk of infection in children of mothers who are positive in terms of HBsAg serum level is very high. Therefore, the aim of this systematic review and meta-analysis is to determine the prevalence of hepatitis B infection in Iranian pregnant women. Materials and Methods: This study is a systematic review and meta-analysis by examining Scientific Information Database (SID), Medline (PubMed), ScienceDirect and Google Scholar until February 2024. Results: In a review of 45 studies with a sample size of 77,641 pregnant women, based on meta-analysis, the prevalence of hepatitis B infection in Iranian pregnant women was reported to be 1.1% (95% CI: 0.9-1.4 %), meta-regression results showed that with increasing The sample size, the prevalence of hepatitis B infection in Iranian pregnant women decreased (P<0.05) and also with the increase in the years of conducting studies, the prevalence of hepatitis B infection in Iranian pregnant women decreased (P<0.05) and also with the increasing age of women. pregnant, the prevalence of hepatitis B infection increases in Iranian pregnant women (P=0.133). Conclusion: The results of the present study show that the prevalence of hepatitis B infection in Iranian pregnant women is not at a high level, but according to the meta-regression analysis, which shows the effect of age at the same time as the increase of this infection in women, it is necessary to continue preventive measures and reach The lower levels of attention of health policy makers in this area should be directed to carry out extensive information and screening. [ABSTRACT FROM AUTHOR]

With Currently, Endoscopic retrograde cholangiopancreatography (ERCP) has evolved as a therapeutic intervention for treating disorders related to the biliary system and plays an important role in treating benign and malignant strictures of the biliary system. The placement of biliary stents is a frequent and useful procedure to decompress the biliary system, and endoscopic biliary stenting seems relatively simple. However, in some cases, it can lead to several complications. Distal or proximal migration of endoscopically placed biliary stents is one of the known complications of ERCP and can affect up to 6-10% of patients. Several factors, including those related to the patient, endoscopy, or stent, are involved in stent migration. When migration occurs, it is necessary to remove or replace endoprosthesis to prevent recurrent biliary complications and more severe consequences such as cholangitis and sepsis. This review explores the frequency, etiology, risk factors, complications, and management strategies pertaining to biliary stent migration, consolidating diverse management approaches for informed decision-making. [ABSTRACT FROM AUTHOR]

Background: The impact of thyroid function on the prognosis and complications of liver cirrhosis remains unclear. Therefore, this study aimed to determine the relationship between thyroid hormones and cirrhosis prognosis and complications. Materials and Methods: This cross-sectional study was conducted from March 2021 to March 2022 at Imam Khomeini Hospital in Iran. A total of 100 patients with cirrhosis, aged 18 to 80 years, were recruited. The questionnaire designed for collecting data included patients' demographics, laboratory data, and criteria for cirrhosis progression. Results: The study revealed a significant correlation between the model for end-stage liver disease (MELD) and free tri-iodothyronine (FT3) (P=0.019). For each unit increase in FT3, the MELD score is expected to decrease by approximately 2.268 units. In men, there was a correlation between MELD and FT3 (P=0.033). Additionally, in women, there was a correlation between MELD and FT4 (P=0.03). MELD had a significant correlation with ascites and hepatic encephalopathy. Furthermore, a significant relationship was found between FT3 and ascites and esophageal varices. Results of analysis of the relationship between FT3 and MELD components revealed a significant correlation between FT3 and bilirubin (P=0.001). Moreover, an inverse relationship was found between thyroid stimulating hormone (TSH) and international normalized ratio (INR) (P=0.03). High FT3 levels were found to be 15 times more frequent in Child-Pugh A and B patients compared to Child-Pugh C patients. Conclusion: FT3 is correlated with the MELD score and complications of cirrhosis. The value of FT3 can serve as a prognostic criterion. It is recommended to monitor thyroid levels in patients with cirrhosis and provide treatment if any disorder is detected. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is one of the most common gastrointestinal cancers worldwide. KRAS mutations are found in 20-30% of the cases and are associated with poor response to anti-EGFR therapies. Mutations in the KRAS gene induce the constitutive protein activity by eliminating the GTPase activity in the signal transduction pathway. Somatic mutations of KRAS are located up to 90% in codons 12 and 13 of exon 2. Therefore, this study evaluated the association between KRAS mutations and clinicopathological features of patients with CRC in Isfahan. Materials and Methods: This study was performed on 52 patients with CRC referred to Al-Zahra Hospital in Isfahan. Total DNA was extracted from fresh tumor and normal tissues. The exon 2 of KRAS gene was amplified and sequenced for detection of the point mutations. After mutation analysis, the clinical and pathological associations of mutant genes were assessed. Results: The prevalence of KRAS gene mutation was 15/4% (8 out of the 52 cases). Six mutations found in codon 12 (75%), were G12D and G12A, and two mutations found in codon 13 (25%) were G13D. Common tumor sites were rectum and rectosigmoid. The mean age of the patients was 61/2±13/9 years (range: 31-87 years). There was no significant relationship between the mutations and clinicopathological features of patients with CRC (p>0.05). Conclusion: This paper presents new results on the frequency of KRAS mutations in patients with CRC. KRAS mutations could be used as molecular biomarkers to predict the lack of response to anti-EGFR monoclonal antibodies. [ABSTRACT FROM AUTHOR]

Background: The Celiac National Institute has recently devised a diagnostic algorithm for celiac, which has been adopted from the most recent guidelines and articles worldwide. All Iranian provinces are requested to set all diagnoses based on the newest national protocol devised by the National Institute of Celiac Disease; however, some incompatibilities are observed. Therefore, this study was conducted to demonstrate these incompatibilities. Materials and Methods: In this descriptive-analytical study, we enrolled 250 cases of celiac disease referred to the province registry system and revised the diagnosis based on the national protocol for celiac disease diagnosis. All data were analyzed using SPSS software version 26. Results: Among the 250 patients diagnosed with celiac disease, 88 (35.2%) had incompatibility. The mean age of the patients was 37.19 years. 28 people (31.8 %) were men. Results indicated that in 40.9% of incompatibility cases, only pathology tests were performed, and in 52.3% of incompatibility cases, only serological tests were performed. In 6.8% of cases, both tests were performed, but the diagnosis was indefinite. Pathological results indicated that 0.5% of patients were in Marsh 1, 19% in Marsh 2, 35.7% in 3a, 23.8% in 3b, and 19% in Marsh 3c phases. Conclusion: There are cases of diagnostic incompatibilities between the most recent national protocol for celiac disease and physicians' practice. Therefore, it is vital that practitioners are trained with the national protocol for celiac disease diagnosis. [ABSTRACT FROM AUTHOR]

A group of diseases resulting from the abnormal aggregation of amyloid fibrils, mainly in the extracellular spaces of tissues, is known collectively as amyloidosis. Clinical presentations of gastrointestinal (GI) amyloidosis are mainly GI bleeding, malabsorption, protein-losing enteropathy, and dysmotility. Here, we describe an 87-year-old woman presenting with acute onset of sharp, constant, and non-radiating epigastric pain that was accompanied by nausea or vomiting. After a thorough investigation, we finally found an isolated jejunojejunal intussusception by laparotomy. The pathological study revealed massive small bowel involvement by amyloidosis in immunostaining. To our knowledge, this is the first report of small intestinal obstruction resulting from intussusception due to intraluminal amyloid polypoid nodules, as the first presentation of light-chain amyloidosis. Amyloidosis should be considered in old patients with intraluminal masses of the proximal small bowel. [ABSTRACT FROM AUTHOR]

