ghorbanali rahimian

Gallstone disease (GSD) and kidney stone disease (KSD) have increased due to lifestyle in recent decades. This systematic review and meta-analysis aimed to investigate the association between these two diseases.

A comprehensive electronic database search was conducted before August 25, 2024. This systematic review and meta-analysis included observational studies. The meta-analysis employed a random-effects model to compute the overall summary estimates of the association between GSD and KSD using risk ratios with 95% confidence intervals (CIs) as the primary measure of the effect size. Heterogeneity was evaluated using chi-square tests, the I² statistic, and forest plots. Publication bias was assessed through Begg’s and Egger’s tests. A P value of less than 0.05 was considered statistically significant, and all analyses were performed using Stata 17 software.

The meta-analysis included 9 studies encompassing 982847 participants. The pooled analysis revealed a statistically significant association between GSD and KSD, with a risk of 1.78 (95% CI: 1.572.03, P≤0.001). Begg’s and Egger’s tests demonstrated no significant bias (Begg’s test P=0.835, Egger’s test P=0.812). Variables such as study year, sample size, mean age of participants, mean follow-up, and study quality as determined by the Newcastle-Ottawa Scale (NOS) were examined, but none could significantly impact heterogeneity (P>0.10).

This systematic review and meta-analysis provide evidence of a significant association between GSD and KSD. Therefore, further investigation into the underlying mechanisms and potential risk factors is necessary.

 Ulcerative colitis (UC) is an inflammatory bowel disease, which is spreading continuously. This study aimed to determine the epidemiologic profile of the patients with UC in Chaharmahal and Bakhtiari province, Iran, as a database for other researches.

This descriptive cross-sectional study was performed on the profiles of the patients with a definitive diagnosis of UC during 2012-2016 in Chaharmahal and Bakhtiari in 2019. All the samples were selected through the census method. The data consisted of demographic characteristics, clinical features, as well as colonoscopy and histopathology results, and other symptoms which were collected based on the checklists. The data were analyzed in SPSS software (version 22); moreover, the qualitative and quantitative variables were reported using frequency and percentage as well as mean and standard deviation, respectively.

This study analyzed 177 UC patients with a mean age of 38.31±11.69 years. According to the findings, the 31-40-year-old group was the most vulnerable age group. Regarding gender, 59.3% of the patients were male. The mean duration between the onset of the symptoms and diagnosis was reported as 7±11.51 years. The most common symptoms were bleeding (72%) and abdominal pain (53%). Moreover, erythema (63.27%) and erosion (54.8%) were the most prevalent complications based on the pathologic findings. Extra-intestinal manifestations were reported among 18.36% of the cases. Considering the involved locations, pancolitis (36.72%) and the inflammation of rectosigmoid (35.6%) were the most common types.

The results of this study were similar to the findings of other investigations in terms of demographic characteristics. On the other hand, the clinical symptoms and complications of the disease were different from those in some previous studies.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) whichinvolves the rectum and colonic mucosa, and is often constantly expanding. Few data are available onrisk factors in Chaharmahal and Bakhtiari province. Therefore, the aim of this study was to investigatethe association between potential risk factors and UC in Shahrekord. A case-control study was conducted on patients diagnosed with UC. Overall, 27 new casesof UC and 54 healthy controls in the age range of 20–80 years were studied. Participants were recruitedfrom Pathologic Centers in Shahrekord in 2018. Chi-square test and t test and were used. Logisticregression model was employed to analyze the association between risk factors and UC disease. The mean age at diagnosis was 41.74 years (SD: 7.16 years) and 44.94 years (SD: 6.67years) for case and control subjects, respectively. Moreover, univariate and multiple odds ratio (OR)showed that there was no significant association between UC and any of the risk factors includinggender, marital status, education, diastolic blood pressure, history of diabetes, history of hypertension,permanent use of piped water, night shift work, history of thyroid diseases, depression, history of fattyliver disease, history of kidney stones, and sleep time and wake-up time in the morning. Generally, no significant association was observed between UC and the variables in thepresent study. Thus, further studies with larger sample size are necessary to better understand the otherrisk factors and environmental determinants of UC.

