GOVARESH Quarterly ygolotapeH dna ygoloretneortsaG fo noitaicossA nainarI eht fo lanruoJ cifitneicS lanruoJ fo eht nainarI noitaicossA fo ygoloretneortsaG dna ygolotapeH

pISSN: 1560-7186, oISSN: 2008-756x, eISSN: 2008-7578 Vol. 17, Supplement, Autumn 2012, No. 80-1

Concessioner: Founder and Director: Iranian Association of Gastroenterology and Hepatology Mirmadjlessi SH, M.D.

Publisher: Editor-in-Chief: Iranian Association of Gastroenterology and Hepatology Ebrahimi Daryani N, M.D.

Editorial Board (In Alphabetic order) Associate Editors Aghazadeh R, M.D. Masjedizadeh AR, M.D. Antikchi MH, M.D. Mir-Nasseri MM, M.D.,MPH Darvish Moghaddam S, M.D. Massarat S, M.D. Bagheri M, M.D. Mohammadnejad M, M.D. Daryani NE, M.D. Mikaeli J, M.D. Falahi GH, M.D. Pourshams A, M.D. MPH Emami NajafiDehkordi SMH M.D. Minakari M, M.D. Farahvash M, M.D. Setoodehmanesh R, M.D. Hashemi SJ, M.D. NasiriToosi M, M.D. Ghadir MR, M.D. Taheri H, M.D. Malekzadeh R, M.D. Sima HR, M.D. Maleki I, M.D. Zamani F, M.D. Mansour-Ghanaei F, M.D. Somi MH, M.D. Merat S, M.D. Zendehdel N, M.D.

International Members of Editorial Board

Adler G M.D. (Germany) Sobhani I M.D. (France)

Keshavarzian A M.D. (USA) Schuppan D M.D. (USA)

Executive Editor Scientific Editor

Mir-Nasseri MM, M.D., MPH Mohammadnejad M, M.D.

Persian Text Editors English Text Editor Sadjadieh AH, M.D., Namazi HR, M.D. Kim Vagharfard, M.S. Ansari E, M. D.

Office Staff Page designing Sayyad M, Mazloum S, Etehad F Etehad F

Address of Editorial Office Publisher's Address Iranian Association of Gastroenterology and Iranian Association of Gastroenterology and Hepatology, Hepatology, Unit 1, No. 13, Shahrivar Alley, Unit 1, No. 13, Shahrivar Alley, Kargar-e-Shomali Ave., Kargar-e-Shomali Ave., Tehran, Iran. Tehran, Iran. Dr. Massarat S Dr. Mirmadjlessi SH P. O. Box: 14395-163 Tehran, Iran. Telefax: +98 21 88 33 50 61-3 Telefax: +98 21 88 33 50 61-3 E-mail: [email protected]

This journal is sponsored by Iranian Association of Gastroenterology and Hepatology. Any reproduction or use of contents of articles of this journal is permitted only if the source is cited precisely. Web Site: www.iagh.org E-mail: [email protected] In The name of God

Abstract Submitted for Iranian Congress of Gastroenterology and Hepatology - ICGH 2011 November 28-30, 2012

Contents

ICGH 2012 Committees • Executive Committee ...... 3 • Scientific Committee ...... 4

• Sponsor Societies ...... 5 • Abstracts Categories ...... 6

Abstracts of the ICGH 2012 ...... 7-87

• Author Index ...... 88 ICGH 2012 Committees

Organizing committees:

President, ICGH 2012 Honorary President, Iranian Association of Reza Malekzadeh, MD Gastroenterology and Hepatology Professor of Medicine and Gastroenterology Seid Hossein Mir-Madjlessi, MD Director, Digestive Disease Research Center, Internist, Gastroenterologist, Tehran University of Medical Sciences Iranian Institute of Medicine

Scientific Secretary, ICGH 2012 Executive Secretary, ICGH 2012 Shahin Merat, MD Seyed Mohammad Mehdi Mir- Nasseri,MD, MPH Professor of Medicine and Gastroenterology Research Fellow, Deputy of Research, Digestive Disease Research Institute Digestive Disease Research Center, Tehran University of Medical Sciences, Theran University of Medical Sciences

Executive Committee (Alphabetical):

• Abbasi S. • Markarian M. • Abbasi Y. • Maroofi M. • Ansari E., MD • Maroofi N. • Bakhshi M. • Mazlum S. • Barzin G., MD • Merat S., MD • Bashiri • Mir-Nasseri MM., MD • Bohlouli S. • Mohsenifar F. • Etehad F. • Moradi H., MD • Gharaqouzlu A. • Nabaei • Janeshin M. • Nourbakhsh R. • Kavyani S. • Shakeri R., MD

Govaresh\ Vol.17\ Supplement\ Autumn 2012 3 ICGH 2012 Committees

Scientific Committee (Alphabetical):

Adibi P., MD Massoumi H., MD Agah S., MD Mikaeli J., MD Aghazadeh R., MD Minakari M., MD Alavian SM., MD Mirbagheri A., MD Ansari R., MD Mohammad-Alizadeh AH., MD Antikchi MH., MD Mohammad-Nejhad M., MD Ashktorab H., MD Moini M., MD Asl-Soleimani H., MD Montazeri Gh., MD Bagheri M., MD Naseri-Moghaddam S., MD Bagheri-Lankarani K., MD Nassiri-Toosi M., MD Darvish-Moghaddam S., MD Noorbakhsh K., MD Delavari A., MD Pazouki A., MD Derakhshan F., MD Pourshams A., MD Derakhshan MH., MD Poustchi H., MD D'Haens G., MD Qamaruddin K., MD Dooghai-Moghaddam M., MD Rinse K., MD Ebrahimi-Dariani N., MD Saadatnia H., MD Eghtesad B., MD Saberfiroozi M., MD Ehsani MJ., MD Saidi R., MD Emami MH., MD Sandouk F., MD Esmaili S., MD Sarie HR., MD Fallah SA., MD Semnani S., MD Farahvash MJ., MD Shahbazkhani B., MD Fattahi MR., MD Shokri- Shirvani J., MD Frootan M., MD Sobhani I., MD Froutan H., MD Somi MH., MD Ghadir MR., MD Soroush AR., MD Hajiani E., MD Sotoudeh M., MD Hoogenraad T., MD Sotoudehmanesh R., MD Ibrahim N., MD Taheri H., MD Jafarian A., MD Tirgar- Fakheri H., MD Keshavarzian A., MD Vahedi H., MD Khatibian M., MD Vosoughinia H., MD Malekhoseini SA., MD Yazdanbod A., MD Maleki I., MD Zahedi MJ. MD Malekzadeh R., MD Zamani F., MD Mansoor-Ghanaee F., MD Zhernakova A., MD Mansouri S., MD Ziad-Alizadeh B., MD Massarrat S., MD Zojaji H., MD

4 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Sponsor Scoieties

►Espadana Darou Pars Co. ► Barsian Darou Co. ► Cobel Darou Co. (AstraZeneca) ► Roche Pharmaceutica

►Fanavari Azmayeshgahi Co. ►Pars Didegan Co. ►Tabib abzar Gostar ►Advance Medical Technology Co. (Olympus) (Endo-Flex)

► Pooyesh Darou Pharmaceutica ►Jahan Behbood Co. (Janssen-Cilag) ► Rossendarman Pharmaceutica (Tillotts)

►Teb Dakheli Pishro Co. ►Arya Jarah Co. ► Ofogh Arman Pars Co. ►Arman Idehgostar Pars (AIP) (Pentax) (Endomed) (Niti-S)

►Mavaraye Fonoon Asr (Boston Scientific) ►Nikan Teb Sasan Co. ►Peyk Darou Nikan Co. (Nycomed)

►Irenic Co. ► Tehran Chemie Pharmaceutica ►Zahravi Pharmaceutica ►Actover Co.

Govaresh\ Vol.17\ Supplement\ Autumn 2012 5 Abstract Categories

Schedule of Abstracts Peresentation - ICGH 2012

Day 1: Wednesday, November 28/Azar 8 W-F-001 to W-F-050...... 7-32 Day 2: Thursday, November 29/Azar 9 T-S-051 to T-S-99...... 32-59 Day 3: Firday,November 30/Azar 10 F-T-100 to F-T-148...... 60-87

Abstract Categories

Category: 1- CLINICAL PRACTICE Category: 7. LIVER 1.1 Epidemiology…...... 7-18 7.2 Nutrition - metabolism – pharmacology...... …. 57-59 1.2 Management strategies…...... 18-19 7.3 Metabolic/genetic disorders…...... 59-61 1.3 Evidence-based clinical practice…...... 19-20 7.6 Cirrhosis and complications: clinical aspects…...... 61-63 1.4 Outcome studies...... …. 21-22 7.7 Viral hepatitis: basic aspects...... …. 63-65 7.8 Viral hepatitis B: clinical aspects…...... 65-66 Category: 2- ESOPHAGEAL-GASTRIC AND DUODENAL 7.9 Viral hepatitis C: clinical aspects...... …. 67-70 DISORDERS 7.10 Immunology - autoimmune liver disease...... …. 71 2.1 Cell/molecular biology/pathology...... …. 23 7.13 Miscellaneous…...... 71 2.2 Dyspepsia …...... 24-25 2.3 Barretts…...... 26 Category: 8. BILIARY 2.4 Reflux disease – pathogenesis…...... 26 8-2 Gallstones…...... 72-73 2.5 Reflux disease – diagnosis…...... 27 8.3 Malignant hepato-biliary diseases…...... 74 2.6 Reflux disease – treatment...... …. 27 2.7 Reflux disease – complications...... …. 28 Category: 9. PANCREAS 2.8 Esophageal malignant disease…...... 29 9.5 Malignant disease and endocrine tumors of the pancreas…... 74 2.9 Other esophageal disorders …...... 29-31 2.12 Acid peptic disease (includes NSAIDS - but NOT H.pylori)- Category: 10. NUTRITION diagnosis and treatment...... …. 31 10.2 Nutrients and gut function…...... 75 2.13 Gastroduodenal malignancies…...... 32-35 Category: 12. SURGERY Category: 3. H.PYLORI 12.1 Esophagus / stomach / duodenum…...... 75 3.1 Epidemiology/natural history…...... 35-36 3.2 Molecular biology/genetics/pathology…...... 36 Category: 13. ONCOLOGY-BASIC 3.3 Pathogenesis: host factors/histo-pathology...... …. 37 13.2 Molecular biology/genetics/pathology…...... 76-78 3.4 Diagnosis…...... 38-39 3.5 Management strategies…...... 39-42 Category: 14. ONCOLOGY-CLINICAL 14.1 Malignant disease - epidemiology - screening and preven- Category: 4. INTESTINAL tion…...... 78-81 4.2 Coeliac disease/malabsorption syndromes and food en- teropathies…...... 43-48 Category: 15. NERVE GUT AND MOTILITY 15.5 Functional gastrointestinal disorders (clinical - manage- Category: 5. IBD ment)…...... 81-83 5.2 Etiology/epidemiology…...... 48-50 5.3 Genetics…...... 50-51 Category: 16. IMMUNOLOGY/MICROBIOLOGY 16.3 Gastrointestinal infections…...... 84 Category: 6. COLONIC AND ANORECTAL DISORDERS 6.1 Malignant disease – pathogenesis…...... 51-53 Category: 18. GASTROINTESTINAL BLEEDING…...... 84 6.2 Malignant disease - diagnosis/histopathology…...... 53 6.3 Malignant disease – management…...... 54 Category: 19. ENDOSCOPY AND IMAGING 6.4 Other colonic and anorectal disorders…...... 54-56 19.1 Endoscopy - Upper GI…...... 85-86 19.3 Endoscopy – ERCP…...... 86-87

6 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

Code: 2293 Seyed Saeed Sarkeshikian1, Seyed- Moayed Alavian2 Category: 1- CLINICAL PRACTICE 1 Shahid Beheshti Hospital, Qom University of Medical 1.1 Epidemiology Sciences, Qom, Iran 2 W-F-001 Gastroenterology and hepatology Section, Baghiatallah University of Medical Sciences, Tehran, Iran DBI Gú ìHPç ÞõkÞBó ko D ôüPBìýò uÇe AoqüBGþ Introduction: Hepatitis B is the most common chronic * 1 Öpøíñl ÖBÆíú viral infection of the human being and the most GýíBouPBó ìpÞr ÆHþ ÞõkÞBó , kAðzãBû OùpAó OùpAó kAðzãBû , ÞõkÞBó ÆHþ ìpÞr GýíBouPBó 1 common cause of death in viral hepatitis. It is ðÛ{ OñËýî Þññlû uývPî Aüíñþ kAyPú ô ko WpüBó ko ô kAyPú Aüíñþ uývPî Þññlû OñËýî ðÛ{ D ôüPBìýò ølÙ: ô qìýñú estimated that out of the 350 million carriers of HBV, ðÛ{ OñËýî ô ÞñPpë AèPùBJ oA ðýr kAok. ìýrAó ÞíHõk ìýrAó kAok. ðýr oA AèPùBJ ÞñPpë ô OñËýî ðÛ{ DBI oôkû AèPùBGþ GýíBoÿ 40 million would die of liver cirrhosis and 60 million ko ÞõkÞBó ko ìñBÆÜ ìhPéØ ìP×BôR AuQ ô Gú ìvBüê ìhPéØ GvPãþ ìhPéØ ìvBüê Gú ô AuQ ìP×BôR ìhPéØ ìñBÆÜ ko ÞõkÞBó ko D ôüPBìýò of hepatocellular carcinoma. As 70-80% of chronic hepatitis cases are caused by HBV in Iran, this virus ÞíPp D ôüPBìýò upìþ ìÛBküp GByñl kAyPú øî DBI Þú ÞõkÞBðþ ko « g¿õ¾B kAok. alone is considered as the most important cause of ô oüvà ÖBÞPõoøBÿ oüvà ô OÏýýò ìÇBèÏú Aüò Aq ølÙ GByl. ìþ ìÏíõë Aq ecnelaverP liver diseases and the major cause of mortality arising AuQ. AuQ. DBI Gú ìHPç ÞõkÞBó ko D ôüPBìýò ÞíHõk WùQ æqï from viral hepatitis cases in Iran. , (ìpAWÏú Þññlû Gú ìpÞr Gú Þññlû (ìpAWÏú , DBI Gú ìHPç Þõká 53 ko ìÇBèÏú Aüò ko Gpouþ: oô} Since the Qom Province, Iran, has special features and ) Æþ uBèùBÿ (0931 ƒ 9831) AðlAqû âýpÿ AðlAqû 9831) ƒ (0931 uBèùBÿ Æþ ) HO ( 3Dtiv 52 upìþ uÇe ÞõkÞBó) ÆHþ a heterogeneous population, we planned this study to ô ìlR qìBó GýíBoÿ, ÖÏBèýQ GýíBoÿ ô ì¿pÙ ô GýíBoÿ ÖÏBèýQ GýíBoÿ, qìBó ìlR ô DBI ðõÑ kìõâpAÖýà, AÆçÎBR yl. determine the prevalence of hepatitis B in the general D ôüPBìýò ÞíHõk yl. SHQ ÚHéþ ylû AðXBï AèPùBGþ ìBoÞpøBÿ ðËp, ìõok kAoôøBÿ population of the province. It seems that the results of D ôüPBìýò upìþ uÇe GByl qüp ÆHÜ DtiV upìþ uÇe Þú yl ìþ â×Pú ôÚPþ this study would provide new data on the disease in Qom, thus enabling the health officials to adopt better AuQ. AuQ. lm/gn GpcvI decisions on both preventing the complications of and 001-03 :tneiciffuS ,92-01 :tneiciffusnI , 01< tneicifeD. 01< , :tneiciffusnI ,92-01 :tneiciffuS 001-03 treating the disease. )51-01( tneicifed yletaredoM 5< tneicifed ylereveS tneicifed 5< yletaredoM tneicifed )51-01( Method: The present study is a cross-sectional study. Aq Þê 53 ð×p 51 ð×p ìnÞp (68/24%) 02 ð×p ìõðU (41/75%)Gõk. ÖÛÈ 2 ÖÛÈ (41/75%)Gõk. ìõðU ð×p 02 (68/24%) ìnÞp ð×p 51 ð×p 53 Þê Aq øB: üBÖPú A total of 3,690 samples were collected out of 7 rural Þõká (17/5%) uÇe upìþ GBæOp Aq ðpìBë kAyQ. ko 21 Þõká (82/43%) uÇe (82/43%) Þõká 21 ko kAyQ. ðpìBë Aq GBæOp upìþ uÇe (17/5%) Þõká clusters and 116 urban clusters. Ten teams, each ko 81 ð×p (24/15%) Gú (24/15%) ð×p 81 ko ylereveS tneicifed Gõk. KBüýò GvýBo D ôüPBìýò upìþ consisting of 2 trained members, were assigned to ô 3 ð×p (75/8%) ðBÞBÖþ Gõk. Gõk. ðBÞBÖþ (75/8%) ð×p 3 ô tneicifeD yletaredom Gõk. KBüýò ìPõuÈ Æõo conduct sampling and filling the questionnaires. The ô ðõÑ GýíBoÿ ô ylR @ó ko ÞõkÞBó ko @ó ylR ô GýíBoÿ ðõÑ ô uÇe Gýò AoOHBÆþ øýa . data were analyzed using the SPSS software. D tiv D nI tneiciffus Results: ô ðõÑ ì¿pÙ kAoô ôWõk ðlAyQ. ðlAyQ. ôWõk kAoô ì¿pÙ ðõÑ ô The prevalence rate of hepatitis B infection in Qom Province was 1.3%. The mean age of the øvPñl D ôüPBìýò ÞíHõk k^Bo DBI Gú ìHPç ÞõkÞBó Aq qüBkÿ OÏlAk âýpÿ: ðPýXú patients with hepatitis B was 44.17 years. The ìpOI ìõðýPõo yõk. AuP×Bkû Aq ôüPBìýò Aq AuP×Bkû yõk. ìõðýPõo ìpOI DBI Gú ìHPç ÞõkÞBó ko GBül tiv D uÇe prevalence of hepatitis B was 1.6% in men and 1.1% ko Aüò ÞõkÞBó Oõ¾ýú ìþ yõk. yõk. ìþ Oõ¾ýú ÞõkÞBó Aüò ko D in women. Moreover, the prevalence of hepatitis B was positively correlated with the factors of age, Send Date: 2012/07/04 tattooing and literacy level. Conclusion: The prevalence rate of hepatitis B in Qom is medium. It is possible to prevent the disease by Code: 2314 increasing public awareness. Further investigations on Category: 1- CLINICAL PRACTICE clinical presentations and determining the genotype of 1.1 Epidemiology the virus are suggested. W-F-002 Send Date: 2012/07/27 Distribution and risk factors of Hepatitis-B in the General Code: 2325 Population of Qom: A Population-based Study Category: 1- CLINICAL PRACTICE Mohammad-Reza Ghadir1* , Akram Heidari1, Hoseinali Habibinejad1, Abolfazl Iranikhah1, 1.1 Epidemiology W-F-003

Govaresh\ Vol.17\ Supplement\ Autumn 2012 7 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

Prevalence of chronic constipation and 1.1 Epidemiology associated factors in kermanian adult population W-F-004 Mohammad Javad Zahedi1, Sodaif Darvish Causes and risk factors for Moghadam1, Sayyed mahdi Sayyed Mirzaii1, upper gastrointestinal bleeding Mahdi Hayat Bakhshe Abasi1, Sara Shafiei pour1* in Khorram Abad in 1390 1 Department of gastroenterology,Afzalipour Hospital, Koorush Ghanadi1*, Khatereh Anbari2, Kerman University of Medical Sciences, Kerman, Iran Majid Abdolahian1, Abolfazl Zendedel1 Introduction: Chronic constipation is a common 1internal medicine department, lorestan university problem in the world that have negative effect on 2community medicine department, lorestan university quality of life. Because of the impact of the Introduction: Acute upper gastrointestinal bIeeding psychological and cultural factors on the function of is a common medicaI emergency and is known as one bowel tract and the vast variety of ethnic and habit in of the main causes of mortaIity and morbidity . Iranian people, the present study describes the Method: in this cross sectional study, all patients with occurrence of the constipation, and associated factors Acute upper gastrointestinal bIeeding living in the in Kermanian population. khorramabad city and its suburbs , whose refered to Method: A cross-sectional study was conducted in shohada ashayer hospital , were evaluate. Kerman from March 2009 to October 2010, including control group were selected through consecutive 2191 adult persons who were selected randomly and sampling from patients and their relative who were interviewed face to face by a validated questionnaires refered to outpatient clinics of shohada hospital , base on Rome III criteria. demographic ,habit and provided no history of heart disease , gastrointestinal personality factors were assessed. and rheumatologic disease and discophaties and Results: Of the 2191 participants, 9.4% had chronic matched with patient group as age and sex.endoscopy constipation according to Rome III criteria . was used for diagnosing the causes of acute bIeeding constipation was more prevalent in female ,older, low of the upper digestive system .data gathering tools in physical activity ,anxious ,depressed and opium this study was questionnaire included demographic addicted individuals (P value <0.001) .but cigarette variable,clinical features and endoscopy findings in smoking and amount of fiber in diet not significantly this patient .fishers exact test and chi-squre was used different between constipated and non constipated for data analysis . groups(P value =0.2 ,P value >0.05 respectively). Results: Of 62 patients, 32.3%were femaIe and 67.7% In the first degree of constipated group prevalence of colon cancer and inflammatory bowel disease were maIe, with a mean age of 54. 5±12.1 years oId. decreased comparing to the first degree of non The most frequent gastrointestinal bleeding was seen constipated group (2.4%versus9.3% and 0% versus in 69-79 years age group Among aII the patients ,29% 8.9%, respectively) but was not statistically significant of patient had a history of regular NSAIDs difference between these results(P value =0.5 ,P value consumption , out of whom 76.5% consumed ASA. =0.02 ,respectively). history of regular NSAID used in the control group Conclusion: In our survey, prevalence of chronic was 6%. odds ratio for gastrointestinal bIeeding in constipation in Kerman was more than the other regular NSAIDs consumption was 3.8 ( CI=1.3-4.8). studies that were performed in general population of significant association was not seen between regular Iran but was lower than western countries. we consumption of cigarettes and upper gastrointestinal suggest cohort study for finding association among % constipation with colorectal cancer and inflammatory bleeding. Hematemesis (62.9 ) was the most bowel disease. common primary presentation. the most common Send Date : 2012/08/06 prevaIent underlying diseasepredisposing bleeding in this patient was liver cirrhosis (61.5%). The main Code: 2338 causes of bleeding were digestive ulcers (42.7%), of Category: 1- CLINICAL PRACTICE

8 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 which duodenum uIcers had the highest prevaIence Results: A total of 2189 subject were analyzed. Mean (27.8%).more frequent cause of upper gastrointestinal age was 33.45 ± 0.07 years. The prevalence of GERD was 29.3% that was related to age and gender. Among bIeeding ,in male (26.8%) and female(30%) was the demographic features elderly, female gender, duodenal ulcers . the most common cause of upper lower educational level, Housekeeping and gastrointestinal bIeeding ,in patient under 40 years Retirement were associated with GERD. Higher (35%) and over 60 years (36%) was duodenal ulcer BMI, waist circumference, hip circumference were and in 40-60 age group (43.8%)was esophageal anthropometric measures that showed a significant varices. correlation with GERD (p=0.2). Hyperlipidemia, Conclusion: provide preventive and treatment cardiovascular diseases, metabolic syndrome, drug strategies for patient can prevent or reduce the Consumption, cigarette smoking, opium addiction, incidence of this disease and its complications. light and severe physical activity, depression and Send Date : 2012/08/12 anxiety were also significantly correlated with GERD (p<0.0001- 0.02). Conclusion: Code: 2372 GERD was common among inhabitants Category: 1- CLINICAL PRACTICE in this urban area. It seems that multiple variables 1.1 Epidemiology including the demographic features and life style W-F-005 affects the prevalence of GERD. Prevalence of gastroesophageal reflux Send Date : 2012/08/30 disease in a population based study and the related risk factors Code : 2406 Sodaif Darvish Moghaddam1* , Mohammad Javad Zahedi1, Mehdi Hayatbakhsh Abbasi1, Category : 1- CLINICAL PRACTICE Ali Akbar Haghdost2, Elham Karimi Googheri3 1.1 Epidemiology 1 Afzalipoor Hospital , Department of Internal Medicine, W-F-006 GI section, Kerman University of Medical Sciences, Incidence of Colorectal polyps and Kerman, Iran premalignant Lesions in Asymptomatic 2 School of Public Health, Kerman University of Medical people Referring to the Check- up Sciences, Kerman, Iran Clinic of Razavi Hospital from 2006- 2011 3 Clinical Research Unit, Afzalipour Hospital, Kerman sarah Tayebi1*, Ali Abdolhosseini1, Maryam Razavi1 University of Medical Sciences, Kerman, Iran 1Razavi Hospital Introduction: Gasrtoesophagial reflux dsease Introduction: Colorectal cancer (CRC) is the third (GERD) is common around the world. We studied most common cause of cancer death worldwide. whole parameters that are supposed to be the risk prevalence of CRC and colonic polyps varies in factors of this chronic disorder. The aim of this study different ethnics and populations. The preferred was to detect the prevalence of GERD and related method for screening of CRC and colonic polyps risk factors in an urban area; Kerman, Iran. among asymptomatic people is colonoscopy. The aim Method: This population- based cross sectional study of this study is to evaluate the results of colonoscopy was conducted in a one stage randomized clustered among asymptomatic people referring to Razavi sample of adult inhabitants in Kerman city in Hospital check up clinic, during 2006-2011 by a 2010-2011. A total of 2275 subjects with age range cross-sectional study. of 15-75 years old were enrolled. Data collection and Method: In this study the demographic and physical examination was performed by a trained colonoscopy results of 212 asymptomatic people who physician and nurse by a face to face interview. have been referred to the Check-Up Clinic of Razavi GERD was defined as at least weekly heart burn and Hospital from 2006 till 2011, were evaluated and then / or acid regurgitation during the past year. analyzed by SPSS. Association of GERD with demographic features, Results: The mean age of the people was 54.72, medical conditions, diet and habits were analyzed.

Govaresh\ Vol.17\ Supplement\ Autumn 2012 9 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 included 78.3% males and 21.7% females. Department of Research Affair, Razavi Hospital, Mashhad, Pathological lesions were more common in males Iran (89.5%) than females (10.5%). Considering risk 3 Gastric Cancer Research Group, Mashhad University of assessment for CRC, 86.8% of them were estimated Medical Sciences, Mashhad, Iran in the average risk group and 13.2% in the increased Department of Internal Medicine, Imam Reza Hospital, School of Medicine, Mashhad University of Medical risk group. Among these people, the incidence of Sciences, Mashhad, IRAN polyp was 29.7%. It was revealed that sigmoid colon 4 Gastric Cancer Research Group, Mashhad University of (34.9%) and rectum (15.9%) were the most common Medical Sciences, Mashhad, Iran affected sites. Due to the pathological analysis, 74.6% Islamic Azad University, Mashhad Branch, Mashhad, Iran of the subjects were reported with low grade 5 Gastric Cancer Research Group, Mashhad University of adenocarcinoma; 11.11% with hyperplasic polyp; Medical Sciences, Mashhad, Iran 4.76% with high grade adenocarcinoma and 7.95% Student Research Committee, School of Medicine, with other pathological colorectal lesions. Mashhad University of Medical Sciences, Mashhad No significant relation was found between the type Introduction: Colorectal cancer(CC) is the fourth of diet and risk of colon cancer as well as incidence most common cancer in the world. The incidence of of polyp. Also, No significant relation was observed colorectal cancer is being increased in Iran and It between the intake of calcium, folic acid, ASA, alcohol seems that changing of life style is the main reason of consumption, smoking, BMI, and pathological this event. Statics show that in iran CC is the fourth colorectal lesion. cause of cancer and third cause of death among other Conclusion: Our findings support that, the incidence types of cancers. This study was designed to of polyp was 29.7% among our target group and determine a new data of anatomical distribution and prevalence of colorectal lesions was higher in men demographic data of CC in North East of Iran. than women. It was found that the intake of calcium, Method: records of patients diagnosed with primary folic acid and ASA has not protective role in colorectal cancer from 2006-2012 in mashhad Qaem asymptomatic people.Further studies should be done hospital were reviewed for demographic data and in this area. anatomical location of tumor. results were analyzed Send Date : 2012/09/04 by SPSS version18. Results: Participants (n=397) were 230 men (57,9%) and 167 woman (42,1%) with a mean age of Code: 2422 59,42±17,463 and 56,97±15,751 years, respectively. Category: 1- CLINICAL PRACTICE 18 patients(4,5%) had caecum involvement, 40 1.1 Epidemiology patients (10,1%) with sigmoid and 2 patients(0,5%) W-F-007 descending colon involvement, 1 of them(0,3%) Anatomical distribution and suffered from transverse colon and 1 case(0,3%) demographic data of colorectal ascending colon and 8 patients(2%) appendix cancer from 2006-2012 in North East of Iran cancer.326 cases(82,1%) were unspecified and 1 m Farzaneh far1, Kamran Ghaffarzadehgan2, patient(0,3%) had overlapping lesions of colon. Hamid Reza sima3, anahita Masoum4*, Conclusion: colorectal cancer involves descending ezzat hajmollarezai5, sara Khashkhashi colon and sigmoid colon the most which is the same 4 4 4 moghaddam , marzieh Maleki , mona asadi , as other studies.data shows that Men in their 50s are 4 5 Tahoora abdolahi , shima shamsaiee the main victims of this disease. 1 Gastric Cancer Research Group, Mashhad University of Therefore, screening of colorectal cancer in middle Medical Sciences, Mashhad, Iran Department of Internal Medicine,Qaem Hospital, School age is an efficient strategy to early diagnosis of this of Medicine, Mashhad University of Medical Sciences, lethal disease. Mashhad, IRAN Send Date : 2012/09/05 2 Gastric Cancer Research Group, Mashhad University of Medical Sciences, Mashhad, Iran

10 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

Code: 2423 body of literature that suggests bloating as a very Category: 1- CLINICAL PRACTICE common symptom in general population. This may 1.1 Epidemiology lead to serious impacts on health behavior of the W-F-008 community in general. Despite the prevalence of this Prevalence and the demographic risk factors of disorder, little knowledge is known about its bloating and functional bloating in Isfahan, Iran pathophysiology and treatment. Thus, further Ammar Hassanzadeh Keshteli2, Parnaz research on underlying mechanisms and effective Daneshpajouhnejad1*, Hamed Daghaghzadeh2, treatments is suggested. Awat Feizi2, Peyman Adibi1 Send Date : 2012/09/05 1 Isfahan Medical Students’ Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 2 Integrative Functional Gastroenterology Research Code: 2424 Center, Isfahan University of Medical Sciences, Isfahan, Category: 1- CLINICAL PRACTICE Iran 1.1 Epidemiology Introduction: Bloating is an unpleasant but W-F-009 extremely common gastrointestinal symptom, which The study on the epidemiology of psychological, is experienced by a large number of people at some alimentary health and nutrition (SEPAHAN): stage in their lives and imposes great costs on the Overview of methodology community. Due to the lack of data on the prevalence 1 Peyman Adibi1*, Ammar Hassanzadeh Keshteli , of bloating, the current survey among healthy Ahmad Esmaillzadeh2, Hamid Afshar3, Hamidreza volunteers was conducted to determine the bloating Roohafza3, Reza Bagherian-Sararoudi4, Hamed and functional bloating prevalence. Daghaghzadeh1, Nouroddin Soltanian1, Christine Method: This study is a part of the Study on the Feinle-Bisset5, Philip Boyce6, Nicholas J Talley7 Epidemiology of Psychological, Alimentary Health 1 Integrative Functional Gastroenterology Research and Nutrition (SEPAHAN), conducted in April-May Center, Isfahan University of Medical Sciences 2010 on an adult population in Isfahan, Iran. 2 Food Security Research Center And Department of Self-administrated questionnaires including questions Community Nutrition, School of Nutrition and Food on demographic factors, symptom of bloating and Science, Isfahan University of Medical Sciences 3 functional bloating criteria according to Rome III Psychosomatic Research Center, Isfahan University of Medical Sciences questionnaire were distributed. 4 Results: Behavioral Sciences Research Center, Isfahan University A total of 4763 participants (44.2% male and of Medical Sciences 55.8% female) with a mean age of 36.58±8.093 5 Discipline of Medicine, University of Adelaide, Adelaide, completed the questionnaires. Nearly half of subjects Australia (2390) experienced bloating, while 940 (19.7%) 6 Discipline of Psychiatry, University of Sydney suffered from functional bloating. The prevalence of 7Division of Gastroenterology and Hepatology, Mayo bloating was 44.2% (931) among men and 54.9% Clinic, Rochester, MN, United States (1459) among women, which was significantly Introduction: Functional gastrointestinal disorders different (P-value<0.0001, OR=1.537 [95% (FGIDs) are common worldwide and cause confidence interval: 1.370 to 1.724]), but the considerable social and economicburden. The aims difference between prevalence of functional bloating of SEPAHAN project were to 1) assess the in men and women was not statistically significant. prevalence of different FGIDs within an Iranian The relationship between marital status and population. prevalence of bloating is only considered as partially Method: It was a cross-sectional study among staff significant (51.0% in married, versus 47.2% in of Isfahan University of Medical Sciences and Health single subjects, P-value=0.07). Education level and Sciences, Isfahan age did not have a significant role in the prevalence Results: In the first and second phases of the study, of bloating or functional bloating. 8691 and 6239 adults were recruited, respectively. Conclusion: The present study adds to a growing The complete information of 4763 subjects has been

Govaresh\ Vol.17\ Supplement\ Autumn 2012 11 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 provided after linking the questionnaires from both increase in were the most common GI disease that phases. can be on result of prevalence of H.pylori Conclusion: SEPAHAN project is a novel study Send Date: 2012/09/06 that providesthe opportunity of investigating epidemiological aspects of FGIDs and their relationship with different lifestyle and psychological factors. Code: 2492 Send Date : 2012/09/05 Category: 1- CLINICAL PRACTICE 1.1 Epidemiology W-F-011 Code: 2426 Prevalence of hepatitis C virus infection in Category: 1- CLINICAL PRACTICE Amol,Apopulation based study 1.1 Epidemiology Masoudreza Sohrabi1*, Farhad Zamani1, W-F-010 Hossein Ajdarkosh1, Hossein Kayvani1, Most common diseases in Mahmood reza Khansari1, Kholamreza Hemassi1, 2 1 patients referring to GI clinics in Yazd Mansooreh Maadi , Khadijeh Hatami , 1 Mohsen Akhondi-Meybodi1*, saebha ghasemi2, Maziar Moradi Lake 1 Mahmood Vakili1, hassan salmanroughani1, Gastrointestinal and Liver disease research center asghar khoshnood1, mohamad hosain antikchi1, (GILDRC), Firoozgar Hospital, Tehran 2 mohamadkazem amirbaigi1, Mahmood baghbanian1 Gastrointestinal and Liver disease research center 1 (GILDRC), Haraz Centre, Tehran Shahid Sadoughi hospital, Shahid Sadoughi University Introduction: of Medical Sciences-Yazd, Iran The prevalence of hepatitis C infection 2 Islamic Azad Univercity Branch Yazd Medical school of in Iran is considered to be between 0.13% - 0.16% Ali ebn abi taleb, Islamic Azad Univercity Branch Yazd but this rate is not homogenous in all parts of this Medical school of Ali ebn abi taleb country. The aim of this survey was to determine the Introduction: Gastrointestinal and liver diseases are prevalence of HCV infection in general population of the most common causes of morbidity and one of north of Iran . common causes of death in Iran. Method: We randomly recruited 6145 individuals Method: This is a cross-sectional descriptive study from urban and rural areas of the city of Amol in both conducted on 400 patients who referred to GI clinics gender and different ages. Anti hepatitis C antibody in Yazd in 1389. was tested by a third generation ELIZA .The positive Results: According to this study the most common results were confirmed by a recombinant immunoblot diseases in GI clinics were respectively as follows: assay (RIBA) and quantitative HCV-RNA– Gastroesophageal Reflux (22.5%), irritated bowel Polymerase chain reaction (PCR). syndrome (17.8%), non ulcer dyspepsia (14.3%) and Risk factors were recorded and bivariant and multi- other diseases (13.8%) and ulcerative colitis (14.5%). variate analysis was done. oküØ GýíBoÿ ðBï OÏlAk ko¾l oküØ GýíBoÿ ðBï OÏlAk ko¾l Results: From all participants, 51.7% (3507) were 1 ìpÿ Gú ìÏlû oü×çÞw GýíBoÿ 09 5/22 51 ÞHlÿ uýpôq 4 1 male, with mean age of 42.70±17.10 .ELISA 2 Knüp Odpüà oôkû uñloï 17 8/71 61 IG gnideelb 3 0/8 3 noN reclu aispepsyd 75 41/3 71 ¾×pAôÿ ìXBoÿ uñä 3 8/0 anti-HCV antibody positive was found in 12 4 ÒýpâõAoyþ øBÿ GýíBoÿ uBüp 55 8/31 81 KBðßpAx ÞBðvp 2 5/0 individuals in which 5 subjects were RIBA positive 5 AôèvpAOýõ ÞõèýQ 81 5/4 91 Aôèýú ¾×pAôÿ uýpôq 2 5/0 and 3 subjects ,all of them were male were PCR 6 citpeP reclu esaesid 61 4 02 uBüßõuõìBOýà GýíBoÿ øBÿ 1 3/0 7 âBuPpüQ 31 3/3 12 KBðßpAOýQ 1 3/0 positive. The prevalent of HCV was predominant 8 @ðBë Öýzp 31 3/3 22 @KBðlüvýQ 1 3/0 among male than female. In multivariate analysis the 9 @ðPpüQ âBuPpô 21 3 32 oôkû cBk AðvlAk 1 3/0 01 B øLBOýQ 11 2/8 42 Þpôó GýíBoÿ 1 3/0 unsterile punctuation and history of infection in 11 øíõoôDýl 8 2 52 ìpÿ ÞBðvp 1 3/0 family member were associated with HCV infection. 21 uývPýQ Þõèú 5 3/1 62 ìÏlû ÞBðvp 1 3/0 Conclusion: 31 Þõèõó Þñvp 5 3/1 72 C øLBOýQ 1 3 We revealed that the rate of HCV true 41 uýéýBá AuLpôÿ 4 1 82 WíÐ 004 001 infection in this region is lower than previous reports Conclusion: The study results revealed that acid of Iran . It probably due to lower prevalence of pepsin diseases and irritated bowel syndrome high –risk behaviors in this part of Iran . However we

12 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 have to consider the different routs of transmission nationwide vaccination against hepatitis B during the of infection. last two decades and also patient education. But the Send Date: 2012/09/30 rate of HBcAb positive was 10.5% which revealed the exposure of hepatitis B infection. The rate of hepatitis B was higher among male and in urban than Code: 2493 female and rural area. Category: 1- CLINICAL PRACTICE Send Date: 2012/09/30 1.1 Epidemiology W-F-012 Epidemiology of viral hepatitis B in North of Code: 2500 Iran ; A population based study in Amol city Category: 1- CLINICAL PRACTICE Masoudreza Sohrabi1*, Farhad Zamani1, 1.1 Epidemiology Mahmood reza Khansari1, Maziar Moradi lakeh1, W-F-013 Hossein Kayvani1, Hossein Ajdarkosh1, Mansooreh Gú Þññlû ìpAWÏú gõó ÞññlâBó AølA ko ìTHQ bAVCH yýõÑ ÖpAôAðþ Gpouþ Moaadi1, Khadijeh Hatami1, Mitra Ameli1 8731-8831 uBèùBÿ ko @GBk gpï yùpuPBó gõó AðPÛBë uBqìBó 1 Gastrointestinal and Liver disease research center , 1 ÞBôüBðþ ìtâBó kÞPp , &1 ÎHlAèùýBó ìXýl kÞPp (GILDRC), Firoozgar Hospital, Tehran 2 ðõoÿ âê ÖBDrû kÞPp , 1 ÚñBkÿ Þõoô} kÞPp Introduction: Viral hepatitis is a major health âpôû kAgéþ âõAo} ô ÞHl, kAðzãBû Îéõï Kryßþ èpuPBó Kryßþ Îéõï kAðzãBû ÞHl, ô âõAo} kAgéþ âpôû 1 problem in different countries. The change of 2 2 transmission pattern of hepatitis B make a necessary èpuPBó Kryßþ kAðzßlû Îíõìþ, Kry¼ to reevaluating the prevalence and risk factors of this , AuQ gõó AðPÛBë Aq Kw øLBOýQ Gpôq A¾éþ Îéê Aq C øLBOýQ ølÙ: ô qìýñú infection. Gú ìýPõðl Þú AuQ ÞHlÿ ìrìò GýíBoüùBÿ ÎõAìê ìùíPpüò Aq üßþ øí`ñýò Method: We conducted a Cluster-random sampling OÏýýò ìñËõo Gú ìÇBèÏú Aüò . yõk ìñXp ÞHl upÆBó ô KýzpÖPú ÞHlÿ uýpôq population based cohort study in Amol and its gõó AðPÛBë uBqìBó Gú Þññlû ìpAWÏú gõó ÞññlâBó AølA ìýBó ko bAVCH yýõÑ surrounded areas .In this projects we recruited 6145 . AuQ ylû AðXBï 7831-8831 uBèùBÿ ko @GBk gpï subjects from urban and rural areas. The health Gú Þññlû ìpAWÏú gõó Þññlû AølA ð×p 76162 ìÇBèÏú ìõok WBìÏú Gpouþ: oô} centers were assigned for case selection and GpAÿ ASILE @qìõó Gõk. 8831 7831ô uBèùBÿ ko @GBk gpï gõó AðPÛBë uBqìBó randomization was done base on Health Center AuP×Bkû yl . . yl AuP×Bkû Aq ìTHQ ìõAok OBüýl GpAÿ ô Aôèýú OzhýÀ population. A questionnaire including demographic TOLBNRETSEW and anthropometrics data were completed. A blood ko yýõÑ Aüò ô @ìl GluQ AÖpAk ko¾l 1/0 ko BAVCH Þéþ yýõÑ øB: üBÖPú sample ten milliliter (10 ml) was taken from each uýßê Od¿ýçR uÇe GB AÖpAk ìýBó ko uBë 94-04 ô uBë -03 93 uñþ âpôøùBÿ study subject that checked for hepatitis B markers. , OBøê ôÂÏýQ ìýBó ôAÂdþ AoOHBÉ ôèþ Gõk GýzPp @qAk ìzBÒê ìýBó ko ô ÞíPp ô Results: Of 6145 participants, 51.7% (3507) were . ðýBìl GluQ bAVCH yýõÑ GB ußõðQ ôìdê , WñvýQ male and 42.9% were female with mean age of ânyPú køú Gú ðvHQ ìTHQ bAVCH yýõÑ ìÇBèÏú Aüò AuBx Gp âýpÿ: ðPýXú 42.70±17.10 .About half of them from urban and Þzõo ìhPéØ ÿ AuPBðùB ko @ó yýõÑ Gú ðvHQ ô AuQ kAyPú ÞBø{ @GBk gpï ko rural areas (3138 vs. 3507).The prevalence of KpgÇp âpôøùBÿ ko Kýzãýpÿ ASp ko Þú AuQ ÞíPp ðýr ìñÇÛú øBÿ Þzõo Gpgþ ô HBsAg, HBsAb, HBcAb was 63 (1%), 1711(27.9%), and 644 (10.5%) respectively. Among different risk . AuQ ðËp Aüò Aq AølAüþ gõðùBÿ ÒpGBèãpÿ ðýr ô factors the male sex (P=0.002) and aging (P=0.04) Send Date : 2012/09/30 have correlation with HBsAg by bivariant analysis and in multivariate analysis the history of prison has a predictive effect on positivity of HBsAg(OR=2.49). Code: 2501 However the history of IV drug abuse, traditional Category: 1- CLINICAL PRACTICE phlebotomy, and history of hepatitis have correlation 1.1 Epidemiology with HBcAB by OR of 2.58,1.32 and 132 respectively. W-F-014 Conclusion: Our result revealed a lower HBsAg rate Association between meat and fish in Amol compared with other geographic areas in consumption and cooking method and Iran. This observation directly correlated with esophageal squamous cell carcinoma

Govaresh\ Vol.17\ Supplement\ Autumn 2012 13 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

Asieh Golzar1*, Arash Etemadi1, Akbar Fazeltabar Code: 2504 Malekshah1, Farin Kamangar2, Phil Taylor3, Category: 1- CLINICAL PRACTICE Paolo Boffetta4, Christian Abnet3, 1.1 Epidemiology 5 1 Sandy Dawsey , Reza Malekzadeh W-F-015 1 Digestive Disease Research Institute, Tehran University Reproductive factors and risk of esophageal of Medical Sciences squamous cell carcinoma in northern 2 Department of Public Health Analysis, Morgan State University Iran- A case-control study in 3 Division of Cancer Epidemiology and Genetics, National a high risk area and literature review Cancer Institute Farhad Islami1*, Farin Kamangar2, 4 Institute for Translational Epidemiology, Mount Sinai Dariush Nasrollahzadeh3, Haji-Amin Marjani1, School of Medicine Ramin Shakeri1, Saman Fahimi4, Masoud Sotoudeh1, 5 Division of Cancer Epidemiology and Genetics, National Sanford Dawsey5, Christian C. Abnet6, Cancer Institute Paolo Boffetta7, Reza Malekzadeh1 Introduction: High temperature cooking such as 1 Digestive Disease Research Center, Tehran University of frying has been shown to be associated with increased Medical Sciences 2 risk of cancer in different organs, most likely due to Department of Epidemiology, Harvard School of Public Health the formation of carcinogenic particles such as 3 Department of Medical Epidemiology and Biostatistics, heterocyclic amines. Karolinska Institute Method: Using data from the Golestan case-control 4 Department of Public Health and Primary Care, study, conducted between 2003 and 2007 in a University of Cambridge high-risk region for esophageal squamous cell 5 Division of Cancer Epidemiology and Genetics, National carcinoma (ESCC), we sought to investigate the Cancer Institute association between meat consumption and 6 Division of Cancer Epidemiology and Genetics, National preparation and ESCC. Information on food Cancer Institute 7 preparation methods and dietary habits were gathered The Tisch Cancer Institute and Institute for Transitional from 300 cases and 571 controls individually Epidemiology, Mount Sinai School of Medicine Introduction: Several epidemiologic studies have matched for age and sex using a structured suggested an inverse association between female questionnaire and a semi-quantitative food frequency reproductive factors and risk of esophageal squamous questionnaire, respectively. Multivariate conditional cell carcinoma (ESCC), but the evidence is not logistic regression was used to estimate odds ratios conclusive. We investigated the association of the (OR) adjusted for other known risk factors. number of pregnancies, live-births, and miscarriages/ Results: More than 95% of the participants reported stillbirths in women and of the number of children in using meat, most of which was red meat. Being in both sexes with ESCC risk in Golestan Province, a higher quartiles of red meat intake was associated high-risk area in Iran. with higher OR for ESCC (P value for trend<0.001). Method: Data from 297 histopathologically While consuming fish decreased the odds of ESCC confirmed ESCC cases (149 women) and 568 by 3.4 (95% confidence interval (CI) 1.9-5.7), controls (290 women) individually matched to cases chicken conuse had a no significant association with for age, sex, and neighborhood of residence were ESCC. Among meat users, OR’s for frying meat (red included in this analysis. Conditional logistic or white) and fish were 2.5 (1.1-4.8) and 2.4 (1.3-4.5), regression was used to calculate odds ratios (ORs) respectively. and corresponding 95% confidence intervals (CIs). Conclusion: Our results suggest a role for frying Results: The average number of live-births and meat or fish in ESCC carcinogeneity. Moreover it miscarriages/stillbirths among controls was 8.2 and shows that while red meat intake is probably 0.8, respectively. Women with 6 or more live-births associated with an increased risk of ESCC, fish were at approximately one-third the risk of ESCC as intake may reduce this risk. Send Date : 2012/09/30 those with 0–3 live-births; the OR (95% CI) for having 6–7 live-births was 0.33 (0.12-0.92). In

