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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: 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 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 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]

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 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 In this study, we investigated the expression profile of this disease to identify new hub genes to help diagnose hepatocellular carcinoma (HCC). Materials and Methods: Weighted gene co-expression network (WGCNA) analysis was used in this study to identify key modules and hub genes associated with HCC in the GSE176271 dataset. We also looked at the clinical significance of key genes and the biological pathways linked to them in external databases. We validated the identified hub genes using data from the GEPIA and XenaBrowser databases. Results: The Midnight blue module was found to be significantly related to the pathological stage (r=0.94, P=1e-11). Five hub genes (CLEC4M, CLEC4G, FCN2, OIT3, and ASPG) were associated with prognosis using DEG identification and WGCNA analysis. The three biological pathways associated with the Midnight blue module were copper ion detoxification, cell ion homeostasis, and complement activation, as well as the lectin pathway. Conclusion: The current study's findings provide new and effective molecular targets for the detection of HCC, which can improve patients’ prognosis. [ABSTRACT FROM AUTHOR]

Background: Endoscopy is one of the most common diagnostic and therapeutic methods in patients with gastrointestinal diseases. Anxiety and pain are associated with the patients. This procedure is unpleasant and intolerable. The present study was performed to determine the effect of the clinical Orientation Tour on the anxiety, pain, and satisfaction of patients who were candidates for endoscopy referred to Hospital in Rafsanjan in 2019. Hazrat Ali Ibn Abitaleb (AS) Hospital in Rafsanjan in 2019. Materials and Methods: In this clinical trial study, 64 patients referred to the hospital were randomly divided into control and intervention groups. Demographic characteristics, Spiel Berger Anxiety Scale, Visual Analogue Pain Scale, and Modified Questionnaire (GHAA-9) were the data collection tools. The intervention was Orientation Tour with endoscopy and direct endoscopic observation. Patient's anxiety before and after the intervention, pain during endoscopy, and satisfaction after endoscopy were measured. Data were analyzed using paired t-test, independent t-test, Chi-square, linear regression, and Mann-Whitney tests. Analysis was done using SPSS software version 16. Results: The mean score of overt anxiety before the intervention was 56.78 ± 7.32 and after the intervention was 35.19 ± 12.52, latent anxiety ranged from 57.22 ± 9.04 to 32.25 ± 13.67, and total anxiety from 114.00±15.90 decreased to 67.44 ± 25.76, which was statistically significant (P=0.0001). However, in the control group, it was associated with an increase in anxiety scores after the intervention. Pain during endoscopy was also statistically significant between the intervention and control groups (P=0.0001). But the mean satisfaction score after endoscopy was not significantly different between the two groups (P=0.161). Conclusion: Clinical orientation training is effective in reducing anxiety and pain in patients undergoing esophagogastroduodenoscopy. It can therefore be suggested to reduce anxiety. [ABSTRACT FROM AUTHOR]

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: 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 Hepatitis B vaccination is necessary to prevent infection with this virus and to prevent the development of chronic hepatocellular carcinoma. Materials and Methods: Assessing the immunization status after receiving the vaccine and identifying non-respondents, especially among health care workers and physicians, is important because of the higher risk of contact with infected patients and their body fluids. In this study, the vaccination status of health and medical staff of a children's hospital was investigated to measure the anti-HBs antibody titer and its relationship with body mass index, smoking, and drugs used in individuals with underlying diseases. In this study HBsAb kit, DIA.PRO; Italy was used to measure the antibody titers. Statistical analysis was done using SPSS software version 26. Results: The results of this study showed that a proper antibody titer is present in 66.6% of the participants. Reduced antibody titers to unsafe levels were measured among the employees older than 50 years, smokers, and employees with low or very high body mass index. Conclusion: In this study, the decrease in antibody titer did not show any association with underlying diseases and related medications. The presence of an unsafe antibody titer among young vaccinated staff suggested additional studies to identify non-responders after receiving a booster dose of the vaccine. [ABSTRACT FROM AUTHOR]

