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Celiac is a hereditary disease presented with chronic inflammation of small intestine. Several studies supposed a relationship between Celiac disease and Inflammatory Bowel Disease (IBD). Tissue trans-glutaminase antibody is one of the best serological markers in Celiac disease. This study was designed to evaluate the association of Celiac and IBD using tissue trans-glutaminase antibody.

In this descriptive study 127 confirmed IBD patients who were referred by gastroentrologists 2005-08 enrolled into the study. A questionnaire was completed and tissue trans-glutaminase antibody was evaluated with ELISA method with a Cut-off=12 U/ml.

Among 127 referred patients, serum samples of 102 patients were collected. Mean±SD of age was 36.17±15.2 years and 48% were males. Ulcerative colitis, Crohn’s disease and other colitis were observed in 76 (74.5%), 7 (6.9%) and 19 (18.6%) of patients, respectively. Tissue trans-glutaminase antibody was positive (19.8 U/L) in one 46-years-old male patient with ulcerative colitis.

Tissue trans-glutaminase antibody titer was not significantly different between IBD patients and controls, thus it seems not appropriate to suggest as one of the routine tests in IBD patients.

Helicobacter pylori (H.pylori) with positive Cytotoxin associated Gene A (CagA) have higher potential for pathogenesis. Cytotoxin associated Gene A (CagA) accelerate the pathogenecity of bacteria due to cytotoxin production stimulation. The aim of this study was to determine the prevalence of the anti-CagA antibody among H. pylori infected persons in Golestan province-North of Iran.

This descriptive study was carried out on 676 H. pylori positive subjects in Golestan province, northern Iran during 2008. Anti CagA antibody were determined in H.pylori positive subjects. Data analyzed by SPSS-16 software and chi-square test.

Prevalence of anti CagA in Helicobacter pylori infected cases was 57.7% (390 cases: 179 males and 211 females) (95% CI: 53.9-61.4). According to age the highest and lowest cases of anti CagA antibody were seen in, 15-24 (63.4%) and under 5 years old (26.3%). The level of anti CagA antibody in Sistanian ethnicity group (67.2%) was more than other ethnic group. Anti CagA antibody in Rural area was more than urban regions. Sero prevalence of anti CagA antibody was highest in Minudasht twon (78%), located in East of province in comparison with Bandar Gaz (44%) in west of province.

This study showed the prevalence of CagA positive Helicobacter pylori strains in this region is similar to other regions of Iran, Asia and Europe and higher than African population.

Golestan province, located in north of Iran has been known as a high risk area for esophageal cancer. The relationship between esophageal cancer and Selenium (Se) has been assessed in previous studies. This study was conducted to assess the relationship between Soil selenium levels and development of esophageal cancer in Golestan province of Iran. In this ecologic study, Golestan province in northern Iran was divided into 135 blocks based on geographical altitude and longitude on the map. One Soil sample was collected from the center of each block. Selenium level in Soil samples was determined by flame atomic absorption spectrometry. Statistical analysis was performed by Pearson correlation andT-Student tests. The mean±SD of Soil Selenium level in Golestan province was 3.7±1.61 mg/kg. There was a positive correlation between Soil level of Selenium and esophageal cancer rates in this area (P=0.03), (Pearson correlation coefficient=0.19). The Soil Selenium level for high risk and low risk area for esophageal cancer were (4.13 mg/kg) and (3.39 mg/kg) respectively (P=0.01). This study showed that there is high Soil Selenium level in Golestan province in north of Iran. Also it is found to be a significant positive relationship between Soil Selenium level and esophageal cancer rate in this area.

