Iranian Journal of Colorectal Research
Volume:11 Issue: 4, Dec 2023

Although it is a condition of the elderly, diverticular disease (especially in the right colon) is seen in patients under the age of 50. In the past two decades, there have been an increasing number of reports on right-sided colon diverticulitis in the young population. Etiological and epidemiological studies give us partial answers on the occurrence of this condition. The sidedness and the fact that it occurs in younger populations makes this condition actual in terms of early and proper diagnosis thus avoiding unnecessary surgical explorative laparoscopies, laparotomies, appendectomies, etc. Most of the cases with acute right-sided colonic diverticulitis are mild, thus requiring a conservative treatment. However, complicated right-sided colonic diverticulitis is treated with some kind of intervention (percutaneous drainage or surgery). No treatment guidelines are present yet and the approach should be individualized and tailored according to the patient's condition and the severity of the diverticulitis. In case of a clinical deterioration, surgery should be considered regardless open or minimally invasive.

Allicin, a main component of garlic, possesses various beneficial pharmacological and therapeutic properties, including anticarcinogenic, bactericidal, and intestinal regulatory effects. Although it is known to regulate intestinal contraction and ion transport, its direct correlation remains unclear. In this study, we investigated the correlation between the allicin-induced activation of peristalsis and ion transport in the rat intestine.We used the ileal segment, which has more active spontaneous contractions than the colonic segment. To examine the role of allicin in regulating electrogenic ion transport in the rat ileum, we measured the transmural potential difference (ΔPD) with an Ussing chamber system. To study intestinal peristalsis, we performed an experiment to measure the velocity of the movement of an artificial pellet during intestinal peristalsis by recording videos with an overhead camera.A dose of 100 μM Allicin induced a significant positive ΔPD when administered to the serosal side of the ileum. The removal of chloride ions from the incubation solution did not significantly change the allicin-induced positive ΔPD. Removing bicarbonate ions from the incubating solution completely suppressed the allicin-induced increase in ΔPD. Allicin-induced pellet movement in the ileum significantly diminished when bicarbonate ions were removed from the incubation solution. Allicin-induced ileal spontaneous peristalsis was completely suppressed in the presence of an inhibitor of bicarbonate ion transporter, 30μM 5-Nitro-2-(3-phenylpropylamine) benzoic acid (NPPB).The present study on ion transport suggests that allicin mainly induces the electrogenic secretion of bicarbonate ions in rat ileum. In addition, a study of intestinal peristalsis suggested that allicin-induced ileal peristalsis depends on the extracellular bicarbonate ions electrogenically secreted in the ileum.

The benefits of laparoscopy versus open surgery for patients with rectal cancer have been well established. This study evaluates the role of re-laparoscopy in patients who develop complications following laparoscopic rectal cancer surgery.

This is a retrospective case series of 22 (5.9%) re-laparoscopy cases of the 373 rectal cancer patients with rectal cancer who underwent laparoscopic primary surgery at Omid, Ghaem, and Razavi hospitals in Mashhad, Iran, between July 2011 and December 2020.

Twenty-two (5.9%) eligible patients with a mean± SD age of 50.9±10.4 years were included in the study, of which 15(68.2%) were male and 7(31.6%) were female. After 22 laparoscopic primary surgery, anastomosis-fail/peritonitis was the most common complication requiring re-laparoscopy (n = 9, 40.9%). Other complications included obstruction (n = 8, 36.4%), bleeding (n =3, 13.6%), and intestinal injury (n = 2, 9.1%). The complications of all patients (n =22) who underwent re-laparoscopy were successfully managed by re-laparoscopy.

In the case of available facilities and the presence of an experienced surgeon in the medical center, re-laparoscopy for managing complications following laparoscopic rectal cancer surgery appears to be safe and effective in selected patients.

Colon cancer is one of the deadliest cancers in the world. Several factors are determined to be related to the survival rate of this cancer. Identifying factors associated with the survival of the disease is helpful in better management, efficient treatment, and increasing patient survival. Therefore, in this study, we investigated the relationship between 5-year mortality of colon cancer and demographic, clinical, and laboratory findings of colon cancer patients

A retrospective study was performed on 54 patients who were diagnosed with colon cancer. Demographic data, comorbidities, and clinical and laboratory data of colon cancer patients were collected. The relationship between these data and the 5-year mortality of colon cancer was measured. The Spearman non-parametric statistical correlation test was used to analyze the relationships. P-value<0.05 is considered meaningful in all analysis.

The mean age of the patients was 60 ± 12 years. A significant relationship was shown between CEA level, recent significant weight loss, and pathological stage with a 5-year mortality of colon cancer. The relationship between 5-year mortality of colon cancer and comorbidities, age, gender, anatomical location of cancer, the number of postoperative chemotherapy sessions, the type of surgery in patients, degree of tumor differentiation, the lymphocyte count, the serum albumin level, the hemoglobin level, and the need for emergency surgery was not statistically significant.

CEA level, significant weight loss, and pathological stage of tumors may affect the 5-year mortality of colon cancer.

I read with great interest the article in your journal entitled: Anti-proliferative and Apoptotic Potential of Ferula Asafoetida’s Essential Oil via Inhibiting NF-kB and TNF-alpha Receptors Pathway (1). In this study, the anti-proliferative and apoptotic effect of various doses of essential oil from Ferula asafoetida as an herbal medicine was investigated on colon cancer cell lines i.e. SW620 and CT26. The authors determined the percentage cytotoxicity and the levels of NF-kB, TNF-alpha, TGF-beta and Caspases.The study is very interesting and it investigated the role in gene regulation of herbal medicine and it is valuable for future studies. They concluded that this herbal medicine shows the role in gene regulation to attenuate the colon cancer. It could be used as a potent anti-cancer in the treatment of human colon cancer but after more in vivo and clinical studies. Although the authors discussed their findings comprehensively, I feel that there are some additional issues to be clarified. In this study, the essential oil is used and significant cytotoxic potential on both cell lines was seen. The IC50 value of the oil was 7.21±0.29 µg/ml for HepG2 and 8.0±0.36 g/ml for SK-Hep1, respectively, while the IC50 of crude extract against cancer cells doesn’t exceed 30 μg/ml (2). According to the IC50 value of the Ferula Asafoetida’s essential oil, is it possible to use it for cancer chemotherapy in animal models? I think the use of crude extract could be safer for animal or human studies. From this point of view, I think that it would be worthwhile if the authors considered this issue.

Rotavirus infection is a significant cause of childhood morbidity and mortality, resulting in severe diarrhea, dehydration, electrolyte imbalances, and metabolic acidosis in infants and young children (1). The destruction of enterocytes following rotavirus infection can lead to malabsorption, which is the inability to absorb nutrients from the intestines. Gastroenteritis may also be a risk factor for developing inflammatory bowel disease (IBD), and gastrointestinal infections can exacerbate colitis in patients with existing IBD (2). Rotavirus remains the leading cause of diarrheal deaths globally, accounting for nearly 19.11% of such deaths in 2019 (3). Global statistics reveal that 80% of rotavirus-related deaths occur in developing nations. Notably, India, Nigeria, Pakistan, and the Democratic Republic of Congo, continue to account for a substantial portion of rotavirus deaths (4). While the overall Age-Standardized Death Rate (ASDR) has declined, regional variations persist, with Africa, Oceania, and South Asia facing a considerable burden that requires a nuanced approach to public health strategies(3).