فهرست مطالب hamid mohaghegh shalmani

Colon cancer ranks third among the most common cancers. In Iran, this disease ranks fourth in men and second in women. The incidence and mortality caused by this cancer are different in different geographical areas. It is known to reduce the incidence of colon cancer by performing screening methods because most cases originate from polyps that can be seen and removed in colonoscopy before they become malignant. Also, screening methods are able to detect cancer in its early stages and reduce the death rate caused by this disease. However, the implementation of screening programs worldwide, including in Iran, has always faced problems such as the cost of diagnostic equipment, insurance coverage, health infrastructure, human resources, and, most importantly, acceptance by the people. Today, different methods are used for colon cancer screening in different countries, and the choice of these methods depends on several factors, including the prevalence and incidence of this disease, economic resources, and health infrastructure in each region. The purpose of this study was to investigate the common methods for colon cancer screening so that, according to the current situation and considering the screening facilities available in Iran, the best method can be suggested to cover more and more people who need screening.

With the growing interest in plant-derived chemotherapeutic agents, there has been a significant rise in research exploring a broad range of plants in recent years. Scrophularia striata has gained attention due to its extensive medical applications. This study aimed to investigate the effect of S. striata extract on HeLa cervical cancer cells, specifically their migration, apoptosis, and necrosis.

We first cultured HeLa cells in Dulbecco’s Modified Eagle’s Medium (DMEM) supplemented with 10% FBS and 1% penicillin/streptomycin. We then examined the cytotoxicity of S. striata extract at varying concentrations (0, 1, 10, 100, 500, and 1000 μg/mL) using the MTT assay after 24 hours. We evaluated the extent of wound healing using a scratch assay and analyzed the apoptosis activity of the extract using flow cytometry.

Our results showed that S. striata extract (IC50: 433.8 μg/mL) significantly enhances wound healing (P≤0.01) in cervical cancer and promotes apoptosis and necrosis of HeLa cells.

Our findings suggest that S. striata may serve as an effective treatment for cervical cancer by inducing cell death and reducing migration.

This meta-analysis was designed to reassess the prognostic and clinicopathologic values of the microRNA-125 family in GC patients.

The miR-125 family (including miR-125a, miR-125b) has been reported as being pivotal prognostic biomarkers of gastric cancer (GC). However, there is controversy about the role of the miR-125 family in predicting the progression of GC.

The miR-125 family (including miR-125a, miR-125b) has been reported as being pivotal prognostic biomarkers of gastric cancer (GC). However, there is controversy about the role of the miR-125 family in predicting the progression of GC.

The electronic databases of PubMed, ISI Web of Science, Scopus, and Cochrane Library were systematically searched for relevant studies. Overall survival (OS) rate as the primary outcome from each study was extracted. The overall hazard ratio (HR or survival rate in patients with GC) and odds ratio (OR) with 95% confidence interval (CI) was calculated to evaluate the association between miR-125 family expression and prognosis and susceptibility to gastric cancer. The quality of evidence was evaluated using the Newcastle-Ottava Scale (NOS). The extracted data was combined based on the random-effects model.

The low expression of miR-125 family predicts poor OS in GC patients. Thus, the miR-125 family may be helpful as a potential biomarker for the prognosis of gastric cancer.

Gastrointestinal bleeding is an overwhelming complication of patients taking antithrombotic agents. These drugs pose a challenge to physicians in the management of bleeding to establish hemostasis without putting these patients at a higher risk for thromboembolism. This study aims to propose an algorithmic approach to four major groups of patients receiving antithrombotic agents (single antiplatelet agents, dual antiplatelet agents, anticoagulants and direct oral anticoagulants) to decide when and how these drugs should be held or restarted to offset between the risk of re-bleeding and thromboembolism. Four case-based algorithms are proposed in this article based on some relevant articles. Having designed four case-based algorithms, we are hoping to guide physicians who face a dilemma on the management of patients receiving antithrombotics when gastrointestinal bleeding occurs. Patients using antithrombotics referred for gastrointestinal bleeding were stratified into four groups based on the medication which is used as an antithrombotic agent and four algorithms were designed which are presented here. We have made an attempt to have a stepwise approach to four cases relevant to the study and have an evaluation on the management of their antithrombotic agents during an episode of gastrointestinal bleeding. It is widely accepted that antithrombotic agents should be restarted as soon as possible after the establishment of hemostasis in a patient taking antithrombotics referring for gastrointestinal bleeding. The time for resuming these drugs is different based on the severity of bleeding, the probability of thromboembolic events, and the nature of the antithrombotic medication which is used by the patient.

