Govaresh
Volume:22 Issue: 2, 2017

Gastric cancer )GC( is the second leading cause of cancer-related deaths worldwide. Long non-coding RNAs )LncRNAs(, a small class of molecules that are transcribed as non-coding RNAs with lengths ranging from 200 nt to 100 kb have no protein coding capacity. Ectopic expression of LncRNAs, plays an important role in the development of GC. These molecules are involved in physiological cellular processes such as genomic imprinting, X-chromosome inactivation, maintenance of pluripotency and organogenesis through making changes in chromatin, transcription, translation, and processing. It has been known that LncRNAs act as oncogenes or tumor suppressor genes. Some studies show that LncRNAs could interact with miRNA and block miRNA access to their mRNA targets. Recent studies have shown that LncRNAs involve in tumorigenesis, angiogenesis, proliferation, migration and differentiation, and apoptosis. They can be used as novel biomarkers for the early detection of GC as well as therapeutic targets. In this study we aimed to describe the latest findings about the role of LncRNAs in the development of GC.

Studying the validity and reliability of short-form )SF(-Nepean Dyspepsia Index )NDI( in patients with functional dyspepsia )FD(.
After translating to Persian, the NDI-10 was filled out by 210 patients with FD, whose disease had been diagnosed by a gastroenterologist based on Rome 3 criteria, who admitted to Gastroenterology Clinic of Afzalipour Hospital in 2015. The reliability of the questionnaire was studied by test-retest and Cronbach’s alpha coefficient. The validity of the questionnaire was evaluated through content-validity and criterion-validity.
Through analyzing the results of test-retest of the questionnaire, the Pearson coefficient was obtained as 83%, which proves the reliability of the questionnaire. Criterion-validity with the correlation coefficient of 0.56 and content-validity both prove the adequacy of questionnaire for measuring the quality of life in patients with FD.
Generally, Persian translation of this questionnaire has acceptable validity and reliability for measuring the quality of life in patients with FD.

Colorectal cancer is one of the important causes of death due to cancer worldwide. Survival time in this cancer should be controlled to decrease the risk of mortality. In this study survival time and factors that could affect it are evaluated.
In the present study, the files of 446 patients afflicted with colorectal cancer who had referred to Taleghani Hospital, Tehran from 1985 to 2013 were chosen as the study group. The exponential model was used here, for the purpose of investigating the survival of patients with colorectal cancer and finding proper variables affecting this survival and longevity.
In this study, the subjects had the mean (standard deviation) survival time 4.52 (0.182) year. The patients’ age at the time of diagnosis (P = 0.002) and tumor size (P = 0.032) were the only significant variables affecting the survival of patients in the exponential model. Sex, the family history of colorectal cancer, the tumor site, and body mass index had no significant effect on the survival time of the patients with colorectal cancer.
The results of the study show that to improve the survival chance of the patients with colorectal cancer or decrease the mortality rate, due attention should be paid to the age of the patient at the time of diagnosis.

Atherosclerosis is involved in inflammatory diseases, and inflammation can be a valuable predictor of cardiovascular disease. On the other hand, an increase in intima-media thickness (IMT) is usually considered as a primary marker of atherosclerotic lesions. Hence, measurement of IMT may be useful for early detection of atherosclerosis in patients with inflammatory bowel disease (IBD). The aim of this study was to systematically review the literature in which the IMT had been evaluated as diagnostic marker for the detection of atherosclerosis in patients with IBD.
A systematic literature search was performed in PubMed, Scopus, and Google scholar using the following search method ((inflammatory bowel disease OR IBD OR Crohn’s disease OR ulcerative colitis)) AND (intima OR intima media thickness OR intimal medial thickness OR IMT OR carotid intima-media thickness OR CIMT) to evaluate the association between IBD and IMT. After collecting the eligible documents, the desired data were extracted and analyzed.
Of total 278 collected documents, only 14 relevant articles with total 1333 participants including 720 patients with IBD and 613 healthy controls were included for data assessment. The results of the articles did not support significant association between IMT and IBD. However, in some studies it was shown that IMT was elevated in patients with IBD.
The results of this survey showed that there was no significant difference in IMT between the patients with IBD and healthy control groups; therefore, IMT cannot be considered as a predictor of atherosclerosis and future cardiovascular events in patients with IBD.

