sara ashtari

Pollutants, including polycyclic aromatic hydrocarbons (PAHs), pose significant environmental and health risks. Exposure to PAHs has been associated with adverse pregnancy outcomes. Therefore, the study aimed to evaluate the relationship between maternal exposure to PAHs and Preterm Birth.

In this systematic review and meta-analysis, Scopus, MEDLINE/PubMed, Web of Science, Cochrane Library, and ProQuest databases were searched without a time limit until June 16, 2024. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS) and GRADE framework to evaluate the credibility of the evidence. Data analysis was done using random-effects models and odds ratio with 95% confidence interval to synthesize association estimates. Heterogeneity between studies was investigated using Cochran’s Q test and I-squared (I2) statistic, and publication bias was evaluated through funnel plots, Begg's test, and Egger's test. All statistical analyses were conducted using STATA version 17 (Stata Corp; College Station; TX, USA) software.

Out of 5695 studies screened, 6 with a total sample size of 45158 were included in our final review. The results of the meta-analysis showed a non-significant overall association between maternal exposure to PAH metabolites and preterm birth (OR: 1.09, 95%CI: 0.80-1.49, P=0.59) and the I-squared index indicated significant heterogeneity among studies (I2 = 88.23%, P<0.001). Based on the funnel plot analysis and the results Begg's test (P=0.964) and Egger's regression test (P=0.855) both suggested no significant publication bias.

This study underscores the no effect of PAHs exposure on preterm birth. However, further well-designed prospective studies with standardized exposure assessment methods and rigorous control of confounding factors are necessary to elucidate the underlying mechanisms linking PAH exposure to adverse pregnancy outcomes.

This study aimed to examine the environmental factors associated in Iranian patients withinflammatory bowel disease(IBD).

The role of environmental factors in the development of IBD remains uncertain.

In this case-control study, the patients with IBD referred to the Taleghani Hospital, Tehran, Iran, were recruited from 2017 to 2019. Controls were matched by sex. Data were collected using the designed questionnaire and also valid questionnaire suchPittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) for sleep quality and anxiety/depression, respectively. Conditional logistic regression models were used to estimate adjusted odds ratios (ORs).

The study population included 200 individuals: 100 (50%) IBD patients and 100 (50%) controls. Age under 50, marital status, sleep difficulties, vitamin D insufficiency, anxiety/depression, dietary fiber deficit, post-menopausal hormone treatment, oral contraceptives, and antibiotics were all prognostic factors for IBD on the univariate analysis (P< 0.005). In multivariate analysis, the risk of IBD was significantly increased with 50 years (OR: 6.699, 95%CI: 3.271-8.662, P=0.017), abnormal sleep status (OR: 6.383, 95%CI: 3.389-7.19, P=0.001), and using oral contraceptive (OR: 7.426, 95%CI: 5.327-9.865, P=0.001). However, the risk of IBD was significantly decreased with older age (OR: 0.795, 95%CI: 0.697-0.907, P=0.001) and married status (OR: 0.008,95%CI: 0.001-0.438, P=0.018).

Data suggest that the environmental factors play a significant role in the etiology of IBD and probably on the disease course. While the evidence for some factors is strong, many factors require further supportive data.

Despite advances in the treatment of abdominal injuries in patients with trauma, it remains a major public health problem worldwide. Evaluation of hazard ratio (HR) of 90-day mortality in intensive care unit (ICU) patients with abdominal injuries compare with head injuries in trauma patients and non-trauma surgical ICU patients.

This single-center, prospective cohort study was conducted on 400 patients admitted to the ICU between 2018 and 2019 due to trauma or surgery in Hamadan, Iran. The main outcome was mortality at 90-day after ICU admission. Cox proportional hazards models were used to determine the HR and 95% confidence interval (CI) for 90-day mortality.

The 90-day mortality was 21.9% in abdominal injuries patients. According to multivariate Cox regression, the expected hazard mortality was 2.758 times higher in patients with abdominal injuries compared to non-trauma patients (HR: 2.758, 95% CI: 1.077–7.063, P = 0.034). About more than 50% of all deaths in the abdominal and head trauma groups occurred within 20 days after admission. Mean time to death was 27.85± 20.1, 30.27 ± 18.22 and 31.43± 26.24 days for abdominal-trauma, surgical-ICU, and head-trauma groups, respectively.

