فهرست مطالب abdolreza pazouki

Obesity and Helicobacter pylori (H. pylori) infection are public health problems in the world and Iran. This study aimed to indicate the anatomical place with the most accurate results for H. pylori. According to gastric mapping, this study will be able to evaluate the prevalence of H. pylori based on the pathology of gastric mapping and the accuracy of the antral rapid urease test (RUT) based on endoscopic findings.  

In this cross-sectional study, upper digestive endoscopy and gastric pathology were studied in 196 obese patients candidates for bariatric surgery. Statistical analyses were performed using a t-test and Chi-square/fisher’s exact test to compare the groups. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and odds ratio (OR) were used to compare RUT and pathological H. pylori test of each of the six areas of the stomach. We set a positive test of the pathology of 6 regions of the stomach as our gold standard (in this study).  

The most common area of the stomach for pathological findings of H. pylori were incisura (116, 59.2%), greater curvature of the antrum (115, 58.3%), lesser curvature of the antrum (113, 57.7%), lesser curvature of the corpus (112, 57.1%), greater curvature of the corpus (111, 56.6%) and cardia (103, 52.6%). The prevalence of H. pylori was 58.2% (114 cases) and 61.2% (120 cases) with RUT and gastric pathology, respectively. Mild, moderate, and severe infection of H. pylori in cardia (58, 29.6%), greater and lesser curvature of the antrum (61, 31.1%), and greater curvature of the antrum (37, 18.9%) had the highest percentages of incidence comparing to other sites of the stomach, respectively. The most sensitive area for pathologic biopsy was incisura (96.6%, 95% confidence interval: 91.7, 98.7).  

According to the highest sensitivity, PLR, NPV, and pathological findings of H. pylori in accordance with the lowest NLR in the incisura compared with other parts of the stomach, it is highly recommended to take the biopsy from the incisura instead of other anatomical places of stomach for detecting H. pylori specifically if our strategy is taking only one biopsy.

Background and Objective Bariatric surgery is one of methods for treatment of morbid obesity. Psychological factors can affect its outcome. This study aims to investigate the relationship between coping strategies and the outcome of bariatric surgery in patients with morbid obesity.
Materials & Methods This prospective observational study was conducted on 85 patients who underwent bariatric surgery in the obesity clinic of Hazrat-e Rasul Akram and Milad Hospitals in Tehran, Iran. Subjects were evaluated before and two years after surgery using Folkman & Lazarus’ ways of coping questionnaire and the Bariatric Analysis and Reporting Outcome System (BAROS).
Results During the follow-up, 9 patients left the study. The mean age of participants was 38.11±11.5 years (ranged 17-65 years). Problem-focused coping strategies and their components had a significant positive relationship with the surgery outcome (P<0.05), but emotion-focused coping strategies had no significant relationship with the surgery outcome (P>0.05). 
Conclusion Problem-focused coping strategies can predict the outcome of bariatric surgery.

Insufficient angiogenesis is associated with serious diabetic complications. Recently, adipose-derived mesenchymal stem cells (ADScs) are known to be a promising tool causing therapeutic neovascularization. However, the overall therapeutic efficacy of these cells is impaired by diabetes. This study aims to investigate whether in vitro pharmacological priming with deferoxamine, a hypoxia mimetic agent, could restore the angiogenic potential of diabetic human ADSCs.

Diabetic human ADSCs were treated with deferoxamine and compared to normal and nontreated diabetic ADSCs for the expression of hypoxia inducible factor 1-alpha (HIF- 1α), vascular endothelial growth factor (VEGF), fibroblast growth factor-2 (FGF-2) and stromal cell-derived factor-1α (SDF-1α), at mRNA and protein levels, using qRT-PCR, western blotting and ELISA assay. Activities of matrix metalloproteinases (MMPs)-2 and -9 were measured using a gelatin zymography assay. Angiogenic potentials of conditioned media derived from normal, Deferoxamine treated, and non-treated ADSCs were determined by in vitro scratch assay and also three-dimensional tube formation assay.

