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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: 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]

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: 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]

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]

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 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]

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]

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: 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 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: Tumor necrosis factor-alpha (TNF-alpha) inhibitors, such as adalimumab (ADA) and infliximab, are among the most effective biological drugs for inducing and maintaining remission in patients with moderate to severe inflammatory bowel disease (IBD). Studies have shown that the effectiveness of infliximab is increased with the concomitant use of immunosuppressive drugs. However, little is known about ADA. Our aim was to compare the efficacy of monotherapy with biosimilar ADA and combination therapy with ADA+azathioprine (AZA) in IBD patients. Materials and Methods: In this retrospective cohort study, the medical records of anti-TNF-naïve IBD patients referred to a tertiary hospital in Tehran during 2019-2020 who received biosimilar ADA (CinnoRA®) were reviewed. We compared the effectiveness of treatment, serum levels of ADA, anti-adalimumab antibodies, and laboratory data between the two monotherapy and combination therapy groups. Results: A total of 65 patients were enrolled. Fifty-six (86.2%) patients had ulcerative colitis, and the remaining had Crohn’s disease. 50 patients (76.9%) received combination therapy, and 15 (23.1%) were in the monotherapy group. The rate of clinical remission in the combination therapy group (50%) did not differ significantly from the monotherapy group (40%). The drug levels were in the therapeutic range (≥7.5 µg/mL) in 57.5% of patients in the combination therapy group and 76.9% of those in the monotherapy group. The antibody test result was positive in 40% of patients taking AZA+ADA and 10% of patients in the ADA group, neither were significantly different. Conclusion: Adding AZA may not play a significant role in improving the therapeutic effectiveness of ADA in treating IBD. [ABSTRACT FROM AUTHOR]

Background: Gastrointestinal stromal tumors (GISTs) are the most common gastrointestinal mesenchymal neoplasms. The risk factors for GISTs are older age and inherited genetic syndromes. Moreover, lifestyle-related or environmental causes of GISTs are unknown, and due to the lack of a similar study in the Babol region, we decided to investigate the frequency of GISTs in hospitals in Babol. Materials and Methods: The present study is a cross-sectional study performed on 30 cases of GISTs in the pathology archive of hospitals in Babol from March 21, 2010, to March 20, 2021. Patients’ information such as age, sex, family history, smoking, and clinical signs were evaluated. Results: In this study, the prevalence of GISTs was 5.81 per thousand. 16 (53.3%) patients were in the group of less than 57-year-olds, and 14 (46.7%) patients were aged more than 57 years. 18 (60%) patients were males and 12 (40%) were females. The stomach was the most common site of the stromal tumor, with a frequency of 16 (53.3%) cases. While the second and third categories were the esophagus with 10 (33.4%) cases and the intestine with 4 (13.3%) cases, respectively. Abdominal pain in 17 (56.7%) patients with stromal tumors was reported as the most common symptom. Conclusion: This study showed that the frequency of GISTs was similar to the results of studies inside and outside Iran. In addition, the prevalence of stromal tumors in the 50s and men was similar to other studies. [ABSTRACT FROM AUTHOR]

Background: Acute pancreatitis is one of the most common complications following endoscopic retrograde cholangiopancreatography (ERCP), which can be life-threatening if the treatment is postponed. This study aimed to evaluate the effect of non-steroidal anti-inflammatory drugs (suppository diclofenac) on preventing post-ERCP pancreatitis (PEP). Materials and Methods: In this double-blind, randomized clinical trial, 219 patients referred to our ERCP unit who passed inclusion and exclusion criteria were randomly assigned to two groups: group A (103 patients) received a diclofenac suppository 30 minutes before and immediately after ERCP. In Group B (116 patients), a diclofenac suppository was prescribed only before the procedure. Patients were evaluated regarding clinical signs and symptoms of pancreatitis for 24 hours. Also, serum amylase level was checked at baseline, 6, and 24 hours after the procedure. The study protocol was approved by the Ethics Committee of the Iran University of Medical Sciences (IR.IUMS.FMD. REC.1399.190). Also, the study protocol was registered in the Iranian Registry for Clinical Trials (IRCT20191231045969N2). Results: The PEP was seen in three patients in group A and seven patients in group B, which was not significantly different (P=0.341). The severity of pancreatitis was mild in all patients except one in group B, who developed moderate PEP. Moreover, in 97.71 % of cases, ERCP was successful for the first time, and in 94.18 % of group A and 89.66% of group B, no complications of bleeding or perforation were detected. Conclusion: Administration of rectal diclofenac before and after ERCP had no significant effect on the prevention of pancreatitis compared with pre-ERCP administration. [ABSTRACT FROM AUTHOR]

