Evaluation of haptoglobin genotype and some risk factors of cancer in patients with early stage esophageal cancer

Introduction: Esophageal cancer is one of the most lethal gastrointestinal cancers that has a complex and diverse etiology, with several genetic and nutritional factors involved in its etiology. The purpose of this study was to investigate the type of haptoglobin genotype and its relationship with some nutritional and biochemical risk factors affecting the prevalence of esophageal cancer in patients with early stage esophageal cancer. Materials and methods: In this study, 44 patients (20 males and 24 females) with early stage esophageal cancer and 44 healthy subjects, classified as control group, (19 males and 25 females) were selected. Haptoglobin (HP) genotype was determined employing PCR technique. Nutritional data were analyzed using standard food frequency questionnaire (FFQ) method. Serum levels of malondialdehyde (MDA), nitrate and nitrite were measured employing the colorimetric method. Serum levels of p53 protein were measured using the enzyme-linked immunosorbent assay (ELISA) technique. Results: The results of our study showed for the first time that HP1-1 genotype was the most prevalent genotype in esophageal cancer patients in Golestan province, Iran. HP2-2 genotype was the most frequent in the control group. Serum levels of MDA were significantly higher in the patients' group compared to the control group (P < 0.001). Weight and body mass index (BMI) were significantly lower in the patients' group than the control group (P < 0.01). Food frequency analysis revealed that the consumption of fruits and vegetables in the patients' group was lower than that of the control group (P < 0.05). Conclusion: The results of our study showed for the first time that HP1-1 genotype is the dominant genotype in patients with esophageal cancer in Golestan province. As well, modification of nutritional pattern and consumption of high level of antioxidant compounds can be effective in reducing the prevalence of esophageal cancer in this region. © 2019, Asian Pacific Organization for Cancer Prevention

A systematic review and meta-analysis for association of Helicobacter pylori colonization and celiac disease

Background and objectives Based on some previous observational studies, there is a theory that suggests a potential relationship between Helicobacter pylori (H. pylori) colonization and celiac disease (CeD); however, the type of this relationship is still controversial. Therefore, we aimed to conduct a systematic review and meta-analysis to explore all related primary studies to find any possible association between CeD and human H. pylori colonization. Data sources Studies were systematically searched and collected from four databases and different types of gray literature to cover all available evidence. After screening, the quality and risk of bias assessment of the selected articles were evaluated. Synthesis methods Meta-analysis calculated pooled odds ratio (OR) on the extracted data. Furthermore, heterogeneity, sensitivity, subgroups, and publication bias analyses were assessed. Results Twenty-six studies were included in this systematic review, with a total of 6001 cases and 135512 control people. The results of meta-analysis on 26 studies showed a significant and negative association between H. pylori colonization and CeD (pooled OR = 0.56; 95 CI = 0.45-0.70; P < 0.001), with no publication bias (P = 0.825). The L'Abbé plots also showed a trend of having more H. pylori colonization in the control group. Among subgroups, ORs were notably different only when the data were stratified by continents or risk of bias; however, subgroup analysis could not determine the source of heterogeneity. Conclusions According to the meta-analysis, this negative association might imply a mild protective role of H. pylori against celiac disease. Although this negative association is not strong, it is statistically significant and should be further considered. Further investigations in both molecular and clinic fields with proper methodology and more detailed information are needed to discover more evidence and underlying mechanisms to clear the interactive aspects of H. pylori colonization in CeD patients. Copyright: © 2021 Amlashi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

From bowel inflammation to the bone and joints: musculoskeletal examination in inflammatory bowel disease (IBD)

Background: One of the most important complications in inflammatory Bowel Disease (IBD) are musculoskeletal manifestations that are reported in more than 50 of patients. Objectives: In this study, we aimed to evaluate the musculoskeletal and radiologic manifestations in our IBD patients. Methods: In this cross-sectional study on 96 mild-to-moderate IBD patients (76 UC, 18 CD and 2 undifferentiated IBD) with mean (SD) age of 39.28 (11.42) years, 44 (45.8) were males and 52 were (54.2) females. Patients were examined by an expert rheumatologist and their musculoskeletal symptoms were assessed. The musculoskeletal system was evaluated by Modified Schober test, Thoracic expansion (TE), Occiput to wall distance (OWD), and Patrick�s or FABER test. Peripheral joints were also examined in all four extremities. Then patients were referred for pelvic and lumbosacral x-ray. Sacroiliitis grading was performed using the New York criteria. Results: Inflammatory low back pain was reported in 5 (5.2), enthesopathy in 6 (6.5) and dactylitis in 1 (1.1). Positive Schober test was recorded in 5 (5.2) and Patrick test in 3 (3.1). Forty-nine (51) cases had normal imaging with no sacroiliitis, endplate sclerosis was seen in 33 cases (34.4), grade 3 and grade 4 were seen in 10 cases (10.4). Conclusions: In the present study, 34.4 of the IBD patients had mild radiologic changes as endplate sclerosis and 95 had a normal physical examination. © 2021, The Author(s)

Effect of Adding Intravenous Somatostatin to Rectal Indomethacin on Post-Endoscopic Retrograde Cholangiopancreatography (ERCP) Pancreatitis in High-risk Patients: A Double-blind Randomized Placebo-controlled Clinical Trial

