volume 16, Number 3, Supplement, Autumn, 2011

âõAo}ÖÖ¿¿ééññBBììúú

ðzpüú Îéíþ AðXíò ìPh¿¿ýò âõAo} ô ÞHl AüpAó

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kÞPp ðB¾p AGpAøýíþ koüBðþ

kÞPpocýî @ÚBqAkûkÞPp ðB¾p AGpAøýíþ koüBðþkÞPp uýlìdílcvò AìBìþ ðX×þ køßpkÿkÞPp ¾lüØ koôü{ ìÛlïkÞPp cíýloÂB uýíBkÞPp ìdílcvýò ¾õìþkÞPp ÎHlAèpcýî ìvXlÿ qAkû

kÞPp ¾BkÝ ìvpRkÞPp oÂB ìéà qAkûkÞPp ÖpüHpq ìñ¿õoÚñBÎþkÞPp WõAk ìýßBDýéþ kÞPp ìdíl ìýñBÞBoÿkÞPp ìdvò ð¿ýpÿ ÆõuþkÞPp uýlWçë øByíþ

kÞPp âõülô@kèp (@èíBó)kÞPp Îéþ ÞzBôoqüBó (AüBæR ìPdlû @ìpüßB)kÞPp AüpZ uHdBðþ (ÖpAðvú) kÞPp kOéØ yõKBó (AüBæR ìPdlû @ìpüßB)

kÞPp ìùlÿ ìdílðtAk

kÞPp Aìýpcvýò uXBküú, kÞPp cíýloÂB ðíBqÿ, kÞPp AuíBÎýê Að¿Boÿ

kÞPp uýl ìdílìùlÿ ìýpðB¾pÿ

ÖpqAðú AOdBk

OùpAó, gýBGBó ÞBoâp yíBèþ, WñI ìpÞr ÚéI OùpAó, Þõú yùpüõo, yíBoû 31, ôAcl 1¾ñlôÝ KvPþ 361- 59341kÞPp ¾BkÝ ìvpROé×ò ô ðíBGp: 3- 16 05 33 88

OùpAó, gýBGBó ÞBoâp yíBèþ, WñI ìpÞr ÚéI OùpAó, Þõú yùpüõo, yíBoû 31, ôAcl 1 kÞPp uýlcvýò ìýpìXévþOé×ò ô ðíBGp: 3- 16 05 33 88 KvQ AèßPpôðýà: gro.hgai@ofni

Aüò ðzpüú ìõok cíBüQ ìBèþ AðXíò ìPh¿¿ýò âõAo} ôÞHl AüpAó ìþ GByl. øpâõðú AuP×Bkû Aq ìÇBèI ðzpüú GB mÞp ìñHÐ GçìBðÐ AuQ.

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kÞPp GùBo Aèú ôokÿ kÞPp ìdíl GBÚpÿ kÞPp AÞpï KõoyíwkÞPp Îéþ qAoÑ ìùpWpkÿkÞPp ÖpøBk qìBðþkÞPp ðvpüò qðlû këkÞPp ouõë uPõkû ìñ{

kÞPp ìdílWÏ×p Öpû ô}kÞPp Òçìdvýò ÖçcþkÞPp yBøýò ìp@RkÞPp ÚloR Aèú ìñPËpÿkÞPp uýlìdílìùlÿ ìýpðB¾pÿ

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ÖÖppïï AAooAADDúú ììÛÛBBææRR WWùùQQ BBNN kkoo ððzzppüüúú ââõõAAoo}}

ÎÎññõõAAóó ììÛÛBBèèúú::........................................................................................................................................