The aim of present study is to evaluate the factor associated with functional constipation (FC) and determine a normal range of bowel movement (BM) in an Iranian Auto factory’s worker.  

The digestive system may be affected by workplace condition.  Some occupational conditions can effect on bowel habit and FC.

In this cross -sectional study, 3590 workers who worked in Tehran suburb in 2017 were evaluated. The workers were working at morning or rotatory shifts and in the official and non- official sections. In addition to demographic and stool frequency questions, workers were asked to complete the Rome IV Questionnaire.

The normal range of BM frequency was determined between one and three per day. The BM frequency had a significant association with age (P=0.002), marital status (P=0.024), education (P=0.011), expose to chemical materials (P<0.001) and work section (P<0.001). The total prevalence of FC was 9.7% and among rotatory shift working, was more than the only morning shift working, (10% vs 6%; P=0.02). Independent factors associated with FC were found as age (for 30- 40 years old: OR=1.88; 95% CI (1.20, 3.03) and for ?41 years old: OR=1.91; 95% CI (1.12,3.17)), smoking (OR=1.52; 95% CI (1.20,1.93)) and work section (for Paint section: OR=0.33; 95% CI (0.12,0.87), for Montage section: OR=0.44; 95% CI (0.18,1.10), for Press & Platform section: OR=0.12; 95% CI (0.05,0.37)).

Occupational condition probably makes difference in bowel habit. Rotatory shift, official working and smoking may increase the risk of constipation.

We assessed the knowledge of physicians regarding diagnosis and treatment of celiac disease (CD). Specialists as the main therapist group of CD patients may play crucial role in the diagnosis and treatment of CD. Therefore, training and ensuring their capabilities is important. The population was specialists including Gastroenterologist, GI fellow, consultants, residents and general practitioners graduated in Medical Sciences Universities in Iran. The examination was the experts made and aimed to assess the educational needs of physicians and explore their failures in the diagnosis and treatment of CD with the key feature approach. Data was collected using a questionnaire that its validity and reliability was confirmed by experts (r = 91.6%). The total score was 150 with the classification of participants to the following categories: good (112- 150), intermediate (39-112) and weak ( ?38). Out of 300 participants, 197 questionnaires were returned (Response rate = 66%). The mean age of the participants was 42.67 years (SD = 7.9 years) with majority were male (63.6%). Average score of participates who had less than three year’s experience was significantly higher than others (P?0.05). Only 12.1% and 9.8% of specialists have got the excellent score for diagnosis and treatment, respectively. It may conclude that specialists have had performance gap and around 90% needed training based on the principles of instructional design in order to improve their knowledge and skills to do and practice their assigned tasks. Therefore, development of training packages according to the principles of instructional design is suggested.Keywords: Instructional design, Celiac Disease, specialists, need assessment.(Please cite as: Barzegar F, Rostami-Nejad M, Rostami K, Ahmadi S, Mohaghegh-Shalmani H, Sadeghi A, et al. Lack of health care professional’s awareness for management of celiac disease may contribute to the under diagnosis of celiac disease Gastroenterol Hepatol Bed Bench 2019;12(3):203-208).

Present study aimed to evaluate association between job -related factors and gastroesophageal reflux disease (GERD) among Iranian auto factory’s workers. Many of the gastrointestinal disorders may be caused as the result of stress-related occupations and biorhythm disruption. We performed a cross-sectional study on 3590 Iranian Auto factory employees. GERD symptoms, demographic information, work shift, work section and history of some gastrointestinal disease were asked from all employees by physician. Logistic regression was used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for GERD symptoms according to the potential risk factors. The prevalence of GERD was 25.57%, which was higher in rotatory shift (91.6%) than the fixed shift (8.4%) (P-value = 0.009). Smoking (OR: 1.31; 95% CI: (1.09, 1.57)), working in official section (P-value < 0.001), history of GERD (OR: 8.63; 95 % CI (6.53, 11.40)), history of peptic ulcer (OR: 2.96; 95 % CI (2.08, 4.20)), family history of gastrointestinal cancers (OR: 1.47; 95 % CI (1.19, 1.81)) were the factors associated with GERD symptoms. The prevalence of GERD in the rotatory shift was more than the fixed shift. Smoking, family history of gastrointestinal cancers and peptic ulcer could be associated with GERD symptoms. Working in the special job with high activity, may probably lead to decrease in the risk of reflux.

