mehrdad kashifard

Helicobacter pylori infection is the most common cause of peptic ulcer disease. However, the prevalence rates of non-helicobacter pylori idiopathic peptic ulcers have increased over the past few years. This study aims to compare the characteristics of Helicobacter pylori-positive with idiopathic duodenal ulcers.

A cross-sectional cohort study was conducted on 950 patients which were excluded from the analysis process duo to the concomitant presence of gastric ulcer, malignancy, Zollinger Ellison syndrome, Crohn's disease, esophageal varices, history of taking anti-Helicobacter pylori therapy, and history of taking NSAID or aspirin. Eventually, 647 subjects were enrolled for the analysis process. In this case, these subjects were divided into two groups: (I) Helicobacter pylori-positive ulcer group and (II) Helicobacter pylori-negative and non-NSAID (idiopathic) ulcer group.

The findings showed that 417 patients (64.5%) had duodenal ulcers induced by Helicobacter pylori, and 111 patients (17.1%) had Helicobacter pylori-negative and non-NSAID ulcers. The mean ages of patients in Helicobacter pylori-positive and idiopathic ulcer groups were 39±15 and 42±17, respectively. In this case, 33 patients (29.7%) with idiopathic ulcers and 56 patients (25.1%) with Helicobacter pylori-positive ulcers had upper gastrointestinal bleeding. Also, 22 patients (21%) with idiopathic ulcers and 31 patients (16.5%) with Helicobacter pylori-positive ulcers had multiple duodenal ulcers

The present study demonstrated that the idiopathic ulcers included 17.1% of duodenal ulcers. Also, it was concluded that patients with idiopathic ulcers were predominantly male with an age range older than the other group. In addition, patients in this group had more ulcers.

This article aimed to evaluate nitric oxide (NO) and nitric oxide synthase (iNOS) markers in patients with erosive esophagitis (EE) and those with non-erosive reflux disease (NERD) and compare them with the control group.

Gastro-esophageal reflux disease (GERD) is one of the most common disturbances of the upper digestive tract. Inducible nitric oxide synthase (iNOS) is expressed in esophageal adenocarcinoma. NO, the product of this enzyme, has been implicated in the pathogenesis of this condition. Nevertheless, the data on whether iNOS and NO are expressed in the early stages of GERD is conflicting.

In this study, tissue samples were obtained from fifty-four patients (27 with erosive esophagitis and 27 with non-erosive reflux disease) and 27 controls. Tissue concentrations of nitrite, nitrate, and iNOS were measured using Enzyme-Linked Immunesorbent Assay (ELISA). The Bradford method was used to determine the protein concentration of samples. The results were analyzed by SPSS software (version 22.0). In multiple comparisons, the Tukey test was performed, and p < 0.05 was considered as the level of significance.

Results:

Tissue amounts of iNOS were significantly higher (p= 0.001) in EE patients compared with the control group. There was a significant difference (p= 0.01) in this factor between EE patients and patients with NERD. Moreover, tissue levels of nitrite and nitrate were significantly higher (p = 0.001) in patient groups compared with the control group.

It was observed that NO and iNOS protein were increased in human esophagitis tissue. The results indicated that nitric oxide and iNOS levels are useful and effective markers in the pathogenesis of GERD. While the results are not certain, it is thought that a link exists between the expressions of iNOS and disease progression.

Inflammatory bowel disease (IBD) is a broad term that refers to a group of chronic inflammatory disorders that have an unknown origin and might be associated with other diseases. The aim of this study was to determine the frequency of chronic diseases in patients with IBD.

In this case-control study, 280 patients with IBD were compared with 280 healthy individuals, frequency-matched by age, sex, place of residence and marital status. Random sampling was performed in patients that referred to the internal medicine and gastroenterology wards of hospitals affiliated to Babol University of Medical Sciences. Data collection tools included a demographic questionnaire and a checklist for chronic diseases, which were completed through interviews with the case and control groups.