ìùp ô AìÃBF oOHú Îéíþ ðBï ðõüvñlâBó

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***ðzpüú âõAo} Aq Knüp} ô BN ìÛBæOþ Þú ko uBüp ìXçR Îéíþ kAgê ô gBoZ Þzõo Gú BN ouýlû GByñl ìÏnôo AuQ. ***• @üB ìÛBèú GpAÿ BN Gú ìXçR gBoWþ AouBë ylû AuQ ? Géþ � ��gýp �ðPýXú:......................................• @üB ìÛBèú ÚHç« GpAÿ BN Gú ìXéú küãpÿ ko kAgê AouBë ylû AuQ? Géþ ��gýp ��ðBï ìXçR.................................ðPýXú Gpouþ: ....................................• @üB ìÛBèú yíB ìÇBGÜ <oAøñíBÿ ðãBo} ìÛBæR> ko ðzpüú âõAo} @ìBkû ylû AuQ? Géþ �gýp��• ðzBðþ, yíBoû Oé×ò , ðíBGp ô liamE ðõüvñlû ìvEõë ko ¾×dú ÎñõAó koZ ylû AuQ? Géþ �gýp �• gç¾ú ÖBouþ: kAok��ðlAok �gç¾ú Aðãéývþ: kAok �ðlAok � �• ôAsû øBÿ Þéýlÿ ÖBouþ ô Aðãéývþ kAok ��ðlAok �� Îßw ô Wlôë : kAok� �ðlAok� �• AuBìþ ðõüvñlâBó ko gç¾ú ÖBouþ ô Aðãéývþ: kAok ��ðlAok �ypf qüp Îßw: kAok ��ðlAok� �• ÎñõAó ìßpo (eltiT gninnuR) : kAok �ðlAok �AüñXBðJ ...........................................ðõüvñlû ìvEõë ìÛBèú yBÒê ko .................................................Aq ÆpÙ uBüp ðõüvñlâBó ìÛBèú ¾dQìñloWBR ÖõÝ oA OBDýl ô AÎçï ìþ ðíBüî , Þú OíBï ðõüvñlâBó ìÛBèú, ðíõðú ðùBüþ @ó oA ìÇBèÏú ô OBDýl ðíõkû Aðl ô OÏùl ìþ ðíBüî Þú ÚHê Aq OÏýýò ðPýXú Gpouþ OõuÈøýEQ Odpüpüú ìdPpï ðzpüú âõAo}, Aüò ìÛBèú oA GpAÿ BN ko ðzpüú küãpÿ AouBë ðhõAøl yl. ðzBðþ ô Oé×ò ìdê ÞBo:

ðzBðþ ô Oé×ò ìñrë:

ðzBðþ ô Oé×ò ìÇI :

Oé×ò øípAû: :liam.E

ìùpôAìÃBF:

oAøñíBÿ AyPpAáÖ¿éñBìú Îéíþ- Ktôøzþ <<ââõõAAoo}}>>

GpAÿ AyPpAá ìXéú Öpï oA Oßíýê ðíBüýl (ÖPõÞLþ Öpï ÚBGê ÚHõë AuQ) ô øípAû GB A¾ê Öý{ GBðßþ Þú Gú cvBJ WBoÿ yíBoû157 GBðà oÖBû ÞBoâpAó, yÏHú GýíBuPBó ypüÏPþ (Þl 331) Gú ðBï @ÚBÿ kÞPp uýl cvýò ìýpìXévþ ôAoür ylû AuQ, Gú ðzBðþOùpAó, ¾ñlôÝ KvPþ 361-59341 AouBë ÖpìBüýl.

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kogõAuQ AyPpAá Ö¿éñBìú Îéíþ-Ktôøzþ <âõAo}>

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ìýrAó Od¿ýçR:............................................ypôÑ AyPpAá Aq yíBoû: ..................................................

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KpkAgQ ylû ko yÏHú:......................................yíBoû øBÿ kogõAuQ ÚHéþ:..............................................

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KpkAgQ ylû ko yÏHú:

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ÞlKvPþ:¾ñlôÝ KvPþ:

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OBoüi ô AìÃB:

cÜ AyPpAá uBæðú• kAgê Þzõo: 000 /002 oüBë • gBoZ Þzõo

ÞzõoøBÿ øíXõAo 000/003 oüBëAoôKB 000/004 oüBë@ìpüßB, ÞBðBkA, AuPpAèýB ô sAKò000 /005 oüBë

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ìXéú âõAo} ko ðíBüú øBÿ qüp AüñlÞw ìþ GByl:

Phillips David ....................77Pishahang Parinaz .............80Pishdad Raha .....................58PooyanAshkan.................... 8PouriAliasghar ..................26Pournaghi Javad................ 40PourshamsAkram .......63,77Poustchi Hossein......62,63,69RRabeiAzar ..........................61Rabiei Maryam.................... 7Rabiei Neda....................... 43Rafatpanah Houshang .......30RafeeyMandana ................39Rahbani Mohammad......... 62Rahimi Hojatalah ...............35RahmatiAtieh ....................12RajaeefardAbdolreza ........10Rakhshani Nasser.............. 78Rakhshani Nasser ..............79Ramazanzadeh Elham....... 53Ranjpour Farza ..................12Rashe Zahra.................. 38,59Rashid Javad ......................53Rashtak Shadi.................... 42Rasooli Reyhaneh ..............81RazavizadehMohsen ........65Raziee Hamid-Reza .....27,30rezaee mehrnoosh.............. 61RezaeiAbbas .....................48Rezaeifar Parisa .................58RezaianzadehAbbas...................................10,14,19Rezghi Mehrnaz ................49Rezvan Hoori .....................61RiahiAina ..........................15RiahinAli-Akbar ...............50Roshandel Gholamreza..............................16,31,46,47Rosta Turaj .........................34Rowshandel Mehdi ...........81SSaadatnia Hassan ....39,40,62Sabahi Farzaneh ................60Saberifiroozi Mehdi....................15,18,2056,75,79sadat-Mirkarimi Honey .....46