Finding important differential genes between grade II and grade III of rectum cancer was the aim of this study. Colorectal (CRC) cancers (CRC) are known as the third diagnosed cancer and the second leading to death cancers. Life style is an important risk factor of CRCs. Diagnosis of rectum cancer estimated as 44% of colon cancer. Differentially expressed genes (DEGS) related to grade II into grade II in 6 patients are retrieved from gene expression omnibus (GEO) and investigated by protein-protein interaction (PPI) network analysis. Central nodes of the network are identified and enriched to determine biochemical pathways. Action map is illustrated for the central genes. Among 15 central genes including AKT1, PRDM10, GAPDH, TP53, SRC, EGFR, ALB, INS, CTNNB1, EGF, IL6, RHOA, DECR1, ACACA, GMPS role of AKT1 is highlighted due to prominent role in the integrity of the network and participation in the most determined pathways. However, significant regulatory effect of INS, AKT1, EGF, EGFR, and CTNNB1 is tinted in action map. It seems that AKT1, EGFR, and TP3 are suitable drug targets to prevent rectum cancer progression.

Aim: To perform a simple, rapid and sensitive Real-time PCR based SYBR Green method to determine the human leukocyte antigen (HLA)-DQ 2/8 alleles in celiac disease (CD) patients.
Many molecular techniques are available to determine the HLA-DQ2 and DQ8 alleles, but they are too expensive and have many steps that make them difficult to use.
To determine the HLA-DQ 2/8 alleles we have developed a new real-time PCR assay, using SYBR Green technique with melting curve analysis on genomic DNA isolated from 75 CD patients and 94 healthy controls. The specific primers to examine HLA-DQA1*05, HLA-DQB1*02 and HLA-DQB1*0302 alleles were used and results were compared with commercially available kits.
Using this method, the presence of HLA-DQ2 and HLA-DQ8 alleles were determined with sensitivity and specificity 80% and 100% respectively and compared to low resolution commercially available kits, the results of this method were more efficient. The frequency of DQ2 and DQ8 in patients was 76% and 29%, respectively and overall 96% of patients were carries DQ2 and/or DQ8 alleles.
The result of this study showed that Real-time PCR using SYBR Green method with melting curve analysis has good efficiency to identify the HLA-DQ2/8 risk alleles.

Aim: The aim of this study was to investigate the effects of education on patients’ knowledge of celiac disease, in an Iranian population.
Education can increase patients’ knowledge regarding their disease, leading to improvements in their health.
This cross-sectional study was conducted on patients who had been diagnosed with celiac disease. The patients attended an educational meeting in September, 2016. During the educational meeting information regarding the epidemiology, diagnosis and treatment of celiac disease was provided to the study subjects. Each patient completed a questionnaire regarding celiac disease before and after the educational meeting. The questionnaires were scored. Study data was analyzed using SPSS version 20.
90 patients were recruited (69 [77%] were women). Analysis of questionnaire responses showed that except for awareness of cross contamination with gluten, the education meeting significantly increased the knowledge of patients with celiac disease regarding epidemiology, diagnosis and treatment (p=0.001).
The result of this study shows that an educational meeting can increase the knowledge of CD patients in treatment. Increasing patients’ knowledge may lead to improvements in patients’ health.

