فهرست مطالب
Govaresh
Volume:27 Issue: 1, Spring 2022
- تاریخ انتشار: 1401/06/09
- تعداد عناوین: 8
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Pages 6-16
Currently, the microbiota is considered an irreplaceable component in the human body, which has a crucial role in different physiological functions. The gallbladder and hepatobiliary ducts are of the most unknown environments in the human body due to difficulty in collecting samples. For a long time, the biliary system of healthy people has been considered sterile. One reason for this hypothesis is the presence of several defensive mechanisms in the biliary system. Intestinal and upper gastrointestinal tract microbiota as well as systemic bacteremia, are considered possible sources of biliary microbiota. Molecular studies demonstrated that changes in the bile microbiota population were associated with the formation of gallstones. Furthermore, changes in the components and contents of the biliary microbiota could be possible factors in the development of gallbladder inflammatory diseases, including primary sclerosis cholangitis and primary biliary cholangitis as well as biliary tract cancer. Clarifying the details of these relationships requires further studies. A detailed comprehension of the impact of the biliary microbiota on the development or progression of biliary diseases may facilitate the development of strategies for modulating the biliary microbiota in order to prevent the occurrence or treatment of such diseases.
Keywords: Microbiota, Biliary tract, Biliary diseases -
Pages 17-24Background
Understanding the bacterial community composition of gastric microbes and the relationship between its differences in the development and progression of gastritis can be of great help in the perception of the mechanism of this disease and designing preventive treatment pathways for its progression. We aimed to investigate the simultaneous colonization of bacterial agents in patients with chronic gastritis.
Materials and MethodsThe study was performed on 168 gastric biopsy specimens of patients with gastric complaints who were referred to the endoscopic ward of Firoozgar hospital in Tehran. Biopsy specimens in the pathology department were examined histologically by the hematoxylin-eosin staining method and in the specific culture medium of Helicobacter under microaerophilic growth conditions and in general culture medium under aerobic conditions for the presence of Helicobacter and other bacteria. Identification of Helicobacter pylori (H. pylori) isolates was performed by analyzing colony morphology, gram staining, positive reactions of oxidase and catalase, rapid urease test, and polymerase chain reaction (PCR). Other bacteria were identified by biochemical and phenotypical analysis.
ResultsIn our study, the recovery rate of H. pylori infection was 27.4 %. The mean age of patients in the two groups with and without H. pylori infection was almost the same. 87.5% of all patients had chronic gastritis, which showed significant associations with H. pylori infection (p-value: 0.00). We identified 140 bacterial colonies that belonged to 12 genera and 3 phyla. At the genus level, Streptococcus and Staphylococcus were predominant followed by Micrococcus, Escherichia coli, Bacillus, Enterococcus, Klebsiella, Pseudomonas, Enterobacter, Citrobacter, and Providencia. The predominant phyla were Proteobacteria and Firmicutes while Actinobacteria was less frequent. Co-infection of H. pylori with other isolated bacteria, especially Streptococcus and Staphylococcus was observed.
ConclusionThe presence of different bacterial genera in the gastric tissue of patients with gastritis in the absence of H. pylori suggests their possible role in the occurrence or progression of this disease. Additional studies to determine the association of the persistence of these bacteria with the use of drugs that modulate gastric acidity and pathological changes can be useful in the prevention and treatment of gastritis.
Keywords: Gastritis, Helicobacter pylori, Gastric microbiota -
Pages 25-32Background
Bariatric surgery is one of the recent advances in the treatment of morbid obesity associated with gastrointestinal disorders. Because of the importance of lifestyle on health promotion, we aimed to investigate the effect of lifestyle modification on gastrointestinal disorders in patients undergoing sleeve gastrectomy.
Materials and MethodsThis study was a clinical trial performed in the surgical ward of Hazrat Valiasr Hospital during 2020-2021. 70 patients underwent bariatric surgery according to the inclusion and exclusion criteria and were purposefully selected and randomly assigned using quadratic block A and B and divided into experimental and control groups The day before the surgery, an educational intervention was performed for the experimental group with respect to lifestyle modification including six dimensions (nutrition, physical activity, responsibility for health, stress management, relationships and interpersonal support, and spiritual growth, and selffulfillment). The day before and two months after sleeve gastrectomy, the participants were evaluated using the health-promoting lifestyle profile II and a researcher-made questionnaire on gastrointestinal complications. Data were analyzed by SPSS software, version 22, using descriptive and inferential statistical tests (Chi-square, dependent and independent t test and McNemar test) at the significance level of P < 0.05.
ResultsThe rate of constipation and diarrhea decreased after the intervention in the experimental group but the difference was not statistically significant. The rate of nausea and vomiting before and after the intervention was different in both experimental and control group. However, the rate of nausea was significantly lower in the experimental group compared with the control group after the intervention. The rate of reflux reduced before and after the intervention in the experimental group compared with the control group, but the difference not statistically significant compared with the control group after the intervention.
ConclusionConsidering the effectiveness of lifestyle modification in reducing gastrointestinal disorders in patients undergoing sleeve gastrectomy, planning to perform this educational intervention is recommended.
