Govaresh
Volume:25 Issue: 1, 2020

related deaths worldwide. Aberrant expression of long non-coding RNAs (lncRNAs) plays a crucial role in the development of GC. These molecules take part in various biological processes such as apoptosis, invasion, cell death markers, reprogramming of pluripotent stem cells, and genomic imprinting, which show that lncRNAs play an essential role in eukaryotic gene expression. LncRNAs interact with epigenetic factors including DNA methylases, histone modifiers, miRNAs, and chromatin remodeling complex, which lead to altered gene expression and cancer progression. Because the symptoms of GC usually develop in advanced stages, it is important to identify factors that are of clinical value for early diagnosis and prognosis of the disease. Therefore, in this review article, lncRNAs whose expression levels are increased in GC tissue and by interacting with epigenetic factors may be involved in the development of GC are discussed.

Considering the potential role of zinc deficiency in the quality of life of patients with cirrhosis and complications of the disease, in the present study we aimed to assess the prevalence of zinc deficiency and its relation to the stage of the disease and complications in the affected patients.

In this cross-sectional study, 76 patients with cirrhosis from Qom, Iran, were included during a 1-year period. Data including the level of liver stiffness, severity of the liver disease based on Child-Pugh, MELD(Model for End-Stage Liver Disease), APRI(Aspartate aminotransferase to Platelet Ratio Index), AAR(Aspartate aminotransferase to alanine aminotransferase ratio), FIB-4 (Fibrosis-4), and King scoring systems, and complications including hepatic encephalopathy, were collected by a checklist and were analyzed by using SPSS software version 21. Independent samples t test and Pearson correlation coefficient were used appropriately and p<0.05 was considered significant.

Of the 76 patients, 50 were men and 26 were women with a mean age of 49.46 ± 14.53 years and mean liver stiffness of 28.29±16.11 kPa in fibroscan. The mean serum level of zinc was 78.4±18.1 µg/dL, which was significantly higher in patients with child A than patients with child B and C classes (p =0.007). This finding was significant in other scoring systems including AAR (p =0.020), KING (p =0.000), MELD (p =0.004), and FIB-4 (p =0.006). No significant relation was detected between serum zinc level and hepatic encephalopathy, bleeding from esophageal varices, and spontaneous bacterial peritonitis.

Severity of zinc deficiency is related to the severity of liver cirrhosis but is not related to complications.

Primary liver cancer is one of the most malignant and deadly cancers, which reduces the quality of life. Health-related quality of life (HRQOL) is an important criterion for evaluating the health care, controlling diseases, outcomes, benefits, and disadvantages of treatments, quality of medical treatment and nursing care, and screening individuals at risk for physical and psychological problems. The aim of this study was to investigate the predictive factors of HRQOL in patients with liver cancer. The results of this study can improve the quality of life of the patients and the level of health care.

This study was performed on 272 patients referred to Imam Khomeini Hospital in Tehran (2018-2019), by using convenience sampling method. For assessing patients, we used Function Assessment Cancer Therapy, Hospital Anxiety and Depression Scale, Fatigue Severity Scale, Edmonton Symptoms Assessment Scale, and Characteristics Demographic. Data were collected in two stages (before and one month after treatment). In order to validate these tools, previous studies were cited and their reliability was assessed by test-retest. Data were analyzed by using SPSS software version 21. Descriptive statistics, correlation test, paired t test, and linear regression were used as appropriated.

The mean HRQOL score in patients with liver cancer was 58.11 (±17.31). Effective factors in HRQOL was the type of treatment, physical and psychological consequences, and some demographic characteristics.

The present study showed that many factors can predict HRQOL in patient with liver cancer. Also, awareness of these factors provides the basis for developing effective care plans to promote HRQOL and increase life expectancy in affected patients. These factors are very important because based on them HRQOL of patient with liver cancer can be estimated with 59/8% accuracy.

This guideline was developed to assure the highest level of protection against COVID-19 for both patients and health care providers in endoscopy departments while providing high quality and timely gastroenterology care during the current COVID-19 pandemic. We electronically searched the databases of PubMed, Google Scholar, and MedRxiv up to April 10, 2020. Then, a questionnaire was designed based on available documents and international recommendations. Three Delphi rounds were conducted via online forms. Eighteen statements were developed on risk stratification of patients and procedures and recommendations for performing necessary procedures while safeguarding patients, nurses, physicians and other service providers with appropriate use of personal protection equipment, sanitizing of environments and redesigning the endoscopy suits. Considering the dynamic of COVID-19 pandemic in the world and Iran, this guideline will be updated online as needed.

From mid-December of 2019 a newly diagnosed Corona virus with a highly human to human transmission rate was discovered in china which rapidly involved many countries and became pandemic. Although most infected cases are mild but this virus can cause severe lung injury which lead to severe mortality and morbidity. The mortality rate of this virus is high in immunosuppressed patient or with previous medical disorder. Many Inflammatory bowel disease patient are using immunosuppressive or immunomodulating agents which has raised the concern of severe disease in these patients.

Colonoscope is a diagnostic tool of choice to examine the lower part of the gastrointestinal tract, which includes the colon and the beginning of the ileum. Colonoscopes are used for diagnostic and therapeutic purposes. Colonoscopy is also accompanied by abdominal pain. Accordingly, the purpose of this study was to evaluate the analgesic effect of Ziziphora tenuior essential oil and lubricant gel in patients undergoing colonoscopy using a randomized double-blind clinical trial.

In this clinical trial, 100 patients who were candidates for colonoscopy were selected through convenience sampling and were randomly divided into two groups. The control group (n=50) used lubricant gel (placebo) and the treatment group (n=50) used the gel containing Ziziphora tenuior essential oil (the compounds of the Ziziphora tenuior essential oil were identified by injection of the sample into a gas chromatography-mass spectrometry (GC-MS) device). The patients' satisfaction and pain were assessed using a standard questionnaire and the collected data were analyzed by descriptive and inferential tests (t test).