Background: Irritable bowel syndrome (IBS) is a prevalent functional disorder of the gastrointestinal tract that affects approximately 11% of people worldwide. The exact mechanisms underlying IBS remain unclear, but evidence suggests that low-grade inflammation is involved in its pathophysiology. Interleukin-6 (IL-6) is a key cytokine that mediates inflammatory responses in the intestinal mucosa and has been linked to the development of IBS. Our study aimed to provide an overview of the current knowledge on the role of IL-6 in IBS. Materials and Methods: The present study was conducted based on a search on the PubMed database, where only 26 articles investigated the role of IL-6 in irritable bowel syndrome were found. Results: Our review revealed that patients with IBS had higher levels of IL-6 in their serum/plasma. Furthermore, increased expression of IL-6 mediated by cholinergic signalling was associated with increased abdominal pain/discomfort and bloating. More recently, an interaction between IL-6 and corticotrophin-releasing factor was shown to provide more insight into the mechanisms underlying IBS symptoms during stressful periods, which are experienced by almost two-thirds of patients with IBS. Elevated levels of IL-6 were also correlated with increased fatigue and intestinal inflammation. Targeting IL-6 expression or IL-6 signalling pathway using probiotics, vitamin D3 or a replacement diet may offer a novel therapeutic strategy to improve IBS symptoms, abdominal pain, bloating and fatigue after consumption of ancient wheat products. Conclusion: Further studies are needed to elucidate the causal relationship between IL-6 and IBS, as well as the molecular pathways and cellular targets of IL-6 in the gut. [ABSTRACT FROM AUTHOR]

Background: Celiac disease (CD) is an enteropathy associated with a genetic disorder and several constitutive genes. This study examines the genes and factors affecting CD. Materials and Methods: This review was conducted on structured findings up to September 2023 regardless of language published according to the protocol of systematic review articles (PRISMA). To identify relevant studies, online searches were generally conducted in PubMed, Google Scholar, MEDLINE, and SCOPUS databases. Results: Many studies have been conducted on CD genes, and researchers have achieved good results. So far, 60 genomic loci related to CD have been discovered, which is the most important genetic loci of CD related to HLA(Human Leukocyte Antigen). Most of the gene loci identified in autoimmune diseases have pleiotropic effects and cause disruption of the immune system, which in turn causes CD. Conclusion: According to the linkage studies conducted on genetic regions, the most important genetic positions identified in CD are HLADQ2 and HLA-DQ8. Due to the progress of genetic science and the uncertainty of the genomic position of this disease, they have not been able to use genetic science to prevent this disease. Considering the common genes that this disease has with other gastrointestinal diseases as well as thalassemia, there may be newer and more effective genetic approaches to treat this disease in the future. [ABSTRACT FROM AUTHOR]

Background: To date, magnetic resonance imaging (MRI) plays a critical role in the management of rectal cancer. Although neoadjuvant chemoradiotherapy (nCRT) is a gold standard approach in advance to surgical management, it might alter the tissue texture, affecting MRI findings applied for decision-making in a procedural approach. Aim: The current study aimed to assess the predictive parameters in MRI associated with response to nCRT in rectal cancer. Materials and Methods: The current cross-sectional study has been conducted on 50 patients with rectal cancer who were candidates for nCRT during 2020- 21. Data including tumor markers and MRI parameters including tumor signal, tumor stage (TMN), lymph node involvement, mesorectal fascia (MRF), extramural venous invation (EMVI), peritoneal reflection invasion and tumor size were gathered at baseline and within 4-6 weeks after nCRT. The predictive factors for response to nCRT were evaluated using tumor regression grade (TRG) and TNM staging. Results: Tumor size (P<0.001), MRI signal intensity (P=0.038), tumor appearance in diffuse weighted imaging (DWI) (P<0.001), tumor stage (P<0.001), lymph node involvement (P<0.001), MRF (P<0.001), EMVI (P<0.001), and peritoneal reflection invasion (P<0.001) remarkably improved in post-nCRT assessments. Tumor size was associated with 3.75 (95%CI: 1.61-8.72) and 2.64 (95%CI: 1.40-4.97) folds, and lymph node involvement was associated with 77% (95%CI: 0.21-15.02) and 60% (95%CI: 0.21- 11.96) increased probability of response to treatment based on TRG and TNM, respectively. Conclusion: Based on the findings of this study, nCRT could remarkably improve adenocarcinoma of rectal cancer-related laboratory and imaging parameters; however, tumor size and lymph node involvement were the only predicting factors for response to nCRT. [ABSTRACT FROM AUTHOR]

Background: With the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic posing a global health emergency, selfmedication with ivermectin has been observed in certain Latin American countries. This study aimed to characterize the clinical features of liver injury associated with ivermectin when used as self-medication for treating coronavirus disease 2019 (COVID-19). Materials and Methods: We reviewed the clinical records of patients diagnosed with severe COVID-19 at the Emergency Room of Rebagliati Hospital in Lima, Peru, in March 2021. The criteria of the Drug-Induced Liver Injury (DILI) Expert Working Group and the Council for International Organizations of Medical Sciences/Roussel Uclaf Causality Assessment Method (CIOMS/RUCAM) were utilized to establish the diagnosis of drug-induced liver injury and assess causality, respectively. Results: We report five cases of ivermectin-induced liver injury (IILI), comprising four men and one woman, with a mean age of 49.3±12.3 years. The mean daily dose, duration, and total dose of ivermectin were 32.9±21.8 mg/day, 2.6 ± 0.6 days, and 89.6±71.4 mg, respectively. On average, IILI occurred 11±3.8 days after the initiation of treatment, and none of the cases developed jaundice. The mean levels of alanine aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase were elevated 8±4.4, 1.7±0.9, and 10.9±5.0 times above the upper limit of normal, respectively. Two patients exhibited a hepatocellular pattern, two had a mixed pattern, and one displayed a cholestatic pattern. All cases were classified as mild and achieved recovery. Causality assessment categorized four cases as "possible" and one case as "highly probable.". Conclusion: The findings emphasize the need for further pharmacovigilance studies on IILI when used for COVID-19 treatment. [ABSTRACT FROM AUTHOR]

Background: Parasitic infections in children are one of the most important health and health problems worldwide, especially in developing countries. Diarrheal diseases such as those caused by Entamoeba histolytica are among the causes of death in children, so the purpose of this systematic review and meta-analysis is to determine the prevalence of Entamoeba histolytica in Iranian children. Materials and Methods: This study is a systematic review and meta-analysis by examining the Scientific Information Database (SID), Medline (PubMed), Scopus and Google Scholar until March 2023. Results: In a review of 12 studies with a sample size of 10,982 Iranian children, the prevalence of Entamoeba Histolytica in Iranian children was reported to be 1% (95% CI 0.6-1.7%). The meta-regression results showed that in examining the factors influencing the heterogeneity of studies and examining the effect of sample size on this heterogeneity, it was reported that with increasing sample size, the prevalence of Entamoeba histolytica in Iranian children decreased (P<0.05) and also with the increase in the year of conducting studies, the prevalence decreases in Iranian children (P=0.289). Conclusion: The results of the present study show that the prevalence of Entamoeba histolytica in Iranian children is not at a very high level, but to continue preventive measures and reach lower levels, it still requires the attention of health policymakers in this area to carry out extensive information and screening to prevent the effects of this parasitic disease on children. [ABSTRACT FROM AUTHOR]