14 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 contrast, the number of miscarriages/stillbirths was 10 International Agency for Research on Cancer, Lyon, associated with an increase in ESCC risk. The OR France (95% CI) for ≥ 3, versus no, miscarriages/stillbirths 11 Departments of Oncology and Public Health and Primary was 4.43 (2.11-9.33). Care, University of Cambridge, Cambridge, United Conclusion: In contrast to men, the number of Kingdom 12 Golestan Research Center of Gastroenterology and children in women was suggestive an inverse Hepatology , Golestan University of Medical association with ESCC, although this association was Sciences, Gorgan, Iran not statistically significant. Findings of this study Introduction: Only a limited number of studies have support the influence of female hormonal factors on investigated the correlation between hematocrit ESCC risk. However, further epidemiological and (HCT) and mortality in the general population, and mechanistic studies in order to provide conclusive few of those studies have had data on the full range of evidence of a causal association are warranted. low and high HCT levels. Send Date: 2012/09/30 Method: 49,983 adult participants in the Golestan Cohort Study, Iran, with a large spectrum of HCT values, among whom 2262 deaths were reported Code: 2506 during a mean follow-up of 5 years. Category: 1- CLINICAL PRACTICE Results: There was a U-shaped relationship between 1.1 Epidemiology categories of HCT and mortality in both sexes: both W-F-016 low and high levels of HCT were associated with Hematocrit and mortality, a U-shaped increased overall mortality and mortality from relationship – the Golestan Cohort Study cardiovascular disease and cancer. The U-shaped Paolo Boffetta1, Farhad Islami1, Rajesh Vedanthan2, relationship persisted in sensitivity analyses, such as: Akram Pourshams3*, Farin Kamangar4, Hooman Khademi5, Arash Etemadi6, Rasool Salahi7, restricting the analyses to non-smokers; excluding Shahryar Semnani8, Ashkan Emadi9, deaths due to accidents and other external causes as Christian C. Abnet8, Paul Brennan10, Paul D Pharoah11, well as deaths in those with self-reported ischemic Sanford M. Dawsey12, Reza Malekzadeh7 heart disease at the baseline interview; and excluding 1 Institute for Transitional Epidemiology and the Tisch the first two years of follow-up. Cancer Institute, Mount Sinai School of Medicine, New Conclusion: Low and high HCT levels are associated York, United States with increased mortality in the general population. 2 The Zena and Michael A. Wiener Cardiovascular Institute, Results of this study can be of particular importance Mount Sinai School of Medicine, New York, United States for other low- and middle-income countries, where a 3 Digestive Disease Research Center, Shariati Hospital, substantial proportion of the population lives with Tehran University of Medical Sciences, Tehran, Iran 4 Department of Public Health Analysis, School of suboptimal HCT levels. Community Health and Policy, Morgan State University, Send Date: 2012/09/30 Baltimore, United States 5 International Agency for Research on Cancer, Lyon, France Code: 2507 6 Division of Cancer Epidemiology and Genetics, National Category: 1- CLINICAL PRACTICE Cancer Institute, National Institutes of Health Bethesda, 1.1 Epidemiology United States W-F-017 7 Digestive Disease Research Center, Shariati Hospital, Cooking Methods and Tehran University of Medical Sciences, Tehran, Iran Esophageal Cancer in Iran 8 Golestan Research Center of Gastroenterology and Roya Hakami1* , Arash Etemadi1, Farin Kamangar2, Hepatology, Golestan University of Medical Sciences, Farhad Islami1, Akram Pourshams1, Dariush Gorgan, Iran Nasrollahzadeh1, Javad Mohtadinia3, Mehdi 9 Division of Hematology, Department of Internal Saber Firoozi4, Nicholas Birkett 5, Medicine, School of Medicine, Johns Hopkins Paolo Boffetta6, Reza Malekzadeh1 University, Baltimore, United States

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1 Digestive Disease Research Center, Tehran University of gastric adenocarcinoma .Case control study Medical Sciences Ramin Shakeri1, Reza Malekzadeh2, Arash Etemadi2, 2Department of Public Health Analysis, Morgan State Dariush Nasrollahzadeh2, Karim Aghcheli2, University Masoud Sotoudeh2, Farhad Islami3, 3 School of health and Nutrition, Tabriz University of Medical Akram Pourshams2*, Michel Pawilta4, Sciences Paolo Boffetta5, Sanford M. Dawsey6, 4 Gastroenterohepatology research center, Shiraz University Christian C. Abnet7, Farin Kamangar8 of Medical Sciences 1Digestive Disease Research Center, Medical Sciences/ 5 Department of Epidemiology and Community Medicine, University of Tehran, Tehran, Iran University of Ottawa 2 Digestive Disease Research Center, Shariati Hospital, 6 International Prevention Research Institute, Lyon, France Tehran University of Medical Sciences, Tehran, Iran Introduction: Cooking method in some studies has 3 Institute for Translational Epidemiology and Tisch been implicated in the etiology of upper Cancer Institute, Mount Sinai School of Medicine, New gastrointestinal cancers. York, NY, USA Method: We used a validated Food Frequency 4 Genome Modifications and Carcinogenesis Division, Infection Questionnaire and a pre-tested cooking method and Cancer Program, German Cancer Research Center, questionnaire in three groups: forty ESCC Heidelberg, Germany (Deutsches Krebsforschungszentrum, DKFZ) (Esophageal Squamous Cell Carcinoma) cases, forty 5 Institute for Translational Epidemiology and Tisch healthy subjects from this same area, and forty Cancer Institute, Mount Sinai School of Medicine, New healthy subjects from a low-risk area in Southern York, NY, USA Iran. We compared the frequency of using boiling, 6 Division of Cancer Epidemiology and Genetics, National grilling, frying and frying degree of fried foods in Cancer Institute, Bethesda, MD,USA three degree of surface browning in the high-risk area 7 Division of Cancer Epidemiology and Genetics, National of ESCC and then compared with those in a low-risk Cancer Institute, Bethesda, MD,USA area in Iran. We also calculated “frying index” by 8Department of Public Health Analysis, School of multiplying the frequency of each fried food item by Community Health and Policy, Morgan State University, its frying degree. Baltimore, MD. Introduction: Opium use has been associated with Results: There was no difference in the frequency of higher risk of malignancies in esophagus, bladder, fried meat consumption between the high-risk and the and larynx. No previous study examined the low-risk ESCC or cases and their clinical controls, association between opium use and gastric cancer. however based on surface browning, frying chicken There is very little information on the association at higher frying degree was more common in the high between use of hookah (water pipe) or nass (a chewing risk than in the low risk controls (P<0.05) and in tobacco product) and gastric adenocarcinoma risk. We ESCC patients than in their clinical controls studied the association between use of opium and (P<0.001). “Frying index” showed a significant several tobacco products (cigarette, hookah, and nass) difference among groups, it was higher in the with risk of gastric adenocarcinoma. high-risk than in the low-risk controls (P<0.01) and in Method: In a case-control study in Golestan Province of cases than in their clinical controls (P<0.05). Iran, we enrolled 309 cases of gastric adenocarcinoma (118 Conclusion: Cooking methods may have a role in noncardia, 161 cardia, and 30 mixed adenocarcinoma) and ESCC in Iran. Send Date : 2012/09/30 613 matched controls. Detailed information on long-term use of opium, tobacco, and other covariates were collected using structured and validated lifestyle and Code: 2509 food frequency questionnaires. Odds ratios (OR) and Category: 1- CLINICAL PRACTICE 95% confidence intervals (95% CI) were obtained 1.1 Epidemiology using conditional logistic regression models. Results: W-F-018 Opium use was associated with an increased Opium; an emerging risk factor for risk of all gastric adenocarcinoma, with adjusted OR (95% CI) of 3.1 (1.9 – 5.1), and an increased risk of

16 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 both major anatomic subsites (i.e., cardia and levels and there were less patients in higher educated noncardia adenocarcinoma). All adjustments and groups (P value <0.001). There was not any relationship sensitivity analyses substantiated these findings. We between frequency of dyspepsia and age or marital status. did not find a statistically significant association Conclusion: This study reveals that dyspepsia is between use of any of the tobacco products and risk prevalent in Isfahan province and is associated with of all gastric adenocarcinoma or anatomic subtypes. some demographic factors such as gender and Conclusion: The results of this study add to the education level. However, as it has a heterogeneous current literature that opium use can cause of a ariety of pathophysiology and not all the aspects of disorder cancers. Given that an estimated 13 to 22 million people are apparent, performing more studies seems to be use opium or its derivatives worldwide, these results are necessary. of public health significance. Send Date : 2012/10/01 Send Date : 2012/09/30

Code: 2567 Code: 2566 Category: 1- CLINICAL PRACTICE Category: 1- CLINICAL PRACTICE 1.1 Epidemiology 1.1 Epidemiology W-F-020 W-F-019 Epidemiology of Irritable Prevalence and the demographic Bowel Syndrome in Isfahan, Iran risk factors of dyspepsia and Ammar Hassanzadeh Keshteli1, Pegah Jahangiri2*, functional dyspepsia in Isfahan, Iran Hamed Daghaghzadeh1, Peyman Adibi1 Ammar Hassanzadeh Keshteli1, Ehssan Amini2*, 1 Integrative Functional Gastroenterology Research Center, Hamed Daghaghzadeh1, Awat Feizi1, Peyman Adibi1 Isfahan University of Medical Sciences, Isfahan, Iran 1 Integrative Functional Gastroenterology Research Center, 2 Isfahan Medical Students’ Research Center, Isfahan Isfahan University of Medical Sciences, Isfahan, Iran University of Medical Sciences, Isfahan, Iran 2 Isfahan Medical Students’ Research Center, Isfahan Introduction: Irritable bowel syndrome (IBS) is a University of Medical Sciences, Isfahan, Iran common health problem that may affect a substantial Introduction: Functional dyspepsia is a heterogeneous proportion of general population. IBS etiology is the disorder including two subgroups of epigastric pain subject of much debate. In the present study, we syndrome and postprandial distress syndrome. evaluated IBS prevalence by different demographic Herein, we will study the prevalence of dyspepsia in factors in Isfahan province. a large sample of Iranians in Isfahan province. Method: This cross sectional study is a part of the Method: This study has been carried out as a part of Study on the Epidemiology of Psychological, the Study on the Epidemiology of Psychological, Alimentary Health and Nutrition (SEPAHAN), Alimentary Health and Nutrition (SEPAHAN). We conducted in 2010 in Isfahan province. Using self- conducted a cross-sectional study using self-administered administrated questionnaires, the diagnosis of IBS questionnaires based on Rome III criteria in 2010. and its subtypes were made using Rom III criteria. Results: Overall, 4763 participants (mean age: Results: Of 4763 participants (mean age of 36.58±8.093; 44.2% male, 55.8% female) took part in 36.58±8.093) 44.2% were male and 55.8% were this study. Seven hundred and twenty three subjects female. The overall prevalence of IBS based on (15.2%) fulfilled the criteria for dyspepsia and 549 Rome III criteria was 21.5% with a male-to-female (11.53%) met the Rome III criteria for postprandial ratio of 1:1.65 (P‹0.05). Three hundred and forty distress syndrome. The prevalence of dyspepsia eight (34%) IBS individuals had IBS-C, whereas seemed to be higher among women; 17.2% versus 27%, 20% and 19% had IBS-U, IBS-D and IBS-M, 12.6% in male and the difference was statistically respectively. The prevalence of IBS was highest significant (P value < 0.001, OR = 1.43, 95% CI: (51.3%) in the ages between 35 to 50, followed by 1.274-1.846). The prevalence of dyspepsia varied 44.4% in 19-34. The prevalence of IBS was among the participants with different education significantly higher in females compared with males.

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Conclusion: According to the results, IBS is Code: 2571 prevalent among adults in Isfahan province and Category: 1- CLINICAL PRACTICE affects females more than males. Considering that it 1.1 Epidemiology has significant impacts on work, lifestyle and social W-F-022 well-being, IBS imposes a substantial economic Dyspepsia in Iran: burden in medical and social costs in the studied A SEPAHAN systematic review population. Ehssan Amini1*, Ammar Hassanzadeh Send Date: 2012/10/01 Keshteli2, Peyman Adibi2 1 Isfahan medical students' research center, Isfahan university of medical sciences Code: 2569 2 Integrative Functional Gastroenterology Research Category: 1- CLINICAL PRACTICE Center, Isfahan university of medical sciences Introduction: 1.1 Epidemiology Dyspepsia is an upper gastrointestinal W-F-021 tract syndrome presenting with epigastric pain, Constipation in Iran: fullness sensation, burning, early satiety, nausea and A SEPAHAN Systematic Review vomiting. Studies have shown its prevalence to be Niloufar Iraji1, Marsa Hashemi Jazi1*, high all over the world. Method: Ammar Hassanzadeh Keshteli2, In this study four electronic databases Parnaz Daneshpajouhnejad1, Peyman Adibi2 including Pubmed, Google scholar, IranMedex and 1 Isfahan medical students' research center, Isfahan Scientific Information Database were searched using university of medical sciences the keywords “dyspepsia” and “Iran”. At last two 2 Integrative Functional Gastroenterology Research Center, independent reviewers reviewed the selected articles Isfahan university of medical sciences and purified them based on our criteria. Introduction: Constipation is a common gastrointestinal Results: Among four databases searched, nine symptom with a high prevalence all over the world and articles approved our criteria. The prevalence of it has unpleasant effects on individuals’ quality of life. dyspepsia in these studies ranged from 2.2% to This study is a systematic review of previous 29.9%. Dyspepsia has been seen to be more epidemiologic studies on constipation in Iran. prevalent in women in most of these studies. Method: Bibliographic databases including PubMed, Conclusion: This study demonstrated that dyspepsia Google Scholar, Scientific Information Databases, is prevalent in Iran. But as the prevalence has been Iran Medex and Magiran were searched to select reported in a wide range it seems necessary to studies reporting the prevalence of constipation in conducting more studies on its epidemiology and risk Iran. factors influencing its prevalence. Results: Overall, 10 articles met the inclusion Send Date: 2012/10/01 criteria of the current study. The prevalence of constipation and functional constipation in Iran varied from 1.4 to 37% and 2.4 to 11.2%, Code: 2453 respectively. Gender, age, socioeconomic status and Category: 1- CLINICAL PRACTICE educational level seem to have major effects on these 1.2 Management strategies conditions. W-F-023 Conclusion: The prevalence of constipation is higher Predictive factors of in-hospital than expected Iran is. The available data on the mortality in patients with UGI natural history, quality of life and risk factors of bleeding treated in intensive care unit constipation in Iran is scarce. More population-based Majid Azadegan1* studies are needed to explore different epidemiological 1 Loghman hakim.hospital, Shahid Beheshti.SBMU aspects of constipation in Iran. Introduction: Backgrounds: This prospective, cohort Send Date: 2012/10/01 study assessed the independent predictors of in-hospital mortality in patients with acute upper

18 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 gastrointestinal haemorrhage admitted to the medical Method: We presented a 14-year-old male that intensive care unit (MICU) at the University Medical refered with massive ascites and progressive Centre. abdominal pain. After recognition of eosinophilia in Method: Using univariate, multivariate and logistic blood and ascite fluid, suspicion was go on Eosinophilic regression methods the predictors of mortality in 54 gastroenteritis, and after serial examinations was upper gastrointestinal haemorrhage patients (47 men, performed. Ultimately Eosinophilic gastroenteritis was mean ± SD age 61.6 ± 14.2 years) were investigated. closely diagnosed after laparascopic full thickness The mean ± SD duration of treatment in the MICU biopsy. The patient was treated with prednisolone. was 2.8 ± 2.9 days and the mortality rate was 31.5%. The massive ascites and abdominal pain subsided Results: Significant differences between nonsurvivors soon after initiation of steroid treatment. and survivors were observed in haemorrhagic shock, Results: Eosinophilic gastroenteritis may involve heart failure, infection, diastolic blood pressure at more than one layer of the gastrointestinal tract. admission, haemoglobin and red blood cell count at Clinical features depend on the layer and location to admission, and lowest haemoglobin and red blood be involved. Involvement of the serosal layer occurs cell count during treatment. in 10% of cases of eosinophilic gastroenteritis and Conclusion: Heart failure (odds ratio 59.13) was the typically presents as ascites. The patient was treated most significant independent predictor of in-hospital with prednisolone. mortality. Haemorrhagic shock and the lowest red Conclusion: Eosinophilic gastroenteritis may involve blood cell count during treatment were also more than one layer of the gastrointestinal tract.The important independent predictive factors of in- massive ascites and abdominal pain subsided soon hospital mortality. after initiation of steroid treatment. Send Date: 2012/09/24 Send Date: 2012/09/28

Code: 2478 Code: 2508 Category: 1- CLINICAL PRACTICE Category: 1- CLINICAL PRACTICE 1.2 Management strategies 1.3 Evidence-based clinical practice W-F-024 W-F-025 Eosinophilic Gastroenteritis presented Randomized Placebo-Controlled Trial of With massive Ascitis, A Case Report Mesenchymal Stem Cell Transplantation Mohammad Reza Ghadir1*, Amir Hosein Ghanooni1, in Decompensated Cirrhosis Seyed Saeed Sarkeshikian1, Abolfazl Iranikhah1 Mehdi Mohamadnejad1*, Leila Abdollahzadeh1, 1 Gastroenterology and hepatology Section, Qom University Shahram Akhlaghpoor 2, Maryam Bashtar3, of Medical Sciences, Qom, Iran Ardeshir Ghavamzadeh 4, Reza Malekzadeh1 Introduction: Eosinophilic gastroenteritis is a 1 Digestive Disease Research Center, Tehran University of heterogeneous disorder affecting both children and Medical Sciences adults and is characterized by the presence of an 2 Noor Medical Imaging Center, Tehran, Iran intense eosinophilic infiltrate on histopathology of 3Hematology, Oncology, Bone Marrow Transplantation one or multiple segments from the esophagus to the Research Center, Tehran University of Medical Sciences 4 rectum. Eosinophilic gastroenteritis may involve Hematology, Oncology, Bone Marrow Transplantation Research Center, Tehran University of Medical Sciences more than one layer of the gastrointestinal tract. Introduction: There has been great interest in recent Clinical features depend on the layer and location to years to take advantage of bone marrow stem cells to be involved. Involvement of the serosal layer occurs treat cirrhosis. Our uncontrolled trial showed in 10% of cases of eosinophilic gastroenteritis and promising results for bone marrow mesenchymal typically presents as ascites. This patient is as likely stem cell (MSC) transplantation in cirrhosis. as those patients who refer with full thickness Therefore, we conducted a randomized, placebo- involvement and presenting ascite and it has controlled trial to evaluate the efficacy of autologous completely improved after steroid treatment.

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MSC transplantation in cirrhosis. used as a remedy for some gastrointestinal disorders Method: The enrolled patients with decompensated such as bloat. cirrhosis were randomly assigned to receive MSC or Method: 57 patients who fulfilled ROME II criteria placebo infusions. A median of 245 million (range: with no other accompanied illnesses enrolled.Patients 190 to 295 million) cultured MSCs were infused were asked to complete an IBS-associated symptoms through a peripheral vein. The primary outcomes questionnaire to specify their symptoms at the 1st, were absolute changes in MELD score, Child score, 2nd and 4th week after oral administration of liver function tests, and liver volumes between the cuminum extract. MSC and placebo group 12 months after infusion. Results: according to the study, the intensity of Results: A total of 27 patients were enrolled. Of abdominal pain, bloating and mucus discharge were these, 15 patients received MSC and 12 patients significantly reduced and Symptoms relief continued received placebo. One patient in the MSC group and on follow-up visits.Improvement of stool frequency one patient in the placebo group were lost to follow and consistency were observed in both patients with up. Three patients in the MSC group died of liver constipation-predominant and diarrhea IBS. failure 3 months (1 patient), or 5 months (2 patients) Conclusion: Considering the low cost and after cellular infusion. The baseline MELD scores of widespread accessibility, cumin administration seems the deceased patients were significantly higher than to be economical. However, conducting more those who remained alive in either group (20.0 vs. placebo-controlled studies with a larger sample size 15.1; P: 0.02). Final analyses were performed in the is recommended. remaining 22 patients (11 in the MSC and 11 in the Send Date: 2012/09/30 placebo group) who completed 12 months of follow up. The absolute changes in Child scores, MELD scores, serum albumin, INR, serum transaminases, and Code: 2515 liver volumes did not differ significantly between the Category: 1- CLINICAL PRACTICE MSC and placebo groups at 12 months of follow up. 1.3 Evidence-based clinical practice Conclusion: This randomized, placebo-controlled W-F-027 trial showed no benefit of autologous bone marrow Chamomile Efficacy in Patients MSC transplantation through peripheral vein in with Irritable Bowel Syndrome cirrhotic patients. Shahram Agah1, Narges Gorji1, Amir Mehdi taleb2, Send Date: 2012/09/30 Reyhaneh Asadi1* , Mehrdokht Najafi1 1 Colorectal Research Center, Rasool Akram Hospital, Tehran University of Medical Sciences Code : 2514 2 school of pharmacy, Tehran University of Medical Sciences Introduction: Irritable bowel syndrome (IBS) is a Category : 1- CLINICAL PRACTICE common GI functional disorder, which presents with 1.3 Evidence-based clinical practice a wide range of symptoms such as chronic abdominal W-F-026 The effect of cumin on the symptoms discomfort, bloating and altered bowel habits. The of Irritable Bowel Syndrome patients variety of symptoms has led to a difficult therapeutic Shahram Agah2, Amir Mehdi taleb1, challenge and no specific treatment for relieving all Reyhaneh Moini2, Narges Gorji2, Reyhaneh Asadi2* IBS symptoms has been suggested yet. The purpose 1 school of pharmacy, Tehran University of Medical Sciences of this study was to evaluate the impact of 2 Colorectal Research Center, Rasool Akram Hospital, Chamomile extract on IBS symptoms. Tehran University of Medical Sciences Method: In a randomized clinical trial, 45 patients Introduction: IBS is one of the most common who fulfilled the ROOM II criteria and had no gastrointestinal isorders.Unfortunately, no specific organic disease enrolled in this study and were asked treatment for relieving all IBS symptoms has been to take Chamomile 20 drops daily for four weeks. suggested yet.The purpose was to assay the impact They were asked to fill in IBS-associated symptoms of cumin on all IBS symptoms, a herb known to be questionnaire to specify abdominal pain intensity,

20 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 bloating, nausea, stool consistency and altered bowel “Ramadan” and “Islamic fasting”, and the equivalent habits. The questionnaire was filled out during 5 terms in Farsi. Articles on the relation between GI visits: at the first day, at the second and fourth weeks symptoms and disorders and Ramadan, published in after starting the treatment and also the second and English or Farsi were selected. This study provided fourth weeks after the end of intervention. background knowledge for “The Study on the Results: IBS symptoms were significantly reduced at Epidemiology of Psychological, Alimentary Health the second and fourth weeks after beginning of the and Nutrition” (SEPAHAN). herbal therapy (p<0.000). Symptom relief continued Results: We found 2312 related articles, of which 23 up to 2 weeks after the end of intervention and started fulfilled our inclusion criteria. Ramadan fasting to decrease in 4 weeks time. appears to increase complications of peptic ulcer and However, comparing to the first visit, the symptoms have a deteriorating effect on patients on drug therapy were still improved significantly (p<0.000). for chronic peptic ulcer disease, but not on duodenal Conclusion: Chamomile has proven to have ulcer patients under treatment. Although healthy inhibitory effect on gastrointestinal spasm and to individuals may experience minor GI symptoms, no prohibit ulcer development. This herb is well known serious complications have been reported. Studies as a tranquilizer and bloat reliever, too. Considering reported conflicting results regarding the incidence the improving effects of Chamomile on all IBS of acute appendicitis in Ramadan, but acute symptoms, it may have a positive effect on the mesenteric ischemia, hyperemesis gravidarum and syndrome pathogenesis as well. Furthermore, in view small bowel volvulus seem to increase during of its low cost, availability and safety, Chamomile Ramadan. Ramadan fasting does not appear to extract can be recommended as a choice treatment for increase idiopathic intussusception or impose serious IBS symptoms. risks on patients with inflammatory bowel diseases. Send Date: 2012/09/30 Conclusion: Fasting in Ramadan is generally safe for healthy individuals, but might be hazardous to patients with various GI diseases and may increase Code: 2463 the risk of complications in this group. Category: 1- CLINICAL PRACTICE Send Date: 2012/09/26 1.4 Outcome studies W-F-028 A review of Ramadan fasting and Code: 2522 gastrointestinal disorders: Category: 1- CLINICAL PRACTICE A SEPAHAN team systematic review 1.4 Outcome studies Shirin Sadeghpour1*, Ammar W-F-029 Hassanzadeh Keshteli2, Peyman Adibi2 Self-perceived changes in upper 1 Isfahan medical students' research center, Isfahan gastrointestinal symptoms in Ramadan: university of medical sciences A SEPAHAN cross-sectional study 2 Integrative Functional Gastroenterology Research Center, Shirin Sadeghpour1*, Ammar Hassanzadeh Isfahan university of medical sciences 2 3 2 Introduction: Keshteli , Awat Feizi , Peyman Adibi Ramadan is the 9th month in Hijri 1 Isfahan Medical Students' Research Center, Isfahan calendar, during which healthy adult Muslims University of Medical Sciences observe the Islamic fast. They avoid eating and 2 Integrative Functional Gastroenterology Research Center, drinking from sunrise to sunset. Our study aimed to Isfahan University of Medical Sciences investigate effects of Ramadan fasting on 3 Department of Biostatistics, School of Health, Isfahan gastrointestinal (GI) symptoms and disorders by University of Medical Sciences means of reviewing the available findings. Introduction: During Ramadan, the 9th month in Method: In March 2012, we searched PubMed, Google Islamic Hijri calendar, adult Muslims fast from Scholar, Iran Medex and Scientific Information Database sunrise to sunset and abstain from food and drinks. to find related articles. Our keywords included In our study self-perceived changes in upper

Govaresh\ Vol.17\ Supplement\ Autumn 2012 21 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 gastrointestinal (GI) symptoms in Ramadan was constipation, diarrhea and bloating) in Ramadan. investigated in a sample of adult population in Isfahan, Iran. Method: As a part of "The Study on the Epidemiology Method: This study was a part of SEPAHAN of Psychological, Alimentary Health and Nutrition" project; a cross-sectional self-administered (SEPAHAN), in a cross sectional self-administered questionnaire based study, carried out in September questionnaire setting, 840 adults (58.7 % female) in 2010. A community-based sample of adults Isfahan, Iran, filled out the questionnaires about a participated in our study and filled out the week after Ramadan, in September 2010. questionnaires about a week after Ramadan. Results: Sixty-eight percent of the studied sample Results: The studied sample consisted of 839 had not experienced constipation, while 15.7% individuals (58.8 % female). A total of 57.4% of the reported that they had suffered more, and 16.3% had population had not experienced symptoms of GER, suffered less from the symptom during Ramadan. As while 22.0% and 20.6% reported that they suffered for Bloating, 64.2% of individuals were less from GER symptoms and more during Ramadan, symptom-free, in 15.4% the symptoms had worsened respectively. As for dyspepsia, 56.5% of individuals while 20.4% had suffered less from the symptom. A were found to be symptom free, and respectively total of 63.3% had not experienced abdominal pain, 19.5% and 24.0% had suffered from the symptom 14.4% had experienced an exacerbation in the more during Ramadan and less. Nausea was less symptom while 22.3% reported that they had less prevalent in which 78.3% of the population was abdominal pain during Ramadan. Diarrhea was the symptom free, 13% had experienced an improvement least prevalent symptom in which 91.7% of the in their symptom, and 8.7% had got worse. sampled population was symptom-free; however Conclusion: The majority of the studied sample 2.3% reported that their diarrhea had worsened while hadn’t experienced upper GI symptoms. Among 6% had got better during Ramadan. upper gastrointestinal symptoms, nausea was the least Conclusion: The majority of the studied sample was common and had improved the most during symptom-free. Lower GI symptoms seem to improve Ramadan, which could be due to fasting. during Ramadan, which could be due to fasting. Send Date: 2012/09/30 Prospective studies are needed to determine how fasting in Ramadan could affect patients with GI symptoms. Code: 2523 Send Date: 2012/09/30 Category: 1- CLINICAL PRACTICE 1.4 Outcome studies W-F-030 Code: 2524 Self perceived changes in lower Category: 1- CLINICAL PRACTICE gastrointestinal symptoms during Ramadan: 1.4 Outcome studies A SEPAHAN cross-sectional study W-F-031 Shirin Sadeghpour1* , Ammar Hassanzadeh The Sahur meal and upper gastrointestinal Keshteli2, Awat Feizi3, Peyman Adibi2 symptoms in Ramadan: A SEPAHAN study 1 Isfahan Medical Students' Research Center, Isfahan Shirin Sadeghpour1* , Ammar Hassanzadeh University of Medical Sciences Keshteli2, Awat Feizi3, Peyman Adibi2 2 Integrative Functional Gastroenterology Research Center, 1 Isfahan Medical Students' Research Center, Isfahan Isfahan University of Medical Sciences University of Medical Sciences 3 Department of Biostatistics and Epidemiology, School of 2 Integrative Functional Gastroenterology Research Center, Health, Isfahan University of Medical Sciences Isfahan University of Medical Sciences Introduction: During Ramadan, the 9th month in the 3 Department of Biostatistics and Epidemiology, Isfahan Hijri calendar, adult Muslims are obliged to fast and University of Medical Sciences they don’t eat or drink from sunrise to sunset. This Introduction: During Ramadan, Muslims refrain study investigates self-perceived changes in lower from eating and drinking during the day and consume gastrointestinal (GI) symptoms (abdominal pain, only two large meals: one before the sunrise (Sahur),

22 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 and the other right after the sunset. This study, aimed ÎñõAó Gú GBoR ìpÿ ^ñýò ìýßñlôøî KýlA âýpÿ ^zî AÖrAü{ uýßéõAÞvýtðBq-2 at investigating the association between upper ÞñPpë @ül.ènA ìþ cvBJ Gú ìpÿ @kðõÞBouýñõï AüXBk ìùî ÖBÞPõo oüvà üà gastrointestinal (GI) symptoms and consumption of AgýpA uýßéõAÞvýtðBq-2 AgP¿B¾þ øBÿ ìùBoÞññlû OõuÈ uéõèþ OßTýp ô AèPùBJ Sahur. ìpôoÿ ìÇBèÏú üà ¾õoR Gú cBÂp AuQ.ìÇBèÏú ylû ôAÚÐ Wlÿ OõWú ìõok Method: The present study was a population-based, uývPíBOýà ô ÖpAOdéýéþ WùQ Gpouþ ASpAR Þéýñýßþ ìùBo Þññlû øBÿ Þññlû ìùBo Þéýñýßþ ASpAR Gpouþ WùQ ÖpAOdéýéþ ô uývPíBOýà cross sectional study, carried out in September 2010, on an adult population in Isfahan, Iran, filling out AuQ. âpkülû ÆpAcþ uýßéõAÞvýtðBq-2 AgP¿B¾þ questionnaires about a week after Ramadan. It was a ìÛBèú 32 clôk Kryßþ ìhPéØ ìñBGÐ ko GBWvPXõ ìÇBèÏú koAüò Gpouþ: oô} part of SEPAHAN: “Study on the Epidemiology of ¾õoR Gú Þú ylðl ìPB@ðBèýr ôAok ìÇBèÏBOþ OñùB @ìl. GluQ ìõÂõÑ GB ìpOHÈ Psychological, Alimentary Health and Nutrition”. Gõkðl. ðËp ìõok Þéýñýßþ GBypAüÈ GBoR ìpÿ Gú ìHPç GýíBoAó ko GBèýñþ ÞBo@qìBüþ Results: The majority of the 863 individuals (58% Oõèýl ô Gpôq ô uéõèþ OßTýp ðËp Aq kAoôüþ koìBó Aq GÏl ô ÚHê GýíBoAó female) participating in the study, i.e. 74.5% had had AÖrAo ðpï Aq GBAuP×Bkû ðPBüY âpÖPñl. ÚpAo ìÇBèÏú OdQ uýßéõAÞvýtðBq-2 Sahur almost every day. The association between having âpÖQ. ÚpAo @ìBoÿ Odéýê ô ôOXrüú Gpouþ ìõok 2-AMC Sahur and upper GI symptoms (gastroesophageal reflux, GpAuBx ðPBüY cB¾ê Aq ìÇBèÏBR ìzhÀ âpkül Þú yBgÀ OßTýp yBgÀ Þú âpkül ìzhÀ ìÇBèÏBR Aq cB¾ê ðPBüY GpAuBx øB: üBÖPú dyspepsia, and nausea) was not significant. The association between nausea and the time interval Kw âýpÿ ^zî Æõo Gú uýßéõAÞvýtðBq-2 Gpôq ôèþ ðlAyPú ^ñlAðþ OÓýýp uéõèþ between Sahur and going back to bed was significant ) 500/0

Govaresh\ Vol.17\ Supplement\ Autumn 2012 23 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

Method: In this case-control setting, 61 FD patients A¾×ùBó Kryßþ Îéõï kAðzãBû âõAo}, WBìÐ OdÛýÛBR ìpÞr 4 were studied and compared to 30 healthy adults in ðËýp âõAoyþ AgPçæR GB ìÓnÿ ìõAk ô ÒnAøB Gýò AoOHBÉ øp^ñl ølÙ: ô qìýñú Tabriz Imam Reza Hospital during a 22-month @ðBèýr Aq cB¾ê Aÿ OÓnüú oÖPBoøBÿ @üB Aüñßú AìB AuQ, ylû Gpouþ clôkÿ OB uõøBÂíú period. The two groups were helicobacter pylori (HP) ðývQ. ylû yñBgPú øñõq ðú üB GByl ìþ ìpOHÈ GýíBoÿ Aüò GB ðýr KñùBó Þçx negative and matched for age and sex. The ô KñùBó Þçx @ðBèýr oô} GB Aÿ OÓnüú oÖPBoøBÿ yñBuBüþ ølÙ GB cBÂp ìÇBèÏú GñBGpAüò CD4+/CD8+ T-cells were isolated from gastric ) ko ko ) ( Îíéßpkÿ uõøBÂíú GB @ðùB AoOHBÉ OÏýýò mucosa biopsy samples, and then quantified by DF = lanoitcnuF aispepsyD microscopy while the membrane phenotypes were yl. AðXBï A¾×ùBðþ GroâvBæó determined by immunohistochemistry. Frequency A¾×ùBðþ ìýBðvBë AÖpAk Aq ð×p 3674 oôÿ Gp cBÂp ìÛÇÏþ ìÇBèÏú Gpouþ: oô} and percentage of these cells, as well as the Aÿ OÓnüú oÖPBoøBÿ yl. AðXBï Gõkðl ylû AðPhBJ @uBó âýpÿ ðíõðú oô} GB Þú CD4+/CD8+ ratio were compared between the two øípA ìBüÏBR ì¿pÙ gõokó, ÒnA upÎQ ÒnAüþ, øBÿ ôÎlû Aèãõÿ AuBx Gp AÖpAk groups. AoqüBGþ KpuzñBìú Aq AuP×Bkû GB gõAGýló ô gõokó ÒnA Gýò qìBðþ ÖB¾éú ô ÒnA GB Results: Sixty one FD patients, 26 males and 35 yñBuBüþ AÖpAk Aÿ OÓnüú oÖPBoøBÿ KñùBó Þçx @ðBèýr oô} Aq AuP×Bkû GB yl. females with a mean age of 46.35±12.36 (26-63) WùQ AoqüBGþ AgPçæR Îíéßpkÿ âõAo} Îíéßpkÿ AgPçæR AoqüBGþ WùQ EMOR III KpuzñBìú Aq âpkül. years and 30 controls, 13 males and 17 females, with a mean age of 45.63±11.76 (26-63) years were WùQ âpkül. OÏpüØ ìÏýBoøB Aüò ÆHÜ Îíéßpkÿ uõøBÂíú ô yl AuP×Bkû recruited (p=0.949 and 0.794, respectively). No âpkül. AuP×Bkû Odéýéþ @ìBo Aq øB AoOHBÉ Gpouþ patient in the case group had CD4+ T-cell in gastric âpôû kô Gú ÒnAüþ øBÿ ôÎlû Aèãõÿ KñùBó, Þçx @ðBèýr Aq AuP×Bkû GB øB: üBÖPú mucosa specimens. This rate was significantly higher âpôû uú ko gõokó ÒnA upÎQ AuBx Gp AÖpAk ylðl. O×ßýà "ðBìñËî" ô "ìñËî" in the controls (16.7%, p=0.003). CD8+ T-cell was ìBüÏBR ì¿pÙ AuBx Gp ô Oñl" Gú "ìPõuÈ ô Þñl" Gú "ìPõuÈ ìPõuÈ", upÎQ "GB recognized in 3.3% of the cases vs. 20% in the Gýò qìBðþ ÖB¾éú qìýñú ko ylðl. OÛvýî ðõyBó" "ìPõuÈ ô ðõyBó" "Kp âpôû kô Gú controls (p=0.014). Gýò Þî "ÖB¾éú ô ÒnA" ô gõAJ Gýò qüBk "ÖB¾éú âpôû kô ðýr gõAGýló ô gõokó ÒnA The mean percentage of CD4+ T-cells was significantly Gú AGPç yBðw ìhlôyãp, ÎõAìê OÏlüê Aq Kw yl. yñBuBüþ ÒnA" ô gõAJ higher in the controls (4.73±16.95% vs. 0%; p=0.031). The similar rate for the CD8+ percentage Gú kAyPñl, "ðBìñËî" ÒnAüþ øBÿ ôÎlû Aèãõÿ Þú AÖpAkÿ ko Îíéßpkÿ uõøBÂíú was not significantly different between the two kAyPñl "ìñËî" ÒnAüþ øBÿ ôÎlû Aèãõÿ Þú AÖpAkÿ Gú ðvHQ kAoÿ ìÏñþ Æõo groups (2.30±13.09% in the case group vs. gõk ÒnAÿ Þú AÖpAkÿ øíýñÇõo . ) :RO ;24.1 %59 57.1-51.1:IC Gõk( GýzPp 8.40±24.48% in the case group; p=0.124). The mean upÎQ GB oA gõk ÒnAÿ Þú AÖpAkÿ Gú ðvHQ gõokðl ìþ Oñl" Gú "ìPõuÈ upÎQ GB oA CD4+/CD8+ ratio was zero in both groups. . Gõkðl GpgõokAo DF Gú AGPç WùQ GýzPpÿ yBðw Aq gõokðl ìþ "ìPõuÈ" Conclusion: Based on current findings, the CD4+/ øípAû Gú ìBüÏBR ì¿pÙ Gýò kAoÿ ìÏñþ AoOHBÉ ) :RO ;94.1 %59 30.2-90.1:IC ( CD8+ T-cells in gastric mucosa may have a ðzl. ìzBølû Îíéßpkÿ uõøBÂíú GB gõAGýló ô gõokó ÒnA Gýò qìBðþ ÖB¾éú ô ÒnA protective role against FD in HP- individuals. Send Date: 2012/10/01 Aÿ OÓnüú oÖPBoøBÿ Gýò ìvPÛýî AoOHBÉ Aq cBÞþ cBÂp ìÇBèÏú øBÿ üBÖPú âýpÿ: ðPýXú ðBkouQ GB uõøBÂíú Îíéßpkÿ ìþ GByl. ènA GB Kýzãýpÿ ô O¿dýe Aüò ÎBkAR ÒnAüþ ÎBkAR Aüò O¿dýe ô Kýzãýpÿ GB ènA GByl. ìþ Îíéßpkÿ uõøBÂíú GB ðBkouQ ðBkouQ ìþ OõAó âBï ìõSpÿ ko ÞBø{ ÎçDî uõøBÂíú GpkAyQ. uõøBÂíú ÎçDî ÞBø{ ko ìõSpÿ âBï OõAó ìþ ðBkouQ Code: 2445 Send Date: 2012/09/21 Category: 2- ESOPHAGEAL-GASTRIC AND DUODENAL DISORDERS 2.2 Dyspepsia Code: 2457 W-F-034 Category: 2- ESOPHAGEAL-GASTRIC AND AoOHBÉ Gýò oÖPBoøBÿ OÓnüú Aÿ yñBuBüþ ylû GB oô} GB ylû yñBuBüþ Aÿ OÓnüú oÖPBoøBÿ Gýò AoOHBÉ DUODENAL DISORDERS @ðBèýr Þçx KñùBó GB uõøBÂíú Îíéßpkÿ ko AÖpAk ìýBðvBë A¾×ùBðþ ìýBðvBë AÖpAk ko Îíéßpkÿ uõøBÂíú GB KñùBó Þçx @ðBèýr 2.2 Dyspepsia , , 3 qAkû cvò ÎíBo , 2 ÖýÃþ @ôAR , 1 qoüHBÙ ÖBÆíú W-F-035 4& 4& AküHþ ,KýíBó 1 qAkû AuíBÎýê Acíl The accuracy of alarm features to predicting of ìpÞr OdÛýÛBR AìñýQ ÒnAüþ, kAðzãBû Îéõï Kryßþ A¾×ùBó Kryßþ Îéõï kAðzãBû ÒnAüþ, AìñýQ OdÛýÛBR ìpÞr 1 upper GI malignancy in patients with dyspepsia 1* âpôû @ìBo ô AKýlìýõèõsÿ,kAðzãBû Îéõï Kryßþ A¾×ùBó Kryßþ Îéõï AKýlìýõèõsÿ,kAðzãBû ô @ìBo âpôû 2 shahriar nikpour 1 loghman hakim hospital, shahid beheshti university ìpÞr OdÛýÛBR ^BÞú âõAo}, kAðzãBû Îéõï Kryßþ A¾×ùBó Kryßþ Îéõï kAðzãBû âõAo}, ^BÞú OdÛýÛBR ìpÞr 3

24 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

Introduction: There is insufficient evidence to define not been thoroughly validated in our country. The the optimal approach to dyspepsia in Iran. objective of this study was to determine the yield of This study was aimed to determine the diagnostic endoscopy in patients in whom empiric therapy is accuracy of alarm features in predicting upper GI unsuccessful and compare them with the initial malignancy in dyspeptic patients, in Loghman Hakim endoscopy strategy. hospital, Tehran. Method: Patients undergoing upper gastrointestinal Method: All patients with dyspepsia referring to the endoscopy at Loghman Hakim hospital (non-referral gastroenterology clinic of Loghman Hakim Hospital, center) were enrolled in this study. They were divided from September 2007 to February 2009 were into three groups: failed empiric therapy with PPI prospectively enrolled. The alarm features included (A), failed empiric therapy with H2B (B), and family history of upper gastrointestinal malignancy, patients without any empiric therapy (C). Endoscopic unexplained weight loss, upper gastrointestinal findings were compared in these groups. bleeding, dysphagia, unexplained iron deficiency Results: A total of 450 cases (150 in each group) anemia, persistent vomiting, jaundice, intractable pain were studied (41.1% male, mean age 35years). The in upper abdomen and lymphadenopathy or mass. only case of upper gastrointestinal malignancy was Results: A total of 1700 patients (43.6% male, mean gastric cancer in a patient in the initial endoscopy age 43.7±17 years) were studied. Esophageal cancer group (0.67%). Peptic ulcers (group A: 6.7%, B: was found in two patients (0.1%) and gastric cancer 10.7% and C: 8.0%) and other upper gastrointestinal in 17 patients (1.0%), all of whom were older than 50 lesions were similar in the three groups. years. The highest positive predictive value was Conclusion: This study showed that the empiric found in dysphagia (3.4%) for esophageal cancer and treatment approach to dyspepsia based on age and alarm Iron deficiency anemia (5.9%) for gastric cancer. symptoms appears to be safe. However, there still is a Conclusion: None of the alarm features showed a need for endoscopy in refractory cases, before high positive predictive value and their use for considering the diagnosis of functional dyspepsia. selection of patients for endoscopy seems to be of Send Date: 2012/09/25 limited value. Selection of the age over 50 years appears to be appropriate for endoscopic evaluation of dyspeptic patients. Code: 2527 Send Date: 2012/09/25 Category: 2- ESOPHAGEAL-GASTRIC AND DUODENAL DISORDERS 2.2 Dyspepsia Code: 2459 W-F-037 Category: 2- ESOPHAGEAL-GASTRIC AND Peptic ulcer disease is the most common DUODENAL DISORDERS cause of gastric outlet obstruction 2.2 Dyspepsia (GOO) in the Iranian population W-F-036 shahriar nikpour1* Low yield of upper endoscopy 1 internal medicine loghman hospital, shahid beheshti in patients with persistent dyspepsia medical university Introduction: Taking Proton Pump Inhibitor according to medical literature Benign shahriar nikpour1* stenosis due to recurrent peptic ulcer was a common 1 internal medicine loghman hospital, shahid beheshti university cause of gastric outlet (GOO) in the past but is rather Introduction: Most clinical guidelines suggest rare now. It is therefore important to rule out a empiric treatment for young patients with dyspepsia neoplastic process, which is a more common cause without alarm features and reserve upper of GOO than peptic ulcer disease gastrointestinal endoscopy for refractory cases. Method: The charts of 185 patients with GOO However, upper GI malignancies are common in admitted to loghman hakim hospital between some parts of Iran and the safety of this approach has khordad 1382 and shahrivar 1391 were reviewed to

Govaresh\ Vol.17\ Supplement\ Autumn 2012 25 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 determine etiology and management,(mean age 46.8 gastroesophageal junction in distal esophagus and years, 56.0%female) The diagnosis of GOO was sent for histology. based on clinical presentation,upper endoscopy Results: In this study 145 male and 155 female with and/or barium meal. mean age of 46.5±17.2 were evaluated. Barrett's Results: eighty-two percent (152 patients) had PUD esophagus was diagnosed by histology in 37 patients as the cause of their gastric outlet obstruction. (12.3%). History of smoking was more frequent in Eighteen percent (33 patients) had malignant disease. patients with Barrett’s esophagus (21.6% vs. 4.9%, The patients with cancer were older, and fewer had a p=0.002). There was no significant relationship history of peptic ulcer disease, although these factors between age, sex and duration of gastroesophageal were not statistically significant.10 patients had reflux and presence of Barrett's esophagus. malignancy that had not been suspected before Conclusion: The frequency of Barrett's esophagus operation despite numerous endoscopic and was higher in our GERD patients than previously radiological studies. reported. The importance of this lesion needs to be Conclusion: In our study the incidence of PUD in investigated. patients with GOO is greater than 80%. The etiology Send Date: 2012/09/25 of GOO cannot be predicted by age and history of PUD . The endoscopic treatment of GOO should be approached with caution because malignancy Code: 2446 cancannot be reliably excluded by endoscopic studies Category: 2- ESOPHAGEAL-GASTRIC AND Send Date: 2012/09/30 DUODENAL DISORDERS 2.4 Reflux disease - pathogenesis W-F-039 OÏýýò AoOHBÉ Gýò oÖPBoøBÿ OÓnüú Aÿ yñBuBüþ ylû yñBuBüþ Aÿ OÓnüú oÖPBoøBÿ Gýò AoOHBÉ OÏýýò Code: 2460 ìpÿ Gú ìÏlû oÖçÞw GB KñùBó Þçx @ðBèýr oô} GB Category: 2- ESOPHAGEAL-GASTRIC AND NAHAPES ìÇBèÏú Aq cB¾ê øBÿ üBÖPú A¾×ùBðþ: ìýBðvBë AÖpAk ko DUODENAL DISORDERS , 3 qAkû cvò ÎíBo , 2 qoüHBÙ ÖBÆíú , 1 ÖýÃþ @ôAR 2.3 Barretts 3& AküHþ KýíBó , 2 qAkû AuíBÎýê Acíl W-F-038 A¾×ùBó Kryßþ Îéõï kAðzãBû AKýlìýõèõsÿ, ô @ìBo âpôû 1 Prevalence of Barrett's esophagus ìpÞr OdÛýÛBR AìñýQ ÒnAüþ, kAðzãBû Îéõï Kryßþ A¾×ùBó Kryßþ Îéõï kAðzãBû ÒnAüþ, AìñýQ OdÛýÛBR ìpÞr 2 and its related factors in patients ìpÞr OdÛýÛBR WBìÐ âõAo}, kAðzãBû Îéõï Kryßþ A¾×ùBó Kryßþ Îéõï kAðzãBû âõAo}, WBìÐ OdÛýÛBR ìpÞr 3 with Gastro Esophageal Reflux AÆçÎBR GvýBo AðlÞþ ko qìýñú Aüñßú @üB oÖPBoøBÿ OÓnüú Aÿ cB¾ê Aÿ OÓnüú oÖPBoøBÿ @üB Aüñßú qìýñú ko AðlÞþ GvýBo AÆçÎBR ølÙ: ô qìýñú shahriar nikpour1* 1 internal medicine loghman hospital, shahid beheshti øñõq ðú üB GByl ìþ ) DREG ( ìpOHÈ ìpÿ Gú ìÏlû oÖçÞw GB KñùBó Þçx @ðBèýr Aq university Aÿ OÓnüú oÖPBoøBÿ yñBuBüþ ølÙ GB cBÂp ìÇBèÏú GñBGpAüò ðývQ. ylû yñBgPú Introduction: There are few studies from Iran that A¾×ùBðþ GroâvBæó ko DREG GB @ðùB AoOHBÉ OÏýýò ô KñùBó Þçx @ðBèýr oô} GB have reported the prevalence of Barrett’s esophagus yl. AðXBï by endoscopy and histology. The aim of our study 3674 oôÿ Gp ô NAHAPES ìÇBèÏú ÚBèI cBÂpko ìÛÇÏþ ìÇBèÏú Gpouþ: oô} was to assess the frequency of Barrett's esophagus by ð×p Aq AÖpAk ìýBðvBë A¾×ùBðþ Þú GB oô} ðíõðú âýpÿ @uBó AðPhBJ ylû Gõkðl ylû AðPhBJ @uBó âýpÿ ðíõðú oô} GB Þú A¾×ùBðþ ìýBðvBë AÖpAk Aq ð×p endoscopy and histology studies in patients with gastro-esophageal reflux disease (GERD). upÎQ ÒnAüþ, øBÿ ôÎlû Aèãõÿ AuBx Gp AÖpAk Aÿ OÓnüú oÖPBoøBÿ yl. AðXBï Method: We conducted a cross-sectional study and gõAGýló ô gõokó ÒnA Gýò qìBðþ ÖB¾éú ô ÒnA GB øípA ìBüÏBR ì¿pÙ gõokó, ÒnA obtained data from 300 Patients with symptom of KñùBó Þçx @ðBèýr oô} Aq AuP×Bkû GB yl. AoqüBGþ KpuzñBìú Aq AuP×Bkû GB gastro esophageal reflux disease who underwent WùQ EMOR III KpuzñBìú Aq âpkül. yñBuBüþ AÖpAk Aÿ OÓnüú oÖPBoøBÿ upper GI endoscopy at Loghman Hakim hospital in ìÏýBoøB Aüò ÆHÜ DREG ô yl AuP×Bkû âõAo} Îíéßpkÿ AgPçæR AoqüBGþ Tehran in 2009. Age, sex, smoking history, duration âpkül. AuP×Bkû Odéýéþ @ìBo Aq øB AoOHBÉ Gpouþ WùQ âpkül. OÏpüØ of GERD and upper gastrointestinal endoscopic âpôû kô Gú ÒnAüþ øBÿ ôÎlû Aèãõÿ KñùBó, Þçx @ðBèýr Aq AuP×Bkû GB øB: üBÖPú findings were recorded. Four to six biopsies were "ìñËî" ô "ðBìñËî" O×ßýà ylðl. AÖpAk Gp AuBx upÎQ ÒnA gõokó ko uú âpôû uú ko gõokó ÒnA upÎQ AuBx Gp AÖpAk ylðl. O×ßýà "ðBìñËî" ô "ìñËî" taken from four quadrants above the