Background: A data-driven colorectal cancer screening strategy based on a personalized approach can improve health outcomes. This study aims to develop an information road map for personalized colorectal cancer screening in Iran. Materials and Methods: This study is a mix-method research (MMR) which consisted of three phases: phase I, the development of a checklist with 275 items for assessing required data elements of personalized colorectal cancer screening; phase II, situational analysis of colorectal cancer screening dataset according to the checklist; phase III, development of national information roadmap for personalized colorectal cancer screening with in-depth interview and focus groups. Results: Personalized datasets of colorectal cancer screening were defined in four dimensions, including a clinical dataset, a genetic dataset, a demographic dataset, and a social determinant dataset. In the next step data elements of colorectal cancer screening based on personalized datasets were analyzed. Of the 275 items, only 96 items are recorded. In the final step, a national information roadmap of personalized colorectal cancer screening with 6 levels was developed. Conclusion: Personalized screening based on integration dataset play a key role in the successful implementation of the screening program. Implementation of a national roadmap can assist to improve the quality of data in personalized screening. [ABSTRACT FROM AUTHOR]

Background: The efficacy of endoscopic retrograde cholangiopancreatography (ERCP) has increased significantly over time. However, there are few studies evaluating the success rate of ERCP in Iran. Materials and Methods: We aimed to evaluate the success rate, adverse events, and mortality of ERCP in an academic medical center. This cross-sectional study was conducted over 2 years between February 2018 and January 2020 and 347 patients were enrolled. The success rates and causes of procedure failure were recorded by the endoscopists. The patients were followed up for all adverse events until discharge. Results: Eventually, 302 patients ended the study. The most common indication for ERCP was CBD stone (73.2%). The ERCP procedure was successful in 240 (79.5%) patients. Unsuccessful outcomes were due to cardiovascular conditions (n=7) and endoscopic problems (n=34). Of 34 cases of impossible cannulation, in 32 (10.6%) cases, the papilla was found but cannulation was not possible and in 2 (0.7%) cases it was not possible to access the papilla. The mean (SD) age of the patients with unsuccessful ERCP was significantly higher than successful cases (P=0.001). The times of cannulation, cannulation attempts, and dye injection were significantly higher in unsuccessful procedures as compared with successful procedures (P=0.014, P=0.001, and P=0.001, respectively). The mean time of cannulation (minute) was 5.05 in successful ERCPs and 11.99 in unsuccessful cases (P=0.014). Failure of ERCP was significantly associated with adverse events during ERCP (P=0.001). The most common adverse event was post-ERCP pancreatitis (PEP) (14.6%) and severe cases were 3.6%. PEP was significantly associated with sex (P=0.034). There was no mortality during the study. Conclusion: We found that ERCP could be a safe and effective procedure, especially for patients under 65 years. The overall success rate and adverse events were compatible with the available data in the literature. [ABSTRACT FROM AUTHOR]

Background: Interleukin-8 (IL-8) is a member of the pro-inflammatory chemokine family that has been reported to be overexpressed in various human tumors. This chemokine contributes to cancer cell survival, proliferation, metastasis, and angiogenesis. The purpose of this study was to examine the expression level and clinicopathological significance of IL-8 in colorectal cancer (CRC) tissues compared with adjacent normal colorectal tissues in the Iranian population. Materials and Methods: The population of the study consisted of 45 pathologically confirmed patients with CRC, including CRC and adjacent control tissues. The expression levels of the IL-8 gene were evaluated by quantitative real-time polymerase chain reaction (RT-qPCR). The correlation between the expression levels and the clinicopathological features was determined. Results: IL-8 gene expression was overexpressed in CRC samples compared with controls (fold change=5.5; P= 0.02). The area under the ROC curve for IL-8 indicates the potential of IL-8 as the diagnostic marker in CRC (P=0.012). Conclusion: IL-8, which is up-regulated in CRC tissues, can be used to distinguish inflammation-induced CRC from control samples. The significantly up-regulated level of IL-8 needs future investigation for consideration as a biomarker to evaluate the prognosis of CRC. [ABSTRACT FROM AUTHOR]