SadeghiYazdan................. 16Sadeghian Faezeh .............64Saefari Kyhan ....................49Saeidi Hamidreza ..............50SafarpourAlireza................ 7Sahebari Maryam ..............40Sahebfosoul Fereshteh ......38Sajjadi Masoud ..................30Salehvand mohamad .........54Salek- ZamaniYagoub...... 53Salimi Elnaz....................... 32Samimi Rasoul ..................56Saneian Hossein ................13Sarkeshikian Seyed-Saeid...................................10,32,73SarramiAmirhosein ..........90Sarsar Ebrahim ..................68Sattarnezhad Neda ..57,80,82Savadkoohi Shahriar......... 72Savari Mohammad ...........33Sayehmiri Kourosh ...........62Sayyah-Melli Manijeh ......82Sedighy Sima ....................47Semnani Shahryar ...16,46,47Seyyedein Sasan ................47Shad Esrafil ........................17ShafaghiAfshin ............50,68Shafieipour Sara ................52shahbazian Hajieh .............54Shahbazkhani Bijhan ...12,74Shahzamani Kiana .......60,84Shakeri Mohammad-Taghi.............................................. 8Shamsdin Seyedeh-Azra ...79ShariatiAlireza ....................8Shariati Mohammad-Javad...............................................8Sharifi Davood ..................62Sharifi Mohsen ..................90Sharifi Ghasem-Mohammad.............................................90ShavakhiAhmad ..........66,86ShayestehAliakbar ......37,66ShayestehMehdi ..............37Sheikhesmaeili Farshad...............................51,7378,84Shirani Shapoor................. 24

Shokraneh Farhad ...............9Shokrishirvany Javad ...17,72Sima Hamid-Reza.........11,27,28,29,30,40,55,62Soleimanpour Maryam .....44SoleymanyAli................... 37Soltanpour Narges............. 13SomiMohammadhossein......... 9,22,26,34,38,41,44,45,47,58,59,67,70,81,62SotoudehMasoud... 22,54,62Sotoudehmanesh Rasoul........................54,68,86,87,89Sydnzhad Farshad............. 22TTaba-Taba-Vakili Sahar....... 8Tabrizian Tahmineh ...........42TadayonMohsen ..........28,29Taghavi Seyed-Alireza..............................19,26,43,77TaghaviYasser................... 72taghipour Hoda ..................32Taheri Diana....................... 16Taheri Hassan............... 17,72TaheriAmir........................ 51Talebi-Taher Mahshid........................................32,64Tavakol Kamran................ 13Tavakol-Afshari Jalil...................................28,29,30Tavakoli Hamid................. 25TavassoliAlireza ...............10TghyzadyahMohammad ..70Tollabzadeh Zahra............. 26VVaez-Javadi Maryam........ 84Vafaeimaneh Jamshid .......32Vahedi Homayoon ..15,42,45Vahedi Hamid ....................61Valizadeh Narges ..............30van-Schooten Frederik-Jan.............................................77Villar Stephanie .................22Vosoghiniya Hassan....................... 39,62,8,11,40YYazdanfar Seyed-Kamalaldin

.............................................10ZZaare Maryam.............. 57,53Zahedi Mohammad-Javad........................................33,60Zamani Farhad..............31,49,55,63,69,72,79Zare Najaf ................18,20,75ZargarAli........................... 56ZarghamiMehran ..............41Zoghian Reihaneh........ 27,30Zonubi Zahra..................... 14

Govaresh\ Vol.16\ Supplement\ Autumn 2011 93

Index

AuPBkocýíþÎéþoÂB.................84AÞHpÿAcvBó...........................28Aðõyúìdíl............................96KõoyíwAÞpï.........................32KõoÿÎéþA¾Óp.................52,62,95WÏ×pÿAèùBï............................32cvýñþWrðþðýíB......................96gBkìþøõìò..........................32uXBkÿÎéýpÂB........................32yõÞQðÛlûìÏ¿õìú....................96¾BGpÿÖýpôqÿìùlÿ...................21¾õìþìdílcvýò.......52,62,84,95ÎBGlüBóyý×Pú..........................21ÎBGlÿìñ{ðvýî......................84ÎBGlÿìñ{uÏýl......................84ÖBÂêOHBoìéßzBûAÞHp..................32ÚõWBqAkûìpOÃþ................52,62,95âõâçðþâõøpyBk.....................32ìPnÞpìpOÃþ..........................96ìdílqAkûÚpûGBÒþìdílAìýò.......95ìéàqAkûoÂB.......................32,21ìýpðB¾pÿìdílìùlÿ.................21