Liver cancer is a highly lethal cancer with 5 year survival rate of about 18%. This cancer is a leading cause of death in many countries. As there is not a comprehensive population base study on liver cancer mortality rates by cause in national and provincial level in Iran. We aimed to estimate the liver cancer mortality rate, its patterns, and temporal trends during 26 years by sex, age, geographical distribution, and cause.
We used the Iranian death registration system (DRS), in addition to demographic and statistical methods, to address the incompleteness and misclassification and uncertainty of death registration system to estimate annual liver cancer mortality rate. Direct age standardized approach was applied using Iran national population 2015 as a standard population to facilitate the comparison between the provinces.
Liver cancer age standardized mortality rate in Iran increased by more than four times from 1.18 (95% uncertainty interval; 0.86 to 1.61) deaths per 100,000 person in 1990 to 5.66 (95% uncertainty interval; 4.20 to 7.63) deaths per 100,000 person in 2015. Male to female age adjusted mortality ratio changed from 0.87 to 1.82 during the 26 years of the study. With increasing age, liver cancer mortality rate increased in both sex and all provinces. At provincial level, the province with highest mortality rate have 2.96 times greater rate compare to the lowest. Generally, about 71% of mortality at national level is due to hepatitis B and C infection.
In order to reduce liver cancer mortality rate, it is recommended to control main risk factors including chronic hepatitis infections. Because of the growing rate of mortality from liver cancer, augmenting life expectancy, and increasing number of the elderly in Iran, policy makers are more expected to adopt measures including hepatitis B vaccination or hepatitis C treatment.

IgG4-associated cholangitis (IAC) is a subgroup of IgG4-related disease, which is more common in elderly men.IAC is frequently coincident with autoimmune pancreatitis (AIP).However, some IAC cases do not have other organsinvolvement. The diagnosis of IAC is based on biochemical, radiological, and histological features.Among these, elevated serum levels of IgG4, extra- and intrahepatic biliary strictures (as visualized by cholangiography), lymphoplasmacytic infiltrations in the liver and bile duct tissue, and association with AIP are of key importance. IAC may mimicprimary sclerosing cholangitis or cholangiocarcinoma(CC). It is classically a corticosteroid-responsive condition and corticosteroid is regarded as the initial treatment of choice in this disease.However, relapse following corticosteroid withdrawal is a frequent event.

Aim: In the current study, we analysised only the articles that investigate serum proteome profile of cirrhosis patients or HCC patients versus healthy controls.
Increased understanding of cancer biology has enabled identification of molecular events that lead to the discovery of numerous potential biomarkers in diseases. Protein-protein interaction networks is one of aspect that could elevate the understanding level of molecular events and protein connections that lead to the identification of genes and proteins associated with diseases.
Gene expression data, including 63 gene or protein names for hepatocellular carcinoma and 29 gene or protein names for cirrhosis, were extracted from a number of previous investigations. The networks of related differentially expressed genes were explored using Cytoscape and the PPI analysis methods such as MCODE and ClueGO. Centrality and cluster screening identified hub genes, including APOE, TTR, CLU, and APOA1 in cirrhosis.
CLU and APOE belong to the regulation of positive regulation of neurofibrillary tangle assembly. HP and APOE involved in cellular oxidant detoxification. C4B and C4BP belong to the complement activation, classical pathway and acute inflammation response pathway. Also, it was reported TTR, TFRC, VWF, CLU, A2M, APOA1, CKAP5, ZNF648, CASP8, and HSP27 as hubs in HCC. In HCC, these include A2M that are corresponding to platelet degranulation, humoral immune response, and negative regulation of immune effector process. CLU belong to the reverse cholesterol transport, platelet degranulation and human immune response. APOA1 corresponds to the reverse cholesterol transport, platelet degranulation and humoral immune response, as well as negative regulation of immune effector process pathway.
In conclusion, this study suggests that there is a common molecular relationship between cirrhosis and hepatocellular cancer that may help with identification of target molecules for early treatment that is essential in cancer therapy.

To evaluate the HIV/AIDS burden in Iran from 1980 to 2010 using the Global Burden of Disease Study 2010 (GBD 2010).
The burden of HIV/AIDS in Iran was obtained from a systematic study from 1990 to 2010 by the GBD team. The GBD 2010 disability weights were used to calculate the HIV/AIDS Disability Adjusted Life Years (DALY) based on the HIV prevalence reported by the Joint United Nations Program on HIV/AIDS (UNAIDS) estimation. Mortality data were obtained from the vital registration and statistics system of Iran. In the current study, the results are discussed, and the potential solutions are provided for observed deficiencies.
HIV/AIDS-related DALYs (3.6 per 100,000 in 1990, and 154 per 100,000 in 2010) and death (0.07 per 100,000 in 1990, and 3 per 100,000 in 2010) had increased in Iran from 1990 to 2010. The majority of individuals who died of HIV were between 15 to 49 years old. The estimated rank of HIV/AIDS burden compared with the burden of other leading disease was 152nd in 1990 and considerably increased to 37th in 2010 in Iran.
Since the majority of HIV/AIDS DALYs and deaths occur among young people, the burden of HIV/AIDS still remains high in Iran. Due to the limitations of the GBD study, National and Sub-National Burden of Diseases (NASBOD) study is being conducted in Iran to calculate the burden of diseases, including HIV/AIDS.