Copyright of Iranian Journal of Gastroenterology & Hepatology (GOVARESH) is the property of Iranian Association of Gastroenterology & Hepatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The aim of this study was to evaluate the prevalence of helicobacter pylori (H. pylori) infection and its association with endoscopic, histopathological findings, and clinical symptoms of children with dyspepsia referring to Masoumeh Children Hospital of Qom. The eradication therapy of H. pylori infection in children as well as the clinical response to dyspepsia in H. pylori-negative children, were evaluated. Materials and Methods: This cross-sectional study was performed on 170 children 4 to 15 years old with dyspepsia referred to Hazrat Masoumeh Hospital in Qom. After recording basic information about children such as age, sex, place of residence, and their disease history, these children were examined by endoscopy. Two biopsy specimens were obtained from the body and the antrum of the stomach. And if the rapid urease test and histology were positive for H. pylori tissue examination, the confirmed H. pylori infection would be considered in the child with H. pylori infection. Consequently, these patients were divided into two groups: H. pylori-positive and H. Pylori-negative. The two groups were compared for clinical signs and symptoms, endoscopic findings, and histological results. Results: 85 patients (49.4%) were male and 87 patients (50.6%) were female. No significant relationship was found between the sex of the patients, place of residence, and H. pylori infection. There was no significant difference between the two groups in gastritis erosive, duodenitis, gastritis erythematosus, esophagitis, and acute inflammation in the antrum. No mass was found in both groups, and no hemorrhagic gastritis, ulcer, duodenal metaplasia, dysplasia, maltoma, H. pylori accumulation, or atrophy was recorded. In H. pylori-positive subjects in 83 patients (95.4%), chronic inflammation in the antrum was mild and in four patients, it was moderate (4.6%). This finding in H. pylori-negative patients, in 31 patients (36.5%) was not found, and in 54 patients (63.5%) was found. There were no significant differences between the two groups in the clinical signs, abdominal pain, heartburn, anorexia, burning, recent weight loss, hematomas, melena, the only clinical symptom of nausea in HP positive patients (37.9%) and HP negative in 46 patients (54.1%) had a significant difference between the two groups. Nodular gastritis was found in the endoscopic evaluation of 27 (31%) patients with H. pylori infection, significantly more than dyspeptic patients (15 cases) who were H. pylori negative. Conclusion: According to the results of this study, no clinical signs other than nausea were correlated with H. pylori infection. In endoscopic findings, nodular gastritis has a significant correlation with H. pylori positivity, and according to the histopathological evaluation we significantly found more chronic gastritis in H. pylori infection. [ABSTRACT FROM AUTHOR]

Background: Clos‌tridioides difficile is one of the important causes of hospital infections worldwide. Regarding the importance of Clos‌tridioides difficile infection (CDI) epidemics and limited available prevalence reports of CDI in Iran, the present investigation was done on the incidence of CDI in hospitalized patients from 2017-2018. Our study outlined the requirements for CDI and followed up on the causative agent of antibiotic-associated diarrhea (AAD). Materials and Methods: We evaluated the CDI rates by multiplex real-time polymerase chain reaction (PCR) assay directly from inpatient fecal samples with a history of antibiotic therapy (2-8 weeks) and combined with anaerobic culture and toxicity assessments to isolate toxigenic and non-toxigenic types. The results were analyzed through one-way analysis of variance (ANOVA), pairwise two-tailed correlation, and regression using SPSS software version 25.0 (IBM® SPSS® Statistics, USA). Results: Among 491 fecal samples, 49 (9.9%) toxigenic C. difficile were characterized by real-time PCR, while 40 were isolated by toxigenic culture and cytotoxicity assay. Toxin profiling showed 43 (9.7%) tcdA+/tcdB+ and 6 (1.4%) tcdB+. Conclusion: A considerable prevalence of CDI among patients with AAD was demonstrated, and causative organisms mostly produce both toxins A and B. Since C. difficile still has problematic treatment and is costly, rapid and early detection may help to curb C. difficile infection more efficaciously. [ABSTRACT FROM AUTHOR]

Background: The vermiform appendix, the worm-shaped, closed-ended tube containing a large number of lymphoid follicles, displays variations in its position and macroscopic dimensions according to age, sex, race, and other relevant factors. Variable locations of the appendix may mislead physicians into making an incorrect decision or identification of other diseases. Hence there is a necessity for the study of the different positions of the appendix in patients with appendicitis. Materials and Methods: The present study was carried out on 400 bodies (253 males, 147 females) in the autopsy hall of the Forensic Medicine Organization, Tehran province, Iran, from March 2020 to March 2021. The anatomical position of the appendix was recorded during the autopsy. Appendix length and diameter were measured in millimeters using a ruler. The sex of the bodies was recorded based on the observed phenotype, and their age was verified based on their identity document. The data obtained were analyzed using SPSS software version 20. Results: The pelvic appendix was found to be the most common (29.7%) in both men and women, followed by paracecal in (21.8%), prececal (19.5%), retrocecal (12.5%), subcecal (8%), pre-ileal (6%), and post-ileal (2.5%). The association between sex and appendiceal length was statistically significant, with women having longer appendices than men (85.1 ± 13.8 mm vs. 81.9 ± 13.4 mm, P = 0.028). Also, the appendiceal diameter was significantly larger in women than in men (3.81 ± 0.7 mm vs. 3.45 ± 0.66 mm, P = 0.017). There was a significant association between sex and position of the appendix, with paracecal position being more prevalent in men and retrocecal in women (P = 0.04). The mesoappendix was complete in all cases. Conclusion: In our study, the commonest position of the appendix was pelvic. The maximal length and diameter of the appendix were 85.1±13.8 and 3.81±0.7 mm, respectively. This shows variations with related reports from other populations. Knowledge of these variations is essential for early detection, treatment, and fewer complications for related diseases. [ABSTRACT FROM AUTHOR]