26 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

"GB upÎQ ìPõuÈ", "ìPõuÈ Gú Þñl" ô "ìPõuÈ Gú Oñl" ô Gp AuBx ì¿pÙ ìBüÏBR ì¿pÙ AuBx Gp ô Oñl" Gú "ìPõuÈ ô Þñl" Gú "ìPõuÈ ìPõuÈ", upÎQ "GB the prominent symptom in our series being reported Gú kô âpôû "Kp ðõyBó" ô "ìPõuÈ ðõyBó" OÛvýî ylðl. ko qìýñú ÖB¾éú qìBðþ Gýò qìBðþ ÖB¾éú qìýñú ko ylðl. OÛvýî ðõyBó" "ìPõuÈ ô ðõyBó" "Kp âpôû kô Gú by 75 (60%) patients followed by fever in 35 (28%). ÒnA gõokó ô gõAGýló ðýr kô âpôû "ÖB¾éú qüBk Gýò gõAJ ô ÒnA" ô "ÖB¾éú Þî Gýò Þî "ÖB¾éú ô ÒnA" ô gõAJ Gýò qüBk "ÖB¾éú âpôû kô ðýr gõAGýló ô gõokó ÒnA Erythema (33.6%), esophageal ulcer (11.2%), and gõAJ ô ÒnA" yñBuBüþ yl. Kw Aq OÏlüê ÎõAìê ìhlôyãp, yBðw AGPç Gú AGPç yBðw ìhlôyãp, ÎõAìê OÏlüê Aq Kw yl. yñBuBüþ ÒnA" ô gõAJ whitish patch (8.0%) were the most common ko AÖpAkÿ Þú Aèãõÿ ôÎlû øBÿ ÒnAüþ "ðBìñËî" kAyPñl, Gú Æõo ìÏñþ Æõo Gú kAyPñl, "ðBìñËî" ÒnAüþ øBÿ ôÎlû Aèãõÿ Þú AÖpAkÿ ko DREG endoscopic findings while reflux esophagitis (32.8%), chronic (6.4%) and acute esophagitis (5.6%), kAoÿ ðvHQ Gú AÖpAkÿ Þú Aèãõÿ ôÎlû øBÿ ÒnAüþ "ìñËî" kAyPñl GýzPp Gõk GýzPp kAyPñl "ìñËî" ÒnAüþ øBÿ ôÎlû Aèãõÿ Þú AÖpAkÿ Gú ðvHQ kAoÿ and candida esophagitis (5.6%) were the most common ) . øíýñÇõo AÖpAkÿ Þú ÒnAÿ gõk oA GB upÎQ GB oA gõk ÒnAÿ Þú AÖpAkÿ øíýñÇõo . ) :RO ;32.1 %59 :IC 64.1-30.1 ( histological diagnoses. Just 1 (0.8%) patient was "ìPõuÈ Gú Oñl" ìþ gõokðl ðvHQ Gú AÖpAkÿ Þú ÒnAÿ gõk oA GB upÎQ "ìPõuÈ" upÎQ GB oA gõk ÒnAÿ Þú AÖpAkÿ Gú ðvHQ gõokðl ìþ Oñl" Gú "ìPõuÈ diagnosed as having eosinophilic esophagitis, GpgõokAo Gõkðl . Gõkðl GpgõokAo DREG Gú AGPç WùQ GýzPpÿ yBðw Aq gõokðl ìþ aspergillosis, and graft versus host disease. ) ÖB¾éú qìBðþ qüBk Gýò ÒnA gõokó ô gõAGýló ô gõokó ÒnA Gýò qüBk qìBðþ ÖB¾éú ) :RO ;23.1 %59 :IC 37.1-10.1 ( Conclusion: Reflux is the most common cause of 59.0-75.0 :IC %59 :IC 59.0-75.0 .( kAyQ kAo ìÏñþ ìÏßõx AoOHBÉ DREG AGPç gÇp GB esophagitis in the pediatric population of southern )AoOHBÉ ìÏñþ kAoÿ Gýò ì¿pÙ ìBüÏBR øípAû ÒnA GB gÇp oÖçÞw gÇp GB ÒnA øípAû ìBüÏBR ì¿pÙ Gýò kAoÿ ìÏñþ )AoOHBÉ :RO ;37.0 Iran.Despite previous reports the prevalence of ìÏlû Gú ìpÿ ìzBølû ðzl. ìzBølû ìpÿ Gú ìÏlû eosinophilic esophagitis is far less than estimated while the prevalence of opportunistic infections is üBÖPú øBÿ ìÇBèÏú cBÂp cBÞþ Aq AoOHBÉ ìvPÛýî Gýò oÖPBoøBÿ Gýò ìvPÛýî AoOHBÉ Aq cBÞþ cBÂp ìÇBèÏú øBÿ üBÖPú âýpÿ: ðPýXú higher secondary to post liver transplantation. OÓnüú Aÿ ðBkouQ GB oÖçÞw ìÏlû Gú ìpÿ ìþ GByl. ènA GB Kýzãýpÿ ô O¿dýe ô Kýzãýpÿ GB ènA GByl. ìþ ìpÿ Gú ìÏlû oÖçÞw GB ðBkouQ Aÿ OÓnüú Send Date: 2012/10/01 Aüò oÖPBoøBÿ OÓnüú Aÿ ðBkouQ ìþ OõAó âBï ìõSpÿ ko ÞBø{ ÎçDî oÖçÞw ÎçDî ÞBø{ ko ìõSpÿ âBï OõAó ìþ ðBkouQ Aÿ OÓnüú oÖPBoøBÿ Aüò ìÏlû Gú ìpÿ GpkAyQ. ìpÿ Gú ìÏlû Code: 2383 Send Date: 2012/09/21 Category: 2- ESOPHAGEAL-GASTRIC AND DUODENAL DISORDERS Code: 2565 2.6 Reflux disease - treatment Category: 2- ESOPHAGEAL-GASTRIC AND W-F-041 DUODENAL DISORDERS Effect Of Antireflux-B® Syrup Versus 2.5 Reflux disease - diagnosis Omeprazole And Ranitidine In The Treatment W-F-040 Of Gastroesophageal Reflux Disease 1* 1 Clinical Characteristics of Pediatric Esophagitis Abbas Arj , Mohsen Razavizadeh , 1 1 in Southern Iran: A Single Center Experience Kamal Esalatmanesh , Mohammad Matini , Fakhraddin Sadr1, Hosein Akbari2 Khadijesadat Najib1*, Bita Geramizadeh 1 Internal medicine, Kashan Geramizadeh2, Ebrahim Fallahzadeh3, Mahmood 2 Department of Statistics, Kashan Haghighat4, Mohammad Hadi Imanieh4 Introduction: Gastroesophageal reflux disease 1 Pediatrics, Shiraz University of medical sciences 2 Pathology, Shiraz University of medical sciences (GERD) is one of the most common diseases in GI 3 GI Fellowship, Shiraz University of medical sciences tract as 15% of people in community have the same 4 Pediatric Gastroenterology, Shiraz University of medical symptoms at least once a week. The aim of this sciences survey was to investigate the effect of a herbal syrup Introduction: To determine the clinical characteristics (Antireflux-B®) containing extracts of Aloe vera in of pediatric esophagitis in southern Iran. treatment of GERD in comparison with omeprazole Method: Study was conducted from 2005 to 2009 in and ranitidine. Nemazee hospital of Shiraz.We consecutively included Method: In a randomized clinical trial,132 patients all the pediatric patients who had pathology-confirmed with GERD symptoms referred to gastroenterologist, diagnosis of esophagitis. Data regarding the patients' enrolled to three groups : antireflux-B ( 10 ml before demographic characteristic,comorbidities and clinical breakfast & diner), omeprazole( one capsule 20 mg findings were recorded using a questionnaire. before breakfast) or ranitidine( 150 mg ,twice daily). Results: We studied 125 children among whom there In first visit, 2 weeks and 4 weeks after treatment the were 61 (48.8%) girls and 64 (51.2%) boys with patients were visited upon clinical features. The data mean age of 6.6±5.5 years. Repeated vomiting was has been analyzed with Wilcoxon test, Mcnemar and

Govaresh\ Vol.17\ Supplement\ Autumn 2012 27 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 paired T test. association between GERD and PD. This suggests the Results: There was no significant difference between presence of pathogenic link between chronic inflam- 3 treatment groups upon cross matching factors (age, matory periodontal diseases and the presence of gender, educational status, …)(P >0.05). The effect pathological gastroesophageal reflux. of antireflux-B, omeprazole and ranitidine on Send Date : 2012/09/14 severity of reflux symptoms was 74%,82% and 79% respectively. There was no significant differences upon relieving main reflux symptoms (heart burn, Code: 2540 souring sensation,….) in three groups (P >0.1).The Category: 2- ESOPHAGEAL-GASTRIC AND frequency of adverse effects were nearly similar in DUODENAL DISORDERS all groups. 2.7 Reflux disease - complications Conclusion: According to similar effects of three W-F-043 drugs in relieving the symptoms of GERD, the The association of gastroesophageal reflux researchers were concluded that Antireflux-B syrup disease and tooth loss: SEPAHAN can prescribed in patient with gastroesophageal community-based study reflux disease. Malih Sadat Firouzei1* , Saber Khazaei1, 2 3 Send Date: 2012/09/02 Omid Savabi , Peyman Adibi 1Dental Students’ Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 2 Code: 2432 School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran Category: 2- ESOPHAGEAL-GASTRIC AND 3 Integrative Functional Gastroenterology Research Center, DUODENAL DISORDERS Isfahan University of Medical Sciences, Isfahan, Iran 2.7 Reflux disease - complications Introduction: To investigate the relation between W-F-042 gastroesophageal reflux disease (GERD), and tooth Periodontal disease in patients with loss and masticatory ability. gastro-oesophageal reflux disease Method: SEPAHAN project is a community-based Masoud shirmohammadi1, mohammad study among adults population. A validated hossein soumi1*, Adileh shirmohammadi2 questionnaire containing questions regarding the 1Gastroenterology and Hepatology research center, presence and severity of GERD, tooth loss and tabriz univercity of medical sciences masticatory ability was distributed through the 2 periodontics, tabriz univercity of medical sciences subjects. Data were analyzed by SPSS 16 statistical Introduction: Dental erosion has been considered an software. extraesophageal manifestation of gastro-esophageal Results: 1120 out of 4585 individual (23.5%), had reflux disease. GERD which 29.9% of them had all of their teeth. Method: Studies that assessed the prevalence of PD Prevalence of tooth loss in subjects with GERD was in individuals with GERD or vice versa were 61.8% with less than 6 lost teeth, 4.8% with 6-20 lost identified in Medline and the Cochrane Controlled teeth, 2.5% with more than 20 lost teeth, and 1.1% Trials Register via a systematic research strategy. edentulous subjects ( P=0.252). Results: Seven studies met the selection criteria. 68% of subjects reported that they have good Studies, however, differed greatly as far as design, masticatory ability without problem. 30% and 2% of population methods of diagnosing GERD, duration subjects had moderate and sever problems through of follow-up and, consequently, findings. the mastication respectively. There was significant The median prevalence of PD in GERD patients was difference between masticatory ability and the 32%, with a large range (8-51.5%), and the median presence of GERD (P<0.001). prevalence of GERD in PD adults patients was 34.3% Conclusion: GERD can cause tooth erosion, (range: 18-73%). halitosis and xerestomia which all have negative Conclusion: This review shows that there is an effect on oral health status. GERD plays an

28 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 important role in the maintenance of sufficient significant effects on the survival rate of patients. In chewing ability. multivariate analysis, Age group (P = 0/003), smoker Send Date: 2012/10/01 (P= 0/01) and tumor stage (P= 0/001) were significant predictors of survival. Conclusion: In summary, prognosis of esophageal Code: 2437 cancer in North West of Iran is poor, Therefore, Category: 2- ESOPHAGEAL-GASTRIC AND reduce the exposure to risk factors and early DUODENAL DISORDERS detection can improve survival in such patients. 2.8 Esophageal malignant disease Send Date: 2012/09/20 W-F-044 Survival Rate and prognostic factors of Esophageal cancer in East Code: 2502 Azerbaijan Province, North-West of Iran Category: 2- ESOPHAGEAL-GASTRIC AND Seyed Kazem Mirinezhad 1*, Mohammad Hossein DUODENAL DISORDERS Somi1, Amir Ghasemi Jangjoo 2, Farshad 2.9 Other esophageal disorders Seyednezhad 2, Mohammad Mohammadzadeh2, W-F-045 Ali Reza Naseri2, Saeed Dastgiri3, Behnam Nasiri2 Ethanolamine oleate as a novel therapy 1 Liver and Gastrointestinal Disease Research Center, is effective in resistant idiopathic achalasia Tabriz University of Medical Sciences Javad Mikaeli1*, Ramin Niknam1, Narges Mehrabi1, 2 Radiation Oncology Therapy of IMAM REZA (AS) Laleh Mahmoudi2, Narges Fazlollahi1, Hospital, Tabriz University of Medical Sciences Reza Malekzadeh1, Shapour Shirani3 3 School of Medicine and National public Health Management 1Digestive Disorder Research Institute, Tehran University Center, Tabriz University of Medical Sciences of Medical Scinces Introduction: Esophageal cancer in Iran as the sixth 2 Depatment of Pharmacotherapy, Shiraz University Of most common cancer and five most common cancers Medical Sciences is one in east Azerbaijan. The aim of this study was 3 Tehran Heart Center, Tehran University of Medical to calculate survival rates and define prognostic Scinces factors in esophageal cancer patients. Introduction: Idiopathic achalasia (IA) is a primary Method: In this study, all patients with esophageal motor disorder of the esophagus. cancer registered in the Radiation Therapy Center, Recently, Ethanolamine Oleate (EO) has been during March 2006 to March 2011 were analyzed. All introduced as a novel therapy in IA. AIM: to patients were followed up and vital status. Data were investigate long-term efficacy of EO injection in analyzed using the Kaplan–Meier method and the selected patients with IA. Cox proportional hazard models. Method: 220 patients with IA were evaluated Results: Out of 532 patients, survival information prospectively. 31 patients that were resistant to or was available for 460 patients, including 205(44/5 %) poor candidate of pneumatic balloon dilation and/or Female and 255(55/4 %) male. cardiomyotomy, enrolled in this study. The mean age was 65.8±12.2, ranging from 29 to 90 EO was injected into lower esophageal sphincter 3 years at the time of diagnosis. 1- , 3- and 5-year times with 2 weeks intervals. The patients were survival rates after diagnosis were 55%, 18% and evaluated with achalasia symptom score (ASS) and 12%, respectively. The Median survival time in timed barium esophagogram (TBE) before and after patients 13.2 ± .7 (CI 95% =11.8 -14.6) months. In injections. We defined good response as decrease in the univariate analysis, Age group(P=0/001), ASS, height and/or volume of barium in TBE ≥50% education(P=0/001), smoker (P= 0/001), surgery (P= of baseline at 1.5 months after last injection. Relapse 0/001),tumor differentiation (P= 0/003) and tumor was defined as increase in severity of dysphagia ≥2 stage (P= 0/001) were significant prognostic of score after initial good response. survival. Tumor morphology, sex, place of residence, Results: The mean age of patients was 49.32± 19.3 tumor histology and tumor location did not show any years. Twenty nine cases had good response and two

Govaresh\ Vol.17\ Supplement\ Autumn 2012 29 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 had no response. The mean ASS decreased from enrolled. Thirteen patients with normal TBE before 12.48 (±2.06) to 4.50 (±2.96) (P = 0.000) and the treatment were defined as a new group. A total mean volume of barium decreased from 115.35 concordance for complete, partial and non-responders (±93.40) to 45.50 (±60.86) mL at 1.5 months after the was 39% at first month and 42, 44, 35 and 47% at last injection (P = 0.012).The mean duration of 6,12,18,24 months after treatment, while percentages follow-up was 21.16± 11.3 (9 to 59) months. Eleven of non-concordant patients at 1, 6, 12, 18 and 24 patients who relapsed were treated effectively with months after PBD were 61, 58, 56, 65 and 53. re-injection. Minor complications (chest pain, Patients with complete clinical response revealed esophagitis) occurred in some patients. 38.6%, 27.3%, 34.1% complete, partial and Conclusion: This study indicates that EO is effective non-response by TBE at the end of follow-up in long-term follow up and its use can be considered (24months), while these percentages in patients with in selected IA patients. partial clinical response were 22.2, 41.7 and 36.1. Send Date: 2012/09/30 About one-third of clinically non-responder patients had complete barium height response. Conclusion: Patients with achalasia frequently show Code: 2503 different response to PBD according to subjective and Category: 2- ESOPHAGEAL-GASTRIC AND objective assessments, therefore considering both DUODENAL DISORDERS items is necessary for evaluating response rate to 2.9 Other esophageal disorders treatment. W-F-046 Send Date: 2012/09/30 Timed barium oesophagram and clinical symptoms concordance in achalasia patients treated by pneumatic balloon dilation: Code: 2541 long-term follow up Category: 2- ESOPHAGEAL-GASTRIC AND Javad Mikaeli1* , Seyd Saeid Mohammadi Bonehi1, DUODENAL DISORDERS Shapour Shirani2, Narges Fazlollahi1, Narges Mehrabi1 2.9 Other esophageal disorders 1 Digestive Disorder Research Institute, Tehran University W-F-047 of Medical Scinces The relationship between functional 2 Tehran Heart Center, Tehran University of Medical gastrointestinal disorder and halitosis: Scinces SEPAHAN community-based study Introduction: Many centers consider only clinical Parastoo Afghari1*, Malih Sadat Firouzei1, symptoms for evaluation of post-pneumatic balloon Omid Savabi2, Peyman Adibi3 dilation (PBD) response in achalasia. Some have 1 Dental Students’ Research Center, Isfahan University of suggested timed barium oesophagram (TBE) as an Medical Sciences, Isfahan, Iran objective assessment with 70% concordance to 2 School of Dentistry, Isfahan University of Medical clinical symptom score. To evaluate long-term Sciences, Isfahan, Iran subjective and objective response concordance in 3 Integrative Functional Gastroenterology Research Center, achalasia patients. Isfahan University of Medical Sciences, Isfahan, Iran Method: Achalasia patients who referred for the first Introduction: Halitosis is apparent unpleasant odor PBD were enrolled. Clinical symptom score and of the breath, which affects the individuals’ quality barium height at five minutes recorded before and 1, of life. The aim of this study was to investigate the 6, 12, 18 and 24 months after treatment. Patients were relation between functional gastrointestinal disorder divided into three groups; complete, partial and (FGIDs) and halitosis among Isfahan adults population. non-responder according to clinical response, then Method: SEPAHAN project is a community-based concordance was evaluated between clinical study among adults population. A self-assessed improvement and barium height reduction during questionnaire was completed by 4763 individuals. follow-up. Severity of bad breath was determined through Results: One hundred sixty eight patients were questionnaire. The epidemiology of FGIDs was

30 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 determined using Rome III criteria. Data were FGIDs was determined using Rome III criteria. analyzed by SPSS version 16. Results: The complete information of 4763 individuals Results: 51.9% of 4652 studied population has was provided which 15.2%, 21.5%, 33.5% and 19.7% experienced halitosis during last 3 month which had functional dyspepsia, irritable bowel syndrome, 59.9% of them reported low severity of halitosis. constipation and functional bloating respectively. There were significant difference between the There were significant difference between subjects presence of halitosis and gastroesophageal reflux who experienced xerestomia and all FGIDs disease (GERD), functional dyspepsia, IBS, (P<0.0001) except functional bloating (P=0.214). In- constipation (P<0.0001), and functional bloating dividuals with functional dyspepsia showed the most (P=0.046). Subjects who reported halitosis as a severity of xerestomia (9.9%). constant burden have been found most frequently in Conclusion: All types of FGID except bloating were constipation patients (3.9%). in association with xerostomia. Because of Conclusion: Constipation, functional bloating and xerostomis’s impact on quality of life it should be irritable bowel syndrome (IBS) were not previously taken into account in clinical practice through these assessed as associating factors to halitosis. FGIDs, patients. especially constipation is introduced as systemic Send Date: 2012/10/01 factors with pathological origin for halitosis. Send Date: 2012/10/01 Code: 2528 Category: 2- ESOPHAGEAL-GASTRIC AND Code: 2551 DUODENAL DISORDERS Category: 2- ESOPHAGEAL-GASTRIC AND 2.12 Acid peptic disease (includes NSAIDS - but DUODENAL DISORDERS NOT H.pylori)- diagnosis and treatment 2.9 Other esophageal disorders W-F-049 W-F-048 Non-Helicobacter pylori and non-NSAID Functional gastrointestinal disorder and peptic ulcer disease in the Iranian population xerestomia: SEPAHAN community-based study shahriar nikpour1* Ghazal Savabi1*, Saber Khazaei2, 1internal medicine loghman hospital, shahid beheshti Omid Savabi3, Peyman Adibi4 medical university 1Dental Students’ Research Center, Isfahan Azad Introduction: Although Helicobacter pylori(HP) and Islamic University non-steroidal anti-inflammatory drugs (NSAIDs) are 2 Dental Students’ Research Center, Isfahan University of recognized as the major causes of peptic ulcer Medical Sciences, Isfahan, Iran disease(PUD) ,the prevalence of (HP)and (NSAID) 3 School of Dentistry, Isfahan University of Medical negative PUD seems to be increasing in the world but Sciences, Isfahan, Iran the the prevalence isnot known in our population. 4 Integrative Functional Gastroenterology Research Center, Method: To examine the prevalence of H. pylori- Isfahan University of Medical Sciences, Isfahan, Iran Introduction: Xerestomia is defined as a subjective negative PUD without intake of NSAIDs A total of feeling of dry mouth and it can be related to the 452 patients, including 340 patients with Duodenal functional gastrointestinal disorders (FGIDs). The ulcer (DU) and 112 patients with gastric ulcer (GU), aim of this study was to determine association were enrolled.H. pylori status was assessed by rapid between the different types of FGIDs and xerestomia urease tests and histological examinations ,Two among Isfahan adults population. biopsy specimens were taken from the antrum and Method: SEPAHAN project is a community-based two from the body of the stomach, Patients were study through adults population. A self-assessed asked a series of questions regarding risk factors, questionnaire was filled by subjects including including the use of NSAIDs. Results: questions to evaluate presence of xerestomia, and the Of the 340 patients with DU, 32 patients presence of any kind of FGIDs. The epidemiology of (9.4%) were considered to be H. pylori-negative. Of the 112 patients with GU, 15 patients (13.4%) were

Govaresh\ Vol.17\ Supplement\ Autumn 2012 31 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 considered to be H. pylori-negative. Hence, a total of in human disease. Substitutions G587R and V511A 47(14.7%)patients were found to be H. pylori- which are located in catalytic domain are important negative. None of them were taking NSAIDs for the enzymatic function of COX-2 and associated Conclusion: The prevalence of H. pylori and with higher expression of COX-2. NSAID-negative peptic ulcer disease is relatively Send Date: 2012/08/21 high in our population and workup for other causes should be considered. Send Date: 2012/09/30 Code: 2420 Category: 2- ESOPHAGEAL-GASTRIC AND DUODENAL DISORDERS Code: 2365 2.13 Gastroduodenal malignancies Category: 2- ESOPHAGEAL-GASTRIC AND T-S-051 DUODENAL DISORDERS A comparative study of serum levels 2.13 Gastroduodenal malignancies of Matrix metalloproteinase 2,9,10 and W-F-050 Tissue inhibitor of matrix The Functional Role of Amino Acid metalloproteinase1,2 in gastric adenocarcinoma Substitutions in Cyclooxygenase-2 Protein and non-tumoral control groups Function in Gastrointestinal Cancers sepideh ghadri1*, Kamran Ghaffarzadehgan2, ezzat Elnaz Naderi1, Ashraf Mohamadkhani2* hajmollarezai3, Hamid Reza sima4, Tahoora abdolahi1, 1University of Mohaghegh Ardabili, Ardabil, Iran, Hamid Reza Raziee5, Hanieh Hosseinnezhad1, University of Mohaghegh Ardabili homa khanleghi1, farzane abedini1, 2 Digestive Disease Research Centre, Tehran University of Abbas Esmaeilzadeh4 Medical Sciences, Tehran, Iran 1 Gastric Cancer Research Group, Mashhad University of Introduction: Non- synonymous single nucleotide Medical Sciences, Mashhad, Iran polymorphism (nsSNPs) results in the disruption of Islamic Azad University, Mashhad Branch, Mashhad, Iran 2 protein function are used as markers in linkage and Gastric Cancer Research Group, Mashhad University of Medical Sciences, Mashhad, Iran association of human proteins that might be involved Department of Research Affair, Razavi Hospital, Mashhad, Iran in diseases and cancers. 3 Gastric Cancer Research Group, Mashhad University of Method: To study the functional effect of nsSNP in Medical Sciences, Mashhad, Iran cyclooxygenase-2 (COX-2 )ʹs amino acid, the Student Research Committee, School of Medicine, nucleotide sequences of encoding COX-2 gene in Mashhad University of Medical Sciences, Mashhad gastrointestinal cancers were extracted from the 4 Gastric Cancer Research Group, Mashhad University of NCBI (gi|223941909) data bank and analyzed by Medical Sciences, Mashhad, Iran SIFT server. SIFT is a program that predict the Department of Internal Medicine, Imam Reza Hospital, effects of amino acid substitution on protein function. School of Medicine, Mashhad University of Medical Disordered and 3D structure of COX-2 protein was Sciences, Mashhad, IRAN 5 Gastric Cancer Research Group, Mashhad University of analyzed by Cn3D version 4.3 software. This Medical Sciences, Mashhad, Iran software produced by the national center for Imam Reza Hospital, School of Medicine, Mashhad biotechnology information University of Medical Sciences, Mashhad, IRAN Results: COX-2 is an essential enzyme for the Introduction: Epidemiologic studies show that production of pro-inflammatory prostaglandins 50000 people get cancer in Iran every year. The most which are relevant to cancer development and involving system is gastrointestinal specially progression. The substitutions G587R and V511A of stomach. One of basic process in tumor growth is COX-2 in esophageal squamous cell carcinoma proteolysis of surrounding tissue which mediated by (ESCC) and colon cancer linked to reformed protein Matrix metalloproteinase(MMPs). MMPs inhibited function through disruption of enzyme active site . by tissue inhibitors of metalloproteinase(TIMPs). Conclusion: Amino acid substitutions as a Imbalances in expression of MMPs and TIMPs can consequence of COX-2 nsSNPs have important role

32 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 involve in the progression of cancer. So the serum 1 Gastric Cancer Research Group, Mashhad University of levels of MMPs and TIMPs could be used in Medical Sciences, Mashhad, Iran diagnosis of cancer. We evaluated the serum level of Department of Internal Medicine, Imam Reza Hospital, MMP-2 and MMP-9 in patients with gastric School of Medicine, Mashhad University of Medical adenocarcinoma(cases)and in non-patients(controls). Sciences, Mashhad, IRAN 2 Gastric Cancer Research Group, Mashhad University of Method: In this case-control study about 44 healthy Medical Sciences, Mashhad, Iran volunteer controls and 43 patients with gastric Department of Research Affair, Razavi Hospital, Mashhad, adenocarcinoma without any prior history of Iran radiotherapy or chemotherapy who underwent 3 Gastric Cancer Research Group, Mashhad University of gasterectomy in Omid, Imam Reza and Ghaem Medical Sciences, Mashhad, Iran hospitals of mashhad were enrolled.After taking 10cc Student Research Committee, School of Medicine, peripheral venous blood samples from both groups(in Mashhad University of Medical Sciences, Mashhad cases before gaserectomy)sera expression of 4 Gastric Cancer Research Group, Mashhad University of MMP2,MMP9,MMP10,TIMP1,TIMP2 determined Medical Sciences, Mashhad, Iran by Enzyme-linked immunosorbent assay using Islamic Azad University, Mashhad Branch, Mashhad, Iran Introduction: Gastric cancer is the second most ELIZA kit (RayBiotech,USA). common cancer and the second cause of death due to Results: The ratio of men/women in our study was cancer worldwide. Although the global incidence of 56/31.Average age in patients was 56.67 and in gastric cancer has been decreased dramatically in controls was 46.18.According to standard cut off recent decades, it is the most common cancer in north (>800) for MMP2 there was lower significant serum and northeast of Iran. In this study we present some level of this marker (%7 in comparative to controls epidemiological and characteristics of patients with %13.6)(P=0.00).The serum level of TIMP1 and gastric carcinoma in Mashhad. TIMP2 was higher in cancer patients than controls Method: 923 cases of gastric patients (mean age of (p= 0.00).There is no significant difference in serum 63.31±13.59) registered in Ghaem Hospital in level of MMP9(P=1.00) and MMP10(P=0.10) Mashhad from March 2005 to February 2012 were between case and control groups. enrolled in this descriptive and cross-sectional study. Conclusion: Our study demonstrated that increased Existing data were evaluated. Location of lesion and serum levels of TIMP1 &TIMP2 and decreased demographic characteristics include age and genders serum level of MMP2 were associated with gastric were considered. Statistical analysis was performed cancer.Further studies needed for evaluation of these using the SPSS statistical software. tumour markers’ role in diagnosis and prognosis of Results: Participants (n=923) were 668 men (72.4%) gastric cancer. Send Date: 2012/09/05 and 255 women (27.6%) with a mean age of 64.05±12.95 and 61.37±14.99 years, respectively. Location of lesion in 145 (107 male and 38 female) Code: 2421 (15.7%) of patients was in cardia part of stomach, the Category: 2- ESOPHAGEAL-GASTRIC AND most prevalent part. 5 patients (3 male and 2 female) DUODENAL DISORDERS (0.5 %) of them were suffered from lesions in fundus 2.13 Gastroduodenal malignancies of stomach. Body of stomach in 9 (1%) of cases (7 T-S-052 male and 2 female), pyloric antrum in 36 (24 male Anatomical distribution and and 12 female) (3.9%) of cases, pylorus in 7 (6 male demographic data of gastric cancer and 1 female) (0.8%) of cases, an unspecified part of from 2005-2012 in Mashhad, Iran lesser curvature of stomach in 1(0.1%) patient and m Farzaneh far1, Kamran Ghaffarzadehgan2, also an unspecified part of greater curvature of Hamid Reza sima1, mostafa Parizadeh3* , stomach in 1 patient were involved. ezzat hajmollarezai3, maryam abbasimoghaddam3, Conclusion: cardia gastric Cancer is now the most atieh Mohebbi moghaddam3, Hanieh Hosseinnezhad4, common type of stomach cancer and the incidence of Tahoora abdolahi4, zahra jafari3 it have risen in Mashhad during these years. Although

Govaresh\ Vol.17\ Supplement\ Autumn 2012 33 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 there is no significant statistical difference between Gõk. ìBû 5 GýzPp ô uBèú 96 GýíBoAó GpAÿ Þú cBèþ ko Gõk men and women, it seems Men in their 60s are the ÎõAìê Aq Oõìõo ìõÚÏýQ ô WñvýQ, uò, Þú køl ìþ ðzBó ìÇBèÏú Aüò âýpÿ: ðPýXú main victims of gastric cancer. GByñl. ìþ ìPBuPBOýà ìÏlû upÆBó GB GýíBoAó ko Þê GÛBF GpAÿ @âùþ Ký{ ìvPÛê Send Date: 2012/09/05 Send Date : 2012/10/01

Code: 2531 Code: 2537 Category: 2- ESOPHAGEAL-GASTRIC AND Category: 2- ESOPHAGEAL-GASTRIC AND DUODENAL DISORDERS DUODENAL DISORDERS 2.13 Gastroduodenal malignancies 2.13 Gastroduodenal malignancies T-S-053 T-S-054 GÛBF GýíBoAó ìHPç Gú upÆBó ìÏlû ìPBuPBOýà ìÏlû upÆBó Gú ìHPç GýíBoAó GÛBF AüpAó ko âõAo} kuPãBû GýíBoüùBÿ AÚP¿Bkÿ GBo Morteza Ghojazadeh1* , Mohammad Hossein Somi1, Morteza Ghojazadeh1*, Mohammad Hossein Somi1, Aliasghar Pouri1, Mohammad Naghavi Behzad1 Aliasghar Pouri1, Mohammad Naghavi Behzad1 1Liver and gastrointestinal Disease Research Center, 1Liver and gastrointestinal Disease Research Center, Tabriz University of Medical Sciences Tabriz University of Medical Sciences ) GBo AÚP¿Bkÿ uñãýñþ AÎíBë AÎíBë uñãýñþ AÚP¿Bkÿ GBo ) IG ( âõAoyþ kuPãBû øBÿ GýíBoÿ ølÙ: ô qìýñú OÓýýpAR ìPÏlÿ ko AKýlìýõèõsÿ upÆBó ìÏlû ko køú øBÿ ânyPú øBÿ køú ko ìÏlû upÆBó AKýlìýõèõsÿ ko ìPÏlÿ OÓýýpAR ølÙ: ô qìýñú ìþ ðíBüñl. ølÙ Aüò ìÇBèÏú AoADú ârAo} Aôèýú koGBoû GßBoâýpÿ ìpAÚHQ øBÿ ìpAÚHQ GßBoâýpÿ koGBoû Aôèýú ârAo} AoADú ìÇBèÏú Aüò ølÙ ðíBüñl. ìþ ârAo} âpkülû Þú AcPíBæ Glèýê OÓýýpAR ko ÎõAìê gBoWþ ìþ GByl. øí`ñýò GByl. ìþ gBoWþ ÎõAìê ko OÓýýpAR Glèýê AcPíBæ Þú âpkülû ârAo} GùlAyPþ ô ørüñú øBÿ GýíBoüùBÿ kuPãBû âõAoyþ ko AüpAó ìþ GByl. GByl. ìþ AüpAó ko âõAoyþ kuPãBû GýíBoüùBÿ øBÿ ørüñú ô GùlAyPþ Aüò OÓýýpAR ìþ OõAðl ÞBø{ WùBðþ oôðl upÆBó ìÏlû oA Oõ¾ýe køl.ÞBø{ Oõ¾ýe oA ìÏlû upÆBó oôðl WùBðþ ÞBø{ OõAðl ìþ OÓýýpAR Aüò ko Aüò ìÇBèÏú kAkû øB Aq OíBìþ ìñBGÐ ìÇBèHBR OíBìþ ypÞQ øBÿ Gýíú øBÿ ypÞQ OíBìþ ìÇBèHBR ìñBGÐ OíBìþ Aq øB kAkû ìÇBèÏú Aüò ko Gpouþ: oô} ÂBüÏBR küvPBë ô AÖrAü{ Oõìõo øBÿ KpôârüíBë ô ÞBoküB Aq AôAüê køú øzPBk køú AôAüê Aq ÞBoküB ô KpôârüíBë øBÿ Oõìõo AÖrAü{ ô küvPBë ÂBüÏBR ko AüpAó ô ìñBGÐ ìpGõÉ Gú kæüê ìpå ô ìýp AkAoû SHQ ô AcõAë AüpAó ko uBë 9831 WíÐ 9831 uBë ko AüpAó AcõAë ô SHQ AkAoû ìýp ô ìpå kæüê Gú ìpGõÉ ìñBGÐ ô AüpAó ko GýBó ylû AuQ. AüpAó GB OõWú Gú yHBøP{ Gú küãpÿ Þú ko @ó OíBï ÎõAìê OíBï @ó ko Þú küãpÿ Gú yHBøP{ Gú OõWú GB AüpAó AuQ. ylû GýBó @ôoÿ yl. ìB AÆçÎBR koGBoû OíBìþ GýíBoÿ øBÿ âõAoyþ GÏñõAó üà OzhýÀ Aôèýú OzhýÀ üà GÏñõAó âõAoyþ øBÿ GýíBoÿ OíBìþ koGBoû AÆçÎBR ìB yl. @ôoÿ AOýõèõsüßþ oA Glèýê ìõÚÏýQ WÓpAÖýBüþ ô ìzßçR ô ÎBkAR AWPíBÎþ-Öpøñãþ ÎBkAR ô ìzßçR ô WÓpAÖýBüþ ìõÚÏýQ Glèýê oA AOýõèõsüßþ ko ìpAWÏBR Þéýñýßþ, GvPpÿ yló , ô Îéê ìpå ko Aüò ìñBGÐ oA WíÐ @ôoÿ ðíõküî. @ôoÿ WíÐ oA ìñBGÐ Aüò ko ìpå Îéê ô , yló GvPpÿ Þéýñýßþ, ìpAWÏBR ko ko@ó ìþ OõAó üBÖQ, ìhéõÆþ Aq OíBìþ âpAüzBR oA ðzBó kAkû AuQ. ìB Gú ìÇBèÏú Gú ìB AuQ. kAkû ðzBó oA âpAüzBR OíBìþ Aq ìhéõÆþ üBÖQ, OõAó ìþ ko@ó Gp AuBx @ìBo uBqìBðùBÿ Gýíú, kô ìýéýõó ô 008 ørAo ð×p ko Æõë uBë Æõë ko ð×p ørAo 008 ô ìýéýõó kô Gýíú, uBqìBðùBÿ @ìBo AuBx Gp øB: üBÖPú ÎíýÜ Opÿ koGBoû AKýlìýõèõsÿ Aüò GýíBoÿ GB OõWú Gú ÎBkAR WíÏýQ AüpAðþ WíÏýQ ÎBkAR Gú OõWú GB GýíBoÿ Aüò AKýlìýõèõsÿ koGBoû Opÿ ÎíýÜ ÚpAo âpÖPñl. ko Gýò @ðBó, ðvHQ @ðBó, Gýò ko âpÖPñl. ÚpAo IG GýíBoüùBÿ OzhýÀ ìõok AüpAó ko 9831 ðýBqìñlüî.GB ôWõk Aüñßú Gpôq ô ìpå ô ìýp ðByþ Aq upÆBó ìÏlû ko ðýî Úpó Agýp Úpó ðýî ko ìÏlû upÆBó Aq ðByþ ìýp ô ìpå ô Gpôq Aüñßú ôWõk ðýBqìñlüî.GB ìXBoÿ âõAoyþ ÖõÚBðþ ko 5/36ko¾l yBüÐ Gõk. yBüÐ 5/36ko¾l ko ÖõÚBðþ âõAoyþ ìXBoÿ IG øBÿ GýíBoÿ GB GýíBoAó ÞBø{ üBÖPú, ôèþ øí`ñBó GÏñõAó ^ùBoìýò upÆBó A¾éþ ô kôìýò ÎBìê ìpå ÎBìê kôìýò ô A¾éþ upÆBó ^ùBoìýò GÏñõAó øí`ñBó ôèþ üBÖPú, ÞBø{ oA Ozßýê ìþ kAkðl, GB AüòcBë, GB kAkðl, ìþ Ozßýê oA IG GýíBoüùBÿ Þê ko¾l 5/8 ylû GvPpÿ GýíBoAó ðByþ Aq upÆBó ko WùBó AuQ. ðpj GÛBF upÆBó ìÏlû ko okû GlOpüò øBÿ øp ðõÑ øp øBÿ GlOpüò okû ko ìÏlû upÆBó GÛBF ðpj AuQ. WùBó ko upÆBó Aq ðByþ oA yBìê ìþ yõðl. Glgýíþ øBÿ Glgýíþ yõðl. ìþ yBìê oA IG GB ìpOHÈ ìvPÛýî øBÿ ørüñú Aq ko¾l 4/46 Oõìõo u×Q ìþ GByl. Gp gçÙ ìõÖÛýQ yýíþ koìBðþ øBÿ ìloó ko koìBó ko ìloó øBÿ koìBðþ yýíþ ìõÖÛýQ gçÙ Gp GByl. ìþ u×Q Oõìõo kèýê A¾éþ ørüñú øBÿ Kryßþ ko GvPpÿ yló Gõk. upÆBó ìÏlû øí`ñBó ìÏlû upÆBó Gõk. yló GvPpÿ ko Kryßþ øBÿ ørüñú A¾éþ kèýê IG upÆBó øBÿ oôkû Groå, GÛBF 5 uBèú GýíBoAó GB upÆBó ìÏlû KýzpÖPú 1/3% AuQ. 1/3% KýzpÖPú ìÏlû upÆBó GB GýíBoAó uBèú 5 GÛBF Groå, oôkû øBÿ upÆBó ÖzBo AWPíBÎþ AÚP¿Bkÿ AWPíBÎþ ÖzBo IG GýíBoüùBÿ Gõk. AüpAó ko IG Aq ðByþ ìpå A¾éþ kèýê kô ðõÑ ìXrAÿ GBÖPþ upÆBó ìÏlû, "ðõÑ oôkû Aÿ" ô "ðõÑ ìñPzp", Oõ¾ýØ Oõ¾ýØ ìñPzp", "ðõÑ ô Aÿ" oôkû "ðõÑ ìÏlû, upÆBó GBÖPþ ìXrAÿ ðõÑ kô ko ìõAok GvPpÿ ìõAok ko IG øBÿ Glgýíþ GBæÿ ìýp ô ìpå ô upKBüþ ìõAok ko oA uñãýñþ ylû Aðl. ìÇBèÏú cBÂp ko ðËp kAok Gú AoqüBGþ AoOHBÉ GBèýñþ GÛB ko upÆBó ìÏlû ìÏlû upÆBó ko GÛB GBèýñþ AoOHBÉ AoqüBGþ Gú kAok ðËp ko cBÂp ìÇBèÏú Aðl. ylû yló, AÎíBë ìþ ðíBüñl. ðíBüñl. ìþ AÎíBë yló, ìPBuPBOýà GLpkAqk Þú ko @ó OBSýp uò, WñvýQ, ô ÚõìýQ Gpouþ ylû Aðl. ylû Gpouþ ÚõìýQ ô WñvýQ, uò, OBSýp @ó ko Þú GLpkAqk ìPBuPBOýà Gp GßBoâýpÿ GßBoâýpÿ Gp IG øBÿ GýíBoÿ Aq ðByþ ÖzBo cBÂp ìÇBèÏú ðPBüY âýpÿ: ðPýXú øí`ñýò OÏBìçR ìýBó ôütâþ øBÿ GýíBo ô GBÖQ yñBuþ Oõìõo, koWú, AðlAqû ô AðlAqû koWú, Oõìõo, yñBuþ GBÖQ ô GýíBo øBÿ ôütâþ ìýBó OÏBìçR øí`ñýò oA GpAÿ KtôøzãpAó ô uýBuQ ânAoAó ðËBï ânAoAó uýBuQ ô KtôøzãpAó GpAÿ oA IG GýíBoüùBÿ GùlAyPþ øBÿ ìpAÚHQ ìdê (ÞBoküB ô Òýp ÞBoküB) ìõok Gpouþ ÚpAo âpÖPñl. ÚpAo Gpouþ ìõok ÞBoküB) Òýp ô (ÞBoküB ìdê uçìQ Îíõìþ oôyò ìþ ðíBül OB kuPõoAOþ Wlül koGBoû OdÛýÛBR ô Æpf ô OdÛýÛBR koGBoû Wlül kuPõoAOþ OB ðíBül ìþ oôyò Îíõìþ uçìQ GýíBoAó GBèÔ GB upÆBó ìÏlû ìPBuPBOýà ko gçë uBèùBÿ gçë ko ìPBuPBOýà ìÏlû upÆBó GB GBèÔ GýíBoAó Gpouþ: oô} ìpAÚHQ GùlAyPþ üßLBo^ú AüXBk ðíBüñl. AüXBk üßLBo^ú GùlAyPþ ìpAÚHQ 0931-5831 ko ìpAÞr @ìõqyþ koìBðþ OHpür ô AokGýê SHQ ylðl Þú AÆçÎBR OíBï AÆçÎBR Þú ylðl SHQ AokGýê ô OHpür koìBðþ @ìõqyþ ìpAÞr ko 0931-5831 ìõAok Wlül upÆBó Aq 71 ðõÑ GBüãBðþ WíÏýPþ WíÐ @ôoÿ ô SHQ ylðl. GÛBF Þéþ GÛBF ylðl. SHQ ô @ôoÿ WíÐ WíÏýPþ GBüãBðþ ðõÑ 71 Aq upÆBó Wlül ìõAok Send Date: 2012/10/01 GýíBoAó GB upÆBó ìÏlû ìPBuPBOýà oA Gp AuBx WñvýQ, uò, ô âpôû Úõìþ(@moÿ âpôû ô uò, WñvýQ, AuBx Gp oA ìPBuPBOýà ìÏlû upÆBó GB GýíBoAó .Þpk.ÖBox) GB AuP×Bkû Aq ìlèùBÿ OñBuHþ gÇp ÞBÞw ìÛBüvú yl. yl. ìÛBüvú ÞBÞw gÇp OñBuHþ ìlèùBÿ Aq AuP×Bkû GB .Þpk.ÖBox) Code: 2539 Aq uBë 5831OB 0931 OÏlAk 968 GýíBo Gú ¾õoR O¿BkÖþ AðPhBJ ylðl. GýíBoAó ylðl. AðPhBJ O¿BkÖþ ¾õoR Gú GýíBo 968 OÏlAk 0931 5831OB uBë Aq øB: üBÖPú Category: 2- ESOPHAGEAL-GASTRIC AND ) OzhýÀ kAkû ylðl. ðPBüY ylðl. kAkû OzhýÀ ) 100.0

34 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

AoOHBÉ øéýßõGBÞPp Kýéõoÿ ô upÆBó ìÏlû upÆBó ô Kýéõoÿ øéýßõGBÞPp AoOHBÉ Gõk. ylû OBüýl AðùB ko KBOõèõsÿ ÆpüÜ Aq ìÏlû upÆBó 0931 OB 6831 uBë Aq Þú Gõkðl 13-08 Morteza Ghojazadeh1*, Mohammad Hossein Somi1, Gõk. 25ko¾l Gà, AÖvpkâþ ìÏýBo AuBx Gp AÖpAk ko AÖvpkâþ ìýrAó øB: üBÖPú Aliasghar Pouri1, Mohammad Naghavi Behzad1 GB Aÿ ìçcËú ÚBGê GÇõo koìBðþ øBÿ yýõû ô Oõìõo koWú WñvýQ, uò, 1Liver and gastrointestinal Disease Research Center, Tabriz koWú uBèýBðú, ko@ìl GýzPp) üB uBë (55 uò Gõkðl. ìpOHÈ GýíBoAó AÖvpkâþ University of Medical Sciences ) GBæ ) RH ( gÇp ðvHQ GB âýpÿ ^zî GÇõo koìBó ô èñ×Bôÿ øBÿ âpû ìPBuPBq Oõìõo, øéýßõGBÞPpKýéõoÿ GBÞPpÿ âpï ìñ×þ ìBoKý`þ yßéþ AuQ Þú AKýPéýõï Þú AuQ yßéþ ìBoKý`þ ìñ×þ âpï GBÞPpÿ øéýßõGBÞPpKýéõoÿ ølÙ: ô qìýñú GpAÿ GÛBF upÆBó ìÏlû ìpOHÈ Gõkðl. Gõkðl. ìpOHÈ ìÏlû upÆBó GÛBF GpAÿ Aüò Î×õðQ yBüÐ Opüò Î×õðQ ìrìò Î×õðQ Opüò yBüÐ Î×õðQ Aüò « AcPíBæ ô Þñl ìþ @èõkû oA AðvBó Aÿ ìÏlû ðõÑ Aq AÆçÎBR GluQ @ìlû Aq Aüò ÖpÂýú Þú AÖvpkâþ GB GÛBF KBüýò ko KBüýò GÛBF GB AÖvpkâþ Þú ÖpÂýú Aüò Aq @ìlû GluQ AÆçÎBR âýpÿ: ðPýXú GBÞPpüBüþ ko AðvBðùB øvQ AÞTp GýíBoAðþ Þú øéýßõGBÞPpKýéõoÿ ko ìÏlû @ðùB ÞéõðýrAuýõó @ðùB ìÏlû ko øéýßõGBÞPpKýéõoÿ Þú GýíBoAðþ AÞTp øvQ AðvBðùB ko GBÞPpüBüþ GýíBoAó upÆBó ìÏlû AoOHBÉ kAok OBDýl ìþ Þñl. ìÇBèÏBR âvPpkû Op GB OÏlAk GB Op âvPpkû ìÇBèÏBR Þñl. ìþ OBDýl kAok AoOHBÉ ìÏlû upÆBó GýíBoAó ìþ üBGl øpâr k^Bo qgî ðíþ yõðl ô Glôó ÎçìQ ìþ ìBðñl . ìBðñl ìþ ÎçìQ Glôó ô yõðl ðíþ qgî k^Bo øpâr üBGl ìþ ðíõðú øBÿ GýzPp ô kôoû øBÿ Kýãýpÿ Æõæðþ Op ìõok ðýBq ìþ GByñl. ìþ ðýBq ìõok Op Æõæðþ Kýãýpÿ øBÿ kôoû ô GýzPp øBÿ ðíõðú Æþ üà ìÇBèÏú AKýlìýõèõsüà @üñlû ðãp ^ñl ìpÞrÿ ko AüpAó AoOHBÉ AüpAó ko ìpÞrÿ ^ñl ðãp @üñlû AKýlìýõèõsüà ìÇBèÏú üà Æþ Gpouþ: oô} Send Date: 2012/10/02 øéýßõGBÞPp Kýéõoÿ ô upÆBó ìÏlû ìõok Gpouþ ÚpAo âpÖQ . âpÖQ ÚpAo Gpouþ ìõok ìÏlû upÆBó ô Kýéõoÿ øéýßõGBÞPp yýõÑ upìþ øéýßõGBÞPp Kýéõoÿ ko GýíBoAó upÆBó ìÏlû (48ko¾l) ìÏlû upÆBó GýíBoAó ko Kýéõoÿ øéýßõGBÞPp upìþ yýõÑ øB: üBÖPú O×BôR ^zíãýpÿ GB âpôû yBøl (56ko¾l) ðlAyQ; øí`ñýò ko ìýBó âpôøùBÿ ìýBó ko øí`ñýò ðlAyQ; (56ko¾l) yBøl âpôû GB ^zíãýpÿ O×BôR Code: 2359 yBøl (56ko¾l), upÆBó ìñPzp ìÏlû (67ko¾l), ô upÆBó ìÏlû ðõÑ oôkû Aÿ oôkû ðõÑ ìÏlû upÆBó ô (67ko¾l), ìÏlû ìñPzp upÆBó (56ko¾l), yBøl Category: 3. H.PYLORI (29ko¾l) ðýr O×BôR ^zíãýpÿ ðlAyPñl. ko ÎõÅ ìÛBüvú ìýBó upÆBó ìÏlû upÆBó ìýBó ìÛBüvú ÎõÅ ko ðlAyPñl. ^zíãýpÿ O×BôR ðýr (29ko¾l) 3.1 Epidemiology/natural history ðõÑ oôkû Aÿ (29ko¾l øéýßõGBÞPp Kýéõoÿ ìPõuÈ) GB âpôû yBøl ìpOHÈ @ó ìpOHÈ yBøl âpôû GB ìPõuÈ) Kýéõoÿ øéýßõGBÞPp (29ko¾l Aÿ oôkû ðõÑ T-S-057 Prevalence of Peptic Ulcer Disease (95ko¾l øéýßõGBÞPp Kýéõoÿ ìTHQ) O×BôR ìÏñþ kAoÿ Aq èdBÍ @ìBoÿ ìzBølû @ìBoÿ èdBÍ Aq kAoÿ ìÏñþ O×BôR ìTHQ) Kýéõoÿ øéýßõGBÞPp (95ko¾l and its relationship with Helicobacter ). ).