It is demonstrated that deferoxamine (150 and 300 μM) stabilized HIF-1α in primed diabetic ADSCs. At the concentrations used, deferoxamine did not show any cytotoxic effects. In deferoxamine treated ADSCs, expression of VEGF, SDF-1α, FGF-2 and the activity of MMP-2 and MMP-9 were significantly increased compared to nontreated ADSCs. Moreover, deferoxamine increased the paracrine effects of diabetic ADSCs in promoting endothelial cell migration and tube formation.

Deferoxamine might be an effective drug for pharmacological priming of diabetic ADSCs to enhance the expression of proangiogenic factors noted via HIF-1α accumulation. In addition, impaired angiogenic potential of conditioned medium derived from diabetic ADSCs was restored by deferoxamine.

A large liver size is a factor that may increase the difficulty of bariatric surgery (BS) and unwanted complications. Some agents have been used to decrease the liver size before BS. Silymarin has been used as an antioxidant agent to improve liver function tests. This study was designed to evaluate the effects of silymarin on liver dimensions, function, and lipid profile.

A double?blind randomized clinical trial was performed on 56 patients. The patients were divided into silymarin and placebo groups. Blood samples and sonographic examinations were taken from the patients before and 4 weeks after the administration of the silymarin or placebo. In the first group, 140 mg silymarin was prescribed every 8 h for 4 weeks, and the other group received placebo in the same way with the same tablet  hape. After the completion of the 4?week treatment, laboratory tests and ultrasonography were carried out again.

Thirty?nine (69.6%)  atients were female with a mean body mass index (BMI) of 46.2 kg/m2 and a mean age of 36.8 years. Most of the patients had a compliance of 80% and higher. The analysis did not show any significant difference in aspartate transaminase, alkaline transaminase, liver size, cholesterol, and triglyceride changes among the silymarin and placebo groups. BMI loss was slightly higher in the silymarin group although the difference was not statistically significant.

The present findings show that silymarin administration for 4 weeks does not affect liver size and  unction, but further evaluations should be carried out on the subject.

There is little data about the surgical outcomes of different procedures in children.

We aimed to compare the difference in three-year surgical outcomes between laparoscopic sleeve gastrectomy laparoscopic sleeve gastrectomy (LSG) and one-anastomosis gastric bypass one-anastomosis gastric bypass (OAGB) in children undergoing these procedures.

A total of 96 children aged ≤ 19 years were listed for bariatric surgery to be included in this prospective study. Demographic characteristics, such as age and gender, and anthropometric indices, including height, weight, body mass index, waist circumference, and hip circumference, as well as postoperative complications, were recorded. The participants underwent LSG and OAGB by the same surgical team. The variables were compared between the groups at baseline and 1, 3, 6, 12, 24, and 36 months after surgery.

At follow-up, the OAGB group had a higher waist circumference after 1 and 3 month(s) (P = 0.011 and 0.005, respectively) and higher hip circumference 3 months after surgery (P = 0.035). Time significantly affected the trend of changes in weight, body mass index, waist circumference, and hip circumference (P < 0.001). There were no cases of postoperative complications.

Our experience showed that LSG had better outcomes after three months, while LSG and OAGB had favorable outcomes on the weight and body mass index (BMI) of children with morbid obesity until three years after surgery.

Childhood overweight and obesity are public health concerns. It is essential to examine the prevalence of overweight and obesity for effective planning and efficient use of resources in the health system.

The present study’s objective was to investigate the prevalence of overweight and obesity in children aged 8 to 12 years in Tehran, Iran.

In this cross-sectional study, 829 primary school children in Tehran were included. An investigator administered a checklist to collect the relevant data, and anthropometric measurements were performed using standard procedures. We used the World Health Organization’s (WHO) child growth standards to assess overweight and obesity among children. The Chi-square test was used to analyze categorical variables, and statistical significance was confirmed at P < 0.05.

Of the students, 366 (44.1%) were boys, and 463 (55.9%) were girls. The prevalence of overweight and obesity were 20.6% and 14.6%, respectively. The prevalence of obesity was higher among boys than among girls (19.4% vs. 10.8%); the highest prevalence of obesity was observed among 9-year-old children. No relationship was identified between the type of school and the prevalence of obesity (P = 0.33).