Endoscopic submucosal dissection (ESD) is a novel technique for removal of early mucosal neoplasms of gastrointestinal tract. While it has been widely used in Japan and eastern Asian countries, there have been no data available from Iran. Here we report our experience with this method in a single, private, non-tertiary care, and non-referral hospital in Iran.
Demographics, outcomes, and complications of ESD of six lesions in six patients performed at a single center during 2013-2016 were retrospectively evaluated.
The mean (range) age of the patients was 60.5 (40 - 71) years. Of them three had gastric lesions and three had rectal lesions. Two gastric lesions were HGD (High Grade Dysplasia) and one was intramucosal carcinoma. Rectal lesions were villous adenoma in one case and two T1 adenocarcinomas in two other cases. The mean (range) size of the lesions size was 3.1 cm (2.5-8 cm). Complete removal was achieved in all the patients both endoscopically and histopathologically. Microscopic perforation occurred in one case, which was managed conservatively without a need for surgical intervention. No significant late bleeding was observed. No surgery was needed either for completion of removal or control of complications. During mean follow-up of 20 months no recurrence occurred.
Our first experience with ESD shows its high rate of effectiveness with acceptable complication rate and success rate. Proper patient selection and use of standard techniques and instruments are required to produce clinically acceptable outcomes for patients in need of this method to cure their early mucosal neoplasia.

Iron deficiency anemia has been considered as an alarming sign of the possible presence of malignancy in the digestive tract. Inadequate assessment of such affected patients can lead to delay in the diagnosis of gastrointestinal (GI) tumors especially colorectal cancers. Therefore the present study examined the upper and lower GI tract of postmenopausal women with iron deficiency anemia by GI endoscopy.
Women aged over 45 years referred to Gastroenterology Clinic of Imam Khomeini Hospital were asked about their menstruation. Postmenopausal women with the anemia were enrolled. A list of laboratory studies were performed for all included patients. These laboratory studies included complete blood count (CBC), iron profile and stool examination for occult blood. 103 postmenopausal women with iron deficiency anemia according to laboratory tests were interviewed and their clinical and biochemical variables were recorded. All of the study patients underwent esophagogastroduodenoscopy and colonoscopy. The endoscopic findings were recorded regarding the presence of GI lesions causing iron deficiency anemia or the lack of them.
A total of 103 patients participated in this study. Endoscopy revealed a source of iron deficiency anemia in 90.3% of the study population. Upper and lower GI tract lesions were found in 73.8% and 51.5% of the patients, respectively. The most frequent lesions in the upper GI endoscopy were severe gastroesophageal reflux disease involving 34 patients (33%) followed by gastric erosions in 31 cases (30.1%) and duodenal ulcer in 15 cases (14.6%).
In postmenopausal women with iron deficiency anemia as in men, it is necessary to examine the GI tract.

The relationship between primary hyperparathyroidism and pancreatitis has yet to be established firmly. We present a patient with acute pancreatitis and a hypercalcemic crisis induced by a parathyroid adenoma. A 72-year-old woman presented with lethargy and a constant pain in the epigastric region. She had a medical history of diabetes mellitus, hypertension, nephrolithiasis, and ischemic heart disease. Blood examination revealed leukocytosis and high serum amylase and lipase levels. Ultrasound exam confirmed the diagnosis of acute pancreatitis with a normal biliary tract and no gallstones. On further evaluation severe hypercalcemia (24 mg/dL) was detected, which was treated with 0.9% sodium chloride solution and calcitonin. The acute pancreatitis and its symptoms resolved after 3 days. Ultrasound exam and technetium 99 m sestamibi scan showed a parathyroid lesion. Ultimately the patient underwent right thyroid lobectomy because of refractory hypercalcemia. The pathology report was indicative of a parathyroid adenoma. Subsequently, the parathyroid gland was resected with normalization of calcium, parathyroid hormone, and amylase levels and the patient was discharged in good condition 7 days after surgery. Apart from the acute supportive management, common to all cases of acute pancreatitis, definite management must be tailored to the specific cause. Hypercalcemia during the course of pancreatitis must prompt an investigation for primary hyperparathyroidism with early surgical intervention if a parathyroid source is detected.