فهرست مطالب

Middle East Journal of Digestive Diseases
Volume:12 Issue: 1, Jan 2020

  • تاریخ انتشار: 1398/10/29
  • تعداد عناوین: 9
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  • Sama Rezasoltani, Dorrieh Ahmadi Bashirzadeh, Ehsan Nazemalhosseini Mojarad, Hamid Asadzadeh Aghdaei *, Mohsen Norouzinia, Shabnam Shahrokh Pages 249-255

    Gut microbiota is considered as a human organ with its own specific functions and complexity. Development of novel techniques such as shut gun sequencing, metagenomics, and next-generation sequencing (NGS) has enabled bypassing the traditional culturedependent bias and has significantly expanded our understanding of the composition, diversity, and roles of the gut microbiota in human health and diseases. Although amplicon sequencing characterizes the taxonomic composition of the gut microbiome, it is impossible to cover the direct evidence of the microbial biological functions related to the gut microbial community. Hence, the critical next step for gut microbiome studies is shifting from gene/ genome-centric analysis to mechanism-centric techniques by integrating omics data with experimental results. Realizing gut microbial diversity and their bioactive metabolites function will provide insight into the clinical application of gut microbiota in diagnoses and treatments of several diseases. In this review, we focused on explaining the conventional and advanced microbiome analysis techniques regarding gut microbiota investigation with considering the advantages and disadvantages of the platforms.

    Keywords: Gut microbiota, Microbiome analysis techniques, Advantages, Disadvantages
  • Samaneh Mohagheghi Darehranj, Sudabeh Alatab *, Homayoon Vahedi, Anahita Sadeghi, Alireza Sima, Masoud Malekzadeh, Amir Anoshiravani, Hafez Fakheri, Nasser Ebrahimi Daryani, Abdolhamid Mousavi, Fariborz Mansour Ghanaei, Mohammad Javad Zahedi, Reza Malekzadeh Pages 256-262
    BACKGROUND

     The anti-TNF drugs are shown to be highly effective in treatment of patients with moderate-tosevere inflammatory bowel disease (IBD). Here, we aimed to assess the efficacy and safety of antiTNF therapy at the national level.

    METHODS

     IBD patients aged 15 > years who received Infliximab and/or CinnoRA® between 2013 to July 2018 were identified. The data extracted from medical dossier and telephonic interview. The efficacy of therapy was defined as time to drug discontinuation or need for IBD-related surgery. The safety was assessed based on patient’s reported adverse events.

    RESULTS

     We included 315 patients. The mean age of patients was 37.2 years and 62.2% of them developed the disease before age 30 years. Involvement of masculoskeletal system was reported in 7.3% of patients. Partial and complete response to Anti-TNF therapy was seen in 67% of patients. About 16% of patients did not respond to induction therapy and 16.9% of patients lost their response to Anti-TNF during one year. No serious adverse events, serious opportunistic infection, tuberculosis and malignancies reported by patients. Two patients reported pneumonia.

    CONCLUSION

    This study for the first time in our country, provides the evidences for efficacy of anti-TNF therapy in moderate to severe IBD patients.

    Keywords: Inflammatory Bowel disease, Anti-TNF drug, Infliximab, CinnoRA®
  • Faeze Sehatpour, Alireza Salehi *, Hossein Molavi Vardanjani, Hossein Poustchi, Abdullah Gandomkar, Reza Malekzadeh Pages 263-270
    BACKGROUND

    The range of serum alanine aminotransferase (ALT) varies in different sub-populations or countries. Its population-specific cut-off points may provide a more effective screening tool for non-alcoholic fatty liver disease (NAFLD). Objectives To investigate the upper normal level (UNL) of ALT and its association with metabolic syndrome (MS) in a semi-urban population in southern Iran.

    METHODS

    The baseline data of Pars Cohort Study was used. A total of 9264 subjects aged 40-75 years were enrolled. UNL of ALT was estimated based on 95 percentile of ALT in participants who had body mass index (BMI) < 25. Multivariable logistic regression was applied and adjusted odds ratio (OR) and its 95% confidence interval (CI) were estimated.

