javad shokri shirvani

Colorectal cancer could be developed from adenomatous polyp.  The study aimed to evaluate the diagnostic significance of stromal and epithelial CD10 (Neprilysin) expression in patients with colorectal adenocarcinoma and adenomatous polyps.

This cross-sectional study was conducted on 141 patients with colorectal adenocarcinoma and adenomatous polyps referred to Ayatollah Rouhani Hospital from March 2020 to March 2021. Differential diagnoses of colorectal adenocarcinoma and adenomatous polyps were made colonoscopically, and then samples were taken from the lesions. The pathologists confirmed the final diagnosis as colorectal adenocarcinoma, high-grade or low-grade adenomatous polyps. The stromal and epithelial CD10 expression was evaluated by immunohistochemistry. The data was analyzed by SPSS 22 software (p<0.05).

Sixty-five (46.1%) of the cases were low-grade polyps that were included positive (4 cases; 6.20%) and negative (61 cases; 93.80%) CD10 expression (P=0.001), also 76 (53.9%) of them were either high-grade polyps (21 cases) or adenocarcinomas (21 cases). Also, epithelial CD10 expression was significantly higher in the well-differentiated adenocarcinoma (38 cases) group than moderate (13 cases) and poor (4 cases) groups (P =0.001). Moreover, the CD10 expression level in the adenomatous polyps (10 positive cases and 76 negative cases) was correlated with the degree of dysplasia (P = 0.001) and the presence of tumor invasion (8 positive cases and 133 negative cases) (P = 0.001).

The CD10 expression is associated with an increased degree of dysplasia and the presence of tumor invasion in patients with pre-neoplastic lesions and colorectal adenocarcinoma.

Helicobacter pylori as a common gastrointestinal (GI) pathogen must possess certain virulence characteristics to colonize the stomach, evade host immune responses, and subsequently induce GI diseases. This research aimed to investigate the expression level of two important genes, the sialic acid-binding adherence (SabA) and the blood group antigen-binding adhesion (BabA) in H. pylori strains isolated from adult patients living in the northern part of Iran, and their association with peptic ulcer disease (PUD) and gastric cancer (GC). This cross-sectional study was carried out on adult patients referring to the GI clinic of the hospitals affiliated to Babol University of Medical Sciences, Iran. New cases diagnosed with gastritis, peptic ulcer or gastric cancer were included. Endoscopic-guided gastric biopsies were examined and H. pylori positive colonies were analyzed to determine the expression of babA and sabA genes, utilizing specific primers and the SYBR Green dye. Among 175 patients with mean age of 51.6±15.6 years, 101 (57.7%) of the individuals tested positive for H. pylori infection. Statistical analysis revealed a significant correlation between sabA (P=0.003) and babA (P=0.002) gene expression and development of PUD and GC. Smoking (P=0.052), gender (P=0.004) and positive babA gene expression (P=0.009) had the greatest association with occurrence of PUD or GC in H. pylori positive patients.  In summary, the presence of the sabA gene in people infected with H. pylori increased the risk of GC compared to gastritis, while, the presence of the babA gene was significantly increased in gastric ulcer patients. Considering the diversity of H. pylori isolates and the varying results observed in different geographical regions, further comprehensive studies are required to evaluate the function of these genes in H. pylori pathogenesis and their relationship with clinical outcomes.

 Celiac disease is an autoimmune disorder resulting from gluten consumption in genetically predisposed individuals. The present study investigated the epidemiological, endoscopic, and clinicopathological features of patients with celiac disease in the southern littoral of the Caspian sea.

140 patients with celiac disease were interviewed and examined regarding demographic characteristics, clinical symptoms, and serologic, endoscopic, and pathological findings.

44 (31.4%) of the patients were male and 68.6% were female. The mean age of the patients at diagnosis was 27.13±13.4 years (ranging from 2 to 60 years). The most common gastrointestinal symptoms were bloating (47.8%), abdominal pain (47.1%) and diarrhea (30.7%), respectively. Also, 17 (12.1%) patients did not complain of any gastrointestinal symptoms.18 (12.8%) patients had aphthous stomatitis, 10.7% had dermatitis herpetiformis, 3.6% suffered from itching without a rash, two (1.4%) mentioned psoriasis and one (0.7%) had lichen planus. 19 (19.7%) of the female patients complained of menstrual bleeding disorders, 4% mentioned infertility, and 2% experienced primary amenorrhea.The most common comorbid condition was hypothyroidism in 16 (11.4%) patients. The most common endoscopic finding was duodenal scalloping (37.25%). In addition, 7.8% of the patients had a normal endoscopic appearance. 43 (30.7%) patients were classified as Marsh IIIC, 25.7% Marsh IIIB, 17.8% Marsh IIIA, 12.8% Marsh II and 12.8% were classified as Marsh I.

