Govaresh
Volume:27 Issue: 3, Autumn 2022

The aim of this study was to evaluate the prevalence of helicobacter pylori (H. pylori) infection and its association with endoscopic, histopathological findings, and clinical symptoms of children with dyspepsia referring to Masoumeh Children Hospital of Qom. The eradication therapy of H. pylori infection in children as well as the clinical response to dyspepsia in H. pylori-negative children, were evaluated.

This cross-sectional study was performed on 170 children 4 to 15 years old with dyspepsia referred to Hazrat Masoumeh Hospital in Qom. After recording basic information about children such as age, sex, place of residence, and their disease history, these children were examined by endoscopy. Two biopsy specimens were obtained from the body and the antrum of the stomach. And if the rapid urease test and histology were positive for H. pylori tissue examination, the confirmed H. pylori infection would be considered in the child with H. pylori infection. Consequently, these patients were divided into two groups: H. pylori-positive and H. Pylori-negative. The two groups were compared for clinical signs and symptoms, endoscopic findings, and histological results.

85 patients (49.4%) were male and 87 patients (50.6%) were female. No significant relationship was found between the sex of the patients, place of residence, and H. pylori infection. There was no significant difference between the two groups in gastritis erosive, duodenitis, gastritis erythematosus, esophagitis, and acute inflammation in the antrum. No mass was found in both groups, and no hemorrhagic gastritis, ulcer, duodenal metaplasia, dysplasia, maltoma, H. pylori accumulation, or atrophy was recorded. In H. pylori-positive subjects in 83 patients (95.4%), chronic inflammation in the antrum was mild and in four patients, it was moderate (4.6%). This finding in H. pylori-negative patients, in 31 patients (36.5%) was not found, and in 54 patients (63.5%) was found. There were no significant differences between the two groups in the clinical signs, abdominal pain, heartburn, anorexia, burning, recent weight loss, hematomas, melena, the only clinical symptom of nausea in HP positive patients (37.9%) and HP negative in 46 patients (54.1%) had a significant difference between the two groups. Nodular gastritis was found in the endoscopic evaluation of 27 (31%) patients with H. pylori infection, significantly more than dyspeptic patients (15 cases) who were H. pylori negative.

According to the results of this study, no clinical signs other than nausea were correlated with H. pylori infection. In endoscopic findings, nodular gastritis has a significant correlation with H. pylori positivity, and according to the histopathological evaluation we significantly found more chronic gastritis in H. pylori infection.

Interleukin-8 (IL-8) is a member of the pro-inflammatory chemokine family that has been reported to be overexpressed in various human tumors. This chemokine contributes to cancer cell survival, proliferation, metastasis, and angiogenesis. The purpose of this study was to examine the expression level and clinicopathological significance of IL-8 in colorectal cancer (CRC) tissues compared with adjacent normal colorectal tissues in the Iranian population.

The population of the study consisted of 45 pathologically confirmed patients with CRC, including CRC and adjacent control tissues. The expression levels of the IL-8 gene were evaluated by quantitative real-time polymerase chain reaction (RT-qPCR). The correlation between the expression levels and the clinicopathological features was determined.

IL-8 gene expression was overexpressed in CRC samples compared with controls (fold change=5.5; P= 0.02). The area under the ROC curve for IL-8 indicates the potential of IL-8 as the diagnostic marker in CRC (P=0.012).

IL-8, which is up-regulated in CRC tissues, can be used to distinguish inflammation-induced CRC from control samples. The significantly up-regulated level of IL-8 needs future investigation for consideration as a biomarker to evaluate the prognosis of CRC.

This study aimed to investigate the relationship between dietary acid load (DAL) with psychological disorders and the odds of disease in patients with diarrhea-predominant irritable bowel syndrome (IBS-D).