Childhood overweight and obesity were relatively prevalent among 8 - 12-year-old children. So, obesity should be considered a serious health problem in Tehran, requiring more care and interventions to prevent an epidemic of obesity among Iranian children.

Changes in cognitive profile, such as memory and other functions in patients with morbid obesity after bariatric surgery have been reported in the literature with inconsistent results.

This study aimed to evaluate cognitive changes, executive function and depression severity before and after bariatric surgery in patients with morbid obesity.

In this prospective cohort study, 70 patients with morbid obesity (40 patients undergoing bariatric surgery and 30 patients in the waiting list) referred to the Rasool Akram Medical Complex, obesity clinic, Tehran, Iran, in 2016 entered the study. The two groups were assessed using the Wechsler Memory Scale (WMS) (consists of 7 subscales and assesses memory), the Wisconsin Cart Sorting test (WCST) (includes 64 cards and assesses cognitive skills), the Hamilton Depression Scale (HAM-D) (for measuring depression) and bariatric analysis and reporting outcome system (BAROS) questionnaire (scale to report of the therapeutic results of bariatric surgery and including the three criteria of the weight loss percentage, the change in health state, and the quality of life) at the beginning of the study and three months after the surgery. Moreover, the Bariatric Analysis and reporting outcome system (BAROS) questionnaire was filled three months after surgery.

The average changes in WMS score (P = 0.043), working memory (P = 0.002), HAM-A (P = 0.032), weight, and BMI (P = 0.0001) in the surgery group were significantly higher than the control group. There was a significant positive correlation between change in the number of preservative errors in WCST within the surgery group with BAROS score (P = 0.004). Moreover, there was a significant correlation between changes in the score of WMS and those in BMI in the surgery group.

Bariatric surgery is associated with improvements in some cognitive functions and worsening of depressive scores in patients with morbid obesity.

Obesity is one of the most important health problems today that causes other diseases such as diabetes and heart diseases. Obesity is caused by a variety of factors, and viruses, especially adenoviruses  type 36. This study was performed to detect the adenovirus 36 genome in the adipose tissue of  patients who underwent surgery due to severe obesity. Also, the prevalence of antibodies against adenovirus 36 in the control and patient groups was compared and their biochemical parameters were compared and analyzed.

Adenovirus genome was detected in patients with abdominal adipose tissue by PCR technique. Positive samples were sequenced and a phylogenetic tree was drawn. Prevalence of specific antibodies against adenovirus 36 in case and control groups was determined by ELISA technique.

The adenovirus genome was detected in the adipose tissue in 4 of the 60 samples in the case group.  43 obese individuals with a body mass index of less than 35 were also selected as the control group. The prevalence of antibodies against this virus in 103 psrsons was 49%. The prevalence of antibodies was 33% in the patient group and 15% in the control group. In people with antibodies to adenovirus 36, the serum lipid profile changed significantly. These people had lower serum triglycerides and higher low density lipoprotein .Finally, the sequencing analysis showed the adenoviruses found in the specimens were adenovirus-36 and are belonged to subgroup D.

Adenovirus 36 is detected in the adipose tissue of severely obese individuals and the presence of its antibody in the serum affects the lipid profile.

Single anastomosis sleeve ileal bypass (SASI) is one of the new surgical methods for morbid obese and diabetic patients. In this method, a combination of gastric sleeves and gastric bypass is performed, which has shown better results in the treatment of patients with type 2 diabetes by increasing insulin secretion from the pancreas and decreasing the body's insulin resistance. The aim of this study was to systematically evaluate the effects of this method in the treatment of morbid obesity and comorbidities.

In this systematic review, PubMed, Scopus, Web of Science and Google scholar databases with English keywords of single- anastomosis sleeve ileal bypass, SASI, obesity, diabetes, and bariatric bypass surgery were used until October 1, 2021. Due to the novelty of this surgical procedure, there was only 7 articles.

