Publications by authors named "Iradj Maleki"

38 Publications

A Supporting System for Management of Patients with Inflammatory Bowel Disease during COVID-19 Outbreak: Iranian Experience-Study Protocol.

Middle East J Dig Dis 2020 Oct;12(4):238-245

Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

BACKGROUND The COVID-19 pandemic has affected the health care infrastructure dramatically, with abundant resources necessarily being redirected to COVID-19 patients and their care. Also, patients with chronic diseases like inflammatory bowel disease (IBD) may be affected in several ways during this pandemic. METHODS We used the Iranian registry of Crohn's and colitis (IRCC) infrastructure. We called and sent messages to follow-up and support the care of all registered patients. Besides, we prepared and distributed educational materials for these patients and physicians to reduce the risk of COVID-19 infection. We risk-stratified them and prepared outpatient clinics and hospitalization guidance for IBD patients. RESULTS Of 13165 Iranian patients with IBD, 51 have been diagnosed as having COVID-19. IBD patients made 1920 hotline calls. Among the patients with suspicious presentations, 14 COVID-19 infections were diagnosed. Additionally, 1782 patients with IBD from five provinces actively phone-called among whom 28 definite cases were diagnosed. CONCLUSION IBD patients' follow-up could help in diagnosing the affected IBD patients with COVID-19. Additionally, the performance of protective actions and preparing the patients and physicians for decisive proceedings are the principles of protection of IBD patients.
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http://dx.doi.org/10.34172/mejdd.2020.188DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7859612PMC
October 2020

Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in COVID-19 Patients and Control Group and Relationship with Disease Prognosis.

Caspian J Intern Med 2020 ;11(Suppl 1):531-535

Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.

Background: The present study aimed to compare the complete blood count (CBC) indices between COVID-19 patients and the control group, and assess the relationship of these indices with COVID-19 prognosis.

Methods: COVID-19 patients (confirmed by PCR or CT-Scan) who visited Imam Hospital in Sari were selected in this case-control study. The control group was selected from Tabari cohort population matched with the case group in terms of gender and age. CBC, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and outcome of the disease (in the case group) were assessed in this study.

Results: The number of participants were 527 in both case and control groups, of which, 232 (44%) were females in each arms. Platelet count, lymphocyte count, and hemoglobin concentration were also higher in the control group (P=0.000). NLR and PLR were significantly higher in COVID-19 patients compared to the control group (P=0.000). NLR had a significant relationship with the severity of the disease. NLR was two times higher in the patients who died of COVID-19 than those who recovered (P=0.000). ROC curve analysis for diagnostic values of NLR and PLR showed that the areas under the ROC curves for NLR and PLR were 0.703 (95% CI: 0.64-0.76) and 0.535 (95% CI: 0.46-06), respectively.

Conclusion: NLR can be used as a prognostic marker for COVID-19 given the significant difference of NLR between those who died and recovered from COVID-19.
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http://dx.doi.org/10.22088/cjim.11.0.531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7780872PMC
January 2020

Positive association between severity of COVID-19 infection and liver damage: a systematic review and meta-analysis.

Gastroenterol Hepatol Bed Bench 2020 ;13(4):292-304

Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Aim: The current study aimed to report a pooled analysis of the association of the circulating levels of liver enzymes and total bilirubin with severe and non-severe COVID-19.

Background: The ongoing coronavirus outbreak is an important threat to health worldwide. Epidemiological data representing greater risk of liver failure in patients infected with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2).

Methods: Electronic databases were comprehensively searched using Medline, ISI Web of Science, EMBASE, and the Cochrane Library up to July 2020. Outcomes from each relevant study were pooled using a random-effects model. Heterogeneity was analyzed by Q test and I statistics. Sensitivity analysis was also evaluated.

Results: A total of 24 studies were included (4,246 patients) in this study. We found a significant association of COVID-19 severity with increased levels of ALT [SMD: 1.40 U/L; 95% CI (0.93, 1.88); < 0.05, I = 96.5%, 0.000 ], AST [SMD: 2.11 U/L; 95% CI (1.40, 2.83); < 0.05, I = 97.9%, 0.000], LDH [SMD: 3.88 U/L; 95% CI (2.70, 5); < 0.05, I = 98.7%, 0.000] and TBil [SMD: 1.08 mol/L; 95% CI (0.44, 1.72); = 0.001, I = 97.7, 0.000], whereas, ALP values [SMD: 0.31; 95% CI (-1.57, 2.20); = 0.74] was not significant between severe and non-severe COVID-19 patients. Moreover, elevated liver enzymes were found more in males [OR: 1.52, (95% CI 1.26, 1.83), < 0.05] with severe COVID-19 infection than in females.

Conclusion: The alterations of liver function indexes caused by SARS-CoV-2 infection suggested a potential prognosis biomarker for screening of severe patients at early stages of the disease.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7682972PMC
January 2020

INSULIN AND INSULIN RECEPTOR GENE POLYMORPHISMS AND SUSCEPTIBILITY TO NONALCOHOLIC FATTY LIVER DISEASE.

Arq Gastroenterol 2020 Apr-Jun;57(2):203-208

Shahid Beheshti University of Medical Sciences, Research Institute for Gastroenterology and Liver Diseases, Gastroenterology and Liver Diseases Research Center, Tehran, Iran.

Background: Nonalcoholic fatty liver disease (NAFLD) is an increasing global health concern defined by excessive hepatic fat content in the absence of excessive alcohol consumption.

Objective: Given the pivotal role of insulin resistance in NAFLD, we hypothesized that insulin (INS) and insulin receptor (INSR) gene polymorphisms may be associated with NAFLD risk.

Methods: A total of 312 subjects, including 153 cases with biopsy-proven NAFLD and 159 controls were enrolled in this case-control study. Four polymorphisms in INS (rs3842752, rs689) and INSR (rs1052371, rs1799817) genes were genotyped using PCR-RFLP method.

