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Background: Although bariatric surgery has been introduced as a therapeutic option for patients with obesity, there is still debate on the choice of procedure. Objectives: This study aimed to compare two types of bariatric surgeries in patients with obesity: Sleeve gastrectomy (SG) and single anastomosis sleeve ileal (SASI) bypass. Methods: This observational prospective study compares patients with obesity who received either of the two types of bariatric surgeries at Ghadir or Shahid Faghihi hospitals in Shiraz from October 2019 to November 2020. Metabolic profiles, shear wave liver elastography (fibroscan), and cardiac evaluations (echocardiography) were performed at baseline and then seven to eleven months after the surgery. Results: Forty-five patients with obesity who had undergone SG and SASI bypass entered this study. Fasting plasma glucose (FPG) and triglycerides (TG) decreased during the follow-up in both groups (P = 0.032, P < 0.001, respectively). The fibrosis score decreased significantly from 6.45 (4.55) before surgery to 5.40 (3.60) after surgery, and the cardiac ejection fraction increased significantly from 61.5% (12.5%) before surgery to 65.0% (8.5%) after surgery following the SASI bypass compared to the SG (P = 0.034, P = 0.008, respectively). Conclusions: Despite the lack of difference in weight reduction, SASI bypass, compared to sleeve gastrectomy, may result in a more rapid improvement in cardiac function and liver fibrosis. [ABSTRACT FROM AUTHOR]

Variations in Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) encoding genes have been associated with tumorigenesis through the disruption of immune and inflammatory responses. The aims of this study were to evaluate the two single nucleotide polymorphisms (SNPs) of the genes Arg753Gln TLR2 (rs5743708) and Asp299Gly TLR4 (rs4986790) in colorectal cancer patients in southern Iran. Colorectal cancer patients and healthy controls were included in this study (150 Persian subjects in each group). Blood samples were used for genotyping by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The association between these SNPs and colorectal cancer and clinicopathological factors, including age, gender, tumor stage and differentiation were also investigated. A significant association was found between Arg753Gln TLR2 SNP and colorectal cancer. This SNP was significantly more frequent in male patients. However, there was no association between Asp299Gly TLR4 and colorectal cancer. Therefore, Arg753Gln TLR2 SNP can be considered as a risk factor for colorectal cancer incidence in southern Iran, especially in men. Further investigations in other populations are recommended in order to assess the association of this SNP with colorectal cancer.

Aim: Clomipramine (tricyclic antidepressant), Risperidone (a non-typical antidepressant), and Escitalopram (selective serotonin reuptake inhibitor antidepressant) might be good candidates for investigating the anti-colitis activity. Background: The incidence of depression with ulcerative colitis in patients has led to the use of antidepressants in their treatment. In addition to the antidepressant effect of these drugs, anti-inflammatory effects have also been reported. Methods: In this study, 36 rats were used 2 ml of 3% acetic acid solution rectally to show the colitis. Then, Clomipramine (25 mg/kg), Escitalopram (10 mg/kg), Prednisolone (5 mg/kg), Risperidone (2 mg/kg), and normal saline as the control was administered orally for six days. The levels of Tumor Necrosis factor-alpha (TNF-α), Interleukin-6 (IL-6), and myeloperoxidase (MPO) were measured by Enzyme-linked immune sorbent assay (ELISA), and changes in the tissue pathology were investigated. Results: IL-6 level was significantly reduced after the administration of clomipramine and Prednisolone (p=0.025). Risperidone has significantly reduced MPO activity in colonic tissue (P=0.006). We did find no statistical decrease in MPO activity and TNF-α and IL-6 levels after consumption of Escitalopram (p>0.05). Conclusion: Clomipramine showed the best anti-inflammatory effect compared to Escitalopram and Risperidone. Therefore, clomipramine showed the best relieving effect on inflammation of ulcerative colitis in rats. [ABSTRACT FROM AUTHOR]