The GC analysis revealed 42 different compounds in the essential oil. Six of the identified compounds comprised more than 60% of the compounds presented in the oil including pulegone (26.65%), alpha-terpinyl acetate (9.53%), geraniol (7.11%), menthone (5.74%), thymol (5.51%), and alpha-terpineol (3.24%) in decreasing order. The mean value of pain and the duration of colonoscopy in the control group (6.56+1.89) were significantly different from the corresponding value for the case group (4.25+1.2) (p<0.0001).

The use of the mix of Ziziphora tenuior essential oil and lubricant gel as a safe and inexpensive analgesic drug during colonoscopy is recommended.

Portal hypertension is a major complication of cirrhosis, leading to the development of gastroesophageal varices (GEVs). All patients with cirrhosis should be screened by endoscopy for esophageal varices (EVs) at the time of diagnosis. In recent years, several non-invasive methods for detecting EV have been evaluated. Our aim was to combine the imaging data, FibroScan, fibrosis markers, and blood parameters to propose a new score for the prediction of EV.

180 HCV (Hepatitis C virus) positive patients with cirrhosis were enrolled in this cross-sectional study. APRI score, AAR score, FIB4 score, King score, and (PC\SD) (Platelet count/Spleen Diameter) were calculated. Abdominal ultrasonography and FibroScan were done for all patients. Data were collected to develop a scoring system as a non-invasive index combined from eight parameters; platelet count, serum albumin, spleen diameter, portal vein diameter, PC/SD ratio, FIB4, APRI, and FibroScan.

ROC curve analysis of different variables revealed that serum albumin had the highest AUC (0.83, cut off point 2.55) followed by PC/SD ratio (0.82, cut off 681), then came platelet count (0.77, cut off 91.0×103), spleen diameter (0.70, cut off 15.35), APRI (0.73, cut off 1.31), and both FIB4 (0.70, cut off 4.33) and PV diameter (0.67 cut off 13.1) and lastly FibroScan (0.69, cut off 44.6). Using ROC curve analysis to study the discrimination ability of this combination, the AUC was 0.89 (95% CI 0.81-0.98, p <0.001), which gives the score a good discrimination ability at the cut off point of 4.5 (or 56.25 %), with 85% sensitivity and 95% specificity.

Our novel score could be a reliable tool to predict EV instead of a single parameter.

Scientific productions are among the most important criteria in the development of countries. Gastric cancer is the most common gastrointestinal cancer in Iran. In this study, we aimed to analyze the publications about gastric cancer in Iran from 1983 to 2017 using the Web of Science (WoS) database.

In this scientometric study, at first, all terms related to «Gastric Cancer» were extracted using the Medical Subject Headings. Then, WoS database was searched using these terms. The time frame was until the end of 2017. Then, the results were refined to the countries. The data analyses were performed using Excel software.

Among 38554 records indexed in the WoS, 372 (0.965%) were published in Iran, ranking the country 16th in the world. Compound annual growth rate of Iranian scientific productions was 16.76%. Tehran University of Medical Sciences and Shahid Beheshti University of Medical Sciences were identified as the most productive centers with a contribution rate of 31.45% and 15.05%, respectively. The most international collaborations of Iranian researchers were with the United States (5.37%), Sweden (2.68%), and Germany (2.41%). Most articles were published in the Asian Pacific Journal of Cancer Prevention (9.67%). Most scientific productions were related to oncology (36.29%), gastroenterology and hepatology (21.23%), and general internal medicine (11.02%). Most scientific productions were published in the form of an “Article” (63.71%). All of the Iranian scientific productions about gastric cancer were in the English language.

Iranian scientific productions in the field of gastric cancer have been increased from 1983 to 2017, although Iran was ranked 16th in the world.

Leiomyosarcoma of vascular origin is a rare malignant tumor. Inferior vena cava (IVC) is the most common site of vascular leiomyosarcomas. Leiomyosarcoma of IVC is predominantly seen in middle-aged women presenting with non-specific symptoms and clinical findings. Herein, we report a case of leiomyosarcoma of IVC in a 44-year-old woman presented with progressive abdominal discomfort and postprandial vomiting. Laboratory results were in favor of acute liver injury. Imagings revealed a retroperitoneal mass and enhancement in almost the total course of inferior vena cava with extension into both renal veins and right atrium. Histopathological examination showed a malignant spindle cell tumor and immunohistochemistry confirmed smooth muscle origin of the tumor.

Our patient was a 26-year-old man who was admitted to the hospital with complaints of abdominal pain. The patient had a medical history of propranolol and corticosteroid use. The diagnostic tests were done with suspicion of appendicitis. Under general anesthesia with McBurney's incision appendectomy was performed. We found perforated appendicitis and localized peritonitis. The perforated appendix was excised after ligation of its base. On the day after surgery, the patient's body temperature increased to 39 °C accompanied by mild tachycardia and hypertension (BP=170/90 mmHg) but after 4 days, the patient was discharged with a good general condition. 20 days after discharge, the patient returned to the hospital with weakness and rectorrhagia. The onset of rectorrhagia was 3-4 days before the admission. The patient's vital sign was stable. He reported dizziness and cold sweating. He fainted one time and had jaundice with pale conjunctiva and also complained from epigastric tenderness. The patient's laboratory finding showed severe anemia (Hb: 5.5 mg/dL, RBC: 2.16 106/µl) with high WBC count and coagulopathy. Ultrasonic abdominopelvic examination and colonoscopy did not show any specific findings. Ultrasonic evaluation could not detect any fluid in peritoneal or pelvic space but