 Since celiac disease can present with non-gastrointestinal manifestations and the majority of our patients had Marsh III classification, it seems that celiac disease must be considered as a routine screening test in gastrointestinal clinics, and also, it should be kept in mind as a differential diagnosis in other specialty fields.

In the worldwide medical literature, only one case of inlet patch shows a kissing pattern on endoscopy. This article describes a 69-year-old female patient who came to the gastroenterology clinic, Rohani hospital, Babol University of Medical Sciences (Iran) for an examination for indigestion. Endoscopy showed two polyps in the background of a maroon patch just below the upper esophageal sphincter, oppositely positioned in view of the kissing pattern, and extending into muscular mucosa and regional lymph nodes. There was no A polyp biopsy was performed and, on histological evaluation, there was heterotopic cardiac gastric mucosa. Since heterotopic gastric mucosa can be found anywhere in the gastrointestinal tract, careful examination of the proximal esophagus increases the likelihood of detecting an inlet patch.

Various factors, most notably the stone's features, determine the selection of an appropriate method to extract common bile duct (CBD) stones during endoscopic retrograde cholangiopancreatography. In this study, the efficacy and safety of endoscopic sphincterotomy with balloon dilation (ESBD) versus endoscopic sphincterotomy (EST) for CBD stone extraction with a diameter of 10 to 15 millimeters were compared.

This retrospective cross-sectional study included 154 patients referred to the Rouhani Hospital in Babol, Iran, with CBD stones. Consensus sampling was used. Each individual's demographic information and findings from the procedure were entered into the SPSS software (v. 26). A level of less than 0.05 was considered statistically significant.

A total of 154 patients were included in the study, of which 81 (52.6%) were in the EST, and 73 (47.4%) were in the ESBD group. Complete stones removal rate was higher in the ESBD versus the EST group (79.5% versus 46.9%, P<0.001). No significant differences were observed between the two methods' overall side effects rate (P = 0.469).

For the complete extraction of CBD stones larger than 10 millimeters, the ESBD method outperforms the EST method.

Helicobacter pylori infection is the most common cause of peptic ulcer disease. However, the prevalence rates of non-helicobacter pylori idiopathic peptic ulcers have increased over the past few years. This study aims to compare the characteristics of Helicobacter pylori-positive with idiopathic duodenal ulcers.

A cross-sectional cohort study was conducted on 950 patients which were excluded from the analysis process duo to the concomitant presence of gastric ulcer, malignancy, Zollinger Ellison syndrome, Crohn's disease, esophageal varices, history of taking anti-Helicobacter pylori therapy, and history of taking NSAID or aspirin. Eventually, 647 subjects were enrolled for the analysis process. In this case, these subjects were divided into two groups: (I) Helicobacter pylori-positive ulcer group and (II) Helicobacter pylori-negative and non-NSAID (idiopathic) ulcer group.

The findings showed that 417 patients (64.5%) had duodenal ulcers induced by Helicobacter pylori, and 111 patients (17.1%) had Helicobacter pylori-negative and non-NSAID ulcers. The mean ages of patients in Helicobacter pylori-positive and idiopathic ulcer groups were 39±15 and 42±17, respectively. In this case, 33 patients (29.7%) with idiopathic ulcers and 56 patients (25.1%) with Helicobacter pylori-positive ulcers had upper gastrointestinal bleeding. Also, 22 patients (21%) with idiopathic ulcers and 31 patients (16.5%) with Helicobacter pylori-positive ulcers had multiple duodenal ulcers

The present study demonstrated that the idiopathic ulcers included 17.1% of duodenal ulcers. Also, it was concluded that patients with idiopathic ulcers were predominantly male with an age range older than the other group. In addition, patients in this group had more ulcers.

Gastric cancer is the fourth most common cancer and the second cause of cancer-related death worldwide. Various types of gastric cancer are common in different areas in Iran. In this study, we aimed to evaluate 10 years of endoscopic and histopathological data of patients diagnosed with gastric cancer in Babol, Iran.

This descriptive cross-sectional study included all patients with recorded data who were referred to the endoscopic unit with gastric cancer during 2006-2016. Data included demographic characteristics (age, sex, body mass index [BMI], smoking, opium addiction), endoscopic characteristics (site of involvement in different gastric areas), and histopathological types (adenocarcinoma, lymphoma, gastrointestinal stromal tumor (GIST)), which were extracted from the endoscopy unit database and were analyzed using SPSS software.