Results: The cases with NAFLD were older and had higher BMI, systolic blood pressure, diastolic blood pressure, as well as higher serum levels of aspartate aminotransferase, alanine aminotransferase, and gamma glutamyl transferase than the controls (P<0.001). The "TT" genotype of INSR rs1799817 compared with "CC" genotype occurred more frequently in the controls than the cases with NAFLD and the difference remained significant after adjustment for confounding factors (P=0.018; OR=0.10, 95%CI=0.02-0.76). However, no significant difference was found for INS rs3842752, INS rs689, and INSR rs1052371 gene polymorphisms between the cases with NAFLD and the controls either before or after adjustment for the confounders.

Conclusion: These findings corroborate the hypothesis that genetic polymorphisms related to insulin resistance play a role in NAFLD susceptibility. Specifically, the INSR rs1799817 "TT" genotype had a protective effect for NAFLD. However, our results remain to be validated in other studies.
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http://dx.doi.org/10.1590/S0004-2803.202000000-39DOI Listing
November 2020

Evaluation of demographic, pathologic, and clinical characteristics and overall survival of patients with colon cancer in Northern Iran (Mazandaran Province) during 2012-2019.

Gastroenterol Hepatol Bed Bench 2020 ;13(3):209-218

Associate professor ,Gut and Liver Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

Aim: The present study aimed at evaluating the demographic, pathological and clinical characteristics of patients with colon cancer and also the survival rate and its related factors.

Background: Cancer is the most important barrier to increasing life expectancy in the world. Furthermore, colon cancer is the fourth leading cause of cancer in Iran.

Methods: In this descriptive-analytical study, 219 patients with colon cancer were investigated. Data were analyzed through descriptive and univariate methods using R software. Kaplan-Meier survival analysis and log-rank test were used to evaluate the survival rate of the patients.

Results: In the present study, 25% of patients were below 50 years of age. A family history of cancer was positive in 30% of the patients. According to the clinical symptoms of the patients, rectorrhagia was higher in patients with sigmoid tumor site, abdominal pain was higher in patients with transverse and ascending tumor sites, and anemia was higher in patients with ascending and caecum tumor sites (p< 0.05). The mean life expectancy of the patients was 53.71±2.07 months. Three-year, five-year and seven-year survival rates were 70, 49, and 37 %, respectively.

Conclusion: Half of the patients were diagnosed at advanced stage and the mean survival time at advanced stage was approximately four years. One-third of the patients had local recurrence. It is recommended that patients refer to specialists at specified time intervals for timely diagnosis of the disease and prevention of its recurrence. Providing effective training for people in order for them to acquire more knowledge, and performing screening tests will lead to early diagnosis and lower mortality.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7417496PMC
January 2020

Helicobacter pylori eradication in the management of glaucoma.

Caspian J Intern Med 2020 ;11(2):143-149

Pharmaceutical Research Center, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.

Background: To investigate the possibility that the eradication of infection is associated with a reduction in the risk of glaucoma.

Methods: Sixty-five successive patients with elevated intraocular pressure (IOP) or glaucoma were included in the study. Serum samples from all subjects were analyzed for the presence of - antibodies using ELISA. Forty patients with positive serologic test were included. Half of the patients enrolled into intervention group and the other half registered as control. Intervention arm was referred to the Gastroenterology Clinic for eradication of and evaluated for the effect of regimen eradication on IOP and glaucoma over 2 months of follow-up. The age-matched controls did not receive treatment. Urea breath test was applied to confirm eradication.

Results: There was a significant (p=0.005) reduction in IOP after complete eradication in the intervention group. This value was not significant in control patients (p=0.08). The mean IOP before treatment of glaucoma in the control group was 23.60±2.37 mmHg and after treatment with anti-glaucoma drugs was 14.25±1.48 mmHg on the onset of study, and 13.55±2.01 mmHg after follow up. The mean IOP before treatment of glaucoma in the intervention group was 24.55±3.6 mmHg and after treatment with anti-glaucoma drugs was 15.15±1.8 mmHg, and 14.3±1.6 mmHg after the eradication of H pylori with a drug regimen. However, after the treatment of glaucoma in all patients, the overall comparison of mean IOP differences showed no statistical difference (P=0.65).

Conclusion: eradication therapy may have a positive effect on the management of glaucoma.
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http://dx.doi.org/10.22088/cjim.11.2.143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265522PMC
January 2020

Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study.

Gastroenterology 2021 01 12;160(1):99-114.e3. Epub 2020 Apr 12.

Dhaka Medical College & Hospital, Dhaka, Bangladesh.

Background & Aims: Although functional gastrointestinal disorders (FGIDs), now called disorders of gut-brain interaction, have major economic effects on health care systems and adversely affect quality of life, little is known about their global prevalence and distribution. We investigated the prevalence of and factors associated with 22 FGIDs, in 33 countries on 6 continents.

Methods: Data were collected via the Internet in 24 countries, personal interviews in 7 countries, and both in 2 countries, using the Rome IV diagnostic questionnaire, Rome III irritable bowel syndrome questions, and 80 items to identify variables associated with FGIDs. Data collection methods differed for Internet and household groups, so data analyses were conducted and reported separately.

Results: Among the 73,076 adult respondents (49.5% women), diagnostic criteria were met for at least 1 FGID by 40.3% persons who completed the Internet surveys (95% confidence interval [CI], 39.9-40.7) and 20.7% of persons who completed the household surveys (95% CI, 20.2-21.3). FGIDs were more prevalent among women than men, based on responses to the Internet survey (odds ratio, 1.7; 95% CI, 1.6-1.7) and household survey (odds ratio, 1.3; 95% CI, 1.3-1.4). FGIDs were associated with lower quality of life and more frequent doctor visits. Proportions of subjects with irritable bowel syndrome were lower when the Rome IV criteria were used, compared with the Rome III criteria, in the Internet survey (4.1% vs 10.1%) and household survey (1.5% vs 3.5%).