Difficulty in accurate diagnosis due to the complex physiological variability of abdominal trauma, less obvious clinical symptoms in blunt abdominal injuries, multi-organ dysfunction in abdominal injuries, failure to provide timely acute care, as well as different treatment methods all account for the high 90-day mortality rate in abdominal-trauma patients. Therefore, these patients need a multidisciplinary team to care for them both in the ICU and afterwards in the general ward.

 The role of serum neutrophil gelatinase-associated lipocalin (NGAL) in predicting delayed graft function (DGF) after kidney transplantation is poorly defined. The objective of this study was to evaluate the serum NGAL expression in the early postoperative phase after kidney transplantation and compare it with serum creatinine (Cr). We studied 29 patients who received kidney transplantation from deceased (n=24) and lived (n=5) donors from October 2017 to December 2018 at the Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Serum NGAL, Serum Cr, and urine output were measured at 1 to 7 days after transplantation. The need for dialysis in one week after transplantation was evaluated. Among 29 recipients with serum biomarkers measurements, 8 (27.5%) developed DGF (need to hemodialysis within one week of transplantation). Resulted in areas under ROC curves (AUCs) for serum NGAL at early hours following transplantation was (0.839, 95% CI: 0.69-0.98, P-value=0.005) that could accurately predict DGF compared to urine output (0.747, 95% CI: 0.55-0.93, P-value=0.045) and serum Cr (0.607, 95% CI: 0.34-0.86, P-value=0.398) at 24 hours after transplantation. Multivariate analysis revealed that only serum NGAL was a significant independent predictor of DGF (OR: 0.996, 95% CI: 0.993-1.000, P-value=0.039).   Serum NGAL at early hours of post-transplantation was a valuable biomarker for an early accurate predictor of DGF in kidney transplantation compared with traditional biomarkers such as serum Cr and urine output.

As the coronavirus disease 2019 (COVID-19) pandemic rapidly sweeps across the world, it is inducing a considerable degree of psychological problems, which can affect everyone in the community. This study aimed to compare the severity of the psychological distress in the general population and patients during the COVID-19 epidemic in an Iranian population. In this cross-sectional study, the mental health status of 221 COVID-19 infected patients and 241 participants from general population were investigated by the self-report questionnaire of Depression, Anxiety, and Stress Scale (DASS). The DASS-21 questionnaire and sociodemographic data sheet were filled out by the participants. All statistical analyses were performed using SPSS software version 21. The results indicated higher scores of DASS in patients than the population simultaneously (Wilks Lambda = 0.934, F (3, 440) = 10.44, p <0.001) and individually (Mean difference [MD] = 2.55, 95% CI = 1.48 to 3.62 for depression, MD = 1.48, 95% CI = 0.39 to 2.57 for anxiety, and MD = 1.41, 95% CI = 0.32 to 2.49 for depression score). The present study revealed a high prevalence of mental health problems among patients with COVID-19 and gaps in providing them with mental health services. We call for systematic screening of mental health status for all patients and developing specific psychological interventions for this vulnerable population. Psychosocial assessment and monitoring should be developed in the community to support aspects of COVID-19.

This review study was conducted to evaluate the symptoms of COVID-19 in pregnant women with a focus on gastrointestinal symptoms.

COVID-19 is a fatal respiratory disease caused by a novel coronavirus that quickly became a pandemic. Although the main symptoms of this disease include respiratory symptoms, gastrointestinal manifestations have also been observed in some patients suffering from COVID-19. Pregnant women are among the most vulnerable groups in the community to infectious diseases.

Scientific databases were searched for articles published up to May 8, 2020. Any type of study investigating the manifestations of COVID-19 in pregnant women was included. Symptoms of the disease in pregnant women with an emphasis on gastrointestinal symptoms were assessed.