Background Helicobacter pylori (H. pylori) is a bacterium that causes gastritis, gastric ulcers, and cancer. A major problem in the treatment of H. pylori-infected patients is re-infection with other H. pylori strains, which suggests the probability of colonization of this bacteria in other tissues of the body. Adenotonsillar tissues as the entrance of the gastrointestinal system might be considered as a place for H. pylori colonization and a reservoir for re-infection. The aim of this study was to survey the co-incidence of colonization of H. pylori in hyperplastic adenotonsillar tissues and its antigen in children. Materials and Methods: In this cross-sectional study, 92 children candidates for adenotonsillar surgery in Ayatollah Rouhani Hospital of Babol in 2019 were enrolled. Before the surgery, stool samples were taken and tested with the rapid stool antigen kit for H. pylori. In the operating room, a sample with a size of two mm was separated from the adenotonsillar tissues and was placed in the rapid urease kit. Finally, all adenotonsillar tissues were sent for pathologic evaluation. Results: According to obtained results from the study, eight (8.5%) patients had a positive stool antigen for H. pylori, and a positive rapid urease test was reported in the samples of adenotonsillar tissues of six patients. Co-incidence of colonization of H. pylori in hyperplastic adenotonsillar tissues and its antigen were reported in two patients. All samples were confirmed by pathology as lymphoid hyperplasia. Conclusion: H. pylori can be colonized in adenotonsillar tissues, and there is a probability of its co-incidence with H. pylori stool antigen in children. [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 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]

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 Anxiety and stress are important risk factors for psycho-somatic disorders like gastrointestinal disorders. The main purpose of this study is to investigate the relationship between anxiety and stress with functional gastrointestinal disorders (FGID). Materials and Methods: This study was a descriptive-analytical one with a correlation method. In this study, 82 patients with FGID who were referred to Noor Hospital of Isfahan in 2019 were selected and evaluated with anxiety and stress scale (HASS) and severity of gastrointestinal symptoms scale. Data were analyzed with descriptive statistics, Pearson correlation, and multivariate regression. Results: The results showed that there was a significant positive relationship between anxiety and stress with the severity of gastrointestinal symptoms in these patients, and anxiety could predict changes in the severity of gastrointestinal symptoms very well. Conclusion: According to the findings of the study on the correlation between anxiety and stress with the severity of gastrointestinal symptoms in patients with functional disorders, in the treatment of these patients should pay attention to the areas of anxiety and stress and minimize these aggravating factors with psychological measures.es. [ABSTRACT FROM AUTHOR]

Background: Recognition of influential factors is necessary for predicting the severity of cholecystectomy. We aimed to evaluate the diagnostic power of the proposed scoring system for predicting the severity of laparoscopic cholecystectomy. Materials and Methods: In this cross-sectional study, there were 122 patients who underwent cholecystectomy in Shahid Beheshti Hospital during 2018. Prior to surgery, accurate history, and clinical, laboratory, and ultrasound information were recorded and scored on a checklist. Finally, the difficulty of cholecystectomy was divided into three categories of easy (less than 60 minutes, uncomplicated) and difficult (between 60 and 90 minutes, divided into controllable) and very difficult (between 90 and 120 minutes with uncontrollable complications or open surgery). Data were analyzed in SPSS software, version 22, and the indicators were calculated for the purpose of the study. Results: There were 28 (22.4%) men and 97 (77.6%) women. The mean ± SD ages of the patients in easy and difficult operations were 44.71 ± 13.56 and 44.52. 14.56 years, respectively (p = 0.939). The patients’ sex and history of acute cholecystitis attacks did not have a significant relationship with the difficulty of laparoscopic cholecystectomy (p ≥ 0.05). However, between the palpable gallbladder (p < 0.0001), impacted stone (p < 0.0001), gallbladder wall thickness (p < 0.0001), and body mass index above 30 (p < 0.0001) there was a statistically significant relationship between the difficulty of operation. There was also a significant relationship between AST (p = 0.034), T Bill (p = 0.008) WBC (p < 0.0001), and the difficulty of laparoscopic cholecystectomy, but between ALT (p =0.065), the severity of cholecystectomy was not significantly related. Sensitivity (86%), specificity (58%), positive predictive value (44%) and negative predictive value (91%) were calculated for the scoring system for the difficulty of laparoscopic cholecystectomy. Conclusion: To predict the difficulty of laparoscopic cholecystectomy, we strongly recommend the preoperative scoring system. It is also recommended to conduct further studies on the use of the scoring system during surgery. [ABSTRACT FROM AUTHOR]