The aim of this study was to evaluate the Helicobacter pylori eradication in the group receiving standard -dose twice a day for two weeks and continue taking amoxicillin for 4 weeks. Helicobacter pylori is the major etiological cause of chronic gastritis, gastric and duodenal ulcers, gastric cancer and lymphoma. Therefore, patients should be treated after diagnosis of H. pylori infection. Patients and A total of 66 consecutive patients with rapid urease test during endoscopy or biopsy positive for H. pylori were enrolled in this clinical trial study during 2013-2014. Patients were divided randomly into two groups. Group A (standard dose) received omeprazole (20 mg), amoxicillin (1 g), and clarithromycin (500 mg), all two times a day for two weeks. Group B received standard dose like group A and in patients with H.pylori infection amoxicillin were continued for 4 weeks. After completion of treatment, patients did not receive any treatment for a month and then stool antigen was performed to evaluate the H.pylori. The rate of successful HP eradication was significantly higher in group A (90.9% V.s 63.6%; p=0.017). Inflation and bitter mouth were found in 8 and 13 patients in group A and 7 and 9 patients in group B, respectively. The incidence of adverse effects was the same (p=0.437). Increased duration of antibiotic therapy to four weeks significantly raises the rate of successful HP eradication with standard triple therapy without significant increase in adverse effects.

The aim of this study was to determine the concentration of salivary? 2M as a marker of viral proliferation in HBS Ag+, HBV DNA PCR+ and Hbs Ag+ and HBV DNA PCR- subjects. Beta-2 microglobulin (?2M) is responsible for transmission of viral antigens such as Hepatitis B (HBV) on the surface of liver cells as part of an HLA complex. Patients and In this case control study, 25 PCR+ and 2 PCR- patients were included. 5 mL of the saliva sample was obtained from all patients and salivary? 2M level was measured using nephelometer. The data was evaluated by the descriptive, chi square and t tests. 72% of the PCR+ patients received medications and in contrast, 85.7% of the patients with PCR- did not take any medication (P<0.001). The average salivary concentration ofBeta-2 microglobulin in the PCR+ group (5.28 ± 5.45 mg/deciliter) was more than PCR- group (1.51±0.77) and this difference was statistically significant (P=0.003). the salivary B2Mlevel can be used as a marker of viral proliferation in patients with hepatitis B.

To evaluate the efficacy of erythromycin to decrease the time and improves the quality of EGD in patients with acute upper GI bleeding. The diagnostic and therapeutic value of esophagogastroduodenoscopy (EGD) in patients with upper GI bleeding is often limited by the presence of residual blood or clots. Infused erythromycin (3 mg/kg) before EGD, a potent gastro kinetic drug, might improve the quality of EGD in patients with upper GI bleeding and decrease the time of EGD and second- look EGD. Patients and In a prospective, randomized, double-blind controlled trial, 40 patients with acute upper gastrointestinal bleeding in Taleghani hospital, Tehran, Iran were studied. The patients were randomized into 2 groups: 1) nasogastric tube placement receiving placebo, and 2) intravenous erythromycin infusion (3mg/kg at 30 min) combined with nasogastric tube placement. The primary end point was endoscopic yield, as assessed by objective and subjective scoring systems and endoscopic duration. Secondary end points were the need for a second look, blood units transfused, and length of hospital stay and mortality. A clear stomach was found more often in the erythromycin group (100% vs. 25%; P< 0.001). Erythromycin shortened the endoscopic duration (14 vs. 32 minutes in the placebo group; P< 0.001) and reduced the need for second-look endoscopy (1 vs. 3; P< 0.001), admission duration (2 vs 5; P< 0.001) and reduced the blood units transfused (2 vs 4; P< 0.001). In patients with acute upper GI bleeding, infusion of erythromycin before endoscopy significantly decreases the time and improves the quality of EGD.