The search resulted in 852 titles and abstracts, which were narrowed down to 43 studies involving 374 women. The most common symptoms of patients were fever (59.1%) and cough (48.4%), respectively. Gastrointestinal symptoms included diarrhea (4.5%), abdominal pain (1.6%), nausea (0.8%), and loss of appetite (0.3%), respectively. In studies on pregnant women with gastrointestinal symptoms, 13 fetal abortions occurred, most of which were induced abortions due to the risks posed by COVID-19.In thirty cases, and infected pregnant women reported a history of chronic pregnancy-related diseases.

COVID-19 in pregnant women, similar to the general population, can present with gastrointestinal manifestations. The gastrointestinal tract can be a potential route for infection with the novel coronavirus.

To estimate the number of confirmed cases and the rate of death and also to investigate the cause of death in Italy, Iran and South Korea in the next month.

Growing number of confirmed and deaths cases from the coronavirus worldwide, particularly in Italy, Iran and South Korea, has resulted concerns about the future of these countries and their deterioration. Also the European region is likely to face more casualties due to the delay in the virus reaching most of its regions and, of course, as the trend continues.

We conducted a simulation in both current and ideal situation for the next month to predict the death rate and examine the reason for the difference in Italy, Iran and South Korea individually. If we assume the cultural and political factors and age pyramids distribution are similar across regions, the differences are mainly due either to the heavier health-care burden owing to the larger population or to the medical facilities diversities.

Our results for Italy showed higher death number, but the rate would be more for Iran. South Korea is also expected to have a smaller increase in the number of confirmed cases and deaths compared to Iran and Italy by the next month.

Given the prevailing conditions around the world and the increasing number of casualties, it is essential that all countries, especially those with fewer days of involvement, shall do their best to avoid major losses and damages.

Present study aimed to evaluate association between serum levels of interleukin (IL)-1, IL-6, IL-8, IL-15 genes and interferon (IFN)-? and the risk of celiac disease (CD).

The role of serum cytokine levels in the pathophysiology of CD is still an open field to be explored.

This case-control study was performed on 110 patients with CD and 46 healthy controls referred to Taleghani Hospital, Tehran, Iran. Expression levels of IL-1, IL-6, IL-8, IL-15 and IFN-? were assessed by enzyme-linked immunosorbent assay (ELISA) kits.

The Bayesian intervention odds ratio (OR) and Highest Posterior Density (HPD) interval were 1.133 (95% credible interval 1.018- 1.269), 0.947 (95% credible interval 0.898 - 0.996) and 1.004 (95% credible interval 1.001- 1.009) for IL-1, IL-6, and IL-8 respectively.

Serum levels of IL-15 and IFN-? have no effect on the risk of CD and its symptoms, but given the OR and the HPD interval obtained for serum levels of IL-1, IL-6 and IL-8, one unit increase in IL-1 serum, the risk of CD 1.13 times more likely and one unit increase in IL-6 serum reduces risk of CD by 15% and about IL-8, the risk of CD increases 0.004 times with a unit increase in IL-8 serum.

The aim of this study was to compare the different phases of chronic Hepatitis B virus (HBV) infection with different values for normal ALT. 

For many years upper limit of 40 IU was considered normal for ALT for both sexes, but in recent years this value is challenged and some guidelines have lowered their limit. 

In this cross-sectional study, 2000 HBsAg positive patients who were referred to Taleghani Hospital, Tehran, Iran, from 2011 through 2018 were classified in four groups according to American Association of the study of the liver disease (AASLD), European Association of the study of the liver (EASL) /Asian-Pacific Association of the study of the liver (APASL) and American Collage of Gastroenterology (ACG) guidelines. Frequency of each group based on 3 different guidelines was compared.

In HBeAg positive patients (n=100), percentage of immune tolerance phase was 43% according to AASLD cutoff for normal ALT (35 IU for men, 25 IU for women) while it was 68% and 28% with regard to EASL/APASL and ACG (30 IU for men, 19 IU for women) cutoffs respectively. In HBeAg negative patients (n=1900), 66.68% were inactive carriers according to AASLD but the percentage changed to 82.89% and 52.42% considering EASL/APASL and ACG values, respectively.

By using ACG and to a lesser extend AASLD cutoff for ALT, many patients shift from immune tolerance and inactive carrier state into immune active phase. Therefore more patients are candidates for treatment or intensive workup to determine extent of liver injury.