Author Index(Persian Abstracts)

Haghighi Keyvan.............. 40Haghighi Mehran.............. 90Hainaut Pierre ....................22HajAgha-MohammadiAli-Akbar ..................................56Hajian Habibollah .............50Hajiani Eskandar........................24,37,54,58,66HajMola-Rezaee Ezzat......27Hajypour Babak ................70Hakhamaneshi Mohammad-Saeed ..................................78Hakimi Hamid-Reza......... 30Hamidpour Laleh...................19,26,43,51,77,85Hanifpoor Mohammad-Amin.............................................75Hasanzarrini Maryam....... 36Hashemi Seyed-Jalal...................21,24,37,54,58,66HashemiMohammad........ 52Hashemzehi Noralla ..........52Hassannejad Niloofar ........48HassanzadehAbbas ...........21HatamiAshkan.................... 8Hatami Khadijeh............... 43Hatef Mohammad-Reza ....39HatefiAsieh .......................40HayatbakhshAbdolrasol ...39Hayatbakhsh-Abasi Moham-mad-Mehdi................... 33,60Hazrati Jila .........................81HeidariAkram.............. 10,84Heidari Zohreh................... 84HekmatdoostAzita ............75Heydari Seyed- Taghi........ 79Hj-SheykholeslamiArghavan.............................................84Homayoon Katayoon........ 85Honar Naser .......................76Hosaini-askarabadi Ma-soomeh ...............................21Hoseini Moosarreza.......... 62HoshyarYusof ...................53Hosseini Seyed-Vahid .........7Hosseini Fereshteh ............11Hosseini-Asl Seyed-Moham-mad-Kazem........................ 11Hossein-Nattajarab Hadi... 38Hosseinnezhad Hanieh ......27Hosseinnezhad Hanieh...................................28,29,30IImaniehMohammad-Hadi........................................51,76IranikhahAbolfazl ..10,32,73Islami Farhad..................... 77

Ismayeeli Mohsen .............44JJabar-Fattahi Monireh....... 82Jabbarpour-Bonyadi Morteza.............................................44Jacobson Kevan .................75Jafari Elham .......................15Jafarshad Reyhane ........50,68JafarzadehMostafa.............................27,28,29,30JaliliAli ..............................78Jamali Raika....................... 83JamaliArsia ........................83JamshidiAhmad-Reza ......12Japoni Sara.................... 64,76Javadrashid Reza............... 57Javid-Anbardan Sanam....... 8Joshaghani Hamidreza ......47Joukar Farahnaz........ 7,50,68KKalagheichi-azar Hassan... 70Kalani Mohammad ............74Kalantari Hamid ................48Kamangar Farin................. 22Kamkar Mohammadzaman.............................................46Karimi Shahrzad ................65Karimipour Mojtaba.......... 37Kashifard Mehrdad ...........72KazemiMohammadhassan........................................19,77Kazemi Shadi .....................25Keramati Mohammad-Reza...............................................8KeshtkarAbbasali .............16Khademolhosseini Farnaz........................................10,20KhajedalueeMohammad ..11Khaleghi Siamak..32,49,64,72Khaleghnejad Reza........... 42Khamisi Naser ...................66Khanahmadi Naser ............84Khansari Mahmoud-reza........................31,43,63,72,78KhatibianMorteza............. 89KhodadadyAli ...................70KhonchehAhmad ..............12khoshbatenManouchehr............. 34,53,53,57,73,80,82Khoshnia Masoud............. 16khosraviAhmad..11,39,40,62Khosravi Mohammad-Sadegh................................ 75Kia-kojuri Fatemeh ...........43kiana Shahzamani.............. 60Kolahdoozan Shadi..............................84,87,42,45

