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Background and Aim: Ulcerative colitis (UC) causes chronic inflammation in the digestive tract, leading to abdominal pain and diarrhea. Adalimumab, a monoclonal antibody, is used to treat moderate to severe cases. This review and meta‐analysis evaluated adalimumab's effectiveness for severe UC, considering patient age, disease duration, and gender. Methods: This study was designed as a systematic review and a meta‐analysis. Articles were searched in PubMed, Scopus, and Web of Science databases based on the keywords of adalimumab and UC. The titles, the abstracts, and, if necessary, the full texts of the articles were read. Then for further review, the full texts of the related articles were carefully examined, and the final articles were selected. Seventy‐eight articles were searched based on the keywords, and after reading the articles, 50 articles were related to the topic of the dissertation. The 50 articles were evaluated critically based on a checklist prepared by a statistical consultant and four articles with a score above 70% were selected. In the four articles, the main indicators of the effectiveness of adalimumab, including mucosal healing, clinical remission, and clinical response, were evaluated. Results: The effectiveness of adalimumab on the mucosal healing index was 75.40%, the clinical remission index was 70.79%, and the clinical response index was 83.02%, based on different doses and treatment durations in the study. In the four meta‐analysis studies on adalimumab's effectiveness, 1613 UC patients were treated with varying doses over 8 and 52 weeks. Based on a meta‐analysis over 8 and 52 weeks for treating moderate to severe UC, adalimumab's effectiveness was 70%−83%. The highest effectiveness, based on three main indices, was with a 40 mg dose over 52 weeks. Conclusion: According to the meta‐analysis, the effectiveness of adalimumab for treating moderate to severe UC over 8 and 52 weeks was 70%−83%. The highest effectiveness, based on three main indices, was with a 40 mg dose over 52 weeks. [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: 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]