Clinical Validation of an Office-Based 14C-UBT (Heliprobe) for H. pylori Diagnosis in Iranian Dyspeptic Patients

Background. We encountered repeatedly, in our clinical practice, discordant results between UBT and histopathology about H. pylori infection. Goal. To study the diagnostic accuracy of Heliprobe 14C-urea breath test (14C-UBT) for detection of H. pylori infection in an Iranian population. Study. We enrolled 125 dyspeptic patients in our study. All of them underwent gastroscopy, and four gastric biopsies (three from the antrum and one from the corpus) were obtained. One of the antral biopsies was utilized for a rapid urease test (RUT), and three others were evaluated under microscopic examination. Sera from all patients were investigated for the presence of H. pylori IgG antibodies. The 14C-UBT was performed on all subjects using Heliprobe kit, and results were analyzed against the following gold standard (GS): H. pylori infection considered positive when any two of three diagnostic methods (histopathology, RUT, serology) are positive. Results. According to data analysis, the Heliprobe 14C-UBT had 94% sensitivity, 100% specificity, 93% negative predictive value (NPV), 100% positive predictive value (PPV), and 97% accuracy, compared with GS. Conclusion. The Heliprobe 14C-UBT is an easy-to-perform, rapid-response, and accurate test for H. pylori diagnosis, suitable for office use

The Lifestyle Characteristics in Non-Alcoholic Fatty Liver Disease in the PERSIAN Guilan Cohort Study

BACKGROUND: Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common cause of chronic liver disease worldwide. Since the effect and safety of pharmacotherapy for NAFLD are unknown, the proper management of lifestyle is crucial. AIM: The present study was conducted to determine the status of food, Physical Activity (PA), and sleep in patients with and without NAFLD. METHODS: In this analytical- cross-sectional study, 630 clients with 36-60 years old who referred to the PERSIAN Guilan cohort study were included through simple non-random sampling. The developed questionnaire and lifestyle characteristics, including the status of nutrition, physical activity, and sleep, were completed for all samples. BMI was also calculated by determining weight and height, and fatty liver was confirmed based on abdominal ultrasound. RESULTS: The prevalence of NAFLD in this study was by 43.7% (275 / 630). Smoking, alcohol consumption, BMI, and weight loss over the past six months, regular exercise and exercise intensity, sedentary living, speed of eating, consuming fatty food, red meat, sweets beverages, and use of saturated fatty acid (SFA), and consuming fruits and vegetables were associated with presence of NAFLD (all p < 0.05). However, no significant relationship was observed between the parameters of sleep duration, the interval between dinner and night sleep, consuming breakfast and snack during the day and NAFLD (All p > 0.05). CONCLUSION: The onset and progression of NAFLD are associated with lifestyle. Therefore, dietary therapy solutions, physical activity, and sleep and rest situations should be paid attention for people with or at risk of NAFLD

Frequency of Celiac Disease in Patients with Hypothyroidism

Background. Celiac disease (CD) is closely associated with other autoimmune endocrine disorders, particularly autoimmune thyroid disease. The aim of this study was to find the frequency of celiac disease in patients with hypothyroidism in Guilan province, north of Iran. Methods. A total of 454 consecutive patients with hypothyroidism underwent celiac serological tests antiGliadin antibodies (AGA), antitissue transglutaminase antibodies (IgA-tTG) and antiendomysial antibodies (EMA-IgA). Small intestinal biopsy was performed when any of celiac serological tests was positive. Results. Eleven (2.4%) patients were positive for celiac serology, and two patients with documented villous atrophy were diagnosed with classic CD (0.4%; 95%). Two patients with classic CD had Hashimoto's thyroiditis (HT) (0.6%; 95%). Six (54.5%) of 11 were suffering from overt hypothyroidism and 45.5% from subclinical hypothyroidism. Six (54.5%) had HT, and 45.5% had nonautoimmune hypothyroidism. Conclusions. In this study, prevalence of CD was lower than other studies. Most of the patients with CD were suffering from HT, but there was no significant statistical relation between CD and HT

Symptomatic reinfection with COVID-19: A case-report study in Iran

Coronavirus disease 2019 (COVID-19) resulted in a worldwide concern. The role of the immunity system and memory cells in this disease and their ability in preventing a secondary infection is a controversial issue. Here we presented a case of reinfection with this virus eight months after the first episode. A twenty-one-year-old man was referred to our local hospital on 19 February 2020 with symptoms of viral infection. COVID-19 infection was confirmed by RT-PCR. He got hospitalized for 5 days. Eight months later on 4 October 2020, he was again referred with symptoms of viral infection and para-clinical tests confirmed COVID-19 infection. He got hospitalized for 6 days in the second episode. Although the immunity system plays important role in COVID-19 infection through the presence of memory cells it doesn’t guarantee permanent immunity to this virus. Reinfection with COVID-19 is possible and has been reported in some other studies.