Kord-ValeshabadAli ...........7LLashkariAlireza .................80Leghayeeyan Negar........... 44MMaddah Ghodratollah .......29Mahdavy Nafise................ 45Mahluji Sepide ...................14Mahmoodi Samaneh .........64Mahmoudi Laleh............... 24Majidi Golnar ....................58Maleknejad Shohreh .........33Malekzadeh Reza......15,21,22,24,42,45,54,56,63,77Malekzadeh Fatemeh ........42Mansoorabadi Zahra ....26,43Mansour-Ghanaei Fariborz......................................... 7,68MaracyMohammad-Reza....16Marasi Mohammad-reza... 48Masjedi Morad.................. 38MasjedizadehAbdolrahim....................................... 37,66Masnadi-Shirazi Koorosh....................................... 53,57MasoomAnahita..... 28,29,30MasoumiSeyed-Jalil.....8,20,75Massah Saeid......................16Matin Marzieh....................51Mehdioghli Rahim ............81Mehrabani Davood...........................7,18,20,75,79Mehrabi Narges .......21,24,86Mehrabi-Bahar Mostafa.....30MehrazmaMitra ................79Memar Bahram.................. 62Merat Shahin...................54,60,61,63,64,84Mikaeli Javad.......... 21,24,86Minakari Mohammad...................................36,66,86Mirbagheri Seyed-Amir ....79Mirfeizi Seyedezahra........ 39Mirinejhad Seyyed-Kazem...................................22,44,49Mir-nasseri Mohammad-Mehdi..................................15Mirza-Agha F ....................87Mirzaee Vahid.................... 13ModabberniaAmirhossein............................................ 69Modaresi Vajiheh............... 40Modarresi Seyedeh-Zalfa ..40ModirzadehA ....................86Mohamad D .......................86mohamadkhaniAshraf........................................62,63

Mohammad-Doust Faezeh............................................ 11Mohammadi Reza .............46MohammedzadehMo-hammed.............................. 22Moini Maryam .............26,43MojrianAlireza ..................16Mokhtari Mojgan ..............38MokhtarifarAli............. 39,62Momtahen Shabnam ....15,42MontazeriAli ................18,20Moosavi SA....................... 68Moosavy Seyed-Hamid........................................61,70Moradi Fariba...........18,20,75Moradimoghaddam Faride.............................................62MoravvejiAlireza.............. 65Mosavi-fard Seied-Hossein.............................................60MostaghniAhmad .............18MostaghniAmir-Ahmad ...20Mousavi Ghafour ..............70Mousavi Seyed-Mohsen... 73NNaghashi Shahnaz ........34,58Najafi Mehrdokht...................31,43,49,69,72,73naseriAli- Reza .................22Naserimoghadam Siavash............................................ 42Nasiri Behnam ...................22Nasiri- Toosi Mohsen... 61,70Nazari Shahram .................71Nejhadi-Kelarijani Fatemeh........................................16,47nekozadeh Shabaz............. 32NematyMohsen ................55Nikkhoo Bahram ..........51,78NikmahzarAghbibi ...........63Niknam Ramin ..................24Nikroo Hossein.................. 55NikzabnMehrnoosh ..........78NorouziAlireza .................89Nouraie Mehdi ...................54Nouri Mohammad .............80OOlfati Golrokh ....................42OmidiAbdollah .................83ostadrahimi alireza .......41,47PPaknejad Pooya .................81ParizadehMostafa .............28ParniyanMaryam ..............60Parsa Mahboubeh ..............27Peikan-Heirati Masoumeh............................................ 54

Govaresh\ Vol.16\ Supplement\ Autumn 201192

Index

AAbangah Gobad................. 39Abbasi Masoumeh............. 50Abbaszadeh Lili .................53Abdolahi Tahoora...................................27,28,29Abdolahi Nafiseh ...............31Abdolahi Farzan................ 64Abdolhosseinpour Faraneh.............................................40Abdollahi Hamid ...............33Abdollahi Mohammadreza.............................................67Abedian Shifteh ............15,56Abedi-Ardekani Behnoush.............................................22Abedi-Manesh Nasim........................................41,47Abedini Siavash........ 8, 11,40Abedini Sahar..................... 11Abnet Christian............ 22,77AbrishamiMostafa ............28Adhami Leila .....................36Adhamian Pardis ...............13Adibi Peyman.................... 35Adimi Parisa ......................70Afroogh Razieh................. 89AfzalaghaeeMahdi ...........29AfzalaghaeeMonavar .......29Aghamohamadi Nima....... 24Ahadi Mitra........................ 62Ahi Salma........................... 64AhmadiAli .........................16Ahmadi-asl Nser ................70AhmadzadehA ..................58AhsanMajid ......................85Ainechi S............................ 87Ajdarkosh Hossein.....................8,31,55,63,72,78Akhavan-Rezayat Kambiz............................................. 68Akhavan-TabibAtefeh...... 16Akhondi-Meybodi Mohsen..............................................61Alavian Seyed-Moayed........................................10,67Alavian Seyedeh-Hoda .....67Aletaha Najmeh ............74,88Alhojjat Yahya .....................9Ali-AsgariAli ..............87,87Alipour Beitollah ..........41,47AlizadehAhmad ................68Ameli Mitra ..................43,72Amin-daneshpoor Banafsheh.............................................51