Diseases caused by Helicobacter pylori infection, including gastritis and gastric ulcer, can be harmful to epithelial cells in gastric mucosa. Furthermore, pro-inflammatory cytokines can affect the severity of some diseases caused by H. pylori infection. NLRP3 inflammasome detects H. pylori and activates caspase-1 that leads to the release of interleukin-1β (IL-1β) and interleukin-18 (IL-18) in the stomach. Since genetic variations such as polymorphisms may be involved in the expression of genes, this study was conducted to investigate the effect of NLRP3 rs10754558 polymorphism in pathogenesis of H. pylori infection. Four hundred and sixty-four Iranian patients (300 patients infected with H. pylori and 164 patients uninfected with H. pylori) were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Cytokine mRNA and protein expression were evaluated in patients infected with different genotypes of NLRP3 rs10754558 using real time-PCR and western blotting, respectively. The NLRP3 rs10754558 gene polymorphism was not associated with H. pylori infection or diseases caused by this bacterium. It was found out that the level of IL-1β in patients infected was higher than the uninfected individuals. Moreover, no relation was found between these single nucleotide polymorphisms and cytokine expression in H. pylori infected subjects. The findings of this study show that NLRP3 rs10754558 polymorphism may be related to the severity of acute inflammation in these patients. Our findings show that rs10754558 polymorphism might not participate in regulating inflammation and immune responses in patients with H. pylori by influencing the expression of components of the NLRP3 inflammasome.

Nowadays, non-alcoholic fatty liver disease (NAFLD) is considered as the hepatic manifestation of metabolic syndrome. Visceral adiposity index (VAI) and model of adipose distribution (MOAD) are novel indicators of abdominal fat dysfunction shown to have a strong correlation with cardiovascular diseases, even there is controversy for patients with NAFLD. This study aimed to compare VAI and MOAD in patients with NAFLD and healthy individuals.

In a case-control study, 44 patients with NAFLD aged 20-60 years and 44 healthy individuals of the same age and sex were enrolled. Liver enzymes and lipid profile were measured after fasting for 10-12 hours. Anthropometric data, blood pressure, MOAD and VAI were determined for each subject separately.

Although the mean of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), VAI, and MOAD indices were significantly different between case and control groups, all indices could only predict NAFLD in females except for BMI.

This study showed that BMI is not a predictor for the development of NAFLD in males and females. VAI, MOAD indices can be used to estimate the relationship for NAFLD regarding two indices of WC and WHtR as the most powerful indices for estimation of the proportion of the risk for developing NAFLD.

Helicobacter pylori (H. pylori) infection is associated with peptic ulcer and gastric cancer. Polymorphisms of the genes coding Toll-like receptors (TLRs) may influence the innate and adaptive immune responses and affect the susceptibility to H. pylori or the disease outcomes. But the details and association to different polymorphisms and different clinical expression in patients infected with H. pylori have remained unclear. The purpose of this study was to investigate the effect of TLR-4 Asp299Gly polymorphism on expression levels of IL-6 and IL-18 genes in patients infected with H . Pylori in comparison to uninfected patients.
In a case-control study¡ biopsies were collected from 58 H. pylori-infected and 44 uninfected subjects. Genotypes of TLR-4 Asp299Gly single-nuleotide polymorphism were assessed through polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The expression levels of mucosal IL-6 and IL-18 mRNA were measured by real time-PCR. Cytokine expression levels in the two groups were analysed using the t test.
The frequencies of D/D and D/G genotypes were respectively 55.2% and 44.8% in H. pyloriinfected and 77.2% and 22.8% in uninfected subjects. The expression level of IL-6 in H. pylori infected patients with TLR-4 gene polymorphism was significantly higher (P=0.001). However¡ no significant relationship between the expression level of IL-18 and TLR-4 gene polymorphism was reported in patients infected with H. pylori (P=0.419). In addition¡ no significant relationship between IL-6¡ IL-18 expression levels and TLR-4 gene polymorphism was reported in uninfected patients.
TLR-4 Asp299Gly Gene single-nuclotide polymorphism increases the expression levels of TL6 and has an important role in development of Hopylori-associated gastrititis.