Interferon-free treatments for hepatitis C have been recently available. They can cure over 95% of patients within 12 weeks without significant side effects. A combination of daclatasvir and sofosbuvir has been particularly useful as it is effective against all genotypes of hepatitis C virus (HCV). The combination of sofosbuvir and daclatasvir in a single pill has been recently manufactured in Iran (Sovodak®). The current paper is a preliminary report on the first patients treated with Sovodak. Materials and Methods: 100 patients with cirrhosis due to hepatitis C were included. All genotypes of HCV were eligible. All the patients received treatment with daclatasvir and sofosbuvir (Sovodak) in combination with ribavirin for 12 weeks and were evaluated for effectiveness of the treatment 12 weeks after termination of the treatment (SVR12, sustained virological response at 12 week). The results of the first 50 patients are presented here. Results: Of the first 50 patients enrolled in the study, 47 reached the endpoints. Of them, 17 were infected with HCV genotype 3 and showed 100% response to the treatment (17/17). The remaining 30 patients were infected with genotype 1 and 97% responded (29/30) to the treatment. No adverse effects were reported. Conclusion: According to international guidelines, the combination of sofosbuvir and daclatasvir is the first line of treatment for all genotypes of HCV infection. For patients with cirrhosis, ribavirin is also added. In our study the efficacy of this combination in patients with cirrhosis was 97% and 100% for genotypes 1 and 3, respectively. Due to its high efficacy and ease of use, we recommend Sovodak for the treatment of all genotypes of HCV in Iran. [ABSTRACT FROM AUTHOR]

Peptic ulcer was a common disease with the symptoms of epigastria pain and heartburn. Since, literature regarding peptic ulcer was questionable and different, the aim of present study was to evaluate the prevalence of peptic ulcers using the systematic review and meta-analysis methods. Materials and Methods: In this study 6 Iranian papers in the range of 2002 to 2012 were selected and used valid keywords in the SID, Goggle scholar and Elsevier databases and heterogeneously of the sample were obtained used the I2 index. Results: In this research, 751 people were studied with an average of 125 persons per each study while 6 articles used in the meta-analysis. The prevalence of peptic ulcers in women was 30% with 95% confidence intervals (41% -19%),p=0.000 (significant level) and 12 index of 89.6%. Moreover, the prevalence of peptic ulcers in men was 60% with 95% confidence intervals (67% -53%), p = 0.051 and 12 index of 54.7%. The overall incidence of peptic ulcers was 41 % with 95% confidence intervals (47% -36%), p =0.222 and 12 index of 28.4%. Conclusion: The prevalence of peptic ulcers was 41 % and 6-15% in Iran and the rest of the world, respectively. Although, the rate of prevalence was increased annually; this prevalence was 60% and 30% for men and women, respectively indicating that men were more vulnerable to peptic ulcers than women. A major reason for this result could be attributed to this fact that men smoke and smoke quitting was suggested for men. [ABSTRACT FROM AUTHOR]

Psychosis, a relatively common condition that affects 3%-5% percent of the population, occurs in a variety of diagnostic contexts. Various medical conditions may lead to the development of psychotic symptoms. To date psychotic disorders due to infection with hepatitis A virus (HAV) have been rarely reported. In this paper, we described an acute psychotic disorder in an 18-year-old male diagnosed with hepatitis A infection. He presented with complaints nausea, vomiting, fever, constipation and abdominal pain of a one week duration. The patient denied a history of substance abuse. Neurological evaluation was normal. Brain CT scan was remarkable for suspicious hyperdense lesions in the basal ganglia, however the EEG was normal. He had visual hallucinations, persecutory delusion, disorganized behavior, personality changes, sleep disturbances, and disorganized speech. A psychiatrist diagnosed the patient with psychotic disorder due to HAV and treated him with antipsychotic medications. Following the decline in liver enzyme levels and after several days, the patient became clinically well with regression of his psychiatric signs and schizophrenia-like symptoms. We believe this may be the first reported case of an acute psychotic disorder during active HAV infection. Based on the data we have collected from several references we conclude that the most probable reason for this accompaniment is a type of comorbidity between acute psychotic disorder and HAV infection. [ABSTRACT FROM AUTHOR]

Background : The main purpose of the present paper is to examine the effectiveness of acceptance and commitment therapy on perceived stress, stress coping strategies and illness perception in women with Ulcerative Colitis. Materials and Methods: This is an experimental study performed as pretest and post-test. The population consists of woman suffering from Ulcerative Colitis in Isfahan. The sample includes 37 Colitis selected by multi-stage random sampling and randomly assigned to experiment and control groups (control=20, experimental=17). The acceptance and commitment therapy was performed in the experimental group within two months once a week. The tools applied by this study include Perceived Stress Scale, Brief Illness Perception Scale Stress Coping Strategies Scale and Brief Illness Perception Scale. Results: The results of this research showed that the means of coping strategies in experimental group has changed significantly in comparison with control group (p<0.05). Conclusion: Thus, the acceptance and commitment therapy could be used along with other methods of the treatment for the women with Ulcerative Colitis. [ABSTRACT FROM AUTHOR]

Background: Various studies on prevalence of celiac disease in patients with irritable bowel syndrome in Iran is available that Chiefly, the prevalence of this disease and its association with several factors have been investigated. In order to gain a better perspective of Iran and spread across the heterogeneity, all studies included in the systematic review, the findings were analyzed and used a meta-analysis. Materials and Methods: All articles published in Iranian journals and international research project, related papers presented at the Congress, and the Student thesis, in this study used standard and sensitive keyword. All the articles published in this field in the country, where inclusion criteria for assess quality control using random effect, and the meta-analysis were entered. Results: In 7 studies, minimum and maximum prevalence of celiac disease in patients with irritable bowel syndrome, 2/59 % and 13/5 % was calculated, and total prevalence of this disease based on fix effect model 6/26 %, with the heterogeneity index equals Q =13/74 (t2=52/05 and P=56) and reliability 99% (x2= l6/8) was estimated and because of the high heterogeneity based on random effect model, total and final prevalence of the celiac disease in IBS patients 7/59%, with the heterogeneity index equals Q=2/05 (t2=0 and I2=19) and confidence 95% (Cl =8/07-7/23) were counted. Also by using method of meta-regression, main factors causing heterogeneity, variable location, time, and gender of patients were identified. (p<0/01). Conclusion: Considering that the prevalence of celiac disease in patients with irritable bowel syndrome in the country is high, with knowledge and research-centered measures, total level of health in the country should be raised and daily, in the direction to the horizon landscape of civil and global health charter progressed. [ABSTRACT FROM AUTHOR]

Background Metabolic-associated fatty liver disease (MAFLD) is the concurrent presence of fatty liver disease (FLD) with overweight or obesity and/or type 2 diabetes mellitus. We aimed to determine the frequency and characteristics of MAFLD in patients with FLD. Materials and Methods This cross-sectional study was conducted on 143 patients with FLD referred to the gastrointestinal clinic of Shahid Rahimi Hospital in Khorramabad, Iran in 2021-2022. After obtaining a detailed medical history and in case of clinical suspicion of FLD, the levels of functional liver enzymes, fasting blood sugar (FBS), and lipid profile were measured. Furthermore, an ultrasound study of the liver was performed. The degree of insulin resistance was determined by the Homeostasis Model Assessment (HOMA) index. The data were gathered in a checklist and analyzed using SPSS software version 22. Results The mean FBS was 93.15±16.21 mg/dL, and the mean serum insulin levels were 7.88±15.81 mmol/L. The mean triglyceride level was 82.13±172.13 mg/dL, and the mean high-density lipoprotein was 37.27±7.15 mg/dL. In this study, 105 patients (73.4%) had high HOMA indexes. Serum alkaline phosphatase, alanine transaminase, and cholesterol levels were significantly higher in patients with high HOMA index than in those with normal index (P values=0.004, 0.047, and 0.039, respectively). Conclusion There appears to be a strong relationship between insulin resistance and impaired liver function in patients with FLD, indicating the necessity for managing insulin resistance in these patients. [ABSTRACT FROM AUTHOR]

