فهرست مطالب

Gastroenterology and Hepatology From Bed to Bench Journal
Volume:11 Issue: 2, Spring 2018

  • تاریخ انتشار: 1397/03/30
  • تعداد عناوین: 12
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  • Amir Almasi-Hashiani, Erfan Ayubi, Kamyar Mansori, Mostafa Salehi-Vaziri, Yousef Moradi, Behzad Gholamaliei, Salman Khazaei Page 1
    Aim: Present study aimed to systematically review and quantitatively synthesize published data about the prevalence of Hepatitis B Virus (HBV) infection among high risk groups in Iran.
    Background
    Determining true burden of Hepatitis B Virus (HBV) infection among high-risk groups relies on knowledge of occurrence measures such as prevalence rate. There is no conclusive and comprehensive data regarding to prevalence of HBV infection among high risk groups in Iran.
    Methods
    Relevant studies were searched in PubMed, Scopus, Web of Knowledge and local databases. In addition, reference lists of relevant studies were searched manually. Two independent authors reviewed the eligibility of retrieved studies and extracted the required data. Studies reporting HBV infection among high risk groups were included in the meta-analysis using random effects models. Meta regression and sub-group analysis were considered as additional analyses.
    Results
    The initial search yielded 566 citations. After the primary screen, 37 studies were selected for review. Meta-analysis results showed that pooled prevalence of HBV infection among high risk groups in Iran was 4.8% (95% confidence interval: 3.6%-6.1%), with the highest prevalence among in prisoners (5%; 3%-6%), and in central regions of Iran (7%; 4% 11%). Year of study may affect the observed heterogeneity in the estimated prevalence of HBV infection among injection drug users (IDUs) and prisoners.
    Conclusion
    Our results indicate that prevalence of HBV infection among high risk groups was seemingly high in Iran. Health policy decision makers should be aware of prevalence of HBV infection among different high risk groups and in different regions of Iran.
    Keywords: Hepatitis B, Prevalence, Drug users, Sex Workers, Prisoners, Meta-Analysis, Iran
  • Somayeh Jahani Sherafat, Masoad Alebouyeh, Sharareh Moghim, Hamed Ahmadi Amoli, Hajieh Ghasemian-Safaei Page 2
    Colorectal cancer (CRC) is one of the most frequently diagnosed cancers worldwide. Lifestyle is identified as one of the most important risk factors for CRC, especially in sporadic colorectal cancer. The natural composition of the gut microbiota changes rapidly during the first decade of life. Maintaining homeostasis in the gut is essential as structural and metabolic functions of the commensal microbiota inhibit gut colonization of pathogens. Dysbiosis, imbalance in function or structure of gut microbiota, has been associated with a variety of diseases, such as colorectal cancer. The aim of this review was to investigate the possible links between the dysbiosis in gut microbiota and colorectal cancer, and the potential role of anaerobic gut microbiota in the pathogenesis of colorectal cancer. Based on this review, various studies have shown that some of the gut microbiota such as anaerobic bacteria significantly increased in CRC patients, but we suggest more investigations are required to assess the importance of these bacteria and their metabolites in the pathogenesis of CRC are required.
    Keywords: Gut microbiota, Pathogenesis, Colorectal cancer
  • Jamshid Yazdani Charati, Ghasem Janbabaei, Nadia Alipour, Soraya Mohammadi, Somayeh Ghorbani Gholiabad, Afsaneh Fendereski Page 3
    Aim: This study aims to predict survival rate of gastric cancer patients and identify the effective factors related to it, using artificial neural network model.
    Background
    Gastric cancer is the most deadly disease in north and northeast provinces of Iran. A total of 430 patients with gastric cancer who referred to Baghban clinic in Sari, from early November 2006 to late October 2013 were followed.
    Methods
    A historical cohort of patients who referred to Baghban Clinic, the cancer research center of Mazandaran University of Medical Sciences in Sari, from early November 2006 to late October 2013 was studied. Three groups of variables (demographic, biological and socio-economic) were studied. Survival rate and effective factors on survival time were calculated using Kaplan-Meier methods and artificial neural networks and the best network structure were chosen using the mean square error and ROC curve. All analyses were performed using SPSS v.18.0 and the level of significance was selected ? 0.05.