Background and The expression of growth factors, proteolytic enzymes, fibrogenic factors, and cytokines are altered in Helicobacter pylori (H. pylori) infected gastric mucosa. Matrix metalloproteinases (MMP) are a family of zinc-dependent homologous enzymes digesting most of the components of the extracellular matrix and basement membrane and are involved in remodeling and functioning of the biological processes. The purpose of this study was to compare gene expression of matrix metalloproteinase-7 (MMP-7) in patients with H. pylori-infected and uninfected individuals with gastrointestinal diseases.
This study was conducted in 50 H. pylori-negative patients and 50 H. pylori-positive patients being admitted to Shahrekord Hajar Hospital due to gastrointestinal diseases in 2014. The participants’ demographic information was collected and sampling was done. First DNA was extracted, and then PCR was performed to check for the presence of 16sRNA and UreC. The RNA from each sample was also extracted and cDNA was prepared. Afterwards, the expression of MMP-7 was measured by real time-PCR using specific primers and probes.
MMP-7 mRNA expression was significantly higher in biopsies of H. pylori-infected patients compared to that in H. pylori-uninfected patients (P Increased expression of MMP-7 can be effective in inflammatory response and development of the disease. It could be used as a key marker for early diagnosis of gastrointestinal diseases and gastric cancer.

H. pylori infection is associated with gastritis and marked infiltration of the gastric mucosa by inflammatory cells secreting of several cytokines that contribute to maintain and expand the local inflammation. Different clinical expressions of the infection may reflect different patterns of cytokine expression. Interleukin (IL)-1β, tumor necrosis factor (TNF)-α, IL-17, IL-23, and IL-18 have been reported to be involved in H. pylori-induced gastric mucosal inflammation, but the details and relation to different patterns of inflammation remain unclear. Analysis of IL-18 RNA transcripts was performed by real-time PCR. Total RNA was extracted from gastric biopsies of 56 H. pylori-infected patients, 50 H. pylori-negative patients with gastritis, by biozol reagent according to the manufacturer's instructions. CDNA was synthesized from 1 mg of total RNA using First Strand cDNA Synthesis Kit (fermentas) and 3 μL cDNA was amplified by PCR using the 2x Rotor-Gene Probe PCR Master Mix (QIAGEN) and specific primers for each cytokine and β-actin. IL-18 mRNA expression was significantly increased in biopsies of H. pylori-infected patients compared to H. pylori-uninfected individuals. IL-18 may play an important role in the inflammatory response and promoting gastric Th1 responses to H. pylori colonization, and may ultimately influence the outcome of H. pylori-associated diseases that arise within the context of gastritis.

IL-17 and IL-23 play an important role in intestinal mucosal defense against certain infections IL-17 causes neutrophils absorption to the site of infection and it results in inflammation. In this study، IL-23 and IL-17 mRNA expression levels will be checked in gastritis patients with Helicobacter pylori infection and patients without infection by quantitative Real-Time PCR Method. In this a case – control study، 58 patients with gastritis with H. pylori infection and 50 patients who were free of infection، were biopsy through endoscopy. After extracting mRNA into cDNA، mRNA IL-17 and IL-23 expression levels in samples were measured by Real-Time PCR and cytokines expression were analyzed between infected and non infected groups using the Mann–Whitney test. In this study، no significant relation was observed between IL-17 mRNA expression in patients with H. pylori gastritis and gastritis patients without infection (P=0. 941). And also no significant correlation was observed between the expression levels of mRNA IL23 in patients with Helicobacter pylori gastritis and patients without infection (P=0. 76) The results showed that expression level in IL-17 mRNA and IL-23 in patients with Helicobacter pylori gastritis compare with the patients without infection is not higher، so there is not a significant relationship between the two groups. Therefore it’s requiring to seek the role of other involved cytokines in appearing gastritis for evaluation the treatment program.

This study assessed the effects of hypnotherapy in conjunction with pharmacotherapy versus pharmacotherapy on the quality of life in patients diagnosed with irritable bowel syndrome (IBS).This clinical trial used the convenience sampling method to enroll 34 IBS patients. Patients were selected according to Rome III criteria and divided into two groups: i) hypnotherapy plusstandard medical treatmentand ii) standard medical treatment. The QOL-IBS scale assessed patient quality of life at baseline, post-treatment and at the six month follow-up. Data were analyzed using analysis of covariance (ANCOVA).There were significant differences observed between both groups at the post-treatment and follow-up stages in terms of quality of life (p<0.05).Standard medical treatment in addition to hypnotherapy can be used to improve quality of life in IBS patients.