Conclusions: In a large-scale multinational study, we found that more than 40% of persons worldwide have FGIDs, which affect quality of life and health care use. Although the absolute prevalence was higher among Internet respondents, similar trends and relative distributions were found in people who completed Internet vs personal interviews.
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http://dx.doi.org/10.1053/j.gastro.2020.04.014DOI Listing
January 2021

The combination of sofosbuvir and daclatasvir is effective and safe in treating patients with hepatitis C and severe renal impairment.

J Gastroenterol Hepatol 2020 Sep 5;35(9):1590-1594. Epub 2020 Feb 5.

Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background And Aim: Many of the treatment regimens available for hepatitis C include sofosbuvir. Unfortunately, sofosbuvir has not been recommended for use in patients with severe renal impairment leaving these group of patients with very few options. Nevertheless, there are many reports in which these patients have been treated with sofosbuvir-containing regiments without important adverse events. This study aims at determining the safety and effectiveness of a sofosbuvir-based treatment in patients with severe renal impairment, including those on hemodialysis.

Method: We enrolled subjects with hepatitis C and estimated glomerular filtration rate under ml/min/1.73m from 13 centers in Iran. Patients were treated for 12 weeks with a single daily pill containing 400-mg sofosbuvir and 60-mg daclatasvir. Patients with cirrhosis were treated for 24 weeks. Response to treatment was evaluated 12 weeks after end of treatment (sustained viral response [SVR]). ClinicalTrials.gov identifier: NCT03063879.

Results: A total of 103 patients were enrolled from 13 centers. Seventy-five patients were on hemodialysis. Thirty-nine had cirrhosis and eight were decompensated. Fifty-three were Genotype 1, and 27 Genotype 3. Twenty-seven patients had history of previous failed interferon-based treatment. Three patients died in which cause of death was not related to treatment. Six patients were lost to follow-up. The remaining 94 patients all achieved SVR. No adverse events leading to discontinuation of medicine was observed.

Conclusions: The combination of sofosbuvir and daclatasvir is an effective and safe treatment for patients infected with all genotypes of hepatitis C who have severe renal impairment, including patients on hemodialysis.
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http://dx.doi.org/10.1111/jgh.14994DOI Listing
September 2020

Survival of gastric cancer patients based on pathologic and demographic characteristics in Mazandaran between 2007 and 2013.

Gastroenterol Hepatol Bed Bench 2019 ;12(4):315-321

Department of Biostatistics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.

Aim: Survey of the survival levels of gastric cancer and its effective causes.

Background: The survival of gastric cancer because of the advances in this type of cancer cures has been increased during the last decades.

Methods: 643 patients evolved by gastric cancer referred to Imam Khomeini hospital of Sari (2007- 2013) were studied. According to this method, the numbers of 74 patients were neglected because of defective data, and the number of 569 patients went under study. The level of survival was determined by use of Kaplan Meier, so to determine the causes affecting on the patients' survival, the univariate analysis of Log-rank test was used.

Results: Regarding the follow up of these patients during 2013 Nov-Dec the one, 2, 3, 4 and 5 years of survival of these patients were estimated equal to 0.77, 0.65, 0.52, 0.44, 0.27 percent and the survival median equal to 19 months, so survival means equal to 24.49 months. Based on the ranked logarithm test and FDR method some variables like stage (p<0.001) Radiotherapy (p<0.005) and undergo Surgery before Adjuvant chemotherapy (p<0.001) were determined as the effective factors on the survival probability.

Conclusion: The life length of the patients under this article in comparison with developed countries is shallow that might be because of late reference or delayed diagnosis and the shortness of cure facilities. In this way, some materials like soon diagnosis and screen methods could be effective on the increase in patients' survival.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820842PMC
January 2019

Normal values of neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio among Iranian population: Results of Tabari cohort.

Caspian J Intern Med 2019 ;10(3):320-325

Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

Background: Neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR) and platelet-lymphocyte ratio (PLR) have a prognostic value in several types of diseases such as cancers and they vary in different races. So, we aimed to evaluate the normal range of these markers among healthy people to determine the normal value in Iranian population.

Methods: In the present study, cross-sectional data of population-based cohort study named "Tabari cohort study" was utilized. In the first phase of Tabari cohort, 10255 participants aged 35-70 years from urban and rural areas of Sari, Mazandaran, Iran entered into the study. The study included a questionnaire survey and blood collection. Blood samples were collected after 12 hours fasting from all participants during the study. Hematological indices were measured for all samples using Celltac Alpha MEK-6510 K (Tokyo, Japan).

Results: After sample exclusion, 2212 healthy subjects of Tabari's normal cohort population were investigated. The mean age of the samples was 47.9±9.29 years. The mean of NLR, LMR, PLR were 1.70±0.70, 11.15±3.14 and 117.05±47.73, respectively.

Conclusion: Our investigation provides preliminary reference values for NLR, LMR, and PMR among Iranian population that can be used for disease progress in various clinical procedures.
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http://dx.doi.org/10.22088/cjim.10.3.320DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6729162PMC
January 2019

Tabari Cohort Profile and Preliminary Results in Urban Areas and Mountainous Regions of Mazandaran, Iran.

Arch Iran Med 2019 06 1;22(6):279-285. Epub 2019 Jun 1.

Department of Basic Science and Nutrition, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.

Background: The Tabari cohort study (TCS), part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN), is a large longitudinal prospective cohort designed to better understand the risk factors associated with major non-communicable diseases (NCDs) across two urban and mountainous regions in north of Iran.

Methods: The enrollment phase of TCS started in June 2015 and ended in November 2017. During this phase, individuals aged 35-70 years from urban and mountainous regions of Sari township (Mazandaran province) were invited to the cohort center by health volunteers (urban regions) and Behvarz (mountainous areas) using census information. Data was collected based on the PERSIAN cohort study protocols. Hypertension was defind as systolic blood pressure ≥140 mm Hg or a diastolic blood pressure ≥90 mm Hg or history of diagnosis with hypertension or taking antihypertensive medications among participants free from cardiovascular diseases. Diabetes was defined as fasting blood sugar ≥126 mg/dL or a history of diagnosis or taking glucoselowering medications among all participants.