    RESULTS

    95 percentile of ALT was 41.71 U/L and 32.9 U/L in men and women, respectively. Abnormal waist circumference (OR: 1.72, 95%CI: 1.34, 2.21), triglyceride (OR: 1.63, 95%CI: 1.25, 2.13), fasting blood sugar (OR: 1.69, 95%CI: 1.32, 2.16), cholesterol level (OR: 1.06, 95%CI: 1.03, 1.09) and systolic blood pressure (OR: 1.08, 95%CI: 1.01, 1.16) were independently associated with ALT.

    CONCLUSION

    UNL of ALT in southern Iranian women is lower than the current recommended level, while these are almost the same for men. MS components are highly common in southern Iran and are associated with elevated serum ALT. Further studies are recommended to estimate the UNL of serum ALT among the Iranian population with NAFLD.

    Keywords: Alanine aminotransferase, Metabolic syndrome, Upper normal limit, Pars Cohort Study, Iran
  • Taghi Amiriani, Niloofar Rajabli, Maryam Faghani, Sima Besharat*, Gholamreza Roshandel, Atefeh Akhavan Tabib, Hamidreza Joshaghani Pages 271-277
    BACKGROUND

     Inflammatory bowel diseases are managed by different methods, which may not be well tolerated because of their side effects. Recently, pro-prebiotics are considered as a supplementary treatment in gastrointestinal diseases. In this study, the effect of Lactocare® (ZistTakhmir Company) was investigated on the disease severity in mild to moderate ulcerative colitis.

    METHODS

     In this randomized, double-blind clinical trial (Iranian Registry of Clinical Trials number: IRCT201407271264N5), 60 patients with mild to moderate ulcerative colitis were included. An 8-week trial was carried out comparing Lactocare® as a supplement with standard therapy against placebo. Simple Clinical Colitis Activity Index (SCCAI) was measured at baseline and after 8 weeks. Statistical analysis was performed using paired ttest to assess the temporal changes (before and after the treatment) in the mean of SCCAI in each group. Chi-square test was used to compare the response rates. Odds ratios (OR) and the 95% confidence intervals (95%CI) were also calculated. p values of less than 0.05 were considered significant.

    RESULTS

     A significant decreased mean SCCAI was seen in the intervention group (4.56 ± 2.56) vs. placebo group (6.54 ± 2.47) (p < 0.05). Response to treatment was seen in 64.3% of the treatment group vs. 47% in the placebo group (p = 0.18). Response to treatment was observed in 90.9% of patients with ulcerative colitis for more than 5 years compared with 44.4% of the control group (p = 0.01).

    CONCLUSION

     Regarding the effectiveness of pre-probiotics in mitigating symptoms in patients with ulcerative colitis, it could be suggested to try pre-probiotics in the standard treatment particularly in those with more than five years ofthe disease.

    Keywords: Ulcerative colitis, Pre-probiotics, Simple Clinical Colitis Activity Index (SCCAI)
  • Kourosh Masnadi Shirazi, Sima Khayati, Maryam Baradaran Binazir, Zeinab Nikniaz* Pages 278-282
    BACKGROUND

     Introducing a non-invasive method for determining disease activity is important in patients with ulcerative colitis (UC). So in this study, we aimed to assess the association between disease activity index and microalbuminuria in patients with UC.

    METHODS

     In the present cross-sectional study, 84 patients with UC were selected. The disease activity was calculated by the partial Mayo clinic score. Microalbuminuria was assessed using the immunoturbidimetric method in a first-voided sample in the morning in two consecutive days and the mean of these two measurements was reported as urinary microalbumin level. Serum C reactive protein (CRP), erythrocyte sedimentation rate (ESR), and fecal calprotectin were measured respectively using conventional turbidimetric immunoassay, Westergren method, and ELISA methods.