Background: Celiac disease is a small bowel disorder that occurs upon exposure to dietary gluten and is followed by reduced absorption capacity of the intestine. Serological tests are usually used to assess the prevalence of the disease; however, serological tests without pathological results cannot give a precise assessment. In this regard, we attempted to determine the prevalence of celiac disease in the northern regions of Iran by performing a biopsy among adults with positive serological tests. Materials and Methods: This was a population-based cross-sectional study. Serum level of tissue transglutaminase IgA (or, tTg-IgA) was assessed in 5148 individuals, and those with a positive serological test (serum anti-tTG IgA > 20 IU/mL) underwent a biopsy during upper gastrointestinal (GI) endoscopy. Symptoms and other accompanying disorders were also assessed in this study. Results: Among the 5148 participants, 23 patients (12 men) had positive anti-tTG IgA test (0.4%) with a mean age of 45.90 ± 12.45 years. The most common symptoms among the 23 individuals were abdominal distension (100%), abdominal pain (78.26%), chronic constipation (60.86%), and three (13.04%) of them had iron deficiency. 16 individuals out of the 23 accepted to undergo a biopsy during upper GI endoscopy. The pathology results showed that eight (four men) of them had biopsy-proven celiac disease (0.15%). The second serum IgA anti-tTG test was negative in individuals with negative pathologies. Conclusion: The prevalence of celiac disease in Northern Iran was 0.4% and 0.15% based on serological and pathological results, respectively. Half of the patients with positive serum IgA anti-tTG test had negative pathological results, indicating the need to rely on a pathological assessment for a definite diagnosis. [ABSTRACT FROM AUTHOR]

Iatrogenic colonic perforation (ICP) is a rare but serious complication of colonoscopy, with an incidence ranging from 0.016% to 8% depending on the type and purpose of the procedure. Several patient-related, endoscopist-related, and procedure-related factors increase the risk of ICP, which most commonly occurs in the sigmoid colon. Following specific guidelines for colonoscopy performance and quality can help prevent ICP. Early diagnosis is essential, and imaging modalities such as radiography or CT scan may be needed to evaluate the extent of damage. The management of ICP depends on the size and location of the perforation, the presence of peritonitis or sepsis, the underlying colon pathology, and the patient's general condition. Endoscopic, surgical, or conservative methods may be used, but surgical consultation should always be sought urgently. Surgery is usually indicated for large perforations, signs of peritonitis, inadequate bowel preparation, severe comorbidity, failure of conservative treatment, underlying colon disease requiring surgery, transplant recipients, or immunocompromised patients. Laparoscopic-assisted exploration is the preferred surgical technique for ICP. The timing of a follow-up colonoscopy depends on the indication for the initial colonoscopy that led to ICP. [ABSTRACT FROM AUTHOR]

Acute pancreatitis (AP) is a life-threatening condition for which a wide range of etiological factors are considered. While gallstones and alcohol consumption are the leading causative agents, infectious microorganisms are assumed to be involved in some AP cases. During the ongoing coronavirus disease-2019 (COVID-19) pandemic, a coincidence of mild AP and COVID-19 has been reported, and hereby, we present the first cases of COVID-19/AP comorbidity from Iran. We present two cases of AP that occurred in patients with COVID-19 without any other risk factors with different outcomes. One of them had a mild AP and recovered, while the other patient suffered from a severe AP and expired. Also, it was noted that the first patient did not have any COVID-19 symptoms but abdominal pain, which probably was related to AP. Conclusion: Based on this report, COVID-19 can be considered in the AP cases that do not have an underlying risk factor, regardless of the severity of AP and the presence of COVID-19 symptoms. [ABSTRACT FROM AUTHOR]

Alpha-fetoprotein (AFP) is a serum glycoprotein created during gestation and is produced from the fetal liver and yolk sac. In some cases, AFP elevation has been associated with chronic and acute liver diseases and a limited number of cancers. AFP is a useful tumor marker in tumor diagnosis. This study presents a 46-year-old woman with no remarkable medical history who developed acute liver failure (ALF) due to the use of over-the-counter herbal medicine and was referred to our hospital for liver transplantation (LT). Imaging evaluations and laboratory test results demonstrated no evidence of malignancy or carcinoma. After LT, the histopathological report revealed no evidence of malignancy. The AFP level led into the normal range within 1 week after surgery. An increase in AFP serum level often occurs after cancer and malignancy, but in some cases, it can also occur after noncancerous diseases. As we reported in this case, the increase in AFP occurred after ALF and returned to its normal range after LT. [ABSTRACT FROM AUTHOR]

Background: Cytokeratins, a family of intermediate filament proteins, are critical components of the cytoskeletal structure in epithelial cells. Among these, cytokeratin 20 (CK20) has garnered substantial attention as a potential biomarker in colorectal cancer (CRC) due to its role in distinguishing various subtypes of gastrointestinal epithelial cells. Therefore, we aimed to investigate the relationship between immunohistochemical expression of CK20 and colorectal adenocarcinoma prognostic factors. Materials and Methods: This cross-sectional study included 50 tissue blocks from patients with colorectal adenocarcinoma. Demographic and clinicopathological information was extracted from the patients’ pathology report and recorded in a checklist. Then CK20 expression was examined using immunohistochemistry. Results: The present study included 50 patients with colorectal adenocarcinoma, including 23 (46%) men and 27 (54%) women, with a mean age of 50±11.2 years. Immunohistochemical expression of the CK20 marker was negative in 15 patients (30%), but 16 patients (32%) and 19 patients (38%) had focal and diffuse positive expression of this marker, respectively. In other words, the expression of this marker was positive in 40 patients (70%). Based on the results of the present study, a significant correlation between clinicopathological features such as tumor grade, lymphovascular invasion, perineural invasion, and lymph node involvement with the expression of the CK20 marker was reported (P<0.05). Conclusion: In general, based on the results of the present study, there is a significant association between the expression of CK20 and clinicopathological factors, so it is possible to use the CK20 marker in determining the prognosis of colorectal adenocarcinoma, however, more studies with a larger sample size will be required in the future. [ABSTRACT FROM AUTHOR]

Abdominal tuberculosis is one of the most critical and life-threatening ailments affecting the digestive system. Distinguishing it from other gastrointestinal disorders is paramount due to the potential complications of treatment overlap. Therapies such as corticosteroids and anti-tumor necrotic factor (anti-TNF) agents, effective against various diseases, can unintentionally exacerbate and propagate tuberculosis. The case in focus involves a 22-year-old man initially presented with abdominal pain. The clinical, endoscopic, and pathological assessments led to a diagnosis of Crohn’s disease. Subsequently, the patient underwent treatment. However, 6 months into the treatment, the patient developed abdominal distension and ascites, necessitating hospital admission and re-evaluation. A comprehensive series of investigations revealed a diagnosis of military tuberculosis. The patient was subsequently administered four anti-tuberculosis drugs, resulting in a complete resolution of symptoms. This case underscores a crucial point: administering anti-TNF agents can inadvertently contribute to tuberculosis dissemination. Hence, a meticulous assessment to exclude tuberculosis before initiating such treatment is paramount. [ABSTRACT FROM AUTHOR]