Two hundred and twenty-nine (81.78%) patients with IBD had at least one chronic disease. Patients with IBD were at increased risks of rheumatoid arthritis (OR= 4.48, 95%CI: 1.48, 13.54, P= 0.008), eye diseases (OR= 3.49, 95%CI: 1.68, 7.28, P= 0.001), liver diseases (OR= 2.74, 95%CI: 1.40, 5.34, P= 0.003 ), anemia (OR = 2.53, 95%CI: 1.56, 4.13, P= 0.000), depression (OR= 2.43, 95%CI: 1.58, 3.74, P= 0.000), skin diseases (OR= 2.36, 95%CI: 1.18, 4.74, P= 0.015) and hypertension (OR= 1.77, 95%CI: 1.06, 2.95, P= 0.028).

  The frequency of chronic diseases associated with IBD has been high, therefore, physicians and health care professionals should consider the possibility of other chronic diseases when dealing with IBD patients.

Inflammatory bowel disease (IBD) is a chronic disease with a relapsing course of inflammation in the digestive system. Endoscopy and histopathology are the golden standard methods for detection and assessment of IBD. A distinct increase of fecal calprotectin level can be a useful marker for the diagnosis of IBD. The aim of this study was to evaluate the fecal calprotectin level in patients with IBD and without inflammatory diseases of the colon.
Calprotectin levels of patients referred to the Ayatollah Rouhani Hospital of Babol, northern Iran with clinical symptoms of colon disease were evaluated. After a week, colonoscopy and biopsy were performed on all patients and they were divided into two groups. The first group included patients with confirmed IBD and the second group included patients with diseases other than IBD, patients with IBS and healthy persons. Then the measured fecal calprotectin level was compared between the two groups before colonoscopy.
We observed correlation between calprotection in these two groups (p The results pointed to this fact that fecal calprotectin can be a noninvasive marker in differentiating IBD from IBS

Ulcerative colitis is a common type of inflammatory bowel disease (IBD). The aim of the present study was to examine the relationship between lipid profile, especially high-density lipoprotein (HDL), and malondialdehyde (MDA) level in patients with ulcerative colitis.
In this study, 45 patients with ulcerative colitis were selected, 25 of whom were diagnosed with active disease and 20 were in clinical remission. Moreover, 45 healthy subjects were selected as the controls. The status of serum lipid profile and MDA level were measured via precise photometric methods. The obtained data were analyzed, using independent t-test and correlation coefficient test. P The serum level of HDL-C decreased, while the serum level of MDA significantly increased in patients with ulcerative colitis in comparison with the healthy controls (P The inverse correlation between HDL-C and MDA levels can be regarded as an indicator of the protective role of HDL-C against lipid peroxidation in ulcerative colitis. In patients with ulcerative colitis, the serum level of HDL-C decreased in comparison with healthy subjects. Therefore, it is necessary to determine the HDL-C level in patients with ulcerative colitis.

Inflammatory bowel disease (IBD) involves chronic inflammation of the digestive tract. In the past decades, fecal calprotectin has been proposed as a useful biomarker for the differential diagnosis between IBD patients and healthy controls. We designed this study to evaluate the diagnostic ability of fecal calprotectin (FC) and conventional inflammatory markers in IBD patients.
Thirty patients who underwent colonoscopy were cases and thirty healthy subjects undergoing colonoscopy as part of a medical check-up were the controls. These 2 groups were evaluated with regard to age and sex. Severity of the disease was evaluated based on disease endoscopic index. FC, Cross reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) were measured using ELISA, colorimetric and Westergren methods, respectively. The obtained data were analyzed by independent test, correlation test and receiver operating characteristic (ROC) curve analysis. A p Fecal calprotectin level in the case group increased compared to control group (p Discriminating IBD patients from healthy controls was better for FC than conventional inflammatory markers. Additionally, the results produced by FC correlate with the severity of IBD.