Amini-Kafiabad Sedigheh.............................................61AminizadehAli.................... 8AmiriAli ............................32Amiri Hajar ........................35Amiriani Taghi ........16,46,47Andakhshideh Elahe .........30AndrabiYasir................ 61,70Ansari Reza........................ 83Arab Payman .....................87Ardebili Maryam..............................14,26,36,43ArjAbbas ...........................65Arjmandi Fariba ...........35,36ArjmandpoorAkbar ..........36AryanArash......................... 8Asaf Fatima ........................86Ashayeri Rizan ....................9Atef- VahidAhad ...............79Attari Fatemeh ...................73Attarzade-Hosseini Seyed-Reza ....................................55Ayoubian Hiresh................ 78AzarianAli .........................50BBabaei Leila....................... 85BaghbanianMahmoud ......74Bagheri Masood ................38Bagheri Mohammad......... 45Bagheri Zohreh ..................55Bagheri Masood........... 59,81Bagheri-Lankarani Kamran...................................26,43,77BahariAli .................11,52,62Bakhti Hadi ........................78Bakhtiyari Reza ...................8BarootkoobAbdolamir .....75Barzanooni Somayeh ........47BasiAli............................... 78Basiratnia Mitra................. 51Bastani Faegh ....................62Bayat Fatemeh................... 13Bayat Maryam ...................55Belbasi Mojtaba .................10Belladi-behbehani Maryam.............................................66Besharat Sima..........16,46,47Besharat Mahsa............ 46,47Boffetta Paolo.................... 77BolandmartabehMaryam....................................... 50,32Bonyadi Mortaza................. 9Bordbar Marjan .................33BorgheiAfsaneh ................47Borhanmanesh Fathali ......20

Boroumand-NoghabiSamaneh........................ 27,30CChaharmahali Meghedi...................................42,45,89DDadashzadehAlireza ...........7Daghaghzade Hamed........ 35Darabi Masoud ..................62Darvish-Moghadam Sodaif........................................33,60Dastgiri Saeed ....................22Davari Majid ......................16DavarpanahMohammad-Ali.............................................10Dawsey Sanford ...........22,77Dehghani Seyed-Mohsen........................................51,76DerakhshanAli.................. 51Derakhshandeh Roshanak............................................ 79DeyhimMohammad-Reza.............................................61Dordaei Faranak ................53EEbrahimi-Dariani Nasser.....................................8,45,74Eidani Esmaeil................... 21Elahi Elham ..................21,24EmamiMohamad-Hasan..............16,25,35,38,81,85,90Erfani Mina ........................30Esalatmanesh Kamal .........65Esfahanian Samaneh .........67Eslami Masoumeh ........63,69Eslamian Ghazaleh............ 75EsmaeelzadeAbbas..............................28,39,40,62Esmaili Saeed ....................63Etemad-Eslami Reza ...........8EtemadiArash ..............21,77FFaghani Behzad .................16FaghihiAmir-hossein........ 67FaghrjoAsraf .....................34Faiazi Nader....................... 70Fakheri Hafez.................... 41FakhrjooAshraf................. 49FallahzadehMohammad-Hossein............................... 51Farahmand Fatemeh ..........40FarahvashMohammad-Jafar.............................................74Farajzadegan Ziba .............90Farhang Sara ......................45

Farhangi Elham................. 51Farhoodi Mahmood ...........62FarnamAlireza ..................45Farrokhi Farid ....................40Farsinejadmarj Maryam...................................68,86,87Fattahi Mohammadreza...................11,14,26,43,64,85Fattahi Ebrahim ............34,58Fazel-Tabar-MalekshahAkbar ..................................77Fereshtehnejad Seyed-Mohammad .....................8,55Forghani Mohammd-Naser.............................................27Forutan Hossein...................................61,70,74GGanjali Rashin................... 29GanjiAzita ....................39,62GarjaniAfag....................... 53Gasemi-OskouyiAysan..... 67GavidelAli .........................34Geramizadeh Bita......... 20,26Ghadir Mohammad-Reza......10,27,28,29,32,45,50,73,78,84Ghaffarzadegan Kamran..............................27,28,30,62Ghajarieh-Sepanlou Sadaf...................................54,61,63GhamgharAlireza..............34GhannadzadehAli............... 8GhanooniAmir-Hosein .....50GharagozlooMarjan .........48Ghasemi Shima .................50Ghasemi-Barghi Reza .......56Ghasemi-JangjoAmir .......22Ghazanfari Hadi................ 48Gheibi Shahsanam ............37Ghergherehchi Robabeh ...39Ghofrani Hadi ...............61,74GhojazadehMorteza.....................9,26,38,59,67,81Gholami Nasrin................. 53GholamrezaeiAli..........13,85Golbahar-HaghighiArdalan......................................... 9,81Golmohammadi Parisa ......90Golshahi Maryam.............. 11Golshiri Parastoo ...............81HHabibinejad Hosein-Ali ....84HabizadehMohamad-Reza.............................................25Haghighat Mahmood ...51,76