Govaresh\ Vol.17\ Supplement\ Autumn 2012 35 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

90% of subjects that their endoscopy showed PUD and districts of Iran were recruited and genotyped. in 36.6% of subjects with normal endoscopy positive Results: The frequency of vacA s1 was 94.9%, s2 RUT was reported. 5.1%, m1 24.6%, m2 75.4%, i1 40.6%, i2 59.4%, d1 There was a significant relation between PUD 39.9%, d2 60.1%, iceA1 76.8%, iceA2 52.9%, observed in endoscopy and RUT (p
0.001). In iceA1/2 29.7%, babA2 40.6%, and cagA 65.9%. An 89.6% of subjects who had PUD in biopsy, 57.7% individual hierarchical analysis of molecular variance subjects had gastritis with positive H. Pylori and of vacA i1, i2, d1, and d2 alleles and iceA1 and 13.8% subjects had gastritis without H. Pylori. There iceA1/2 genes found significant levels of genetic was a significant relation between gastritis incidence differentiation among populations (P < 0.05). The based on biopsy and RUT (p
0.001). prevalence of vacA i1 and d1 genotypes and iceA1/2 Conclusion: The prevalence of PUD is more gene (but not iceA1 gene) were significantly higher common in asymptomatic males than females. among H. pylori isolates from high-incidence areas Regarding the high prevalence of PUD and H. Pylori of gastric cancer (Age-standardized rates, ASRs> in the population under study, life style change and 20/105, max. 51.8/105) compared with those from healthy nutrition are considered as effective factors low-incidence areas (ASRs < 10/105) in Iran [vacA i1 in PUD prevention. According to the results of this 25/41 (61%) vs. 9/36 (25%), P = 0.003; vacA d1 study, the patients with upper GI symptoms should 24/41 (58.5%) vs. 9/36 (25%), P = 0.003; and iceA1/2 be suspect to PUD and positive H. Pylori infection. 18/41 (43.9%) vs. 5/36 (13.8%), P = 0.004]. The Send Date: 2012/08/19 results of Mantel's test showed a low correlation between the genetic and geographic distances for iceA1 and iceA1/2 genes among 10 districts of Iran Code: 2572 (r= 0.098 and 0.074, respectively, P < 0.05). No Category: 3. H.PYLORI significant difference was found between the genetic 3.1 Epidemiology/natural history and geographic distances for the vacA alleles and the T-S-058 iceA2, babA2, and cagA genes in Iran (P > 0.05). High Distribution of New Determinants Conclusion: It is proposed that the H. pylori vacA of Helicobacter pylori-Related Cancer, i1/-d1 alleles could be considered as important can- vacA i1/-d1 Alleles, in High-Incidence cer-related biomarkers in the high-incidence areas of Areas of Gastric Cancer in Iran gastric cancer in Iran. Saeid Latifi-Navid1*, Shiva Mohammadi1, Send Date: 2012/10/02 Parichehr Maleki1, Saber Zahri 2, Abbas Yazdanbod3, Farideh Siavoshi4, Reza Malekzadeh5 1 Department of Biology, Faculty of Sciences, University Code: 2470 of Mohaghegh Ardabili, Ardabil, Iran. Category: 3. H.PYLORI 2 Department of Biology, Faculty of Sciences, University 3.2 Molecular biology/genetics/pathology of Mohaghegh Ardabili, Ardabil, Iran. 3 Department of Medicine and Pathology, Ardabil T-S-059 University of Medical Sciences, Ardabil, Iran. Studying the effect of Tcf4 silencing on 4Department of Microbiology, School of Biology, University sensitivity of SW480 colon cancer cell line to College of Sciences, University of Tehran, Tehran, Iran. Oxaliplatin, a common chemotherapeutic drug 5 Digestive Disease Research Institute, Shariati Hospital, fatemeh gheidari1, saba hashemi2, Tehran University of Medical Sciences, Tehran, Iran. sirous zeinali3, ladan Teimoori-Toolabi3* Introduction: The distribution of gastric cancer- 1Molecular Medicine Department, Biotechnology Research related Helicobacter pylori genotypes between Center, Pasteur Institute of Iran, Department of different geographic locations of Iran particularly Biotechnology, Faculty of Science, University of Tehran, Iran 2 areas with high- and low-incidence of gastric cancer Molecular Medicine Department, Biotechnology Research was assessed. Center, Pasteur Institute of Iran, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran Method: A total of 138 H. pylori isolates from 10 3Molecular Medicine Department, Biotechnology

36 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

Research Center, Pasteur Institute of Iran, Molecular Code: 2505 Medicine Department, Biotechnology Research Center, Category: 3. H.PYLORI Pasteur Institute of Iran 3.3 Pathogenesis: host factors/histo-pathology Introduction: Colon Cancer as one of the most T-S-060 common malignancies is responsible for the third Gastric Cancer Risk in an Adult General cause of death from cancer in the world. Patients in Population Infected with Helicobacter Pylori: Stage 3- 4 should be treated by 5-FU and Oxaliplatin a Long-Term Follow-up Cohort Study or Irinotecan as chemotherapic drugs along with the Alireza Sajadi1, B. Z. Alizadeh1, M. H. Derakhshan1, surgery. Multiple Drug Resistance to chemotherapeutic A. Etemadi1, M. Babaei2, E. Ahmadi1, M Boreiri1, drugs is mainly due to over expression of ABC A. H. Sharifi1, A. Nikmanesh1, Alireza Delavari1* , transporter members. As TCF4 site is located on the M. Alimohammadian1, A. Houshiar2, F. Pourfarzai2, ABCB1 gene promoter, TCF4/B-catenin complex M. Sotoudeh1, G. H. de Bock3, R. Malekzadeh1 may be responsible for Multiple Drug Resistance. 1Digestive Disease Research Center, Tehran University of B-catenin migration to the nucleus, a sign of active Medical Sciences 2 Wnt pathway, would trigger formation of TCF4/ Gastrointestinal Cancer Research Center, Ardabil University of Medical Sciences b-catenin complex. Wnt pathway, a key player in 3Department of Epidemiology, University of Groningen, development and cell division, is activated in the University Medical Center of Groningen, Groningen, The process of carcinogenesis and even metastasis. Netherlands Method: In this study we designed siRNA against Introduction: As there are currently no clear criteria to TCF4 gene by on-line design tools such as Ambion, recognize individuals at risk of progressing towards Dharmcon, Sirecords and Codex. SiRNA was cloned gastric cancer (GC), this cohort study aimed to identify in the appropriate plasmid vector and then transfected predictors of GC risk in a high-risk population. to SW480 cell line (colon cancer cell line) by Method: 896 randomly selected H.pylori positive lipofection methods. These cells and non transfected permanent residents of Ardabil, Iran, without a SW480 cell line were treated with different history of gastrointestinal diseases, underwent upper concentrations of Oxaliplatin (1 -12 micro molar). endoscopy with targeted biopsy sampling in 2000-1. The cell death in different concentrations of Patients were followed until 2011 for incident Oxaliplatin was assayed by MTT proliferation assay. cancers, and Cox regression was used to estimate Results: While non transfected SW480 cells did not hazard ratios (HR) and 95 % confidence interval (CI). show any significant cell death in tested range (1-12 Results: During 9,096 person-years of follow-up, GC micro molar). In two different clones of cells was developed in 36 participants, yielding an transfected with siRNA against TCF4, the LC50 was incidence rate of 3.96/1000/year. In the multivariate in the range of 3.75 and 4.375 micro molar. This model, baseline severe atrophic gastritis of gastric observation was seen in three rounds of tests and it body was associated with increased GC risk. All showed that it was not random. levels of severity of intestinal metaplasia at gastric Conclusion: Wnt pathway is active in many colon body, but only severe antral intestinal metaplasia cancer cell lines. Activation of this pathway leads to were associated with significantly higher GC risk. B-catenin aggregation in the nucleus and Age over 50, family history of GC (HR=6.8; B-catenin/TCF4 complex formation. This complex 3.0-15.1), smoking (HR=5.3; 2.0-13.9), and stimulates transcription of Wnt related genes such as endoscopically confirmed gastric ulcer (HR=6.6; cyclin D or ABCB1 which leads to carcinogenesis. 2.5-9.1) were independently associated with GC risk. When B-catenin/TCF4 formation is inhibited through Duodenal ulcer and gastroesophageal reflux disease TCF4 gene silencing, its downstream genes such as did not affect the risk of GC. ABCB1 will not be expressed which may be related Conclusion: In this population with a high rate of H. to sensitizing these cells to chemotherapeutic drugs pylori infection, age over 50, smoking, family history such as Oxaliplatin. of GC, atrophic gastritis of corpus, intestinal metaplasia Send Date: 2012/09/27 at either antrum or corpus, and particularly, previously

Govaresh\ Vol.17\ Supplement\ Autumn 2012 37 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 undiagnosed gastric ulcer were significant independent significantly compared to the baseline UBT. Also the risk factors for GC. Assessment of a combination of these difference between the false negative rates of risk factors may identify individuals at risk of GC who baseline UBT and Ubt without citric acid was not may benefit from more intensive surveillance. significant (P>0.05). Send Date: 2012/09/30 Conclusion: These results suggest that acidification of gastric environment during 14C-UBT cannot prevent false negative results and do not increase the Code : 2342 accuracy of the test in patients taking PPIs. Also this Category : 3. H.PYLORI study has the novel finding that Pantoprazol doesn't 3.4 Diagnosis influence the sensitivity of 14C-UBT at all. T-S -061 Send Date: 2012/08/15 Effect of gastric Acidification on the 14C-UBT HELIPROBE® accuracy during Pantoprazol treatment in Code: 2343 Helicobacter Pylori positive patients Category: 3. H.PYLORI Farahnaz Joukar1*, Mohammad Reza Sheikhian1, 3.4 Diagnosis Fatemeh Soati1, Fariborz Mansour-Ghanaei1 T-S-062 1 Gastrointestinal and Liver Diseases Research Center of Comparison of Serum Pepsinogen I and II and Guilan University of Medical Sciences Gastrin 17 level in patients more than 50 years Introduction: The aim of this study was to evaluate with dyspepsia with precancerous gastric lesions the influence of using Citric Acid on false negative Fariborz Mansour-Ghanaei1, Farahnaz rates induced by PPIs during 14C –UBT in dyspeptic Joukar1*, Mohammad Yaghoub Rajput1 patients with H.Pylori infection. 1Gastrointestinal and Liver Diseases Research Center of Method: In a crossover randomized controlled Guilan University of Medical Sciences clinical trial, one hundred dyspeptic patients (46 Introduction: Serum screening systems are beneficial females and 54 males) with determined H. pylori for gastric cancer surveys. The aim of this study was to infection who refered to gastrointestinal Outpatient comparison of serum Pepsinogens, Gastrin 17 and Clinic of Razi Hospital-Rasht, Iran were enrolled in helicobacter pylori Antibody in patients with dyspepsia the study in 2011-2012. All the patients underwent a and precancerous lesions in gastric biopsy. 14C-UBT HELIPROBE® baseline test and the Method: In a cross sectional study, patients with positive ones entered the second phase. They were dyspeptic symptoms who have underwent endoscopy divided randomly to two groups and started PPIs for obtaining gastric specimen were enrolled in this treatment by Pantoprazol (Pantozol® Nycomed study. Biopsy specimens were analyzed for Rapid company). Both groups underwent two other UBTs Urease test and histopathogical pattern. Precancerous in days 12-13 and 14-15 with and without 4 grams lesions (40 patients) and chronic gastritis (88 Citric Acid. Data were analyzed in SPSS 18. P < 0.05 patients) were considered as case and control. Serum was considered significant. pepsinogens I (PGI) and II (PGII), gastrin 17 (G-17), Results: In group I who underwent UBT with Citric and antibodies against IgG H. pylori, and cytotoxin- Acid in days 12-13 (UBT2) and UBT without Citric associated gene A (CagA) antigen were measured Acid in days 14-15 (UBT3 ), there was no significant among all patients in a private laboratory of Rasht. Data difference between the UBT results with and without were analyzed using SPSS version 18. Citric Acid(P≥0.05). In group II who underwent UBT Results: Among patients,120 chronic non-atrophic without Citric Acid in days 12-13 (UBT2) and UBT gastritis, 39 metaplasia, 5 dysplasia and 6 neoplasia with Citric Acid (UBT3) in days 14-15, the false were seen. No atrophic gastritis was detected. negative rates were not significantly different Number of cases with PGI < normal in patients between UBT with and without Citric Acid (P≥0.05). without metaplasia(75.9%) and neoplasia(96.6%) was In both groups the results of UBT without Citric Acid significantly more than patients with metaplasia (24.1%) after Pantoprazol consumption didn’t change and neoplasia(3.4%) respectively.(P<0.05). After

38 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 merging three group of metaplasia, dysplasia and after 12 hours and 73.2% and 90.6% after 24 hours. atrophic gastritis as a new group of precancerous Conclusion: While positive RUT results obtained (case), significant differences were found in regard within one hour after endoscopy are highly reliable, to PGI and PGI/PGII between case and control group negative results need to be kept and read after 24 hours. (P<0.05). Lower normal level of PGI and PGI/PGII Send Date: 2012/09/25 was more frequent in precancerous patients (15%, 20% respectively) than chronic gastritis patients (1.1%, 5.7% respectively). Mean of PGI and Code: 2335 PGI/PGII was lower in precancerous lesion (99.57 Category: 3. H.PYLORI µg/L, 5.89 respectively) rather than chronic gastritis 3.5 Management strategies patients (100.24 µg/L, 8.77 respectively) (P<0.05). T-S-064 No differences were found between group in regard Comparison of two most prescribed to PGII, Gastrin 17, Anti HP Abs. H. pylori eradication regimens in Zahedan Conclusion: According to our findings, low PGI and Alireza Bakhshipour1, Seyed Kazem Nezam1* , 1 PGI/PGII levels were useful markers for detection of Narges Mohsenpour Mohammadi 1 gastric precancerous lesions. Further studies with Ali-ebne Abitaleb Hospital, Zahedan University of Medical Sciences larger sample size are recommended for sensitivity Introduction: Helicobacter pylori infection is the and specificity of serum markers and probable cut off most common infection of human. This organism for mentioned markers. Send Date: 2012/08/15 responsible of majority of peptic ulcer disease, maltoma and gastric cancer, worldwide. Several regimen therapy against H.pylori had Code: 2461 developed but therapies have rarely been optimized, Category: 3. H.PYLORI are prescribed empirically.In this study, we compare 3.4 Diagnosis two regimens that used widely in Iran, triple regimen T-S-063 (clarithromycin, amoxicillin and omeprazole) and Determining the optimum time furazolidone based quaderable regimen(furazolidone, to read the rapid urease test result amoxicillin, bismuth and omeprazole), in some shahriar nikpour1* dyspeptic patients in Zahedan. 1internal medicine loghman hospital, shahid beheshti university Method: In thise cross- sectional study 482 consecutive Introduction: Considering the high prevalence of dyspeptic patients that H.pylori infection was Helicobacter pylori (HP) infection in Iran and established with Urea Breath Test(UBT) randomized availability of the rapid urease test as a low cost, into one of the following groups; group A(treated accurate and fast diagnostic test, this study aimed to with clarithromycin 500mg, amoxicillin 1000 mg and determine the sensitivity, specificity and the optimum omeprazole 20 mg twice daily for 10 days) or group time for reading the test B(furazolidone 100 mg, amoxicillin 1000 mg, Method: This study evaluated 167 patients being bismuth subcitrate 240 mg and omeprazole 20 mg twice referred to the Endoscopy ward of Loghman daily for 14 days). One month after discontinuation of Hospital in Tehran in 2010. HP infection was treatment, H. pylori eradication evaluated with UBT. assessed by obtaining two biopsy specimens from the Results: Mean age of patients was 35.9± 12.3 yaers antrum of stomach. One biopsy was sent for and male to female ratio was 1: 1.6. From all pathologic study as the Gold Standard test and the patients,131(61 and 70 patients in group A and B, other one for RUT. RUT results were serially read for respectively) lost and 351 patients completed the up to 24 hours after taking the specimens. study. In intention to treat analysis, eradication rate Results: Sensitivity and specificity of the RUT were of H.pylori was 63.7 % in comparsion with 80.3 % in as follows: 41.5% and 100% after 10 min, 48.8 and group A and B, respectively(p< 0.004). 100% after 30 min, 52.4% and 100% after 1 hour, Conclusion: Our study showed both routine regimen 62.2% and 96.5% after 3 hours, 68.3% and 94.1%

Govaresh\ Vol.17\ Supplement\ Autumn 2012 39 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 that used for H. pylori eradication in Iran provide this regimen, significant intolerance and side-effects inferior results compared with antimicrobial were the most important limitation of this regimen. therapies for other common infectious diseases, and Send Date: 2012/08/21 furazolidone based quaderable regimen is superior to standard triple regimen. Send Date: 2012/08/12 Code: 2398 Category: 3. H.PYLORI 3.5 Management strategies Code: 2364 T-S-066 Category: 3. H.PYLORI Diagnostic value determination of stool 3.5 Management strategies Antigen test in diagnosis of Helicobacter T-S-065 pylori in compared with Rapid ureas Quantiple (5 drugs) regimen for test in dyspeptic patiets H.pylori radication in quadruple asghar khoshnood1*, hassan salmanrooghani1, non-responder dyspeptic patients neda borhani1, mohammad hossein antikchi1, Afshin Shafaghi1*, Fariborz Mansour-Ghanaei1, mohammad kazem amirbeigi1, mohsen Farahnaz Joukar1, Sayad Kashef1 akhoondi1, mahmood baghbanian1 1Gastrointestinal and Liver Diseases Research Center of 1 shahid sadooghi medical university Guilan University of Medical Sciences Introduction: Helicobacter pylori is one of the Introduction: Helicobacter pylori (HP) infection is a common organisem in human and It is a main agents to common infection in developing countries. There are cause peptic ulcer and gastric cancer,HP is a multiple regimens for the eradication of this infection probable reasons of dyspepsia. The diagnosis of HP is but antibiotic resistance is increasing. The aim of this devided into 2 parts: study is determination of HP eradication rate after invasive methods such as endoscopy and taking biopsy 7-days quntiple therapy in quadruple non-responder and noninvasive methods such as urease breath test and dyspeptic patients. stool Antigen test. In this study aimed to determine Method: This interventional study was performed at diagnostic value of stool Antigen test in diagnosis of 2010-2011 in Rasht Razi hospital. Patient’s age were Helicobacter Pylori in compared with rapid ureas test in 15-65 years. They were treated with a 2-weeks dyspeptic patients. quadruple therapy, previously and were still HP Method: In this study 101 dyspeptic patient who are positive. A seven-day course of quntiple therapy with condidated for endoscopy are considered in Amoxicillin(1g/BD), Tinidazole (500mg/BD), Khatemol anbia gasterointestinal clinic,Rapid Ureas Clarithromycin(500mg/BD), Omeprazole 20mg/BD) Test was done for this patient during endoscopy then and Bismuth Subcitrate (240 mg/BD) was started. Stool Antigen Test was done for the patients and Twelve weeks after the end of treatment, a C13-UBT results of two test are compared. The results are test together with HP stool Ag was performed. analyzed with chi-squar tests and kappa tests by SPSS Eradication was considered successful if the results ver 17 software. of both tests were negative. Chi-square test was used Results: This study is done on 60 women(59.4%) and for statistical analysis A P-Value less than 0.05 was 41 men(40.6%) with average of 41.23 years. considered significant. It shows that there is a diagnostic relation between Results: Out of 97, 35 patients had been excluded due results of stool Ag test and RUT(p.value<0.005) Sen- to intolerance to therapentic regimen. The eradication sivity= 91/4% specifity=96/96% Positive predictive rates were 82.3% and 52.5% by per-protocol & value= 94/11% negative predictive value=95/52% Intention-to-treat analysis, respectively. Accuracy = 95/04% There was no significant relation between HP- Conclusion: It can be cocluded from this study that eradication rate and, age, gender, smoking and the Stool Antigen Test has a high sensivity and specifity presence of cag-A Antigen. in diagnosis of HP and it can be used as an alternative Conclusion: Despite acceptable eradication rate by test. In addition Stool Ag Test is a noninvasive and

40 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 rapid test. 01.014 and 0.04, respectively). The rate of other Send Date: 2012/09/03 complications did not differ between the groups. Conclusion: Half-dose triple-therapy with clarithromycin, amoxicillin and omeprazole is as ef- Code: 2429 fective as full-dose triple-therapy to eradicate the Hp Category: 3. H.PYLORI and according to lower toxicity, complications and 3.5 Management strategies cost is advised in patients with ESRD. T-S-067 Send Date: 2012/09/12 Comparison of the rate of helicobacter pylori eradication with half-dose and full-dose triple therapy regimens in Code: 2456 patients with end-stage renal disease Category: 3. H.PYLORI Mohammad Javad Ehsani Ardakani1, Mohammad 3.5 Management strategies Aghajanian1, Amir Ahmad Nasiri1, Iradj Maleki2* T-S-068 1 Faculty of Medicine, Shahid Beheshti University of Assessment of N-Acetyl Cysteine effect as Medical Sciences an adjuvant treatment in patients with 2 Faculty of Medicine, Mazandaran University of Medical Helicobacter Pylori infection Sciences shahriar nikpour1* Introduction: Helicobacter pylori (Hp) is one the 1loghman hakim hospital, shahid beheshti university most important causes of dyspepsia in patients with Introduction: Helicobacter pylori (HP) colonization end-stage renal disease (ESRD). According to the beneath the biofilm of gastric mucus enables the renal failure, it is desirable to decrease the dosage of organism to survive in the hostile environment of the the antibiotics used for Hp eradication. The main gastric mucosa. It has been proposed that N- purpose of current study was to compare the rate of acetylcysteine (NAC) induces a reduction of gastric successful Hp eradication in patients with ESRD on barrier mucus thickness hemodialysis between half-dose and full-dose Method: Fifty patients with definite indications for antibiotic therapy. helicobacter pylori eradication at Loghman Hakim Method: Twenty six patients with ESRD were hospital were enrolled in this randomized enrolled in the study with Hp infection and peptic placebo-controlled trial. The intervention group (A, disease with a need of Hp eradication. Patients were n=25) received N-acetyl cysteine 600 mg twice daily randomly assigned to full-dose group (A; 15 patients) and Identical inert effervescent tablets were given to or half-dose (B; 11 patients). Patients received the placebo group (B, n=25). Both groups received a clarithromycin 500 mg, amoxicillin 1000 mg and triple regimen containing Omeprazole 20 mg, omeprazole 20 mg twice daily in group A and Clarithromycin 500 mg and Amoxicilin 1000 mg, clarithromycin 250 mg and amoxicillin 500 mg twice twice daily for two weeks. The primary outcome daily and omeprazole 20 mg once daily in group B measure was H. pylori eradication documented by for 2 weeks. Patients provided stool samples at week urea breath test assessed 4-8 weeks after the end of 4 to assess the success of Hp eradication by Hp- treatment. specific stool antigen. Finally, the rate of eradication Results: The mean age of cases was 46.34 years and complications were compared between 2 groups. (SD=16.33), of which 54% were female and 46% Results: The successful Hp eradication was achieved were male. The chief complaints of cases were in 11 patients in group A (73.3%) and in 8 patients epigastric pain in 62%, reflux in 28%, melena in 6% (72.7%) and the difference between 2 groups was not and hematemesis in 4%. Indications for H. pylori statistically significant (p=0.973)(per protocol eradication were duodenal ulcer in 33 patients (66%), analysis). The rate of bitterness of the month and gastric ulcer in 8 patients (16%), and nine first degree abdominal distention were significantly higher in the relatives of patients with gastric cancer (18%). There group A (86.6% and 46.7%, respectively) compared was only nausea as side effect of drugs (8%), which the group B (36.4% and 9.1%, respectively) (p=

Govaresh\ Vol.17\ Supplement\ Autumn 2012 41 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 were all in group A. None of cases discontinued drugs treatment. because of side effects. Eradication rate was 84% in Results: Positive eradication response was revealed group A and 64% in group B on the intention to treat in 82% of participants. Quadruple therapy was analysis. However, this difference did not reach similar in women and men in eradicating H Pylori statistical significance (p=0.196). (81.0% versus 83.3%); that this difference was Conclusion: Although we were unable to find a statistically insignificant. H Pylori eradication rates statistically significant difference between the two with quadruple therapy were found better in the groups, these preliminary results show some younger group so that the eradication rate in the three promise for the use of N-acetyl cysteine in H. pylori age categorizations of 16-20 years, 21-40 years, and eradication regimens, if our results are confirmed in 41-60 years was 100%, 81%, and 77.8%, respectively further studies. (p = 0.001). There was no significant difference in H Send Date: 2012/09/25 Pylori eradication rate between the genders in the age groups of less than 20 years and the middle age group, however in the older group; eradication rate Code: 2513 was significantly higher in women than men (100% Category: 3. H.PYLORI versus 66.6%). 3.5 Management strategies Conclusion: A two-week quadruple therapy T-S-069 including omeprazole, bismuth, amoxicillin, and Eradication rate of Helicobacter pylori metronidazole results in high effectiveness on with a two-week quadruple therapy: H pylori infection with an acceptable eradication rate A report from the south region of Iran in the south region of Iran. The eradication rate seems Mohammad Panahian1, Mohsen Maoodi1, to be lower in older men than in young men or in 1 Amirmansoor Rezadoost , women. 2 1* Amin Heidari , Mehrdokht Najafi Send Date: 2012/09/30 1Colorectal Research Center, Rasool Akram Hospital, Tehran University of Medical Sciences 2 Tropical and Infectious Disease Research Center, Code: 2518 Hormozgan University of Medical Sciences Category: 3. H.PYLORI Introduction: The use of quadruple therapy for 3.5 Management strategies Helicobacter Pylori (H Pylori) eradication has been T-S-070 commonly considered as a gold standard regimen with high efficacy; however, some studies have ô AìLpAqôë OPpAuýßéýò, uýéýò, @ìõÞvþ kAoôüþ ^ùBo osüî ASpGhzþ OÏýýò suggested its-related high compliance problems and KLvþ küw yßBüQ GB GýíBoAó ko øéýßõGBÞPpKýéõoÿ Þñþ oüzú Gp GývíõR side effects. In current study, we evaluated the H afshin hoshiar1*, shahram habibzadeh1, pylori eradication rate following a quadruple therapy firoz amani1, somaye matin1, samira matin1, including omeprazole, bismuth, amoxicillin, and amin bagheri1, elmira matin1 metronidazole in Hormozgan, the most southern 1 imam khomeini hospital, Ardabil University of Medical province in Iran with high rates of H Pylori infection Sciences and its-related disorders. ôÎõAoÅ GýíBoAó ko ìPpôðýlAqôë Gú ìÛBôìQ ìzBølû Gú OõWú GB ølÙ: ô qìýñú Method: One hundred patients with with dyspepsia ìÛBôìQ ô ÎõAoÅ ðýr ô ÞçoüPpôìBüvýò GBæÿ ørüñú ô ÖõoAqôèýlôó GBæÿ and H Pylori infection documented by (13)C-urea oüzúÞñþ Aôë gÈ kokoìBó uéýò @ìõÞvþ ô OPpAuýßéýò Gú ylû ârAo} Þî breath test (UBT) or rapid ureas test were treated with Gú koìHPçüBó oA kAoôüþ osüî4 OBSýpAüò OB ylüî Gp@ó Kýéõoÿ, øéýßõGBÞPp a quadruple regimen containing bismuth subcitrate ðíBüýî. AoqüBGþ ìTHQ H irolyp KLvþ küw (120 mg, 2 tablet/Q12h), amoxicillin (500 mg/Q8h), ¾õoR KLvþ küw yßBüQ GB GýíBo, 881 oôÿ Gp ìÇBèÏú Aüò Gpouþ: oô} metronidazole (250 mg/Q8h), and omeprazole (20 ), DB GývíõR( ), DB OPpAuBüßéýò( 4kAoôüþ osüî GýíBoAó41oôq KnüpÖQ.Gú mg/Q12h) for two weeks. Our primary efficacy outcome was H pylori eradication, established by ðãùlAoðlû koìBó ø×Pú yl.GýíBoAó4 OXõür ) DB ( IPP ô ) DB uýéýò( @ìõÞvþ negative UBT at least four weeks after the end of ÚpAo TBU OdQ GýíBoAó OíBìþ @ó, ÚÇÐ Aq Kw ø×Pú ô2 koüBÖQ ) DB ( IPP

42 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

ìõok @ðBèýr @ìBoÿ ÚpAo âpÖQ. ÚpAo @ìBoÿ @ðBèýr ìõok 61vSSPS GB ðPBüY âpÖPñl. questionnaire was designed in a pilot study for Aq Gýò 881 GýíBo, 47 ð×p (4/93%) ìpk ô 411 ð×p(6/06%) qó ô ìýBðãýò ô qó ð×p(6/06%) 411 ô ìpk (4/93%) ð×p 47 GýíBo, 881 Gýò Aq øB: üBÖPú measuring the KAP, the validity was approved by uñþ 12/21± 34/34 uBë Gõk. ÚHê Aq ypôÑ OXõür kAoô Aq 841 GýíBo(27/87 841 Aq kAoô OXõür ypôÑ Aq ÚHê Gõk. uBë 34/34 12/21± uñþ face validity and the reliability by Cronbach’s Alpha. ko¾l) @ðlôußõKþ Gú Îíê @ìl Þú âBuPpüQ yBüÐ Opüò üBÖPú @ðlôußõKþ @ðùB @ðlôußõKþ üBÖPú Opüò yBüÐ âBuPpüQ Þú @ìl Îíê Gú @ðlôußõKþ ko¾l) The total score of knowledge and practice was , 03 GýíBo(61 03 , TUR GB GýíBo(5/71) 33 GýõKvþ, GB ko¾l) GýíBo(3/46 121 Gõk. calculated from 100. Patients responded to the KAP questionnaire and the Gastrointestinal Symptom OzhýÀ Î×õðQ Î×õðQ OzhýÀ GB ko¾l) GýíBo(2/2 4 ô upôèõsÿ GB ko¾l) TBU Rating Scale. øéýßõGBÞPpKýéõoÿ ko @ðùB ânAyPú yl. 581 ð×p (5/89 ko¾l) ìÇBèÏú oA Gú KBüBó Gú oA ìÇBèÏú ko¾l) (5/89 ð×p 581 yl. ânAyPú @ðùB ko øéýßõGBÞPpKýéõoÿ Results: From 96 patients, 72 responded to the ouBðlû ô 3 GýíBo (5/1%) Gú kèýê upkok ylül ô kok ylül yßî kôoû koìBðþ oA koìBðþ kôoû yßî ylül kok ô ylül upkok kèýê Gú (5/1%) GýíBo 3 ô ouBðlû questionnaires (response rate = 75%). There were 57 ðýíú OíBï ânAyPñl. ko 51 GýíBo ÎõAoÅ WBðHþ ÚBGê Odíê ìzBølû yl Þú yl ìzBølû Odíê ÚBGê WBðHþ ÎõAoÅ GýíBo 51 ko ânAyPñl. OíBï ðýíú adult and 15 children patients (for whom the parents yBüÐ Opüò @ó OùõÑ ko 9 GýíBo(68/4 ko¾l) Gõk. Gõk. ko¾l) GýíBo(68/4 9 ko OùõÑ @ó Opüò yBüÐ responded). The total knowledge score was oüzú Þñþ ìõÖÛýQ @ìýr Î×õðQ ko 371 GýíBo (5/39 ko¾l) ìzBølû yl ô ko¾l ô yl ìzBølû ko¾l) (5/39 GýíBo 371 ko Î×õðQ @ìýr ìõÖÛýQ Þñþ oüzú 51.5±16.3 (6.9 to 84.9), with higher knowledge of the 20/29ko¾l noitnetnI ot taert ô 5/39ko¾l reP locotorp @ðBèýr GB Þñþ oüzú patients in domains of pathophysiology (63.2±25.5) ìdBuHú âpkül. âpkül. ìdBuHú and diet (60.0±18.0). About half of the patients concerned about the quality, taste, appearance, and Aüò ìÇBèÏú ðzBó kAk Þú Aüò osüî ^ùBo kAoôüþ GB ìýrAó oüzú Þñþ oüzú ìýrAó GB kAoôüþ ^ùBo osüî Aüò Þú kAk ðzBó ìÇBèÏú Aüò âýpÿ: ðPýXú energy of gluten free foods. They didn’t trust food GvýBo GBæ, ørüñú KBüýò ô ÎõAoÅ Þî, ìþ OõAðl Gú ÎñõAó üà osüî gÈ Aôë ko ko Aôë gÈ osüî üà ÎñõAó Gú OõAðl ìþ Þî, ÎõAoÅ ô KBüýò ørüñú GBæ, GvýBo stores when they buying gluten free foods. Emotion oüzú Þñþ Aüò Î×õðQ GßBo âpÖPú yõk âpÖPú GßBo Î×õðQ Aüò Þñþ oüzú of the patients were generally positive to their Send Date: 2012/09/30 disease. Total practice score was 55.9±14.3 (17.9 to 82.1). Adherence to gluten free diet was complete, partial, and no adherence in 60.9%, 30.4%, and 8.7% Code: 2384 of the patients, respectively. The most important Category: 4. INTESTINAL causes of non-adherence were the lack of gluten free 4.2 Coeliac disease/malabsorption syndromes and food store. No association was found between food enteropathies knowledge and practice scores. The lack of gluten T-S-071 free food store and time consuming of preparing such Knowledge, attitude, and practice foods were associated with lower practice scores and of Iranian patients with celiac disease higher symptom severity (r = -0.316 and 0.343). Hossein Saneian1, Gilda Granmaye2, Ali Conclusion: The current status of Iranian patients Gholamrezaei1* , Nahid Jamali1, Shirin Moraveji3, with celiac disease regarding their knowledge is not Zahra Bashari4, Masoud Pezeshki3, fair. Their attitude, however, regarding their disease Mohammad Hassan Emami3 reflect the problems they have in seeking and 1 Iranian Celiac Association, Isfahan University of preparing gluten free foods, leading to non-adherence Medical Sciences to the diet. Iranian patients with celiac disease need 2Poursina Hakim Research Institution, Najaf Abad more education about the disease and facilities for Islamic Azad University 3 Poursina Hakim Research Institution, Isfahan University accessing gluten free foods. of Medical Sciences Send Date: 2012/09/02 4 Iranian Celiac Association, Poursina Hakim Research Institution Introduction: Limited data are available on Code: 2385 knowledge, attitude, and practice (KAP) of patients Category: 4. INTESTINAL with celiac disease, and there is no report in this 4.2 Coeliac disease/malabsorption syndromes and regard from Iran. We investigated the KAP among food enteropathies Iranian patients with celiac disease. T-S-072 Method: Patients with celiac disease who have been Quality of life and psychological registered by the Iranian Celiac Society (ICA) in state in Iranian celiac patients Isfahan, participated in this study. An appropriate Ali Gholamrezaei1*, Nahid Jamali1, Pardis

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Adhamian2, Hamideh Aghamohammadi2, Leily Code: 2386 Ghadirian2, Mohammad Hassan Emami3 Category: 4. INTESTINAL 1Iranian Celiac Association, Isfahan University of 4.2 Coeliac disease/malabsorption syndromes and Medical Sciences food enteropathies 2 Iranian Celiac Association, Poursina Hakim Research T-S-073 Institution Prevalence of Inflammatory Bowel Disease 3 Poursina Hakim Research Institution, Isfahan University of Medical Sciences in Iranian Patients with Celiac Disease 1* Introduction: Limited data are available about the Mohammad Hassan Emami , Nahid Jamali1, Ali Gholamrezaei1, Pardis impact of celiac disease (CD) on patients quality of life Adhamian2, Manijeh Mohammadi2 (QOL) and associated factors. We assessed the QOl and 1Poursina Hakim Research Institute, Isfahan University of psychological state of Iranian patients with CD. Medical Sciences Method: Biopsy-proven CD patients (n=57; mean 2 Iranian Celiac Association, Poursina Hakim Research age = 40.3±14.5 yrs, mean disease duration = 3.9±2.7 Institute yrs; range 1-10 yrs; female 75.4%) completed The Introduction: Limited and controversial data are Short-Form 36-Item (SF-36) QOL measure, The available on the association between celiac disease and Hospital Anxiety and Depression Scale (HADS), inflammatory bowel diseases (IBD). We assessed the Gastrointestinal Symptom Rating Scale (GSRS), prevalence of IBD in Iranian patients with celiac disease. adherence to GFD, overall compliance to treatments, Method: Biopsy-proven celiac disease patients who and demographic questionnaire. have been registered between 2002 and 2012 in Results: Patients’ quality of life was significantly Iranian Celiac Association were investigated. Patients lower in most domains compared with age matched who had endoscopic and pathologic evidence of IBD control data from the general population. Anxiety and were identified, and their pathology was reviewed. depression scores were above the cut-off levels (+8) Results: Among 157 adult patients with celiac in 80.7% and 43.9% of the patients. Total SF-36 disease, IBD was identified in 5 cases (3.8%, mean scores were associated with age (-0.375, P = 0.006), age = 34.0±13.8). Three patients had ulcerative anxiety (-0.741, P < 0.001), depression (-0.591, P < colitis and two had Crohn's disease. Celiac pathology 0.001), and GSRS scores (-0.459, P < 0.001). In were included four MARSH III and one MARSH I, multivariate analyses, mental disorder, higher age, and presentations were with diarrhea in three and and more severe symptoms were associated with a with liver dysfunction and amenorrhea in each of the reduced physical summary score of the SF-36, but other patients. Celiac patients with IBD were similar only mental disorder predicted a reduced mental to those without IBD regarding age and gender, but summary score of the SF-36. Adherence to GFD was diarrhea was the major presenting symptom more partial in 63.1% and others were non-adherent to frequently in those with IBD than those without. In GFD. Higher depression scores were associated with two patients with diarrhea, no response to gluten free lower overall compliance, and in turn higher diet lead us to further diagnostic evaluations and the compliance was associated with lower GSRS- final diagnosis of concurrent IBD. Two of the patients indigestion syndrome. Lower adherence to GFD was with IBD also had primary sclerosing cholangitis. associated to GSRS-diarrhea syndrome. Conclusion: Within Iranian patients with celiac Conclusion: Reduced health-related quality of life in disease, IBD is significantly more common than what is Iranian celiac patients is associated with physical expected from the general population. Pathology of symptoms and mental health of the patients. Adherence celiac in patients with concurrent IBD shows a more to GFD and overall compliance to treatments are severe disease in these patients. Diarrhea in a celiac associated with lower symptoms. Further studies with patient non-response to gluten free diet can suggest larger sample sizes are warranted in this regard. concurrent IBD and should be further investigated. Send Date: 2012/09/02 More studies are required on clinical importance of the association between celiac disease and IBD. Send Date: 2012/09/02

44 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

Code: 2387 be due to hepatic failure and malignancies in adults Category: 4. INTESTINAL and intractable diarrhea in children that occurred 4.2 Coeliac disease/malabsorption syndromes and because of incompliance to diet and probably delay in food enteropathies diagnosis. T-S-074 Send Date: 2012/09/02 Mortality and causes of death in Iranian patients with celiac disease Nahid Jamali1*, Mahboobeh Faridan Code: 2389 Esfahani2, Shirin Moraveji2, Masoud Category: 4. INTESTINAL Pezeshki2, Zahra Bashari3, Hossein Saneian3, 4.2 Coeliac disease/malabsorption syndromes and Mohammad Hassan Emami2 food enteropathies 1Iranian Celiac Association, Poursina Hakim Research T-S-075 Institute First Round on the Iranian Celiac 2 Poursina Hakim Research Institute, Isfahan University of Association Guideline on Diagnostic Medical Sciences Approach and Follow-up Protocol of 3Iranian Celiac Association, Isfahan University of Medical Sciences Patients with Celiac Disease 1* 2 Introduction: Celiac disease (CD) is one of the most Mohammad Hassan Emami , Nahid Jamali , Hossein 1 3 4 prevalent autoimmune gastrointestinal disorders, but Saneian , Manoochehr Khoshbaten , Kamran Rostami , Mohammad Rostaminejad5, Jalal Hashemi6, Adnan diagnosis is often delayed or missed. Patients with Zadhush2, Ali Gholamrezaei1, Azita Ganji7, Hamidreza CD have an increased risk of death from Sima7, Akram Pourshams8, Hamed Daghaghzadeh9, gastrointestinal malignancies and lymphomas, but Mehdi Salak9, Mehdi Seyed Mirzaeei10, little is known about mortality from other causes and Mohammad Zali11, Reza Malekzadeh8 few studies have assessed long-term outcomes in our 1Poursina Hakim Research Institution, Isfahan University society. We evaluated mortality and the cause of of Medical Sciences death in registered patients with celiac disease in 2Iranian Celiac Association, Poursina Hakim Research Isfahan celiac research center as a branch of Iranians Institution 3 Celiac Association (ICA). Iranian Celiac Association, Tabriz University of Medical Method: A document review and telephone interview Sciences 4School of Medicine, University of Birmingham was done for patients with CD who have been 5Research Center for Gastroenterology and Liver Disease, diagnosed and registered in ICA from 2002 to 2012, Shahid Beheshti University of Medical Sciences including 157 adult and 70 children patients with 6Iranian Celiac Association, Ahvaz University of Medical definite CD. Disease related causes of death was Sciences investigated. 7Iranian Celiac Association, Mashhad University of Results: Six patients died during the evaluation Medical Sciences period because of a disease including 5 adult patients 8Iranian Celiac Association, Tehran University of Medical and one child. Presentations were diarrhea in 2 (40%) Sciences 9 and liver dysfunction in 3 (60%) of the adults and Iranian Celiac Association, Isfahan University of diarrhea in the child. Of the adults, only one patient Medical Sciences 10Iranian Celiac Association, Kerman University of followed gluten free diet (GFD) completely, and the Medical Sciences others were partially adherent. The child was 11Iranian Celiac Association, Shahid Beheshti University completely adherent to GFD. The direct cause of of Medical Sciences death was diarrhea in the child, cirrhosis in three Introduction: We aimed to prepare a guideline on adults, adenocarcinoma and primary abdominal diagnostic approach and follow-up protocol of lymphoma in each of the other adult patients. patients with Celiac disease in our society. Conclusion: Mortality from celiac disease in our Method: For this aim, current guidelines were geographical area is increased compared with the reviewed and a primary guideline was developed general population, and this increased risk seems to based on our experiences with celiac patients in