Functional Dyspepsia (FD) is a common symptom of upper gastrointestinal discomfort. Few data are available on the role of psychotherapy in the treatment of dyspeptic syndromes. This study assesses whether brief core conflictual relationship theme (CCRT) psychoanalytic psychotherapy improves gastrointestinal and psychiatric symptoms in patients with functional dyspepsia. A randomized, controlled trial was planned in two educational hospitals in city of Babol. Forty-nine patients with FD were randomly assigned to receive standard medication treatment with CCRT psychotherapy (24 participants) or standard medication treatment alone (25 participants). The participants completed the Patient Assessment of Upper Gastrointestinal Symptom Severity Index (PAGI-SYM) and Symptom Checklist-90-Revised (SCL-90-R) questionnaires before the trial, after the treatment and at 1 and 12-month follow-ups. The mixed-effects (regression) model was used to analyze the data. The results showed that CCRT psychotherapy improved all of the FD symptoms (heartburn/regurgitation, nausea/vomiting, fullness, bloating, upper abdominal pain, and lower abdominal pain) and many of the psychiatric symptoms (depression, anxiety, somatization, interpersonal sensitivity and paranoid ideation) after the treatment and at 1-month and 12-month follow-ups. Brief CCRT psychoanalytic psychotherapy can serve as an effective intervention for promoting gastrointestinal and psychiatric symptoms in patients with functional dyspepsia.

The combination of propofol-fentanyl for sedation during colonoscopy is characterized by the frequent incidence of side effects. Etomidate-fentanyl provides fewer hemodynamic and respiratory complications. The aim of our study was to compare the safety and efficacy of propofol-fentanyl and etomidate-fentanyl for conscious sedation in elective colonoscopy. This double-blind clinical trial was conducted on 90 patients aged between 18 and 55 years old who were candidates for elective colonoscopy. Patients were randomized to receive sedation with fentanyl plus propofol or etomidate. Two minutes after injecting 1 micro/kg of fentanyl, the patients received propofol (0.5 mg/kg followed 25 micro/kg/min) or etomidate (0.1 mg/kg followed 15 micro/kg/min). Pulse rate, mean arterial blood pressure, respiratory rate, and saturation of peripheral oxygen (SPO2) were monitored. Indeed, the patient and colonoscopist satisfaction, the recovery time, sedation and pain score in both groups were assessed. Sedation score in propofol group was higher. Pain score as well as the physician and patient satisfaction showed no significant difference in two study groups. Hemodynamic changes and arterial saturation were the same in both groups. The duration of recovery was 1.27±0.82 minutes in the etomidate group; whereas, it was 2.57±2.46 minutes in the propofol group (P=0.001). Hospital discharge in the propofol group was 5.53±4.67 minutes and in the etomidate group was 2.68±3.14 minutes (p=0.001). The combination of fentanyl and etomidate provides an acceptable alternative to sedation with fentanyl and propofol with the advantage of significantly faster recovery time, which are of relevance in the outpatient setting.

Gastric adenocarcinoma is the second leading cause of death due to cancer in the world and in advanced stages the prognosis is poor with current therapies. Over-expression of HER-2/neu has been seen in several cancers such as gastric cancer and its expression is associated with poor prognosis. The aim of this study is to evaluate the over-expression of HER-2/neu in gastric biopsy samples of patients with gastric carcinoma diagnosis; and to evaluate its probable relationship with clinical and pathological findings. The over-expression of HER-2/neu was examined retrospectively by immunohistochemistry method in 60 paraffin embedded samples collected in Babol, Iran, between 2010 and 2011. The over-expression of HER-2/neu has been observed in 6 patients (10%) and this over-expression was greater in the intestinal type of gastric adenocarcinoma than the diffuse type (12% vs. 6%); however, no statistically significant correlation between HER-2/neu expression and subtype, degree of differentiation, tumor type and age was observed. This over-expression was greater in differentiated types than undifferentiated types (18% vs. 5%).