    Results
    In this research, the median survival time was 19±2.04 months. The 1 to 5-year survival rates for patients were 0.64, 0.44, 0.34, 0.24 and 0.19, respectively. The percentage of right predictions of the selected network and the area under the ROC curve were 92% and 94%, respectively. According to the results, the type of treatment, metastasis, stage of disease, histology grade, histology type and the age of diagnosis were effective factors on survival period.
    Conclusion
    the 5 years survival rate of gastric cancer patients in Mazandaran is lower than other provinces which could be due to the delay in diagnosis or patient’s referral. Therefore, the use of screening methods and early diagnosis could be influential for improving survival rate of these patients.
    Keywords: Gastric cancer, Survival analysis, Artificial neural network
  • Mostafa Rezaei, Tavirani, Sina Rezaei Tavirani, Fatemeh Tajik Rostami Page 4
    Aim: Pathway analysis of gastric atrophy to find new molecular prospective of disease.
    Background
    Gastric atrophy as a process which is accompanied with “loss of glans” in stomach can be considered as a risk factor of gastric cancer. Here, the correlated biochemical pathways to the disorder have been analyzed via protein-protein interaction (PPI) network analysis.
    Methods
    The genes related to gastric atrophy were retrieved by STRING database and organized in a network by Cytoscape. Three significant clusters were determined by ClusterONE plug-in of Cytoscape. The elements of cluster-2 which contained all central nodes of the network were enriched by ClueGO and the biochemical pathways discussed in details.
    Results
    The number of seven central nodes (which are included in cluster-2); INS, TP53, IL6, TNF, SRC, MYC, and IL8 were identified. The biochemical pathways related to the elements of cluster-2 were determined and clustered in nine groups. The pathways were discussed in details.
    Conclusion
    Pathway analysis indicates that the introduced central genes of the network can be considered as biomarkers of gastric atrophy.
    Keywords: Gastric atrophy, Network analysis, Gene, Biochemical pathway, Central node
  • Adnan Qureshi, Saira Bibi, Ravi Madhotra Page 5
    Aim: The aim of this study was to determine common factors leading to incomplete colonoscopy with a special interest in patient body mass index (BMI), and also to determine most common second line investigation, its pick up rates for cancer and the success rate of re-scoping.
    Background
    Wide availability of scope guide in all procedures may decrease failure rate.
    Methods
    We retrospectively reviewed 2891 colonoscopies performed at our institution from August 2015 to July 2016. The cohort was composed of all incomplete procedures (148) during this time period and a second cohort (148) of complete examinations which were randomly selected for relation of BMI only. The data in incomplete colonoscopy group included age, gender, BMI, causes of failure, mode of referral, second line investigation. The success of re-scope to pick up a cancer was compared to other modalities i.e. CT Colonography etc.
    Results
    Male to female ratio was 1:4.8. High incomplete colonoscopy rate was noted in females (81%). Mean age in failure group was 64 ±15. Average BMI was 28± 15.Most common mode of referral was urgent or suspected cancer (74%). Common cause of failure was patient intolerance (30%). Most common anatomical site of failure was sigmoid colon 35%). Completion rate of re-scoping in experienced hands was 95%. A lower BMI is related with higher chances of failure or vice versa.
    Conclusion
    Lower BMI has higher chance of failure, possibly due to less extra colonic fat leading to tortuous colon. Female sex is second most common cause of failure due to low intolerance to pain. Using stronger pain relief and equal distribution of these characteristics on different list will have least implications in busy cancer screening unit.
    Keywords: BMI, Colonoscopy, Cancer
  • Sara Romani, Seyed Masoud Hosseini, Seyed Reza Mohebbi, Andre Boonstra, Armin Hosseini Razavi, Afsaneh Sharifian Page 6
    Aim: To determine the distribution of important mutations of the “a” determinant region in the HBV genome among patients in different clinical phases of HBV infection.
    Background
    Variations in Hepatitis B infection not only change the outcome of the disease but also the symptoms from which the chronic HBV patients are suffering.