Background: One of the common diseases is fatty liver disease, which can be seen significantly in patients with excessive obesity as well as patients with diabetes. Using ultrasound imaging methods, it can be possible to identify and evaluate patients affected by this disease. The aim of this study was to use advanced machine learning algorithms for better and more accurate classification of the acquired images from different patients affected by fatty liver disease. Materials and Methods: In this study, the acquired ultrasound images of 55 patients suspicious as having fatty liver disease have been used. The level of fat for different patients was labeled by biopsy sampling. Based on this experiment, the patients were predicated as having a fatty liver when more than 5% of their liver hepatocytes were accompanied by infiltration of fat. Then, we utilized some pre-trained convolutional neural networks, including Inception-ResNetV2, GoogleNet, and AlexNet to extract high-level features of the collection of the acquired images. After that, a SoftMax layer was implemented to classify the images that indicated fatty liver. Results: The resulted precisions for Inception-ResNetV2, GoogleNet, and AlexNet pre-trained convolutional networks were 0.8108, 0.9459, and 0.9932, respectively. Also, the area under the curve of receiver operating characteristics (AUC) for these networks were 0.9757, 0.9960, and 0.9963, respectively. Conclusion: The proposed intelligent algorithm can help sonography experts to recognize the liver tissues with fat automatically and accurately without the need for a specialist to assign the region of interest for evaluation. [ABSTRACT FROM AUTHOR]

Background: Nowadays, gastroenterologists work a wide variety of areas and in this field a lot of new trends have been set up worldwide. According to our nation’s goals in science production and being a leader in innovation and technology, and also creating several cohorts in digestive and liver diseases, we need to calculate and predict the workforce needed. Materials and Methods: Among the 51 medical universities in Iran, 12 train adult and 5 train pediatric gastroenterologists and hepatologists. About 33 to 35 adult and 8 to 10 pediatric gastroenterologists are trained every year. Currently we have about 650 adult and pediatric gastroenterologists working in Iran, meaning one gastroenterologist per 124,000 population, which 30% are practicing in Tehran. Results: Each year 40-45 fellows of gastroenterology will be trained, leading to 950 adult and pediatric gastroenterologists by 2025. Our population is estimated to be about 90 million persons by then, leading to one gastroenterologist per every 95-100.000 population. Conclusion: Estimating the need for gastroenterologists depends on the per capita income, governmental funds and insurance policies. Distribution of gastroenterologists is centralized in large cities and capitals of each province. Every year about 45 gastroenterologists enter Iran’s workforce, along with this increase we need necessary equipment for diagnostic and therapeutic endoscopic procedures. Proper distribution of graduates can facilitate and improve services in this field. Till 2025, our population is estimated to be about 90 million and we will have about 950 gastroenterologists, meaning 1 per every 95-100.000 population. Therefore, the estimates given by Strategic Planning Committee seems reasonable and justifiable. [ABSTRACT FROM AUTHOR]

Background: Liver cancer is one of the common cancers. Despite many advances in medical sciences, it continues to be one of the main problems in the care systems. Diagnosis of the disease and its treatments result in many problems for affected patients. The purpose of this study was to assess the consequences of transcatheter arterial chemoembolization. Materials and Methods: The study was performed on 84 patients at Imam Khomeini Hospital in Tehran, using available sampling methods. Questionnaires on cancer treatments, Fatigue Severity Scales, Hospital Anxiety and Depression Scales, Edmonton Symptoms Scales, and demographic characteristics were filled before and after treatment. Data were analyzed using SPSS software version 21. Descriptive statistics, t test, and correlation test were used as appropriated. Results: The study showed many consequences such as anxiety, pain, and fatigue. Mean physical and psychological outcomes after treatment showed a significant increase (p ˂ 0.05), which led to a significant decrease in FACT. Conclusion: Consequences have an inverse and significant relationship with patients’ performances and their quality of life. Due to the direct effects of consequences on life, they should be reduced or eliminated. [ABSTRACT FROM AUTHOR]