Polycystic ovary syndrome (PCOS) is a common, complex endocrine disorder for women of productive age. A high incidence of ovulation failure in women with PCOS is related to insulin resistance. Some studies have assessed the effects of hyperinsulinemia and insulin resistance in relationship with insulin sensitizing agents such as Metformin (Met). These medicines have been suggested new scope for ovulation stimulation enhancement with Clomiphene Citrate (CC) in PCOs women. The aim of this study is to compare the effectiveness of adding Met to CC in women with PCOS. This multicenter, single-blind, randomized controlled trial study was performed on 334 PCOS patients from 2007 to 2009. Patients were randomly divided into two groups and ovulation induction was performed with either CC alone or CC + Met. The treatment was continued for three cycles, then the mature follicle and pregnancy rates were evaluated. In the CC + Met group, 68% had at least one dominant follicle in the first cycle that was significant (p<0.001), and 31.7% had one in the second cycle. In the CC group 54.5% in the first cycle, 31.7% second cycle, and 6.9% ovulated in the third cycle. The pregnancy rate was 28.7% in CC + Met group and 24.6% in the CC group, with no significant differences between the two groups. Adding Met to CC is significant for ovulation, but it does not enhance the pregnancy rate (Registration Number: IRCT138904174306N1).

The majority of dyspeptic patients do not have identifiable disease, which is also known as functional dyspepsia. The therapeutic approach to patients with functional dyspepsia is still a matter of debate; prokinetic agents are commonly used for symptom relief. This study aims to evaluate the efficacy of domperidone and pyridostigmine (an inhibitor of cholinesterase) in patients with functional dyspepsia.This was a single-blind, randomized clinical trial performed on 117 patients (December 2007 to November 2009) diagnosed with functional dyspepsia according to ROME II criteria. The effects of 4 weeks of treatment with domperidone (10 mg tid), pyridostigmine (60 mg tid), and placebo were compared. We scored each patient according to VAS to rank the severity of 8 different upper GI symptoms (epigastric fullness, early satiety, gnawing, nausea, vomiting, belching, bloating, and epigastric pain) both before and at the end of treatment. Data were entered into SPSS software version 16 and analyzed. p ‹ 0.05 was considered significant.At the end of treatment, the total dyspeptic symptom score decreased from 24 to 13. According to ANOVA, there were significant differences between the 3 groups in 3 out of 8 symptom scores of bloating (p=0.039), early satiety (p=0.006), and nausea (p=0.016). The post hoc test determined that domperidone was more effective than pyridostigmine and placebo in improvement of early satiety (p=0.038 and p=0.014, respectively). Domperidone was more effective than pyridostigmine in the control of nausea (p=0.024). Domperidone (p =0.023) and pyridostigmine (p=0.042) were superior in relieving bloating symptoms compared to placebo. Overall, in the control of GI symptoms domperidone was more effective than placebo (p=0.045).Domperidone and pyridostigmine are useful in improving bloating, early satiety, and nausea. However they are similar to placebo in controlling epigastric pain, fullness, belching and gnawing.

Background and Preeclampsia is a pregnancy-specific condition characterized by hypertension and proteinuria. According to many predisposing factors in pathophysiology of preeclampsia, the role of lipid preoxides, is recently important. The aim of this study was to evaluate association of preeclampsia with maternal plasma and umbilical cord Lipid concentration. This case-control study was done on pregnant women referring to Babol Yahyanejad Hospital, during 2008 - 2009. Case group include 31 term preeclamptic pregnant women and for control group 31 term normal pregnant women were recruited. All women had 20-30 years old and were in gravid 1 and 2. Total TG, cholesterol, HDL and LDL for plasma and umbilical cord were measured by enzymatic and calorimetric methods. The mean level of triglyceride (291.1 102.8 VS 309.4 114.4) cholesterol (226.3 48.8 VS 234.9 40.6), LDL (119 38.3 VS 123 33.1), HDL (50.1 10.6 VS 51.5 8.1) and VLDL (59.2 20.8 VS 61.5 22.6) in women with preeclampsia and normal subjects had not significant difference (p>0.05). About level of Lipids in umblical cord, only one case in control group had abnormal Triglycerid level. The mean level of umbilical cord triglyceride (56.3 32 VS 50.1 54) umbilical cord cholesterol (70.9 22.8 VS 64.4 20.8), umbilical cord LDL (30.9 12.7 VS 26.1 10), umbilical cord HDL (28.7 10.7 VS 30.7 8.6) and umbilical cord VLDL (11.6 6.8 VS 9.9 10.7) in preeclampsia and normal groups had not significant difference (p>0.05). Result show that there was no significant association between levels of plasma and umbilical cord lipids with preeclampsia.