    Methods
    We have meticulously selected a total of 40 chronic HBV patients from four different subclasses of chronic HBV clinical phases including immune tolerant (IT), immune active (IA), inactive carrier (IC) and hepatitis B e antigen (HBeAg)-negative (ENEG); 10 samples per each phase. Mutations of the “a” determinant region were identified using PCR-Direct sequencing method.
    Results
    17 amino-acid substitutions at 12 positions inside the “a” determinant were identified in all forty samples; 3 mutations in the IT group, 6 mutations in the IA phase, 3 mutations in the IC patients and 5 mutations in the ENEG phase. Different substitutions were observed in all four clinical phases. The IA phase was the most variant group with the highest number of amino-acid substitutions.
    Conclusion
    These results did not reveal a strong pattern to distinguish different clinical phases of Chronic HBV infection, but there are some obvious differences regarding the number and position of mutations between these four clinical phases.
    Keywords: a determinant region_Chronic hepatitis B infection_Clinical phases_Amino-acid substitution
  • Hosna Rastegarpouyani, Seyed Reza Mohebbi, Seyed Masoud Hosseini, Pedram Azimzadeh, Sedigheh Beyraghie, Afsaneh Sharifian, Hamid Asadzadeh-Aghdaei, Shahnam Arshi, Mohammad Reza Zali Page 7
    Aim: In this study, we investigated the prevalence of PARV4 virus among the healthy population and four other groups of HBV infected, HCV infected, HIV infected and HIV/HCV co-infected individuals in Iran.
    Background
    Parvovirus 4 (PARV4) was first discovered in 2005, in a hepatitis B virus infected injecting drug user (IDU). To date, the best evidence about PARV4 transmission is parenteral roots which comes from IDU individuals. It seems that the prevalence of the virus in the normal population is very low.
    Methods
    A total of 613 patients, including chronic HCV (n=103), HBV (n=193), HIV (n 180) infected individuals, HIV/HCV (n=34) co-infected patients and 103 healthy controls, were studied by using nested-PCR and also real-time PCR techniques.
    Results
    Of those 180 samples were positive for HIV RNA, co-infection of PARV4 was detected in 3 cases (1.66%). All these three patients were male with the age of 28, 32 and 36 years (mean: 32). No statistical differences were found between HIV positive group and the healthy individuals. (P>0.05) The result of PARV4 PCR was negative in all other samples and healthy controls as well.
    Conclusion
    This study is the first to investigate the occurrence of PARV4 among these groups in Iran. The results show that the virus is not significant in Iranian population, even in patients with blood born infections such as HCV, HBV or even HIV patients. Further studies in other areas and various groups are required.
    Keywords: Chronic infection_Hepatitis C virus_HBV_Parvoviridae_Parvovirus 4
  • Babak Sayad, Yosra Naderi, Seyed Moayed Alavian, Farid Najafi, Alireza Janbakhsh, Feyzollah Mansouri, Siavash Vaziri, Mandana Afsharian, Fatemeh Norooznezhad Page 8
    Aim: This study aimed to determine the seroprevalence and viremic infection of hepatitis delta virus (HDV) in Kermanshah.
    Background
    Hepatitis delta is one of the most complex viral infections of liver that along with hepatitis B virus could lead to fulminant hepatitis, progressive chronic hepatitis, cirrhosis, and hepatocellular carcinoma.
    Methods
    Referrals with positive HBs Ag were included and tested for HDV Ab using ELISA. Seropositives were subsequently evaluated for viremia by assaying HDV RNA and HBV DNA using real-time PCR. Viremia related variables were also assessed.
    Results
    From 1749 patients included, 30 had positive HDV Ab, which makes HDV seroprevalence 1.7%. Twenty-nine out of 30 seropositives were assayed for viremia. Fourteen cases (48.3%) had positive HDV PCR, 1 (62.1%) had positive HBV DNA. Eight patients (27.6%) had simultaneous replication of HBV and HDV, six (20.7%) only had HDV replication, ten (34.5%) only had HBV replication and five (17.2%) had no replication of either viruses.
    Conclusion
    Kermanshah seems to be a low prevalent area in Middle East. Viremic HDV infection was lower compared to Europe and Africa, probably due to genetic variations of the hosts or the differences in genotypes or sub-types of hepatitis B and D viruses.