Copyright of Iranian Journal of Gastroenterology & Hepatology (GOVARESH) is the property of Iranian Association of Gastroenterology & Hepatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Epstein-Barr virus (EBV) primary infection and/or reactivation are suggested to play a significant role in the incidence of post-transplantation lymphoproliferative disorders (PTLD) and some other complications in immunocompromised patients, especially organ recipients. We assessed EBV viral load in EBV/PTLD suspected liver transplant recipients at specified times after transplantation and evaluated the respective clinical findings and post-transplant complications. Materials and Methods: Of 696 patients who underwent liver transplantation, the EBV viral load of 127 patients suspected of EBV infection/disease was examined intermittently in this retrospective study. Sampling was performed over a 4-year period from July 2013 to May 2017 using Taq-Man Real-Time Polymerase chain reaction (PCR) assay. Clinical and pathological data were gathered through the review of medical records. Results: The most common and leading cause of liver transplantation was HBV end-stage with 12% frequency; however, in 39% of patients, the underlying disease was unknown. In total, 78 out of 127 (61%) suspected patients exhibited EBV-DNemia, and 19 of them were associated with PTLD. The median viral load in patients with PTLD was significantly higher than in non-affected patients (4035 copy/mL vs. 500 copy/mL, P<0.05). Among the PTLD cases, 13 were living, and six expired. Of the non-PTLD cases, 57 were living, and two expired. Totally, PTLD was diagnosed clinically in 34 subjects (4.9%). The estimated mortality rate in patients with PTLD was 35% during 1.5 years post-transplantation follow-up. Conclusion: We concluded that monitoring of EBV load might detect EBV infection/disease in liver transplant suspected recipients even several weeks before the onset of any manifestation, especially in pediatric cases in whom PTLD incidence and its mortality are high. [ABSTRACT FROM AUTHOR]

Background: There were few studies reporting simultaneous presence of Helicobacter pylori (H.pylori) in stomach and gallbladder stones, most of which have been conducted on bile specimens or gallbladder tissues. Presence of a chronic inflammatory disease may contribute to gallstone formation through production of inflammatory cytokines. Chronic active gastritis due to H.pylori may contribute to lithogenesis in gallbladder. In this regard, the present study aimed to investigate the frequency and association of gastric H.pylori infection and gallstones in patients who were undergoing upper endoscopy in a teaching hospital. Materials and Methods: In this case-control study patients presenting with dyspeptic symptoms who underwent upper endoscopy during 2008-2012 in Shahid Beheshti Hospital of Babol, northern Iran were enrolled, 72 patients with and 136 patients without gallstones were assigned as the case and control groups, respectively. Patients with history of gastric surgery PPI, and antibiotic consumption four weeks before endoscopy were excluded from the study. Two biopsies were obtained from gastric antrum and body of each patient in both groups and examined histologically for gastritis and the presence of H.pylori. Then, endoscopic, his-tological and demographic features (age, gender, BMI, smoking, NSAUD) in these two groups were compared. The SPSS software (version 18) was used for analysis. P-value of O.05 was considered as statistically significant. Results: Fifty-two (72.2%) and 98(72.1%) of all patients with and without gallstone were female, respectively (p=0.7). The mean age of patients with gallstone was 51.8±14 years, while it was 51.1±15 years in patients without gallstone (p= 0.9). H.pylori was detected in gastric mucosa of 31 (43.1 %) and 45 (33.8%) cases with and without gallstone, respectively. Although H.pylori infection was higher in patients with gallstones, the difference was not statistically significant (p =0.19). In the group with gallstones, 21(29.2%) patients revealed severe gastritis, and in those without gallstones, 17(12.5%) patients were found with severe gastritis. This difference was statistically significant (p=0.003, OR=2.88, CI: 1.41-5.91). Conclusion: This study demonstrates that patients with severe H.pylori induced gastritis are likely to have gallstone in comparison with mild gastritis. The frequency of H.pylori infection in patients with gallstones is more than those without gallstones. [ABSTRACT FROM AUTHOR]

