GOVARESH JOURNAL
Year:2018 | Volume:23 | Issue:1|Papers Count:8

Diet is a source of microbiota. Different food consumption can affect the composition of gut microbiota. The gut microflora plays a main role in energy hemostasis from the diet and also has a key role in maintaining human health. Imbalance in the gut microbiota is associated with weight gain and several mechanisms are proposed in this issue. The influences of the gut microbiota composition extent to multiple systems including glucose and lipid hemostasis, and inflammation and fat mass related diseases. The gut microflora composition is different in lean and obese humans. Manipulation of host diet may lead to new treatments of obesity. Antibiotics, prebiotics, and probiotics modify the gut microbiota. The effect of probiotics on the gut microflora depends on the strain and could be associated with weight loss. Weight loss is also associated with changes in the gut microflora. Dietary properties and specific strategies can modulate metabolism by regulation of gut microbiota. In this article, we reviewed the effects of gut microbiota on weight regulation and their potential abilities for weight loss. Currently, the gut microflora is known as a microbial organ placed within the human. Thus, it is useful to improve strategies for gut microbiota manipulation to control metabolic disorders. Further studies are needed to clarify the underlying mechanisms of microbe-host interactions.

Background: In patients with cirrhosis use of proton pump inhibitors (PPIs) may increase the risk of infection including spontaneous bacterial peritonitis. Also، in some studies PPIs usage had significant relationship with the severity of cirrhosis and development of hepatocellular carcinoma. In recent studies the relationship between PPIs usage and hepatic encephalopathy had been considered. The aim of this study was to assess the relationship between PPIs and hepatic encephalopathy for investigating their effects in the treatment of patients with cirrhosis. Materials and Methods: In this study، 61 patients with liver cirrhosis were evaluated. The patients were followed up in two groups: patients with hepatic encephalopathy and patients with other complications. Results: PPIs usage and also the type and dosage of these drugs were not statistically different between the two groups. The duration of PPIs usage in the patients with hepatic encephalopathy was 23 ± 5. 72 months and in the second group was 13. 04 ± 3. 061 months (p = 0. 039). Conclusion: In patients with cirrhosis، PPIs consumption for a long period، increases the risk of hepatic encephalopathy.

Background: This study aimed to predict the intensity of symptoms in patients with irritable bowel syndrome (IBS) based on their mental health، quality of life، and use of leisure time. Materials and Methods: To do this، 300 patients were chosen from those who referred to two gastrointestinal clinics in north and east of Tehran by using target-based sampling method. Of them 92 patients filled out the Rome– III diagnostic questionnaire، Ryff Scale of Psychological Well-Being (RSPWB)، SF-12 questionnaire، and leisure time questionnaire. Data were analyzed by using Pearson correlation coefficient and multiple stepwise logistic regression analysis. Results: The results showed that mental health، quality of life، and use of leisure time can predict the intensity of symptoms in these patients (p ≤ 0. 01). It was also observed that among the demographic variables، age (older patients)، sex (female patients)، marital status (married patients)، level of education (low literacy skills)، and the number of referrals to physicians can predict the intensity of symptoms (p ≤ 0. 01). Conclusion: It can be concluded that mental health turned out to be the strongest predictive variable. Also، quality of life and use of leisure time can predict the intensity of symptoms in patients. Hence، improving mental health and providing a better environment for living and recreation may have a positive outcome for patients with IBS.

Background: Understanding of the mechanisms governing liver regeneration may be useful for designing treatments for patients with hepatitis، liver injury، or liver transplant. The aim of the present study was to investigate the ultrastructural changes and BCL-2 protein expression associated with partial hepatectomy (PHx). Materials and Methods: This study was carried out on 30 male albino rats assigned to three experimental groups. PHx was done for all the 30 animals and liver tissues were collected to become control tissues. The rats were sacrificed in 24 h (group A)، 48 h (group B)، and 72 h (group C) after PHx. Liver specimens were processed for light and transmission electron microscope. BCL-2 protein expression was evaluated in all groups. Results: Hepatocytes of groups A and B showed several apoptotic changes. BCL-2 protein expression was not detected in the hepatocytes of controls. 48h after PHx، the nuclei of the hepatocytes showed abundant heterochromatin with indistinct nucleoli. The cytoplasms showed numerous electron lucent vacuoles، and swollen mitochondria compared with the controls. Moreover، dilated bile canaliculi with absent microvilli were observed. Meanwhile، 72 h after PHx، the general architecture of liver was retained nearly to normal. Conclusion: In conclusion، during the 48 h after PHx، the hepatocytes underwent proliferative and apoptotic changes followed by regaining their normal structure and organization.