Index

Author Index(English Abstracts)

4Poursina Hakim Research Institute.5Isfahan University of Medical SciencesIntroduction: Pneumatic dilation (PD) is areasonable nonsurgical option for management ofachalasia. Few methods have been used to predictlong-term efficacy of PD but, with some limitations,hazards, and expenses. This study was designed toevaluate the potential of a new grading method,Achalasia Endoscopic Visual Scale (EVS), forpredicting long-term outcome of PD in patients withachalasia.Method: In a prospective study, 65 patients withdefinite achalasia underwent PD, consecutively.Based on the amount of Mucosal Tearing (MT) afterPD, patients were graded from 1to 4 and for loweresophageal sphincter opening (LES opening) from Ato D (LES doesn’t open by air insufflations to LES isopen spontaneously without air insufflations with adiameter of 11 mm or more). A validated symptomscore questionnaire were used before PD and one, sixand twelve months after PD. Annual visits wereperformed thereafter in order to detect any symptom

recurrence and need for re-intervention.Results: Sixty patients (58.3% female) with mean ageof 39.9 ±18.9 years completed the study. The mean ofsymptom free survival of PD was 58.9±6.2 months(95% CI: 46.6-71.1) in all patients. Mean (95% CI)symptom free survival with MT grade 1 to 4 were36.5±6.3 (24.1-49.0), 68.8±10.3 (48.5-89.1),79.8±10.1 (59.8-99.8), and 30.0±0.0 months,respectively; P = 0.014. Mean symptom free survivalbased on LES opening grading of A to D were30±4.2, 52.0±7.9, 53.6±8.2, and 51.4±7.0 months,respectively; p= 0.256.Conclusion: Achalasia EVS based on new MTclassification is a strong independent predictor oflong-term symptom free survival of PD. Multi-centricstudies are required to find intra- and inter-observervariations of this grading system and to incorporateLES opening and clinical factors in formula for moreprecise prediction of the PD prognosis.Send Date: 2011/08/05


Abstracts of Iranian Congress of Gastroenterology and Hepatology- 2011

spleen. Surgery consult was done. The next day,Laparoscopic surgery was recommended to be doneto exclude bowel perforation and the probability offinding the source of bleeding. Diagnosticlaparoscopy was done. All the small intestine wasinvestigated. No perforation was seen. Small amountof reactive fluid in the abdomen was seen. In distal ofileum there was a Meckel's diverticulum about 1.5cm. Mini laparatomy was done and Meckel’sdiverticuli resected and anastomosis was done.Pathology confirmed ectopic gastric tissue.Discussion: Post-DBE pancreatitis has beenrecognized as a complication. In diagnosticprocedures, pancreatitis is the most common andmost severe complication. The first post-DBE acutepancreatitis was reported by Honda et al in 2006.Acute pancreatitis is a feared complication of oralDBE (51 cases of acute pancreatitis have beendescribed in the literature to date, one of them fatal).The underlying mechanism of pancreatitis in thesecases is unclear. Pancreatic duct obstruction by directpressure of the papilla with the inflated balloon, anincrease in duodenal intraluminal pressure caused bythe overtube and gastrointestinal shorteningtechnique, the reflux of duodenal contents into thepancreatic duct due to intraluminal hypertensioncaused by the inflated balloon, or traumatic injury orischemia due stretching and shortening of theproximal small bowel have been discussed aspossible mechanisms.Send Date: 2011/05/18

Category: 20 THERAPEUTIC ENDOSCOPY/IN-TERVENTIONAL PADIOLOGY20.1 Biliary and pancreatic stentingF-T-152

The effect of adding gentamicin to contrastmedia for prevention of cholangitis after biliary

stenting; a randomized controlled trialAlireza Norouzi1*, Morteza Khatibian1,

Razieh Afroogh1, MeghediChaharmahali1, Rasoul Sotoudehmanesh1

1Digestive Disease Research Center, Tehran University ofMedical UniversityIntroduction: Cholangitis is the most commoninfectious complication of ERCP. Prophylacticaddition of aminoglycosides to contrast medium was

