GOVARESH Journal
Year:2023 | Volume:28 | Issue:1|Papers Count:8

Background Considering that no study on the efficacy of dexmedetomidine during endoscopic retrograde cholangiopancreatography (ERCP) has been performed in Iran so far, we decided to evaluate the efficacy and effectiveness of dexmedetomidine and patient satisfaction in patients undergoing ERCP. Materials and Methods: A double-blind clinical trial was performed (2020) among 80 patients undergoing ERCP grade ASA I, and II who had no asthma, cardiovascular diseases, and no history of allergies to propofol and dexmedetomidine. The patients were randomly divided into two groups (fentanyl and propofol) and (fentanyl and dexmedetomidine). Their heart rate per minute, mean arterial pressure, respiration rate per minute, and blood oxygen saturation at intervals of 5 and 15 minutes after the start and end of the procedure, the level of patient cooperation, and endoscopies satisfaction were compared. Results: Mean age of the propofol group was 63/13 ±,17/88 and the dexmedetomidine group was 16/99 ±,58/55 (P = 0. 191). Mean heart rate and respiration rate per minute were not different significantly in any of the time intervals. Mean arterial pressure in the propofol group before, 5, and 15 minutes after the start and end of ERCP were higher than dexmedetomidine group (105/95 ±,15/91, 123/75 ±,25/54, 118/10 ±,13/06 and 14/61 ±,117/50, respectively). The percentage of oxygen saturation at 5 minutes and at the end of the procedure was higher in the propofol group (P = 0. 01 and P = 0. 03, respectively) Conclusion: Due to fewer side effects and more satisfaction of patients receiving propofol,this drug is preferred for these patients.

Background In this study, we investigated the expression profile of this disease to identify new hub genes to help diagnose hepatocellular carcinoma (HCC). Materials and Methods: Weighted gene co-expression network (WGCNA) analysis was used in this study to identify key modules and hub genes associated with HCC in the GSE176271 dataset. We also looked at the clinical significance of key genes and the biological pathways linked to them in external databases. We validated the identified hub genes using data from the GEPIA and XenaBrowser databases. Results: The Midnight blue module was found to be significantly related to the pathological stage (r = 0. 94, P = 1e-11). Five hub genes (CLEC4M, CLEC4G, FCN2, OIT3, and ASPG) were associated with prognosis using DEG identification and WGCNA analysis. The three biological pathways associated with the Midnight blue module were copper ion detoxification, cell ion homeostasis, and complement activation, as well as the lectin pathway. Conclusion: The current study's findings provide new and effective molecular targets for the detection of HCC, which can improve patients’,prognosis.

Background: The current study aimed to investigate the prevalence, risk factors, endoscopic findings, and outcome of gastrointestinal bleeding in COVID-19 hospitalized patients. Materials and Methods: This study is a retrospective review of COVID-19 hospitalized patients with gastrointestinal bleeding from a large university hospital in southeast Iran. This study was conducted over one year from April 2020 to March 2021. Results: Out of 3563 COVID-19 inpatients with approximately equal sex distribution (52. 5% of men and 47. 5% of women), 80 (2. 24%) patients with a mean age of 58. 01 ±,20. 71 were identified with signs of gastrointestinal bleeding, including,melena (48. 8%), hemoglobin drop (42. 5%), fresh blood hematemesis (31. 3%), rectorrhagia (20%) and coffee ground emesis (10%). 52 patients (65%) had signs of gastrointestinal bleeding on admission, and 28 patients (35%) developed gastrointestinal bleeding during their hospital admissions, most of whom were men (63. 8%). Endoscopic characteristics were,gastric erosion (27. 7%), gastric ulcer (23%), duodenal ulcer (21. 5%), esophageal ulcer (12. 3%), and esophageal erosion (6. 1%) in upper gastrointestinal endoscopy. On colonoscopy, hemorrhoids (25%), mass lesions (16%), fissures (8. 3%), diverticular lesions (8. 3%), and polyps (8. 3%) were the most common findings. The overall mortality of the patients in the present study was 36. 2%. However, gastrointestinal bleedingrelated deaths were 7. 5%. Conclusion: Gastrointestinal bleeding was identified in 2. 24% of hospitalized COVID-19 patients, with gastroduodenal ulcers and erosions as the most common symptoms.

Background: Celiac disease (CD), or as it is called gluten enteropathy, could result in various complications such as liver abnormalities. Nonalcoholic fatty liver disease (NAFLD) affects 25. 2% of individuals worldwide and has become one of the most common causes of cirrhosis. This study aimed to report the frequency of fatty liver in ultrasonography of patients with CD in Golestan province, Northeast Iran. Materials and Methods: In this cross-sectional study, patients diagnosed with CD based on a positive anti-tTG Ab and proved by small bowel biopsy were recruited between March 2018 and March 2020 (N = 80), through the registry system located in Golestan Research Center of Gastroenterology and Hepatology, Northeast Iran. Ultrasonography was performed and the fatty liver diagnosis was done based on attenuation of the liver itself (less than 40 Hounsfield Unit (HU)) or in comparison with the spleen (liver attenuation ≤,10, than spleen). Results: Among 80 patients with CD (46 women, mean age 39. 13 ±,12. 5 years), fatty liver was reported in 34 (43. 5%), which was mild in 31 (39%), moderate in 2 (2. 5%), and severe in 1 (1. 3%) patients. One cirrhosis and no hepatomegaly were found. Conclusion: In the present study, fatty liver was seen in 43. 5% of our patients, which is a large amount. It may be suggested to do a closer follow-up of the complications of CD.

