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سال:1398 | دوره:24 | شماره:2 |تعداد مقالات:7

Background: Irritable bowel syndrome (IBS) is a functional disorder with an unknown etiology. Some recent studies report the presence of a microscopic inflammation in people with IBS. This micro-inflammation can be due to an alteration in the pattern of recognition receptors especially in Toll-like receptors (TLRs). In this systematic review, we reviewed an evaluated existing studies related to TLRs and their changes in patients with IBS. Materials and Methods: Three science citation index databases including Web of Science, Pubmed and Embase were searched for related keywords from September 2000 to September 2018. There was no language restriction. Two reviewers screened and extracted data independently. Results: A total of 178 records were retrieved and eight eligible studies (265 patients) were included for data extraction and analysis. The results showed that, compared with the healthy group, the expression of some of the TLRs such as TLR2, TLR3, TLR4 and TLR5 increased whereas the expression of some others including TLR7 and TLR8 decreased significantly. Conclusion: Alteration of TLRs in patients with IBS can be due to changes in microbiota causing a micro-inflammation. This alteration can have a potential role in pathophysiology of IBS.

Background: Liver fibrosis is the main prognostic factor for chronic hepatitis B (CHB). Change of inactive hepatitis B to active one is usually done silently. In this setting accurate estimation of fibrosis is an important step in the management of affected patients. The aim of this study was to determine the impact of fibroscan to evaluate liver fibrosis in inactive chronic hepatitis B. Materials and Methods: In a prospective study between February 2016 and June 2018, we evaluated liver fibrosis among patients with inactive CHB by fibroscan assessment. The inclusion criteria were the presence of serum HBsAg more than 6 months, persistence normal liver enzymes during the last 6 months, and HBV– DNA viral load < 20000 IU/mL. All other liver diseases were excluded. All patients underwent liver fibroscan. The factors affecting fibroscan results such as severe obesity, cardiac and renal failure, decompensate cirrhosis, and ascites were excluded. The patients were visited every 6 months. The eligible patients were followed up for one year. Results: 210 patients were enrolled in this study. The mean age was 37. 49 ± 12. 8 years and of them132 patients were male. Regarding the HBV DNA load, 48 (22. 9%), 84 (40%), and 78 (37. 1%) patient had viral load undetectable, under, and more than 2000 IU/mL, respectively. The mean transit elastography (TE) value among these patients was 5. 8 ± 1. 26 kPa. TE value more than 7. 2 kp was seen in 25 (11. 9%) patients with mean of 8. 1 ± 1. 4 kPa. There was no significant association between TE results and viral load levels in general. Moreover, we did not observe a significant association between age and viral load and TE. Conclusion: We showed that inactive hepatitis B is not a benign condition, which needed regular follow-up by evaluating liver enzymes, vial load, and TE. Hepatic fibrosis has prognostic significance because afflicted patients are at higher risk of developing cirrhosis; although liver biopsy is considered as the best available gold standard for assessing hepatic fibrosis.

Background: Many studies have clearly reported the advantages of colonoscopy screening in terms of reducing the mortality rate of colorectal cancers in general population. However, the importance of colonoscopy screening in improving the survival rate of kidney transplant recipients is still unclear. So, the aim of this study is to survey the importance and feasibility of colonoscopy screening in kidney transplant recipients. Materials and Methods: This clinical study was conducted from February 2015 to November 2016. All participants received polyethylene glycolelectrolyte solution (PEG-ES) or magnesium hydroxide for bowel preparation. Colonoscopy was done and the location and the size of any lesions were recorded in all participants. Results: Among 247 post-kidney transplant patients who were visited routinely in Labbafi-Nejad Hospital in Tehran, 30 individuals with any signs or symptoms of malignant or non-malignant colorectal diseases and patients who had a colonoscopy during the previous year or had a failed transplant procedure and subsequent return to dialysis were excluded. Finally, 217 kidney transplant recipients were enrolled in this study, of which 121 patients completed the study. Conclusion: The results of this study, for the first time, confirm the safety and efficiency of colonoscopy as a routine gastrointestinal screening method among post-kidney transplant recipients in Iran, and suggest that it can be highly proficient in detecting gastrointestinal lesions and its implementation is without significant adverse effects in such patients.