To investigate routes of transmission, demographic characteristics and frequency of different phases of chronic hepatitis B (CHB) in 2000 Iranian patients.

Knowledge about the most frequent risk factors of CHB and its different phases is very important for optimal prevention and management policy making.

In this cross-sectional study, 2000 HBsAg positive patients who were referred to Taleghani Hospital from 2011 through 2018 were enrolled. ELISA method was employed to detect serological markers of CHB. Taking into account the HBV DNA and ALT levels and HBeAg status, patients were classified in four groups, according to AASLD 2017 guideline.

Male and female patients had nearly equal frequencies in our study and 82.5 % of them aged more than 20 years. A great number of our patients (95%) were HBeAg negative and the most frequent risk factors of HBV infection were positive periodontal and family history (40.3% and 24.9%, respectively). Majority of our patients were inactive carriers (63.35%) while minority of them were in immune tolerant group (2.15 %).

Immune tolerance phase group had lowest members in our study and most of them were above 20 years old.This can be due to the mass vaccination of neonates since 1993. Most of CHB patients were in inactive carrier group. Although it is recommended not to treat these patients, but performing periodic liver function tests and disease severity assesment is warranted, especially in patients above 40 years old.

Some errors may occur in the disease registry system. One of them is misclassification error in cancer registration. It occurs because some of the patients from deprived provinces travel to their adjacent provinces to receive better healthcare without mentioning their permanent residence. The aim of this study was to re-estimate the incidence of gastric cancer using the Bayesian correction for misclassification across Iranian provinces.

Data of gastric cancer incidence were adapted from the Iranian national cancer registration reports from 2004 to 2008. Bayesian analysis was performed to estimate the misclassification rate with a beta prior distribution for misclassification parameter. Parameters of beta distribution were selected according to the expected coverage of new cancer cases in each medical university of the country.

There was a remarkable misclassification with reference to the registration of cancer cases across the provinces of the country. The average estimated misclassification rate was between 15% and 68%, and higher rates were estimated for more deprived provinces.

Misclassification error reduces the accuracy of the registry data, in turn causing underestimation and overestimation in the assessment of the risk of cancer in different areas. In conclusion, correcting the regional misclassification in cancer registry data is essential for discerning high-risk regions and making plans for cancer control and prevention.

The aim of this study was to evaluate the prevalence of gastrointestinal disorders in non-cardiac chest pain (NCCP) Iranian patients. Gastro-esophageal reflux disease (GERD) is the most common cause of NCCP, which accounts for about one third of cases. This was a descriptive study on consecutive NCCP patients who referred to the gastroenterology clinic at the Taleghani Hospital, Tehran, Iran from 2015 to 2017. Medical history, physical examination and esophageal test including upper gastroenterology (UGI) endoscopy, esophageal manometry and 24 hour ambulatory esophageal pH monitoring were done for each participant. The study included 102 patients, of which 58.9% were women, and the mean age of patients was 41.5 ± 11.2 years. The most common symptoms associated with chest pain were regurgitation in 28.4%, dysphagia in 23.5% and heartburn in 19.6% patients. UGI endoscopy was abnormal in 29.4% cases, esophageal manometry was abnormal in 61.7% cases and ambulatory pH monitoring was abnormal in 37.2% patients. Using UGI endoscopy and combined 24-h pH monitoring determined the prevalence of GERD 44.1% , and based on manometry the most frequent causes of NCCP was ineffective esophageal motility (IEM) in 19.6% patients with NCCP. Detecting etiology of NCCP allows healthcare providers to assure patients of the benign nature of their condition and provide appropriate treatment. It can also help prevent excessive hospital and physician visits as well as the costly and potentially risky testing which often results.

The aim of this study was to identify the esophageal cancer (EC) high risk regions to evaluate changes of relative risks (RRs) for both genders by time in Iranian provinces. EC is one of the public health problems in Iran. In spite of this fact, there is not comprehensive study estimating RRs across the Iranian provinces. In this cross-sectional study the data for EC cases were extracted from Ministry of Health and Medical Education (MOHME) including 30 provinces from 2004 to 2010. For estimating the model parameters, we used Bayesian approach by regarding spatial correlations of adjacent provinces. The Northern half of Iran has high risk and other half has low risk. During the time, the range of RRs has decreased for both gender and also the dispersion of EC is decreasing for women but nearly is fixed for men. While RR has declined during the study, focusing on the Northern half of Iran as high risk regions is a considerable fact for policymakers.