Background: Celiac disease (CD) is one of the most common and chronic immune-mediated disorders of the gastrointestinal tract that affects the small intestine. Genetic factors, including human leukocyte antigen (HLA), and non-HLA genes are major risk factors in CD pathology. Moreover, environmental factors such as infections may affect CD incidence. Materials and Methods: The goal of the present study is to investigate the association between CD and viral, bacterial, fungal, and parasitic infections. Databases including Scopus, PubMed, Google Scholar, and Web of Science were searched for relevant literature until 2022. Results: Several infections have been reported to be associated with CD including reovirus, rotavirus, hepatitis B virus, influenza virus, helicobacter pylori, campylobacter jejuni, giardia lamblia, toxoplasma gondii, candida albicans, etc. Conclusion: Moreover, antibiotic administration might be a risk factor for further CD development. On the other hand, there are reports regarding the susceptibility of patients with CD to some infections, as well as protective infections against CD. Consequently, more studies are required to explain the two-sided relations between CD and infectious diseases.

Background: There is increasing evidence that surgical approaches to weight loss (bariatric surgery) are the most effective and steady treatment for morbidly obese patients. This study assessed the nutritional status of obese participants candidates for laparoscopic gastric plication (LGP) before and after the surgery. Materials and Methods: Our study was conducted on 38 participants aged 18 to 65, with a mean body mass index (BMI) of 41. 45 ±,5. 68 kg/m2, scheduled for LGP. BMI and Dietary intakes were assessed at baseline and 6 months after surgery. The mean daily energy intake and microand macronutrients were calculated and compared with the dietary reference intake each time. Results: The mean excess weight loss was 44. 45 ±,9. 78%. The mean daily energy intake decreased to one-third of the baseline 6 months after surgery. All patients had a low intake of protein, vitamins A, D, and folic acid before and after LGP. After surgery, over 60% of patients had inadequate vitamin B1, B2, B3, B6, calcium, and iron levels. Conclusion: 6 months after LGP, our results demonstrated dietary deficiencies, including inadequate protein and certain micronutrients. Some of these nutritional deficiencies existed before surgery and persisted or worsened after surgery. In order to ensure optimal health before and after surgery, patient care should place a strong emphasis on nutritional counseling and supplementation.

Background: Hepatocellular carcinoma (HCC) ranks as the first and the second malignancy in men and women in Egypt. Many inflammatory markers are included in HCC pathogenesis. Matrix metalloproteinase-14 (MMP-14) is one of them and it is implicated in regulating HCC tumor progression and prognosis. This study was done basically to assess the frequency of alleles of rs2236307 single nucleotide polymorphism (SNPs) of the MMP-14 ( + 7096) gene in patients with HCC and to determine if there is an association between its alleles polymorphism and the occurrence of HCC in Egyptian patients. Materials and Methods: A case-control study was done in the Tropical Medicine Department at Zagazig University Hospitals and the Medical Biochemistry Department, Faculty of Medicine, Zagazig University. The study included 540 subjects, classified into three groups HCC, cirrhotic, and controls (180 in each group). MMP-14 gene polymorphism analysis in the promoter of the MMP-14 gene rs2236307 was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: The TC genotype was significantly higher among patients with HCC when compared with the control group (77. 8% versus 16. 7%, respectively). The TC genotype was higher among patients with HCC compared with the cirrhotic group (77. 8% versus 38. 9%, respectively). Metastatic lesions and portal vein thrombosis were significantly higher among the TC group compared with the CC and the TT groups in the HCC group. Conclusion: The polymorphisms of MMP-14 rs2236307 increase the risk of HCC. Both the TC and the CC genotypes showed HCC risk association but the the CC genotype appeared with lower potential.

Background: Hepatitis C virus (HCV) infection affects around 170 million individuals worldwide, with an estimated 3% of the world’, s population presently afflicted. More than 350, 000 people are killed each year by HCV throughout Asia and the rest of the globe due to liver disorders such as cirrhosis, chronic hepatitis, and hepatocellular carcinoma (HCC). Understanding viral-host protein interactions are essential for understanding viral infection, disease etiology, and the development of innovative therapeutics. This is due to the inherent limits of laboratory techniques for finding host-virus protein-protein interactions (PPIs). There seems to be a strong computational effect on the research of cellular infection. Materials and Methods: In this study, we predicted the interaction between human and HCV proteins using an ensemble learning technique. Support vector machines (SVMs) nuclear liner and radial are the cornerstones of our model, as are K-Nearest Neighbors (KNN) and Random Forest (RF). Four different feature vectors were used to encode human and HCV proteins: the tripeptide composition (TPC), The composition of k-spaced acid pairs (CKSAAP), the amino acid autocorrelation-autocovariance (AAutoCor), and the conjoint triad (CT). Results: The predictive power of the suggested technique is evaluated using a benchmark dataset that contains both consistently positive and negative PPIs. A support vector machine (Radial-SVM) model was used to predict which human proteins interact with HCV. To achieve accuracy and specificity of 84. 9 and 88. 3 percent, we employed tenfold cross-validation and principal component analysis (PCA). Conclusion: Our technique correctly predicts PPIs based on human and HCV proteins. The discovery of HCV-human protein interaction networks, enriched pathways, gene ontology, and functional categories has improved our knowledge of HCV infection.