Constipation is one of the most prevalent causes of abdominal pain in pediatrics, with no underlying pathology. It is dened as functional constipation in 95% of cases evaluated. This study was designed to compare the therapeutic effect of polyethylene glycol (PEG) and lactulose in treating chronic functional constipation in children. In this randomized, double blind clinical trial, patients were classied into two groups: lactulose (n=65) and PEG (n=63). During an eight week period, patients were either treated with an average of 3.5 g/day (PEG) or 7 g/day (lactulose). Successful treatment was dened as defecation (painless and soft, or normal) three times or more per week. Analysis was performed by calculation and comparison of the success rate in both groups, followed by reporting the relative risk and number needed to treat (NNT). Response to treatment in the second week was signicantly higher in the PEG group when compared with the lactulose group (P<0.0001). There was a signicant difference in the response rate between both groups in the 4th and 6th weeks (P<0.0001). In the 8th week all patients in the PEG group were treated successfully, whereas there were ve (7.7%) cases who did not respond in the lactulose group. These results have shown that a four week treatment period with PEG (3 g/day) lead to a response rate of 87% in children, in comparison with lactulose (7 g/day) which needed at least eight weeks of treatment.

Hepatitis C virus (HCV) is one of the main causative factors of liver disease which can lead to chronic hepatitis C infection in 80% of cases. HCV genotypes have a special worldwide geographic distribution. The goal of the present study was to detect HCV genotypes in patients with anti-HCV positive titers in Golestan Province, Iran. In this cross-sectional study, 95 positive HCV samples as detected by RIBA were evaluated. Viral RNA was extracted with a Roche extraction kit and the Fermentase cDNA kit Random hexamer primers was used for viral genomic cDNA synthesis. PCR was performed on all samples by a general pair of primers. Second-step PCR was done with specic primers, and the results were obtained following electrophoresis in 1.5% agarose gel and ethidium bromide staining in documentation gel. General primer PCR revealed 91 positive samples. Assessment of 77 samples determined that the following genotypes were present: 1 and 3 [1a (19.5%), 1b (19.5%), 3a (15.6%), 3b (24.7%)], 2a (2.6%), 4 (7.8%). The remaining samples were a mixture of genotypes 1 and 3 (6.5%). The ingmost prevalent genotypes found were types 1 and 3 in Golestan Province. This distribution pattern differed from other areas in Iran, however genotype 4 was in accordance with other studies. Genotype 2 was only reported in this study and a study in Tehran. Thus, additional, larger studies of HCV genotypes should be performed for further analysis of genotypic distribution patterns.

Colorectal cancer (CRC) is the third common malignancy all over the world. Modern life styles affecting nutritional habits have been providing a potential impact on CRC. This study aims to assess the nutritional characteristics in CRC patients of Golestan province, Northeast of Iran. All incident CRC cases (N=47) in northeast of Iran (2004-2005) and a matched number of healthy persons were selected as cases and controls respectively. The subjects filled the Questionnaires containing socio-demographic and nutritional characteristics (FFQ). Data analysis showed that Total Energy Expenditure (TEE) higher than 1837.5 Kcal/ day (first quartile of TEE) was significantly related to CRC risk (OR= 3.8; 95% CI: 1.2- 11.3); no other relationship was reported. Findings suggested that higher levels of total energy expenditure may increase the risk of CRC about 4-fold. We also found that there are relationships between CRC and high fat diets or cooking methods. Nutritional interventions should be considered as an important part in colorectal cancer prevention programs.

Esophageal and gastric cancers are among prevalent cancers in the world and it is believed that nitrate and nitrite contaminations of drinking water are important factors in increasing the risk of these cancers. This study was designed to determine the correlations between these factors and upper gastrointestinal cancers. In this ecologic study, mean concentrations of nitrite and nitrate of drinking waters in Golestan urban areas were obtained during 2004-2005. All patients with esophageal and gastric cancers during this period who resided in urban areas were recruited to estimate the incidence rate and Age Standardized Rate (ASR) of these cancers. The province was divided into three regions of low, intermediate and high incidence based on 33% and 66% quartiles of both cancers. Spearman Correlation Coefficient and regression line were used to analyze data. Based on the results, nitrite and nitrate concentration of drinking waters in all three regions were in the standard range. There was a significant positive correlation between nitrate increase and esophageal cancer incidence (R=0.624, P=0.013). There was no correlation between levels of nitrite in drinking water and the risk of esophageal and stomach cancer. It seems that there is an increased risk of esophageal cancer correlated with higher nitrate levels in drinking water. But nitrite level of drinking water has no impact on the esophageal and gastric cancer, from the ecological point of view. Further studies on food resources and drinking water of urban and rural areas are recommended to determine the effects of these factors on the upper gastrointestinal cancers.