Celiac disease (CD) is an immune mediated condition that leads to small bowel atrophy that resolves with a gluten free diet (GFD). Extra-intestinal manifestations of CD include hypertransaminasemia. In this study, the effects of a GFD on hypertransaminasemia in patients with newly diagnosed CD were studied. Ninety eight new diagnosed consecutive patients with CD 40 males and 58 females) with mean age of 32 ± 17.1 were studied. All patients with CD were treated with a GFD. Patients with hypertransaminasemia, at diagnosis, had a cirrhosis screen performed. Patients with a negative cirrhosis screen were reviewed, 6 months after the introduction of a GFD, and serum levels of liver transaminases were measured again. Nine patients had hypertransaminasemia. One patient was Hepatitis B surface antigen positive and was excluded from this study. The 8 remaining patients had no obvious cause for the hypertransaminasemia. Mean (± SD) of baseline aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were 42.6 ± 16.5 IU/L (range: 16-66 IU/L) and 69.3 ± 9.3 IU/L (range: 52-81 IU/L). Six months after treatment with a GFD, mean AST and ALT levels decreased to 24.5 ± 5.1 IU/L (range: 18-31 IU/L) (P: 0.04) and 24.6 ± 6 IU/L (range: 17-32 IU/L) (P: 0.01), respectively. In 7 patients the hypertransaminasemia, at diagnosis had resolved. This study provides further evidence that some patients with CD have a reversible hypertransaminasemia that resolves with a GFD.

This study aimed to evaluate the success of H.pylori eradication therapy in patients with dyspepsia by therapeutics regimes with and without clidinium C. Helicobacter pylori infections are reported in all parts of the world. Appropriate antibiotic therapy can treat infection. The ideal treatment regimen has not been specified.Patients and In a randomized, double blind clinical trials study, 250 patients with dyspepsia were enrolled. All patients were treated by Omeprazole, Metronidazole, Amoxicillin and Bismuth (OMAB) for two weeks. One tablet clidinium C before each meal was added to this regimen in the intervention group (A). Urea Breath Test (UBT) was carried out after 8-12 weeks after treatment for evaluation of H.pylori eradication. 132 patients in the intervention group (A) and 118 patients in the control group (B) were enrolled to the study. The rate of eradication in group A was significantly higher than group B (62.1% vs. 50%, p=0.04). The results supported the effect of clidinium C for increasing of helicobacter pylori eradication, but further studies need to be performed.

In this study, genetic polymorphism of two tRNA-liked short tandem repeat (STR)-containing loci, R-R and S-Q, was analyzed in order to clarify further the genotypic differences among E. dispar isolates. Entamoeba dispar is closely related to the human pathogen E. histolytica, the agent of amebic dysentery and amebic liver abscesses. E. dispar is, to some extent, capable of producing variable focal intestinal lesions in animals and of destroying epithelial cell monolayers in vitro, and some have reported it to be capable of producing amoebic liver abscess in hamsters. However no evidence exists at present to link E. dispar with human disease.Patients and A total of 28 E. dispar samples from gastrointestinal disorder patients were characterized using PCR and sequencing. The sequences obtained were edited manually and aligned. sequence analysis showed 9 and 6 different patterns of units in the repeat-containing region of R-R and S-Q, respectively. The repeat-containing regions of R-R and S-Q loci were found to be extensively polymorphic, varying in size, number and order of repeat units. The results demonstrate extensive genetic variability among Iranian E. dispar clinical isolates. The genetic diversity of tRNA gene-linked STR loci shows them to be suitable for epidemiological studies such as the characterization of the routes of transmission of these parasites in Iran.

There are little data on the prevalence of serological markers of hepatitis B and hepatitis C viruses in pregnant women in Iran. This study was designed to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among pregnant women in Lorestan, west of Iran.Patients and Serum samples of 827 pregnant women who lived in rural (36.8%) and urban areas (63.2%) of Lorestan were collected during 2007-2008. Data were obtained through questionnaires. Samples were first screened for anti-HCV and anti-HBc by ELISA. Those who were positive for anti-HBc were tested for HBsAg. Anti-HBc was found in 28 of 827 pregnant women (overall prevalence, 3.4%; 14 of 523 in urban areas, 2.7%; 14 of 304 in rural areas, 4.6%). Of the 28 positive samples, 6 (0.7%) were positive for HBs-Ag. Only 2 samples (0.2%) were anti-HCV-positive. These results underscore the need for prenatal screening for HBV infection in pregnant women and treatment of newborns from HBsAg-positive mothers. More studies are needed to identify risk factors of HCV infection and highlight the importance of HCV screening and treatment programs.