Background: Primary liver cancer is one of the most malignant and deadly cancers, which reduces the quality of life. Health-related quality of life (HRQOL) is an important criterion for evaluating the health care, controlling diseases, outcomes, benefits, and disadvantages of treatments, quality of medical treatment and nursing care, and screening individuals at risk for physical and psychological problems. The aim of this study was to investigate the predictive factors of HRQOL in patients with liver cancer. The results of this study can improve the quality of life of the patients and the level of health care. Materials and Methods: This study was performed on 272 patients referred to Imam Khomeini Hospital in Tehran (2018-2019), by using convenience sampling method. For assessing patients, we used Function Assessment Cancer Therapy, Hospital Anxiety and Depression Scale, Fatigue Severity Scale, Edmonton Symptoms Assessment Scale, and Characteristics Demographic. Data were collected in two stages (before and one month after treatment). In order to validate these tools, previous studies were cited and their reliability was assessed by test-retest. Data were analyzed by using SPSS software version 21. Descriptive statistics, correlation test, paired t test, and linear regression were used as appropriated. Results: The mean HRQOL score in patients with liver cancer was 58.11 (±17.31). Effective factors in HRQOL was the type of treatment, physical and psychological consequences, and some demographic characteristics. Conclusion: The present study showed that many factors can predict HRQOL in patient with liver cancer. Also, awareness of these factors provides the basis for developing effective care plans to promote HRQOL and increase life expectancy in affected patients. These factors are very important because based on them HRQOL of patient with liver cancer can be estimated with 59.8% accuracy. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to develop a therapeutic plan based on hypnotherapy for patients with irritable bowel syndrome (IBS) and determine the effectiveness of this treatment on the intensity of IBS symptoms and rumination of patients with IBS. Materials and Methods: The research design was a quasi-experimental with a pre-test, a post-test, and 3 months of follow-up. Of the patients who were referred to gastroenterology clinics in Tehran, 32 patients with IBS were randomly divided into two groups; hypnotherapy group and control group. Medical treatment along with hypnotherapy was individually conducted for eight sessions in the intervention group and the control group received only medical treatment. IBS Symptom Severity Scale (IBS-SSS) and rumination were completed in pretest, post-test, and follow-up stages by the patients and data were analyzed with repeated measures analysis of variance. Results: The variable scores of symptoms severity and rumination in experimental group was significantly lower than the control group (p < 0.05) and the effect of the therapeutic plan persisted until the follow-up stage. Conclusion: The results showed that hypnotherapy can be an effective treatment for patients with irritable bowel syndrome. Therefore, psychological treatment is essential for the management of these patients. [ABSTRACT FROM AUTHOR]

Background: Celiac disease is an autoimmune disorder that can occur in genetically predisposed people who ingested gluten. The most effective treatment for celiac disease is lifelong adherence to a strict gluten-free diet. Therefore, patients with celiac disease need to provide gluten free products. On the other hand, the price of these products are higher than normal ones. Therefore, the aim of this study was to compare the cost of gluten free products with similar regular non-gluten free products. Materials and Methods: All available gluten free and similar regular products were collected during 2018 in Tehran, Iran and their prices and weights were calculated. The gluten free and similar regular products were divided into 13 categories and the items were calculated based on the weight and the prices were compared according to the same weights. The data were analyzed using SPSS software version 21. Results: A total of 128 products, 36 local and 28 imported gluten free product and 64 similar regular products food samples were collected and their prices were calculated in the same amounts of food. Overall, gluten free products were significantly more expensive than regular products. Most of the daily food requirements for patients with celiac disease were in average less than 5,000 Tomans. Only 19.11% of these gluten free products had an average price more than 30000 Tomans. Conclusion: Considering the significant increase in the price of gluten-free products compared with gluten-rich products, the cost of food preparation for people with celiac disease in Iran is high, which can also affect the adherence to a gluten free diet. [ABSTRACT FROM AUTHOR]