Background: Considering the beneficial effect of the Mediterranean diet on health in different populations, we aimed to validate the Persian version of the Mediterranean Diet Adherence Screener (MEDAS) in the healthy population. Materials and Methods: This cross-sectional study was performed on healthy Iranian adult s, in December 2020. The scale was translated into Persian language and then confirmed by back-translation. Data were collected by google forms. To evaluate the content validity, the two concepts of content validity index (CVI) and content validity ratio (CVR) were used according to the evaluation of 18 medical experts. Intra-class correlation coefficients (ICC) and Pearson’s r correlation coefficient wwere used to evaluate the internal reliability of the items. Results: Three hundred and four healthy volunteers (mean±SD age: 36.43±10.14 years; mean±SD body mass index: 25.65±4.18 kg/m² ) were enrolled in our study. According to medical experts’ opinions, CVR was ≥0.714 and CVI was 1. Also, a significant correlation was seen regarding Pearson coefficient for test-retest reliability (r=0.74, p < 0.001). Conclusion: The cultural modified persian version of MEDAS had an acceptable validity and reliablity for rapid assessment of adherence to the Mediterranean healthy diet and it can be useful in research and clinical practice. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer is the fourth most common cancer and the second cause of cancer-related death worldwide. Various types of gastric cancer are common in different areas in Iran. In this study, we aimed to evaluate 10 years of endoscopic and histopathological data of patients diagnosed with gastric cancer in Babol, Iran. Materials and Methods: This descriptive cross-sectional study included all patients with recorded data who were referred to the endoscopic unit with gastric cancer during 2006-2016. Data included demographic characteristics (age, sex, body mass index [BMI], smoking, opium addiction), endoscopic characteristics (site of involvement in different gastric areas), and histopathological types (adenocarcinoma, lymphoma, gastrointestinal stromal tumor (GIST)), which were extracted from the endoscopy unit database and were analyzed using SPSS software. Results: 435 cases of gastric cancer were studied. The mean age was 66.75 ± 14.03 years, with a minimum and maximum age of 21 and 94 years, respectively. The data demonstrated that men were affected 2.3 times more than women (69.2% were men and 30.8% were women). 420 out of 435 patients were diagnosed with adenocarcinoma. Also, 46 cases (or 10.9%) were signet ring adenocarcinoma, and 374 cases (89.1%) were non-signet ring adenocarcinoma. Eight cases were lymphoma, and seven cases were GIST. In addition, 112 patients (25.8%) had proximal, and 323 patients (74.2%) had distal involvements, mostly involving the antrum (36.8%). Regarding the effects of cigarette smoking and opium addiction, 124 patients diagnosed with gastric cancer were investigated. 13 patients (10.4%) had a history of smoking. Also, five patients (4%) had a history of opium addiction. Three patients (2.2%) had a history of both. Conclusion: In our study, non-cardiac intestinal type adenocarcinoma was more prevalent than cardiac type. [ABSTRACT FROM AUTHOR]

Background: Bariatric surgery is one of the recent advances in the treatment of morbid obesity associated with gastrointestinal disorders. Because of the importance of lifestyle on health promotion, we aimed to investigate the effect of lifestyle modification on gastrointestinal disorders in patients undergoing sleeve gastrectomy. Materials and Methods: This study was a clinical trial performed in the surgical ward of Hazrat Valiasr Hospital during 2020-2021. 70 patients underwent bariatric surgery according to the inclusion and exclusion criteria and were purposefully selected and randomly assigned using quadratic block A and B and divided into experimental and control groups The day before the surgery, an educational intervention was performed for the experimental group with respect to lifestyle modification including six dimensions (nutrition, physical activity, responsibility for health, stress management, relationships and interpersonal support, and spiritual growth, and selffulfillment). The day before and two months after sleeve gastrectomy, the participants were evaluated using the health-promoting lifestyle profile II and a researcher-made questionnaire on gastrointestinal complications. Data were analyzed by SPSS software, version 22, using descriptive and inferential statistical tests (Chi-square, dependent and independent t test and McNemar test) at the significance level of P < 0.05. Results: The rate of constipation and diarrhea decreased after the intervention in the experimental group but the difference was not statistically significant. The rate of nausea and vomiting before and after the intervention was different in both experimental and control group. However, the rate of nausea was significantly lower in the experimental group compared with the control group after the intervention. The rate of reflux reduced before and after the intervention in the experimental group compared with the control group, but the difference not statistically significant compared with the control group after the intervention. Conclusion: Considering the effectiveness of lifestyle modification in reducing gastrointestinal disorders in patients undergoing sleeve gastrectomy, planning to perform this educational intervention is recommended. [ABSTRACT FROM AUTHOR]

Background: Celiac disease is a common malabsorptive bowel disease caused by gluten sensitivity that affects other organs of the body in addition to the gastrointestinal tract, such as the liver, brain, and respiratory system. In this study, we aimed to evaluate the pulmonary volumes in patients with celiac disease in Kerman city. Materials and Methods: This cross-sectional descriptive study was performed on all adult patients with celiac disease in the Celiac Registry in Afzalipour Hospital. All patients whose records were complete were included in the study. At this stage, height and weight were measured, and their demographic information was recorded in a checklist. Then, according to the standard conditions, spirometry was performed. Data were analyzed using SPSS software version 22. Results: The study cases comprised 58 patients with celiac disease. The average age of the patients was 37.59±18.02 years. The mean height was 157.22±14.30 cm and the mean weight was 57.09±17.06 kg. The results showed that the mean forced vital capacity (FVC) was 3.15±0.93 L, the mean forced expiratory volume in 1 second (FEV1) was 2.68±0.76 L, the mean ratio of FEV1 to FVC 83.06 ± 5.56%, and the mean of peak expiratory flow (PEF) was 6.64±1.61 L. Conclusion: The results of this study indicated pulmonary volumes in celiac patients were lower than the normal age- and sex-matched population. Further studies to follow up and assess respiratory problems in these patients are needed. [ABSTRACT FROM AUTHOR]