Silis (SiO2) is an oxide of silicon that its existence in food products is known as a contamination, classified as a human carcinogen. Some suggest it as an etiology of esophageal cancer. Golestan province has a high incidence and prevalence of esophageal cancer and is on the world belt of this disease. This study was designed to determine the concentration of silis in flour produced in Golestan province, north of Iran

This descriptive study was done in spring 2005. Census method was used to gather flour samples from flour manufactures. Samples were transported to laboratory. Base-melting method in nickel cruise was used in 550°c and the extract was reduced with acid. The complex was evaluated with spectrophotometer. Data entered into SPSS-12, and the differences between silis concentration in various regions were compared with non-parametric Kruskul Walis test.

Median silis concentration was 0.0030 grams, mean concentration was 0.008760 with 0.004265 standard deviation, minimum was 0.003 and maximum was. 018 grams in each 100 grams flour produced in province's factories. Mean silis concentrations were 0.012, 0.01 and 0.003 in Gorgan and the central part of the province, western and eastern part, respectively. The differences were not significant.

Although in earlier reports it was shown that silis level in the flour is high, but the findings of this study indicated that the above element is in normal range.

Celiac is a digestive disease. In this disease, small bowel is damaged and the absorption of nutrients are adversely affected. These patients do not absorb gluten. There is probably a correlation between esophagus cancer and celiac. The aim of this research was to study the seroepidemiology celiac disease in this area with high prevalency of esophagus cancer. This research was a descriptive study, which was performed on blood donors in Golestan province during the year 2005-06. blood samples were taken from 2547 subjects. tTG-IgA determination were carried out using ElISA technique, the titre<4U/ml, 4-10U/ml and >10Um/l were considered to be as negative, weakly positive and positive respectively. EMA antibody assessment were carried out on all sample population with more than 4U/ml, using IFA method. 28 subjects (1.1%) had tTG-Ab positive test, out of this number 18 subjects (0.7%) were weakly positive and 10 persons (0.4%) were considered to be positive. EMA test were positive in 70% of subjects with tTG positive results. There was not any significant meaning between positive tTG test and ethnicity from weakly positive tTG, 15 subjects (83.3%) and 3 subjects (16.7%) were male and female respectively. The entire tTG positive were male subjects. In regard to high prevalency of esophagus cancer in the region and the relation of celiac disease with above cancer, it seems necessary to look more seriously at the celiac disease.

15-20% of TB cases are extra pulmonary tuberculosis (EPTB). Abdominal TB is the most common type of extra intestinal TB. Signs and symptoms of abdominal TB are unspecific. In this study, we identified all GITB cases in Golestan province (Iran) between 1999 and 2003 and determined their demographic characteristics. We reviewed all new cases of TB reported during 1999-2003 from TB centers of Golestan province. Then EPTB and especially GI and abdominal TB cases were selected. We completed a questionnaire containing demographic information for each of them. The information entered the computer in SPSS-13 was used to analyze the data. 30 patients had been treated for GI and abdominal TB, most of them were females (22 cases, 73.3%). Mean age of the patients was 32.03±13.73 with higher incidence in age before 40 years old (70%). Most common complaints of the patients were fatigue, weight loss, anorexia, fever and abdominal pain, respectively. In 66.7% of patients the diagnosis was pathologically documented. Our data suggest that 38.46% of all TB cases in Golestan province were EPTB, and this scale is higher than other studies. In this study, 5.27% of EPTB cases were GI and abdominal TB, higher than the world reports (3%).