In evaluating the effects of SASI surgical method in patients with morbid obesity, the results showed that fasting blood sugar, cholesterol, high-density lipoprotein, low-density lipoprotein, body mass index and hemoglobin A1C in the one-year follow-up were significantly changed (P=0.05). Comorbidities, such as diabetes and high blood pressure, usually improved.

SASI by-pass surgery is an effective, safe and simple method for the treatment of morbid obesity and comorbidities and has fewer nutritional side effects. The presence of two food passageways following SASI makes it possible to reduce malnutrition.It also allows the examination of digestive problems by endoscopy.. Therefore, it is an ideal way to reduce both weight and comorbidities.

Previous studies have demonstrated that patients with obesity can be metabolically healthy. However, little is known about the healthy or unhealthy metabolic status of patients undergoing bariatric surgery. This study, therefore, assesses the prevalence of metabolically healthy (MHO) and unhealthy (MUO) obesity among bariatric surgery candidates.

The study involved 713 bariatric surgery candidates (580 women and 133 men; age range 18-69 years). MHO and MUO were defined according to The National Cholesterol Education Program-Adult Treatment Panel III (ATP III).

Mean (±SD) patient age, weight, body mass index (BMI), waist and hip circumference were 40.44 (±10.26) years, 127.15 (±22.15) kg, 164.33 (±8.85) cm, 46.90 (±5.79) kg/m2, 122.57 (±13.93) cm, and 140.10 ( ±12.40) cm, respectively. 318 patients (44.6%) were classified as MHO and 395 (55.4%) as MUO. A higher percentage of participants aged 40 years and older suffered from unhealthy metabolic status (61%).

A large percentage of bariatric surgery candidates are metabolically healthy.  Additionally, the prevalence of MHO was higher at younger ages

Any physiologic or pathologic situation can affect oral and dental health. Obesity and Bariatric surgery are two different factors which have their own signs and symptoms in the oral cavity. Soft tissue, hard tissue, oral flora and saliva can manifest changes in these patients and some intervention would be needed to control it. Our goal is to review oral manifestations in obese and bariatric patients to attract attention to oral care in these patients.

The aim of this study was to describe three neglected pregnancy at the time of bariatric surgery (BS) who had negative pregnancy test before surgery and underwent single-anastomosis gastric bypass surgery in obesity clinic in Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. The first case was a 38 years old woman with BMI of 47.1 suffering from nausea and vomiting one month after surgery that medical treatment did not work and it was found positive βHCG test as and 13W + 6D fetus in sonography. The second case was a 30 years old woman with BMI of 46.2 suffering uterus bleeding four months after surgery. The third case was a 32 years old woman with BMI of 44.6 with suffering from resistant nausea and vomiting, epigastric pain, and delayed mense three month after surgery. These cases show the necessity of βHCG test at the time of bariatric surgery for childbearing females.

 To evaluate the association between menstrual cycle disorders with obesity in Iranian women.

In the present case-control study, 405 obese women of reproductive age who referred to the Obesity Clinic of Minimally Invasive Surgery Research Center, Rasoul-e-Akram Hospital, Tehran, between Jan 2013 and Oct 2015 were included as the case group and were compared with a control normal-weight group, selected from their family members (N=293). Menstrual cycle characteristics were documented in a researcher-designed checklist. For the statistical analysis, we used SPSS version 19 and Stata version 5.0.

In the case group, 47 women (11.6%) had irregular menstrual cycles, while it existed in 22 (7.5%) of the control group (P<0.001). The prevalence of different menstrual disorders was as follows: polymenorrhea 107 (26.4%) in cases and 51 (17.4%) in controls (P<0.001), oligomenorrhea 22 (5.4%) in cases and 16 (5.5%) in controls (P<0.001).

The results of the present study showed that morbid obesity increases the risk of menstrual irregularities and dysmenorrhea; therefore, it is essential to pay greater attention to this issue in morbid obese patients for proper management of this disturbing comorbidity.

Nowadays, surgical option is the most powerful and durable treatment modality for morbid obese patients in the world. Postoperative Gastrointestinal bleeding is one of complications which has been encountered in the early and late postoperative period after bariatric surgery. One of probable locations of gastrointestinal bleeding after gastric bypass is gastrojejunostomy anastomosis site. Use of metal clips in the tip of inner aspect of gastrojejunostomy anastomosis may reduce intraluminal bleeding in early postoperative period.