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.

Cancers of the gastrointestinal (GI) track are a serious global health problem. The human GI tract is home to trillions of
microorganisms that known as gut microbiota and have established a symbiotic relationship with the host. The human intestinal
microbiota plays an important role in the development of the gut immune system, metabolism, nutrition absorption, production of
short-chain fatty acids and essential vitamins, resistance to pathogenic microorganisms, and modulates a normal immunological
response. Microbiota imbalance has been involved in many disorders including inflammatory bowel disease, obesity, asthma,
psychiatric illnesses, and cancers. Oral administration of probiotics seems to play a protective role against cancer development as a
kind of functional foods. Moreover, clinical application of probiotics has shown that some probiotic strains can reduce the incidence
of post-operative inflammation in cancer patients. In the present narrative review, we carried out update knowledge on probiotic
effects and underlying mechanism to GI cancers. Currently, it is accept that most commercial probiotic products are generally safe
and can used as a supplement for cancer prevention and treatment. Nevertheless, well-designed, randomized, double blind, placebocontrolled
human studies are required to gain the acceptance of the potential probiotics as an alternative therapy for cancer control..
Keywords: Probiotic, Prebiotics, Gastrointestinal cancer, Gut microbiota.
(Please cite as: Javanmard A, Ashtari S, Sabet B, Davoodi SH, Rostami-Nejad M, Akbari ME, et al. Probiotics and
their role in gastrointestinal cancers prevention and treatment; an overview. Gastroenterol Hepatol Bed Bench
2018;11(4):284-295).

Aim: The objective of this study was to determine the epidemiologic characteristics of patients with liver cirrhosis.
Liver cirrhosis is an end-stage condition of chronic liver disease. Liver disease is an important cause of morbidity and mortality worldwide.
In this cross-sectional study, demographic and epidemiologic characteristics of 203 patients with liver cirrhosis who were admitted in Taleghani Hospital over a period of two years were determined.
A total of 203 patients with liver cirrhosis consisted of 136 (67%) males and 67 (33%) females and the mean age was 53.7±15.2 years. No etiology were found in (59.6%) cirrhotic patients; therefore, they were labeled as cryptogenic cirrhosis, but according to clinical evidence and ultrasonography findings, (29.7%) of these patients were probable NAFLD. The other causes of liver cirrhosis in this study were HBV (20.2%), HCV (11.8%) and autoimmune hepatitis (AIH) (8.4%), respectively. Esophageal varices were present in (41.9%), ascites in (36.5%), variceal bleeding in (8.9%), encephalopathy in (7.4%) and spontaneous bacterial peritonitis (SBP) in (5.4%) of patients. When cirrhotic patients were grouped according to Child-Pugh classification, 26.1%, 54.7% and 19.2% were in classes A, B and C respectively. The mean MELD score was 16.16±7.7.
In this study we found that the leading etiology of cirrhosis is cryptogenic cirrhosis 59.6% (in all age groups) and followed by HBV. Noteworthy, according to the clinical and ultrasonography findings, 29.7% of patients who were labeled as cryptogenic cirrhosis were consistent with NAFLD.

Aim: The objective of this study was to evaluate the impact of the hepatitis B virus (HBV) vaccination program, 24 years after its implementation, by analyzing patients with hepatitis B surface antigen (HBsAg) infection based on gender and age group.
Since the launch of the first universal vaccination program against HBV in Iran in 1993, the epidemiological pattern of HBV prevalence may have changed in our country.
All data for this cross-sectional study were collected from medical records of HBsAg positive patients, who were referred to the Golhak and Armin private laboratories and also to the Gastrointestinal Department of Tehran’s Taleghani Hospital and Day Hospital in Iran over a period of 5 years (2011-2016). In total, 8,606 HBsAg positive subjects were assessed according to gender and age group.
The rates of HBsAg carriage were 0.8%, 7.8%, 49.3%, 27.9% and 14.1% among subjects under 14 years old, 15-24 years, 25-44 years, 45-59 years and those older than 60 years, respectively. According to the age subgroup analyses; the highest (26.2%) and lowest (0.6%) rate of HBsAg positivity was seen in the 31-40 age group and younger than 10 year old children, respectively.
Global vaccination against hepatitis B has significantly reduced carrier rates among children and teenagers under 20 years old in this country. Nevertheless, HBsAg carriers still remain highly prevalent among 25-35-year age group. Therefore, the decline is limited to the younger population born after 1993, and it remains high in the middle-aged individuals.