Background As congenital gastrointestinal diseases are pretty common and can lead to fatal consequences when combined with congenital heart diseases, we conducted a study in Iran to explore the relationship and prevalence of these two conditions. Our objective was to identify the types and frequency of congenital heart diseases in children who also have gastrointestinal anomalies. Materials and Methods: This was a cross-sectional analytical study. The research population was the patients referred to the Gastrointestinal Clinic of Hazrat Masoumeh Children's Subspecialty Hospital during the 2011-2017. In this study, the echocardiography in the patients’ files performed by a pediatric heart specialist was examined, and in the next step, the patients were divided into two groups with and without heart disorders. Gastrointestinal abnormalities were also recorded in the relevant checklist. Finally, the recorded information was entered into SPSS software version 22, and Chi-square and Fisher exact tests were used to compare the qualitative findings. The significant level for all tests was considered to be 0.05. Results: The average age of the children in this study was 7.93±7.74 months. 105 boys (54.7%) and 87 girls (45.3%) were examined. 167 children (87%) had cardiovascular abnormalities and 25 children (13%) had no abnormalities. The most common types of cardiovascular abnormalities were 69 (35.9%) septal defects, 36 (18.8%) atrial septal defects, and 22 (11.5%) pulmonary valve stenosis. The least frequent abnormalities were cardiomyopathy in three (1.6%) and ventricular inter-atrial septal defects along with atrial septal defects in one (0.5%) patient There was not a significant correlation between congenital heart diseases and frequency of closed anus, rectovaginal fistula, Hirschsprung, anal stenosis, rectal prolapse, perianal fistula, esophageal atresia, pyloric hypertrophy, intestinal obstruction, annular pancreas, biliary atresia, diaphragmatic hernia, Meckel's diverticulum.(P>0.05). A significant relationship was found only between omphalocele and pyloric hypertrophy with the presence of cardiovascular disorders (P<0.05). Conclusion: The results showed that congenital heart diseases have a high prevalence in infants with gastrointestinal anomalies, so cardiac examination is mandatory in all infants with gastrointestinal anomalies. [ABSTRACT FROM AUTHOR]

Colon cancer ranks third among the most common cancers. In Iran, this disease ranks fourth in men and second in women. The incidence and mortality caused by this cancer are different in different geographical areas. It is known to reduce the incidence of colon cancer by performing screening methods because most cases originate from polyps that can be seen and removed in colonoscopy before they become malignant. Also, screening methods are able to detect cancer in its early stages and reduce the death rate caused by this disease. However, the implementation of screening programs worldwide, including in Iran, has always faced problems such as the cost of diagnostic equipment, insurance coverage, health infrastructure, human resources, and, most importantly, acceptance by the people. Today, different methods are used for colon cancer screening in different countries, and the choice of these methods depends on several factors, including the prevalence and incidence of this disease, economic resources, and health infrastructure in each region. The purpose of this study was to investigate the common methods for colon cancer screening so that, according to the current situation and considering the screening facilities available in Iran, the best method can be suggested to cover more and more people who need screening. [ABSTRACT FROM AUTHOR]

Background: Fecal incontinence is defined as the involuntary loss of fecal material. Fecal incontinence is a particularly embarrassing and distressing condition with significant medical, social and economic implications. The purpose of this article is to review the relevant the role of pelvic floor muscle dysfunction in fecal incontinence. Materials and Methods: We performed a literature search in PubMed, Scopus, Elsevier, Ovid, CINAHL, Science Direct, ProQuest, Google Scholar, Thompson, EMBASE and Medline databases for the period of 1985-2013. The following keywords were used: puborectalis muscle, anal incontinence, fecal incontinence, pelvic floor muscles, biofeedback, pelvic floor exercise, electrical stimulation. Results: Out of 56 papers, 23 met the criteria for this study. We divided these studies into three categories: 1) the role of pelvic floor muscles in the maintenance of anal continence; 2) the role of pelvic floor muscle dysfunction in fecal incontinence; and 3) the role of pelvic floor muscle retraining in management of fecal incontinence. Conclusion: The results indicate there is adequate evidence to support the role of the pelvic floor muscles in the maintenance of anal continence and any damage or dysfunction to these muscles can affect proper disposal and may lead to incontinence. Prevention of incontinence should attempt at preserving the pelvic floor musculature, particularly in patients with impaired defecatory maneuver, which may play a pathophysiological role in the process. The pelvic floor muscles should be considered a goal of treatment in incontinence and improvement in their function should be included as a key outcome in the evaluation of treatment. [ABSTRACT FROM AUTHOR]

Menetrier's disease or hypertrophic gastritis is a premalignant rare disease that often presents with hypertrophy in the gastric folds, hypoalbuminemia and decreased acid secretion. There are a few papers worldwide that report concomitant Menetrier's disease and ulcerative colitis (U.C), however none are from Iran. This is the first case reported in Iranian literature. The pathogenesis of this coexistence is unknown. We report the case of a 28-year-old woman with intermittent bilateral edema of the lower extremities, weight loss and epigastric pain associated with chronic intermittent diarrhea and one episode of nocturnal dysentery. Paraclinical evaluations showed hypoalbuminemia, low serum protein level, severe 25 OH vitamin D deficiency, a positive Helicobacter pylori urea breath test and negative cytomegalovirus (CMV) IgM antibody. Histologic, radiologic and endoscopic findings were consistent with Menetrier's disease associated with U.C. The patient was prescribed mesalazine, asacol suppositories and pantoprazole. During a follow up visit the patient noted improvement in her symptoms. She was referred to a surgeon to discuss additional possible therapeutic treatments. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) can invade the gastrointestinal (GI) tract and cause GI bleeding. Although HCC invasion to the GI tract is rare, its prognosis is very poor. Here, we reported a 67-year-old man with GI bleeding manifestation. Esophagogastroduodenoscopy (EGD) showed lesions in gaster and duodenal, while abdominal CT confirm a solid epigastric mass with invasion to gaster. We performed a laparotomy biopsy, while the diagnosis of HCC was established by histopathological and IHC studies. Because of its difficulty to diagnose and its ability to masquerade as other GI bleeding, it is important to increase awareness about the issue. [ABSTRACT FROM AUTHOR]

Endoscopic retrograde cholangiopancreatography (ERCP) is a specific technique used to study the pancreatobiliary system that is performed in hepatogastroenterology centers. Recent, common uses for therapeutic ERCP are largely due to advanced imaging techniques such as magnetic resonance cholangiopancreatography and endosonography. In the United States alone, over 500,000 therapeutic ERCP are performed annually. Due to its potential for complications, all practitioners should be well-educated about the indications for ERCP, its contraindications, sedations, patient monitoring during and after ERCP, and the necessary co-operation amongst medical personnel. As a diagnostic and therapeutic procedure, there are potential complications directly related to the severity of the disease and complexity of the procedure. In this paper, we present a review of primary ERCP complications. [ABSTRACT FROM AUTHOR]