Results: A total of 10,255 participants were enrolled in TCS, 59.5% of whom were female. Among the total population, 7,012 participants were urban residents (68.4%). The prevalence of daily smoking in the total population was 9.1%. Body mass index in 75.9% of participants was ≥25 kg/m2. The prevalence of hypertension, diabetes, and thyroid disorders were 22.2%, 17.2%, and 10.5%, respectively.

Conclusion: The Tabari cohort is different from other cohorts in terms of levels of risk factors associated with NCDs. This study has certain important strengths including its population-based design and large sample size that provides a valid platform for conducting future investigations and trials. A biobank that has been designed to store blood, nail, hair and urine samples for future research is another strength of this study. Researchers who are interested in using the information can refer to the following web page: http://persiancohort.com.
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June 2019

Evaluation of the Additive Effect of Domperidone on Patients with Refractory Gastroesophageal Reflux Disease; A Randomized Double Blind Clinical Trial.

Middle East J Dig Dis 2019 Jan 14;11(1):24-31. Epub 2018 Nov 14.

Associate Professor of Gastroenterology, Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

BACKGROUND Gastroesophageal reflux disease (GERD) is a common problem with annoying symptoms. It is associated with negative impact on quality of life. Prokinetic agents may be used in combination with acid suppression agents as an adjunctive in patients with GERD refractory to proton pump inhibitors (PPI) therapy, rather than as sole treatment. This study aimed to evaluate the efficacy of combination of PPI with domperidone (a prokinetic agent) compared with PPI alone in the treatment of patients with refractory GERD. METHODS This study was a double blind clinical trial on 29 patients with GERD refractory to PPI during the period of one month. By randomization, the patients were divided into two groups. Group A was treated by pantoprazole 40 mg twice daily and domperidone three times a day for a month, while group B was treated by pantoprazole 40 mg twice daily and placebo three times a day. In this study endoscopy was performed to evaluate the prevalence of erosive esophagitis, non-erosive reflux, and hiatal hernia. Manometry was conducted to study the prevalence of dysmotility. GERD symptom questionnaires including the Gastrointestinal Symptom Rating Scale (GSRS), Carlson Dennett, and the Medical Outcomes Study Short Form-36 health survey (SF36) were used before and after treatment for screening GERD and assessing treatment response. RESULTS There were 17 (58.62%) women and 12 (41.37%) men. The prevalence of erosive esophagitis and non-erosive reflux, was 10.34% and 89.66%, respectively. There was a significant difference comparing reflux symptoms before and after treatment between the two groups according to reflux and Carlson Dennett questionnaires. At the end of the study, symptoms of reflux significantly improved by treatment. Although, the quality of life questionnaire scores improved by treatment, there was no statistically significant difference in response to treatment between the two groups. CONCLUSION In this research, we showed that adding domperidone to PPI could not make any improvement in patients with refractory reflux regarding the quality of life and improving the symptoms.
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http://dx.doi.org/10.15171/mejdd.2018.124DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488498PMC
January 2019

Comparison of Oral versus Intravenous Proton Pump Inhibitors in Preventing Re-bleeding from Peptic Ulcer after Successful Endoscopic Therapy.

Middle East J Dig Dis 2018 Oct 22;10(4):236-241. Epub 2018 Jul 22.

Assistant Professor of Gastroenterology, Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

BACKGROUND Proton pump inhibitors (PPIs) are now widely prescribed for the management of patients with acute upper gastrointestinal bleeding; although its optimal dose and route of administration has remained a controversial issue. The aim of this study was to assess the clinical effectiveness of high dose oral versus intravenous (IV) PPI after successful endoscopic therapy in patients with bleeding peptic ulcer disease. METHODS 178 patients with active upper gastrointestinal bleeding due to a peptic ulcer with stigmata of high risk for re-bleeding entered the study. After successful endoscopic hemostasis, they were randomized to receive either high dose oral pantoprazole (80 mg stat and 80 mg twice daily for 3 days) or high dose intravenous pantoprazole (80 mg IV infusion within 30 minutes and 8 mg per hour for 3 days). After the 3rd day, the patients in both groups received oral pantoprazole 40 mg twice daily for one month. The end points were comparing the rate of re-bleeding or mortality, and the need for blood transfusion or surgery during the first month between the two groups. RESULTS There were not significant statistical differences between the two groups in the volume of blood transfusion, mean duration of hospital stay, need to surgery, or mortality rates. However, the rates of re-bleeding were 2.3% (2:88) in the IV group and 3.3% (3:90) in the oral group ( = 0.6). CONCLUSION According to our findings, it seems that high dose oral PPI can be a good alternative to high dose IV PPI in patients with bleeding peptic ulcer who are at high risk of re-bleeding. Due to the lower cost and the availability of oral PPIs, their use can be economically much more affordable.
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http://dx.doi.org/10.15171/mejdd.2018.116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488504PMC
October 2018

Iranian Registry of Crohn's and Colitis: study profile of first nation-wide inflammatory bowel disease registry in Middle East.

Intest Res 2019 Jul 24;17(3):330-339. Epub 2019 Apr 24.

Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background/aims: A recent study revealed increasing incidence and prevalence of inflammatory bowel disease (IBD) in Iran. The Iranian Registry of Crohn's and Colitis (IRCC) was designed recently to answer the needs. We reported the design, methods of data collection, and aims of IRCC in this paper.

Methods: IRCC is a multicenter prospective registry, which is established with collaboration of more than 100 gastroenterologists from different provinces of Iran. Minimum data set for IRCC was defined according to an international consensus on standard set of outcomes for IBD. A pilot feasibility study was performed on 553 IBD patients with a web-based questionnaire. The reliability of questionnaire evaluated by Cronbach's α.