Background Common bile duct (CBD) stone is the most common disorder in the biliary tract, which may lead to hospital admission. Opium addiction is one of the most challenging social and health issues in many societies. An important side effect of opium addiction is the Oddi’s sphincter spasm; i.e., it is likely that the prolonged stasis of bile acid increases the risk of gallstone formation in the CBD. Materials and methods: This cross-sectional study was done from April 2019 to November 2019 in Ghaem Hospital in Mashhad, Iran. 400 patients aged 20-80 years were enrolled. All patients had a definite diagnosis of CBD stones and were candidates for endoscopic retrograde cholangiopancreatography (ERCP). Demographic information of patients, history of underlying diseases, liver laboratory disorders, the existence of concomitant gallbladder stones, and opium addiction information were collected. Results The average age of the patients with opium addiction was 65.12 years, and it was significantly higher than the mean age of the patients (61.41 years) without opium addiction (P=0.01). 74.3% were hospitalized, and 25.3% were outpatients. 35.5% of the patients were men, and 64.5% were women. Our study showed that 41.5% of the patients with CBD stones were opiumaddicted. The average CBD stone size in patients with opium addiction (10.15±4.85 mm) was larger than in patients without opium addiction, but a t test showed that this difference was not significant (P = 0.9). Conclusion In this study of patients with CBD stones referred for ERCP, we observed a high prevalence of opium addiction in patients with CBD stones. [ABSTRACT FROM AUTHOR]

Background The parents of children with autism spectrum disorder have special challenges and problems with their children’s disorder, so they have more stress in parenting than other parents, also having psychological disorders is very common in these parents. The aim of this study is to evaluate the effect of psychological disorders and parental stress on children with autism spectrum disorder and digestive problems. Materials and Methods: This study was a descriptive-analytical one with a correlation method. Based on the purpose of the study, the statistical population was all parents with children with autism spectrum disorder who were referred to special need schools in Isfahan. 30 participants were chosen using the available sampling method. In this study, SPSS version 22 was used to analyze the data. Results : The results showed that parental stress had no significant effect on gastrointestinal disorders in children with autism and the results showed a positive and significant effect of parental psychological disorders on the severity of gastrointestinal disorders in children with autism. The results showed the effect of psychological disorders of parents that need to be considered as an effective factor in the treatment process of this disease. Conclusion: Factors may contribute to gastrointestinal problems in autistic children, including a variety of gastrointestinal bacteria and gene expression patterns, as well as inadequate dietary fiber, which acts as a natural anti-constipation agent. [ABSTRACT FROM AUTHOR]

Background In patients in intensive care units, gastrointestinal problems occur frequently and often with adverse consequences. The importance of gastrointestinal failure in patients is underestimated. This study that was done in intensive care centers of Mashhad pediatric hospitals evaluated the effectiveness of Pediatric Risk of Mortality (PRISM-3) and Pediatric Index of Mortality (PIM-3) systems in predicting mortality in patients with digestive diseases. Materials and Methods: This study was performed on critically ill children aged≤ 18 years who were referred to receive critical care in two hospitals. A comparison was made between the PIM-3 and PRISM-3 scores according to the discrimination (the area under the receiver operating characteristic [AUC] curve), and calibration (agreement between expected and observed mortality). Results: A total of 339 patients (median age 5, IQR: 0.76-25 months, 54.6% male) with 54 deaths were considered in the study. PRISM-3 discrimination was more than PIM-3 (AUC=0.779, 0.739) and the difference between AUC scores was significant (P=0.001). There was a good agreement between the observed and predicted mortality by both models with no deviation from the true probabilities suggesting good calibration for our population. There was a significant relationship between the patients' deaths and increased scores of PRISM-3 and PIM-3 models. The weakest prognosis was related to patients with esophageal, gastric, and intestinal problems. Conclusion: It was found that the performance of PRISM-3 in discrimination and calibration of mortality is superior to PIM-3. According to the results of this study, the performance of PRISM-3 in discrimination and calibration to mortality was superior to PIM-3, and the use of scoring systems can predict the mortality of children with gastrointestinal problems and reduce their mortality. [ABSTRACT FROM AUTHOR]