Background: Gastroesophageal reflux disease (GERD) is a common disorder, which is associated with mental disorders. Therefore, it is essential to study mental health and strategies for coping with stress, in such individuals. This study was performed to compare Profile of Mental Health and Strategies for Coping with Stress in Women with and without Gastroesophageal Reflux Disease. Materials and Methods: The design of this study was descriptive-causal comparative. The population included all women with and without Gastroesophageal Reflux Disease, from Zahedan province in year 2018. 46 women who were detected as having GERD and were advised to receive gluten-free products from the relevant centers and gastrointestinal clinic were selected and 47 healthy individual who were matched with respect to demographic characteristics with the patients with GERD were selected by purposive sampling method. The participants answered SCL-90-R and Andler & Parker coping strategies questionnaires. Results: The results of multivariate analysis of variance showed that the mean scores of somatic symptoms (F = 17.41), interpersonal sensitivity (F = 3.8), depression (F = 10.59), anxiety (F = 16.68), phobia (F = 4/97), psychosis (F = 4/34), and avoidance style (F = 20/20) were significantly more in patients with GERD compared with healthy people. Conclusion: Mental health in patients with GERD is significantly worse than healthy people and the use of avoidant coping strategies in such patients is more common than healthy individuals. Therefore, it is essential to pay attention to the psychological status of such patients. [ABSTRACT FROM AUTHOR]

Background: Acute upper gastrointestinal bleeding (UGIB) is a common and life-threatening problem. The identification of high-risk patients with regard to the need for urgent endoscopy and immediate intervention in patients with acute UGIB is a challenge for emergency physicians. The use of Rockall and Blatchford scoring systems has diminished this challenge to some extent. Therefore, the aim of this study was to investigate the role of Blatchford and Rockall systems in the outcomes of patients with UGIB referred to Emergency Department of Shahid Beheshti Hospital in Qom. Materials and Methods: In this retrospective analytic study, using a checklist of Blatchford and Rockall Scoring Systems and an easy sampling method, the clinical records of 194 patients with UGIB who aged over 18 years and had no trauma referring from 2013 to 2016 to the Emergency Department of Shahid Beheshti Hospital were studied. The role of Blatchford and Rockall Scoring Systems was investigated by Statistical tests regard to the significance level of p = 0.05. Results: This study showed a significant relationship between the interventions for patients with UGIB in Shahid Beheshti Hospital with predicted interventions by the Blatchford Scoring System (p = 0.000, kappa = 0.294). Also, there was a significant relationship between the place of admission of patients in Shahid Beheshti Hospital with predicted place of hospitalization determined by Rockall (p = 0.000, kappa = 0.182). Also, there was a significant relationship between age and Rockall Scoring System (p < 0.00001). Conclusion: The Blatchford Scoring System can be used as a clinical guide to determine the type of treatment intervention immediately and in the emergency department as a clinical guide to determine the type of patient's care. [ABSTRACT FROM AUTHOR]