Results: All sections of questionnaire had Cronbach's α of more than 0.6. In pilot study, 312 of participants (56.4%) were male and mean age was 38 years (standard deviation=12.8) and 378 patients (68.35%) had ulcerative colitis, 303 subjects (54,7%) had college education and 358 patients (64.74%) were of Fars ethnicity. We found that 68 (12.3%), 44 (7.9%), 13 (2.3%) of participants were smokers, hookah and opium users, respectively. History of appendectomy was reported in 58 of patients (10.48%). The most common medication was 5-aminosalicylate (94.39%).

Conclusions: To the best of our knowledge, IRCC is the first national IBD registry in the Middle East and could become a reliable infrastructure for national and international research on IBD. IRCC will improve the quality of care of IBD patients and provide national information for policy makers to better plan for controlling IBD in Iran.
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http://dx.doi.org/10.5217/ir.2018.00157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667360PMC
July 2019

Prevalence of infection in Sari Northern Iran; a population based study.

Gastroenterol Hepatol Bed Bench 2019 ;12(1):31-37

Associate professor, Department of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.

Aim: In this study prevalence rate of and its associated factors have been investigated in urban and rural areas of Sari.

Background: has an important role in gastrointestinal diseases including peptic ulcer and gastric cancer. It is the most common infection in human population worldwide. Hence, the epidemiology of this infection in all parts of the world is of utmost importance.

Methods: We conducted a cross-sectional study on 497 individuals ranging 15-65 years of age in Sari city and its surrounding rural residents. The sampling method was a cluster random sampling multi staged in stratified population by urban and rural areas. Questionnaires for personal and socio-economic data were filled. Blood samples were drawn and kept for analysis (IgG antibody ELISA for ). The data was analyzed by SPSS statistical software and Chi-square test and logistic regression were used.

Results: The prevalence of helicobacter infection was 44.5% in the studied population. This prevalence was 41.3% and 47.8% in urban and rural areas, respectively. Just a significant association between the infection and the age of subjects was observed in multiple regression analysis (p=0.001). However, in univariate analysis the level of education was also significantly associated with infection (p=0.015). No other variable was associated with the infection.

Conclusion: The prevalence of helicobacter infection has dropped significantly in the region in comparison with the previous studies during the last 15 years.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441486PMC
January 2019

Zingiber officinale and oxidative stress in patients with ulcerative colitis: A randomized, placebo-controlled, clinical trial.

Complement Ther Med 2019 Apr 2;43:1-6. Epub 2019 Jan 2.

Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Objectives: Oxidative stress plays an essential role in ulcerative colitis (UC) initiation and severity. We aimed to investigate the effect of ginger as a well-known antioxidant agent on the quality of life, disease activity index and oxidative stress in patients with UC.

Methods: Forty six patients with active mild to moderate UC randomly assigned to consume 2000 mg/day dried ginger powder in 4 capsules or similar placebo capsules for 12 weeks. Disease activity index, quality of life and some oxidative stress factors were measured before, at the middle and at the end of the intervention through valid and reliable questionnaires and blood sampling.

Results: Ginger reduced Malondialdehyde (MDA) significantly after 6 weeks (p = 0.003) and 12 weeks (p < 0.001) of intervention, whereas it did not affect serum total anti-oxidant capacity (TAC). The scores of severity of disease activity at 12th week was significantly improved in ginger group in comparison to placebo (p = 0.017). Moreover, ginger increased patients quality of life significantly at 12 week (p = 0.039).

Conclusion: Our data indicate that ginger supplementation can improve treatment of patients with UC. Further clinical trials with different dosages and duration of ginger or its standard extract supplementation are needed to obtain firm conclusion.
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http://dx.doi.org/10.1016/j.ctim.2018.12.021DOI Listing
April 2019

Ginger in gastrointestinal disorders: A systematic review of clinical trials.

Food Sci Nutr 2019 Jan 5;7(1):96-108. Epub 2018 Nov 5.

Department of Clinical Nutrition and Dietetics Faculty of Nutrition Sciences and Food Technology National Nutrition and Food Technology Research Institute Shahid Beheshti University of Medical Sciences Tehran Iran.

Ginger, the rhizome of Zingiber officinale, which is used as a spice globally has a long history of medicinal use that stimulates investigators to assess its potential roles as an adjuvant therapy or alternative medicine in a range of diseases. Anti-inflammatory, antioxidant, antitumor, and antiulcer effects of ginger have been proven in many scientific studies, and some of the ancient applications of ginger as a home remedy has been confirmed in human. In this review, we summarized the current evidence on the effects of ginger consumption on gastrointestinal disorders based on clinical trials. Our data indicate that divided lower daily dosage of 1500 mg ginger is beneficial for nausea relief. Because of limited number of studies on some other gastrointestinal disorders, the results may not be as much powered as to find significant results. Therefore, more extensive and well-controlled human studies of ginger or its standard extracts are required to demonstrate its efficacy as a gastroprotective agent. Dose-finding studies should be undertaken to accurately determine the effective dose and preparation of ginger in further clinical trials protocol.
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http://dx.doi.org/10.1002/fsn3.807DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341159PMC
January 2019

CD4+CD25+CD127low FoxP3+ regulatory T cells in Crohn's disease.

Rom J Intern Med 2018 Sep;56(3):158-166

Department of Immunology, School of Medicine, Babol University of Medical Sciences, Babol, I.R. Iran.

Background: Regulatory T (Treg) cell plays a key role in autoimmune diseases. We evaluated the regulatory function and frequency of Treg cells and secreted IL-10, IL-35 concentration in Crohn's disease (CD).

Methods: Twenty-three patients with CD and 25 healthy controls (HC) were included in this study. We analysed the alteration of Tregs frequency using flow cytometry for CD4, CD25, CD127 and FoxP3 markers. Surface expression of CD4, CD25 and CD127 markers were used for isolation of relatively pure Treg cells. Suppressive activity of Tregs was determined by measuring their ability to inhibit the proliferation of T responder (Tres) cells. In addition, the amounts of IL-10 and IL-35 cytokines in co-culture supernatants were measured by ELISA assay after stimulation with anti-CD2/CD3/CD28.