Keywords: Lifestyle, Functional gastrointestinal disorders, Bariatric surgery -
Pages 35-38Background
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.
Materials and MethodsThis 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.
Results435 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.
ConclusionIn our study, non-cardiac intestinal type adenocarcinoma was more prevalent than cardiac type
Keywords: Stomach neoplasms, Endoscopy, Pathology, Demography -
Pages 39-44Background
Considering the beneficial effect of the Mediterranean diet on health in different populations, we aimed to validate the Persian version of the Mediterranean Diet Adherence Screener (MEDAS) in the healthy population.
Materials and MethodsThis cross-sectional study was performed on healthy Iranian adult s, in December 2020. The scale was translated into Persian language and then confirmed by back-translation. Data were collected by google forms. To evaluate the content validity, the two concepts of content validity index (CVI) and content validity ratio (CVR) were used according to the evaluation of 18 medical experts. Intra-class correlation coefficients (ICC) and Pearson’s r correlation coefficient wwere used to evaluate the internal reliability of the items.
ResultsThree hundred and four healthy volunteers (mean±SD age: 36.43±10.14 years; mean±SD body mass index: 25.65±4.18 kg/m2 ) were enrolled in our study. According to medical experts’ opinions, CVR was ≥0.714 and CVI was 1. Also, a significant correlation was seen regarding Pearson coefficient for test-retest reliability (r=0.74 , p < 0.001).
ConclusionThe cultural modified persian version of MEDAS had an acceptable validity and reliablity for rapid assessment of adherence to the Mediterranean healthy diet and it can be useful in research and clinical practice.
Keywords: Mediterranean Diet, Mediterranean Diet Adherence Screener, Reliability, Validity, Healthy adult -
Pages 45-50Background
Celiac disease (CD) is an autoimmune disorder of the small intestine with a genetic predisposition. The gold standard for CD diagnosis is evaluating small bowel biopsy samples. As biopsy sampling is an invasive procedure, researchers focus on finding an alternative non-invasive test that can detect CD at an earlier stage. We aimed to investigate the laboratory finding of patients with CD to introduce new diagnostic biomarkers for this disorder.
Materials and MethodsIn this cross-sectional study laboratory results of 175 patients with celiac were evaluated. Subjects were analyzed through following variables: age, sex, Marsh classification, hemoglobin level, white blood cell count, platelets, eosinophil, neutrophil, lymphocytes, ferritin, liver enzymes, fat profile, iron profile, calcium, and phosphorus. SPSS software, version 22, was used for analysis.
Results69 (39.4%) patients were men and 106 (60.6%) were women with a mean age of 34.4 years. The extraintestinal symptoms were predominant which anemia (28.6%), microcytic erythrocytes (20%) and hypochromic RBCs (26.9%) were the most laboratory findings. Hypertransaminasemia, low ferritin, hypocalcemia and leukemia was reported in 23.4%, 17.1%, 5.7% and 4.7% of patients respectively. According to the pathological classification: 23 (13.1%) patients were Marsh I, 29 (16.6%) patients Marsh II, and 118 (67.4%) patients Marsh III.
ConclusionThe lack of food, vitamins and minerals can be evaluated through laboratory studies and may open the door to early detection of the disease.
Keywords: Celiac disease, Laboratory study, Diagnostic test -
Pages 51-54
Caroli disease is characterized by bile duct ectasia without other liver abnormalities. In contrast, Caroli syndrome is characterized by bile duct dilatation with congenital liver fibrosis. Caroli disease is rarer than Caroli syndrome. This paper introduces a 32-yearold man with vitiligo and asymptomatic Caroli disease who was accidentally diagnosed following a fall from a height.
Keywords: Caroli disease, Intrahepatic bile ducts, Vitiligo -
Pages 55-59
The ectopic endometrial tissue can be found in different places with no symptoms (such as intestinal endometriosis) and common symptoms such as abnormal bleeding, dysmenorrhea, and chronic pelvic pain. Early diagnosis and treatments, especially with surgical procedures, play an important role in patients’ recovery. We describe a 39-year-old woman with intermural and submucosal endometriosis. The compressive effect of the mass in the rectosigmoid colon caused digestive symptoms. After necessary procedures such as colonoscopy, computed tomography (CT) and endoscopic ultrasonography (EUS), we performed surgery, and the distal colon was resected. Ovarian cysts caused by endometrial tissue displacement can have symptoms similar to gastrointestinal stromal tumors (GISTs) if they are large enough to push through the gastrointestinal (GI) system. These symptoms can be diarrhea, abdominal tenderness, and so on. Surgery is the best diagnostic way for endometriomas and one of the diagnostic ways in GISTs. Also, with considering the drug resistance of GISTs to the current chemotherapy, the best treatment is also surgery. Location and tissue involvement of masses of the GI system are important points that should be considered in the differential diagnoses. In this way, early diagnosis and timely treatment, especially surgical, will have the best prognosis for the affected patients.
Keywords: Sigmoidal Endometrioma, Subepithelial Lesion, Gastrointestinal, Stromal, Tumors