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Iranian Celiac Association (ICA), including pitfalls on 60 patients with microscopic colitis (pathologically of diagnosis and treatment we observed during about approved) and 120 age and sex matched control group 10 years from 2002. Also, related data from our referred to Sanandaj Tohid hospital in 1391. The studies and those from others that were done in Iran control group was selected from family members of on celiac disease epidemiology, diagnostic tests, and patients that had been admitted in ENT ward; not etc. were considered. The guideline was then tested suffering from any GI problem (like diarrhea), weight for one year and revised accordingly. loss or anemia (the anemia was excluded by a CBC Results: The ICA guideline includes diagnostic test). Demographic data was taken and documented approach for patients suspicious to celiac disease and whenever the patients referred to the clinic and Blood follow-up protocol that are useful for both specialized sampling for measuring the Ig-G anti gliadin and and general physicians. It is now sent to experts in the Ig-A anti tissue trans glutaminase level (By Eliza field for their opinions and will be revised in a method) was performed for them. Once one of the consensus, parallel with the congress. The guideline antibodies became positive, “positive serology” term is available from www.celiacngo.ir. was used in this study. The prevalence of positive Send Date : 2012/09/02 serology was compared statistically in patient and control groups. Results: From 60 patients with microscopic colitis Code: 2400 (32 male, 28 female) 53 had lymphocytic and 7 cases Category: 4. INTESTINAL had Collagenous colitis. 4.2 Coeliac disease/malabsorption syndromes and From patients with lymphocytic colitis twenty food enteropathies four(45%) and from patients with Collagenous T-S-076 colitis three patients(42%) had positive serology for Comparison of prevalence of celiac serology anti celiac antibodies (45% of all patients with between patients with microscopic colitis and microscopic colitis). normal population in Kurdistan province From 120 healthy cases (64 male, 56 female) 19 Amir Taheri1*, Mohsen Nikandish1, Farshad persons (15.8%) were positive for Celiac serology. 1 1 2 Sheykhesmayeeli , Bahram Nikkhoo , Elham Farhangi The mean age was 35.8 ±13.1 for the patients with 1 kurdistan digestive disease center, kurdistan university of microscopic colitis and 35.1 ±12 in healthy cases. medical science From 23 patients with pathologically proved 2Private clinic, kurdistan university of medical science Introduction: Celiac disease is one of the most microscopic colitis, for whom small intestine biopsy important malabsorption diseases, caused by the had been performed either, 13 cases (56.5%) were reaction to Gluten and resulting inflammation in the positive for criteria of celiac disease in their duodenal small intestine. Increased intraepithelial lymphocyte biopsy. Conclusion: (IEL) is one of pathologic changes in celiac disease. In this study the rate of positive serology The most important pathologic change in lymphocytic tests for Celiac disease was higher significantly in colitis (one type of microscopic colitis) is also increased patients with microscopic colitis comparing to the number of IEL. This similar pathologic change poses healthy individuals in Kurdistan province. So it is some correlation between microscopic colitis and wisely to recommend evaluating any patient with celiac disease (pathologically, epidemiologically and microscopic colitis for coincident celiac disease, or etiologically). So this study was designed to especially if symptomatic relief not achieved after evaluate any epidemiological co incidence between ordinary treatment of microscopic colitis. Also it can microscopic colitis and positive serology of anti be recommended to evaluate any patient with celiac antibodies. It is crystal clear that further refractory celiac disease for having coincidental evaluations with pathologic confirmation of celiac microscopic colitis. Send Date: 2012/09/03 disease need in order to pose any correlation between celiac and microscopic colitis. Method: This case control study has been performed

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Code: 2495 ΙΙ and 114 patients with Marsh ΙΙΙ including (43 ΙΙΙa Category: 4. INTESTINAL , 36 ΙΙΙb , 35 ΙΙΙc). TTG serum has been elevated in 4.2 Coeliac disease/malabsorption syndromes and 113 patients ( > 15 ) . EMA was positive in 95 food enteropathies patients which were examined for it and 33 have T-S-077 elevated AGA antibody (>10). The Clinical Presentation Conclusion: Classic symptoms of celiac disease are of Iranian Celiac Disease rarely seen today. we concluded that atypical Gholamreza Hemassi1*, Masoudreza sohrabi1, presentation of celiac disease is the important reason Farhad Zamani1, Mahmood reza Khansari1, Hossein for misdiagnosing of celiac and causes increasing Ajdarkosh1, Mitra Ameli1, ali Sadeghi1, prevalence for celiac. These non specific symptoms 1 1 SHIMA Alizadeh , Afsaneh Setareh cause delay in diagnosis or not well managing for CD 1 Gastrointestinal and Liver disease research center Most of the patients were under symptom therapy (GILDRC),Firoozgar hospital, Tehran without any documented diagnosis. Some of them Introduction: Celiac disease (CD) is characterized had been referred to gastroenterologist with by small intestinal malabsorption of nutrients. The complication such as lymphoma, severe anemia or clinical presentation of celiac disease is remarkably cirrhosis. We concluded that celiac is being missed varied and that is why CD described as iceberg. The among physician and internist and just been clinical presentation of celiac disease dependent to diagnosed in gastroenterology center and this is age and duration of disease, but the patient may be because lack of organized referral system for CD found without any symptom in screening program. diagnosis. Knowledge and thinking of physician about CD is Send Date: 2012/09/30 important for diagnosis of CD. The AIM of this study is the description of clinical presentation and paraclinical findings of celiac disease in Firoozgar Code: 2543 Hospital, a general referral Hospital in Tehran, Iran Category: 4. INTESTINAL Method: We determined 133 patients with CD in a 4.2 Coeliac disease/malabsorption syndromes and descriptive case-series study from 2005 to 2012. food enteropathies .Data including demographics, clinical symptoms, T-S-078 past medical history, associated disorders and Comparative study of histopathological laboratories finding(serologic markers{anti-TTG, Marsh grading with body mass index (BMI) AGA, EMA} ,CBC, Ferrittin) of 133 patients with in celiac disease in IRAN CD collected by a trained physician using a structured Ali Sadeghi1*, Farhad Zamani1, Masoudreza Sohrabi1, questionnaire. Upper endoscopic and biopsy had been Shima Alizadeh1, Hossein Kiyvani1, Afsaneh Setareh1 done for all suspected cases according to the clinical 1Gastrointestinal and Liver disease research center or paracliniacal findings. The diagnosis of CD was (GILDRC),Tehran made by at least two serologic markers and histologic Introduction: Anorexia is a classic symptom of CD. finding according to MARSH classification However recently the trends of societies are toward Results: The mean age of patients was 42 years from weigh gain and obesity which could mask CD 3.5 to 70 years old and 60% were men and 40 % were presentation. This study aimed to establish the women. The most common chief complaint was correlation between BMI and severity of CD accord- diarrhea in 57 patients (43%) .The other chief ing to Marsh classification. complaints including significant weight loss (8), Method: Patients demographics, clinical presentation Anemia (26), chronic fatigue (12),constipation (8), , and Body Mass Index (BMI) recorded and reflux (8),chronic dyspepsia (8), recurrent statistically analyzed . Endoscopic biopsy was abortion(2), infertility(1), cirrhosis (1), ulcerative performed in all patients. colitis (1), chronic intestinal pseudoobstruction (1). Results: Age of participants varied from 3.5 to 87 Endoscopy was reported by Marsh Classification. 3 years. out of 122 CD patients diagnosed between patients classified as Marsh Ι. 6 patients with Marsh

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2005 and 2012, 73 patients were female and 49 male pathologists about adult CD, especially in its atypical .Body mass indexes (BMI) of participants in "Grade forms will aid in diagnosing more cases from the 1 and 2" group were higher than other marsh grade "celiac iceberg". groups (P < 0.05). Send Date: 2012/10/01 Conclusion: We determined the correlation between severity of CD and BMI , and the patients with higher grade in marsh classification were gone underweight Code: 2341 and so we suggest the need for a careful follow-up of Category: 5. IBD nutritional status after diagnosis of CD. 5.2 Etiology/epidemiology Send Date: 2012/10/01 T-S-080 Frequency of clinical and demographic characteristics of Inflammatory Bowel Code: 2552 Disease patients in Guilan province Category: 4. INTESTINAL and produce an IBD Database 4.2 Coeliac disease/malabsorption syndromes and Fariborz Mansour-Ghanaei1*, Farahnaz Joukar1, food enteropathies Masoomeh Shekarriz Foomani 1 T-S-079 1Gastrointestinal and Liver Diseases Research Center of Correlation between histopathological Guilan University of Medical Sciences Introduction: marsh grading and anti-TTG In respect to importance of inflammatory among celiac disease patients bowel diseases in different countries in recent decades, Mahmood reza Khansari1*, Masoudreza sohrabi1, the goal of this study was evaluation of frequency of Hossein Ajdarkosh1, Ali Sadeghi1, Gholamreza Hemassi1, clinical and demographic characteristic of IBD Farhad Zamani1, Afsaneh Setareh1 including & ulcerative colitis crohns disease patients 1Gastrointestinal and Liver disease research center and preparation of databank for this disease in Guilan (GILDRC), Firoozgar Hospital, Tehran Province. Introduction: CD screening is faculted by IgA based Method: Patients diagnosed as inflammatory bowel tests including CD anti-TTG antibody. Diagnosis is disease and referred to gastrointestinal tertiary cen- based on histological characteristics changes based ter were included in this study. Databank in 28 pages on March scoring system.The aim of this study was was created. to investigate the correlation between anti –TTG Results: Among 55 patiens, 45(81.8%) and antibody and march grading score. 10(18.2%) were Ulcerative colitis and Crohn’s Method: The subjects refer to Firoozgar hospital with disease, respectively. Mean age and standard CD before treatments were included. The IgA deviation of patiens with Crohn’s disease and anti-TTG antibody was measured for all of them by Ulcerative colitis 36.6±15.9 and 43.2±11.95, ELIZA technique. The eligible cases underwent respectively. Sixty percent of patients were female. upper endoscopy and biopsy of duodenum. The None of the patients with Crohn’s disease and a total specimens were evaluated and classified on March of 39(86.4%) of patiens with IBD had never smoked. grading Score. The most common symptom in Crohn’s disease and Results: Age of participants varied from 3.5 to 87 Ulcerative colitis was abdominal pain.The most years with mean of 35.4 ± 15.4.Of them40.2% were common site of involvement in Crohn’s disease and female .It was not a significant correlation between Ulcerative colitis was small bowel and H sidedcolitis, age and sex and marsh grading score (P > 0.05). It respectively. was an correlation between Anti-tTG levels and Conclusion: Due to chronicity of IBD and necessity "grade 3c(P= 0.02) also we find an association for frequent visit and follow up of these patients, between ant-TTG level with grade 1,2,3a ( P= 0.049). creation of a clinical databank will be an inevitable Conclusion: Anti-TTG levels have been proven to issue. correlate with increasing severity of mucosal Send Date: 2012/08/15 damage. Increased awareness among clinicians and

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Code: 2407 Farzinezhad2, Saeed Yazdani3, Seyed Saeed Category: 5. IBD Sarkeshikian1, Abolfazl Iranikhah1 5.2 Etiology/epidemiology 1Gastroenterology and hepatology Section T-S-081 Qom University of Medical Sciences, Qom, Iran 2 Musculoskeletal manifestations GeneralPhysician,AZAD QOM medical university, QOM, Iran, Qom Azad University of Medical Sciences, of inflammatory bowel disease Qom, Iran in Iranian patients 3 Gastroenterology and hepatology Section 2* 1 Mohammad Hassan Emami , Ali Mohammad Fatemi , Qom Azad University of Medical Sciences, Qom, Iran 2 2 Hourossadat Hashemijazi , Kazemizadeh Amir Introduction: Inflammatory bowel disease (IBD) is 1 Department of Rheumatology, Isfahan University of an immune-mediated chronic intestinal condition. Medical Sciences Ulcerative colitis (UC) and Crohn's disease (CD) are 2 Poursina Hakim Research Institution, Isfahan University of Medical Sciences the two major types of IBD.unfortunately,The true Introduction: The most common extra-intestinal epidemiologic profile of IBD in Iran is still unknown. manifestations of IBD are musculoskeletal disorders. Age ,Sex ,History of Appendectomy and Tonsilectomy There are rare information about epidemiology and in patients,OCP and Alchoholusing, Cigarrettsmoking, pattern of musculoskeletal involvement in Iranian Family history of IBD, Chief complaint of paitients, population. Our goal in this study was to determine Demographic and clinical features, extraintestinal demographic pattern, the prevalence and clinical manifestations, The mean lag time between the onset spectrum of musculoskeletal complication of IBD in of complaints and confirmationof diagnosis of 204 Iranian patients. patients with ulcerative colitis (UC), 32 with Crohn’s Method: 350 definite cases of IBD were interviewed disease (CD) were assessed retrospectively. Method: and examined by a rheumatologist and followed for This was descriptive, analyticalcross- one year for the evaluation of rheumatologic sectional study, including236 patient with IBD manifestations. For patients with active arthritis (UC&CD) diagnosis referral to GI clinic's of QOM HLA-27, P-ANCA, C-ANCA, ANA, ASCA, ESR from 2007-2011.The exact course of physicians’ and CRP were recommended. visits of 100 IBD patient was asked through face- Results: In 350 patients with IBD,162 female and to-face interviewand analyzed with statistical test. Results: 188 male, four patients had at least one active Mean age at diagnosis was 35.39 years in arthritis, three of them with peripheral involvement UC and 33.03 years in CD patients. The male to ,one with AS. Five patients had a history of peripheral female ratio was 1 for UC and 1.28 for CD. The arthritis but no active involvement. One patient had percentage of CD and UC patients who were Fibromyalgia. Three patients expired and one left the non-smokers was 87.3% and 87.5%, respectively. study. Patients with UC presented with rectal bleeding Conclusion: Our study shows a low prevalence of (64.2%), whereas those with CD complained of musculoskeletal manifestations in Iranian IBD abdominal pain (65.6%). Among UC patients, patients. The clinical spectrum is just that defined by proctosigmoid was affected in 47%.The mean lag spondyloarthropathy criteria. time between the onset of symptoms and definite Send Date: 2012/09/04 diagnosis was 13.8 and 20.56 months for UC and CD patients, respectively. Conclusion: The demographic and clinical picture of Code: 2475 IBD is more or less the same as that of other developing Category: 5. IBD countries; however, the rarity of CD in Iran is noted.In 5.2 Etiology/epidemiology this study we clarified IBD.we need more studies for T-S-082 determination of indication of epidemiologic statusof it Inflammatory bowel disease more carefully. Key words:Inflammatory bowel disease, in center of Iran,Qom Crohn’s disease, epidemiology, ulcerative colitis. Mohammad Reza Ghadir1*, Mohammad Mehdi Send Date: 2012/09/28

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Code: 2562 Studying association between Category: 5. IBD C3435T gene polymorphism 5.2 Etiology/epidemiology in the MDR1 gene and ulcerative colitis T-S-083 Mojgan Mohammadi1, 4, Mohammad Mahdi Epidemiology of Inflammatory Hayatbakhsh2*, Mohammad Javad Zahedi2, Bowel Diseases (IBD) in Iran: Payam Khazaeli3, Amin Reza Nikpoor4, Mahdi Nazem3 A review of 740 patients in Southern Iran 1 Physiology Research Centre, Kerman University of Alireza Taghavai1, Alireza Safarpour1*, Medical Sciences, Kerman, Iran 2 Seyed Vahid Hoseini2, Maral Safarpour3 Department of Gastroenterology, Afzalipour Hospital, 1Gastroenterology research center, Shiraz University of Kerman University of Medical Sciences, Kerman, Iran 3 Medical Sciences School of Pharmacy, Kerman University of Medical 2 colorectal research center, Shiraz University of Medical Sciences, Kerman, Iran 4 Sciences Department of Microbiology, Virology and Immunology, 3 pharmacy ward, Shiraz University of Medical Sciences Medical School, Kerman University of Medical Sciences, Introduction: To study of recent epidemiological Kerman, Iran Introduction: Ulcerative colitis (UC) is an aspects of patients with Inflammatory Bowel Disease inflammatory disorder with unknown cause in which (IBD) in the southern parts of Iran the data from a genetic, immunological and environmental factors population based registry of Inflammatory Bowel may be involved. P-glycoprotein is an important Diseases were analyzed, retrospectively. factor in the deposition of many drugs and toxins Method: Between 1989 and 2010, 740 patients with from cells and is expressed by MDR1 gene. MDR1 IBD, 620 ones with ulcerative colitis (UC) and 120 gene polymorphisms such as C3435T are correlated ones with crohn’s disease (CD), were diagnosed as with low P-glycoprotein expression and susceptibility IBD cases and referred to our center.Their for UC. demographic characteristics, disease related Method: 85 UC patients and 100 healthy ethnically manifestations, complications, and chief complaints matched controls were enrolled in our study. were analyzed. PCR-RFLP method was recruited to detect C3435T Results: The mean age at diagnosis was 34.68±1.44 gene polymorphism in MDR1 gene. (range: 8 – 79 years) for UC patients and 32.97±1.34 Results: There was no association between C3435T (range: 9 – 80 years) for CD ones. The male/female gene polymorphism in MDR1 gene and susceptibility ratio was 0.9/1 and 0.98/1 for UC and CD patients, of ulcerative colitis (p value = 0.71) in our population. respectively. In comparison to rural patients, more Conclusion: Association between C3435T gene urban ones with both UC and CD were registered polymorphism in the MDR1 gene and ulcerative (86.4). colitis has been reported in several western Conclusion: An obvious increase in the number of populations. However there is also a controversy IBD patients has been detected in our population regarding the above-mentioned polymorphism during the past decades. This can be attributed to studies with UC. For example our results are similar either improvement in the patients’ and the to the published data from Milan population, but also physicians’ knowledge and availability of diagnostic are not in agreement with results of genetic study in tools or a real increase in the incidence rate of the Tehran, Iran, which might be related to heterogeneity disease. Send Date : 2012/10/01 of Iranian populations and sample size of various studies. We suggest that increasing the sample size for future genetic studies might have influence on the accuracy of data with regard to ulcerative colitis Code: 2428 disease in the population of south east of Iran. Category: 5. IBD Send Date: 2012/09/10 5.3 Genetics T-S-084

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Code: 2497 patient compared with 55.3% of healthy subjects. Category: 5. IBD Conclusion: In this study we have evaluated a SNP 5.3 Genetics polymorphism (C3435T) in IBD; Interestingly, In T-S-085 contrast with other studies in IRAN, a significant Multidrug resistance 1 gene polymorphism association was found between the MDR1 C3435T and susceptibility to inflammatory bowel polymorphism and patients from Iranian Azeri Turk disease in Azeri patients from northwest of Iran ethnic group in northwest of Iran with (OR = 1.88; Sousan Mir Najde Gerami1*, Morteza 95% CI: 0.88-4.05). Jabbarpour Bonyadi1, Mohammad Hossein Send Date: 2012/09/30 Somi1, Manouchehr Khoshbaten1 1Liver& Gastrointestinal Disease Research center, Tabriz university of Medical Science Code: 2366 Introduction: The Multidrug resistance 1 gene is an Category: 6. COLONIC AND ANORECTAL DIS- attractive candidate gene for the pathogenesis of ORDERS inflammatory bowel disease (IBD) and response to 6.1 Malignant disease - pathogenesis therapy, with evidences at both functional and genetic T-S-086 levels. MDR1 produces the P-glycoprotein (P-gp) Evaluation of methylation of MGMT that acts as a transmembrane efflux pump thus (O6- methyl guanine methyl transferase) influencing disposition and response of many drugs, gene promoter in sporadic colon cancer some of whom (i.e. glucocorticoids) central to IBD Hassan Farzanefar, Hassan vossoughinia1, Hossein therapy. In addition P-gp is highly expressed in many Ayatollahi1, Raheleh Jabini2, Mohammad Reza epithelial surfaces, included gastrointestinal tract Farzanefar1*, Hassan Saadatnia1, Alireza Tavassoli1, (G-I) with an assumed role in decreasing the Monavvar Afzal Aghaei1, Ahmad absorption of endogenous or exogenous toxins, and Khosravi Khorashad1, Mitra Ahadi1 host-bacteria interaction. Many genetic variations of 1 Ghaem hospital, Mashhad university of medical sciences 2 MDR1 gene has been described and in some Pharmacy faculty, Mashhad university of medical instances evidences for different P-gp expression as sciences Introduction: Sporadic colorectal cancers often arise well drugs metabolism have been provided. from a region of cells characterized by a “ field defect However data are often conflicting due to genetic ” that has not been well defined molecularly. DNA heterogeneity and different methodologies employed. methylation has been proposed as a candidate Studies investigating MDR1 gene polymorphism and mediator of this field defect. The DNA repair gene O predisposition to IBD have also shown conflicting 6 -methylguanine-DNA methyltransferase (MGMT) results, owing to the known difficulties in complex is frequently methylated in colorectal cancer. We diseases, especially when the supposed genetic hypothesized that MGMT methylation could be one contribution is weak. of the mediators of field cancerization in the colon Method: Our main objective was to evaluate the MDR1 mucosa. gene polymorphism at C3435T in inflammatory bowel Method: We studied MGMT promoter methylation disease. The present study included 173 IBD and 85 percent by real-time Quantitative Methylation- age-sex matched control samples for the analysis of Specific PCR (QMSP) and bisulfite-based techniques MDR1 C3435T polymorphism, by the PCR-RFLP in tumor, five and ten centimeter distance of tumor method. from 40 known case patients with colorectal cancer in Results: The MDR1 genotype distribution revealed four Stage (Ten patients in each stage ) and in colon an evaluated frequency of the CC genotype in IBD mucosa from 30 subjects with no evidence of cancer. cases (25.4%) as compared to control (15.3%). The Statistical tests were two-sided. homozygous TT genotype was observed in 24.9% Results: MGMT promoter methylation was present and 29.4% of case and control respectively. The in 27.5% of the tumors. Patients whose cancer had heterozygous CT genotype was found in 49.7% of MGMT promoter methylation also had substantial

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MGMT promoter methylation in 5centimeter distant through production of carcinogens, cocarcinogens of tumors(12.5% )and in 10 centimeter distant of and pro carcinogens. In fact colon is a place for tumors(10%). Mean MGMT promoter methylation complex variety of microorganisms that is critical for percent was 6.25±17.02 of tumors and 0.86±0.36 normal health and alteration in balance challenges the from subjects with no evidence of cancer(p<0.001) normal role of these microorganisms colonization. (T-test).But in comparison of mean MGMT promoter Method: This case control study were carried out methylation percent between four stages of patients from October 2010 till August 2011 on 77 out there was not significant statistical difference patients include 42 colorectal cancer and 35 control (p=0.06) .Comparison of mean MGMT promoter group. A questionnaire was completed for routine methylation percent between three grades of tumors dietary intake in two groups. One week following there was not significant statistical difference colonoscopy 4 gram stool sample was obtained and (p=0.175) (T-test) cultured immediately within 5 minutes of samplings Conclusion: Mean MGMT promoter methylation . Incubation was done for 25 to 48 hours for aerobic percent significantly increased in patients with and 72 hours for anaerobic culture in oxygen free jar. colorectal cancer in comparison from subjects with All colonies particularly four bacterial species were no evidence of cancer,but between stages and grades calculated include Entrococcus spp. and Streptococcus Mean MGMT promoter methylation percent is not Bovis, Eschreshia colli , Bacteroid fragilis. All significant. individuals were asked about routine basal weekly di- Send Date: 2012/08/23 etary habits includes meat, fresh vegetables, fruits and dairy in last year. Statistical analysis was performed to determine correlation of intestinal flora Code: 2462 and diet in colorectal cancers and comparing with Category: 6. COLONIC AND ANORECTAL DIS- normal individuals. ORDERS Results: In our study airobic bacterial count was 6.1 Malignant disease - pathogenesis higher in cotrol group . There was no significant T-S-087 difference between two groups in total colony count Is There any Correlation Between (sum of aerobic and anaerobic counts).Comparing Colorectal Cancer and intestinal flora? particular species of bacteria between two groups Abbas Esmaeilzadeh, Azita Ganji1*, Ghobad revealed just significant difference for streptococcus 1 2 Abangah , Kiarash Ghazvini , Kamran bovis (P-value=0.003), and no significant difference 3 3 Ghafarzadegan , Zahra Hejazi in Bacteroid fragilis,Entrococcus and Escherichia 1 Gastroenterology, Mashhad University of Medical coli. There was significant difference in meat sciences 2 Microbiology and Virology Research Center, consumption between two groups and aerobic colony Mashhad University of Medical sciences count bacteria. Association of aerobic colony count 3 Moayed Research center, Mashhad University of and dairy consumption was not significant but Medical sciences individuals with more consumption showed higher Introduction: Colorectal cancer is the most common counts for bacterial flora. gastrointestinal cancer and the second leading cause There was significant difference between weekly of cancer death .Risk factors of colorectal cancer fresh vegetables and fruits consumption and include both hereditary and environmental Factors. Steptococcus bovis (P-value=0.042), and other three Dietary habits and intestinal flora have been bacteria did not show any association. There was no discussed in several studies lately. It has been significant difference in aerobic and anaerobic counts reported that dietary factors as nonhereditary factor in proximal and distal colon cancers but their counts affect on intestinal flora and effect of diet on were lower in diagnosed proximal cancers compared carcinogenic process could be mediated by with distal colon cancer. composition of colonic micro flora . Intestinal Conclusion: Our study provides evidence that diet bacteria could play a part in initiation of colon cancer and intestinal flora can play a role in promotion and

52 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 aggravation of mucosal health and we found positive may be low in Indonesia these molecular alterations correlation of colorectal cancer and low aerobic have occurred largely in young female patients. colony counts. We found correlation between Strep Send Date : 2012/10/02 .Bovis and colorectal cancer and even between less consumption of vegetables and more Strep. Bovis Send Date: 2012/09/26 Code: 2413 Category: 6. COLONIC AND ANORECTAL DIS- ORDERS Code: 2576 6.2 Malignant disease - diagnosis/histopathology Category: 6. COLONIC AND ANORECTAL DIS- T-S-089 ORDERS Rapid detection of Glutathione 6.1 Malignant disease - pathogenesis S-transferase Theta1 gene variant on the T-S-088 LightCycler by hybridization probes KRAS Mutation and BAT-26 and outcome of colorectal cancer (Microsatellite Instability) in Young Monireh Aghajany-Nasab1*, Ahmad Movahedian2, Indonesia Colorectal Cancer Patients Siamak Mirab Samiee3, Mojtaba Panjehpour2 Abdullah M1, Utomo AR2, Handjari DR3, Syam AF1, 1 Clinical Biochemistry Department, Guilan university of Fauzi A1, Sastranegara F2, Wicaksono BD2, Sandra F2, medical sciences Cornain S2,3, Rani AA1 2 Clinical Biochemistry department , Isfahan University 1 Division of Gastronterology, Department of Internal of Medical sciences Medicine. Faculty of Medicine, University of Indonesia, 3 Food and Drug laboratory research center, Minestry of Jakarta, Indonesia Health and Medical Education 2 Stem Cell and Cancer Institute, PT Kalbe Fama Tbk. Introduction: Glutathione S-transferase Theta Jakarta. Indonsia (GSTTs) are detoxifying enzymes encoded by a set 3 Department of Pathology, Faculty of Medicine. of polymorphic genes. Wide variety of free radicals, University of lndonesia, Jakarta, Indonesia carcinogens and chemotherapeutics are the substrates Introduction: Significant numbers of Indonesian of GSTs. Gene deletion of GSTT1 is expected to have colorectal cancer patients are younger than 40 years old. an impaired ability to metabolically eliminate To determine the molecular alterations in these patients, carcinogens and free radicals. The aim of this study we evaluated the status of KRAS and 84T-26. was to investigate the possible effect of GST Theta1 Methods: Tumour DNA samples were isolated from null genotype on susceptibility to developing clinical 43 sporadic cases of whom 16 young patients (<=40 outcome of colorectal cancer in a group of CRC yrs) and 27 old patients (>=60 yrs). KRAS mutations patients in comparison to age and gender matched were screened using PCR High Resolution Melting control group. followed by DNA sequencing. Microsatellite in Method: DNA was extracted from blood of 140 CRC stability (MSl) was tested using patients and 90 healthy individuals and a set of PCR with BAT-26 primers. sequence specific hybridization probes was used for Results: Tumour DNA isolated from 43 evaluable GSTT1 genotyping by real-time PCR in Light-Cycler patient samples were screened for KRAS and MSl. instrument. Chi-squared test was used to assess the Overall KRAS mutation rate was 16.3% with Young statistical significance of observed differences between patients (2s%) have slightly higher rate than old the patient and control subjects of different genders and patients 11.2% (p>0.05) MSI was found in 2 out of 13 ages. To estimate the risk for overall and stratified young patients (15%) and None in old patients. analyses, odds ratios (OR) with 95% confidence intervals Young female patients have higher rate of either (CI) computed with logistic regression. KRAS mutation or MSI (40%) than old female Results: The differences between GSTT1 null patients (19%) (p=0.014). Molecular alteration has genotype in case and control groups was not not been found in male patients yet. significant (p-value=0.5). No significant association Conclusions:While overall KRAS mutation or MSI was found (P>0.05) between the GSTT1 null

Govaresh\ Vol.17\ Supplement\ Autumn 2012 53 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 genotype with tumor site (right, left, rectum). No them. We used t-test for descriptive variables and significant trend was observed between GSTT1 null Chi-square tests to compare categorical variables. genotype frequency and tumor differentiation (well, Results: In this study 3650 patients were enrolled and moderately, p-value 0.5). all of them underwent complete examination of the Conclusion: The analysis of the GSTT1 in 230 DNA colon. From 1984 males (54.3%) and 1666 females samples with this LC assay revealed that this method (45.7%), mean age of our patients was 48.7±18.6 [5- is reliable for high throughput analysis of this key 100]. The risk factors most likely to be associated polymorphism in the GSTT1 gene. Our findings with a finding of colorectal cancer were rectorrhagia suggest that the GSTT1 null genotype may not (34%), abdominal pain (18.4%), diarrhea (17.9%), contribute to colorectal cancer development in this constipation (12.6%), anemia (9.1%), history of CRC study groups. (7.3%) and positive fecal occult blood test (0.7%), Send Date: 2012/09/05 respectively. From those who had rectorrhagia 52.7% were males and 47.3% were females. Polyps were detected in 545 patients (15%). From those who had Code: 2442 polyp 326 patients were male (59.8%) and 219 Category: 6. COLONIC AND ANORECTAL DIS- patients were female (40.2%). Most common ORDERS location of polyp was in rectum (26.5%). Other 6.3 Malignant disease – management colonoscopy findings were hemorrhoid (78.1%), skin T-S-090 tag (8.7%), anal fissure (6.5%), diverticule (4.6%) Positive colonoscopy findings for colorectal and lesions (2.1%), respectively. From those who had cancer in relation with age and gender hemorrhoid 52.6% were males and 47.4 were Mohammadhossein Somi2, Mohammadreza females. From those who had history of colorectal 1* 2 Abdollahi , sepideh lotfi sadigh , Morteza cancer 56.4% were males and 43.6% were females. 3 2 Ghojazadeh , Behnaz Hossein Torabi , Mahsa Conclusion: There was a significant relation between Khademi2, Mohammad Naghavi Behzad2 CRC risk factors and male gender. Most frequently 1 Young Researchers Club,Tabriz Branch, Islamic Azad University of Tabriz associated with positive colonoscopy findings were 2 Liver and gastrointestinal diseases research center, Tabriz rectorrhagia, presence of abdominal pain and history University of Medical Science of CRC. A history to include these risk factors can 3 Physiology Department, Tabriz University of Medical serve to prioritize the need for a colonoscopic Science examination. Introduction: Colorectal cancer (CRC) is a major Send Date: 2012/09/20 cause of morbidity and mortality throughout the world. It is the third most common cancer worldwide and the fourth most common cause of death. Code: 2345 Colonoscopic screening has been recommended for Category: 6. COLONIC AND ANORECTAL DIS- all persons who have had a colorectal adenoma or ORDERS carcinoma. Colonoscopy has the advantage of 6.4 Other colonic and anorectal disorders allowing biopsy and/or removal of lesions during the T-S-091 same procedure. In this study we aimed to analyze Colonoscopic findings in patients the colonoscopy results of 3650 patients for CRC risk with hematochezia factors and find the relation of them with age and Taghi Amiriani1*, Narjes Mozafari1, Gholamreza gender. Roshandel1, Sima Besharat1 1 Method: All records (n=3650) patients undergoing Golestan University of Medical Sciences, Golestan colonoscopy from 2008 to 2012 at Tabriz University Research Center of Gastroenterology and Hepatology Introduction: Hematochezia refers to passage blood of Medical science were analyzed. We also evaluated per rectum commonly originating from lower the age, gender, having polyp, signs and symptoms, gastrointestinal tract. Several lesions could cause other colonoscopy findings and relationship between hematochezia which benign etiologies are common

54 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 among them. Seyed Mirzaee1, Hamid Najafipoor2, Lower GI endoscopy is the examination of choice for Ali Akbar Haghdoost3, Azadeh Mahmmoodi1, diagnosis. This study was designed to evaluate the Azadeh Mahmmoodi1 1 lesions cause hematochezia and associated symptoms. Afzalipoor Hospital, Kerman University of Medical Method: In this cross-sectional study, one hundred Science, Kerman, Iran 2 Physiology Reserch Center, Kerman University of and seventeen patients presenting with hematochezia Medical Science, Kerman, Iran and underwent colonoscopy at 5-Azar Hospital, 3 School of Public Health, Kerman University of Medical Golestan province, Northeast of Iran during 2010. Science, Kerman, Iran Biopsies were taken. Cases with a positive personal Introduction: Irritable bowel syndrome (IBS) is the history of colorectal cancer or inflammatory bowel most prevalent gastrointestinal functional disorder, disease and those with a suspected source of upper characterized by non-specific symptoms such as GI were excluded. Associated symptoms (abdominal abdominal pain and discomfort, altered bowel habit pain, weight loss, diarrhea, constipation) were and bloating .Its prevalence varies between 3.5 to 30 recorded. Data were entered into SPSS-16 software percent in the world .This study was conducted in and a descriptive analysis was done. order to determine of prevalence of IBS in the adult Results: Sixty seven females and 50 males with a population of Kerman city, which is a representative of mean (±SD) age of 44.7 (± 16.1) years (range= 18-87 population living in southeast of Iran, in 2010-2011. years) were included. Colonoscopic findings Method: The study was conducted in a cross sectional included: hemorrhoid (28.2%), adenocarcinoma design. The sampling method was one stage (24.8%), ulcerative colitis (20.5%), anal fissures randomized clustering. 2259 persons were recruited and (8.5%), polyps (7.7%), solitary rectal ulcer (4.3%), interviewed in a specialty clinic. The questionnaire for diverticular disease (3.4%) and ischemic colitis collecting data was based on ROME III criteria and (0.9%) and 2 (1.7%) had normal colonoscopy. The demographic form. Data was analyzed by SPSS 16 most common associated symptom in our patients software and chisquare and logistic regression tests was abdominal pain (46.2%). There was a significant were used for analysis of data. Level of significance relationship between abdominal pain and weight loss was considered as P value less than 0.05. with cancer (P-value=0.004 and 0.001, respectively). Results: The population consisted of 1088 (48.2%) The relationship between diarrhea and constipation male and 1171(51.8%) female. Mean age was 43±16 with cancer was not statistically significant. years and the prevalence of IBS was (4.38%).The Conclusion: The most common colonoscopic findings regression analysis showed that there is a significant in our study were hemorrhoid, adenocarcinoma and inverse relationship between IBS and age ulcerative colitis. Rectal bleeding should be considered (P=0.0001). The most common symptoms of IBS as an important issue to suspect a malignancy especially were need to strain on defecation and bloating .The in high risk areas like the studied region. most common subgroup of IBS was IBS-D (IBS with Send Date: 2012/08/15 diarrhea predominant) (49.5%). Conclusion: The result of this study showed the prevalence of IBS in Kerman was less than of what Code: 2368 were in the western countries but it is common in Category: 6. COLONIC AND ANORECTAL DIS- young population so it should be considered as ORDERS important disease due to composition of Iran popula- 6.4 Other colonic and anorectal disorders tion that are mostly in young ages. T-S-092 Send Date: 2012/08/29 The Outbreak of Irritable Bowel Syndrome , Its Clinical Symptoms And Related Factors Among Adult Population In Kerman City Code: 2441 Mehdi Hayatbakhsh Abbasi1*, Mohammad Javad Category: 6. COLONIC AND ANORECTAL 1 1 Zahedi , Sodaif Darvish Moghaddam , Seyed Mehdi DISORDERS

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6.4 Other colonic and anorectal disorders (0.8%), respectively. Polyps location in females were T-S-093 in sigmoid (25%), rectum (23.8%), descending colon Large intestine polyp location (19.4%), ascending colon (12.9%), transverse colon in relation to age and gender (12.9%), anal canal (4.4%), all colon (1.2%) and Mohammadhossein Somi2, Mohammadreza cecum (0.4%), respectively. Abdollahi1*, Sepideh Lotfi sadigh2, Conclusion: There was significant relation between Sevda Ebrahimzadeh2, Maryam Parvizi age and gender with location of polyps. Due to our 2 3 Aghdam , Morteza Ghojazadeh , Mohammadamin results colonic polyps were more prevalent in males. 2 Mohammadzadeh Garebaghi Most common location of polyps in males was 1 Young Researchers Club,Tabriz Branch, Islamic Azad rectum and in females was sigmoid. University of Tabriz Send Date: 2012/09/20 2 Liver and gastrointestinal diseases research center, Tabriz university of medical science 3 Physiology Department, Tabriz University of Medical Science Code: 2510 Introduction: An enlarging body of evidence Category : 6. COLONIC AND ANORECTAL DIS- supports the importance of the colonic polyp as a ORDERS precursor to the development of colorectal cancer. 6.4 Other colonic and anorectal disorders Although there are exceptions, most authors agree T-S-094 that the majority of polyps are found in the distal 25 Prevalence and the demographic cm. of the colon.In this study we aimed to analyze risk factors of constipation and the relationship of age and gender with location of functional constipation in Isfahan, Iran large intestine polyps in Tabriz University of medical Ammar Hassanzadeh Keshteli, Marsa Sadat Hashemi 1* 2 2 science clinic clients through colonoscopy. Jazi , Hamed Daghaghzadeh , Peyman Adibi 1 Method: All records (n=3650) patients undergoing Isfahan Medical Students, Research Center, Isfahan University of Medical Sciences, Isfahan, Iran colonoscopy from 2008 to 2012 at Tabriz University 2 Integrative Functional Gastroenterology Research Center, of Medical science were analyzed. We also evaluated Isfahan University of Medical Sciences, Isfahan, Iran the age, gender, having polyp, location of polyps and Introduction: Constipation is a common symptom relationship between them. We used t-test for and Functional constipation is another term, known descriptive variables and Chi-square tests to compare as constipation that has no apparent physical or categorical variables. physiological cause, and does not meet irritable Results: Out of 3650 patients, 1984 males (54.3%) bowel syndrome criteria. The aim of this study was to and 1666 females (45.7%), polyps were detected in evaluate the prevalence of constipation and functional 545 patients (15%).Mean age of our patients was constipation in a community-based adult population 48.7±18.6 [5-100]. The mean age in males were in Isfahan, Iran and investigate its association with 48.7±19.3 and in females were 48.6±17.8. From demographic factors. those who had polyp 326 patients were male (59.8%) Method: This study is a part of the Study on the and 219 patients were female (40.2%).The most Epidemiology of Psychological, Alimentary Health common age range in patients who had polyp was 60- and Nutrition (SEPAHAN).The participants fulfilled 70 year (22.4%).Most common locations of polyp two self-administered questionnaires aimed to collect were in rectum (26.5%), sigmoid (25.5%), ascending data on demographic information and constipation colon (14.9%), descending colon (14.4%), transverse and functional constipation symptoms. colon (13.1%), anal canal (3.6%), all colon (1%) and Results: Overall, 4763 subjects with a mean age of cecum (1%) in those who had polyps, respectively. 36.58 ± 8.093 (44.2% male, 55.8% female) Polyp location in males were in rectum (28.4%), participated in this study. The prevalence of sigmoid (25.8%), ascending colon (16.3%), constipation and functional constipation were 33.4% transverse colon (13.2%), descending colon (11%), and 23.5%, respectively (Constipation: 24.8% in anal canal (3.1%), cecum (1.4%) and all colon men, 40.2% in women; Functional constipation:

56 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

14.9% in men, 30.3% in women). Except for the gastroenterology clinic with evidence of fatty liver in severity of lumpy or hard stool, that did not have a ultrasonography. After excluding other causes, significant difference among men and women, other participants with persistent elevated alanine symptoms of constipation were more severe in aminotransferase (ALT) levels were presumed to women. About 55.3% of participants had at least one have NASH and were enrolled. symptom of constipation. Constipation and functional They were randomly assigned to lifestyle constipation were associated with education level, modification alone or lifestyle modification plus HP however these disorders were found to have no eradication. HP eradication was documented by urea relation with marital status or age. The prevalence of breath test after six weeks post treatment. Fasting serum constipation symptoms including fewer than 3 glucose (FSG), ALT, aspartate aminotransferase (AST), defecation per week, lumpy or hard stool, straining alkaline phosphatase (ALP), triglyceride (TG), during defecation, sensation of incomplete cholesterol (CHOL), high and low-density evacuation, sensation of anorectal obstruction and lipoprotein (HDL, LDL), and HOMA-IR were manual maneuver were 21.2%, 34.7%, 47.3%, checked at baseline and six weeks post-treatment. 48.0%, 31.3% and 18%, respectively. Sensation of Results: Forty patients (20 males) with mean age of incomplete evacuation and manual maneuver were 41.57 (± 12.30) were included. HP eradication rate the most and the less prevalent symptoms. was 95%. Serum level of AST, ALT, ALP, FSG, TG, Conclusion: According to this study, further CHOL, LDL, HDL, and HOMA-IR, were decreased population-based studies are needed to investigate the from baseline to six weeks post-treatment in both prevalence of constipation and functional groups (All P values < 0.05). constipation in society. No statistically significant differences were seen Send Date: 2012/09/30 between the two treatment groups with regard to the changes of laboratory parameters from baseline to six weeks post-treatment (All P values > 0.05). Code: 2308 Conclusion: It seems that successful HP eradication Category: 7. LIVER per se might not affect liver function tests, lipid 7.2 Nutrition - metabolism – pharmacology profile and insulin resistance more than life style T-S-095 modification in non-diabetic NAFLD patients. The effect of helicobacter pylori eradication Send Date: 2012/07/19 on liver function tests in non-diabetic non-alcoholic steatohepatitis patients Raika Jamali1*, Neda Shayegan2, Code: 2444 Shahab Dowlatshahi1 Category: 7. LIVER 1Internal medicine ward, Sina hospital, Tehran University 7.2 Nutrition - metabolism – pharmacology of Medical Sciences T-S-096 2 Internal medicine ward, Sina hospital, Tehran University How does addition of regular aerobic of Medical Sciences exercise influence the efficacy of Introduction: Helicobacter pylori (HP) antigens have colorie-restricted diet on been found in the liver of individuals with benign and ultrasonografic features and malignant liver diseases. The role of HP in the quality of life in patients with NASH? pathogenesis of non-alcoholic steatohepatitis mohsen nematy1, hossein nikroo2* , maryam (NASH) is controversial. The aim of study is to mohamadian3, hamidreza sima4, evaluate the effect of HP eradication on liver Seyed Reza Attarzade Hosseini2 function tests, lipid profile, and homeostasis model 1Department of Biochemistry & Nutrition, Faculty of assessment-IR (HOMA-IR) index in NASH patients. Medicine, Mashad University of Medical Sciences Method: This randomized double blind clinical trial 2 Faculty of Physical Education and Sport Sciences, was performed in non-diabetic dyspeptic patients Ferdowsi University of Mashhad with positive antibody to HP who were referred to 3 Faculty of Medicine, Mashad University of Medical

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Sciences Bahareh AmirKalali1*, masoudreza Sohrabi1, 4 Department of Internal Medicine, Faculty of Medicine, Hossein Keyvani2, Mahmood Reza Mashad University of Medical Sciences Khansari1, Hossein Ajdarkosh1, Mansooreh Introduction: Nonalcoholic Steatohepatitis (NASH) Maadi1, Farhad Zamani1, Ali Sadeghi1 is part of a broad spectrum of nonalcoholic fatty liver 1 Gastrointestinal and Liver disease research center, disease (NAFLD). We aimed to compare the effect Firoozgar Hospital, Tehran University 2 of aerobic exercise along with diet and diet alone on School of Medicine, Tehran University of Medical ultrasonographic features and quality of life in Sciences, Tehran, Iran Introduction: Recent studies have shown an patients with NASH. increasing rise in the prevalence of NAFLD in Method: Twenty-five NASH patients were randomly eastern countries but a few studies are available on divided in two groups and underwent aerobic the prevalence of NAFLD and its potential risk exercise along with diet (n=12) or diet alone (n=13). factors in Iran.So the aims of this study were to In this study, low-caloric diet in both groups included determine the prevalence of NAFLD, its potential 500 kilocalories of energy less than estimated daily risk factors and their sex distribution in north of Iran, energy requirement. In addition to diet, the first group Amol. were participated in aerobic exercises for a period of Method: This population based cross-sectional study 12 weeks, 3 days a week with 55–60% heart rate included adult individuals who were randomly reserve. selected from Amol healthcare centers and its Liver ultrasonography was done by a single expert suburbs. Clinical histories were reviewed and radiologist at the beginning and the end of the study. anthropometric measurements, blood analysis and Quality of life questionnaires (SF-36) were filled hepatic sonography were performed for each before and after intervention by the patients. individual. Men and women with more than 30 g/day Results: Twenty-five patients (24 men and one and 20 g/day of alcohol intake respectively and woman), with mean age of 36 years (18-55 years) individuals with cognitive and chronic liver diseases completed 12 weeks of intervention. Improvement in were excluded from the study. Metabolic syndrome ultrasonographic features of fatty liver was found was defined according to National Cholesterol only in those who treated with aerobic exercise as Education Program Adult Treatment Panel III criteria well (P=0.01). In assessment of quality of life in diet (ATPIII). plus aerobic exercise group, physical function, role Results: 5023 individuals with mean age of limitations due to physical health, physical 45.35±15.87 years entered into this study. component score, general health, vitality and in other The prevalence of NAFLD and metabolic syndrome group general health and vitality improved after was 43.8% and 29.6% respectively. Both NAFLD intervention but was not meaningful difference in and Metabolic Syndrome were significantly more compare of groups. prevalent in women than men (P= 0.01 and P<0.001 Conclusion: Regular aerobic exercise along with respectively). Among the components of metabolic low-caloric diet may be more effective than syndrome women had significantly higher waist low-caloric diet alone in treatment of patients with circumference and fasting Serum Glucose and lower nonalcoholic steatohepatitis. Send Date: 2012/09/20 HDL (all, P<0.001). The best cut-off points of serum ALT to detect NAFLD in men and women were 20.9 U/L and 15.9 U/L respectively. The strongest Code: 2490 predictors of NAFLD in men were waist circumfer- Category: 7. LIVER ence, serum alanine aminotransferase and the age 7.2 Nutrition - metabolism – pharmacology group of 40-60 years. The strongest predictors of T-S-097 NAFLD in women were waist circumference, the age Prevalence of non-alcoholic fatty groups of 40-60 years and >60 years. Conclusion: liver disease (NAFLD) and its best This study showed a high prevalence of predictors in north of Iran, Amol NAFLD and metabolic syndrome in Amol and its