Results: CD patients had significantly lower frequency of CD4+ CD25+ CD127low FoxP3+ Treg cells in comparison with controls (2.17 ± 1.04 vs. 2.83 ± 1.07, p = 0.0352). Additionally, Treg cells mediated suppression was not significantly different in CD patients compared to controls. There was a significant difference in IL-10 secretion in response to anti-CD2/CD3/CD28 stimulation compared with HC (p = 0.0074).

Conclusion: The frequency of CD4+ CD25+ CD127low FoxP3+ Tregs decreased in active stage of CD but there was no impaired suppressive function of CD4+ CD25+ CD127low FoxP3+ Treg cells. We suggest that an alteration in the balance of Tregs and T effectors may contribute to pathogenesis of CD.
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http://dx.doi.org/10.2478/rjim-2018-0006DOI Listing
September 2018

An Ill-Defined Upper Abdominal Mass.

Clin Gastroenterol Hepatol 2018 03 13;16(3):e33-e34. Epub 2017 Jul 13.

Department of Internal Medicine, Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

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http://dx.doi.org/10.1016/j.cgh.2017.07.001DOI Listing
March 2018

Translation and validation of the Farsi version of Rome III diagnostic questionnaire for the adult functional gastrointestinal disorders.

J Res Med Sci 2016 2;21:103. Epub 2016 Nov 2.

Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.

Background: The aim of this study was to validate the Farsi version of Rome III modular questionnaire which contains all functional gastrointestinal disorders (FGIDs).

Materials And Methods: We used Rome foundation guidelines for translation of English version into Farsi, and all the steps were performed. In the first step, 2 forward translations into Farsi were completed by two authors separately, and then translators, who participated in Step 1, together with our monitor, compared the two target-language versions and made some changes. The product of Phase 2 was translated back into English by an American-Iranian physician. The final step was comparison of the two English versions and validation of the translation. In this step, we compared the final version item by item, and also we used focus groups of patients after pretesting.

Results: Our results showed that FGIDs questionnaire diagnosed 153 patients among 169 patients who were diagnosed to have different types of FGIDs. The sensitivity of this questionnaire was 90.5%. It was determined that the odd questions' values of Cronbach's alpha was 0.77 (very reliable), and it was 0.71 (very reliable) in other sections. The split-half test reliability of whole items value was 0.72, which is statistically significant.

Conclusion: Our findings showed that the Farsi version of Rome III diagnostic questionnaire for the adult functional gastrointestinal disorders demonstrated good validity and reliability and could be used in clinical studies.
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http://dx.doi.org/10.4103/1735-1995.193175DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5322693PMC
November 2016

A Comparison between Hybrid and Concomitant Regimens for Eradication: A Randomized Clinical Trial.

Middle East J Dig Dis 2016 Jul;8(3):219-225

Fellow of Gastroenterology, Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

BACKGROUND is one of the most common bacterial infections worldwide. We designed a study to compare the efficacy of 14-day hybrid regimen with 10-day concomitant therapy for eradication in Iran. METHODS 252 patients with naïve infection were randomly divided to receive either hybrid regimen (pantoprazole 40 mg, and amoxicillin 1 gr twice daily for 14 days, accompanied by clarithromycin 500 mg, and metronidazole 500 mg, twice daily just during the last 7 days) or concomitant regimen (pantoprazole 40 mg, amoxicillin 1 gr, clarithromycin 500 mg, and metronidazole 500 mg, all twice daily for 10 days). 8 weeks after therapy, C- urease breath test was performed to confirm eradication. RESULTS According to intention to treat analysis, the eradication rates were 87.3% (95% CI: 81.4-93.1) and 80.9% (95% CI: 74-87.8) in hybrid and concomitant groups, respectively (=0.38). Per-protocol eradication rates were 89.3% (95% CI: 83.8-94.7) and 83.1% (95% CI: 76.3-89.8), respectively (=0.19). The rates of severe side effects were not statistically different between the two groups (4% vs. 8.7%). CONCLUSION 14-day hybrid therapy can be considered as a nearly acceptable regimen with few severe side effects in Iran. However, it seems that the efficacy of this therapy is decreasing as the resistance rates to antibiotics are increasing. We suggest further studies to assess the efficacy of a more prolonged concomitant therapy for eradication in Iran.
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http://dx.doi.org/10.15171/mejdd.2016.24DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045675PMC
July 2016

Cancer stem cells CD133 and CD24 in colorectal cancers in Northern Iran.

Gastroenterol Hepatol Bed Bench 2016 ;9(2):132-9

Department of Pathology, Imam Hospital, Mazandaran University of Medical Sciences, Sari, Iran.

Aim: We aimed to study the expression of CD24 and CD133 in colorectal cancer and normal adjacent tissues to assess a relationship between these markers and clinic-pathological characteristics and patient's survival.

Background: Cancer stem cells are a group of tumor cells that have regeneration and multi-order differentiation capabilities.

Patients And Methods: Expression of CD24 and CD133 was studied in a paraffin block of colorectal cancer and normal tissues near tumors with the immuneohistochemical method in patients who were referred to Imam Khomeini Hospital in Sari.

Results: A total of 50 samples (25 males and 25 females) with a mean age of 67.57±13.9 years old with range 28-93 years, included 3 mucinous carcinoma and 47 adenocarcinoma. Expression of CD133 marker was negative in 29 cases and positive in 21 cases. Expression of CD24 in tissue near tumor cells was found in 30% of available samples. The relationship between expressing CD24 with treatment (surgery and chemotherapy) was significant and its relationship with patient's survival was insignificant statistically. However, there was a clear difference as mean survival age of patients based on CD24 expression was 26.64±18.15 for negative cases and 41.75±28.76 months for positive cases. CD24 and CD133 expressions and their co-expression with other clinic-pathological factors were not significant.

Conclusion: During this study, the relationship between CD24 and treatment type was significant. To confirm this result, various studies with high sample numbers and other stem cell markers are recommended.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833852PMC
April 2016

Emerging Epidemic of Inflammatory Bowel Disease in a Middle Income Country: A Nation-wide Study from Iran.