    RESULTS

     The mean age of the participants was 40.01 ± 12.85 years, 60.8% of them were female and 53.5% had microalbuminuria. The frequency of microalbuminuria was significantly higher in patients with active compared with inactive inflammatory bowel disease (IBD). There were significant differences between the patients with active and inactive disease regarding CRP, ESR, and calprotectin (p < 0.001). Moreover, there was a strong correlation between microalbuminuria and CRP (r = 0.89, p < 0.001), ESR (r = 0.92, p < 0.001), and calprotectin (r = 0.91, p < 0.001).

    CONCLUSION

     Microalbuminuria could be used as a non-invasive marker of disease activity in patients with UC.

    Keywords: Microalbuminuria, Ulcerative colitis, C-reactive protein, Calprotectin
  • Sholeh Ghaedamini, Mehdi Nikbakht, Mitra Soleimani* Pages 283-288
    BACKGROUND

     MBD1, the largest member of methyl binding domain family, has the most downregulated mRNA expression and upregulated methylation levels in advanced colorectal cancer (CRC). In this study, we evaluated the immune-histochemical expression of MBD1 in CRC and assessed its correlation with clinicopathological features to study its prognostic value in CRC.

    METHODS

    A total of 60 samples of CRC, from patients who underwent surgical gastroenterology operations, were randomly selected. The samples included one tumor-rich section per case and one adjacent tumor-free section as a normal control for that case. Then, immunohistochemistry (ICH) was performed for MBD1 protein on all samples and the expression of MBD1 was analyzed in cancerous and normal samples. In the next step, the correlation between MBD1 and clinicopathological features including age, sex, location of the tumor, grade, and stage were evaluated.

    RESULTS

     The expression of MBD1 protein had a significant downregulation in cancerous samples compared with normal control samples. This downregulation increased corresponding to both grade and stage of cancer. However, no correlation was seen between the expression of MBD1 and sex, age and location of the tumor.

    CONCLUSION

     MBD1 protein may be considered as a protein marker in the detection of CRC and its progression.

    Keywords: CRC, MBD1, Clinicopathological features, ICH
  • Pezhman Alavinejad *, Amir Hossein Sina, Damoon Dehnavi, Morteza Nayebi Pages 289-291

    Heterotopic pancreatic tissue, known as pancreatic rest, is a pancreatic tissue that lacks anatomic and vascular continuity with the main body of the pancreas. Common locations for this tissue include the stomach, duodenum, jejunum, Meckel diverticulum, and ileum. In this report, we present a case of a patient whose pancreatic rest was diagnosed primarily during the investigation of dysphagia with solid foods and it was located in the mid esophagus as an unusual location.

    Keywords: Esophageal Ulcer, Ectopic Pancreatic, Dysphagia, Esophagus
  • Irappa Madabhavi *_Sandeep KS_Rahul Dharmarajan Lethika_Satish Tumbal_Arun T Miskin_Malay Sarkar_Mitul Modi Pages 292-295

    Hepatocellular carcinoma (HCC) is the commontumor of the liver and the third most common cause of cancer-related mortality worldwide. Patients with HCC may have metastasis to different sites. Intrahepatic and extrahepatic metastases are found in (~50–75%). Lung and regional lymph nodes are the most commonly involved sites. Metastasis to bone, skin, and adrenal glands are rare. Orbit metastasis and intracranial invasion are extremely rare. We are presenting a case of HCC that metastasized to the orbital cavity. The patient presented with progressive proptosis of the eyeball with retrobulbar and intracranial invasion and involvement of the sub-scalp region. Based on the imaging findings, it was initially misdiagnosed as meningioma; however, histopathological examination of the biopsy specimen resulted in a definitive diagnosis of HCC metastasis. The present case reveals that the alternative diagnosis of metastasis must be considered when diagnosing retrobulbar lesions in patients with HCC.

    Keywords: Hepatocellular carcinoma, Intraconal metastasis, Sorafenib, Imaging
  • Amirhossein Boghratian, Nasser Rakhshani, Jamshid Vafaeimanesh* Pages 296-298