Helicobacter pylori infection is one of the most common human infections which have been associated with many upper gasterointestinal complications. Different treatment regimens for Helicobacter pylori eradication have been used. One of these regimes is the quadruple therapy regimen which metronidazole is one of the medications. In recent years several reports on H. pylori resistance to this antibiotic has been presented. This study was performed to compare the effects of garlic and peppermint extract combination with metronidazole in the treatment of Helicobacter pylori infection. In this randomized double blind clinical trial, 142 patients who were eligible for inclusion in study after completing the questionnaire and consent form were randomly divided into two groups, receiving garlic and peppermint extract or metronidazole. Moreover, for both groups the drugs; amoxicillin, omeprazole and bismuth were also administrated. Two weeks after drug administration completion, urease breath test (UBT) was performed and based on the obtained data, the recovery rate in the two groups were compare using SPSS 16 software T-test and Ki squire. The patients mean age was 43.89± 13.37 years. Evaluating the age and sex factors, we found no significant difference between two groups. Results suggest that although the combination of amoxicillin, omeprazole, bismuth plus garlic and peppermint was not successful in the eradication of Helicobacter pylori such as the quadruple therapy, but less than half of cases lead to eradication of Helicobacter pylori infection.

Irritable bowel syndrome is one of the most prevalent functional bowel disorders which is characterized by chronic abdominal pain and altered bowel habit in the absence of any observable causes (IBS). Hypnotherapy is suggested to be effective in decreasing symptoms in irritable bowel syndrome، but few studies have been done in this regard. The aim of this study was to investigate the effects of hypnotherapy with drug therapy on severity and frequency of symptoms of patient''s with irritable bowel syndrome. In this clinical trial study 34 IBS patients were divided into two groups of hypnotherapy plus drug therapy or drug therapy alone. Bowel symptoms severity and frequency Scale (BSS-FS) was used for evaluation of patient s’ symptoms in pre-test، post – test and 6 months after treatment (follow-up). Data were analyzed using Ancova test. There were significant differences in the severity and frequency of IBS symptoms between the two groups in post-test stage regarding BSS-FS (P<0. 05). However، no significant difference was abserved at follow up stage between the two groups (P>0. 05). Hypnotherapy in addition to drug therapy might be effective useful in decreasing the severity and frequency of symptoms of IBS-D patients. However، stopping this treatment may lead to recurrence of the symptoms.

Gastric cancer is one of the most important diseases and after lung cancer, is the second cause of cancer death worldwide. Genetic factors including oncogenes and tumor suppressor genes are always contributed in progression of this cancer. The P53 tumor suppressor gene has a broad role in genomic stability and DNA repair. The aim of this study was to determine the P53 gene mutations in gastric cancer specimens in Chaharmahal Va Bakhtiari Province.

In this descriptive-lab based study, we investigated the promoter, exons 2-4 and 9-11 of P53 gene mutations in 38 paraffin embedded gastric cancer specimens. DNA was extracted following the standard phenol chloroform protocol. The P53 gene mutations were determined using PCR-SSCP procedure.

Our study revealed no P53 gene mutation in promoter and exons 2-4 and 9-11 in the gastric cancer subjects studied.

While P53 gene mutations have been reported as the most frequent genetic alterations and are found in about 50% of the human malignancies, no mutation was detected in this study. The reason may be due to small sample size or mutations on other genes or epigenetic factors.

Helicobacter pylori is a common bacterial pathogens in human. The organism is associated with development of acute and chronic gastritis, peptic ulcer diseases, and gastric cancer. The prevalence of Helicobacter pylori in children ranges from 10% to more than 80%. High prevalence occurs in developing countries. This aimed to determine the frequency and risk factors of Helicobacter pylori in children of 6 years old from Shahrekord in 2006. In this descriptive and analytical study, a total of 215 stool samples from children selected none randomly at age of 6 years. Infection was determined based on antigen immunoassay in stool using the enzyme-linked immunosorbent assay method. (Diaper kit, Italy). Data were analyzed using X2 and Regression Logistic tests. According the results, 50 of 215 (23.3%) children, were positive for the H.pylori. There were no significant differences between the prevalence of H.pylori infection and sex, smoking of parent, abdominal pain growth of children, nausea, vomiting, loss of appetite, peptic ulcer in parents and history of breast milk (P>0.05). But there was a significant relationship between the prevalence of H.pylori infection and history of stomach cancer in their family and level of education in their parents (P<0.05). Less than a quarter of the children studied tested positive for H.pylori. Thus, the promosion of health services should be considered.