Arch Iran Med 2016 Jan;19(1):2-15

Department of Medicine, Dezful University of Medical Science, Dezful, Iran.

Background: The burden of inflammatory bowel disease (IBD) hasn't been reported in Iran. We aimed to estimate the prevalence and incidence of IBD and its trend in Iran at national and subnational level from 1990 to 2012.

Methods: We conducted a systematic review of English and Persian databases about the epidemiology of IBD. We also collected outpatient data from 17 provinces of Iran using almost all public and private referral gastroenterology clinics. Prevalence and incidence rate was calculated at national and subnational levels. The Kriging method was used to extrapolate provinces with missing data and GPR model to calculate time trends of rates at subnational level.

Results: We found 16 case series, two population-based studies, and two review articles. We collected 11,000 IBD cases from outpatient databases. Among them, 9,269 (84.26%) had ulcerative colitis (UC), 1,646 (14.96%) had Crohn's disease (CD), and 85 had intermediate colitis (IC). A total of 5,452 (49.56%) patients were male. Mean age at diagnosis was 32.80 years (CI: 13 - 61) for UC and 29.98 years (CI: 11 - 58) for CD. Annual incidences of IBD, UC, and CD in 2012 were 3.11, 2.70, and 0.41 per 100,000 subjects respectively. Prevalence of IBD, UC, and CD in 2012 were 40.67, 35.52, and 5.03 per 100,000 subjects respectively. The incidence of UC and CD showed a significant increase during the study period (P for trend < 0.05).

Conclusions: The incidence and prevalence of IBD are increasing in Iran. Establishing a national IBD registry seems necessary for comprehensive care of IBD patients in Iran.
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http://dx.doi.org/0161901/AIM.003DOI Listing
January 2016

Simultaneous Esophageal Squamous Cell Carcinoma and Adenocarcinoma: A Case Report.

Middle East J Dig Dis 2015 Oct;7(4):257-60

Research Assistant, Inflammatory Diseases of Upper Gastrointestinal Tract Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

Esophageal squamous cell carcinoma is a rather common cancer in northern Iran. Incidence of adenocarcinoma of esophagus has an increasing trend in Iran. Co-existence of both cancers in one patient is very rare. We report a middle age woman from northern Iran with a typical presentation of esophageal cancer, who was found to have a dual esophageal cancer. The disease was found in the advanced stage with pulmonary metastasis at the presentation. Palliative chemo-radiotherapy induced partial clinical response.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655848PMC
October 2015

Decrease of CD4(+) CD25(+) CD127(low) FoxP3(+) regulatory T cells with impaired suppressive function in untreated ulcerative colitis patients.

Autoimmunity 2015 31;48(8):556-61. Epub 2015 Aug 31.

c Gut and Liver Research Center, Mazandaran University of Medical Sciences , Sari , Iran.

Regulatory T (Treg) cells take part in immune homeostasis and play a pivotal role in maintaining peripheral tolerance. The aim of this study was to evaluate the frequency and function of Treg cells in active and untreated ulcerative colitis (UC) patients. Thirty-two subjects with newly diagnosed UC and 31 age-matched healthy controls were included in this survey. The frequency of Tregs was analyzed with flow cytometry using CD4, CD25, CD127 and FoxP3 markers. We used surface expression of CD4(+), CD25(+) and CD127(low) markers for isolation of a relatively pure Treg population. Suppressive activity of Tregs was determined by measuring their ability to inhibit the proliferation of T responder cells. UC patients had a lower frequency of CD4(+) CD25(+) CD127(low) FoxP3(+) Treg cells. Additionally, Treg cell-mediated suppression was lower in UC patients compared to controls. The frequency and suppressive capacity of Tregs and MFI of FoxP3 were inversely correlated with disease activity. These results suggest that CD4(+) CD25(+) CD127(low) FoxP3(+) Treg cells may contribute to immunopathogenesis of UC, and assessment of Treg cell frequency and function may have clinical value.
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http://dx.doi.org/10.3109/08916934.2015.1070835DOI Listing
September 2016

Validation of the Persian version of the inflammatory bowel disease questionnaire (IBDQ) in ulcerative colitis patients.

Caspian J Intern Med 2015 ;6(1):20-4

Department of Radiology, Mazandaran University of Medical Sciences, Sari, Iran.

Background: Inflammatory bowel diseases (IBD) are a group of inflammatory conditions of the colon and small intestine that may have critical consequences on patient's quality of life (QOL). Many disease-specific QOL tools have been developed recently. The McMaster Inflammatory Bowel Disease Questionnaire (IBDQ) is one of them. The aim of this study was to translate the IBDQ from English to Persian and evaluate the validity and reliability of this version of the McMaster IBDQ.

Methods: 68 subjects with ulcerative colitis were recruited in this study. The original IBDQ was translated into Persian using back- translation method. The reliability of the subscales and the summary score of the Persian IBDQ was demonstrated by intraclass correlation coefficients, their validity was evaluated by their correlations with SF-36, visual analogue scale and colitis activity index.

Results: All dimensions of IBDQ met the standards of construct validity and were correlated well with SF-36, visual analog scale and colitis activity index. IBDQ was able to discriminate the different groups of patients. The intraclass correlation coefficient was very high and its value was close to one (P<0.05). All dimensional scores differed significantly between the baseline and the follow-up measurement.

Conclusion: The findings of this study conclude that the Persian translation of IBDQ confers satisfactory psychometric and cultural properties when applied to a sample of Iranian population with inflammatory bowel disease. This questionnaire is recommended for use in clinical trials and in the assessment of efficacy of interventions and therapy.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478114PMC
July 2015

Comparison of quadruple and triple Furazolidone containing regimens on eradication of helicobacter pylori.

Med J Islam Repub Iran 2015 6;29:195. Epub 2015 Apr 6.

Professor PhD, Department of Biostatistics and Community Medicine, Imam Khomeini Hospital, Sari, Iran.