This case-control study was performed on 61 patients with IBS-D and 61 healthy matched individuals aged 20 to 55 years in Isfahan. To collect data, 3‐day dietary record and Depression, Anxiety and Stress Scale - 21 Items (DASS-21) were used. Also, anthropometric indices were measured.  

No significant difference was found between potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores between the two groups. There was a significant direct relationship between NEAP scores with stress and depression in the IBS-D group and also with anxiety in the two groups (P<0.05). No association was found between PRAL and NEAP with odds of IBS-D in both crude and adjusted models.

Dietary acid load may be associated with psychological disorders in patients with IBS-D. Further prospective studies are needed to confirm these findings.

Endoscopy is one of the most common diagnostic and therapeutic methods in patients with gastrointestinal diseases. Anxiety and pain are associated with the patients. This procedure is unpleasant and intolerable. The present study was performed to determine the effect of the clinical Orientation Tour on the anxiety, pain, and satisfaction of patients who were candidates for endoscopy referred to Hospital in Rafsanjan in 2019. Hazrat Ali Ibn Abitaleb (AS) Hospital in Rafsanjan in 2019.

In this clinical trial study, 64 patients referred to the hospital were randomly divided into control and intervention groups. Demographic characteristics, Spiel Berger Anxiety Scale, Visual Analogue Pain Scale, and Modified Questionnaire (GHAA-9) were the data collection tools. The intervention was Orientation Tour with endoscopy and direct endoscopic observation. Patient's anxiety before and after the intervention, pain during endoscopy, and satisfaction after endoscopy were measured. Data were analyzed using paired t-test, independent t-test, Chi-square, linear regression, and Mann-Whitney tests. Analysis was done using SPSS software version 16.

The mean score of overt anxiety before the intervention was 56.78±7.32 and after the intervention was 35.19±12.52, latent anxiety ranged from 57.22±9.04 to 32.25±13.67, and total anxiety from 114.00±15.90 decreased to 67.44±25.76, which was statistically significant (P=0.0001). However, in the control group, it was associated with an increase in anxiety scores after the intervention. Pain during endoscopy was also statistically significant between the intervention and control groups (P=0.0001). But the mean satisfaction score after endoscopy was not significantly different between the two groups (P=0.161).

Clinical orientation training is effective in reducing anxiety and pain in patients undergoing esophagogastroduodenoscopy. It can therefore be suggested to reduce anxiety.

Clostridioides difficile is one of the important causes of hospital infections worldwide. Regarding the importance of Clostridioides difficile infection (CDI) epidemics and limited available prevalence reports of CDI in Iran, the present investigation was done on the incidence of CDI in hospitalized patients from 2017-2018. Our study outlined the requirements for CDI and followed up on the causative agent of antibiotic-associated diarrhea (AAD).

We evaluated the CDI rates by multiplex real-time polymerase chain reaction (PCR) assay directly from inpatient fecal samples with a history of antibiotic therapy (2-8 weeks) and combined with anaerobic culture and toxicity assessments to isolate toxigenic and non-toxigenic types. The results were analyzed through one-way analysis of variance (ANOVA), pairwise two-tailed correlation, and regression using SPSS software version 25.0 (IBM® SPSS® Statistics, USA).

Among 491 fecal samples, 49 (9.9%) toxigenic C. difficile were characterized by real-time PCR, while 40 were isolated by toxigenic culture and cytotoxicity assay. Toxin profiling showed 43 (9.7%) tcdA+/tcdB+ and 6 (1.4%) tcdB+.

A considerable prevalence of CDI among patients with AAD was demonstrated, and causative organisms mostly produce both toxins A and B. Since C. difficile still has problematic treatment and is costly, rapid and early detection may help to curb C. difficile infection more efficaciously.

The vermiform appendix, the worm-shaped, closed-ended tube containing a large number of lymphoid follicles, displays variations in its position and macroscopic dimensions according to age, sex, race, and other relevant factors. Variable locations of the appendix may mislead physicians into making an incorrect decision or identification of other diseases. Hence there is a necessity for the study of the different positions of the appendix in patients with appendicitis.