Background and Polycystic ovary syndrome (PÇÔS), a common endocrine disorder with lipid disturbances, is associated with increase in the risk of cardiovascular disease and central obesity. The aim of this study was to determine the relationship between the postparandial lipid level with waist-to-hip ratio and insulin in women with PÇÔS in comparison with a control group. This case-control study was conducted at Fatemat Zahra Ïnfertility Çenter in Babol on 20 women with PÇÔS and 20 healthy women as controls who were matched according to age and had a body mass index between 20 to 23 kg/m2. Waist-to-hip ratio, insulin, glucose tolerance test, the levels of fasting and postparandial triglyceride, cholestrol and HDL-cholestrol were all measured and compared between the two groups. Ïn comparison with the control group, women with PÇÔS had higher levels of postparandial triglyceride (203.6±121.5 mg/dl VS 117.7±41.5 mg/dl, P=0.018), postparandial cholestrol (210.1±36.9 mg/dl VS 169.9±29 mg/dl, P=0.001), FBS (91.6±11.7 mg/dl VS 81.8±14.2 mg/dl, P=0.023), insulin (131.7±25.2 ÏÜ/dl VS 75.2±18 ÏÜ/dl, P=0.033) and waist-to-hip ratio (0.87±0.06 VS 0.74±0.14, P=0.001). The levels of fasting triglyceride (158.1±68.9 mg/dl VS 118±35.9 mg/dl, P=0.029) and cholesterol (189.9±32.6 mg/dl VS 154±25 mg/dl, P=0.000) in PÇÔS women were higher than that of the control group. There was no relationship between the level of lipids with insulin level and waist-to-hip ratio.Çonclusion: The levels of insulin, fasting and postparandial triglyceride and cholesterol in women with PÇÔS were higher than the healthy group. Ït seems that waist-to-hip ratio and insulin level had no effect on this relationship.

Basic fibroblast growth factor (bFGF) is a glycoprotein with stimulating ability of angiogenesis. In addition, bFGF plays an important role in wound healing process in some tissues for example gastrointestinal tract, but its ability for discrimination of various stages of wound severity in these diseases was not reported. Therefore, we aimed to determine the bFGF levels in gastric ulcer patients compared with healthy control as a biomarker for staging the severity of wound The study group consisted of 33 patients with gastric ulcer and 27 healthy controls. The diagnosis of patients was based on standard clinical, endoscopic, and histological criteria. Serum levels of bFGF were analyzed by an ELISA kit. According to the histological findings, 19 (57.6%) patients were in moderate stage of ulcer and 14 (42.4%) patients were in the severe stage of gastric ulcer. The mean bFGF serum levels in patients group (7.8±1.3pg/ml) were lower than the healthy group (8.2±1.4pg/ml) in crude data, but in statistical analysis the differences were not significant (p=0.082). The mean bFGF serum levels in patients with severe stage of gastric ulcer were greater than patients in moderate gastric ulcer (8.4±1.3 vs. 7.4±1.2 pg) and the differences were statistically significant (p<0.05). Differences in serum bFGF levels in patients with severe stage of gastric ulcer vs. moderate gastric ulcer was significant. Therefore, serum bFGF level measurements can be used as a useful clinical tool for discrimination of patients with severe stage of gastric ulcer vs. moderate gastric ulcer, when endoscopic and histological examination are not possible to perform.