Background: Endoscopic retrograde cholangiopancreatography (ERCP) has an important role in the treatment of pancreaticobiliary disorders. Goals: Considering the high prevalence and importance of postendoscopic retrograde cholangiopancreatography pancreatitis (PEP) and the controversial findings, we aimed to determine the effect of adding intravenous somatostatin to rectal indomethacin on the incidence of PEP in high-risk patients. Study: In this prospective study, 530 patients underwent ERCP during March 2018 and February 2019. Patients were randomized into 2 groups. The intervention group received a bolus injection of 250 μg somatostatin followed by an infusion of 500 μg of somatostatin for 2 hours. In both groups, 100 mg of pre-ERCP suppository indomethacin was administrated. All patients were screened for PEP symptoms and signs for 24 hours after ERCP (Iranian Registry of Clinical Trials code: IRCT20080921001264N11). Results: A total of 376 patients were finally analyzed. PEP was the most common adverse event with 50 (13.2) episodes, including 21 (5.5) mild, 23 (6.1) moderate, and 6 (1.2) severe. The rate of PEP was 15.2 in the control group and 11.4 in the intervention group (P=0.666). The incidence of post-ERCP hyperamylasemia was 21.7 in the control group and 18.2 in the intervention group (P=0.395). No death occurred. Conclusions: In this study administration of somatostatin plus indomethacin could safely reduce the rate of post-ERCP hyperamylasemia and PEP in the intervention group compared with the control group, but the differences were not significant. Further studies with larger sample sizes are required. © 2021 Thieme Medical Publishers, Inc.. All rights reserved

Primary liver cancer in Golestan Province, Northeastern Iran: 13-year experience of Golestan Population-Based Cancer Registry (GPCR)

Background: Liver cancer (LC) is among the most common and fatal cancers worldwide. A four-fold increasing trend is reported for LC age-standardized mortality rate (ASMR) in Iran within 1990-2015. In the present study, we aimed to report the incidence rate of LC during the 13-year establishment of the Golestan population-based cancer registry (GPCR). Methods: Age-standardized incidence rate (ASIR) per 100 000 person-years was calculated using CanReg5 software. The Joint point regression analysis was used to assess the temporal trends in incidence rate of LC. Results: During the study period, GPCR registered 575 of LC cases, of which 373 (64.9) were men and 297 (51.6) lived in rural areas. The mean (SD) age of LC in men and women were 60.3 (17.2) and 58.0 (17.1), respectively. The ASIR of LC was significantly higher in men than women (4.7 vs. 2.6; P value < 0.01) and a minimal increasing trend in LC incidence was observed in both sexes. The incidence rate of LC was significantly higher in rural areas compared to the urbans (3.91 vs. 3.40; P value = 0.04). In the last 13 years, rural population had a significant increasing trend in ASIR of LC (average annual percent change AAPC = 7.85, P value = 0.005). Conclusion: LC was more prevalent in men among both urban and rural populations. The results showed a significant increasing trend in rural areas that requires Golestan health care system to take action in controlling the burden of LC in rural areas. © 2021 Academy of Medical Sciences of I.R. Iran. All rights reserved

Detection rate of colorectal polyps in symptomatic candidates of colonoscopy: When should we do a total colonoscopy?

BACKGROUND The incidence of colorectal cancer is increasing in the northeast of Iran. Colorectal polyps are among the proposed risk factors noted, especially in the elder population. This study was designed to study the diagnosed cases of intestinal polyps detected from 2011 to 2016 in the northeast of Iran. METHODS The population consisted of symptomatic candidates referred to the colonoscopy center in Gorgan city. Based on the available colonoscopy and pathology reports, 1706 cases were enrolled after the exclusion of cases without sufficient data. RESULTS Among 1709 (55.5 males and 44.5 females) cases, 1405 cases with 1912 polyps were detected. Among them, 345 (25) aged less than 50 years. Tubular adenoma (N = 826, 43.2) and hyperplastic polyps (N = 519, 27.1) were the top two histological findings. Out of 1405 patients with polyps, 660 (39.6) polyps were detected in proximal colon (15.6 in proximal and 24 in both proximal and distal). Malignancies were detected in 13.2 (0.8 malignant polyps and 12.4 malignant masses). CONCLUSION A considerable number of colorectal adenomas in proximal colon and in patients younger than 50 years old, suggesting to schedule colorectal cancer screening from at least 10 years younger and continuing colonoscopy up to the proximal area. © 2021 The Author(s)

National, sub-national, and risk-attributed burden of thyroid cancer in Iran from 1990 to 2019

An updated exploration of the burden of thyroid cancer across a country is always required for making correct decisions. The objective of this study is to present the thyroid cancer burden and attributed burden to the high Body Mass Index (BMI) in Iran at national and sub-national levels from 1990 to 2019. The data was obtained from the GBD 2019 study estimates. To explain the pattern of changes in incidence from 1990 to 2019, decomposition analysis was conducted. Besides, the attribution of high BMI in the thyroid cancer DALYs and deaths were obtained. The age-standardized incidence rate of thyroid cancer was 1.57 (95 UI: 1.33�1.86) in 1990 and increased 131 (53�191) until 2019. The age-standardized prevalence rate of thyroid cancer was 30.19 (18.75�34.55) in 2019 which increased 164 (77�246) from 11.44 (9.38�13.85) in 1990. In 2019, the death rate, and Disability-adjusted life years of thyroid cancer was 0.49 (0.36�0.53), and 13.16 (8.93�14.62), respectively. These numbers also increased since 1990. The DALYs and deaths attributable to high BMI was 1.91 (0.95�3.11) and 0.07 (0.04�0.11), respectively. The thyroid cancer burden and high BMI attributed burden has increased from 1990 to 2019 in Iran. This study and similar studies� results can be used for accurate resource allocation for efficient management and all potential risks� modification for thyroid cancer with a cost-conscious view. © 2022, The Author(s)