Background: Neuropathy means nerve damage، which interferes with the functioning of the peripheral nervous system. It has been mentioned as one of the extra-intestinal manifestations of celiac disease. This study aimed to investigate the prevalence of celiac disease in patients presented with idiopathic neuropathy. Materials and Methods: A cross-sectional study was done in patients with idiopathic neuropathy at Shariati Hospital، Tehran. Serological tests including endomysial IgA، tissue transglutaminase (TTG) IgA and IgG، and DGP (deamidated gliadin peptide) IgA، and genetic assessment for HLA DQ2 and DQ8 (human leukocyte antigen) were done for all patients and those who had positive celiac serology and HLA DQ2/DQ8 underwent endoscopy and adequate biopsy samples were taken. Diagnosis was made based on histopathological report of celiac disease. Results: 101 patients with idiopathic neuropathy were enrolled. The mean age was 43. 56 ± 10. 66 years (range 70-18 years). The prevalence of HLA-DQ2 and HLA-DQ8 positivity in patients with idiopathic neuropathy was 36. 6% and 9. 9%، respectively. The most common neuropathy subtype in patients with positive HLA-DQ2 and DQ8 was demyelinating PN (Polyneuropathy). One patient (1%) was diagnosed as havine celiac disease. Conclusion: Although the prevalence of celiac disease in patients with idiopathic neuropathy was similar to the general population، having considered the pravalence of celiac disease، treating this condition with gluten-free diet is of importance.

Background: Patients with liver cirrhosis seem to be at increased risk of complications during fasting. This study aimed to assess the effect of Ramadan fasting on liver functions and portal hemodynamics among patients with liver cirrhosis in comparison with healthy subjects. Materials and Methods: Participants were divided into three groups. Group I: patients with liver cirrhosis who fasted during Ramadan (n = 34)، group II: patients with cirrhosis who did not fast (n = 8)، and group III: healthy volunteers who fasted (n = 30). This study was done from May 2017 to July 2017 and the month of Ramadan began on May 27th to June 26th، 2017. Portal hemodynamics were evaluated by portal vein diameter، congestion index (CI)، and portal flow velocity. Laboratory investigations were determined before، during، and after Ramadan as an indicator of the changes in the liver functions. Results: There were no dropouts during the study. Among the three groups، portal vein parameters showed statistically non-significant differences. Model for End stage Liver Disease (MELD) score and serum albumin levels showed a significant difference when the group I and II compared separately to group III (p = 0. 000)، while there were no differences between group I and group II (p = 0. 6 and 0. 57، respectively). For portal vein CI، there was a significant difference between the patients with cirrhosis (fasting; group I and non-fasting; group II) and healthy subjects (group III) (p = 0. 000)، while the CI did not change significantly between the groups I and II (p = 0. 54). Conclusion: Patients with cirrhosis showed changes in their liver functions and portal hemodynamics irrespective of their fasting status and these differences were more pronounced in portal vein CI، MELD score، and serum albumin when compared with healthy subjects.

Background: We aimed to determine the effects of anti-platelet drugs use on adverse outcomes in patients with non-variceal upper gastrointestinal bleeding (UGIB). Materials and Methods: A historical cohort study was performed on patients with non-variceal UGIB admitted to a tertiary care hospital. Clinical outcomes were compared among users of aspirin and patients who did not receive aspirin. Adverse outcome variables consisted of re-bleeding, need for surgery, and death Results: Out of 271 patients (77. 5% men, mean age 59. 5 ± 19. 0 years) with non-variceal UGIB, 157 (57. 9%) did not receive any antiplatelet drugs, 87 (32. 1%) received only aspirin, and 27 (10. 0%) received dual anti-platelet therapy. The frequency of adverse outcomes was significantly higher in patients who bled while not receiving anti-platelets (31. 2% no anti-platelets, 12. 6% single anti-platelet agent, and 14. 8% on dual anti-platelets, p = 0. 002). A significant difference in the duration of admission was not found between the three groups (5. 5 ± 4. 3 in patients with no anti-platelet drugs, 5. 6 ± 4. 6 in patients received single anti-platelet agent, and 5. 0 ± 4. 3 in patients received dual anti-platelets, p = 0. 84). Conclusion: Patients with non-variceal UGIB while taking anti-platelet drugs had a lower rate of adverse outcomes compared with non-users of anti-platelets.

Primary squamous cell carcinoma (SCC) of the liver is a very rare entity and to the best of our knowledge only 35 cases have been so far reported worldwide. Squamous cell carcinoma is usually diagnosed in skin، head and neck، respiratory tract، esophagus، cervix، and rectum. However، it can rarely occur in the liver as a primary tumor. It has been reported to be associated with liver cysts، chronic inflammation of biliary ducts، and biliary stones. Primary SCC of the liver has an aggressive behavior and poor prognosis. Herein، we reported a middle-aged lady presented with a hepatic mass. Biopsy of the mass revealed SCC and no primary source، other than the liver itself، could be found despite extensive examinations. That is why the tumor was considered to be a primary occurrence of SCC in the liver.