Introduction: Carcinoembryonic antigen (CEA) is one of important tumor markers for diagnosis and monitoring of colorectal cancers (CRC) Elevated concentration of CEA from normal level could be a sign of CRC. However, in early stages of CRC, CEA concentration could not be differentiable from normal range by the available tools This review shows that fluorescent features, and physical chemical properties of GQDs composites has been applied in ECL immunosensors for determination of CEA in early stages of CRC. Methods: Relevant studies in the electronic database were chosen by the medline library. Only papers published in revent English have included. Results: Electrochemiluminescence (ECL) as a powerful analytical technique has chemiluminescence and electrochemical analysis advantages such as wide response range and high sensitivity. High specific interaction of antigen and antibody has made electrochemiluminescence immunosensors as most important sensors for the specific analysis of CEA. Graphen quantum dots (GQDs) with unique electro-optical properties and biocompatibility have great potential applications in ECL sensing. Immobilization of antibodies on GQDs/Au@Pt improves performance of ECL immunosensor for CEA detection in serum samples between 1.0 pg/mL to 10 ng/mLwith the excellent detection limit of 0.6 pg/mL. ECL intensity of hydrazide GQDs / gold nanoparticles (AuNPs) immunosensor is decreased as a result of elevating CEA concentration (detection limit= 0.01 ng/mL). Additionally, ultrasensitive sandwich type ECL immunosensor based on poly (5-formylindole) graphene oxide/Au nanoparticle/graphene quantum dots has been exhibited broad linear range between 0.1 pg/mL to 10 ng/mL as well as low detection limit of 3.78 fg/mL for CEA detection. Conclusion: In conclusion, ECL immunosensors and apta sensors based on graphene-quantom dots composites could increase detection capability of CEA in the early stages of CRC because of their broad linear ranges as well as higher detection of limits. [ABSTRACT FROM AUTHOR]

Background The aim of this article is investigating the microbiome's effect on the development and progression of gastric cancer can substantially improve preventing, diagnosing, and treating this disease. Method In this review article, after analyzing the studies searched in PubMed and Scopus databases, related articles have been selected from 2015 to 2022, and based on this, the carcinogenic role of the gastric microbiome, which is caused by complex communities of bacteria, viruses, and fungi, were investigated. Results With the discovery of Helicobacter Pylori (H. pylori) in 1982, the theory that the stomach is sterile was refuted, leading to a period of gastric microbial research. In addition, advances in nucleic acid sequencing techniques indicated that a complex community of microbes might coexist with H. pylori in the gastric area. Numerous studies have examined the crucial function of H. pylori in gastric cancer, particularly strains that harbor the Cag A and Vac A genes. These bacteria contribute to carcinogenesis by altering gastric acidity and, consequently, the organization of the gastric microbiota. While there is increasing evidence that microorganisms other than H. pylori and their metabolites play a significant role in gastric carcinogenesis, the function of the viral and fungal microbiome in gastric cancer has received less consideration. Conclusion More investigations are needed to provide new insights into diagnosing, preventing, and treating gastric cancer. Also, clinical research design related to the interaction between the gastric microbiome genome and the human host genome, besides identifying the signaling pathways involved in the pathogenesis of gastric cancer, can be practical. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, the implementation of social distancing and public fear of the virus postponed follow-up visits to manage patients’ underlying medical problems, especially cardiovascular diseases and diabetes. Telehealth provides accessible and cost-effective care for vulnerable patients. The aim of this early study was to review the telehealth interventions for patients with cardiovascular and metabolic disorders during Covid-19 outbreak. Materials and Methods: This study used rapid review to provide an accurate review of the articles. Study selection was based on the Preferred Reporting Items for Systematic Reviews (PRISMA) guideline. A systematic review was conducted on studies published from January 2020 to July 30, 2020, in PubMed, Web of Science, Google Scholar, and Scopus databases, and the update was done on October 31, 2020 Results: Technology-based interventions were performed in various countries: two studies in the USA, three in Europe (Italy, Germany, and London), two in Asia (China and Pakistan), and one in South America. Most Telehealth approaches used in the included articles are video consultations using mobile applications such as Skype, face time, and regular phone calls. Conclusion: According to the results, the application of technology in the management of cardiovascular and metabolic disorders can be used to provide healthcare to patients regardless of distance, detection of disease, monitoring disease progression and complications, reducing healthcare costs, saving available resources, preventing readmission of patients, reducing the provider workload, and increasing family participation in disease management, quality of life, and patient satisfaction. [ABSTRACT FROM AUTHOR]

Background Consuming gluten can lead to the immune-mediated condition known as celiac disease (CD) in genetically-prone people. Presently, the only approved and available treatment is stringent and lifetime devotion to a gluten-free diet (GFD). This study aimed to assess GFD adherence in patients with CD in Golestan province, northeast Iran. Materials and Methods All cases with confirmed CD registered in the Golestan Registry of Celiac (N=220) were selected for this cross-sectional study. 87 patients volunteered to take part in the interviews and completed the questionnaire. Since the day of diagnosis, all patients in this center had been treated with a GFD, but their adherence to the regime was unknown. Celiac Dietary Adherence Test (CDAT) and the Standardized Dietician Evaluation (SDE) were used to evaluate their adherence to GFD. Results Among the 85 individuals who responded in depth to the CDAT, the mean (standard deviation) age was 32.41 (15.45) years, 32 (36.8%) were male, and 72 (32.8%) adhered to the diet according to their self-expression. However, in the SDE, only 52 (30.23%) exhibited great to good adherence. Conclusions The adherence and weak adherence groups had similar mean ages. However, non-adherence was associated with higher mean age. Although women had stronger adherence, there was no difference in sex. The elderly and males exhibited low GFD adherence. [ABSTRACT FROM AUTHOR]

Background: Celiac disease (CeD) is a permanent immune-mediated enteropathy triggered by gluten. Patients with CeD have various clinical features. In the present study, we aimed to evaluate the clinical, laboratory, and histopathological features of 150 patients with CeD in Zahedan, Southeast Iran. Materials and Methods: In a retrospective cross-sectional study, we investigated the characteristics of 150 patients with celiac in Zahedan from 2008 to 2018. In addition to the demographic characteristics of the patients, other parameters such as clinical symptoms, comorbidities, serum level of anti-tissue transglutaminase (IgA-TTG), liver function tests, and report of the intestinal biopsy were obtained from patients’ recorded files. Descriptive statistics were used for the collected data. Results: 150 patients were included in the study. 72 (48%) were males, and 78 (52%) were females. The mean (±SD) age was 28.5 (±10.69) years (range 16-82 years). The most frequent symptom was abdominal pain (38%), followed by diarrhea (32%) and nausea (30%). Iron-deficiency anemia was found in 30% of patients. Immunoglobulin A, and anti-tissue transglutaminase antibodies (IgA antiTTG) were found in 144 (96%) patients. The results of the biopsy showed 76% with Marsh I, 10% with Marsh II, and 52% with Marsh III histological changes according to the Marsh classification. Conclusions: Most of our patients with CeD were oligo-symptomatic forms. It is essential for healthcare professionals to have the clinical features of patients diagnosed with CeD in their area. [ABSTRACT FROM AUTHOR]

Background: There is evidence of a direct relationship between peptic ulcer disease (PUD) and the risk of gastric cancer. This study determined the prevalence of gastric cancer in individuals with solitary proximal or distal gastric ulcers admitted to Shahid Rahimi Hospital in Khorramabad, Iran, from 2019 to 2021. Materials and Methods: In this cross-sectional study, 635 patients were included. Age group and sex as well as data related to the year of admission, pathological examination, and location of the ulcer, were recorded in a researcher-made checklist. Data were analyzed using the SPSS software version 22 at a significance level of 0.05. Results: Out of the 635 patients, 66.3% (421) were male, and 33.7% (214) were women. The mean age was 62.5±17.7 years. Overall, 16.7% of patients with gastric ulcers were diagnosed with gastric cancer by pathological examination. The frequency of malignancy was highest in the 80 years and older age group. There was a considerable association between malignancy and age group (P˂0.001; df=4; χ2=27.24). There was no significant association between malignancy and sex (P=0.144). A significant relationship was observed between malignancy and ulcer location (P˂0.001). Proximal ulcers were malignant in 24.6% of the cases (n=74), while distal ulcers were malignant in 9.6% (n=32). Conclusion: Older patients, men, and patients with gastric ulcers are more likely to develop gastric cancer. Therefore, more effective strategies should be developed to prevent this fatal condition. [ABSTRACT FROM AUTHOR]