To evaluate the role of endoscopic ultrasonography (EUS) in the diagnosis of gallbladder microlithiasis, sludge, and stone in patients with clinical suspicion of cholecystitis, but with normal transabdominal ultrasonography (TUS) during six months follow-up after laparosopic cholecystectomy (LCT). Endosonography has been shown to be highly sensitive in the detection of choledocholithiasis, especially in patients with small stones and nondilated bile ducts, and gallbladder microlithiasis.Patients and A prospective study was performed on patients with biliary pain and normal transabdominal ultrasonography, for presence of microlithiasis, sludge, and stone in gallbladder at Arad hospital, Tehran, Iran from January 2004 to January 2007. EUS examination was performed with a mechanical radial scanning UM-20 echo-endoscope (Olympus Optical, Tokyo, Japan). Patients in whom EUS demonstrated gallbladder sludge, microlithisis, and stone were offered laparoscopic cholecystectomy within one week. A total of 245 patients (176 female and 69 male) were included in this study from January 2005 to January 2007. 88 out of 245 (36%) patients had gallbladder abnormalities which were diagnosed by EUS including: 43 gallbladder microlithiasis (48.3%), 23 gallbladder sludge (26%), 22 gallbladder stone (24.7%). Surgery performed for all these cases. Episodes of biliary pain during six months after LC reported in eight cases with gallbladder stone, but in no cases of microlithiasis or sludge. EUS seems to be a choice imaging method for detection of microlithiasis, sludge and stone of gallbladder in patients with biliary colic but normal transabdominal ultrasonography. In subjects with biliary pain and negative EUS, it is not reasonable to offer cholecystectomy.

Hepatitis C virus (HCV) infection has been explained as a disease that sometimes present with rheumatic manifestations indistinguishable from rheumatoid arthritis. This study has been performed to evaluate the frequency of hepatitis C virus infection in a group of patients with rheumatoid arthritis.Patients and In this study, during one year, serum samples collected from two hundred consecutive patients with rheumatoid arthritis in all affiliated hospitals of Shaheed Beheshti University, M.C., were examined for anti-HCV antibody and HCV-RNA by ELISA and RT-PCR method, respectively. Using a questionnaire, the frequency of HCVinfection, age and sex distribution, duration of rheumatoid arthritis, associated immune mediated disorders and risk factors for hepatitis C virus infection were assessed. A total of 200 patients (M/F=26/174) who were mainly aged 51-70 years were studied. The frequency of HCV was found to be 2% (95%CI: 0.6-7%). All of the infected persons have had a low risk occupation in terms of exposure to the virus and none of them had HCV risk factors. No associated immune mediated disorder was found in HCV infected patients. Our results did not support any contribution of HCV infection in the pathogenesis of rheumatoid arthritis.

To evaluate endoscopic results of a large number of Iranian patients with dyspepsia. Dyspepsia is quite common among adults and has a great impact on the patient''s quality of life. The present study was designed to investigate the structure of dyspepsia and to determine existing symptoms and endoscopic findings. Patients and Over a period of 14 months (April 2003- June 2004), 940 consecutive outpatients referred for upper gastrointestinal endoscopy because of dyspepsia. The value of the criteria distinguishing between the two major diagnostic groups, peptic ulcer and non-ulcer dyspepsia, was assessed by comparing the group of non-ulcer dyspepsia with the group of patients with peptic ulcer. Ulcer-like presentation (69.3%) was the predominant symptom. Totally, 133 (14.1%) have peptic ulcer disease (PUD). Alcohol use and smoking were significantly higher in PUD group. H.Pylori was higher in PUD (68.4% in PUD versus 41.5% in NUD, p=0.000). Regardless of numerous studies and trials, dyspepsia still remains a controversial issue. The analysis of the data of the overall patient population remains the subject of future research