Background: Patients recognize chemotherapy-induced nausea and vomiting as major side effects. So, it is important to prevent chemotherapyinduced nausea and vomiting in patients suffering from cancer. Objective: The aim of this study was to determine the effects of laughter therapy on chemotherapy-induced nausea and vomiting in patients suffering from cancer. Materials and Methods: This study was a clinical trial performed on 80 patients referred to the chemotherapy department of a hospital in Khorramabad. The participants were randomly divided into two groups: the intervention group (40 persons) and the control group (40 persons). The data gathering tools included the demographic data questionnaire and Morrow nausea and vomiting assessment scale. In order to data analysis, descriptive statistical and inferential statistical methods (Chi-square, Mann Whitney, and Wilcoxon test) were used. SPSS software version 22 was used for analysis. Results: The mean age of the participants was 70 ±10.19 years. The result of Chi-square test showed that there was no significant statistical difference between the two intervention and control groups in terms of the severity of nausea after chemotherapy (p > 0.05). The result of Chi-square test showed that there was a significant statistical difference between the two intervention and control groups in terms of frequency of nausea after chemotherapy (p < 0.05). There was a significant statistical difference between the two intervention and control groups in terms of the severity of nausea and vomiting after chemotherapy (p < 0.05). Conclusion: Laughter therapy is effective in reducing the incidence of nausea and reducing the severity of nausea and vomiting. It is recommended that health workers, especially nurses, become familiar with how laughter therapy is performed as part of the care of patients undergoing chemotherapy and use it in clinics. [ABSTRACT FROM AUTHOR]

In the present study, we aimed to explain the model of quality of life based on illness perception and coping strategies in patients with irritable bowel syndrome (IBS). Materials and Methods: The research method was descriptive and correlational. The statistical population of the study consisted of all patients with IBS in Kashan. For this purpose, 250 patients were selected via the available sampling method. In order to collect data, Patrick, Drossman et al Quality of Life Questionnaire (IBS-QOL-34)(1998), Endler, Parker Coping Inventory for Stressful Situations (CISS)(1990), and Broadbent, Petrie, Main, Weinman illness perception (2006) were used to analyze the data. Explanatory factor analysis and structural equation modeling were used. Results: The results (using Amos software) showed that structural equation modeling indexes fit the research data with the theoretical foundation of the study. Models illness perception and coping strategies with quality of life in patients with IBS, directly and indirectly, demonstrated good fitness. In total, structural models (predictor and mediated models) of illness perception and coping strategies explained 28/37 of the variances of quality of life in patients with IBS. Conclusion: The results of the structural model showed that there was a significant relationship between illness perception and quality of life with the mediating role of coping strategies. [ABSTRACT FROM AUTHOR]

Background Laparoscopic cholecystectomy is the treatment of choice for cholecystitis. The aim of this study was to evaluate the frequency of complications in patients referring to educational centers in Rasht Materials and Methods: In this descriptive cross-sectional study, the records of 132 patients referred to Poursina and Razi Hospitals of Rasht in 2006 were studied. Complications such as the need for open surgery, surgical site infection, and bile duct injury were evaluated in subsequent visits. Results: The subjects aged between 19 and 80 years with a mean of 14.65 ± 53.06 years. An open surgical procedure was reported in 8.2% of the subjects. Biliary duct injury and surgical site infections in patients undergoing laparoscopic cystectomy were estimated 4.1% and 8.2%, respectively. 2% of the subjects suffered from a surgical abscess. Vomiting and fever were reported in 16.3% and 8.2% of the cases, respectively. The mean age of the subjects with the surgical site infection was significantly higher than others. In addition, the open surgery rate in men was significantly higher in women. Conclusion: Laparoscopic cholecystectomy is a safe and effective method with low complications and, as a standard method of cholecystectomy, in the conditions and facilities available in our country, has a high success rate. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to examine the prevalence of the diseases and the reasons for outpatient referral of gastrointestinal patients to the subspecialty gastroenterology center of Ziaeian Hospital in Tehran. Materials and Methods: In the present cross-sectional study, the main causes of outpatient referrals in 2019 were extracted from the data bank of Ziaeian Hospital. The final diagnosis of all patients is based on the first visit, subsequent referrals, and the diagnostic procedures performed. Results: The present study examined the data collected from 1072 patients. The results showed that 70% of the participants (756 patients) were female, and the patients in the age group of 41-50 years had the highest frequency accounting for 23.9% of the patients (259 persons). Besides, the most commonly diagnosed diseases in the whole population and both sexes were functional dyspepsia (35.72%), reflux (14.73%), irritable bowel syndrome (8.02%), and anal fissure (8.02%). Furthermore, the early onset symptoms were abdominal pain (44.8%), retrosternal pain and burning (12.7%), bleeding (8.1%), and defecatory disorders (7.5%). Conclusion: The findings of the study can have some implications for preventive planning and interventions and the allocation of health resources. [ABSTRACT FROM AUTHOR]