58 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 suburbs. Women were more at risk of having 7.2 Nutrition - metabolism – pharmacology metabolic syndrome and NAFLD. Waist T-S-099 circumference and the age group of 40-60 years were Beneficial effects of Silymarin on the strongest predictors of NAFLD in both sexes. reducing liver aminotransferases Send Date: 2012/09/30 in patients with nonalcoholic steatohepatitis Amirmansoor Rezadoost1, Mohsen Maoodi1, Mehdi Vojdanian1, Mehrdokht Najafi1* Code: 2499 1 Colorectal Research Center, Rasool Akram Hospital, Category : 7. LIVER Tehran University of Medical Sciences 7.2 Nutrition - metabolism – pharmacology Introduction: Hepatoprotective effects of Silymarin T-S-098 have been confirmed by various researchers from all Captopril ameliorates aflatoxin over the world; however a few studies are available B1 –induced biochemical, peroxidative about the therapeutic impact of Silymarin on the level changes in isolated perfused rat liver of aminotransferases in patients with Nonalcoholic amir moghaddam jafari1* steatohepatitis (NASH). Our purpose was to 1 departement of toxicology, Department of Toxicology, determine whether Silymarin improves serum level Faculty of Veterinary Medicine, Ferdowsi University of of aminotransferases in patients with NASH. Mashhad, Mashhad, Iran Method: A double blind, randomized, placebo- Introduction: The liver is the major target organ for controlled trial was performed on 100 patients with aflatoxin B1 (AFB1) and ingestation of aflatoxin in NASH. Subjects were randomized to receive contaminated food and feed is known to cause Silymarin (two tablet containing 140 mg silymarin hepatotoxicty. To find new agent to help the per day for three months or placebo in the same hepatotoxicity induced by aflatoxin, the protective manner. A blood sample was drawn at baseline effects of captopril was suggested. (before treatment) as well as after the completion of Method: The isolated perfused rat liver (IPRL) was treatment schedule for assessing serum levels of chosen for evaluating hepatic function. Sixteen rats aminotransferases. Body mass index (BMI) was were divided randomly into four experimental measured before and after administration of the drug groups: control, captopril, AFB1 and AFB1 + and placebo for both groups of patients. captopril. The level of glutathione content and lipid Results: The changes of BMI in both Silymarin and peroxidation, as marker of oxidative stress was placebo groups were insignificant. The mean serum determined. Lactate dehydrogenase (LDH), alanine level of ALT in the case group was significantly transaminase (ALT) and aspartate transaminase changed from 84.06 to 68.54 IU/mL following (AST) activities were measured as biochemical treatment with Silymarin (P<0.001), while this analysis. change was not meaningful in the control group. The Results: There was a significant decrease in lipid mean serum AST level in the case group was peroxidation and same increase was observed in significantly decreased from 71.94 to 54.70 IU/mL glutathione level. Treatment with captopril also after treatment with Silymarin, while this change in modulated the enzymes activity and pH of perfusate. the placebo group was not significant (from 62.94 to Conclusion: This experimental result that captopril 61.56 IU/mL). intervention ameliorates the AFB1 induced toxicity. Conclusion: Administration of Silymarin can Therefore, the effects of captopril treatment effectively reduce liver aminotransferases without suggested a new strategy to reduce of aflatoxins any changes in BMI in patients with NASH disease. toxicity. Send Date: 2012/09/30 Send Date: 2012/09/30

Code: 2396 Code: 2512 Category: 7. LIVER Category: 7. LIVER 7.3 Metabolic/genetic disorders

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F-T-100 this effect in pioglitazone group was lesser than Comparison of the therapeutic effects of metformin metformin group. and pioglitazone in nonalcoholic steatohepatitis Send Date: 2012/09/03 Mohsen razavizadeh1*, Abbas Arj1, Seyyed Mohammad Matini2, Effat Taherkhani2, Seyyed Alireza Moraveji3 1Internal Medicine Ward Shahid Beheshti Kashan Code: 2430 Hospital, Kashan University of Medical Sciences Category: 7. LIVER 2 Internal Medicine Ward Shahid Beheshti Kashan 7.3 Metabolic/genetic disorders Hospital, Kashan University of Medical Sciences F-T-101 3 Department of Community Medicine, Kashan University Diagnostic value of plasma pentraxin3 of Medical Sciences and hs-CRP level in patients with Introduction: Non-alcoholic steatohepatitis (NASH) non-alcoholic fatty liver disease is one of the common liver diseases that may Iradj Maleki1*, Alireza Rafiei1, progreses to cirrhosis without treatment . There is a Maryam Barzin1, Tarang Taghvaei1, strong association of NASH with insulin resistance Vahid Hosseini1, Azadeh Rastegar1 and, hence, insulin sensitizer drugs for this disease 1 Faculty of Medicine, Mazandaran University of Medical have been used. The aim of this study was Sciences comparison the effect of pioglitazone with metformin Introduction: The spectrum of changes in the liver on liver transaminases,HOMA index and Adiponectin in nonalcoholic fatty liver disease (NAFLD) range in patients with NASH. from steatosis to Steatohepatitis (NASH). However Method: This double blind clinical trial performed it has remained difficult to differentiate between on 80 patients with NASH according to imaging NASH and non-progressive NAFLD on the basis of finding and abnormal liver function test.Patients the clinical and para-clinical findings alone, making divided to two 40 member groups based on block liver biopsy a gold standard in this regard. randomization.In one group patients received Method: In this study we investigated the clinical metformin 500 mg BID and other group received usefulness of plasma Pentraxin3 (PTX3) and hs-CRP pioglitazone 30 mg daily for 4 months. AST, ALT, levels to predict NASH. Plasma PTX3 and hs-CRP ALKP, FBS and lipid profile were evaluated befor was measured in 34 patients with histologically study, 2 and 4 months after.HOMA Index and verified NAFLD (24 with non-NASH and 9 with Adiponectin evaluated befor study and 4 months NASH) and 36 healthy control subjects. after.Data analysis carried out with spss by using Results: There was no significant difference between repeated measurement and ANCOVA tests.P<0.05 the plasma PTX3 and hs-CRP in the NAFLD cases was considered significant. and controls. There is no significant difference Results: Forty patients(37 male) in pioglitazone between the plasma PTX3 and hs-CRP in NASH group and forty patients(31 male) in metformin group cases and non-NASH cases either. The plasma hs- were included. There was no significant difference in CRP level was significantly higher in the NASH both group between age ,sex and weight.The ALT and cases in stages 3-4 than in the NASH cases in stages ALKP levels decreased significantly in pioglitazone 1-2 fibrosis. group in comparison with metformin group. There Conclusion: The results suggest that plasma PTX3 was no significant difference in both group about levels cannot predict the severity of NASH but AST, FBS,TG,LDL,HDL and HOMA Index.After plasma hs-CRP levels maybe can be a marker of the treatment adiponectin level in metformin group was severity of hepatic fibrosis in NASH. less than pioglitazone group. Send Date: 2012/09/12 Conclusion: The results showed that pioglitazone is more effective versus metformin and led to greater reduction in liver transaminases level. Pioglitazone Code: 2538 and metformin had the same effect on FBS and Category: 7. LIVER HOMA Index.Both drugs reduced adiponectin, but 7.3 Metabolic/genetic disorders

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F-T-102 2 Department of gastroenterology, North Khorasan evaluation of frequency of causes University of Medical Sciences, Bojnurd of persistently elevated ALT levels 3 North Khorasan University of Medical Sciences, North in patients refered to the GI clinics Khorasan University of Medical Sciences, Bojnurd 4 of Ghaem and Emam rezahospitals Department of gastroenterology, Shahid Beheshti University of Medical Science Ahmad khosravi khorashad1*, Hassan Introduction: Non-alcoholic steatohepatitis (NASH) is Saadatnia1, Hassan vossoughinia1, monavvar Afzal Aghaei1, linda barari1 a clinicopathological entity that is being recognized more 1 ghaem hospital, mums frequently in recent years. This study aimed to evaluate Introduction: Chronic liver disease is a major cause of the effects of Metformin, with and without a probiotic morbidity and mortality in all over the world. Causes of supplement on liver function in patients with NASH. elevated serum alanine aminotransferase (ALT) levels Method: Patients were randomized to one of the vary depending on the population under study. The aim following treatments for 6 months: group I, probiotic of this study was to evaluation of frequency of causes of (Protexin two tablets per day) plus Metformin 500 mg persistently elevated alanine aminotransferase levels in two tablets per day(Met/Pro), or group II, Metformin 500 patients referred to the gastroentrol clinic in Ghaem and mg two tablets per day plus two placebo tablet (Met/P). Emam Reza hospitals. Results: In group I, serum alanine aminotransferase Method: A total of 100 patients who had persistently (ALT: 133.7±70 vs 45.2±32.5; P < 0.001 ), and elevated ALT level (Those with ≥ 2 times within 6 aspartate aminotransferase activity (AST: 123.1±72 months of ALT > 40 u/l) and referred to the gastroentrol vs 44.2±33.9; P < 0.001), and ultrasound grading of clinic in Ghaem and Emam Reza hospitals were studied. NASH (P<0.001) all decreased significantly by the A comprehensive history regarding alcohol drinking end of the treatment period. In group II, whilst serum and medication was taken, physical examination was alanine aminotransferase (ALT) was not significantly done, then underwent Blood tests and ultrasonography, reduced (118.4±67.9 vs 112.5±68.7; P < 0.064), and if it was necessary, liver biopsy was done. aspartate aminotransferase activity (AST: 125.3±71 Results: A total of 100 patients participated in the vs 113.4±71; P < 0.001), and ultrasound grading of study, %55 with non-alcoholic fatty liver disease NASH did fall significantly (P<0.01). Body mass (NAFLD), %17 with hepatitis B, %13 with Index(BMI), Fasting blood sugar(FBS), cholesterol autoimmune hepatitis, %4 with hepatitis C, %2 with and triglyceride fell significantly in both groups. autoimmune hepatitis & hepatitis C, %2 with Conclusion: Probiotic combination with Metformin overlap autoimmune disease, %1 with Wilson diseas, improves liver function better than metformin alone %1 with PSC, %2 was cryptogenic. Send Date: 2012/10/01 Conclusion: NAFLD is the most common cause of persistently elevated serum ALT level in this study. Send Date: 2012/10/01 Code: 2334 Category: 7. LIVER 7.6 Cirrhosis and complications: clinical aspects Code: 2560 F-T-104 Category: 7. LIVER Effects of losartan on renal 7.3 Metabolic/genetic disorders hemodynamics in patients with cirrhosis F-T-103 Seyed Kazem Nezam1, Alireza Bakhshipour1* Effect of a Probiotic and Metformin 1Ali- ebne Abitaleb Hospital, Zahedan University of on Nonalcoholic Steatohepatitis: Medical Sciences Introduction: Portal hypertension is a major A double blind randomized clinical trial complication of liver cirrhosis, and non- selective Ahmad Shavakhi1*, Mohammad Minakari1, Hassan Firouzain2, Raheleh Assali3, Azita Hekmatdoost4 beta blockers(such as propranolol) are used to treat 1 Department of gastroenterology, Isfahan university of this problem. It has been reported that losartan, an medical science. angiotensin II receptor antagonist, also have a portal

Govaresh\ Vol.17\ Supplement\ Autumn 2012 61 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 hypotensive effect, but studies of their usefulness for center from September 1995 to September 2011. portal hypertension is scarce. In this study, effect of Patients’ recorded information and tumor characteristics losartan on renal arterial resistive indices(RI), a were analyzed and compared between those with and mirror of hepatic vein pressure gradiant(HVPG), was without tumor recurrence. examined. Results: Of 1236 liver transplantations, HCC was Method: Thirty patients with cirrhosis and portal reported in explanted livers of 35 recipients. In 5 out of hypertension on routine drugs used for portal 35 patients the tumors were incidental pathological hypertension(propranolol)were studied. Renal findings without pre transplant diagnosis. Triphasic arterial Resistive Indices(RI) was measured prior to dynamic computed tomography (CT) findings were and 14 days after oral administration of 12.5 mg typical in 17 cases (48.6%) and suggestive in 12 cases losarton twice daily, using Doppler ultrasonography. (34.3%) and pre transplant diagnosis of HCC in one Results: Mean age of patients was 42.9± 15.2 yaers case was made only by ultrasound and confirmed by and male to female ratio was 1: 1.8. 18(60%) and tissue biopsy. HCC recurrence rate was 14.3% (5 12(40%) of patients had Child-Putch score B and C, cases). The sites of recurrent tumors were lung, bone, respectively. The mean renal arterial Resistive regional lymph nodes and transplanted liver. All Index(RI) prior losartan administration was 0.659 ± cause mortality rate during study time was 28.6% (10 0.584 in comparsion with 0.635 ± 0.597 after cases) and only 3 deaths (9%) were related to HCC treatment with losartan(p=0.005). recurrence. Significant factors associated with tumor Conclusion: Effect of losartan on renal arterial recurrence in clinical aspects was extrahepatic tumor Resistive Index(RI) appear significant and may involvement at the time of transplant and in become one of the effective treatments for portal pathologic aspects were poorly differentiated tumor, hypertension in the future. TNM stage beyond IIIB and tumors exceeding Send Date: 2012/08/12 University of California, San Francisco (UCSF) criteria (a single HCC nodule up to 6.5 cm, or up to three lesions, the largest of which is 4.5 cm or smaller Code: 2416 and the sum of the diameters no larger than 8 cm). Category: 7. LIVER Conclusion: Liver transplantation is an effective 7.6 Cirrhosis and complications: clinical aspects treatment for HCC with an acceptable recurrence F-T-105 rate. Post transplant HCC recurrence is likely the re- Outcome of Hepatocellular sult of microscopic extrahepatic disease that man- Carcinoma after Liver Transplantation: dates more precise pre transplant evaluation. A single center experience from Iran Pathology of the explanted liver may be useful to de- Maryam Moeeni1, Bita Geramizadeh2, tect patients at high risk for tumor recurrence. 3 1* Saman Nikeghbalian , ebrahim fallahzadeh Send Date: 2012/09/05 1 GI Ward, Shiraz University of Medical Sciences 2 Pathology, Shiraz University of Medical Sciences 3 Transplant Surgery, Shiraz University of Medical Sciences Code: 2435 Introduction: Liver transplantation is one of the Category: 7. LIVER accepted treatment modalities for hepatocellular 7.6 Cirrhosis and complications: clinical aspects carcinoma (HCC) that can lead to cure. Defining the F-T-106 most precise pre transplant criteria to predict post Noradrenalin versus the combination transplant tumor recurrence may be challenging as of Midodrine and Octreotide in the rate of tumor recurrence may be significantly high patients with hepatorenal syndrome: despite careful patient selection. a prospective, randomized, unblinded study Method: The study was done on all 35 recipients of Hamid Tavakkoli1, Kambiz liver organ with pathologically documented HCC in Yazdanpanah1*, Marjan Mansourian2 their explants in Nemazi hospital organ transplant 1Gastroenterology and Hepatology Department, Isfahan

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University of Medical University Seyed Mohsen Dehghani, Mahmood Haghighat1, 2 Epidemiology Department, Isfahan University of Abdorrasoul Malekpour1* , Hamdollah Medical University Karamifar1, Mohammad Hadi Imanieh1 Introduction: Among the various complications of 1 Gastroenterohepatology Research Center, Shiraz cirrhosis, hepatorenal syndrome (HRS) bears the University of Medical Sciences worst prognosis. Vasoconstrictors have been shown Introduction: There is some evidence that decrease to be effective in improving renal function and in triiodothyronine (T3) and thyroxine (T4) ratio have extending the patients’ survival before liver a direct relationship with liver disease and they could transplantation. This study assessed the efficacy of be used in disease prognosis. According to these Noradrenalin, a widely available and non-expensive studies thyroid hormone levels have an association alpha-adrenergic agonist, in comparison with the with the severity of liver disease but there are some efficacy of the combination of Midodrine and paradoxes in the results. This study aimed to evaluate Octreotide in the treatment of patients with HPS type the correlation between thyroid hormone levels and 1 and 2. severity of liver disease. Method: Twenty-three cirrhotic patients with HRS Method: Levels of thyroid hormones were measured (15 with HRS type 1; 8 with HRS type 2) were in 83 children with liver cirrhosis using enrolled consecutively into the study. Patients were radioimmunoassay techniques. randomly selected to be treated with noradrenalin Results: Four patients (4.8%) showed a decrease in (0.1–0.7 µg/kg/min) and albumin (11 patients) or the amount of T3 and nine (10.8%) revealed with combination of Midodrine and Octreotide increased levels of T3. Also, the decrease in the (Octreotide 100-200 µg subcutaneously TID, amount of T4 was seen in 7 patients (8.4%) and 4 Midodrine 5-15 mg orally TID) and albumin (12 (4.8%) patients showed the increase in the level of patients). Treatment was continued until HRS T4. Serum albumin was lower and INR was higher reversal or for a maximum of 14 days. Survived in patients with low T3 and low T4 insignificantly. patients were followed-up for three months. This study reveals that PELD/MELD scores are Results: Complete response of HRS was observed in statistically related to the decreased amounts of T4. 9 of the 11 patients (81.8%) treated with noradrenalin (p=0.036) Mean PELD/MELD and Child scores were and in9 of the 12 patients (75%) treated with higher in low T3 patients insignificantly. (p>0.05) Midoderin-Octreotide, p = ns. Renal and circulatory Conclusion: Decrease levels of thyroid hormones are function improved in both groups without appearance seen in more advanced cirrhosis and correlated to of myocardial ischemia or any major side effect. After severity of disease. The patients with the decreased three months, 5 of the 9 patients (55.5%) responded to T4 levels need liver transplantation more noradrenalin and 6 of the 9 patients (67%) responded to immediately compared to other patients. Midoderin-Octereotide were survived, p = ns. Send Date: 2012/09/23 Conclusion: Both noradrenaline and Midoderin- Octreotide are efficient in reversal of HRS and can improve three-month survival of the patients. Code: 2295 Noradrenaline, because of being more available and Category: 7. LIVER lower cost, may be a preferred vasoconstrictor in HRS. 7.7 Viral hepatitis: basic aspects Send Date: 2012/09/16 F-T-108 Do thalassemia and hemophilia patients with chronic hepatitis C need to be vaccinated against Code: 2451 Pegah Karimi Elizee1* , Seyyed-Mohammad Miri2, 1 3 Category: 7. LIVER Bita Behnava , Mohammad Gholami Fesharaki , 1 4 7.6 Cirrhosis and complications: clinical aspects Shima Salimi , Maryam Keshvari , Leila Mehrnoush1, Mostafa Shafie1, F-T-107 Seyed-Moayed Alavian2, Seyedeh Hoda Alavian1 Thyroid Hormone Levels in Children with Liver 1 Tehran Hepatitis Center, baghiatallah university of Cirrhosis Who Waiting a Liver Transplant

Govaresh\ Vol.17\ Supplement\ Autumn 2012 63 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 medical sciences Blood transfusion is not a risk factor for 2 Baqiyatallah Research Center for Gastroenterology and acquiring Hepatitis E virus infection Liver Diseases, baghiatallah university of medical sciences among thalassemia and hemophilia patients 3 Biostatistics Department, Tarbiat modares university Pegah Karimi Elizee1, Seyyed-Mohammad Miri2*, 4 Iranian Blood Transfusion Organization research Center, Bita Behnava1, Seyedeh Hoda Alavian1, Iranian Blood Transfusion Organization Maryam Keshvari3, Mohammad Gholami Introduction: Individuals with poly-transfused Fesharaki4, Leila Mehrnoush1, Shima salimi1, disease such as thalassemia and inherited bleeding Mostafa Shafie1, Seyed-Moayed Alavian2 disorders like hemophilia are at higher risk of viral 1 Tehran Hepatitis Center, baghiatallah university of hepatitis. Hepatitis A virus (HAV) infection, a medical sciences self-limited disease, usually spread through 2 Baqiyatallah Research Center for Gastroenterology and oral- fecal rout but blood transfusion is also known as Liver Diseases, baghiatallah university of medical sciences 3 one of the routes of transmission. We aimed to Blood Transfusion Organization research Center, Blood determine the seroprevalence of anti HAV antibody in Transfusion Organization 4 Biostatistics Department, Tarbiat modares university thalassemia and hemophilia patients who already Introduction: Hepatitis E virus (HEV) infection as a infected with hepatitis C virus (HCV) in Iran. self-limited disease usually spreads through Method: Sera of 219 patients with thalassemia and oral- fecal rout. In endemic area such as Iran, blood hemophilia infected with HCV, referred to Tehran transfusion is a probably rout of transmission Hepatitis center between “2009-2010” from all especially in thalassemia and hemophilia patients. In provinces of Iran, were evaluated by Enzyme-linked these patients that already infected with hepatitis C immunosorbent assay (ELISA) to detect HAV total Ab. virus (HCV), if HEV superinfected, it could lead to Results: Sixty thalassemia patients (93.8 %) had severe hepatitis. We aimed to find out the prevalence HAV total antibody but this rate was lower in of anti HEV antibody in thalassemia and hemophilia hemophilia group, (n=104, 67.1 %, p < 0.001). patients with chronic hepatitis C in Iran. Patients that received first blood unit or coagulation Method: Sera of 217 patients with thalassemia and factor between” 1982-1991”in both groups had hemophilia with HCV, referred to Tehran Hepatitis higher prevalence of HAV Ab than the others. Also, center between “2009-2010” from all provinces of Iran, HAV Ab was associated with male gender, single were evaluated by Enzyme-linked immunosorbent status, and residency in urban area (P<0.05) and there assay (ELISA) to detect HEV total Ab level. was no relationship between level of education with Results: Six patients (2.8%) were seropositive for risk of HAV infection. HEV total Ab (one thalassemia and 5hemophilia). Conclusion: In our study, thalassemia group was Neither gender nor age had significant relationship younger than hemophilia but with higher prevalence with HEV infection. All seropositive cases were from of HAV Ab. It seems that blood transfusion is an urban areas. However, the risk of HEV infection was important rout of HAV infection and the risk of related to low level education (P<0.05). transmission increases with times of blood transfusion in Conclusion: HEV infection prevalence among Iranian thalassemia patients. On the other hand, these patients thalassemia and hemophilia patients, infected with HCV, already infected with HCV and if HAV superinfected, is similar to previous studies in general population of Iran it could lead to severe hepatitis. Vaccination of high (2.3% -9.6%) but lower than previously reported in other risk groups for HAV infection especially thalassemia countries among thalassemia and hemophilia patients. patients in younger ages is recommended. This offers that blood transfusion in our country cannot be Send Date: 2012/07/07 an important rout of HEV transmission. Send Date: 2012/07/07 Code: 2296 Category: 7. LIVER Code: 2356 7.7 Viral hepatitis: basic aspects Category: 7. LIVER F-T-109

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7.7 Viral hepatitis: basic aspects 1 Department of internal medicine, division of F-T-110 Gastroenterology, Imam Khomeini hospital, Tehran The Potential Function of APOBEC3G for University of Medical Sciences Limited Replication of Hepatitis B Virus: 2 Department of Department of Preventive and Community Report of Case Series and the Review of Literature medicine, Tehran University of Medical Sciences 3 Department of Department of Pediatrics, Imam Ashraf Mohamadkhani1*, Akbar Pourdadash1 Khomeini hospital, Tehran University of Medical Sciences 1 Digestive Disease Research Centre, Tehran University of 4 Center for Disease Control and Prevention of Iran, Tehran Medical Sciences, Tehran, Iran University of Medical Sciences Introduction: Recent findings introduced Introduction: Hepatitis B is the most prevalent APOBEC3G (A3G) as a host factor that blocks viral chronic infectious liver disease worldwide with replication. It induces G to A hypermutations in viral serious sequel. Prevention of the infection can be DNA at the step of reverse transcription and in provided by universal vaccination and improving response to interferon. This study aimed to knowledge and behavior about disease transmission. investigate the expression of liver A3G protein in Provision of any educational program requires association with both replication of HBV and inquiry about target g frequency of G to A mutations in BCP (basal core Method: We conducted a questionnaire-based promoter)-PC (pre-core) region. national survey of 18-year-old adolescents according Method: Fifty one liver biopsies of naïve chronic to stratified cluster random sampling in Iran during hepatitis B (CHB) patients enrolled for the 2010. expression of A3G by immunohistochemistry (IHC) Results: Response rate was 87%. Most adolescents standard method. The presence of HBV DNA and (60%) knew that HBV infects the liver. Percent of sequences of BCP-PC region in the time of liver adolescents who gave correct answers to major routes biopsy were investigated in all patients. of HBV transmission were: spouse of an infected Results: Among thirty four patients with detectable person 59%, multi-partners 66%, intravenous drug HBV DNA, 31 carried a range of 1 to 5 G to A use 73%, body piercing 55% and personal belongings mutations in BCP-PC region. IHC results showed that 55%. Higher levels of education, living in rural areas, the expression level of A3G in CHB patients’ liver marriage and (except for body piercing) female was very low. Of all patients, A3G expressed in three gender were associated with better knowledge. The undetectable HBV DNA subjects and a patient with knowledge of HBV infected persons about major 2.24x104 copies/mL of HBV DNA. G to A Mutated routes of HBV transmission were low (P<0.001). residues were indicated at position 1727, 1757, and Conclusion: There are important deficits in 1896 of HBV genome of this patient. adolescents’ knowledge about HBV that requires Conclusion: This study indicates that despite very attention of health educators with tailoring of it to low levels of both A3G in liver and the number of specific groups. positive subjects, A3G has a potential role to restrict Send Date: 2012/09/30 in vivo replication of HBV. Send Date: 2012/08/18 Code: 2346 Category: 7. LIVER Code: 2517 7.8 Viral hepatitis B: clinical aspects Category: 7. LIVER F-T-112 7.7 Viral hepatitis: basic aspects Vaccine therapy in hepatitis B carriers: F-T-111 a randomized double blind clinical trial Hepatitis B knowledge among Behnaz Khodabakhshi1, Abdolvahab Moradi1, Gholam Iranian adolescents: a National Survey reza Roshandel1, Shahryar Semnani1, Taghi Amiriani1* Nader Roushan, Mohsen Nasiri Toosi1, 1 Golestan University of Medical Sciences, Golestan Alipasha Meysamie3 2, Abdoul-Reza Research Center of Gastroenterology and Hepatology Esteghamati3, Homazad Hajrassuliha4*

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Introduction: Hepatitis B virus (HBV) infection is a reaction was reported. common infectious disease throughout the world. Conclusion: Our findings showed that HBV vaccine Chronic carrier state is an important source of have had positive effects on reduction or elimination concern in management of HBV infection. Some of of HBV viral load. Responses to HBV vaccine HBV carriers are asymptomatic, but severe therapy may be influenced by number of doses and complications including cirrhosis and hepatocellular interval of injections. These factors may be carcinoma may develop in others. Anyway, HBV considered as possible reasons why we did not find carriers are persistent sources of the virus and may significant therapeutic effect. HBV vaccine is a safe transmit HBV to healthy individuals. Finding and cost-effective option for reducing or eliminating effective methods for reducing or eliminating viral HBV viral load in chronic carriers. Further studies load in these patients has been considered as an are needed to identify the best protocol for HBV interesting issue in recent studies. This study was vaccine therapy. conducted to assess therapeutic effects of HBV Send Date: 2012/08/15 vaccine in HBV carriers. Method: This study was a randomized double blind clinical trial. Study population included chronic HBV Code: 2357 carriers aged 20 to 65 years old. Patients with Category: 7. LIVER clinical manifestations of HBV infection as well as 7.8 Viral hepatitis B: clinical aspects alanine aminotransferase (ALT) levels of higher than F-T-113 40 IU/L were excluded. Subjects were randomly Association of TLR2 Protein with allocated in four groups. Group 1, 2 and 3 were serum ALT in Chronic Hepatitis B received placebo, one dose and two doses of HBV Patients Harboring Pre-core Mutant vaccine, respectively in months 0, 1 and 6. Group 4 Ashraf Mohamadkhani2*, Parisa Shahnazari1 1 was administered two doses of HBV vaccine in Monoclonal Antibody Research Centre, Avicenna months 0, 1, 2 and 6. All patients in intervention Research Institute, ACECR, Tehran, Iran 2 Digestive Disease Research Centre, Tehran University of groups received standard HBV vaccine manufactured Medical Sciences, Tehran, Iran by the same factory. HBV viral load (IU/ml) was Introduction: Chronic hepatitis B patients harboring assessed before the first dose and two months after pre-core mutant variants of hepatitis B virus (HBV) the last dose of HBV vaccine using real-time PCR may show fluctuating of ALT levels with histologic method. Reducing or elimination of HBV viral load activity on biopsies indicative of inflammation and was considered as main outcomes. This study was injury. Toll-like receptor 2 (TLR2), as a mediator of approved by the Ethics committee of Golestan microbial patterns recognition has important role in University of Medical Sciences. elimination of pathogens. The aim of this study was Results: At the beginning of study, 105 HBV carriers to investigate the association of serum TLR2 with were recruited. At the end of study, 90 patients clinical findings of HBeAg negative chronic received all doses of HBV vaccines including 23, 21, hepatitis B patients. 24 and 22 cases in groups 1, 2, 3 and 4, respectively. Method: Fifty one HBeAg negative patients with The mean age of participants was 33.6 years and 44% detectable HBV DNA were examined for the presence of them were male. There was no significant of mutations in pre-core region of HBV genome. difference in age and sex between groups. The mean Concentration of serum TLR2 was measured by of viral load in intervention groups was significantly enzyme-linked immunoassays. Interaction of tertiary lower after vaccination (P<0.01). HBV viral load structure of truncated HBeAg and TLR2 (2Z80 A) was elimination was occurred in 8.3%, 13.2%, 10.5% and evaluated with molecular docking. 15.7% in groups 1, 2, 3 and 4, respectively (P=0.23). Results: Patients with G1896A mutation had higher HBV Viral loads decreased to lower than 100000 concentration of serum TLR2 compare to patients IU/ml in 76.1%, 88.9%, 85.3% and 92.4% in groups without this mutation (4.8±2.9 vs 3.4±2.2 ng/mL, 1, 2, 3 and 4, respectively (P=0.09). No adverse P=0.03). Estimating regression equations in pre-core

66 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 mutant patients showed with increasing serum TLR2 polymorphisms, on the HCV treatment response. concentration bigger than 6, serum ALT raises Method: One hundred and ninety-nine Iranian sharply. Computational molecular docking studies patients with chronic hepatitis C genotype 1 (M/F: showed an interaction between truncated HBeAg and 167/32), that have been treated with PEG-IFN and TLR2. RBV were enrolled in the present study. For IL28B Conclusion: Present results suggest that serum TLR2 genotyping, genomic DNA was extracted from level might reflect higher expression of membrane- peripheral blood using QIAamp DNA Mini Kit. Two bound TLR2 and its pro-inflammatory results in liver common IL28B polymorphisms (rs12979860 and damage and serum ALT elevation. rs8099917) were genotyped by PCR- RFLP method Send Date: 2012/08/18 and haplotype estimation of the IL28B gene was performed using Expectation Maximization Algorithm Results: We found three IL28B haplotypes Code: 2294 (rs12979860-rs8099917) in our patients including Category: 7. LIVER C-T, T-G and TT haplotypes. We didn’t find the C-G 7.9 Viral hepatitis C: clinical aspects haplotype in any of our patients. The IL28B C-T F-T-114 haplotype was associated with higher rates of SVR An Important Role of IL28B Haplotypes than the T-T haplotype (P=0.01, OR=2.08) and than on Response to Antiviral Therapy the T-G haplotype (P=0.0001, OR=2.63). There was in Patients with Chronic Hepatitis C no significant difference in achieving SVR between Bita Behnava1*, Seyed Moayed Alavian1, the IL28B T-T and T-G haplotypes (P=0.487, 2 3 Ali Pouryasin , Heidar Sharafi , Maryam OR=0.79). 4 1 1 Keshvari , leyla Mehrnoush , shima Salimi , Conclusion: In the current study we showed that the mohammad gholami fesharaki5, pegah Karimi1 IL28B C-T haplotype is associated with favorable 1 Baqiyatallah Research Center for Gastroenterology and Liver Disease, Tehran,iran treatment outcome, while the T-T and T-G haplotypes 2 Department of Genetics, Islamic Azad University, are associated with treatment failure. Also, we found Arsanjan branch, Arsanjan, Iran that there is no significant difference between 3 Armin Pathobiology Laboratory, Tehran, Iran achieving SVR by the IL28B T-T and T-G haplotypes 4 Iranian Blood Transfusion Organisation research center, which also, shows that the IL28B rs12979860 Tehran, Iran, polymorphism predict SVR stronger than the 5 Department of Biostatistics, Tarbiat Modares University, rs8099917 polymorphism. Tehran, Iran Send Date: 2012/07/07 Introduction: Chronic hepatitis C is the major cause of liver failure worldwide. With current standard therapy including a pegylated interferon (PEG-IFN) Code: 2297 and ribavirin (RBV), approximately half of these Category: 7. LIVER patients achieve sustained virologic response (SVR). 7.9 Viral hepatitis C: clinical aspects Recently, several genome-wide association studies F-T-115 found that the particular polymorphisms near IL28B High Virologic Response of HCV Treatment gene such as rs12979860 and rs8099917 polymorphisms among Thalassemia and Hemophilia HCV are associated with response to PEG-IFN and RBV Infected Children in Comparison of Adults therapy. Although few studies suggested that the Leyla Mehrnoush1* , Seyed Moayed Alavian1, Bita rs12979860 polymorphism is the stronger predictor Behnava1, Maryam Keshvari1, shima Salimi1, of SVR than the rs8099917 polymorphism, the exact mohammad gholami fesharaki2, Seyed impact of each of these two polymorphisms on Hossein Alaei-Andabili1, Alaei-Andabili1 hepatitis C virus (HCV) treatment outcome is unclear. 1Baqiyatallah Research Center for Gastroenterology and Here, we assessed the impact of IL28B haplotypes, Liver Disease, Baqiyatallah, Tehran,iran 2 which are tagged by the rs12979860 and rs8099917 Department of Biostatistics, Tarbiat Modares University, Tehran, Iran

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Introduction: Hepatitis C is a major cause of liver 7.9 Viral hepatitis C: clinical aspects disease. In children it is associated with a mild and F-T-116 often asymptomatic disease. Hepatitis C virus (HCV) The Impressive Role of Genetic infection is the most prevalent transfusion transmitted Factors in Treatment of HCV infection in hemophilic and thalassemic patients. Infected Transfusion Dependent Therapeutic trials in HCV infected children are still Maryam Keshvari1*, Seyed Moayed Alavian2, Bita lacking, especially in hemophilic and thalassemic Behnava3, Ali Pouryasin4, Leyla Mehrnoush5, children. So, we decided to evaluate the virologic Shima Salimi6, Heydar Sharafi7, Mohammad 8 9 response to Pegylated interferon (PEG-IFN) alfa Gholami Fesharaki , Pegah Karimi 1 among these two high risk groups of children Iranian Blood Transfusion Organisation Research Cen- ter, Iranian Blood Transfusion Organisation ,Tehran Iran comparing with adults. 2 Method: Baqiyatallah Research Center for Gastroenterology and This study was carried out on 22 Liver Disease, Baqiyatallah university,Tehran Iran thalassemic children patients and 28 hemophilic 3 Baqiyatallah Research Center for Gastroenterology and children patients in comparison with another two Liver Disease, Baqiyatallah university,Tehran Iran groups of 144 thalassemic adult patients and 313 4 Department of Genetics, Islamic Azad University-Ar- hemophilic adult patients that were similar in HCV sanjan branch, Daneshgah Blv., Arsanjan, Iran genotypes, sex and stage of liver disease (cirrhosis or 5 Baqiyatallah Research Center for Gastroenterology and chronic hepatitis). All patients were treated with the Liver Disease, Baqiyatallah university ,Tehran Iran 6 same therapy regimen. Baqiyatallah Research Center for Gastroenterology and Results: In thalassemic children, there were 10 Liver Disease, Baqiyatallah university ,Tehran Iran 7 Armin Pathobiology Laboratory, Baqiyatallah university, patients with HCV genotype 1, 9 patients with Tehran Iran genotype 3, and 2 patients with mixed genotypes. 8 Department of Biostatistics, Tarbiat Modares University, There were 7 patients with liver cirrhosis in this Tehran Iran group. Among hemophilic children, there were 23 9 Baqiyatallah Research Center for Gastroenterology and patients with HCV genotype 1, and 3 patients with Liver Disease, Baqiyatallah university,Tehran Iran genotype 3. There was not any case of cirrhosis in Introduction: The role of genetic factors in response this group. In thalassemic patients, sustained to interferon (IFN) based treatment among Hepatitis virologic response (SVR) was achieved in 78.9% of C virus (HCV) infected patients has been determined. children, compared to 33.8% of adults (P<0.001, Recently, IL28B polymorphism has been identified OR=7.36, 95%CI=3.24-9.87). In hemophilic patients, as a strong predictor HCV treatment response. The SVR was achieved in 81.5% of children, compared HCV infection is the most prevalent transfusion- to 62.9% of adults (P=0.043, OR=2.6, 95%CI=1.8- transmitted infection in transfusion dependent 4.32). thalassemic patients but there is no data about the role Conclusion: These results show an improved SVR of IL28B polymorphisms in HCV treatment of rate in HCV infected children compared to reference thalassemic patients in the literature. In this study, we series in adults with the same regimen, especially in decided to identify the role of IL28B polymorphisms thalassemic children patients. Also, this result is in response to IFN based treatment among Iranian similar to the rate of SVR in non-hemophilic and thalassemic patients. non-thalassemic children patients. Histological Method: Sixty eight poly-transfused thalassemic changes among HCV infected children are mild and patients with chronic hepatitis C were evaluated six cirrhosis is rare which can explain the high virologic months after cessation of treatment with Pegylated response in children. IFN Alpha 2a and Ribavirin. For IL28B genotyping, Send Date: 2012/07/07 genomic DNA was extracted from peripheral blood using QIAamp DNA Mini Kit. Two common IL28B polymorphisms (rs8099917 and rs12979860) were Code: 2298 genotyped by PCR-RFLP method. Category: 7. LIVER Results: From total of 68 thalassemic patients, 43

68 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 individuals were infected with HCV genotypes 1 and Introduction: Chronic hepatitis C is the major cause 25 individuals with HCV genotypes 3. The of liver disease in patients with hereditary bleeding prevalence of the rs12979860 CC genotype in disorders. The current standard therapy of chronic patients with HCV genotype 1 who achieved hepatitis C in hemophilic patients is a combination of sustained virologic response (SVR) was significantly pegylated interferon alpha (PEG-IFN) and ribavirin higher than in nonresponder patients (P=0.043). We (RBV). Recent studies revealed that the genetic didn’t observe such association between the IL28B variation of IL28B region can influence the sustained rs8099917 polymorphism and achieving SVR in virologic response (SVR) in hepatitis C virus (HCV) HCV genotype 1 infected patients (P=0.3). Also, in infected patients. Here, we evaluated the influence of HCV genotype 3 infected patients no association IL28B genotypes on response to antiviral therapy in between the IL28B polymorphisms and treatment Iranian hemophilic patients with chronic hepatitis C. response was observed. For HCV genotype 1 infected Method: One hundred and ten Iranian hemophilic patients, we detected an association between patients (M/F: 102/8) with chronic hepatitis C, who achieving complete early virologic response (cEVR) were infected with HCV genotype 1 were enrolled in and SVR (P<0.001). Also, the SVR rate in HCV the present study. They were treated with PEG-IFN genotype 1 infection was significantly higher among alpha-2a and RBV for 48 weeks, during 2008-2009. patients without cirrhosis comparing patients with Two common polymorphisms of the IL28B gene cirrhosis (P= 0.002). (rs8099917 and rs12979860) were genotyped by Conclusion: These results demonstrate that among PCR-RFLP method. HCV genotype 1 infected thalassemic patients, the Results: This study showed that the rs12979860 CC rs12979860 CC genotype is associated with higher genotype is a strong predictor of achieving SVR rates of SVR. Identification of these polymorphisms (P=0.005). The SVR rates were 71.4%, 54.5% and in HCV infected thalassemic patients before 30% for the CC, CT and TT genotypes, respectively. treatment can help physicians to predict the efficacy Also, the rs8099917 TT genotype was associated of Pegylated IFN and Ribavirin therapy. with achieving SVR (P=0.006). In addition, 66.7% Send Date: 2012/07/08 of patients with the rs8099917 TT genotype achieved SVR vs. 41.5% and %37.55 in the GT and GG genotypes, respectively. Also, other predictors of Code: 2309 SVR including younger age (P=0.0001), male sex Category: 7. LIVER (P=0.32), complete EVR (P=0.0001) and patients 7.9 Viral hepatitis C: clinical aspects without cirrhosis (P=0.18) were assessed. F-T-117 Conclusion: In hemophilic patients the rs8099917 and IL28B Polymorphism is a Critical rs12979860 polymorphisms are two important Predictor of Sustained Virologic Response predictors of response to PEG-IFN and RBV therapy. in Hemophilic Patients with Chronic Hepatitis C Liver biopsy in these patients is contraindicated, so the Seyed Moayed Alavian1*, Bita Behnava1, use of degree of liver fibrosis as a predictor of SVR is 2 1 Maryam Keshvari , Leyla Mehrnoush , shima limited. As a result, clinicians can predict SVR with 3 1 4 Salimi , pegah Karimi , Ali Pouryasin , assessment of these two polymorphisms combined with Heidar Sharafi1, mohammad gholami fesharaki5 other response predictors in these patients. 1 Baqiyatallah Research Center for Gastroenterology and Send Date: 2012/07/22 Liver Disease, Baqiyatallah, Tehran,iran 2 Iranian Blood Transfusion Organisation research center, Blood Transfusion Organisation, Tehran, Iran, 3 Baqiyatallah Research Center for Gastroenterology and Code: 2313 Liver Disease, Baqiyatallah Category: 7. LIVER 4 Department of Genetics, Islamic Azad University- 7.9 Viral hepatitis C: clinical aspects Arsanjan branch, Arsanjan, Iran F-T-118 5Department of Biostatistics, Tarbiat Modares THE PREVALENCE of HTLV-I INFECTION in University, Tehran, Iran

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IRANIAN THALASSEMIC Conclusion: Present study shows a significant rate of and HAEMOPHILIC PATIENTS HTLV1 infection in thalassemic patients with chronic with CHRONIC HEPATITIS C hepatitis C. Regard to these data, we suggest the shima Salimi1*, Seyed Moayed Alavian1, Bita Behnava1, screening test of anti HTLV1 in all of the thalassemic Maryam Keshvari2, Leyla Mehrnoush1, Hoseyn and hemophilc patients and also in chronic hepatitis Keyvani3, mohammad gholami fesharaki4 c patients with a history of transfusion. Furthermore, 1 Baqiyatallah Research Center for Gastroenterology and this study showed that blood transfusion has been an Liver Disease, Baqiyatallah, Tehran,iran important rout of HTLV1 transmission especially in 2 Iranian Blood Transfusion Organisation research center, some provinces. Although screening for anti- HTLV- Blood Transfusion Organisation, Tehran, Iran, 3 virology department, Tehran university I antibodies in volunteer blood donors has been 4 Department of Biostatistics, Tarbiat Modares University, routinely done in KHorasan , but it seems that Tehran, Iran HTLV1 screening test should be done in some other Introduction: Human T cell lymph tropic virus type provinces. Further studies should be determined to 1 (HTLV-1) infection is endemic in Iran. HTLV-1 is changing epidemiology of HTLV-I infection in Iran transmitted vertically mainly through breast-feeding and the interaction of HCV and HTLV1 infections. and then blood transfusion in endemic areas. Send Date: 2012/07/22 Transfusion related thalassemia and haemophilia patients are high risk groups for blood borne infections such as HTLV-1. The interaction between Code: 2434 HCV and HTLV1 infections is a mystery subject. We Category: 7. LIVER performed a study to determine the prevalence of 7.9 Viral hepatitis C: clinical aspects HTLV-1 in Iranian thalassemic and haemophilic F-T-119 patients with chronic hepatitis C. Efficacy of double dose recombinant hepatitis B Method: The prevalence of HTLV-I infection was vaccination in chronic hepatitis C patients, investigated in a sample of 218 thalassemic and compared to standard dose vaccination 1* 2 hemophilic patients followed in our clinic for last 18 Mohammad Minakari , Afshin Tahmasbi , Mahyar 3 3 4 months. All the patients we enrolled in our study have Hosseini Motlagh , Behrooz Ataei , Majid Yaran , Hamid Kalantari1, Hamid Tavakkoli1 positive test for HCV PCR for more than 6 months. 1 Gastroenterology Department, Isfahan University of The subjects were initially screened by an enzyme Medical Sciences immunoassay and reactive samples were further 2 Internal medicin Department, Isfahan University of confirmed by Western blot and polymerase chain Medical Sciences reaction. We assess the relation between the gender, 3 infectious disease and tropical medicine research center, marital status, education and the living place (rural Isfahan University of Medical Sciences or urban) with the prevalence of HTLV1. 4 Infectious disease and tropical medicine research center, Results: A total number of 218 patients, consisting Isfahan University of Medical Sciences Introduction: of 64 thalassemic and 154 haemophilic patients with Hepatitis B vaccination is a well mean age of 28.8 were analyzed. The prevalence of known, safe and effective way for protection against HTLV-I infection in thalassemic patients was 10.9 % hepatitis B infection however, non-responders remain (7cases) and in haemophilic patients was1.3 % susceptible to infection with hepatitis B virus. This is (2cases). The HTLV-1 PCR test was only positive in so important in patients with any kind of chronic liver 3 thalassemic and 2 haemophilic patients.HTLV1 disease, especially chronic hepatitis C patients in infections is more prevalent in KHorasan and Gilan whom acute hepatitis B may lead to decompensating provinces. The results of this study shows that HTLV liver disease. Some studies have shown that infection is more frequent among the rural immunogenicity of hepatitis B vaccination is population than urban area .No relation was founded decreased in these patients. The aim of this study was between the gender, marital status, education and the to evaluate the efficacy and safety of double dose prevalence of HTLV1. vaccination of hepatitis B in these patients, compared

70 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 to standard dose vaccination in similar patients and degree of accordance with the diagnostic criteria of healthy adults. IAHG. Method: Sixty-four chronic hepatitis C patients were Results: Sixty patients, 40 females and 20 males, randomized into 2 groups of 32. Group A received with the mean age of 39.45±17.50 years were standard dose hepatitis B (HBV) vaccine, at 0, 1, 6 enrolled in the study. The most common sign and months, whereas group B received double dose HBV symptoms in descending order were fatigue (100%), vaccine. Group C consisted of 32 healthy adults who icter(66.7%), abdominal discomfort (33.3%), also received standard dose vaccination. One month abdominal distension (28.3%), dark urine(23.3%), after the end of vaccination, HBsAb titer was checked edema(23.3%), haematemesis(20.0%), pruritus in all participants and the results were compared. (20.0%), melena (11.7%) and pale stool (10.0%). Results: There was no significant difference in age Hyper gammaglobulinemia was detected in 95.0% or sex among three groups. The response rate in cases.ALKM-1, P-ANCA, ANA and ASMA were groups B and C was 100% (all had HBsAb titer>10 positive in 71.4%, 66.7%, 42.4% and 19.4% cases, mIU/mL), while in group A, 4 patients (12.5%) were respectively. Due to paraclinical study findings, non-responders (HBsAb titer<10 mIU/mL). The portal hypertensive gastropathy (45.0%), esophageal difference in response rate was statistically significant varices (41.7%) and cirrhosis (40.0%) were the most between group A to the other two groups (P<0.05). complications of autoimmune hepatitis in patients. Conclusion: The efficacy of standard dose HBV According to IAHG, 80.0% of cases had definite vaccination in chronic hepatitis C patients was diagnosis, 15.0% of cases had probable diagnosis and suboptimal. Using double dose vaccination in these 5.0% of cases no AIH. patients was an effective way to increase the antibody Conclusion: This study showed that the majority response. cases of our study are diagnosed according to the cri- Send Date: 2012/09/15 teria of IAHG and these criteria is very useful. Send Date: 2012/10/01