To perform screening for colonic cancer and to diagnose other colic diseases, colonoscopies are required. Comfort of patient during colonoscopy is very important. Currently, there are two types of sedation used during colonoscopy-the general anesthesia and sedoanalgesia. Sedo-analgesia is the most frequently used type of sedation employed during colonoscopy worldwide. In a double-blinded randomized clinical trial, 145 patients underwent colonoscopy were randomly assigned to four treatment arms. Group A patients received 50 mg hydroxyzine orally. Group B patients received 50 mg hydroxyzine orally and 25 mg pethidine intravenously. Group C patients were administered 25 mg pethidine intravenously and patients in group D were given 25 mg pethidine plus 2.5 mg midazolam intravenously. The patient satisfaction was then evaluated using a GHAA-9 questionnaire and measuring the pain by a visual analogue scale. There were differences among the three groups. Sedation with hydroxyzine alone or in combination with pethedine resulted in a significantly better satisfaction (p‹0.05). The excellent score for the patient satisfaction was 84.3% in hydroxyzine group, 64.9% in hydroxyzine+pethidine group, 5.7% in pethidine group and 5.7% in pethidine+midazolam group. Oral hydroxyzine is more effective than combinations of a narcotic and benzodiazepine in provision of pain relief and achievement of patient satisfaction in colonoscopy. Hydroxyzine is an excellent alternative to traditional intravenous drugs.

Allium Sativum (garlic) is used widely in the world, especially in Iran. This plant is used in cooking foods as an odorant. In Iran it is believed that it is useful for gastrointestinal disorders. So in this study the effect of Allium Sativum extract on acid and pepsin secretion in rat is investigated. This experimental study is performed on two groups of rats (12 in each group: control group and allium sativum group). After anesthesia with nesdonal (50 mg/kg, ip), rats had gone under surgical tracheotomy, laparatomy and gasterodeodenostomy. In garlic group Allium Sativum extract (100mg/kg) was introduced into the stomach by gasterodeodenostomy canula. In order to stimulation of acid and pepsin secretion, Pentagastrin was used (25mcg/kg, ip). Stomach secretion was washed out and acid was measured using titerimetery and pepsin using Anson method. Data was analyzed using t-test. Allium Sativum caused a meaningful increase in acid and pepsin secretion in garlic group comparing to control group (p<0.001). Pentagastrin also increased acid and pepsin secretion in control group (p<0.001). Using garlic in nutritional regimen causes an increase in acid and pepsin secretion in those using this plant.

Irritable bowel syndrome (IBS) is a common abnormality and is associated with symptoms like abdominal pain or defecation discomfort (i.e., constipation or diarrhea). Treatment of this abnormality requires a high cost. Psychiatric complications of this syndrome are numerous accordingly %20 to %60 of affected individuals suffers from them. Anxiety, depression and somatoform disorders are the most frequent complications. This cross sectional-descriptive study was performed during 6 months on 76 patients who suffered from different gut abnormalities. The research tools were a general health questionnaire (GHQ-28), Rome–II criteria for diagnosis of irritable gut, demographic characteristic check list and clinical interview. The prevalence of IBS was higher among females, married persons, younger people and city dwellers (p<0/05). The prevalence of the syndrome was not differed significantly among people with different levels of literacy. The incidence of depression, anxiety and somatic symptoms differed in control and IBS-affected groups, but there was not a significant difference between them in relation to social functionality (p<0/05). There is a strong relationship between psychological factors and IBS. Mental abnormalities such as depression, distress and somatic symptoms are prevalent among these individuals. So, paying attention to these mental disorders and use of non-medicinal treatment modalities along with medicinal treatments can lead to the reduction of treatment expense and better symptomatic therapy.