Background: Celiac disease is an immune-mediated chronic enteropathy of the small intestine that occurs due to gluten sensitivity in genetically predisposed people. Due to the relatively high incidence of celiac disease in Iran and limited studies on oral manifestations in the Iranian population, the aim of this study was to examine hard and soft tissue manifestations of the oral cavity. Materials and Methods: 53 patients with celiac disease and 53 healthy individuals who matched the case group in terms of age and sex were evaluated. The case group included patients whose disease had been previously confirmed by serological testing and small intestine biopsy. Enamel defects and caries were evaluated according to Aine and WHO criteria, respectively. Other soft tissue manifestations, such as aphthous stomatitis, were either confirmed based on the presence of the lesion at the time of clinical examination or reported by the patient. Xerostomia was assessed based on the answers to Dyasanoor’s questionnaire, and Community Periodontal Index for Treatment Needs was used to assess periodontal status. Data were analyzed using SPSS software version 16. The Chi-square and, if required, Fisher’s exact test was used. Results: There was a significant difference between the two groups in the frequency of enamel defects (OR=8.4, P<0.001) and xerostomia (OR=3.3, P=0.025). In addition, there was no significant difference between subjects with classical and non-classical celiac disease in frequency (P=0.337) and pattern (P=0.466) of hypoplasia and xerostomia (P=0.415). The subjects did not differ significantly in mean Decayed, Missing, Filled Teeth index . Although patients with celiac disease brushed less frequently and their xerostomia was significantly higher compared to controls, caries indices were not significantly different (P=0.85) even when the effect of brushing frequency was adjusted. Multivariate linear regression showed that after adjusting for brushing frequency, the mean periodontal index of the celiac disease group was higher than that of controls (P=0.03). Although soft tissue manifestations such as aphthous stomatitis (P=0.231), atrophic glossitis, geographic tongue, and angular cheilitis were more frequent in the patients, no statistically significant difference was observed. Conclusion: Celiac disease increases the risk of enamel defects and xerostomia. Therefore, dentists can play a key role in the early detection of celiac disease using oral findings. However, the presence of soft tissue manifestations, especially in adults, could not be proven as a meaningful criterion for the early detection of celiac disease. [ABSTRACT FROM AUTHOR]

Background: This study investigated the effects of lactobacillus acidophilus ATCC4356 on the oxidant and antioxidant factors of the liver and levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) before and after streptozotocin-induced diabetes in male rats. Materials and Methods: Thirty male Wistar rats were divided into five groups (n=6): Control (C), Control probiotic (CP), Diabetic (D), Diabetic Pretreatment with lactobacillus (DPB), and Post-treatment with lactobacillus (DPA) groups. C group received daily 1 mL of normal saline for 6 weeks. CP group received daily 1×109 cfu/mL L. acidophilus ATCC 4356 for 6 weeks. D group received daily 1mL normal saline for 2 weeks before and for 4 weeks after diabetes induction. DPB group received daily 1×109 cfu/ml L. acidophilus ATCC 4356 for 2 weeks before and for 4 weeks after diabetes induction. DPA group first received daily 1mL normal saline for 2 weeks before diabetes and then received daily 1×109 cfu/mL L. acidophilus ATCC 4356 for 4 weeks after it. Results: L. acidophilus ATCC 4356 decreased liver malondialdehyde (MDA) and H2O2 concentration and serum AST significantly in both pre- and post-treatment groups compared with the D group. Catalase activity (CAT) and serum ALT showed a significant decrease in the post-treatment group compared with the D group. Glutathione peroxidase (GPx) activity showed a significant increase in the post-treatment group compared to the D group. Conclusion: The present study showed that L. acidophilus ATCC4356 had more protective effects on the liver in the post-treatment group compared with the pretreatment one. [ABSTRACT FROM AUTHOR]

Background Considering that no study on the efficacy of dexmedetomidine during endoscopic retrograde cholangiopancreatography (ERCP) has been performed in Iran so far, we decided to evaluate the efficacy and effectiveness of dexmedetomidine and patient satisfaction in patients undergoing ERCP. Materials and Methods: A double-blind clinical trial was performed (2020) among 80 patients undergoing ERCP grade ASA I, and II who had no asthma, cardiovascular diseases, and no history of allergies to propofol and dexmedetomidine. The patients were randomly divided into two groups (fentanyl and propofol) and (fentanyl and dexmedetomidine). Their heart rate per minute, mean arterial pressure, respiration rate per minute, and blood oxygen saturation at intervals of 5 and 15 minutes after the start and end of the procedure, the level of patient cooperation, and endoscopies satisfaction were compared. Results: Mean age of the propofol group was 63/13±17/88 and the dexmedetomidine group was 16/99±58/55 (P=0.191). Mean heart rate and respiration rate per minute were not different significantly in any of the time intervals. Mean arterial pressure in the propofol group before, 5, and 15 minutes after the start and end of ERCP were higher than dexmedetomidine group (105/95±15/91, 123/75±25/54, 118/10±13/06 and 14/61±117/50, respectively). The percentage of oxygen saturation at 5 minutes and at the end of the procedure was higher in the propofol group (P=0.01 and P=0.03, respectively) Conclusion: Due to fewer side effects and more satisfaction of patients receiving propofol; this drug is preferred for these patients. [ABSTRACT FROM AUTHOR]

Background: Celiac disease (CD), or as it is called gluten enteropathy, could result in various complications such as liver abnormalities. Nonalcoholic fatty liver disease (NAFLD) affects 25.2% of individuals worldwide and has become one of the most common causes of cirrhosis. This study aimed to report the frequency of fatty liver in ultrasonography of patients with CD in Golestan province, Northeast Iran. Materials and Methods: In this cross-sectional study, patients diagnosed with CD based on a positive anti-tTG Ab and proved by small bowel biopsy were recruited between March 2018 and March 2020 (N=80), through the registry system located in Golestan Research Center of Gastroenterology and Hepatology, Northeast Iran. Ultrasonography was performed and the fatty liver diagnosis was done based on attenuation of the liver itself (less than 40 Hounsfield Unit (HU)) or in comparison with the spleen (liver attenuation≤10, than spleen). Results: Among 80 patients with CD (46 women, mean age 39.13±12.5 years), fatty liver was reported in 34 (43.5%), which was mild in 31 (39%), moderate in 2 (2.5%), and severe in 1 (1.3%) patients. One cirrhosis and no hepatomegaly were found. Conclusion: In the present study, fatty liver was seen in 43.5% of our patients, which is a large amount. It may be suggested to do a closer follow-up of the complications of CD. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the response rate to the hepatitis B vaccine and the factors affecting it in people with advanced kidney failure undergoing hemodialysis. Materials and Methods: This cross-sectional study was conducted from 2019 to 2021 at Ziyaian Hospital in Tehran. For patients undergoing hemodialysis, serum levels of the nutritional, inflammatory, and bone and mineral markers were measured before hepatitis B vaccine injection. They then received hepatitis B vaccine, and 6 months later the serum level of hepatitis B antibody was measured. In case of no immune response to the vaccine, a second injection was given. Then the rate of lack of immune response to the vaccine in the subjects under study was determined and the levels of nutritional, inflammatory, and bone factors were compared between those who responded to the vaccine and those without an immune response. Results: 54 people were included in the study. In the first round of vaccination, 45 people participated, of whom 62.2% responded to the vaccine and 37.8% did not respond. 26 people participated in the second round of vaccination, in which 69.2% (18 people) responded to the vaccine and 30.8% (8 people) did not respond to the second round of the vaccine. In the non-response group to the vaccine, the serum levels of albumin, and cholesterol were significantly lower and the serum level of neutrophils and the ratio of neutrophils to lymphocytes was significantly higher than in the patients with response to the vaccine. Conclusion: Inflammatory and nutritional factors can affect the immune response to hepatitis B vaccine. Therefore, it is recommended to check the nutritional status of these patients and encourage them to follow up on the results of the vaccine. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence that surgical approaches to weight loss (bariatric surgery) are the most effective and steady treatment for morbidly obese patients. This study assessed the nutritional status of obese participants candidates for laparoscopic gastric plication (LGP) before and after the surgery. Materials and Methods: Our study was conducted on 38 participants aged 18 to 65, with a mean body mass index (BMI) of 41.45±5.68 kg/m2, scheduled for LGP. BMI and Dietary intakes were assessed at baseline and 6 months after surgery. The mean daily energy intake and microand macronutrients were calculated and compared with the dietary reference intake each time. Results: The mean excess weight loss was 44.45±9.78%. The mean daily energy intake decreased to one-third of the baseline 6 months after surgery. All patients had a low intake of protein, vitamins A, D, and folic acid before and after LGP. After surgery, over 60% of patients had inadequate vitamin B1, B2, B3, B6, calcium, and iron levels. Conclusion: 6 months after LGP, our results demonstrated dietary deficiencies, including inadequate protein and certain micronutrients. Some of these nutritional deficiencies existed before surgery and persisted or worsened after surgery. In order to ensure optimal health before and after surgery, patient care should place a strong emphasis on nutritional counseling and supplementation. [ABSTRACT FROM AUTHOR]