435 cases of gastric cancer were studied. The mean age was 66.75 ± 14.03 years, with a minimum and maximum age of 21 and 94 years, respectively. The data demonstrated that men were affected 2.3 times more than women (69.2% were men and 30.8% were women). 420 out of 435 patients were diagnosed with adenocarcinoma. Also, 46 cases (or 10.9%) were signet ring adenocarcinoma, and 374 cases (89.1%) were non-signet ring adenocarcinoma. Eight cases were lymphoma, and seven cases were GIST. In addition, 112 patients (25.8%) had proximal, and 323 patients (74.2%) had distal involvements, mostly involving the antrum (36.8%). Regarding the effects of cigarette smoking and opium addiction, 124 patients diagnosed with gastric cancer were investigated. 13 patients (10.4%) had a history of smoking. Also, five patients (4%) had a history of opium addiction. Three patients (2.2%) had a history of both.

In our study, non-cardiac intestinal type adenocarcinoma was more prevalent than cardiac type

Strongyloides stercoralis (S. stercoralis) is a helminth, which infects humans widely in tropical and subtropical countries. This parasitic infestation usually does not produce symptoms in humans; however, severe and life-threatening forms of this infection can occur in immunocompromised individuals. Patients with Coronavirus disease 2019 (COVID-19) with concurrent immunosuppressive therapy are at risk of developing Strongyloides hyperinfection syndrome (SHS). We present a 70-year-old male with a history of high-dose dexamethasone therapy due to severe COVID-19 who was referred to our hospital with chest discomfort, nausea, and anorexia. Histological assessment of the gastric and duodenal mucosae revealed numerous eggs and filariform larvae of S. stercoralis indicative of SHS. Ivermectin and albendazole were administered to the patient. Following the treatment, the patient's symptoms improved. Clinicians must be aware of the risk of SHS, especially in S. stercoralis endemic countries before and during corticosteroid therapy for COVID-19 because early diagnosis and appropriate treatment can significantly reduce mortality in these patients.

Unlike some regions of the world where digestive system cancers are not considered as important health problems, these neoplasms are among the most common malignancies in the northern region of Iran.

This observational analytical study was carried out based on data collected by the Cancer Registration Center affiliated to the Vice Chancellery for Health of Babol University of Medical Sciences, North of Iran, during 2008-2017. Crude incidence rate (CR), and age-standardized incidence rate (ASR) have been calculated for different GI cancers, based on the primary involved site; and have been compared in different years, patients' age, gender and place of residence.

Totally, 4332 records were related to digestive system cancers. Mean age of patients was 63.48±14.73 years; men (2743; 63.3%) were more affected than women (1589; 36.7%) (p<0.001). The most incident malignancies of digestive system were from stomach, colorectal and esophagus in men; and colorectal, stomach and esophagus in women, respectively. These three cancers accounted for 3725 (85.98%) of total GI malignancies. The mean age of patients in various types of GI cancers was statistically different (p<0.001). Age- standardized incidence rate showed different values in different years; from 521.40 (95% CI: 462.79-580.00) in year 2016 to 1834.33 (95% CI: 1637.36-2031.29) in year 2008.

Gastric, esophageal and colorectal cancers were the most prevalent digestive system malignancies in Babol, North of Iran, and accounted for about 86% of all GI tract cancers. A considerable variation has been found in incident gastrointestinal cancers in different years.

Inflammatory myofibroblastic tumors (IMTs) are rare with unknown etiology. As pancreas involvement is rare in IMTs, here, we report a case of a girl with IMT, referred to our hospital.

A 4-year-old girl presented with chief complaints of generalized itching and jaundice. Abdominopelvic computed tomography (CT) scans with contrast showed a homogeneous isodense mass lesion in the head of the pancreas with a compressive effect on the distal part of the common bile duct (CBD). Dilatation of intrahepatic bile ducts and CBD (8mm) was observed. Magnetic resonance cholangiopancreatography (MRCP) examination showed dilated gallbladder without stones and intrahepatic/extrahepatic bile ducts. The CBD was dilated and a mass was found in the head of the pancreas. Immune-histochemical studies revealed spindle myofibroblastic tissues with lymphoplasmacyte and eosinophil infiltration. All of them were compatible with pancreatic IMTs. The surgery improved the symptoms.

The IMTs of the pancreas can have symptoms like pancreatic cancer. The careful evaluation by imaging and pathology is recommended.