Code: 2553 Category: 7. LIVER Code: 2393 7.10 Immunology - autoimmune liver disease Category: 7. LIVER F-T-120 7.13 Miscellaneous Autoimmune hepatitis and International criteria F-T-121 Mohammadhossein Somi2, Mohammadreza Normal limits of alanine tranaminase Abdollahi1*, Sepideh Lotfi Sadigh2 and aspartate transaminase in 1Young researchers club,Tabriz branch, Islamic Azad healthy individuals in Kerman, Iran. University Of Tabriz Sodaif Darvish Moghaddam1*, Mohammad Javad 2 Liver and gastrointestinal diseases research center, Tabriz Zahedi1, Mehdi Hayatbakhsh Abbasi1, University of Medical Science Mehdi Khaleghi Nia2, Mahdie Khalily Zade2 Introduction: Autoimmune hepatitis is an inflammation 1 Department of Internal Medicine, GI section, Afzalipoor of the liver of unknown cause. One of widely used Hospital, Kerman University of Medical Sciences, criteria for diagnosis is International Autoimmune Kerman, Iran Hepatitis Group(IAHG) recommendation.This study 2 clinical research unit, Afzalipoor Hospital, Kerman aimed at evaluating the clinical and paraclinical University of Medical Sciences, Kerman, Iran characteristics of AIH,comparing them with IAHG Introduction: Alanine tranaminase ) ALT) and criteria. aspartate transaminase (AST) are sensitive and useful Method: Sixty patients with AIH attended to tools for determination of liver damage. There is no university clinic in Tabriz University of medical consensus on the upper normal limits for these science,during a 12-month period were assessed in a enzymes in healthy people. They are probably case series study.They were evaluated regarding their affected by race and age. If we could find a new cut signs and symptoms,paraclinical results and the off point, we will be able to diagnose a chronic liver

Govaresh\ Vol.17\ Supplement\ Autumn 2012 71 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 disease in earlier stages and in case of a higher cut surgeon was confronted with the choice between off point, the previous normal levels will be conversion to open surgery, or postoperative ERCP confirmed again. (two-stage treatment). With increasing experience of Method: In this descriptive cross sectional study laparoscopic surgeons, it seemed logical to develop a 2745 subjects were selected according to randomized mini-invasive one-stage Laparoscopic common bile cluster sampling. They were the healthy people with duct exploration (LCBDE). Body Mass Index (BMI) of 20 to 24.9 without any Method: This study evaluates our results of LCBDE evidence of acute or chronic liver diseases. Blood in a series of 690 patients treated over 56 months samples were drawn after fasting for 12 hours for [2006(Apr) – 2011(Jan)]. The purpose of this study is biochemical determinations of cholesterol, triglycerides, to evaluate the feasibility and safety of LCBDE fasting blood sugar, ALT and AST. The data and physical during LC. The inclusion criterion was the presence examination were collected on a direct interview. of ultrasound proven gallstones. Patients were Results: The mean age (years ± SD) of the subjects excluded from the study if there was evidence of was 44.7 ± 16.3. 42.5% of them were male. Overall carcinoma of the gallbladder. the mean, standard deviation and median for AST, Results: CBD stones were demonstrated in 99 were 23.89, 12.87, and 22 respectively and for ALT patients by routine IOC (68 cases) or pre-operative they were 22.4, 19.55 and 18. The level of ALT and MRCP (31 cases). LCBDE was done in 78 patients. AST for 95% of subjects were respectively less than In 17 cases of MRCP-diagnosed and 61 cases of 50 and 40 IU/dL. Men had higher average enzyme IOC-diagnosed CBD stone(s) scheduled for LCBDE levels than women (P<0.0001). Both enzymes were we had 3 failure in CBD cleaning (3.8%), cleaned by significantly correlated with age (P=0.001). ERCP. Among 24 patients referred for ERCP [14 Conclusion: Overall in this study, the ALT and AST pre-op MRCP-diagnosed and 7 IOC-diagnosed and levels were lower than previously estimated levels in 3 failed LCBDE], we had 3 failed ERCP (12.5%) healthy subjects. These normal levels are affected by needed reoperations. In 21 patients, CBD closed on a age and gender. C-Tube and in 10 patients LCBDE completed with Send Date: 2012/09/03 T-tube insertion. In 23 cases no CBD drainage was performed. Choledochoduodenostomy was performed in 24 cases. In 60 cases flexible Code: 2290 choledochoscopy was done. The mean operative time Category: 8. BILIARY was 90-130 minutes (mean 95), which is significantly 8-2 Gallstones greater than conventional LC (range 20-40 minutes, F-T-122 mean 30). LCBDE was performed without immediate Laparoscopic Common Bile Duct Exploration; or late complications. We had 2 major bile leakages new targets for the surgeon, new opportunity that in 1 case needed ERCP/ES and in the other for the patient. Does it stand against ERCP? stopped spontaneously. The conversion rate to open Shahram Nazari1* surgery was 3.8%. We had no mortality related to our 1 Erfan Hospital, Tehran University surgery. Introduction: Common bile duct (CBD) stones are Conclusion: There are no debates in the detection found in approximately 16% of patients undergoing and the management of CBD stones in the era of LC. laparoscopic cholecystectomy (LC). Clinical models LCBDE is a cost-effective, efficient, and minimally are inaccurate in predicting CBD stones. Prior to the invasive method of treating choledocholithiasis. development of LC, the management of these patients Send Date: 2012/06/17 included CBD exploration at the time of cholecystectomy. In the era of LC, because of an obvious lack of expertise in laparoscopic surgery, if Code: 2458 the diagnosis of choledocholithiasis was established Category: 8. BILIARY during intraoperative cholangiography (IOC), the 8-2 Gallstones

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F-T-123 Introduction: Cholelithiasis is a one of the most Prevalencle of endoscopic common gastrointestinal disorder and an important esophagogastrointestinal Lesions health problem .The incidence of this problem is not prior to cholecystectomy in loghman hospital follow a homogenized pattern in different parts of shahriar nikpour1* word.Howeverthere are few reports of its frequency 1loghman hakim hospital, shahid beheshti university in Iran which were limited to patient. The aim of this Introduction: Peptic ulcer disease is a common cause cohort study was recognition of frequency of for epigastric pains in patients with cholelithiasis cholelithiasis in general population and consequently considered for laparoscopic cholecystectomy and its risk factors that would be the first step for manage undiagnosed gastric or duodenal ulcer may be the this problem in our society. cause of persistent pains after cholecystectomy. The Method: This is a population based study on 6138 aim of this study was to assess the value of a routine subjects of urban and rural populations in different preoperative esophagogastroduodenoscopy for age groups. Sample selection was stratified –cluster- patients undergoing laparoscopic cholecystectomy. systematic randomization. Health’s centers were Method: Consecutive candidates for cholecystectomy considered as a cluster. A questionnaire including (cholecystitis , group A or symptomatic cholelithiasis, demographic , anthropometrics and laboratories data group B) at the ward of general surgery of Loghman along with medical history, physical exam and Hakim were enrolled in this prospective study. Upper ultrasonography data was completed. gastrointestinal endoscopy was performed in all cases Results: Of 6143 eligible subjects Mean age was to evaluate the prevalence of significant GI lesions. 42.71 years. Samples consist of 3507 (57.1%) male. Peptic ulcer, upper GI malignancy and duodenal The prevalence of gallstone disease was 0.8 %. erosion were defined as significant lesions. Binary logistic regression model showed that Age, Results: A total of 434 patients (286 female and 148 residency state, diastolic hypertension and TG serum male, mean age 45) were studied. Significant lesions level were potential predictors of Gallstone disease. requiring treatment were found in 10% of patients in After adjusting of other covariates, the risk of group A and 9% of patients in group B (p=0.46). gallstone disease for residency in village and Endoscopic finding changed the surgical plan in 2% diastolic hypertension was 3.29 (95%CI: 1.73- 6.26) patients of group B and 1.81 (95%CI: 1.002- 3.28) times higher, Conclusion: Peptic ulcers are common findings in respectively. With each year rise in age the risk of patients selected for cholecystectomy. We suggest gallstone disease would increases 1.04 (95%CI: 1.02- further studies to address the optimal assessment of 1.06) times and with each mmHg rise in diastolic patients with biliary symptoms considered for blood pressure the risk of this disease would increases cholecystectomy. 1.002 (1- 1.004). Send Date: 2012/09/25 Conclusion: despite low incidence gallstone in our survey increasing age, diastolic hypertension and also or rural residency were associated with gallstone Code: 2494 formation in a multivariate analysis. Female gender Category: 8. BILIARY in our study was not correlation with gallstone 8-2 Gallstones disease. However cholesterol levels and hypertension F-T-124 have associated with this disease. we can revered that The Prevalence of cholelithiasis the major of risk factors could prevented by charging among asymptomatic subjects; life style and diet. A population based study Send Date: 2012/09/30 Hossein Ajdarkosh1*, Farhad Zamani1, A Alipour1, Masoudreza sohrabi1, Kholamreza Hemassi1, 1 1 Khadijeh Hatami , Masoomeh Moaadi Code: 2340 1 Gastrointestinal and Liver disease research center Category: 8. BILIARY (GILDRC), Firoozgar Hospital, Tehran

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8.3 Malignant hepato-biliary diseases Cholangiocarcinoma. F-T-125 Send Date: 2012/08/15 Cholangiocarcinoma: Demographic characteristics, diagnostic modalities, therapeutic options and risk factors Code: 2304 in an endemic area of human fascioliasis Category: 9. PANCREAS Fariborz Mansour-Ghanaei 1*, Farahnaz 9.5 Malignant disease and endocrine tumors of the Joukar1, Javid Rasolian2 pancreas 1 Gastrointestinal and Liver Diseases Research Center of F-T-126 Guilan University of Medical Sciences Serum CA19_9 in patients with 2 Gastrointestinal and Liver Diseases Research Center of solid pancreatic mass Guilan University of Medical Sciences Mahmood Baghbanian1*, Hasan Salmanroghani1, Introduction: To assess the demographic characteristics, Bijan Shabazkhani 2, Mohamadkazem diagnostic modalities, therapeutic options and risk Amirbeigi1, Mohsen Akhondi1, Hadi Ghofrani 2 factors of cholangiocarcinoma in an endemic area of 1Sadoughi Hospital, Yazd University of medical science human fascioliasis. 2 Imam Hospital, Tehran University of medical science Method: Twenty two patients with cholangiocarcinoma Introduction: A wide variety of tumor markers have (CCA) and 48 control subjects were enrolled in this been proposed for pancreatic cancer, but currently the study. Controls included twenty four healthy subjects only one with any practical usefulness for diagnosis, and twenty four inpatients with gastrointestinal prognosis, and monitoring of treatment is “CA 19-9”. malignancy and without liver or other systemic This study aims at evaluating the results and value of disease. All cases and controls were carried out from serum CA19-9 in patients with pancreatic solid mass. 2010 to 2011. The medical records and Information Method: The present study which is of a descriptive, about liver diseases, family history, past medical prospective and case series nature , has been studying history, smoking, and alcohol consumption were patients with pancreatic solid mass for a duration of collected on both groups. Blood from all participants two years since November 2009. was tested for HBV and HCV and fasciola markers Results: Serum CA19-9 checked in 159 patients .The and then analyzed. majority of whom was male (68%) and 81% had Results: Twenty two cholangiocarcinoma cases with mass in the head of pancreas . The result of a median age of 68 years were included. Twenty one cytopathology revealed 131 adenocarcinoma (82%) were extrahepatic and only one Intrahepatic , 10 other malignancy (6%) , 7 benign lesion (4%) CCA.Thirteen (59%) had Jaundice and Abdominal and 11 non-diagnostic cases (7%). Mean level of this pain at presentation. Using of CT scan with ERCP or tumor marker in patients with adenocarcinoma, MRCP findings and elevated tumor markers (CA19- non-adenocarcinoma malignancy , benign and 9, CEA) were the most diagnostic procedure in nondiagnostic pathology was 1094 , 1004 , 120 , 259 patients. The prevalence of smoking and alcohol U/ML respectively. There wasn’t any significant consumption were not significantly different between relation between Serum CA19-9 value and cases and controls. Compared with controls, patients histopathology of solid pancreatic mass. had not a higher prevalence of positive HCV Ab Conclusion: Concerning adenocarcinoma , 58 U/ML (Elisa) and HBs Ag. Anti Fasciola Ab was Negative Cut Off Point of CA19-9; Sensitivity , specificity , in all cases and controls. PPV , NPV and accuracy were 85% , 67% , 88% , Conclusion: These findings support that there is not 60% and 81% respectively. This marker has limited positive association between smoking, alcohol sensitivity and specificity and cannot be used as a consumption and Infection with HBV, HCV and definite diagnostic test. So the use of this tumor Fascioliasis with Cholangiocarcinoma in Guilan marker for the differentiation of pancreatic cancer province. However the number of patients was fairly should be applied individually, depending on the low in our study and this limits our ability to detect clinical situation and imaging finding. actual association between these factors and Send Date: 2012/07/18

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Code: 2476 Complication,Comparing Hand-swen Category: 10. NUTRITION and Stapler Anastomosis 10.2 Nutrients and gut function sarah tayebi1*, ali abdolhosseini1, Mohammad F-T-127 Naser Forghani1, Maryam Razavi1 AoOHBÉ ì¿pÙ ÒnAøBÿ Akôüú kAo GB uñloï oôkû Odpüà Knüp Knüp Odpüà oôkû uñloï GB kAo Akôüú ÒnAøBÿ ì¿pÙ AoOHBÉ 1 Reasearch departement of Razavi Hospital, Mashhad NAHAPES ìÇBèÏú A¾×ùBó: yùp WíÏýQ ko Introduction: Cancer of esophagus is a highly lethal 1& AküHþ KýíBó , 1 qAkû AuíBÎýê Acíl , 1 qAkû cvò ÎíBo , 1 y×ýÏþ cBWþ ìpüî malignancy and the 6th most common cause of death ìpÞr OdÛýÛBR AìñýQ ÒnAüþ, kAðzãBû Îéõï Kryßþ A¾×ùBó Kryßþ Îéõï kAðzãBû ÒnAüþ, AìñýQ OdÛýÛBR ìpÞr 1 in the world .Anecdotal reports indicated that the high ìÇBèÏBR ìdlôkÿ Gú AoOHBÉ Gýò ì¿pÙ ÒnAøBÿ Akôüú kAo GB GýíBoÿ GB kAo Akôüú ÒnAøBÿ ì¿pÙ Gýò AoOHBÉ Gú ìdlôkÿ ìÇBèÏBR ølÙ: ô qìýñú rates of esophageal cancer in Iran reflected very high øBÿ âõAoyþ KpkAgPú Aðl. ølÙ Aq ìÇBèÏú cBÂp Gpouþ AoOHBÉ ì¿pÙ ÒnAøBÿ Akôüú kAo Akôüú ÒnAøBÿ ì¿pÙ AoOHBÉ Gpouþ cBÂp ìÇBèÏú Aq ølÙ Aðl. KpkAgPú âõAoyþ øBÿ incidence rates in certain areas of this country, especially Mazandaran and Khorasan Provinces. The GB yýõÑ uñloï oôkû Odpüà Knüp ko WíÏýQ yùp A¾×ùBó ìþ GByl. GByl. ìþ A¾×ùBó yùp WíÏýQ ko Knüp Odpüà oôkû uñloï yýõÑ GB objective of this study is to compare the outcome if ìÇBèÏú ìÛÇÏþ cBÂp Gp oôÿ 9664 ð×p Aq AÖpk GBèÔ A¾×ùBðþ AðXBï A¾×ùBðþ GBèÔ AÖpk Aq ð×p 9664 oôÿ Gp cBÂp ìÛÇÏþ ìÇBèÏú Gpouþ: oô} hand-sewn & staple method in esophago gastric âpÖQ. AÆçÎBR ìpGõÉ Gú ì¿pÙ ÒnAøBÿ Akôüú kAo GB AuP×Bkû Aq KpuzñBìú Aq AuP×Bkû GB kAo Akôüú ÒnAøBÿ ì¿pÙ Gú ìpGõÉ AÆçÎBR âpÖQ. anastomosis, focusing on mortality, anastomosis ÎBkAR ÒnAüþ GB Kpu{ ko ìõok Oßpo ì¿pÙ ÒnAÿ Akôüú kAo ko ø×Pú (ìÏíõæ ko (ìÏíõæ ø×Pú ko kAo Akôüú ÒnAÿ ì¿pÙ Oßpo ìõok ko Kpu{ GB ÒnAüþ ÎBkAR leakage, stricture, other organ failure, and infections ø×Pú ^ñl GBo Aq ÒnAøBÿ Akôüú kAo(kAo^ýò, qok^õGú, Öé×ê, ÞBoÿ ô qðXHýê) ô ÞBoÿ Öé×ê, qok^õGú, kAo(kAo^ýò, Akôüú ÒnAøBÿ Aq GBo ^ñl ø×Pú during first 30 days post operation. AuP×Bkû ìþ Þñýl? Þú AÖpAk uõAë oA Gú ¾õoR OÛpüHB øpâr, 3-1 GBo, 6-4 GBo, 9-7 GBo, 6-4 GBo, 3-1 øpâr, OÛpüHB ¾õoR Gú oA uõAë AÖpAk Þú Þñýl? ìþ AuP×Bkû Method: In a cross sectional study in Razavi GBo ô GýzPp Aq 01 GBo KBui kAkðl) WíÐ @ôoÿ yl. kAkû øBÿ ìpGõÉ Gú Îíéßpk Gú ìpGõÉ øBÿ kAkû yl. @ôoÿ WíÐ kAkðl) KBui GBo 01 Aq GýzPp ô GBo Hospital during 2006-2011 Data of 79 patients who were undergone surgery for squamous cell carcinoma of WíÐ @ôoÿ WíÐ IIIEMOR ylû AuPBðlAok KpuzñBìú Aq AuP×Bkû GB âõAoyþ uývPî thoracic esophagus, by single high volume surgeon, was yl.uñloï oôkû Odpüà Knüp Gú ìõAokÿ AÆçÝ âpkül Þú ðBoAcPþ ô kok yßíþ ko yßíþ kok ô ðBoAcPþ Þú âpkül AÆçÝ ìõAokÿ Gú Knüp Odpüà oôkû yl.uñloï collected trough their review of medical records, Æþ clAÚê 3 oôq Aq ìBû ko Æþ 3 ìBû Agýp Gú øípAû clAÚê kô ìõok Aq ìõAok qüp: GùHõkÿ qüp: ìõAok Aq ìõok kô clAÚê øípAû Gú Agýp ìBû 3 Æþ ko ìBû Aq oôq 3 clAÚê Æþ surgical procedure charts, intensive care unit and kok Gú kðHBë kÖÐ, ypôÑ kok øípAû GB OÓýýp ko Oßpo kÖÐ ô ÚõAï ìlÖõÑ kAyPñl. kAyPñl. ìlÖõÑ ÚõAï ô kÖÐ Oßpo ko OÓýýp GB øípAû kok ypôÑ kÖÐ, kðHBë Gú kok surgical ward notes, histopathological reports during ðPBüY Aüò ìÇBèÏú ðzBó kAk Þú yýõÑ uñloï oôkû Odpüà Knüp ko AÖpAk ko Knüp Odpüà oôkû uñloï yýõÑ Þú kAk ðzBó ìÇBèÏú Aüò ðPBüY øB: üBÖPú hospitalization and surgeon notes for each patient during ìõok ìÇBèÏú 7.12% ( 6.81% ko ìpkAó ô 1.42% ko qðBó) Gõk. øî ko ìpkAó ô øî ko øî ô ìpkAó ko øî Gõk. qðBó) ko 1.42% ô ìpkAó ko 6.81% ( 7.12% ìÇBèÏú ìõok weekly visits for first month post operation. We used qðBó GB AÖrAü{ Oßpo ì¿pÙ Akôüú øB, yýõÑ uñloï oôkû Odpüà Knüp AÖrAü{ Knüp Odpüà oôkû uñloï yýõÑ øB, Akôüú ì¿pÙ Oßpo AÖrAü{ GB qðBó SPSS version 16.5 for statistical analysis. Results: kAyQ. Kw Aq ÞñPpë ÎõAìê ìhlôyãp AÖpAkÿ Þú GýzPp ô ìvBôÿ 01 GBo ko ø×Pú ko GBo 01 ìvBôÿ ô GýzPp Þú AÖpAkÿ ìhlôyãp ÎõAìê ÞñPpë Aq Kw kAyQ. 79 patients ,36(45.6%) male & 43(54.4%) female with 66(83.5%) hand-sewn & 13(16.5) staple ÒnAøBÿ Akôüú kAo ì¿pÙ ìþ Þpkðl ko ìÛBüvú GB AÖpAkÿ Þú øpâr ÒnAÿ Akôüú kAo Akôüú ÒnAÿ øpâr Þú AÖpAkÿ GB ìÛBüvú ko Þpkðl ìþ ì¿pÙ kAo Akôüú ÒnAøBÿ anastomosis were entered to the study.37(56%) of ì¿pÙ ðíþ Þpkðl, 58% yBðw GýzPpÿ WùQ AGPç Gú uñloï oôkû Odpüà Knüp Odpüà oôkû uñloï Gú AGPç WùQ GýzPpÿ yBðw 58% Þpkðl, ðíþ ì¿pÙ hand-sewn & 9(75%) of staple group had received ). ). -RO ;58.1 09.2-81.1 , dnertp 50.0< ( kAyPñl neoadjuvant therapy before operation.4(6.1%) of ôÚPþ Þú kAkû øB Gú O×ßýà Wñw @ðBèýr ylðl, ìzBølû âpkül Þú ko qðBó Aüò qðBó ko Þú âpkül ìzBølû ylðl, @ðBèýr Wñw O×ßýà Gú øB kAkû Þú ôÚPþ hand-sewn & 11(84.6%) of staple group had peri- AoOHBÉ ìÏñþ kAo Gýò ì¿pÙ ÒnAøBÿ Akôüú kAo GB uñloï oôkû Odpüà Knüp ôWõk Knüp Odpüà oôkû uñloï GB kAo Akôüú ÒnAøBÿ ì¿pÙ Gýò kAo ìÏñþ AoOHBÉ operative bleeding more than 500 ml, which was ), AìB ko ìpkAó GB AÖrAü{ ì¿pÙ AÖrAü{ GB ìpkAó ko AìB ), -RO ;30.2 77.3-90.1 , dnertp 50.0< ( kAok significantly more in using staple method(P=0.00).we ÒnAøBÿ Akôüú kAo yBðw AGPç Gú uñloï oôkû Odpüà Knüp AÖrAü{ KýlA ðíþ Þpk. Þpk. ðíþ KýlA AÖrAü{ Knüp Odpüà oôkû uñloï Gú AGPç yBðw kAo Akôüú ÒnAøBÿ had no anastomotic stricture or mortality in neither üBÖPú øBÿ Aüò ìÇBèÏú cBÞþ Aq ôWõk AoOHBÉ ìÏñþ kAo Gýò ì¿pÙ Gýò kAo ìÏñþ AoOHBÉ ôWõk Aq cBÞþ ìÇBèÏú Aüò øBÿ üBÖPú âýpÿ: ðPýXú groups. anastomotic leakage was reported in only one patient in hand-sewn group. two case of arrhythmia ÒnAøBÿ Akôüú kAo GB yýõÑ uñloï oôkû Odpüà Knüp ko qðBó ìþ GByl. AðXBï GByl. ìþ qðBó ko Knüp Odpüà oôkû uñloï yýõÑ GB kAo Akôüú ÒnAøBÿ requiring intervention, one case of sever infection ìÇBèÏBR GýzPp WùQ y×BÙ yló Aüò AoOHBÉ KýzñùBk ìþ âpkk. ìþ KýzñùBk AoOHBÉ Aüò yló y×BÙ WùQ GýzPp ìÇBèÏBR (intra abdominal abscess) and one case of sever Send Date: 2012/09/28 pleural effusion was reported in hand-sewn group. one case of sever pleural effusion and one case if DVT, was reported in staple group. Conclusion: Code: 2361 From this study it could be concluded Category: 12. SURGERY that both hand-sewn& staple method are safe. It 12.1 Esophagus / stomach / duodenum seems that using stapler method causes more peri- F-T-128 operative bleeding.non of these groups had stricture Esophageal Cancer Resection & mortality, which is remarkable. Send Date: 2012/08/19

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Code: 2401 be a suitable marker for diagnosis of gastric cancer. In Category: 13. ONCOLOGY-BASIC addition, we demonstrate for the first time that 13.2 Molecular biology/genetics/pathology CXCR7 expression is enhanced as premalignant F-T-129 lesions progress to malignant tumors, indicating that CXCR7 is Expressed at Low Level on targeting CXCR7 could be a new approach for gastric Precancerous Lesions and is treatment of gastric cancer. Increased Along With Progression to Cancer Send Date: 2012/09/04 Farshad Sheikesmaeili1*, Mehrnoush Nikzabn2, Bahram Nikkhou1, Hoshyar Ghafori1, Shohre Fakhari2, Ali Jalili1 Code: 2402 1 Kurdistan digestive research center, Kurdistan Category: 13. ONCOLOGY-BASIC University of Medical Sciences 13.2 Molecular biology/genetics/pathology 2 Cellular & Molecular Research Center, Kurdistan F-T-130 University of Medical Sciences The Effect of H.Pylori on SDF-1/CXCR4 Axis: Introduction: Stromal derived factor-1 (SDF-1 or A Novel Mechanism for Migration CXCL12), a member of the alpha chemokines (CXC) of Human Bone Marrow-Derived and the ligand for the CXCR4 receptor, has been Mesenchymal Stem Cells into Gastric Tissues shown in the past to be an effective chemoattractant Shohre Fakhari, Farshad Sheikhesmaili1*, for various CXCR4-expressing cells. SDF-1 is Mehrnoush Nikzaban2, Mohamad Reza secreted by stromal and endothelial cells in bone Rahmani2, Mohamad Saeed marrow, lung, skeletal muscle, liver, kidney and Hakhamaneshi2, Fardin Fathi2, Ali Jalili1 brain. It is therefore important for metastasis of 1 Kurdistan Digestive Research Centre, Kurdistan cancer cells to these organs. We have recently shown University of Medical Sciences that CXCR4 is highly expressed on gastric cancers 2 Cellular & Molecular Research Center, Kurdistan and is upregulated by H.pylori infectious. Recent University of Medical Sciences Introduction: studies have shown that a newly identified receptor for Mesenchymal stem cells (MSC) are SDF-1, CXCR7, is expressed on many tumors and play multipotent stem cells which are capable to migrate a critical role in tumor metastasis. However, it across tissues and depending on the surrounding expression in gastric cancer have not yet been studied. microenvironment; they can differentiate into variety Method: Herein, we studied the expression of of cell types. On the other hand, these cells could be CXCR7on gastric samples from patients with the origin of transformed cells in many tumors such precancerous lesions (atrophy, metaplasia and as adenocarcinoma. Recent studies have dysplasia) and gastric adenocarcinoma as well as demonstrated that persistence infection with human gastric carcinoma epithelial cell line, AGS, by helicobacter pylori (H.pylori) leads to migration of employing RT-PCR, immunehistochemistry (IHC) and human bone marrow-derived MSC (BMD-MSC) to Fluorescence Activated Cell Sorting (FACS) techniques. gastric tissues and transforming to adenocarcinoma. Results: RT-PCR data show that CXCR7 is highly However, the mechanism of the BMD-MSC expressed on AGS cells. This was confirmed by IHC recruitment and migration of these cells into gastric and FACS as CXCR7 is detected in cell membrane tissues is unknown. It is a known concept that and cytoplasm of AGS cell line. More importantly, chemokines and their receptors are key players in cell we found that CXCR7 is strongly expressed on trafficking and among them stromal-derived primary gastric cancer cells from patients, but not on factor-1(SDF-1) and its receptor, CXCR4, play a normal gastric cells from normal individuals (as pivotal role in migration of immune cells, stem cells detected by IHC staining and RT-PCR).Furthermore, as well as metathesis of cancerous cells. Method: at low level on gastric precancerous lesions and is Herein, we investigated the possible effects increased along with progression to cancer. of H.pylori on SDF-1/CXCR4 axis. First, BMD-MSC Conclusion: we present evidence that CXCR7 is cells were isolated from bone marrow of healthy expressed on gastric carcinoma and thus CXCR4 may subjects, cultured for four passages and their

76 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 phenotypes were examined by flow cytometry. Introduction: Colorectal cancer is the third- fourth BMD-MSC cells showed to be positive for CD90 and most common cancer in Iranian women and men.Five CD73 and negative for CD45, indicating that these thousand new cases of colorectal cancer are diagnose cells are MSC. Next, we co-cultured either devery year,it is estimated that 1130 people die BMD-MSC or a human gastric epithelial cell line, annually due to colorectal cancer in Iran.Wnt AGS with H.pylori for 24 hours. signaling pathway is responsible for multiple aspects Results: We found that H.pylori induces SDF-1 of homeostasis like development, proliferation, expression in AGS cells upregulates SDF-1 in BMD- differentiation, cellpolarity andmigration. In MSC as detected by RT-PCR and Elisai upregulate addition,hyperactivity of Wnt signaling is one of the CXCR4 in BMD-MSC as determined by flow major factors in tumorgenesis in human cancer. cytometry and Real-Time PCR. In addition, we have Down regulation of the secreted frizzled related found that H.Pylori significantly enhances the protein 1(SFRP1) expression, which antagonizes Wnt migration of BMD-MSC toward SDF-1. signaling pathway, has been seen in many types of Conclusion: Our data indicate for the first time the cancers. In this study, we compared the expression status H.pylori infectious may induce SDF-1 in gastric of SFRP-1 gene in tumor tissues samples in comparison epithelial cells as well as upregulates CXCR4 on with their adjacent normal tissue in 11 patients. BMD-MSC, and that SDF-1 chemoattracts Method: We obtained 11 fresh colorectal tumor BMD-MSC into gastric tissues. tissues and their adjacent normal samples from Imam Send Date: 2012/09/04 Khomeini Hospital. Total RNA of samples were extracted and then their cDNA were synthesized. SFRP1 and β actin and GAPDH(the last two ones as Code: 2414 reference genes) expression were analyzed by syber Category: 13. ONCOLOGY-BASIC green master mix (Applied BioSystem, USA) with 13.2 Molecular biology/genetics/pathology Realtime analyzer ABI 7500 fast. F-T-131 Results: Twenty seven percent of cases had suffered Secreted frizzled related protein 1 from rectal cancer while 73% of cases had colon expression profiling in 11 patients of cancer. In 72% of tumor samples the SFRP1 colorectal cancer and its clinical implication expression was reduced or not detectable in Amirhosein Mehrtash1, Mahdis Ghadir1, comparison with adjacent normal tissues.The 2 Mohammad Sadegh Fazeli , Aghadas SFRP-1 gene expression of tumor tissues from 3 4 Movassagh , Christine Hartoonian , Ladan Rectumhad been reduced 2.78 times in comparison Teimoori-Toolabi5*, masoumeh azizi5 toadjacent normal tissues. In case suffering from 1Molecular Medicine Department, Biotechnology Research Center, Pasteur Institute of Iran, Department of tumors in colon the difference of expression between Biology, Science and Research Baranch, Islamic Azad normal and tumor tissues were diverse. Also in all University, Tehran, Iran female cases SFRP-1 expressionwere decreased in 2 Colorectal Surgery Department, Imam Khomeini tumor tissues in comparison to normal adjacent tissues. Hospital, Tehran university of Medical Sciences However,the reductionin expression was also observed Colorectal Surgery Department, Imam Khomeini in a male cases suffering from rectal cancer. Hospital, Tehran university of Medical Sciences Conclusion: The observation that rectal cancer had 3 Molecular Medicine Department, Biotechnology different expression in normal and tumor tissues Research Center, Pasteur Institute of Iran, Islamic Azad indicate that the expression of SFRP-1 gene showed University of Arsanjan, fars, Iran that over activation of wnt signaling pathway through 4 Virology Department, Pasteur institute of Iran, Virology Department, Pasteur institute of Iran inhibiting this antagonist is more prominent in rectal 5 Molecular Medicine Department, Biotechnology cancer while there should be more studies about the Research Center, Pasteur Institute of Iran role of this antagonist in inhibiting wnt signaling Molecular Medicine Department, Biotechnology Research pathway in females. Center, Pasteur Institute of Iran Send Date: 2012/09/05

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Code: 2415 PCR analyzer. Category: 13. ONCOLOGY-BASIC Results: About 73.5% of cases were female. In 36% 13.2 Molecular biology/genetics/pathology of samples, expression of SFRP-5 gene was F-T-132 decreased in tumor tissues in comparison to their SFRP-5 gene expression profiling in colorectal normal adjacent tissue while in 31.5% of cases, cancer patients and its clinical implications expression status of SFRP-5 in tumors tissue had no Mahdis Ghadir1, Amirhosein Mehrtash1, significant difference with their normal counterparts. Mohammad Sadegh Fazeli2, Kayhan The SFRP-5 gene was not expressed in 31% of Azadmanesh3, Aghdas Movassagh4, samples. The expression status of SFRP-5 in tumoral 5* 5 Ladan Teimoori-Toolabi , masoumeh azizi samples of patients suffering from colon tumors had 1 Molecular Medicine Department, Biotechnology decreased while in patients with rectal cancer this Research Center, Pasteur Institute of Iran, Department of observation was not seen. Biology, Science and Research Baranch, Islamic Azad Conclusion: University, Tehran, Iran According to our samples, we can 2 Colorectal Surgery Department, Imam Khomeini conclude that this disease is more common in Hospital, Tehran university of Medical Sciences, females. Also we can say that the over activation of Colorectal Surgery Department, Imam Khomeini Hospi- Wnt signaling pathway through decreased expression tal, Tehran university of Medical Sciences of wnt inhibitory factors such as SFRP-5 is more 3 Virology Department , Pasteur Institute of Iran common in colon cancer in comparison to rectal 4 Molecular Medicine Department, Biotechnology cancer. This may be due to higher proliferation rate in Research Center, Pasteur Institute of Iran, Islamic Azad colon tissue in comparison to rectum tissue and other University of Arsanjan, Fars , Iran factors may be responsible which should be studied 5 Molecular Medicine Department, Biotechnology well in future. Research Center, Pasteur Institute of Iran Send Date: 2012/09/05 Introduction: Colorectal cancer (CRC) is one of the most common and well-studied malignancies in the world. The disease is thought to originate from Code: 2292 multipotential stem cells located in intestinal crypts Category: 14. ONCOLOGY-CLINICAL from which (non)polypoid precursor lesions and 14.1 Malignant disease - epidemiology - screening finally metastatic CRC can develop. Colorectal and prevention cancer (CRC) arises as a consequence of the F-T-133 accumulation of genetic and epigenetic alterations in Diagnostic value of Pepsinogen I & II for colonic epithelial cells during neoplastic transformation. pre-cancerous gastric lesions in dyspeptic patients Epigenetic modifications, particularly DNA Abdol Rahim Masjedizadeh1*, Eskandar Hajiani1, methylation in CpG islands of Tumor suppressor Pejman Alavinejad1, Tahminah Zarhami 1, gene promoters (e.g,SFRPs gene promotores in Wnt Ali akbar Shaystah1, Jalal Hashemi1 signaling pathway),causes the expression of these 1 Division of Gastroenterology and Hepatology, Dept. of genes to be decreased and this event is recognized as Internal Medicine, Ahvaz Jundishpur University of common molecular alterations in human tumors. we Medical Sciences studied expression status of sFRP-5 gene in tissue Introduction: The strategy of gastric cancer screening samples of colon cancer and their normal adjacent differs around the world. Measurement of pepsinogen I tissue in 19 colon cancer patients. and II as markers of gastric atrophy could be an Method: Total RNA was extracted from colon alternative to endoscopy. The aim of this study is to cancer tissue samples and their normal adjacent tissue determine the diagnostic value of pepsinogen I and II as .Total RNA was converted to cDNA and then the a noninvasive way for evaluation of precancerous expression status of sFRP-5 gene in tumor and lesions in comparison with histologic specimens Normal tissue along with expression status of the obtained by endoscopic biopsy. reference gene( GAPDH) was studied by syber Green Method: Upper endoscopy performed for all mastermix (Applied Biosystem, USA) in a Real-time dyspeptic patients above 40 year old and five biopsy

78 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 samples obtained. The specimens were evaluated 1Gastrointestinal and Liver Diseases Research Center of based on Updated Sydney classification and Guilan University of Medical Sciences simultaneously serum pepsinogen I and II levels were Introduction: Gastric cancer is a leading cause of measured. Intestinal metaplasia and any type of cancer-related deaths in both sexes in Iran. This study dysplasia were interpreted as premalignant lesion. was designed to assess upper GI endoscopic findings The sensitivity, specificity and positive and negative among people > 50 years targeted in a mass predictive value of serum pepsinogen for detecting screening program in a hot-point region. these lesions were determined. Method: Based on the pilot results in Guilan Cancer Results: Overall 176 patients including 92 men and Registry study (GCRS), one of the high point regions 84 women (average age 53.97 ± 10.25) participated in for GC –Lashtenesha- was selected. The target this study. The average serum level of pepsinogen II population was called mainly using two methods: in was more elevated in male patients over 50. rural regions, by house-house direct referral and in pepsinogen I and II levels were lowest in corpus urban areas using public media. Upper GI endoscopy involvement (P=0.0001). With progression of was performed by trained endoscopists. All gastritis, the average level of pepsinogen I decreased participants underwent biopsies for rapid urea test but the decrease in pepsinogen II and pepsinogen I/II (RUT) from the antrum and also further biopsies ratio were meaningful in dysplasia and in different from five defined points of stomach for detection of pathologic situations (p=0.0001). sensitivity, precancerous lesions. In cases of visible gross lesions, specificity, positive predictive value and negative more diagnostic biopsies were taken and submitted predictive value of pepsinogen I< 70 and pepsinogen for histopathologic evaluation. II<7.5 For detection of premalignant lesions were Results: Of 1,394 initial participants, finally 1,382 respectively(58%,82%,78%,64% versus to 45%, persons (702 women, 680 men) with a mean age of 65%, 58%, 52%). These values for pepsinogen I/II<3 61.7±9.0 years (range: 50-87 years) underwent upper were 32%, 95%, 38% and 57% respectively. In case GI endoscopy. H. pylori infection based on the RUT of positive results of all three items the values were was positive in 66.6%. Gastric adenocarcinoma and 15%, 97.6%, 87.5% and 52% respectively. squamous cell carcinoma of esophagus were detected Conclusion: It seems that low sensitivity of these in seven (0.5%) and one (0.07%) persons, tests limits the ability of these biomarkers for screen- respectively. A remarkable proportion of studied ing of premalignant lesions but may be they could participants were found to have esophageal hiatal have a role as one of first steps in evaluation of high hernia (38.4%). Asymptomatic gastric masses found risk persons for gastric cancer. in 1.1% (15) of cases which were mostly located in Send Date: 2012/06/28 antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population. Code: 2344 Conclusion: Upper endoscopy screening is an Category: 14. ONCOLOGY-CLINICAL effective technique for early detection of GC 14.1 Malignant disease - epidemiology - screening especially in high risk populations. Further studies and prevention are required to evaluate cost effectiveness, cost F-T-134 benefit and mortality and morbidity of this method Endoscopic Findings in a Mass Screening among high and moderate risk population before Program for Gastric Cancer in a High Risk recommending this method for the GC surveillance Region - Guilan Province of Iran program at the national level. Fariborz Mansour-Ghanaei1*, Homayoon Sokhanvar1, Send Date: 2012/08/15 Farahnaz Joukar1, Afshin Shafaghi1, Mahmud Yousefi- Mashhour1, Ali Kord Valeshabad1, Saba Fakhrieh1, Keyvan Aminian1, Kambiz Ghorbani1, Zahra Code: 2347 Taherzadeh1, Mohammad Reza Sheykhian1, Mohammad Category: 14. ONCOLOGY-CLINICAL Yaghoub Rajpout1, Alireza Mehrvarz1

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14.1 Malignant disease - epidemiology - screening 5.2% of cases was "death certificate only". The ASR and prevention of CRC was 12.3 and 9.4 per 100000 person-year in F-T-135 males and females, respectively. Changing epidemiology of colorectal cancer in a Conclusion: Our findings showed an increasing trend high risk area for upper gastrointestinal cancers in the incidence of CRC in our region. Previous Gholamreza Roshandel1*, Mohsen Aarabi1, reports suggested that this cancer is not common in Shahryar Semnani1, Mohammad Naeimi Tabiei2, our area. However, we found that CRC is among five SeyedMehdi Sedaghat3, Abbas Moghaddami3, leading cancers and its incidence rate has 1 Honeyehsadat Mirkarimi dramatically increased during recent decades. 1 Golestan University of Medical Sciences, Golestan Changes in the lifestyle and dietary habits of our Research Center of Gastroenterology and Hepatology population into the westernized pattern may be the 2 Golestan University of Medical Sciences,Department of Health, Golestan University of Medical Sciences possible explanation for this trend. So, besides the 3 Golestan University of Medical Sciences, Department of upper GI cancers, controlling the CRC should be Health considered as a priority in future health policy Introduction: Golestan province located in northeast making in Golestan province of Iran. of Iran had been known as a high risk area for upper Send Date: 2012/08/15 gastrointestinal (GI) cancers since about 40 years ago. Previous studies showed that despite a very high incidence rate of esophageal and stomach cancers, the Code: 2348 rate of colorectal cancer (CRC) was considerably low Category: 14. ONCOLOGY-CLINICAL in this region. Recent reports suggested a declining 14.1 Malignant disease - epidemiology - screening trend in the incidence rate of upper GI cancers. In and prevention contrast, an increasing was shown in the rate of lower F-T-136 GI malignancies. This study was conducted to Survival rate of esophageal cancer determine the epidemiology of CRC in Golestan patients in Golestan province of Iran 1* 1 province of Iran. Gholamreza Roshandel , Golnaz Golalipoor , 1 2 1 Method: This study was part of Golestan Mohsen Aarabi , Bita Safaie , Reza Mohammadi 1 Golestan University of Medical Sciences, Golestan population-based cancer registry (GPCR) founded by Research Center of Gastroenterology and Hepatology the Golestan Research Center of Gastroenterology 2 Golestan University of Medical Sciences, Department of and Hepatology (GRCGH) under supervision by the Pathology Digestive Disease Research Center. All newly Introduction: Golestan province has been known as a diagnosed CRC cases in the province were registered high risk area for esophageal cancer (EC). This study between 2004 and 2008. Demographic characteristics was conducted to assess the population-based survival of patients as well as information about the tumor were rate in EC patients in Golestan province of Iran. collected using structured questionnaire from all Method: Newly diagnosed EC patients registered in centers delivering diagnostic and therapeutic services Golestan population-based cancer registry in 2007 to CRC patients. Data about Golestan population was and 2008 were recruited. Data and documents about obtained from the vice-chancellor for health of stage of tumor and patients' vital status were Golestan University of Medical Sciences (GOUMS). collected. Stage of tumor was determined using Age standardized incidence rate (ASR) was calculated summary staging system. Kaplan-Meier method was using the 18 grouped world standard population. used to calculate median survival and log rank test Results: There were 614 newly diagnosed CRC cases was used to compare survival rates between during the study period. It was the fifth common subgroups of variables. Multivariate Cox regression cancer in Golestan province. The mean (SD) age of model was used to determine adjusted hazard ratios the CRC patients was 55.3 (10.1) years. 374 (56.5%) (AHR) for different variables. of cases were male. The proportion of microscopic Results: From 223 patient, 129(57/8%) were male. verification was 73%. The method of diagnosis in The mean age of participants was 64/3 years. The

80 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 median survival in our study was 11.08 months. hospital.All eligibel subjects undewent total Survival rates for 6, 12 and 36 months were 70%, 47% colonoscopy. All lesions were removed and sent to and 15%, respectively. The results of Cox regression pathology centre of hospital for histopathological analysis showed that the AHR for patients with evaluation.The colorectal were classified by size, metastasis stage and regional stage (compared to those location, numbers and pathologic findings. with localized stage) were 9.21 (95% CI: 5.64-15.05) Results: A total of 1208 eligible participants were and 3.2 (95% CI: 1.94-5.29), respectively. enrolled in this study. Of them 623 subjects were Conclusion: Our results showed that survival rate of male. The mean age was 56.45 ± 9.59. The EC patient in our study was higher than the rate distribution of participants in 40-49, 50-59, 60 -69 reported in a previous study from this region. But it and ≥ 70 years old group were 30.1% ,36.8%, 25.4% was still lower than those reported from developed and 7.7% respectively. Overall prevalence of polyp countries. Regarding the stage of tumor as the most was 16.5 % .the prevalence of polyp were more important determinant of survival in these patients, it common among 50-60 (n=76) followed by seems that implementation of appropriate programs 60-70(n=63) years old group. The most common to detect the disease in early stages (screening histopathology finding was tubular adenoma by programs) will increase the survival rate in these 69.3% (n=138) .Age (OR=3.17) and male sex patients. (OR=1.81) have positive correlation with advanced Send Date: 2012/08/15 pathological finding. In Multivariate analysis the pathological finding has not significant correlation with sex, age, Location and number of lesions. Code: 2491 Conclusion: This study revealed that overall Category: 14. ONCOLOGY-CLINICAL prevalence of adenomatose lesions in Iran is almost 14.1 Malignant disease - epidemiology - screening similar to the western countries .But the prevalent of and prevention malignancy is lower than these countries. We also F-T-137 concluded that the subjects aged 40-49 years have a Colonoscopy screening in measurable risk to developing a colorectal neoplasia average-risk population and age 60-69 are more prone to develop polyp and Farhad Zamani, Masoudreza Sohrabi1*, Hossein cancer. Also male sex and age could be considered as 1 1 Ajdarkosh , Kholamreza Hemassi , risk of colorectal adenoma. 1 1 Mahmoodreza Khansari , Naser Rakhshani , Send Date: 2012/09/30 Mitra Ameli1, Khadijeh Hatami1 1Gastrointestinal and Liver disease research center (GILDRC), Firoozgar Hospital, Tehran Code: 2311 Introduction: Colorectal cancer(CRC) is one of the Category: 15. NERVE GUT AND MOTILITY most prevalent cause of death worldwide.In Middle 15.5 Functional gastrointestinal disorders (clinical - East The prevalence of colorectal cancer is estimated management) to be around 0.7-0.8% .In Iran cancer also is the F-T-138 major health problem and cancer is the third most Evaluating the relationship between common cause of death.The aime of this irritable bowel syndrome and investigation is determination of prevalence of Perdectionism in medical students preneoplastic and neoplastic lesions of the colon in Akbar arjmandpour1, Marziyeh Matinfar2*, the average risk population to find the best age group Ali Toghiani2, Ahmad Sobhani1, Hamidreza who benefit from screening. Nikyar1, Rahmatollah Rafiei1, Mehdi Method: This is a longitudinal prospective study for Najafi2, Peyman Adibi3 CRC screening on asymptomatic, average- risk adults 1Associated professor, Islamic Azad University, between 2007-2012 ,aged more than 40 years old, Najafabad Branch, Najafabad, Isfahan, Iran. between 2007-20012 who had no symptom referable 2 Medical Student, Islamic Azad University, Najafabad to gastrointestinal tract in Firoozgar general Branch, Najafabad, Isfahan, Iran.