Surgical treatment of patients with morbid obesity is now the most successful way to return to active life and overcome its effects. Complications during surgery, but still are varied and plentiful. One of the most important of these effects is increased bleeding during surgery and may require further surgery is surgery duration. The use of propranolol in other operations under the impact of which is helpful in reducing blood loss in surgery Bariatric still not been investigated. The purpose of this study is the use of propranolol in reducing gastric bypass surgery is bleeding.

Morbidity and mortality rates are increased due to obesity after organ transplantation; in this regards, bariatric surgery (BS) is believed to be an effective treatment for posttransplant obese patients. Nevertheless, some studies are doubtful in terms of the effectiveness of BS, the most suitable bariatric procedure, and management of immunosuppressant drugs in some kinds of organ transplants. We evaluated nonsurgical therapies, weight reduction, adjustment of immunosuppressants, comorbidities, and the recommended surgical procedures for posttransplant BS for different types of organ transplantations.

Laparoscopy begins with the safe creation of a pneumoperitoneum, often a difficult step in the bariatric patient. To minimize entry-related injuries, several techniques, instruments and approaches have been introduced during the last years. First Trocar insertion related Complications can occur even in the best of hands and it is vital that these are recognized promptly and immediately addressed. In our experience we use some steps in trocar entry to minimize trocar related abdominal injuries.

In this study, we aimed to evaluate the effect of bariatric surgery on constipation followed by the surgery.This prospective cohort study included 237 patients with morbid obesity, who were candidate for Laparoscopic Roux-en-Y Gastric Bypass (RYGB), and One-Anastomosis Gastric Bypass (OAGB) in Obesiyt Clinic of Rasoul Akram Hospital, Tehran, Iran, 2012-2014. The severity of constipation was measured by Wexner Constipation Score (WCS) before and three months after the surgery. Paired t-test, Mc Nemar test, and logistic regression were applied for the analyses. Mean age and BMI of the 237 patients were 31.59±5.92 years and46.59±5.81kg/m2, respectively. Mean WCS decreased significantly in OAGB group (3.1±4.27 vs. 4.72±4.81, P=0.003), while the reduction in WCS mean score was not significant in RYGB group (4.5±4.73 vs. 4.63±5.19, P=0.793). The proportion of constipation reduced (48/103 vs. 32/103) significantly in OAGB group (P=0.002). Conversely, the decrease in this proportion (from 58/134 to 57/134) was not significant in RYGB group (P=0.06). Considering the confounding role of diet and supplementary intake of the patients, the results of this study showed that the frequency of constipation reduced in morbidly obese patients undergoing obesity surgery and postoperative nutritional recommendations. The comparison between techniques showed that OAGB reduced the constipation score and proportion, while this decrease was not significant in RYGB.

Vitamin D3 deficiency is associated with insulin resistance and metabolic syndrome. Although, the evidence was not conclusive. The aim of this study is to investigate the relationship between serum 25-hydroxy vitamin D3 (25(OH) D3) levels with some adiposity and metabolic indices related to metabolic syndrome.

In this cross-sectional study, the anthropometric, body composition information, the clinical laboratory tests including fasting blood sugar (FBS), insulin, lipid profile, liver enzymes, and serum 25(OH) D3 of 3750 patients with morbid obesity are extracted from Iran National Obesity Surgery Database. HOMA-IR and QUICKI were computed based on the standard formula. Associations were tested using analysis of variance and Kruskal–Wallis test.

Approximately 69% of patients with morbid obesity had sub-optimal vitamin D3 levels (<20 ng/mL). An inverse significant relationship between serum 25(OH) D3 and body weight, body fat percentage, waist, and hip circumstance was observed (p<0.05 for all). Low serum 25(OH) D3 levels are significantly associated with higher FBS and A1C, dyslipidemia (higher LDL and TG), and also the elevated level of liver function enzymes (p<0.05 for all). Moreover, the patient with the higher serum 25(OH) D3 had a lower level of HOMA-IR and higher insulin sensitivity (QUICKI index); this association was not statistically significant, though.