Pancreatic cancer is one of the deadliest cancers with short-term survival rates. Trends for pancreatic cancer incidence and mortality varied considerably in the world. To date, the causes of pancreatic cancer are not known sufficiently, although certain risk factors have been identified such as, smoking, obesity, life style, diabetes mellitus, alcohol, dietary factors and chronic pancreatitis. Since there are no current screening recommendations for pancreatic cancer, primary prevention is very important. Therefore, up-to-date statistics on pancreatic cancer occurrence and outcome are essential for the primary prevention of this disease. Due to the lack of information on epidemiology of pancreatic cancer in most Asian countries, and limited of statistics and registration system in this area, we conducted a systematic review study to evaluate the most recent data concerning epidemiology of pancreatic cancer in Asia-Pacific region. In this review we focused on collected recent data on incidence, mortality, survival and risk factors of pancreatic cancer in this region. In addition, we reviewed and used the data of GLOBOCAN 2012 in this paper to complete the information as a source of compiling pancreatic cancer incidence and mortality rate.

Upper gastrointestinal bleeding (UGIB) remains a common medical problem worldwide. It is an emergency medical condition, which may require hospital admission. UGIB also increases the risk of morbidity, and mortality and uses health care resources. The aim of this study was to determine the endoscopic findings and their frequencies in patients with UGIB with regard to age in Tehran’s Taleghani Hospital.
The medical records and endoscopy reports of 990 patients, who underwent endoscopy for UGIB in Tehran’s Taleghani Hospital over a period of 2 years from 2010 to 2012, were retrospectively analyzed.
A total of 990 patients consisted of 594 (60%) men and 396 (40%) women had endoscopy for UGIB. Mean (±SD) age of the patients was 54 (±17.2) years. The commonest (45.5%) cause of UGIB was peptic ulcer disease, which included; duodenal ulcer (26.4%), gastric ulcer (19.1%), followed by esophageal and gastric varices (19.5%). Malignant conditions (cancers) contributed to 14.7%, which included gastric cancer (7.2%), esophageal cancer (5.5%), and duodenal cancer (2%). Other less frequent causes of UGIB were esophageal ulcer (6.7%), erosive gastritis (6.3%), Mallory-Weiss syndrome (5.4%), and Dieulafoy’s lesion (1.2%). Normal endoscopic findings were recorded in 0.7% of the patients with UGIB.
Peptic ulcer diseases are the commonest cause of UGIB followed by esophageal and gastric varices.

Helicobacter pylori (H. pylori) is the cause of most cases of peptic ulcers and gastric cancers and cause some of the most important cause of stomach cancer and lymphoma. The objective of this study was to evaluate the time trend of Helicobacter pylori prevalence and presence of intestinal Metaplasia over the period of 7 years in gastritis Iranian patients.
In this cross-section study data related to H. pylori and intestinal Metaplasia (IM) among 14¡860 consecutive gastritis patients¡ who referred to the gastrointestinal department of Tehran’s Taleghani Hospital in Iran¡ was examined across the sex and age group.
The overall prevalence rate among patient with H. pylori infection was 83.5% (12406/14860) and 11¡394 (84.1%) of them were related to the gastritis. The prevalence rate of H. pylori among patient with gastritis significantly higher )p The results of this study showed that the prevalence of H. pylori infection in Iranian population has declined in recent years; nevertheless it seems to be highly prevalent in Iran. We also find a significant positive relationship between H. pylori infection and IM with gastritis. There is no association between sex and infection but in contrast with the most studies its prevalence decreased with age.