The role of Helicobacter pylori (H. pylori) in inflammatory bowel disease is a controversial argument. The initial theory of this study was that Helicobacter is a risk factor for inflammatory bowel disease. In this study, we investigated the coincidence of H. pylori exposure and IBDs.
This case-control study has been done in Babol, teaching Hospitals; 60 newly diagnosed IBD cases without any Helicobacter eradicating treatment and 120 control patients without inflammatory bowel disease evidence in biopsy, investigated for H. pylori exposure by IgA and IgG ELISA tests. Clinical information, demographics and ELISA test results have been analyzed using SPSS.Version.18 (level of significance was less than 0.05).
Mean age of case group was 42.27±13.64 years; in control group it was 45.52±13.83 years. There was a significant difference between the case and control groups in IgG study of the following subgroups: age under 30, females, males, urban, higher education level and BMI between 18.5 and 24.9 (p-value was respectively; 0.004, 0.014, 0.047, 0.002, 0.013, 0.003). On the basis of logistic regression; IBD was less common in females, patients with lower education and patients with positive result of IgG (p-value was respectively 0.002, 0.013, 0.010).
As a result of this study, Helicobacter pylori exposure, may could play a protective role against inflammatory bowel disease.

Helicobacter pylori infection is one of the most common chronic bacterial infections in the world, especially in the developing countries. This bacterium is the cause of many diseases such as lymphoma, gastritis, peptic ulcers, and stomach cancer. According to recent reports, H. pylori infection can potentially increase the risk of colon cancer. The current study aimed at investigating the association of H. pylori infection and the risk of colorectal cancer and adenomatous polyps. The current study was conducted on 50 patients with colon cancer and adenomatous polyps as the case group and 100 subjects with no specific pathologies (i e, polyps, neoplasms, or inflammatory diseases) as the control group. Blood samples were collected from the patients in order to assess the presence of anti-Helicobacter pylori infection antibodies, and the serum titer levels of anti-Helicobacter pylori IgG and IgA antibodies were measured using indirect enzyme-linked immunosorbent assay (ELISA) and a kit procured by Pishtaz Teb Company (Iran). A total of 33 patients in the current study had adenomatous polyps and 17 had colon cancer. H. pylori infection (IgA >20 U/mL and IgG >10 U/mL) was significantly more prevalent in the patients with colon cancer and adenomatous polyps compared with the healthy controls (P= 0.003, P= 0.039, respectively). The obtained results suggested that H. pylori infection can be considered as a risk factor for colon cancer and adenomatous polyps.

Until now, no study has been reported investigating the association between β-thalassemia minor and Helicobacter pylori (H. pylori) infection. This study was designed to compare H. pylori infection rate between β-thalassemia minor patients and healthy controls.
A number of 100 β-thalassemia minor patients (50 males, 50 females) and 100 gender-matched healthy controls were prospectively recruited in this study in a period of 3 months. The study population consisted of the people who referred to a health center in Babol, North of Iran, for premarital counseling. H. pylori status was assessed by measuring the anti-H. pylori IgG antibodies using enzyme-linked immunosorbent assay. Demographic information and informed consent were collected from all participants.
The overall H. pylori infection rate was 43%. The infection was significantly more prevalent in thalassemia patients (53%) than in the controls (33%) in both univariate (OR=2.29, 95% CI: 1.3-4.06) and multivariable analyses (OR=2.05, 95% CI: 1.12-3.76). Age was the only significant factor which was positively correlated with the infection in β-thalassemia minor cases (OR=1.11, 95% CI: 1.02-1.2). Gender, blood groups, residency, and education level were not related to the infection.
According to the results, it can be concluded that β-thalassemia minor patients are possibly more susceptible to H. pylori infection than healthy people. Further studies are needed to discover more about the exact mechanisms of increased susceptibility to H. pylori infection in β-thalassemia minor patients

Helicobacter pylori (H.pylori) is a gram-negative bacterium that has infected more than half of the world's population. This pathogen colonizes the human gastric mucosa and is usually acquired during childhood. It is an important cause of peptic ulcers, chronic gastritis and stomach cancer. Among the risk factors for acquisition of H. pylori infection, poor socioeconomic status, poor sanitization and hygiene practices, and contaminated food and water, are the most significant ones. The main route of H. pylori transmission is still unknown. Studies show that H.pylori bacteria can spread directly from one person to the other, or indirectly from an infected person to the environment. Person to person transmission is divided into fecal-oral, gastric-oral, oral-oral, sexual routes. Presently, interpersonal pathways are more acceptable than environmental exposure routes. Literatures indicate the presence and survival of H. pylori in food samples, such as milk, vegetables and meat, and suggest these foods may play an important role in the environmental transmission of this pathogen. In addition, other studies report the presence of H. pylori in the gastric tissue of some animals (e.g. sheep and cow) and therefore, it is likely they participate in the food chain transmission as reservoirs besides human. Although there are findings which indicate the probable role of food products in the environmental transmission of H. pylori, there is still not enough direct evidence to confirm this and more studies are needed. However, attention to food contamination sources (unhygienic water) and controlling them may prevent transmission of pathogens associated with health.