Objective: Human amniotic membrane (HAM) used as a wound coverage for more than a century. The aim of this study is to evaluate the efficacy of amniotic membrane on wound healing and reduce post-operative complication. Study design: Randomized clinical trial study. Place and duration of study: Surgery Department, Shahid Faghihi Hospital, Shiraz, in the period of between Sep. 2014 and Nov. 2015. Methodology: 73 patients with anal fistula were divided into two groups. The patients suffered from simple perianal fistula (low type) without any past medical history. Fistulotomy were performed for all of them and in interventional group HAM were applied as biologic dressing. Their wound healing improvement was evaluated post-operative in two groups. Results: From 73 patients participated in the study, 36 patients were in control group and 37 patients were in intervention group. According to the analysis of images taken from the wound, the rate of wound healing was 67.39% in intervention group and 54.51% in control group (p

Introduction: Obesity is a multifactorial disease defined by excessive adiposity, posing a health risk by increasing the risk of noncommunicable diseases. We aimed to investigate the relationship between personality traits and physical-social anxiety in overweight women seeking bariatric surgery. Methods: An applied and descriptive-correlational design was used in this cross-sectional study. The participants were overweight women who had applied for bariatric surgery and went to the hospital; a total of 110 people were selected through convenience sampling. The participants completed questionnaires on demographic characteristics, personality (neuroticism-extroversion-openness [NEO] personality inventory), and physical-social features. Data were analyzed using SPSS software via regression and correlation analysis at a significance level of P=0.01. Results: We found a positive relationship between neuroticism and physical-social anxiety (P=0.01). Conversely, extraversion, agreeableness, openness, and conscientiousness exhibited negative associations with physicalsocial anxiety (P=0.01). Conclusion: Our study indicates that neuroticism is a positive and significant predictor of physical-social anxiety, while extraversion, agreeableness, conscientiousness, and openness are negative predictors of physical stress. These findings highlight the importance of considering personality traits in understanding the physicalsocial anxiety of overweight women seeking bariatric surgery. [ABSTRACT FROM AUTHOR]

Introduction: It has been approved that selective serotonin reuptake inhibitors (SSRIs) may exhibit anti-proliferative or cytotoxic effects on several types of cancers. The aim of the present study was to evaluate the cytotoxic effects of a newly formulated niosome of Escitalopram oxalate on a colorectal cancer cell line. Methods: The niosomes were prepared using a thin layer hydration method, resulting in particles with a size range between 150 – 450 nm and spherical morphology. Moreover, its permeability release showed 25% in 4 hours. The cytotoxicity evaluation was performed using a quantitative colorimetric MTT assay. Results: The cell viability of colon cancer cells after treatment with niosomes and pure escitalopram reduced to 28.3 ± 0.83 % and 24.07 ± 0.56%, respectively. However, the cytotoxicity assay of escitalopram-loaded niosomes suggested that the anti-proliferative effect of the niosomal formulation of escitalopram was dose and incubation time-dependent. Conclusion: These results confirm the potential of the anti-proliferative activity of escitalopram-loaded niosomes. Further application to an in vivo model is needed to study various pharmacokinetic and pharmacodynamics parameters to establish its complete therapeutic potential. [ABSTRACT FROM AUTHOR]

Background: Bariatric surgery is the most effective treatment for morbid obesity, resulting in long-term weight loss and considerable improvements in coexisting conditions. We conducted a histopathologic evaluation of resected stomach specimens after laparoscopic sleeve gastrectomy. Methods: We evaluated the medical records of 827 patients who underwent laparoscopic sleeve gastrectomy between 2015 and 2018 at two major refer hospitals in Shiraz, Iran. In this retrospective cross-sectional study, the pathological findings of resected stomach specimens and other variables such as age, sex, preoperative body mass index (BMI), and comorbid illnesses were evaluated. Results: Six hundred and fifty-three cases (78.9%) had chronic gastritis in some form; lymphoid follicle formation (in 197 cases), acute on chronic gastritis (in 67 cases), complete intestinal metaplasia (in 5 cases), hyperplastic polyps (in 5 cases), and gastrointestinal stromal tumors (GISTs) (2 cases) were the next most common findings. Most lymphoid follicle formation was reported in the context of gastritis. Two patients with GIST and one with submucosal lymphoma received further treatment. Conclusion: Abnormal histopathologic findings were found in 88% of sleeve gastrectomy specimens. While almost no malignancies were found, less than 15% of samples were completely normal. Because of the high rate of abnormal pathologies in the resected gastric specimens and since gastric cancer is the most common gastrointestinal malignancy in Iran, we recommend that all patients in our region who are candidates for sleeve gastrectomy undergo an upper gastrointestinal endoscopy before surgery. [ABSTRACT FROM AUTHOR]