    Keywords: Hepatitis D, Prevalence, Viremia, Iran
  • Alan Zakko, Paul Thomas Kroner, Rooma Nankani, Raffi Karagozian Page 9
    Aim: To determine the impact of obesity on development of portal vein thrombosis in cirrhotic patients.
    Background
    Cirrhosis is a known risk factor for portal vein thrombosis (PVT). Evidence also points to obesity as being a risk factor for venous thromboembolism. Limited information is available on how obesity impacts the development of PVT in cirrhotic patients.
    Methods
    This was a retrospective cohort study using the 2013 National Inpatient Sample. Patients older than 18 years with an ICD-9 CM code for any diagnosis of liver cirrhosis were included. There was no exclusion criteria. The primary outcome was the impact of obesity on development of PVT. Obesity was also sub-classified according to body-mass index (BMI). Secondary outcomes were inhospital mortality, ICU admission, shock, TPN use, and resource utilization. Odds ratios (OR) and means were adjusted for age, gender, and ethnicity.
    Results
    We included 69,934 obese cirrhotics of which, 1,125 developed PVT (mean age 59 years, 35% female). Overall in-hospital mortality rates were 9% (11% with PVT vs 5% without PVT). On multivariate analysis, obesity was not associated with a significantly different adjusted OR for development of PVT compared to non-obese. When stratifying by obesity subtype, class 1 obesity was associated with increased odds of PVT (OR: 1.45, 95%CI: 1.06-1.96, p=0.02), while class 3 obesity was associated with a decreased odds of PVT (OR: 0.72, 95%CI: 0.58-0.88, p
    Conclusion
    Obesity is not associated with increased odds of PVT.
    Keywords: Obesity, Portal vein thrombosis, Cirrhosis, ICD-9
  • Dhamia K. Suker, Fatimah Abbood Jasim Page 10
    Aim: The present study designed to evaluate the toxic effect of anatase TiO2 NPs on BALF biochemical changes and liver alteration in rats.
    Background
    Titanium dioxide (TiO2) nanoparticles (NPs) are utilized in food color additives and cosmetics worldwide. Humans uptake these nanoparticulate by different routes and may exhibit potential side effects, lags behind the rapid development of nanotechnology.
    Methods
    Sixty-three mats rats were used. Included by the control group and the experimental groups treated twice a week with 0.5, 5, 50, 1.5, 15, 150 mg/kg of nano-TiO2 (size 21 nm), for four consecutive weeks. Animals were sacrificed at 4 days, a month and three months post-instillation. The levels of tumor necrosis factor - ? (TNF-?) and macrophage inflammatory protein- 2 (MIP-2) were measured in the lung homogenate and in the bronchoalveolar lavage fluid (BALF) supernatants by enzyme-linked immunosorbent assay (ELISA) and histopathological examination of liver tissue was performed.
    Results
    The results showed that TiO2 NP induces many alterations in the liver structure after 4 days, a month and reduced after 3 months from intratracheal instillation. This included liver heavy infiltration of inflammatory cells, an increase of collagen density in portal triads, beginning of fibrosis formation and Glisson capsule thickness increase and Ti 2 NPs reached the liver tissue after a month from exposure at all doses especially low doses (0.5, 1.5, 5) mg/kg of TiO2 NPs.
    Conclusion
    The immune system was strongly responded in the groups treated with high doses (15, 50, 150) mg/kg of TiO2 NP leading to raising the concentration of ?-TNF, and MIP-2 in BALF while they decrease in tissue homogenate.
    Keywords: Titanium dioxide effects, Liver histopathological alteration, MIP-2 changes, TiO2 effects on TNF-?
  • Pantea Tajik, Amir Hossein Goudarzian Page 11
    A 28-month-old boy with hematochezia for 10 hours was admitted into our hospital. Colonoscopy was performed for the patient in which a mass-like lesion was seen with marron color. The mass suspected intussusception; thus, colonoscopy was interrupted and patient was sent to operation room. After 1 month the patient was good with no abdominal pain or defecation difficulty.
    Keywords: Children, Rectum, Intussusception, Case report
  • Adnan Qureshi, Joanne Cunningham, Ravi Madhotra, Jafer Ali, Kamran Rostami Page 12