The main causes of esophageal squamous cell carcinoma (ESCC) in developing countries differ from developed countries. In developing countries, approximately onefourth of cancer cases are caused by infectious agents. In terms of infectious etiology of esophageal cancer, Helicobacter pylori has been among the most widely investigated, but its role in etiology of ESCC remains unclear.
The present study aimed to investigate the presence of H. pylori in the pathogenesis of ESCC.
In total, 277 formalin-fixed paraffin-embedded esophageal samples (177 with ESCC, and 107 without esophageal malignancy) were examined for H. pylori infection. After removing of paraffin from tissue samples, DNA was extracted and polymerase chain reaction (PCR) was performed to investigate the presence of H. pylori.
H. pylori was not detected in any of the cancerous and non-cancerous esophageal sample.
In the present study, there was no association between H. pylori and ESCC.

Cancers are the second most common cause of non-accidental deaths in Iran, after cardiovascular mortality. Although most cases of esophageal squamous cell carcinoma (ESCC) in the USA and western populations have been attributed to high levels of exposure to tobacco and alcohol, but in Iranian populations the other risk factors especially infectious agents have been postulated as possible causes, particularly human papillomavirus (HPV). This study aimed to determine the prevalence and the types of HPV infection in biopsy samples taken from non-cancerous esophageal lesions during upper endoscopy. A total of 80 non-cancerous esophageal samples were collected in parafinnated blocks of tissue archives in pathology. After DNA extraction, qualitative PCR (qPCR) was performed using the HPV L1 primer pairs MY09/MY11 and then genotyping was performed in HPV DNA positive by Real time PCR. From 80 cases, 29 (36.3%) were qPCR positive. Using the Real-time PCR method, a total of 14 HPV genotypes were assessed. We detected HPV-11 as a dominant type in this study and we did not find any type of HPV-16 and 18. In this study, HPV-II was the most common type in esophageal samples, in contrast we have found no oncogenic HPV like HPV 16 and 18 which are the most known responsible factors of ESCC in other countries

The role of psychological factors in peptic ulcer disease (PUD) and functional dyspepsia (FD) has not been clearly determined. In this study the role of conflict management styles, psychiatric symptoms, and alexithymia were assessed in patients with PUD and FD and in the healthy individuals. Ninety subjects [30PUD (15 women, 15 men), 30 FD (15 women, 15 men), and 30 healthy individuals (15 women, 15 men) in two endoscopy wards of Babol University of Medical Sciences were evaluated. Three groups were matched with regard to demographic variables. Conflict management styles, psychiatric symptoms, and alexithymia were evaluated by appropriate questionnaires. The patients with PUD reported less mean scores on psychiatric symptoms than the FD patients (depression 12.6±7.5 vs 28±9.5, anxiety 8.2±5.9 vs 18.7±6. obsessive-compulsive disorder 15.7±7.5 vs 21.8±8.4, interpersonal sensitivity 9.5±7.4 vs 16±7, psychoticism 8.03±4.5 vs 14.3±6.3, somatization 12.5±10.8 vs 20.7±8.1, and the total score of psychiatric symptoms 94.4±49.9 vs 160.1±46.6). The mean scores use of unconstructive conflict management styles in PUD patients were lower than FD (dominating 17.7±3.5 vs 20.2±2.7, avoiding 17.5±3 vs 23.8±4.4). Alexithymia symptoms were higher in FD patients than PUD individuals (difficulty in identifying feelings 23.5±6.3 vs 27.8±3.9, difficulty in describing feeling 16.5±4.4 vs 17.3±3.6). The PUD and FD patients had higher scores regarding these variables than the healthy subjects. The results show that both PUD and FD patients experienced more psychiatric symptoms, unconstructive conflict management styles, and alexithymia than the healthy subjects. FD patients had worse psychiatric problems than PUD.

Çolon lipoma is a rare benign tumor which is usually detected incidentally and is mostly asymptomatic. The author describes a case of obstruction due to lipoma. Â 46-year-old man with a two-month history of abdominal pain, and intermittent nausea, vomiting and melena for 3 weeks is reported. During colonoscopy, it was found that there was a colon mass and the pathological report showed chronic inflammation and a complete obstruction with barium was observed. Due to his constipation, severe abdominal pain and transverse, colectomy was performed. Pathological report showed submucosal lipoma. Finally, he felt well and was discharged from hospital