Background and Sucrose can be used as a marker for gastric ulcer as healthy gastric tissue is almost impermeable to sucrose. The aim of this study was to determine the plasma and urine sucrose level in patients with gastric ulcer compared with the control group. Â cross-sectional study was performed on 30 patients with benign gastric ulcer (based on endoscopy and pathology reports) and 30 healthy subjects as the control group. Plasma and urinary sucrose levels were indirectly measured by acid hydrolyze method using a spectrophotometer at 510 nm. Data were analyzed with Fisher's exact and T-test using SPSS, and P<0.05 was considered as significant level. The mean plasma and urinary excretion of sucrose in patients were 22.17 ± 1.85 an. 51 ± 2.5, respectively, whereas in the control group, they were 6.62 ± 2.31 and 2.83 ± 0.63, respectively. These differences were statistically significant between the two groups (P<0.05 in all instances).Çonclusion: Determination of sucrose can be used as a non-invasive method in the diagnosis of benign gastric ulcer.

Halothane is the routine used inhalation anesthetic drug in the world but at present, there is an increasing interest for using intravenous anesthetics like propofol. The purpose of this study was to compare these anesthetic effects on hepatic enzymes. From 2006 to 2007, this study was performed on fifty eight patients classified in class I of American Society of Anesthetics. These patients had no preliminary symptomatic hepatic, cardiac or renal disease admitted for elective surgery in Yahyahnejiad Hospital, Babol University of Medical Sciences. These patients were divided randomly into two groups. Thirty patients in the study group (Propofol) and twenty eight patients in the control group (Halothane). In both groups, pre-meditation and induction of anesthesia were the same. For the maintenance of anesthesia in the study group there was continuous infusion of propofol and for the control group, 0.5-1% halothane inhalation. From all the patients, we got three blood samples separately prior to the anesthesia, twenty four hours and seven days after the anesthesia. These samples were tested for aspartate aminotransferase (AST), alanine amino transferase (ALT), alkaline phosphates (ALP) and Billirubin (total and direct). Seven days after anesthesia ALP, the total and direct Billirubin levels did not have differences between the two groups. However, AST (p=0.008) and ALT (p=0.003) increased in halothane group in compared with propofol group. The results show that propofol has less effect on liver enzymes as compared to halothane.

Gestational diabetes is the most common metabolic disorder in pregnancy. Glucose Challenge Test (GCT) is done for all pregnant women during the 24th to 28th weeks of gestation. If the GCT value is more than 130 mg/dl a Glucose Tolerance Test (GTT) is asked and if GTT is impaired, gestational diabetes mellitus (GDM) is diagnosed and she will receive treatment accordingly. Some studies have illustrated that impaired GCT can cause unfavorable pregnancy outcomes. Therefore, the goal of this study was to determine the pregnancy outcome in pregnant women with abnormal GCTs. This study was done on all pregnant women attending Babol Shahid Yahyanezhad Hospital for prenatal care during 1999 to 2009. GCT was done for all the participants during the 24th to 28th weeks of gestation. Pregnancy outcomes of 225 pregnant women with abnormal GCTs and normal GTTs were compared with those of 225 pregnant women with normal GCTs as the controls. The individuals were compared for pregnancy outcomes such as macrosomia, premature rupture of membranes (PROM) and the need for a cesarean section (C/S). The average birth weight of the neonates were 3.5  0.5 kg and 3.3  0.4 kg (p < 0.001) in the cases and controls, respectively. Twenty-five neonates in the case group (12.1%) and eight neonates in the control group (3.6%) had macrosomia (p = 0.003). Frequency of PROM was 17.85% (40) in the cases and 8.9% (20) in the controls (p = 0.008). The cases had a higher frequency for preeclampsia 4.4% (10) than the controls 1.8% (4), (p = 0.17). And pregnancy in the cases lead to a greater number of Cesarean sections, 42.2% (95) in comparison to the controls, 28% (63), (p < 0.001). Prevalence of macrosomia, PROM and C/S were higher in pregnant women with abnormal GCTs. Due to the aforementioned unfavorable conditions that bear the risk of a poor perinatal outcome, early diagnosis and proper follow up of women with GDM is suggested during the prenatal period.