Vitamin D3 deficiency has been associated with adiposity, impaired glucose metabolism, and metabolic disorders related to insulin resistance. Thus, vitamin D3 supplementation could be a potential approach in treatment or decrease of the metabolic complication of obesity before and after bariatric surgery.

According to the IFSO worldwide survey report in 2014, 579517 bariatric operations have been performed in a year, of which nearly half the procedures were SG followed by RYGB. This procedure is a proven successful treatment of patients with morbid obesity which induces considerable weight loss and improvement of type 2 diabetes mellitus, insulin resistance, inflammation, and vascular function. In the present study, we aimed to build a machine based on a decision tree to mimics the surgeonchr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))s pathway to select the type of bariatric surgery for patients.

We used patient’s data from the National Bariatric Surgery registry between March 2009 and October 2020. A decision tree was constructed to predict the type of surgery. The validation of the decision tree confirmed using 4-folds cross-validation.

We rich a decision tree with a depth of 5 that is able to classify 77% of patients into correct surgery groups. In addition, using this model we are able to predict 99% of bypass cases (Sensitivity) correctly. The waist circumference less than 126 cm and BMI equal to or more than 43 kg/m2, age equal to or greater than 30 years old, and being hypertensive or diabetes are the most important separators.

The effects of all nodes have been studied before and the references confirmed the relations of them and surgery type.

 One anastomosis gastric bypass (OAGB) is considered as a surgical treatment option for patients with morbid obesity. However, significant decreases in dietary intake and nutrient malabsorption after OAGB may potentially lead to nutritional deficiencies. This study was therefore conducted to assess and compare the mean values of dietary intake over 12 months following OAGB in patients with different pre-operative body mass index (BMI).

 The study was performed on 60 patients with morbid obesity (88.3% female) who underwent OAGB between January 2011 and November 2018. The average daily nutrient intake values were obtained from food frequency questionnaires. Other data were drawn from the National Obesity Surgery Database.

 The mean (SD) pre-operative age, weight and BMI were 41.08 (9.41) years, 121.43 (21.01) kg, and 46.77 (6.17) kg/ m2, respectively. Participants were divided into two groups based on their pre-operative BMI (1: BMI≤ 45 kg/m2, n=29; and 2: BMI> 45 kg/m2, n= 31). The mean %EWL at one year postoperatively was 52.37±8.63 and 50.82±8.75 in groups 1  and 2, respectively. However, there was no significant difference in %EWL between groups (P=0.49). Additionally, the percentage of energy consumption from carbohydrates, protein and fats after surgery was 55.49±6.19%, 16.18±2.60% and 32.05±5.97%, respectively. No significant difference was observed in average daily energy and macronutrient intakes between groups (P>0.05 for all).

 Pre-operative BMI values probably had no significant effect on post-operative %EWL, nor on energy and macronutrient intake. Large-scale studies are needed to confirm these findings.

Obesity and upper gastrointestinal disorders are the public health problems in the world and Iran. The role of routine preoperative upper gastrointestinal endoscopy of the morbid obese patients undergoing bariatric surgery is a subject of discussion. The aim of this study was to determine the relationship between gastric pathological findings in morbid obese patients with demographic information, Helicobacter pylori, biochemical status and inflammatory factors.

Upper digestive endoscopic findings, including rapid urease test and pathological examples in the six areas of stomach were examined in 196 morbid obese patients who were candidates for bariatric surgery. These cases had either body mass index (BMI) higher than 40 or higher than 35 in addition to one comorbidity. For grading chronic gastritis, six samples were given from these areas of stomach: two biopsies from antrum, with 2-3 centimeters (cm) from pylorus, one sample from distal of lesser curvature, another one from distal of greater curvature, two samples from corpus with eight cms distance from cardia (one of them from lesser curvature another one from greater curvature) and one sample from incisura angularis according to Sydney system. Height, weight, sex, triglyceride (TG), cholesterol (Chol), high density lipoprotein (HDL), low density lipoprotein (LDH), fasting blood sugar (FBS), and history of some diseases (hypothyroidism, lipid profile metabolism disorders, diabetes mellitus type II, sleep apnea, menstrual abnormalities, and eating disorders) were evaluated as well. We get six samples from three areas of the stomach for grading chronic gastritis according to Sydney system: two biopsy samples from pylorus, by 2-3 cm from pylorus, one from distal of lesser curvature, one from distal of greater curvature, two sample from cardia, with eight cm distance from cardia (one from lesser and the other from greater curvature), and one sample from incisura angularis. T-test, chi-square and Fisher exact test were used in statistical analysis. This study was approved by ethics committee of Iran University of Medical Sciences by this code: 25669.1396 IR.IUMS.REC.