Today, the development of critical thinking is considered an expected outcome of graduate studies. This study was designed to determine the critical thinking skills of students of Shahid Beheshti and Tehran University of Medical Sciences.
In a descriptive study, evaluated critical thinking skills of 60 medical students of Shahid Beheshti University of Medical Sciences and 60 medical students of Tehran University of Medical Sciences, after completing internship. Data was gathered using California standard test of critical thinking skills (form B) which was run officially. The data was analyzed by SPSS software using T-test, ANOVA and Pearson correlation coefficient.
The mean and standard deviation of critical thinking scores for medical students of Shahid Beheshti and Tehran University were 13.03 ± 5.08 and 12.63 ±3.27, respectively (p>0.05). There was no significant relationship between the ranks in University entrance exam and total score of critical thinking. Among domains of critical thinking, there was just significant relationship between the domains of deductive reasoning and diploma grade, with a relatively low correlation in medical students.
The mean scores of critical thinking skill in this research was similar to scores of some survey in our country, but were lower than other countries. This means that the educational program cannot promote critical thinking skills in University and revising the curriculum seems necessary.

The objective of this study was to evaluate the time trend of Helicobacter pylori (H. pylori) prevalence and presence of intestinal Metaplasia over the period of seven years among gastritis Iranian patients. H. pylori is the major causal factor in chronic gastritis. Its acquisition leads to a chronic, usually lifelong, inflammation of the gastric mucosa, which may gradually progress to atrophy with intestinal metaplasia in a significant proportion of infected individuals. Patients and H. pylori and intestinal Metaplasia data among 14,860 consecutive gastritis patients, who referred to the gastrointestinal department of Tehran’s Taleghani Hospital in Iran from 2008 to 2014, was examined by sex and age group. The patients were divided into six age groups (16-30, 30-40, 40-50, 50-60 and >70). The chi-square test was used to compare the qualitative variables. The overall prevalence rate among patient with H. pylori infection was 83.5% 12406/14860) and 11,394 (84.1%) of them were related to the gastritis. The prevalence rate of H. pylori among patient with severe gastritis was significantly higher (P<0.05) compared to mild and moderate gastritis. In addition, the prevalence of H. pylori decreased with age and has been declined in recent years. The presence of intestinal metaplasia increased with age (P<0.05). The results of this study showed that the prevalence of H. pylori infection in Iranian population has been declined in recent years; nevertheless it seems to be highly prevalent in Iran. We also find a significant positive relationship between H. pylori infection and gastritis. There is no association between sex and infection, however in contrast with the most studies its prevalence decreased with age.

The objective of this study was to evaluate the real outcomes of chronic hepatitis C patients, who treated with interferon plus ribavirin (INF-RBV) and peg-interferon plus ribavirin (PEG-RBV). Despite the PEG-RBV has become a standard treatment of hepatitis C virus (HCV) around the world; and in Iran too, but in developing countries like as Iran, INF-RBV is still used among some patients for treating HCV, due to the high costs of treatment with PEG-RBV.Patients and The present cross-sectional study was conducted on 77 naïve patients referred to a private gastroenterology clinic between years 2007 through 2009 in Tehran. Patients had participated in this study taking two types of combination therapies, based on standard protocol of the Iranian Ministry of Health. At the end of the treatment, sustain virological response (SVR) rate was evaluated. The outcomes showed in INF-RBV treatment; 11.6%, 16.3% and 34.9% patients were suffered from relapse, lost follow-up their treatment and non-responder, respectively, and finally 37.2% of the patients reached SVR. In PEG-RBV treatment outcomes were as follows; 2.9%, 14.7% and 14.7% patients were non-responder, lost follow-up their treatment and suffered from a relapse, respectively, and 67.6% of the patients reached SVR. The multivariate-adjusted odds ratios of outcomes showed that treated with PEG-RIB and also genotype 3a than the others genotypes in this treated had more chance to achieved SVR. The findings of the present study showed that the rate of SVR in patients who treated with PEG-RBV significantly was higher than patients who treated with INF-RBV. Also in PEG-RBV the chance of achieving SVR is higher among the patients with genotype 3a than among those with other genotypes.