Background: Bariatric surgery is an appropriate treatment for obese patients with metabolic syndrome. Adipose tissue is an active endocrine tissue secreting leptin and adiponectin that affect body metabolism. Nowadays, a high incidence of metabolic syndrome with an increased risk of serious diseases has been detected in Shiraz. This study aimed to assess the levels of leptin and adiponectin as well as the adiponectin-to-leptin ratio in three different bariatric surgeries among obese patients in Shiraz. The results will play an important role in physicians' choice of surgery by distinguishing the effects of these three bariatric surgeries. Materials and Methods: The serum adiponectin and leptin levels were measured using enzyme-linked immunosorbent assay. Blood glucose, lipid profile, weight, and liver enzyme level were measured before and 7 months after surgery. Results: This clinical trial was conducted on 81 obese patients who underwent sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and single anastomosis sleeve ileal (SASI) bypass surgeries. The results revealed a decrease in fasting blood sugar and triglyceride (TG) levels 7 months after the surgeries. In addition, decrease of body mass index (BMI) was more significantly in the SASI group (12.8 ± 3 4.95) compared to the Roux-en-Y gastric group (8.56 ± 4.61) (P = 0.026). Besides, a more significant improvement in liver function was observed in SG (P < 0.05). Furthermore, the results revealed a significant difference among the three groups regarding the increase in the adiponectin level (P = 0.039). Decrease in the leptin level and increase in the adiponectin level were more significant after the RYGB surgery compared to the SG group (P < 0.05). Conclusion: The three bariatric surgeries were effective in increasing the adiponectin level and decreasing the leptin levels. The surgeries also changed the metabolic risk factors including TGs, high-density lipoprotein, fasting blood glucose, and BMI. [ABSTRACT FROM AUTHOR]

Background and purpose: Diabetic cardiomyopathy is a complication of diabetes defined as cardiac dysfunction without the involvement of pericardial vessels, hypertension, or cardiac valve disorders. Ranolazine, an antianginal drug, acts through blocking of cardiac late sodium channels and/or inhibiting beta-oxidation of fatty acids. With regard to its mechanism of action, the present work has been carried out to investigate the potential useful effects of ranolazine on the systolic and diastolic dysfunctions in an experimental rat model of diabetic cardiomyopathy. Lidocaine, as a sodium channel blocker, was used to have a clearer image of the involved mechanisms. Experimental approach: Diabetes was induced by streptozocin. After 8 weeks, the effects of cumulative concentrations of ranolazine and lidocaine were evaluated on diabetic and normal hearts by the Langendorff method. Finally, the hearts were isolated from the Langendorff system and adenosine three phosphates (ATP) and adenosine diphosphate (ADP) concentrations were measured to assay the metabolic effect of ranolazine. Findings/Results: Ranolazine significantly decreased the velocity of systolic contraction (+dP/dt) and the velocity of diastolic relaxation (-dP/dt) and developed pressure in normal and diabetic rat hearts. However, this negative effect was greater in normal hearts compared to diabetics. Ranolazine (100 μM) decreased the ATP level only in normal hearts and the ATP/ADP ratio decreased significantly (P < 0.05) in both groups. This reduction was more prominent in normal hearts. Conclusion and implications: It is concluded that in the isolated rat heart preparation, ranolazine has no benefit on diabetic cardiomyopathy and may even worsen it. It seems that these effects are related to the metabolic effects of ranolazine. [ABSTRACT FROM AUTHOR]