Background: One of the most stressful situations in clinical environments is exposure to invasive diagnostic methods, one of which is the endoscopy of the digestive tract. Endoscopy related anxiety can prevent achieving optimal results. Aromatherapy is one of complementary treatments that can reduce anxiety. The aim of this study was to determine the effect of inhalation of matricaria chamomile essential oil on the anxiety before Esophagogastroduodenoscopy. Materials and Methods: This study is a randomized clinical trial that was carried out in May 2014 among patients referred to the Endoscopy Department of Imam Reza Hospital in Mashhad. The population of the study included 152 participants who were randomly divided into intervention and control groups. Anxiety was measured by using State-Trait Anxiety Inventory (STAI) questionnaire. Then for 20 minutes, the intervention group inhaled matricaria chamomile essential oil and the control group inhaled placebo (sesame oil). 10 minutes after inhalation, anxiety was again measured and compared between the groups. Data analysis was done using SPSS software version 21. Results: The mean age of the participants was 42.05 ± 4.5 years and 41.33% of them were male. Mean level of anxiety after inhalation in the intervention group was 35.89 ± 8.40 and in the control group was 39.88 ± 8.40, which decreased in both groups but in the intervention group the decrease was significant. Conclusion: The findings showed that matricaria chamomile essential oil inhalation was effective in decreasing the anxiety of patients who were candidate for endoscopy. It is recommended to reduce anxiety in stressful situations. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer is one of the important causes of death due to cancer worldwide. Survival time in this cancer should be controlled to decrease the risk of mortality. In this study survival time and factors that could affect it are evaluated. Materials and Methods: In the present study, the files of 446 patients afflicted with colorectal cancer who had referred to Taleghani Hospital, Tehran from 1985 to 2013 were chosen as the study group. The exponential model was used here, for the purpose of investigating the survival of patients with colorectal cancer and finding proper variables affecting this survival and longevity. Results: In this study, the subjects had the mean (standard deviation) survival time 4.52 (0.182) year. The patients' age at the time of diagnosis (P = 0.002) and tumor size (P = 0.032) were the only significant variables affecting the survival of patients in the exponential model. Sex, the family history of colorectal cancer, the tumor site, and body mass index had no significant effect on the survival time of the patients with colorectal cancer. Conclusion: The results of the study show that to improve the survival chance of the patients with colorectal cancer or decrease the mortality rate, due attention should be paid to the age of the patient at the time of diagnosis. [ABSTRACT FROM AUTHOR]

Background: Helicobacter pylori (H. pylori) is the cause of most cases of peptic ulcers and gastric cancers and cause some of the most important cause of stomach cancer and lymphoma. The objective of this study was to evaluate the time trend of Helicobacter pylori prevalence and presence of intestinal Metaplasia over the period of 7 years in gastritis Iranian patients. Materials and Methods: In this cross-section study data related to H. pylori and intestinal Metaplasia (IM) among 14,860 consecutive gastritis patients, who referred to the gastrointestinal department of Tehran's Taleghani Hospital in Iran, was examined across the sex and age group. Results: The overall prevalence rate among patient with H. pylori infection was 83.5% (12406/14860) and 11,394 (84.1%) of them were related to the gastritis. The prevalence rate of H. pylori among patient with gastritis significantly higher (p<0.05) compared to patients without gastritis. In addition, the prevalence decreased with age while the presence of intestinal metaplasia increased with age (p<0.05). Conclusion: The results of this study showed that the prevalence of H. pylori infection in Iranian population has declined in recent years; nevertheless it seems to be highly prevalent in Iran. We also find a significant positive relationship between H. pylori infection and IM with gastritis. There is no association between sex and infection but in contrast with the most studies its prevalence decreased with age. [ABSTRACT FROM AUTHOR]

Background: The Unified treatment approach (UP), an emotion-focused cognitive-behavioral therapy that holds emotional processes as a central target of treatment, is applicable for disorders with strong emotional components. The aim of this study was to examine the effectiveness of emotion regulation intervention derivative from the UP on emotional problems and quality of life among patients with functional gastrointestinal disorders. Materials and Methods: The study was a randomized clinical trial. Sixteen patients with functional gastrointestinal disorders were entered in treatment process, in term of the qualification criteria. The intervention was conducted in 12 group sessions during 2 hours. The tests of DASS & SF-36 was used to evaluate the efficiency of intervention. Data were analyzed using descriptive statistics and covariance analysis. Results: The results of the covariance analysis showed that there was significant decrease in severity of depression (p<0.01), anxiety (p <0.05) and stress (p <0.01) and also significant increase in quality of life (p <0.01) in intervention group. Conclusion: Emotional regulation intervention on the basis of the UP was effective in decrease of severity of emotional symptoms (depression, anxiety, stress) and increase of quality of life patients with psychosomatic disorders. So, the UP, transdiagnostic therapy have proper efficacy in improvement emotional regulation and quality of life patients with functional gastrointestinal disorders. [ABSTRACT FROM AUTHOR]