Background: The current study aimed to investigate the prevalence, risk factors, endoscopic findings, and outcome of gastrointestinal bleeding in COVID-19 hospitalized patients. Materials and Methods: This study is a retrospective review of COVID-19 hospitalized patients with gastrointestinal bleeding from a large university hospital in southeast Iran. This study was conducted over one year from April 2020 to March 2021. Results: Out of 3563 COVID-19 inpatients with approximately equal sex distribution (52.5% of men and 47.5% of women), 80 (2.24%) patients with a mean age of 58.01±20.71 were identified with signs of gastrointestinal bleeding, including; melena (48.8%), hemoglobin drop (42.5%), fresh blood hematemesis (31.3%), rectorrhagia (20%) and coffee ground emesis (10%). 52 patients (65%) had signs of gastrointestinal bleeding on admission, and 28 patients (35%) developed gastrointestinal bleeding during their hospital admissions, most of whom were men (63.8%). Endoscopic characteristics were; gastric erosion (27.7%), gastric ulcer (23%), duodenal ulcer (21.5%), esophageal ulcer (12.3%), and esophageal erosion (6.1%) in upper gastrointestinal endoscopy. On colonoscopy, hemorrhoids (25%), mass lesions (16%), fissures (8.3%), diverticular lesions (8.3%), and polyps (8.3%) were the most common findings. The overall mortality of the patients in the present study was 36.2%. However, gastrointestinal bleeding related deaths were 7.5%. Conclusion: Gastrointestinal bleeding was identified in 2.24% of hospitalized COVID-19 patients, with gastroduodenal ulcers and erosions as the most common symptoms. [ABSTRACT FROM AUTHOR]

Background: Celiac disease (CD) is one of the most common and chronic immune-mediated disorders of the gastrointestinal tract that affects the small intestine. Genetic factors, including human leukocyte antigen (HLA), and non-HLA genes are major risk factors in CD pathology. Moreover, environmental factors such as infections may affect CD incidence. Materials and Methods: The goal of the present study is to investigate the association between CD and viral, bacterial, fungal, and parasitic infections. Databases including Scopus, PubMed, Google Scholar, and Web of Science were searched for relevant literature until 2022. Results: Several infections have been reported to be associated with CD including reovirus, rotavirus, hepatitis B virus, influenza virus, helicobacter pylori, campylobacter jejuni, giardia lamblia, toxoplasma gondii, candida albicans, etc. Conclusion: Moreover, antibiotic administration might be a risk factor for further CD development. On the other hand, there are reports regarding the susceptibility of patients with CD to some infections, as well as protective infections against CD. Consequently, more studies are required to explain the two-sided relations between CD and infectious diseases. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C virus (HCV) infection affects around 170 million individuals worldwide, with an estimated 3% of the world’s population presently afflicted. More than 350,000 people are killed each year by HCV throughout Asia and the rest of the globe due to liver disorders such as cirrhosis, chronic hepatitis, and hepatocellular carcinoma (HCC). Understanding viral-host protein interactions are essential for understanding viral infection, disease etiology, and the development of innovative therapeutics. This is due to the inherent limits of laboratory techniques for finding host-virus protein-protein interactions (PPIs). There seems to be a strong computational effect on the research of cellular infection. Materials and Methods: In this study, we predicted the interaction between human and HCV proteins using an ensemble learning technique. Support vector machines (SVMs) nuclear liner and radial are the cornerstones of our model, as are K-Nearest Neighbors (KNN) and Random Forest (RF). Four different feature vectors were used to encode human and HCV proteins: the tripeptide composition (TPC), The composition of k-spaced acid pairs (CKSAAP), the amino acid autocorrelation-autocovariance (AAutoCor), and the conjoint triad (CT). Results: The predictive power of the suggested technique is evaluated using a benchmark dataset that contains both consistently positive and negative PPIs. A support vector machine (Radial-SVM) model was used to predict which human proteins interact with HCV. To achieve accuracy and specificity of 84.9 and 88.3 percent, we employed tenfold cross-validation and principal component analysis (PCA). Conclusion: Our technique correctly predicts PPIs based on human and HCV proteins. The discovery of HCV-human protein interaction networks, enriched pathways, gene ontology, and functional categories has improved our knowledge of HCV infection. [ABSTRACT FROM AUTHOR]

Background: Hepatocellular carcinoma (HCC) ranks as the first and the second malignancy in men and women in Egypt. Many inflammatory markers are included in HCC pathogenesis. Matrix metalloproteinase-14 (MMP-14) is one of them and it is implicated in regulating HCC tumor progression and prognosis. This study was done basically to assess the frequency of alleles of rs2236307 single nucleotide polymorphism (SNPs) of the MMP-14 (+7096) gene in patients with HCC and to determine if there is an association between its alleles polymorphism and the occurrence of HCC in Egyptian patients. Materials and Methods: A case-control study was done in the Tropical Medicine Department at Zagazig University Hospitals and the Medical Biochemistry Department, Faculty of Medicine, Zagazig University. The study included 540 subjects, classified into three groups HCC, cirrhotic, and controls (180 in each group). MMP-14 gene polymorphism analysis in the promoter of the MMP-14 gene rs2236307 was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: The TC genotype was significantly higher among patients with HCC when compared with the control group (77.8% versus 16.7%, respectively). The TC genotype was higher among patients with HCC compared with the cirrhotic group (77.8% versus 38.9%, respectively). Metastatic lesions and portal vein thrombosis were significantly higher among the TC group compared with the CC and the TT groups in the HCC group. Conclusion: The polymorphisms of MMP-14 rs2236307 increase the risk of HCC. Both the TC and the CC genotypes showed HCC risk association but the the CC genotype appeared with lower potential. [ABSTRACT FROM AUTHOR]