The present study was carried out on 400 bodies (253 males, 147 females) in the autopsy hall of the Forensic Medicine Organization, Tehran province, Iran, from March 2020 to March 2021. The anatomical position of the appendix was recorded during the autopsy. Appendix length and diameter were measured in millimeters using a ruler. The sex of the bodies was recorded based on the observed phenotype, and their age was verified based on their identity document. The data obtained were analyzed using SPSS software version 20.

The pelvic appendix was found to be the most common (29.7%) in both men and women, followed by paracecal in (21.8%), prececal (19.5%), retrocecal (12.5%), subcecal (8%), pre-ileal (6%), and post-ileal (2.5%). The association between sex and appendiceal length was statistically significant, with women having longer appendices than men (85.1±13.8 mm vs. 81.9±13.4 mm, P=0.028). Also, the appendiceal diameter was significantly larger in women than in men (3.81±0.7 mm vs. 3.45±0.66 mm, P=0.017). There was a significant association between sex and position of the appendix, with paracecal position being more prevalent in men and retrocecal in women (P=0.04). The mesoappendix was complete in all cases.

In our study, the commonest position of the appendix was pelvic. The maximal length and diameter of the appendix were 85.1±13.8 and 3.81±0.7 mm, respectively. This shows variations with related reports from other populations. Knowledge of these variations is essential for early detection, treatment, and fewer complications for related diseases.

In recent years, health information technology methods have been increasingly used to diagnose celiac disease (CD). In order to improve diagnosis, image analysis, deep learning, and machine learning methods have been used to improve the accuracy of diagnosis in the shortest time while requiring the least human resources. This article summarizes these techniques and discusses the latest advances in the diagnosis of CD.

All articles that use patient data for diagnosis are presented in this article, and systems designed for follow-up were excluded. EMBASE, PubMed, Web of Science, and Scopus databases have been searched in this inquiry. After searching different databases to eliminate duplicate and review articles, 2266 articles were evaluated in the first stage, and then the titles, abstracts, and concepts were reviewed, and 33 articles were finally selected.

The results showed that 14 studies were conducted in children (42.42%), eight studies were conducted in adults (27.58%), and 10 studies were conducted in two populations (roughly 30.30%). 14 studies were completed in the United States, 16 studies were completed in Europe, and two studies were completed in Asia. 12 articles (37.93%) used the integration of image processing and artificial intelligence methods. 23 articles (69.69%) used endoscopy images, and nine articles (27.27%) used patient information in their research.

The results express a general acceptance of using information technology to improve the diagnosis of CD, but further research is needed to improve and optimize the method of diagnosis. Recent artificial intelligence techniques using deep learning (DL), machine learning methods such as convolutional neural network, support vector machines, and K-nearest neighbors, and also image processing have emerged as the breakthrough computer technology that can be used for computer-aided diagnosis of CD. The current review summarizes methods used in clinical studies to diagnose CD, from feature extraction methods to artificial intelligence and machine learning techniques.

A gastrointestinal stromal tumor (GIST) is the most common intramural mesenchymal tumor of the gastrointestinal tract. Their metastasis to extragastrointestinal organs is rare, especially the spleen. The patient was a 52-year-old man who, with the diagnosis of peritonitis, underwent laparotomy emergently. At the time of surgery, an extensive tumor was seen in the stomach, esophagus, and jejunum, which had metastases to the spleen. Total gastrectomy, esophagojejunostomy, and splenectomy were performed. The morphological studies showed a spindle-cell type of GIST that were positive for CD117 and Discovered on GIST-1 (DOG1). GIST was diagnosed as high-risk and treated with imatinib. In follow-up, he died 5 months after discharge. Here, we reported a case of GIST synchronous with splenic metastasis. Surgeons must alert for possible metastases associated with GISTs, clinical presentation, diagnosis, treatment, and pathological classification.