There were 86.2% women among all 196 cases. Mean ± standard deviation (SD) of age, weight and BMI of participants were 39.9±10.2 years, 123.5±22.5 kilogram (Kg), and 45.9±6.1 kg/m2, respectively. Smoking in 15.8% and alcohol drinking in 13.8% was observed. Dyslipidemia in 44 (22.4%), hypothyroidism in 42 (21.4%), menstrual abnormality in 39 (19.9%), diabetes mellitus in 26 (13.3%) and sleep apnea in 21 cases (10.7%) were the most common comorbidities in these patients. Family history of obesity: 161 (88.2%), hypertension: 121 (61.7%), diabetes mellitus: 113 (57.7%) and cancer: 64 patients (32.7%) were the most common diseases in family of affected patients. Eating disorders were volume eating in 161 (82.1%), microphagia in 129 (65.8%) and bulimia in 121 cases (61.7%), respectively in descending order.The most common pathologic findings of the stomach were chronic inflammation in 195 (99.5%), acute inflammation in 131 (66.8%), active inflammation in 127 (64.8%), H. pylori infection in 120 (61.2%), active atrophy in 37 (18.9%), metaplasia in 29 (14.8%) and atypia in 19 cases (9.7%), respectively. There was not any cases with dysplasia. The most common H. pylori prevalence was in incisura in 116 cases (59.2%), while, the lowest prevalence was observed in cardia in 103 patients (52.6%). Urease test for H. pylori infection was positive in 114 cases (58.2%), while, H. pylori infection in all six regions of the stomach was observed in 120 cases (61.2%). Urease test result and presence of H. pylori infection had statistically significant association with each other (p<0.001). In 27 cases (22.5%) despite H. pylori infection in pathologic assessment from biopsy samples of one of six regions of the stomach, urease test was falsely negative. On the other hand, in 21 samples (27.6%) despite negative result for H. pylori in all six areas of the stomach, urease was falsely positive. The specificity and sensitivity of rapid urease test were calculated to be 72.4% and 77.5%, respectively. Demographic information, biochemical status and inflammatory factors of the two groups of patients with and without pathological findings in the six areas of stomach were not different (For all of them p>0.050). However, the presence of Helicobacter pylori was associated with pathology finding in only two areas: small corpus and large corpus (p= 0.006 and p<0.001, respectively).

In our study abnormal findings in endoscopy was higher than similar studies. Positive result of urease test was also higher because similar studies have excluded symptomatic cases with gastroesophageal reflux disease and PPI users. The role of routine upper gastrointestinal endoscopy before obesity surgery is under debate. The American Society of Gastroenterologists and Endoscopists (SAGES) recommends the American Society of Metabolic and Obesity Surgeons (ASMBS) and the American Society of Gastroenteroscopic Endoscopies that endoscopy be decided according to each individual condition and type of procedure. It is recommended in patients at high risk for gastric cancer such as a history of Helicobacter pylori, BMI, waist and waist to hip ratio, family history of gastric cancer and male sex and according to protective effects of Helicobacter pylori treatment in the prevention of gastric cancer under the age of 40. It was done to prevent pathology in at least these two areas of the stomach in the future. However, showing the presence of Helicobacter pylori with pathology in these two areas of the stomach in this study does not mean that if Helicobacter pylori is eradicated, the chance of developing gastric cancer in these areas will be zero; Other studies have not shown that Helicobacter pylori infection is associated with pathology in any part of the stomach due to the lack of gastric mapping, so it is likely that what has been said about eradicating Helicobacter pylori and reducing the chance of stomach cancer. It has been due to the eradication of Helicobacter pylori in two areas of small corpus and large corpus of the stomach. According to the association of Helicobacter pylori infection and pathological findings in small corpus and large corpus areas of stomach and the results of other studies that Helicobacter pylori infection increases the chance of gastric cancer and due to high false negative rate of rapid urease test (22.5%) It is recommended that for patients with high risk of gastric cancer use pathological samples, especially in these two areas, to diagnose Helicobacter pylori infection.