Efficacy and tolerability of fourteen-day sequential quadruple regimen

The optimal pharmacological regimen for eradication of Helicobacter pylori (H. pylori) has been investigated for many years. This study aimed to evaluate the efficacy and tolerability of bismuth-based quadruple therapy (B-QT) and a modified sequential therapy (ST) regimens in eradication of H. pylori. A randomized, double-blind trial was conducted on 344 patients. Patients with H. pylori infection and without a history of previous treatment were randomized to receive 14-day B-QT (bismuth subcitrate 240 mg, pantoprazole 40 mg, amoxicillin 1000 mg, and clarithromycin 500 mg twice daily) or 14-day ST (bismuth subcitrate 240 mg, pantoprazole 40 mg, amoxicillin 1000 mg, and metronidazole 500 mg twice a day for seven days followed by bismuth subcitrate 240 mg, pantoprazole 40 mg, amoxicillin 1000 mg, and furazolidone 100 mg twice a day for additional seven days). Drug adverse effects were assessed during the study. H. pylori eradication was determined eight weeks after the end of treatment using 14C-urea breath test. Based on per-protocol and intention-to-treat, the eradication rate was significantly higher (p<0.05) in the B-QT regimen 91.9 % (95 % CI; 88.1-94.0) and 90.2 % (95 % CI; 86.3-92.9), respectively compared to the ST regimen 80.8 % (95 % CI; 76.6-84.9) and 78.1 % (95 % CI; 73.7-82.4), respectively. The severity of vomiting and loss of appetite were significantly higher in ST regimen (p<0.05). The B-QT regimen was more effective and safer than the ST regimen. Conclusively, it is suggested to assess the efficacy and safety of this regimen in longer studies, larger population, and in other communities

The survival rate of hepatocellular carcinoma in Asian countries

Hepatocellular carcinoma or Liver cancer (LC) is the sixth most common cancer and the fourth cause of death worldwide in 2018. There has not been a comprehensive study on the survival rate of patients with LC in Asia yet. Therefore, the present study was conducted to evaluate the survival rate of patients with LC in Asian countries. The methodology of the present study is based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement. The researchers searched five international databases including Medline/PubMed, Scopus, Embase, Web of Knowledge and ProQuest until July 1, 2018. We also searched Google Scholar for detecting grey literature. The Newcastle-Ottawa Quality Assessment Form was used to evaluate the quality of selected papers. A total of 1425 titles were retrieved. 63 studies met the inclusion criteria. Based on the random-effect model one-year, three-year and five-year survival rate of LC were 34.8 % (95 % CI; 30.3-39.3), 19 % (95 % CI ; 18.2-21.8) and 18.1 % (95 % CI ;16.1-20.1) respectively. According to the results of our study, the LC survival rate in Asian countries is relatively lower than in Europe and North America

Anxiety-depressive disorders among irritable bowel syndrome patients in Guilan, Iran

BACKGROUND: Psychiatric disorders are common in irritable bowel syndrome (IBS) patients. The prevalence of psychiatric disorders in IBS patients varies in different cultures. We conducted this study to determine the prevalence of psychiatric disorders METHODS: In a cross-sectional study, 256 IBS patients were selected (using the criteria of Rome III) and evaluated for psychiatric disorders. In the first phase, subjects were screened using the General Health Questionnaire 28 (GHQ28). In the second phase, those who had scores ≥ 23 were assessed through semi-structured psychiatric interviews. RESULTS: Thirty out of 256 subjects had no significant psychiatric symptoms after performing GHQ28. In further psychiatric evaluation of the remaining subjects (226) who suffered from some degree of a psychiatric problem, 36 were diagnosed without Anxiety/Depressive disorder. Thus 66 subjects (25.8%) were known as a group without any significant psychiatric problem. A total of 190 subjects (74.2%) with anxiety-depressive problems were diagnosed; 89 were suffering from pure anxiety disorders, 41 were suffering from depressive disorders and 60 had co-morbid anxiety-depressive disorders. When comparing anxiety-depressive patients (n = 190) with normal subjects (n = 66), gender (P = 0.016), occupation (P = 0.002) and intensity of IBS (P < 0.001) showed statistically significant differences. CONCLUSION: The high prevalence of anxiety-depressive disorders in this study indicates the necessity of psychiatric assessment, early diagnosis and treatment of the patients with IBS. It may improve management of the patients suffering from IBS.Peer reviewe

Prevalence of Gastrointestinal Symptoms among Individuals with and without Diabetes: A Cross-Sectional Study from the PERSIAN Guilan Cohort Study

Objective: Gastrointestinal (GI) symptoms are the most common complaint among individuals with diabetes. This study investigated the prevalence of upper, lower, and general GI symptoms in individuals with and without diabetes among the Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan Cohort study (PGCS) population. Materials and methods: This cross-sectional study of PGCS was conducted on 2669 participants, 1364 with diabetes and 1305 without diabetes. The first part of the questionnaire collected demographical and clinical data, and the second part collected GI symptoms. A 4-point Likert Scale was used for each question. Data were analyzed using SPSS software version 16, and the significance level was considered &lt; 0.05. Results: The mean age of the participants was 52.24 ± 8.75 years, and 55.5% were female. Patients with diabetes have an increased incidence of upper GI symptoms (adjusted odds ratio [aOR] = 1.19, 95% confidence interval [CI]: 1.00–1.42, p = 0.045) compared to individuals without diabetes. The most common upper GI symptom in patients with diabetes compared to those without diabetes was eructation (18.6% vs. 14.9%, p = 0.009). Conclusions: The prevalence of GI symptoms was high in patients both with and without diabetes, and the chance of developing GI upper symptoms was higher in patients with diabetes