Background: The effectiveness of classic standard triple therapy regimen of helicobacter pylori (H. pylori) eradication has decreased to unacceptably low levels, largely related to development of resistance to metronidazole and clarithromycin. Thus successful eradication of H. pylori infections remains challenging. Therefore alternative treatments with superior effectiveness and safety should be designed and appropriately tested in all areas depending on the native resistance patterns. Furazolidone has been used successfully in eradication regimens previously and regimens containing furazolidone may be an ideal regimen.

Methods: H. pylori infected patients with proven gastric or duodenal ulcers and /or gastric or duodenal erosions at Imam Khomeini Hospital in Sari/Northern Iran, were randomly allocated into three groups: group A (OABF) with furazolidone (F) (200 mg bid.), group B (OABM-F) metronidazole (M) (500 mg bid.) for the first five days, followed by furazolidone (F) (200 mg bid.) for the second five days and group C (OAF) with furazolidone (F) (200 mg tid.). Omeprazole (O) (20 mg bid.) and amoxicillin (A) (1000 mg bid.) were given in all groups; bismuth (B) (240 mg bid.) was prescribed in groups A & B. Duration of all eradication regimens were ten days. Eight weeks after treatment, a 14C-urea breath test was performed for evaluation of H. pylori eradication.

Results: A total of 372 patients were enrolled in three groups randomly (124 patients in each group); 120 (97%) patients in group A (OABF), 120 (97%) in group B (OABM-F) and 116 (93%) in group C (OAF) completed the study. The intention-to-treat eradication rates were 83.7% (95% CI= 77.3-90.4), 79.8% (95% CI= 72.6-87), and 84.6% (95% CI= 78.2-91.1) and per-protocol eradication rates were 86.6% (95% CI= 80.5-92.8), 82.5% (95% CI= 75.6-89.4), and 90.5% (95% CI= 85.1-95.9) for groups OABF, OABM-F, and OAF, respectively. No statistical significant differences were found in case of severe drug adverse effects between the above mentioned three groups (p> 0.05). The most common side effects, namely nausea and fever, occurred in all groups, but more frequently in group C (OAF) (p< 0.05).

Conclusion: In developing countries such as Iran, furazolidone-based regimens can substitute clarithromycinbased regimens for H. pylori eradication because of a very low level of resistance, low cost and high effectiveness. Considering per-protocol eradication rate of ten days OAF regimen, and the acceptable limit of ninety percent, we recommend this regimen in developing countries such as Iran to be substituted of classic standard triple therapy. In order to minimize rare serious adverse effects, one week high dose OAF regimen should be taken into consideration in other studies.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476222PMC
July 2015

Comparison Between 10- and 14-Day Hybrid Regimens for Helicobacter pylori Eradication: A Randomized Clinical Trial.

Helicobacter 2015 Aug 4;20(4):299-304. Epub 2015 Mar 4.

Inflammatory Diseases of Upper Gastrointestinal Tract Research Center, Department of Gastroenterology, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran.

Background: Helicobacter pylori (H. pylori) eradication has always been a concern. In our previous study, 14-day hybrid regimen showed ideal results. Based on these findings, we decided to compare the efficacy of 10- and 14-day hybrid regimens for H. pylori eradication.

Methods: Two hundred and seventy patients with peptic ulcer disease and H. pylori infection were enrolled in the study. One hundred and thirty-four patients received 10-day hybrid regimen (PACT-10): pantoprazole, 40 mg, and amoxicillin, 1 g, both twice daily for 10 days; plus clarithromycin, 500 mg, and tinidazole, 500 mg, both twice daily just during the last 5 days. One hundred and thirty-six patients received 14-day hybrid regimen (PACT-14): pantoprazole, 40 mg, and amoxicillin, 1 g, both twice a day for 14 days; plus clarithromycin, 500 mg, and tinidazole, 500 mg, both twice daily just for the last 7 days. Eight weeks after treatment, (14) C-urea breath test was performed to evaluate H. pylori eradication.

Results: Two hundred and fifty patients (124 patients in PACT-10 and 126 patients in PACT-14 regimens) completed the study. The intention-to-treat eradication rates were 77.6% (95% confidence interval (CI): 70.6-84.6%) and 86% (95% CI: 80-92%) for the two regimens, respectively (p = .17). Per-protocol eradication rates were 83.8% (95% CI: 80-86%) and 92.8% (95% CI: 88-96%), respectively (p < .01). There were no significant intergroup differences in compliance to treatment or discontinuation of therapy due to severe side effects.

Conclusion: Ten-day hybrid regimen could not achieve acceptable eradication rate. However, 14-day hybrid regimen seems to be an acceptable option for H. pylori eradication in Iran.
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http://dx.doi.org/10.1111/hel.12202DOI Listing
August 2015

Fecal calprotectin and ulcerative colitis endoscopic activity index as indicators of mucosal healing in ulcerative colitis.

Intern Emerg Med 2015 Apr 4;10(3):321-8. Epub 2014 Nov 4.

Inflammatory Diseases of Upper Gastrointestinal Tract Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Amir Mazandarani Street, 48166-33131, Sari, Iran.

Ulcerative colitis (UC) is a chronic, idiopathic, inflammatory large bowel disease with recurrent variable periods of exacerbation. The aim of the current study is to evaluate the correlation of UCEIS with fecal calprotectin (FC) level to assess disease activity in UC patients in order to determine whether FC can prognosticate clinical outcome and disease activity of UC instead of colonoscopic evaluation. Our endoscopic investigations revealed the extension of UC as the following: proctitis (11.6%), procto-sigmoiditis (18.5%), left-sided colitis (15.8%), extensive colitis (11.7%), and normal endoscopy (42.4%). Conclusively, we suggest that FC can be used as a reliable tool to evaluate disease activity in ulcerative colitis patients. Moreover, our findings indicate a significant correlation between FC level and mucosal healing.
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http://dx.doi.org/10.1007/s11739-014-1144-xDOI Listing
April 2015
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