One anastomosis gastric bypass (OAGB)/mini gastric bypass is now considered to be a safe and efficient method for morbidly obese patients but has complications and adverse events such as other surgical procedures. The present paper outlines the need for and the nature of revisional surgery in the long‑term following OAGB in accordance with the preferred reporting items for systematic reviews and meta‑analysis guidelines. A literature search was carried out in PubMed. All articles on OAGB for which the authors described a patient needing revisional surgery in the long term after OAGB were examined.

Emotional reactivity is a key construct for understanding psychopathology. Examining the psychometric properties of the instruments in societies with different cultures can help with their external validity.

The current study aimed at standardization and validation of the Perth emotional reactivity scale (PERS) in Iranian university students.

The Persian version of the PERS was produced through forward translation, reconciliation, and back-translation. A total of 302 (169 males and 133 females) nonclinical students were selected by convenience sampling method, and completed a set of questionnaires, including the PERS, weight efficacy lifestyle questionnaire-short form (WEL-SF), eating attitude test-16 (EAT-16), selfesteem scale (SES), difficulties in emotion regulation scale-16 (DERS-16), and self-compassion scale (SCS) short-form. The construct validity of the PERS was assessed using confirmatory factor analysis and divergent and convergent validity. Internal consistency and test-retest reliability (a 2-weeks interval) were used to evaluate the reliability. Data analysis was performed using LISREL (version 8.8) and SSPS (version 22) software.

All PERS scales and subscales were found with good internal consistency and test-retest reliability in a nonclinical population. The convergent validity and divergent validity were also found good. The results of this study provides the support for the applicability of the six-factor (RMSEA = 0.06, NFI = 0.94, NNFI = 0.96, and CFI = 0.97) and two-factor (RMSEA = 0.07, NFI = 0.94, NNFI = 0.96, and CFI = 0.96) models of the PERS.

The PERS showed good validity and reliability and can be useful in assessing emotional reactivity in the Iranian population. The PERS can be promising as a measure to use in emotional-based studies and clinical settings.

Infection of burn wounds is one of the most important problems in the world. Lactobacillus plantarum is known for burn wound healing because of the immunomodulatory and anti-microbial roles. This study was performed to compare the effects of L. plantarum and imipenem – alone and in combination – on infected burn wound healing.

Burn wounds were experimentally induced on 50 rats in three test groups (germ and supernatant of L. plantarum) and two control groups (n=10 each) and were inoculated with Pseudomonas aeruginosa. During a 14-day period, wounds in all groups were daily treated topically. The data were analyzed using one-way analysis of variance followed by Tukey–Kramer and LSD. A p-value of < 0.05 was considered as statistically significant.

The mean size of the wound on day 14 after the treatment in the probiotic group was significantly lower than the control and the supernatant treated groups (p<0.05).  The percentage of wound healing was significantly higher in the probiotic pellet treated group compared to the imipenem and the supernatant groups (by Anova test: 69.58%, p=0.022). The mean leukocyte count in the probiotic pellet group (12110) and supernatant group (13650) was significantly higher than the imipenem group (7670) (p=0.002 and 0.001, respectively). Wound cultures revealed that the percentage of cases where the pathogens had no growth was significantly different among the comparison groups. In all three test groups, P. aeruginosa was completely eliminated in comparison to the positive control group (p<0.05)

The results of our study showed that L. plantarum and its by-products promote wound healing and can be used as an alternative to antibiotics to treat ulcer infections caused by resistant bacteria.