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3Professor of medicine, Integrative functional Soheila Riahinejad1, Ali Toghiani3, gastroenterology research center, Isfahan University of Mehdi Farhang3, Ahmad Sobhani1, Medical Sciences, Isfahan, Iran Rahmatollah Rafiei1, Peyman Adibi4 Introduction: Perfectionism seems to play an 1Associated professor, Islamic Azad University, important role in etiology, aggravation and flare-up Najafabad Branch, Najafabad, Isfahan, Iran. 2 of many disorders specially psychosomatic disorders Researcher,Psychosomatic Research center, Isfahan such as irritable bowel syndrome; however there are University of Medical Sciences, Isfahan, Iran. 3 Medical Student,Islamic Azad University, Najafabad not many data exist to clarify the relationship Branch, Najafabad, Isfahan, Iran. between perfectionism and IBS . 4Professor of medicine, Integrative functional Method: In this cross-sectional study 250 medical gastroenterology research center, Isfahan University of students from Islamic Azad university, Najafabad Medical Sciences, Isfahan, Iran Branch in different grades were included. Irritable Introduction: Irritable bowel syndrome is one of the bowel syndrome was evaluated using valid and most common functional gastrointestinal disorders reliable farsi version of ROME III criteria and which is presented by bowel habit change and perfectionism was evaluated by a valid and reliable abdominal pain without any structural defect. The questionnaire Prevalence in Iran is reported between 4.2-18.4 %. Results: In basic science grade 14.7%, in Although the etiology is still unknown but many physioathology grade 16.1%, 21.5 % of stagers and factors such as motility disorders, genetics, nutrition, 19.3% of interns had IBS. Positive perfectionism was behavioral disorders may cause it. During Pregnancy diagnosed in 81.9% of basic science grade, 87.1% of GI symptoms like nausea and vomiting are so physioathology grade, 83% of stagers and 91.9% of common. The anxiety level will also increase during interns. Negative perfectionism was diagnosed in this period .Due to the relationship between IBS and 69.9% of basic science grade, 75.8% of these factors this study was designed to evaluate the physioathology grade, 70.7% of stagers and 80.6% IBS symptoms during pregnancy in comparison with of interns.There was a significant correlation between normal objects. IBS and possitive perfectionism scores in medical Method: This was a cross-sectional study to evaluate students but there was no significant correlation Irritable bowel syndrome (IBS) symptoms in between IBS and negative perfectionism (P<0.031 , comparison with normal objects Patients were P<0.231 ). included to the study after full-filling the valid and Conclusion: Prevalence of IBS and both positive and reliable farsi version of ROME III citeria IBS negative perfectionism in medical students were questionnaire. higher than general population. This significant Results: 323 pregnant and 98 controls were included. difference in perfectionism could be explained IBS was seen in 23.5% of pregnant and 13.3% of because both medical students themselves and patients in control group. (P<0.05) . IBS-C had a society expect a lot from educated individuals significant increase in third trimester comparing with specially physicians and perfectionism could first and second trimester (P<0.05).IBS-D had a aggravate IBS symptoms. significant increase in second and third trimester Send Date: 2012/07/22 comparing with control group (P=0.042).IBS-M had a significant increase in third trimester comparing with control group (P=0.008). Code: 2312 Conclusion: In this study frequency of IBS Category: 15. NERVE GUT AND MOTILITY symptoms was higher in pregnant than control group 15.5 Functional gastrointestinal disorders (clinical - and this could be because of hormonal changes and management) psychological factors which are changing during F-T-139 pregnancy. Irritable bowel syndrome symptoms Send Date: 2012/07/22 during pregnancy trimesters Akbar arjmandpour1*, neda Adibi2,

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Code: 2431 15.5 Functional gastrointestinal disorders (clinical - Category: 15. NERVE GUT AND MOTILITY management) 15.5 Functional gastrointestinal disorders (clinical - F-T-141 management) Personality Factors in Irritable F-T-140 Bowel Syndrome: A cross-sectional study gõyú Gñlÿ AgPçæR Îíéßpkÿ âõAoyþ GB AuP×Bkû Aq oô} øBÿ kAkû ÞBôÿ kAkû øBÿ oô} Aq AuP×Bkû GB âõAoyþ Îíéßpkÿ AgPçæR Gñlÿ gõyú hamid afshar, mmar Hassanzadeh Keshteli1, Homa Saadati1, Elham Kavosian1, forough isvand1, Malihe Jafari Naeimi2, Hamid Daghaghzadeh1, Reza Ammar Hassanzadeh Keshteli3, Bagherian2*, Awat Feizi1, Peyman Adibi1 peyman adibi4*, Mehran Rezaei5 1Isfahan University of Medical Sciences, Isfahan, Iran 1 Master Student , k.n. toosi university of Technology 2Behavioral Sciences Research Center,Isfahan University 2 IT Engineer, isfahan university of Medical Sciences, Isfahan, Iran 3 MD, Ph.D Student, Department of Medicine, University Introduction: We investigated whether the of Alberta 4 Professor of medicine, Integrative functional personality factors measured in individuals with gastroenterology research center, Isfahan University of irritable bowel syndrome (IBS) symptoms differ from Medical Sciences, Isfahan, Iran healthy participants, taking into account the 5 Assistant Professor, isfahan university subgroups of IBS (IBS-diarrhea, IBS-constipation, AgPçæR Îíéßpkÿ âõAo} Gú kuPú Aÿ Aq GýíBoÿ øBÿ kuPãBû øBÿ GýíBoÿ Aq Aÿ kuPú Gú âõAo} Îíéßpkÿ AgPçæR ølÙ: ô qìýñú IBS-mixed and IBS-undetermined). âõAo} AÆçÝ ìþ yõk Þú ÎéýpÒî ôWõk AgPçë uBgPBoÿ ko kuPãBû âõAo} kuPãBû ko uBgPBoÿ AgPçë ôWõk ÎéýpÒî Þú yõk ìþ AÆçÝ âõAo} Method: A cross-sectional survey of 4763 GBÎU AüXBk ÎçDî @qAokøñlû Aÿ ìþ âpkðl. Aüò AgPçæR Gú ylR Þý×ýQ qðlâþ Þý×ýQ ylR Gú AgPçæR Aüò âpkðl. ìþ Aÿ @qAokøñlû ÎçDî AüXBk GBÎU participants was carried out in Isfahan University of Öpk ìHPç oA ìhPê ìþ Þññl ô ko ¾lo ìpAWÏBR âõAoyþ ÚpAo kAoðl. GB Aüò cBë Gú cBë Aüò GB kAoðl. ÚpAo âõAoyþ ìpAWÏBR ¾lo ko ô Þññl ìþ ìhPê oA ìHPç Öpk medical sciences. They were asked to fill two questionnaires: kèýê Îlï ôWõk oô} OzhýÀ ÚÇÏþ üB koìBðþ ìzhÀ, ørüñú øBÿ GBæüþ Gp GBæüþ øBÿ ørüñú ìzhÀ, koìBðþ üB ÚÇÏþ OzhýÀ oô} ôWõk Îlï kèýê A validated questionnaire which fulfilled Rome III WBìÏú Odíýê ìþ Þññl. Oç} øBÿ AðXBï ylû OBÞñõó, ko WùQ ÆHÛú Gñlÿ ÆHÛú WùQ ko OBÞñõó, ylû AðXBï øBÿ Oç} Þññl. ìþ Odíýê WBìÏú criteria for IBS considering their sociodemographic AðõAÑ AgPçæR Îíéßpkÿ âõAo}, ìdlôk Gú AuP×Bkû Aq oô} øBÿ @ìBoÿ Gõkû @ìBoÿ øBÿ oô} Aq AuP×Bkû Gú ìdlôk âõAo}, Îíéßpkÿ AgPçæR AðõAÑ and lifestyle data as well, and the NEO-FFI ques- AuQ ô ko cBë cBÂp AGrAo A¾éþ OzhýÀ ô ÆHÛú Gñlÿ Aüò AgPçæR ìÏýBoøBÿ AgPçæR Aüò Gñlÿ ÆHÛú ô OzhýÀ A¾éþ AGrAo cBÂp cBë ko ô AuQ tionnaire. Data was processed and analyzed using ìþ GByl Þú Gp AuBx oô} O¿íýî âýpÿ kè×þ Olôüò ylû AuQ. ylû Olôüò kè×þ âýpÿ O¿íýî oô} AuBx Gp Þú GByl ìþ IIIEMOR SPSS, Student’s t-test for quantitative variables and ølÙ Aüò ìÇBèÏú AuP×Bkû Aq Oßñýà øBÿ kAkû ÞBôÿ GpAÿ gõyú Gñlÿ AgPçæR Gñlÿ gõyú GpAÿ ÞBôÿ kAkû øBÿ Oßñýà Aq AuP×Bkû ìÇBèÏú Aüò ølÙ Chi-squared statistic test for qualitative variables. Îíéßpkÿ âõAoyþ AuQ . . AuQ âõAoyþ Îíéßpkÿ Prevalence of each IBS subgroups was also assessed kAkû øBÿ Aüò OdÛýÜ yBìê 9326 oÞõok ô 381 ìzh¿ú øvPñl Þú øvPñl ìzh¿ú 381 ô oÞõok 9326 yBìê OdÛýÜ Aüò øBÿ kAkû Gpouþ: oô} according to predominant stool pattern. Results: There were significant differences between ìþ GByñl . Aüò ìXíõÎú ÿ kAkû Aÿ kAkû ÿ ìXíõÎú Aüò . GByñl ìþ NAHAPES Kpôsû ÿ kôï Gh{ Gú ìPÏéÜ IBS and non-IBS group in all dimension except ô GB AuP×Bkû Aq AuP×Bkû GB ô snaem-k AèãõoüPî OõuÈ , MD-PSIRC ìPlôèõsÿ AuBx Gp openness(p<0.01). The mean score of neuroticism ìõok Gpouþ ÚpAo âpÖQ. âpÖQ. ÚpAo Gpouþ ìõok enitnemelC ô akeW ðpï AÖrAoøBÿ was significantly lower in non-IBS group but they ko Aüò ìÛBèú GB AÎíBë Oßñýà øBÿ kAkû ÞBôÿ , ìõÖÜ Gú yñBuBüþ gõyú øBüþ gõyú yñBuBüþ Gú ìõÖÜ , ÞBôÿ kAkû øBÿ Oßñýà AÎíBë GB ìÛBèú Aüò ko øB: üBÖPú showed a significantly higher level of extraversion, ylüî Þú GýBðãp Aèãõÿ oôAGÈ ìõWõk ìBGýò AgPçæR Îíéßpkÿ âõAoyþ ìþ GByñl. ìþ GByñl. âõAoyþ Îíéßpkÿ AgPçæR ìBGýò ìõWõk oôAGÈ Aèãõÿ GýBðãp Þú ylüî agreeableness and conscientiousness. Mean score of GýBðãp EMOR III Gñlÿ GBkuPú øB gõyú ÿ ìÛBüvú Aq cB¾ê ðPBüY âýpÿ: ðPýXú all dimensions was reported to be higher in female AüXBk kô ðõÑ gõyú ìþ GByl: gõyú øBüþ Þú GB OÏBoüØ ÚHéþ AgPçæR Îíéßpkÿ AgPçæR ÚHéþ OÏBoüØ GB Þú øBüþ gõyú GByl: ìþ gõyú ðõÑ kô AüXBk patients except extraversion (p<0.01). Conclusion: The results indicate that the personality uBqâBoðl ô gõyú øBüþ Þú ko OÏBoüØ ÚHê ôWõk ÚHê OÏBoüØ ko Þú øBüþ gõyú ô uBqâBoðl EMOR III Gñlÿ kuPú ko âõAoyþ dimensions in irritable bowel syndrome differ from ðlAoðl ôèþ ÆHÜ üBÖPú øBÿ GBèýñþ , ôWõk GýíBoAðþ GB AüòAgPçæR ìñÇÛþ Gú ðËp ìþ ðËp Gú ìñÇÛþ AüòAgPçæR GB GýíBoAðþ ôWõk , GBèýñþ øBÿ üBÖPú ÆHÜ ôèþ ðlAoðl non-IBS group. oul. KýzñùBk ìþ yõk ko ìÇBèÏBR @Oþ GB AÎíBë AèãõoüPî øBÿ küãp gõyú Gñlÿ Gú Gñlÿ gõyú küãp øBÿ AèãõoüPî AÎíBë GB @Oþ ìÇBèÏBR ko yõk ìþ KýzñùBk oul. Send Date: 2012/09/27 Gpouþ ìýrAó øíLõyBðþ ko gõyú øB KpkAgPú yõk. KpkAgPú øB gõyú ko øíLõyBðþ ìýrAó Gpouþ Send Date : 2012/09/13 Code: 2419 Category: 16. IMMUNOLOGY/MICROBIOLOGY Code : 2469 16.3 Gastrointestinal infections Category: 15. NERVE GUT AND MOTILITY F-T-142

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Enterococcus faecalis in subgingival biofilm of infections helps develop effective treating strategies. patients with chronic refractory periodontitis Send Date: 2012/09/05 masoud shirmohammadi1* 1 Gastroenterology and Hepatology research center, Tabriz univercity of medical sciences Code: 2482 Introduction: Enterococci are normal human Category: 18. GASTROINTESTINAL BLEEDING commensals adapted to the nutrient-rich, oxygen- F-T-143 depleted, and ecologically complex environments of Kw GBÿ Îíê Aq Kw ÖõÚBðþ âõAo} kuPãBû gõðpürÿ ðvHþ ÖpAôAðþ Gpouþ the oral cavity,gastrointestinal tract, and vaginal @ó gÇp ôÎõAìê 9831 uBë ko oWBüþ yùýl ÚéI GýíBouPBó ko Þpôðpÿ ÎpôÝ vault. Enterococci now rank among the top three Mehrdad Haghazali1*, Alireaza Alizadeh nosocomial bacterial pathogens and strains resistant ghavidel1, Hooman Bakhshandeh1, to currently available antibiotics and pose real Alimohammad Shariati moghaddam1, Akram therapeutic difficulties. Up to 90% of enterococcal Kaffash1, Tina Shooshtari zadeh2, Sepideh Haghazali3 1 infections in humans are caused by Enterococcus Shahid rajaei heart center, Tehran university of medical faecalis especially in gastrointestinal tract. The sciecnes 2 hasheminejad kidney center, Tehran university of medical presence of E. faecalis in the oral cavity raises the sciecnes question of whether the mouth could be a source for 3Bank melli hospital infection with this microorganism. In addition, the ÎõAoÅ Opüò Wlÿ Aq üßþ ÖõÚBðþ âõAo} kuPãBû gõðpürÿ ølÙ: ô qìýñú microorganism has been reported as the species most ko¾l 3 OB 1 ÎBoÂú Aüò yýõÑ ^ú Aâp GByl. ìþ Þpôðpÿ ÎpôÝ Kw GBÿ WpAcþ commonly recovered from teeth with failed AuQ, AìB GB ìýrAó ìpå ô ìýp ô ÎõAoÅ GBæ (04 OB 06 ko¾l) ârAo} ylû AuQ. ylû ârAo} ko¾l) 06 OB (04 GBæ ÎõAoÅ ô ìýp ô ìpå ìýrAó GB AìB AuQ, endodontic treatment and persistent infections. Refractory periodontitis is the occurrence of AðXBï Þññlû Kýzãýpÿ ÎõAìê ô ÖBÞPõoøB oüvà ìõok ko Þíþ ìÇBèÏBR OBÞñõó additional clinical attachment loss after repeated ÎõAìê yñBuBüþ ô gõðpürÿ Gpôq ìýrAó Gpouþ Ktôø{ Aüò ølÙ AuQ. ylû attempts to control the infection with conventional AuQ ÎBoÂú upüÏPp koìBó ô Wéõâýpÿ WùQ gÇp periodontal therapy. Some microorganisms seem to Þú GýíBo 046 Kpôðlû ìÇBèÏú Aüò ko ìýHByl, Oõ¾ý×þ Ktôø{ Aüò Gpouþ: oô} be involved in the pathogenesis of chronic refractory ÎpôÝ Kw GBÿ Îíê OdQ OùpAó oWBüþ yùýl ôÎpôÝ ÚéI ìpÞr ko 9831 uBë ko periodontitis. The prevalence of Enterococcus ìÏýBoøBÿ AcPvBJ Aq Kw ô âpÖQ ÚpAo ìÇBèÏú Gõkðl,ìõok âpÖPú ÚpAo Þpôðpÿ faecalis in the oral cavity seems to be higher in GvPpÿ ko Kw GBÿ Aq ÚHê âõAoyþ gõðpürÿ Kw, GBÿ Aq Òýp øírìBó (Îíê gpôZ individuals with periodontitis. Therefore, the present study investigated the presence of E.faecalis in ylðl ìÇBèÏú ôAok GýíBo 845 Kpôðlû) ðBÞBìê AÆçÎBR , OpgýÀ Aq ÚHê ÖõR , Agýp subgingival biofilm of patients with chronic âpÖQ. AðXBï KpuzñBìú AÆçÎBR @ðBèýr SSPS @ìBoÿ AGrAoøBÿ Aq AuP×Bkû GB uLw ô refractory periodontal disease. Aq Kw ko¾l). (8/2 ylðl WpAcþ Aq Kw BIGU k^Bo ð×p 046 Aq ð×p 81 øB: üBÖPú Method: Periodontal treatment was instituted for 100 Aq ð×p 51 ylðl. BIGU k^Bo (8/1%) GýíBo 01 , GýíBo 845 Aq gpôZ ìÏýBoøBÿ AÎíBë patients suffering from chronic periodontitis. Then Gõkðl. ylû ðýr BIGU k^Bo @ðùB Aq ð×p 3 Þú Þpkðl ÖõR Îíê Aq Kw GýíBo 845 samples were obtained from 27 successfully treated 02 ðvHþ ìõoOBèýPþ ô ko¾l 54/0 Þéþ ôìýp(ìõoOBèýPþ) ìpå ìýrAó koìÇBèÏú and 27 chronic refractory periodontitis subjects and AìB Gõk Oñ×vþ ÚéHþ AüvQ ìpå ÎéQ @ìl.GýzPpüò GluQ BIGU GpAÿ ko¾l then cultured. Statistical evaluation was performed ko uú GýíBo, gõðpürÿ âõAoyþ ÖõÚBðþ AoOHÈ ìvPÛýíþ GB ìpå kAyQ, ko ôAÚÐ ko kAyQ, ìpå GB ìvPÛýíþ AoOHÈ ÖõÚBðþ âõAoyþ gõðpürÿ GýíBo, uú ko for descriptive purposes. Results: 27% of the patients had chronic refractory Gýò Gõk. ko¾l 61/66 , BIGU Þzñlâþ ìýrAó ìÇBèÏú Aüò ko â×Q OõAó ìþ periodontitis. The difference in the presence of E. @ìl: GluQ kAoÿ ìÏñB @ìBoÿ AoOHBÉ qüp øBÿ ìPÓýp ô BIGU faecalis in the pockets between the successfully treated :RO 500.1 :IC[ ]900.1-100.1 :eulav-P( )410.0 ìßBðýßþ ôðPýçuýõó (11.1%) and chronic refractory (51.8%) groups by :RO 436.31 :IC[ ]886.38-122.2 :eulav-P( )500.0 GýíBo âõAoyþ qgî uBGÛú culture methods was statistically significant (P<0.05). :RO 26.1 :IC[ ]221.1-005.1 :eulav-P( )43.0 uò Conclusion: Data showed that E. faecalis is GluQ ko¾l 8/1 âõAoyþ kuPãBû ÖõÚBðþ ÚvíQ gõðpürÿ ìýrAó ìÇBèÏú Aüò ko probably involved in the pathogenesis of refractory AuQ, ÞíPp @ðùB Aq GvýBoÿ Aq Géßú ô ÞzõoøB küãp @ìBo ìdlôkû ko ìýrAó Aüò Þú @ìl periodontitis.Accurate knowledge about the pathogen oüvà ÖBÞPõoøBÿ ìùî ko Aüò ìÇBèÏú yBìê uò GBæÿ 06 , uBGÛú qgî âõAoyþ qgî uBGÛú , 06 GBæÿ uò yBìê ìÇBèÏú Aüò ko ìùî ÖBÞPõoøBÿ oüvà and its role in the pathogenesis of refractory

84 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012

ô Æõë ìlR GýzPp ôðPýçuýõó ìßBðýßþ Gõk Þú Aq èdBÍ GBèýñþ ðýr ÚBGê ÚHõë ìþ GByl. GByl. ìþ ÚHõë ÚBGê ðýr GBèýñþ èdBÍ Aq Þú Gõk ìßBðýßþ ôðPýçuýõó GýzPp ìlR Æõë ô The patient was about the benign nature of the ènA KýzñùBk ìþ âpkk oAÖpAkÿ Þú Aüò oüvà ÖBÞPõoøB Gõütû uBGÛú Gõütû ÖBÞPõoøB oüvà Aüò Þú oAÖpAkÿ âpkk ìþ KýzñùBk ènA âýpÿ: ðPýXú disease, and the bleeding lesions were managed qgî âõAoyþ oA kAoðl, KpôÖýçÞvþ ÚHê Aq Îíê ypôÑ yõk ô Kw Aq Îíê ðýr Îíê Aq Kw ô yõk ypôÑ Îíê Aq ÚHê KpôÖýçÞvþ kAoðl, oA âõAoyþ qgî conservatively with iron supplement, along with an Gpouþ ô ìpAÚHQ GýzPpÿ ¾õoR Knüpk. Knüpk. ¾õoR GýzPpÿ ìpAÚHQ ô Gpouþ advice for periodic follow-up. Conclusion: Mainly, Treatment of BRBNS is Send Date: 2012/09/28 conservative but laparotomy with intraoperative endoscopy may be best approach in patient with severe anemia and multiple lesions in GI tract. Code: 2329 Send Date: 2012/08/06 Category: 19. ENDOSCOPY AND IMAGING 19.1 Endoscopy - Upper GI F-T-144 Code: 2330 Blue rubber bean nevus syndrome a rare Category: 19. ENDOSCOPY AND IMAGING cause of iron deficiency anemia :a case report 19.1 Endoscopy - Upper GI 1 Mohammad Javad Zahedi , Sodaif Darvish F-T-145 Moghadam1, Sayyed mahdi Sayyed Mirzaii1, High dose versus low dose intravenous Sara Shafiei pour1*, Atefeh Rasti1 1 Department of gastroenterology, Afzalipour Hospital, pantoperazole infustion in bleedig peptic ulcer 1 1 Kerman University of Medical Sciences, Kerman, Iran Abdol Rahim masjedizadeh , Eskandar Hajiani , Jalal 1 1* Introduction: Blue Rubber Bleb Nevus Syndrome Hashemi , Abdol Rahim masjedizadeh , Ali Akbar Shayesteh1, Norolah jamshidian1, pejman alavinejad1 (BRBNS) is a disorder characterized by multiple 1 Research institute for infectious diseases of digestive cutaneous venous malformations in the skin and system,school of medicine, Ahvaz Jundi Shapur gastrointestinal tract. Iron deficiency anemia (IDA) University of Medical sciences, Ahvaz, Iran is the most common clinical presentation of BRBNS, Introduction: An appropriate dose of proton pump however melena, hematochezia and involvement of inhibitors drugs in the treatment of patients with internal organs have also been reported. It is a rare upper gastrointestinal bleeding is still controversial. Syndrome of abnormal blood vessels affecting the The aim of this study is to compare High-dose Iv PPI gastrointestinal tract and according to our MEDLINE with Low-dose for preventing the complications of search about 200 case reports has been published till gastrointestinal bleeding. 2012 in English lectures. Method: At first, 166 patients with gastrointestinal Case Report: We present a case of 22-year old man bleeding who had an etiology of peptic ulcer were who was referred to gastroenterology department in stabilized their hemodynamic status, and then, they our hospital for evaluation of IDA. At the physical underwent the therapeutic endoscopy by using examination, he had some compressible bluish method APC and injected with epinephrine. Patients nodules (fig.1) of 0.5 cm to 1.5 cm in diameter at the were randomly classified into two groups: High-dose sole of the foot on his lower extremity, and these (Pantoprazole80 mg bolus and then, 8 mg per hour) nodules tended to refill with blood after compression. and Low-dose (Pantoprazole40 mg bolus and then, 4 The upper endoscopy revealed one bluish vascular mg per hour) for three days and underwent infusion. lesion in the proximity of 10mm in diameter and Initial results were: re-bleeding, need for surgery, wrinkled surface in proximal of duodenum (fig.2-a) hemoglobin drop of more than two units, hospitalization and similar lesion in colonoscopy in descending part for more than five days; and secondary results included of colon(fig.2-b) .He refused enteroscopy for mortality rate and need for surgery. detecting potential lesions in small bowel. Results: 83 patients were grouped into High-dose, A diagnosis of BRBNS in this case was made on the and 83 patients were grouped into Low-dose. The basis of the typical skin lesions, bluish nevi in average age of persons in the High dose group was duodenum and colon on GI endoscopy, and 59/50±15 /6years and it was 52/3±13/ 3years in the histological picture of venous malformation on skin Low dose group (P =0.58). In terms of gender, most biopsy. patients were male (69/7). In the High-dose group,

Govaresh\ Vol.17\ Supplement\ Autumn 2012 85 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 the mean of received blood was3.3 ±1.71 units and Ghzþ ASp ô yl Kp GýíBoAó OõuÈ Gà AÂÇpAJ KpuzñBìú ìXlkA @ðlôußõKþ in the Low-dose group was2.82±1.73 units (P = 0.50) âpÖQ. ÚpAo AoqüBGþ ìõok ìhPéØ oôyùBÿ .36 patients (43.37% ) in the High-dose group and 40 ðípû ìýBðãýò üBÖPú AÖrAü{ øíßBoÿ Gú GýíBoAó OíBüê Þú kAk ðzBó ðPBüY : øB üBÖPú patients (48.19%) in the Low-dose group had more Aq ìlAgéú Aq Kw Oõ†ï âpôû ô ÞPHþ âpôû ô y×Bøþ âpôû GB yBøl âpôû AÂÇpAJ than 5 days of residence duration (P=0.53). 27 ðípû ìýBðãýò O×BôR Aüò ôèþ ). 100.0

86 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2012 prevalence of acute pancreatitis between two groups bile duct (CBD) cannulation and reducing of with NNT 5 and safety profile of N Acetyl Cysteine, post-ERCP pancreatitis. it could be used as a useful tool for prevention of post Method: From 2010 through 2011, patients who need ERCP pancreatitis. It is recommended that results of to ERCP and referred to shahid Beheshti and Rohany this study be checked in additional clinical trials. teaching hospital were entered into the study. Send Date: 2012/06/25 standard cannulation (78cases) and guide wire cannulation (65cases) were performed on them randomly. data from these cases were collected and Code: 2299 analyzed. Category: 19. ENDOSCOPY AND IMAGING Results: on hundred eighteen (82.5%) patients were 19.3 Endoscopy - ERCP female and 28(17.5%) were male. the mean age of F-T -148 these patients was 56.5+-16.8 years. Post ERCP- Evaluation of guide wire cannulation pancreatitis rate in guide wire group was 6(9.2%) and in reduced risk of post-ERCP pancreatitis in the standard group was 12(15.4%)(p=0.269). and facilitated bile duct cannulation successful cannulation in these two groups was Shahriar Savadkoohi1*, javad shokri1, (67.7% and 67.9%,respectively(p=0.974). 2 hesam savadkoohi Conclusion: The result show that post ERCP- 1 Rohani Hospital, Babol university of medica science pancrestitis rate in both groups are similar. other 2 karaj hospital, Azad studies with large number of cases are required to Introduction: Pancreatitis is most common confirm our results. complication of post-ERCP and needs to admission at least for one day.the purpose of this study was to Send Date: 2012/07/13 assess the efficacy of guide wire for better common

Govaresh\ Vol.17\ Supplement\ Autumn 2012 87 Index

Author Index (English Abstracts)

A Attarzade Hosseini R...... 57 Fallahzadeh E...... 27, 62 Aarabi M...... 80 Ayatollahi H...... 51 Farhang M...... 82 Abangah G ...... 52 Azadegan M...... 18 Farhangi E...... 46 Abbasimoghaddam M ...... 33 Azadmanesh K...... 78 Faridan Esfahan M...... 45 Abdolahi T...... 32,33 Azizi M...... 77, 78 Farzanefar H...... 51 Abdolahi Shamsaiee S...... 10 Farzanehfar M...... 10, 33, 51 Abdolahian M ...... 8 B Farzinezhad MM...... 49 Abdolhosseini A ...... 9, 35, 75 Babaei M...... 37 Fatemi AM...... 49 Abdollahi MR ...... 54, 56, 71 Baghbanian M...... 12, 40, 74 Fathi F...... 76 Abdollahzadeh L...... 19 Bagheri A...... 42 Fauzi A...... 53 Abedini F ...... 32 Bagherian R...... 11, 83 Fazeli MS...... 77, 78 Abnet C...... 14, 15, 16 Bakhshandeh H...... 84 Fazeltabar Malekshah A...... 14 Adhamian P...... 43, 44 Bakhshipour AR...... 39, 61 Fazlollahi N...... 29, 30 Adibi N...... 82 Barari L...... 61 Feinle-Bisset C...... 11 Adibi P ...... 11, 17, 18, Barzin M...... 60 Feizi A...... 11, 17, 21, 22, 83 21,22, 28, 30, 31, 56, 81, 82, 83 Bashari Z...... 43, 45 Firouzain H...... 61 Afghari P...... 30 Bashtar M...... 19 Firouzei M...... 28, 30 Afshar H ...... 11, 83 Behnava B...... 63,64,67,98,69,70 Forghani MN...... 75 Afzal Aghaei M...... 51, 61 Besharat S...... 54 Agah S...... 20 Birkett N...... 15 G Aghajanian M...... 41 Boffetta P...... 14, 15,16 Ganji A...... 45, 52 Aghajany-Nasa M...... 53 Boreiri M...... 37 Geramizadeh B...... 27, 62 Aghamohammadi H...... 43 Borhani N...... 40 Ghadir MR...... 7, 19, 49,77,78 Aghcheli K...... 16 Boyce P...... 11 Ghadirian L...... 43 Ahadi M ...... 51 Brennan P...... 15 Ghadri S...... 32 Ahmadi E...... 37 Ghafarzadegan K...... 10, 32, 33, 52 Ajdarkosh H...... 12,13,47,48,58,73, 81 C Ghafori H...... 76 Akbari H ...... 27 Cornain S...... 53 Ghanadi K...... 8 Akhlaghpoor S...... 19 Ghanooni AH...... 19 Akhondi M...... 12, 40, 74 D Ghasemi S...... 12 Alaei-Andabili H...... 67 Daghaghzadeh H...... 11,17,45,56,83 Ghasemi Jangjoo A ...... 29 Alavi Nejad P...... 86 Daneshpajouhnejad P...... 11,18 Ghavamzadeh A...... 19 Alavian M...... 7,63,64, 67,69,98,70 Darvish Moghadam S...... 8,9,55,71,85 Ghazvini K...... 52 Alavian H...... 63, 64 Dastgiri S...... 29 Gheidari F...... 36 Alavinejad P...... 78, 85 Dawsey S...... 14, 15, 16 Ghofrani H...... 74 Alimohammadian M...... 37 De Bock GH...... 37 Ghojazadeh M...... 34, 35, 54, 56 Alipour A...... 73 Dehghani M...... 63 Gholami Fesharaki M...... 63, 64, 67, Alizadeh Ghavidel AR...... 84 Delavari AR...... 37 69, 70, 98 Alizadeh B...... 37 Derakhshan MH...... 37 Gholamrezaei A...... 43, 44, 45 Alizadeh S ...... 47 Dowlatshahi S...... 57 Ghorbani K...... 79 Amani F ...... 42 Golalipoor G...... 80 Ameli M...... 13, 47, 81 E Golzar A...... 14 Amini E...... 17, 18 Ebrahimzadeh S...... 56 Gorji N...... 20 Aminian K...... 79 Ehsani Ardakani MJ...... 41 Granmaye G...... 43 Amirbeigi MK...... 12, 40, 74 Emadi A...... 15 Amiriani T...... 54, 65 Emami MH...... 43, 44, 45, 49 H Amirkalali B...... 58 Esalatmanesh K...... 27 Habibinejad H...... 7 Anbari K...... 8 Esmaeilzadeh A...... 11, 32, 52 Habibzadeh S...... 42 Antikchi MH...... 12, 40 Esteghamati AR...... 65 Haghazali M...... 84 Arj A...... 27, 60 Etemadi A...... 14, 15, 16, 37 Haghazali S...... 84 Arjmandpour A...... 81, 82 Haghdoost AA...... 9, 55 Asadi M...... 10 F Haghighat M...... 27, 63 Asadi R...... 20, 61 Fahimi S...... 14 Hajiani E...... 78, 85, 86 Assali R...... 61 Fakhari S...... 76 Hajmollarezai E...... 10, 32, 33 Ataei B...... 70 Fakhrieh S...... 79 Hajrassuliha H...... 65

88 Govaresh\ Vol.17\ Supplement\ Autumn 2012 Index

Hakami R...... 15 Khaleghi Nia M...... 71 Mohamadnejad M...... 19 Hakhamaneshi S...... 76 Khalily Zade M...... 71 Mohammadi M...... 44,50 Handjari Dr...... 53 Khanleghi H...... 32 Mohammadi R...... 80 Hartoonian C...... 45 Khansari MR...... 12, 13, 47, 48, Mohammadi S...... 36 Hashemi J...... 45, 78, 85, 86 58, 81 Mohammadi Bonehi S...... 30 Hashemi S...... 36 Khashkhashi Moghaddam S...... 10 Mohammadzadeh M...... 29 Hashemi Jazi M...... 18, 56 Khazaei S...... 28, 31 Mohammadzadeh Garebaghi MA.... 56 Hashemijazi H...... 49 Khazaeli P...... 50 Mohebbi Moghaddam A...... 33 Hassanzadeh Keshteli A...... 11, Khodabakhshi B...... 65 Mohsenpour Mohammadi N...... 39 17, 18, 21, 22, 56, 83 Khoshbaten M...... 45, 51 Mohtadinia J...... 15 Hatami K...... 12, 13, 73, 81 Khoshnood A...... 12, 40 Moini R...... 20 Hayat Bakhshe Abasi M...... 8, 9, Khosravi Khorashad A...... 51, 61 Moradi AV...... 65 50, 55, 71 Kiyvani H...... 47 Moradi Lakeh M...... 12,13 Heidari A...... 7, 42 Kord Valeshabad A...... 79 Moraveji AR...... 60 Hejazi Z...... 52 Moraveji S...... 43,45 Hekmatdoost A...... 61 L Movahedian A...... 53 Hemassi GR...... 12,47,48,73,81 Latifi-Navid S...... 36 Movassagh A...... 77,78 Hoseini V...... 50, 60 Lotfi Sadigh S...... 54, 56, 71 Mozafari N...... 54 Hoshiar A...... 42 Lzanlo A...... 35 Hossein Torabi B...... 54 N Hosseini Motlagh M...... 70 M Naderi E...... 32 Hosseinnezhad H...... 32, 33 Maadi M...... 12, 58 Naeimi Tabiei M...... 80 Houshiar A...... 37 Mahmmoodi A...... 55 Naghavi Behzad M...... 34, 35,54 Mahmoudi L...... 29 Najafi M...... 81,20,42,59 I Maleki I...... 41, 60 Najafipoor H...... 55 Imanieh MH...... 27, 63 Maleki M...... 10 Najib K...... 27 Iraji N...... 18 Maleki P...... 36 Naseri AR...... 29 Iranikhah A...... 7, 19, 49 Malekpour AR...... 63 Nasiri AA...... 41 Islami F...... 14, 15, 16 Malekzadeh R...... 14, 15, Nasiri B...... 29 Isvand F...... 83 16, 19, 29, 36, 37, 45 Nasiri Toosi M...... 65 Mansour-Ghanaei F...... 38,40,48,74,79 Nasrollahzadeh D...... 14,15,16 J Mansourian M...... 62 Nazari S...... 72,73 Jabbarpour Bonyadi M...... 51 Maoodi M...... 42,59 Nazem M...... 50 Jabini R...... 51 Marjani HA...... 14 Nematy M...... 57 Jafari N...... 35 Masjedizadeh AR...... 78,85,86 Nezam K...... 39,61 Jafari Z...... 33 Masnadi Shirazi K...... 23 Nikandish M...... 46 Jafari Naeimi M...... 83 Masoum A...... 10 Nikeghbalian S...... 62 Jahangiri P...... 17 Matin E...... 42 Nikkhoo B...... 46,76 Jalili A...... 76 Matin S...... 42 Nikmanesh A...... 37 Jamali N...... 43, 44, 45 Matinfar M ...... 81 Niknam R...... 29 Jamali R...... 57 Matini M ...... 27,60 Nikpoor AR...... 50 Jamshidian N...... 85 Mehrabi N ...... 29,30 Nikpour S...... 24,25,26,31,39,41 Joukar F...... 38, 40, 48, 74, 79 Mehrnoush L...... 63,64, 67,69,70,98 Nikroo H...... 57 Mehrtash AH...... 77,78 Nikyar HR...... 81 K Mehrvarz AR...... 79 Nikzaban M...... 76 Kaffash A...... 84 Meysamie AP...... 65 Kalantari H...... 70 Mikaeli J...... 29,30 P Kamangar F...... 14, 15, 16 Minakari M...... 61,70 Panahian M...... 42 Karamifar H...... 63 Mir Najde Gerami S...... 51 Panjehpour M...... 53 Karimi P...... 63,64, 67, 69, 98 Mirab Samiee S...... 53 Parizadeh M...... 33 Karimi Googheri E...... 9 Miri M...... 63,64 Parvizi Aghdam M...... 56 Kavosian E...... 83 Mirinezhad K...... 23,29 Pawilta M...... 16 Kayvani H...... 12, 13 Mirkarimi H...... 80 Pezeshki M...... 43,45 Kazemizadeh A...... 49 Moaadi M...... 13,73 Pharoah D...... 15 Keshvari M...... 63, 64, 67, 69, Moeeni M...... 62 Pourdadash A...... 65 70, 98 Moghaddam Jafari A...... 59 Pourfarzai F...... 37 Keyvani H...... 58, 70 Moghaddami A...... 80 Pouri AA...... 34,35 Khademi H...... 15 Mohamadian M...... 57 Pourshams A...... 15,16,45 Khademi M...... 54 Mohamadkhani A...... 32,65,66 Pouryasin A...... 67,68,69

Govaresh\ Vol.17\ Supplement\ Autumn 2012 89 Index

Shafiei Pour S...... 8,85 Y R Shahnazari P...... 66 Yaran M...... 70 Rafiei AR...... 60 Shakeri R...... 14,16 Yazdanbod A...... 36 Rafiei R...... 81,82 Sharafi H...... 67,69,98 Yazdani S...... 49 Rahmani MR...... 76 Shariati Moghaddam AM...... 84 Yazdanpanah K...... 62 Rajpout MY...... 38,79 Sharifi AH...... 37 Yousefi-Mashh M...... 79 Rakhshani N...... 81 Shavakhi A...... 61 Rani AA...... 53 Shayegan N...... 57 Z Rasolian J...... 74 Shayesteh AA...... 78,86,85 Zadhush A...... 45 Rastegar A...... 60 Sheikesmaeili F...... 46,76 Zahedi MJ...... 8,9, Rasti A...... 85 Sheikhian MR...... 38, 79 50,55,71,85 Razavi M...... 9,75 Shekarriz Foomani M...... 48 Zahri S...... 36 Razavizadeh M...... 27,60 Shirani S...... 29,30 Zali M...... 45 Raziee HR...... 32 Shirmohammadi A...... 28,84 Zamani F...... 12,13,47,48,73,81,58 Rezadoost AM...... 42,59 Shirmohammadi M...... 28 Zarhami T...... 78 Rezaei M...... 83 Shokri J...... 67 Zeinali S...... 36 Riahinejad S...... 82 Shooshtari Zadeh T...... 84 Zendedel A...... 8 Roohafza HR...... 11 Siavoshi F...... 36 Roshandel GR...... 54,65,80 Sima HR...... 10,32,33,45,57 Rostami K...... 45 Soati F...... 38 Rostaminejad M...... 45 Sobhani A...... 81,82 Author Index Roushan N...... 65 Sohrabi MR...... 12,13,47,48,58,73,81 (Persian Abstracts) Sokhanvar H...... 79 S Soltanian N...... 11 AèØ Saadati H...... 83 Somi MH...... 28,29,34,35,51,54,56,71 ...... 42,62,57 KýíBó AküHþ Saadatnia H...... 51,61 Sotoudeh M...... 14,16, 37 42,62,57 Acíl...... qAkû AuíBÎýê Saber Firoozi M...... 15 Syam AF...... 53 N Sadeghi A...... 47,48,58 68 cíýl...... Kõoypü×þ Sadeghpour S...... 21,22 T f Sadr F...... 27 Taghavai AR...... 50 57 ìpüî...... y×ýÏþ cBWþ Safaie B...... 80 Taghvaei T...... 60 ...... 42,62,57 ÎíBo qAkû cvò Safarpour AR...... 50 Taheri A...... 46 68 kAôôk...... uýl ðvI cvýñþ Safarpour M...... 50 Taherkhani E...... 60 k Sajadi AR...... 37 Taherzadeh Z...... 79 ...... 68 ìpüî yßBo kyíò Salahi R...... 15 Tahmasbi A...... 70 q Salak M...... 45 Taleb AM...... 20 42,62 ÖBÆíú...... qoüHBÙ Salehi S...... 23 Talley J...... 11 } Salimi S...... 63,64,67,98,69,70 Tavakkoli H...... 62,70 32 ÖpøBk...... yßpAðú Salmanroghani H...... 12,40,74 Tavassoli AR...... 51 Á Saneian H...... 43,45 Tayebi S...... 9,35,75 32,68 cvýò...... ìdíl ¾õìþ Sarkeshikian S...... 7,19,49 Taylor P...... 14 Ñ Sastranegara F...... 53 Teimoori-Toolabi L...... 6,77,78 ...... 32 ìdíloÂB ÎHlAéùþ Sastranegara F...... 53 Toghiani A...... 81,82 31 ìXýl...... ÎHlAèùýBó Savabi G...... 31 Totonchi Saraf K...... 35 Ù Savabi O...... 28,30,31 7 ÖBÆíú...... Öpøíñl Savadkoohi H...... 67 U 42,62 @ôAR...... ÖýÃþ Savadkoohi S...... 67 Utomo AR...... 53 Ý Sayad K...... 40 31 Þõoô}...... ÚñBkÿ Sayyed Mirzaii M...... 8,85 V 32 ìpOÃþ...... ÚõWBqAkû Sebghatolahi V...... 86 Vakili M...... 12 á Sedaghat M...... 80 Vedanthan R...... 15 ...... 31 ìtâBó ÞBôüBðþ Semnani S...... 15,65,80 Vojdanian M...... 59 å Setareh A...... 47,48 Vossoughinia H...... 51,61 31 ÖBDrû...... ðõoÿ âê Seyed Mirzaeei M...... 45,55 ï Seyednezhad F...... 29 W 32 ìdílAìýò...... GBÒþ Úpû ìdílqAkû Shabazkhani B...... 74 Wicaksono BD...... 53 Shafaghi A...... 40,79 Shafie M...... 63,64

90 Govaresh\ Vol.17\ Supplement\ Autumn 2012 ìXéú âõAo} ko ðíBüú øBÿ qüp AüñlÞw ìþ GByl: ìþ AüñlÞw qüp øBÿ ðíBüú ko âõAo} ìXéú

• SCOPUS (www.scopus.com) • DOAJ(www.doaj.org) • Index Copernicus (http://publishers.indexcopernicus.com) • CABI Publishing • CINAHL • WHO-EMRO Index Medicus (http://www.emro.who.int /emhj.htm) • ISC (Islamic World Science Citation Center) • SID (Scientific Information Database)(www.sid.ir) • IranMedex (Indexing Articles Published in Iran Biomedical Journals) (www.iranmedex.com) • MagIran (Iranian Magazine Database)(www.magiran.com) oAøñíBÿ AyPpAá oAøñíBÿ > } o A õ â < Ktôøzþ Îéíþ- Ö¿éñBìú GpAÿ AyPpAá ìXéú Öpï oA Oßíýê ðíBüýl (ÖPõÞLþ Öpï ÚBGê ÚHõë AuQ) ô øípAû GB A¾ê Öý{ GBðßþ Þú Gú cvBJ WBoÿ yíBoû WBoÿ cvBJ Gú Þú GBðßþ Öý{ A¾ê GB øípAû ô AuQ) ÚHõë ÚBGê Öpï (ÖPõÞLþ ðíBüýl Oßíýê oA Öpï ìXéú AyPpAá GpAÿ 157 GBðà oÖBû ÞBoâpAó, yÏHú GýíBuPBó ypüÏPþ (Þl 331) Gú ðBï @ÚBÿ kÞPp uýl cvýò ìýpìXévþ ôAoür ylû AuQ, Gú ðzBðþ Gú AuQ, ylû ôAoür ìýpìXévþ cvýò uýl kÞPp @ÚBÿ ðBï Gú 331) (Þl ypüÏPþ GýíBuPBó yÏHú ÞBoâpAó, oÖBû GBðà 157 OùpAó, ¾ñlôÝ KvPþ 361-59341 AouBë ÖpìBüýl. AouBë 361-59341 KvPþ ¾ñlôÝ OùpAó, gro.hgai@hseravog :liamE gro.hseravog.www :liamE gro.hgai@hseravog cÜ AyPpAá uBæðú AyPpAá cÜ • kAgê Þzõo: 000 /002 oüBë oüBë /002 000 Þzõo: kAgê • • gBoZ Þzõo gBoZ • ÞzõoøBÿ øíXõAo 000/003 oüBë 000/003 øíXõAo ÞzõoøBÿ AoôKB 000/004 oüBë 000/004 AoôKB @ìpüßB, ÞBðBkA, AuPpAèýB ô sAKò 000 /005 oüBë /005 000 sAKò ô AuPpAèýB ÞBðBkA, @ìpüßB, ------kogõAuQ AyPpAá Ö¿éñBìú Îéíþ-Ktôøzþ <âõAo}> Îéíþ-Ktôøzþ Ö¿éñBìú AyPpAá kogõAuQ ...... gBðõAkâþ: ...... ðBï : ðBï ...... yíBoû: Aq AyPpAá Od¿ýçR:...... ypôÑ ìýrAó .... yíBoû:...... Öý{ ...... Æþ KpkAgPþ: ìHéÔ KpkAgQ ylû ko yÏHú:...... yíBoû øBÿ kogõAuQ ÚHéþ:...... ÚHéþ:...... kogõAuQ øBÿ yÏHú:...... yíBoû ko ylû KpkAgQ ìHéÔ KpkAgPþ GpAÿ yíBoû øBÿ ÚHéþ:...... Æþ Öý{ yíBoû:...... Öý{ ÚHéþ:...... Æþ øBÿ yíBoû GpAÿ KpkAgPþ ìHéÔ KpkAgQ ylû ko yÏHú: ko ylû KpkAgQ ðzBðþ: ÞlKvPþ: ¾ñlôÝ KvPþ: KvPþ: ¾ñlôÝ ÞlKvPþ: Oé×ò: KvQ AèßPpôðýà: AèßPpôðýà: KvQ Oé×ò:

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AÎÃBÿ Gýò Aèíééþ øýEQ Odpüpüú: øýEQ Aèíééþ Gýò AÎÃBÿ kÞPp âõülô@kèp (@èíBó) kÞPp Îéþ ÞzBôoqüBó (AüBæR ìPdlû @ìpüßB) ìPdlû (AüBæR ÞzBôoqüBó Îéþ kÞPp (@èíBó) âõülô@kèp kÞPp kÞPp AüpZ uHdBðþ (ÖpAðvú) kÞPp kOéØ yõKBó (AüBæR ìPdlû @ìpüßB) ìPdlû (AüBæR yõKBó kOéØ kÞPp (ÖpAðvú) uHdBðþ AüpZ kÞPp

ìlüp AWpAüþ: ìlüp : Îéíþ ôüpAü{ kÞPp uýl ìdílìùlÿ ìýpðB¾pÿ ìdílìùlÿ uýl kÞPp Kõoyíw AÞpï kÞPp

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Aìõo kÖPpÿ: Aìõo : @oAüþ ¾×dú ìBoAë ¾ýBk, uíýpA ìËéõï, ÖpqAðú AOdBk ÖpqAðú ìËéõï, uíýpA ¾ýBk, ìBoAë AOdBk ÖpqAðú

ðzBðþ ðByp: ðzBðþ ìXéú: KvPþ ðzBðþ OùpAó, gýBGBó ÞBoâp yíBèþ, WñI ìpÞr ÚéI OùpAó, Þõ^ú yùpüõo, yùpüõo, Þõ^ú OùpAó, ÚéI ìpÞr WñI yíBèþ, ÞBoâp gýBGBó OùpAó, yùpüõo, Þõ^ú OùpAó, ÚéI ìpÞr WñI yíBèþ, ÞBoâp gýBGBó OùpAó, yíBoû 31, ôAcl 1 1 ôAcl 31, yíBoû 1 ôAcl 31, yíBoû kÞPp uýlcvýò ìýpìXévþ uýlcvýò kÞPp 59341 361- KvPþ ¾ñlôÝ 3- 16 05 33 88 88 33 05 16 3- ðíBGp: ô Oé×ò ìvpR ¾BkÝ kÞPp gro.hgai@ofni AèßPpôðýà: KvQ 88 33 05 16 3- ðíBGp: ô é×ò O Aüò ðzpüú ìõok cíBüQ ìBèþ AðXíò ìPh¿¿ýò âõAo} ôÞHl AüpAó ìþ GByl. GByl. ìþ AüpAó ôÞHl âõAo} ìPh¿¿ýò AðXíò ìBèþ cíBüQ ìõok ðzpüú Aüò øpâõðú AuP×Bkû Aq ìÇBèI ðzpüú GB mÞp ìñHÐ GçìBðÐ AuQ. AuQ. GçìBðÐ ìñHÐ mÞp GB ðzpüú ìÇBèI Aq AuP×Bkû øpâõðú :etiS beW :etiS gro.hgai.www :liam-E gro.hgai@hseravog