Background: Chronic constipation is a common problem in children, which may last for years and cause unpleasant effects on the patients' and their family's lives. Timely treatment can reduce the costs and complications. Re-admissions not only have a negative impact on the quality of life of the patients and their family but also has an adverse economic impact on the health system. Therefore, this study was conducted to determine the frequency of constipation re-admissions and some related factors in Motahari Hospital of Urmia from 2013 to 2019. Materials and Methods: In this descriptive-analytical study, 1045 cases of constipated children were investigated from the beginning of 2013 to the end of 2019. At first, a checklist containing demographic information and clinical characteristics of all children admitted with constipation was prepared and completed, and then data were analyzed using SPSS software version 23. Results: Out of 1045 children with constipation, 48% were male, and 52% were female with a mean age of 5/1±2/92 years. 73.4% were urban, and 26.6% were rural residents, and 14% of the children were admitted more than once during 6 years. There was a significant relationship between age, weight, height, parental education, and place of residence with re-admissions in children with chronic constipation (p < 0.05). Conclusion: The findings of this study showed that the cornerstone of re-admissions due to chronic constipation in children might be multifactorial and needs complete evaluation of social, behavioral and health status of children. [ABSTRACT FROM AUTHOR]

Background: Sub-epithelial lesions (SELs) discovered during endoscopy may be originated from either layers of the gastrointestinal (GI) tract or outside of the GI lumen. Endoscopic ultrasonography (EUS) is used to identify the source of these lesions and occasionally to obtain a sample. Aim: In this study, we aimed to obtain the prevalence of upper GI SELs along with their ultrasound and pathological features. Materials and Methods: In this cross-sectional study, all patients referred to a referral endoscopy department for EUS were enrolled. Size and location of lesions, relevant layer, endosonographic and endoscopic features of the lesions, and definitive pathological diagnoses were collected. Results: A total of 305 cases were evaluated. 76.32% of SELs had a homogenous echo pattern. The lesions were predominantly seen in the antrum. The lesions were originated from submucosa (37.38%), muscularis propria (33.77%), and deep mucosa (28.85%), respectively. Gastrointestinal stromal tumors (GISTs) (47.54%) were the most common type of SELs. The most prevalent heteroechoic and hyperechoic lesions were pancreatic rest and lipoma (55.8%), respectively. Conclusion: Most SELs are located in the gastric antrum. Out of all evaluated lesions, GISTs were the most frequent lesion discerned by EUS. [ABSTRACT FROM AUTHOR]

Background: Gastrointestinal disorders are ranked first among medical disorders to seek psychiatric consultation. Various researches report multiple causes for and emphasize the role of psychological factors in causing or exacerbating symptoms of this disorder. Emotional distress highly affects people. Emotional regulation mechanisims are among the factors that could affect the level of emotional distress. The aim of this study was to investigate the predictive role emotional regulation on determining emotional distress in ipatients with psychosomatic and Functional Gastrointestinal disorder. Materials and Methods: In this descriptive and correlational study, the population included 150 patients with FGIDs were selected by purposeful sampling method from indivisuals who referred to a specilalized clinic for Gastroenterology in Tehran. The participants completed Garnefski Cognitive Emotion Regulation Questionnaire :CERQ-36 )2006 ( and Depression Anxiety Stress Scale DASS-21 (1995). Data analysis was done in SPSS 24 using Pearson correlation coefficient and multiple regression. Results: Fndings showed a significant positive relationship between Maladaptive (negative) emotional regulation and emotional distress and its components (depression, anxiety, and stress). Also an indirect significant relationship was detected between Adaptive (positive) emotional regulation and two components of emotional distress in which adaptive emotional regulation signicantly predict depression and stress as two components of emotional distress . Conclusion: Positive (adaptive) cognitive regulation Mechanisim play a role in decreasing the severity of emotional distress in individuals with Functional Gastrointestinal disorders. [ABSTRACT FROM AUTHOR]

Background: Different studies have reported the association between gastroesophageal reflux disease (GERD) and non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome. This association is considered either body mass index (BMI) related or independent of BMI. In the current study, we aimed to illustrate the correlation between GERD symptoms and NAFLD and to determine the role of BMI in this regard. Materials and Methods: This study was conducted on 332 out-patients referred to the clinics affiliated to Imam Khomeini and Imam Reza Hospitals in Kermanshah in 2015-2016 who were divided into two groups of patients with NAFLD and without NAFLD. The two groups were investigated and compared for symptoms of GERD. The confounding effect of BMI and sex were eliminated in this study by multiple logistic regression. Results: The prevalence of heartburn, belching, nausea and vomiting, and hypertension (HTN) was higher in patients with NAFLD (P<0.05). Moreover, these four variables were still associated with NAFLD after eliminating the BMI and sex confounding effect by multiple logistic regression model. Conclusion: Some GERD symptoms are related to NAFLD regardless of BMI effect. [ABSTRACT FROM AUTHOR]