Background: Chronic constipation is a common problem worldwide that negatively impacts quality of life. Because of the effects of psychological and cultural factors on the function of the bowel tract and the vast variety of ethnicities and diet among the Iranian people, the present study describes the occurrence of constipation and its associated factors in Kerman, the largest city in Southeast Iran. Materials and Methods: This was a cross-sectional study conducted in Kerman, Iran from 2011 to 2012 that included 2191 adults who were randomly selected and interviewed face to face using a validated questionnaire based on Rome III criteria. Demographics, cigarette smoking, opium dependence, amount of fiber consumption, physical activity and psychological factors were assessed. Inclusion criteria was ages 15 to 85 years old. Exclusion criteria was the presence of any metabolic and/or neuro-muscular disease that caused constipation. All data were analyzed with Stata11 software, with a confidence interval of 95%. A p-value of ≤0.05 was chosen for statistical significance. Results: Participants had a mean age of 44.9 ± 16.2 years. There were 57.42% female participants. The prevalance of chronic constipation was estimated at 9.4% (7.7%-10.6%). Constipation was more prevalent in females, older individuals, those with decreased physical activity, people who were anxious and depressed, and opium addicted individuals (p<0.05). There was no significant difference in terms of cigarette smoking and amount of dietary fiber between constipated and non-constipated individuals (p>0.2). Conclusion: Although the prevalance of constipation in Iran is estimated to be lower than Western countries, new changes in life style can cause an increase in the burden of constipation in the future. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B and C infections have remained major global health burdens during the most recent century. The viral agents responsible for these diseases share common modes of transmission with human immunodeficiency virus (HIV) such as needle-sharing in IV drug abusers. Coinfection of hepatitis B or C with HIV increases the rate of progression of chronic liver disease. Given the lack of data in Iran, in particular Khorasan Razavi Province, with regards to this coinfection, the present study evaluates the frequency distribution of hepatitis B and C coinfection with HIV infection and their modes of transmission. Materials and Methods: This was a retrospective study based on available data at the Gastrointestinal and Liver Diseases Center, Emam Reza Hospital, Mashhad, Iran. We used questionnaires to collect demographic data from 749 patients infected with hepatitis B or C who refered to this clinic between 2005 and 2008. The available sera of these patients were tested for the coexistence of HIV infection with hepatitis B or C infections. The results were analyzed with SPSS version 16 software. Results: From 749 patients infected with hepatitis B or C viruses, 650 were infected with hepatitis B (64.9% male and 35.1% female). There was no HIV antibody detected in any of the patients' sera who had hepatitis B infection. Among the 106 patients with hepatitis C infection (84% male and 16% female), only one (0.9%) who was an IV drug abuser tested positive for HIV infection. Hepatitis B/hepatitis C coinfection was found in 7 (0.9%) patients. With regards to the risk factors of viral transmission among those with hepatitis B infection, the most common was a positive family history of hepatitis B (37.2%). Other risk factors in order of decreasing frequency included a history of venesection and tattooing (13.8%), transfusions (7.1%), IV drug abuse (2.6%), needle stick accidents (2.3%), and high-risk sexual activity (0.6%). In those with hepatitis C infection, a history of IV drug abuse was the most common risk factor (40.6%), followed by a history of transfusions (28.3%), venesection or tattooing (16%), surgery (13.2%), needle stick accidents (4.7%), hepatitis C infection in a family member (2.8%), and unsafe sexual contact (0.9%). There was a significant difference in the transmission risk factor ratio between hepatitis B and C patients (p=0.001, χ²=261/590) Conclusion: The most common risk factor for transmission of hepatitis B and C infections in patients who presented to Emam Reza Hospital, a referral center in Mashhad, was a positive family history o f hepatitis B infection and IV drug abuse, respectively. The prevalence of HIV coinfection amongst patients with hepatitis B or C infections was low. However, further studies with larger populations are required. [ABSTRACT FROM AUTHOR]