effective in reducing cholangitis in in-vitro studiesbut results of clinical trials are conflicting. We studiedthe effect of intracontrast gentamicin in reducing therate of post-ERCP cholangitis in patients withobstructive jaundice.Method: All patients with obstructive jaundice un-derwent endoscopic biliary stenting at the ShariatiHospital, Tehran between December 2009 andOctober 2010 were enrolled. 10 mg gentamicin ordistilled water, added to each 10cc contrast mediumduring ERCP. Intravenous antibiotics were givenbefore and after the procedure in all patients. AfterERCP and stent deployment, patients were followedfor 72hrs for symptoms and signs of cholangitis.Results: A total of 114 patients were eligible for thestudy. Fifty seven patients were included in eachgroup. Cholangiocarcinoma was the most prevalentdiagnosis. The obstruction was relieved in all patentsby stenting. Five patients in each group (8.8%)developed cholangitis. There was no significantdifference in the incidence of cholangitis between thetwo groups (p=1.000).Conclusion: With adequate drainage of obstructedbiliary tract by proper stenting, adding gentamicin tocontrast media has no significant effect in reductionof post-ERCP cholangitis.Send Date: 2011/08/05

Category: 20 THERAPEUTIC ENDOSCOPY/IN-TERVENTIONAL PADIOLOGY20.2 Enteral dilatation and stenting (esophagus -stomach - duodenum - colon)F-T-153

Achalasia Endoscopic Visual Scale (AchalasiaEVS): A Grading Method Predicting Long-termOutcome of Pneumatic Dilation in Patients with

AchalasiaMohammad Hassan Emami1*, Mohsen Sharifi2,

Ghasem Mohammad Sharifi2, Ziba Farajzadegan3,Parisa Golmohammadi4, Mehran Haghighi5,

Amirhosein Sarrami5

1Poursina Hakim Research Institute, Department ofGastroenterology, Isfahan University of Medical Sciences2 Department of Gastroenterology, Isfahan University ofMedical Sciences,3Poursina Hakim Research Institute, Department of Com-munity Medicine, Isfahan University of Medical Sciences



cases with chronic liver disease, the relationshipbetween the degrees of hepatic dysfunction(Child-Pugh class), history of variceal bleeding,presence of hyponatremia, thrombocytopenia andendoscopic grading of varices with the size of theportal, splenic and azygos veins on EUS wereassessed.Results: In the study period, 63 patients (20 femaleand 43 male) with chronic liver disease and 85control subjects (42 female and 43 male) wereenrolled. Mean age of cases and control were 45.60 ±14 and 48.5 ± 15 respectively. The most commoncause of chronic liver disease was post-necroticcirrhosis due to hepatitis B virus. Patients withchronic liver disease had significantly higher meanportal, splenic and azygos vein diameters than thecontrol group (p<0.001). With azygos, portal andsplenic vein diameters of 10, 11 and 9 mm, sensitivityfor the diagnosis of portal hypertension was 66%,71%, 66% while specificity was 94%, 99% and 99%respectively. Splenic and portal vein dilation andthrombocytopenia were significantly correlated withvariceal bleeding (p<0.05).Conclusion: EUS allows the collection of valuablequantitative data from the portal system for the diag-nosis of portal hypertension and in the follow up ofpatients with chronic liver disease.Send Date: 2011/07/12

Category: 19 ENDOSCOPY AND IMAGING19.5 EnteroscopyF-T-151

Acute pancreatitis as a complication of peroraldouble-balloon enteroscopy: A case report

Najmeh Aletaha1*

1Imam Khomeini Hospital, Tehran University of MedicalSciencesIntroduction: Double-balloon enteroscopy (DBE) isa new technique for evaluation small intestine. DBEwas initially developed by Yamamoto et al, in Japan.Potential complications include perforation,pancreatitis, and gastrointestinal bleeding. Theoverall complication rate is stated as being about1.7%. Hyperamylasemia after per oral DBE wasreported in approximately half of the patients, andwith 1–8% developing pancreatitis. In this paper, we

report a case that developed acute pancreatitis afterDBE. This was the first case of acute pancreatitis inour hospital.Case Report: A 26-year-old’s man was referred to ourhospital for evaluation of obscure GI bleeding. Hehad melana seven times from 2.5 y ago. For thisreason, three times had been hospitalized. Hereceived red blood cell transfusion in 2 times of theprevious hospitalization due to severe bleeding anddecreased hemoglobin level (7.5 g/dl). In the firstendoscopy one clean base linear ulcer was reported ingreater curvature of antrum. Biopsy from ulcer wasperformed and injection with epinephrine was done.Despite medical management, bleeding was repeatedseveral times later. Then, to identify the cause ofbleeding five times endoscopy and three timescolonoscopy performed. In first rectosigmoidoscopy,upper to sigmoid was full of tarry stool and thereforecolonoscopy was not continued. After this period, in2 sessions colonoscopy was done that one of them upto hepatic flexure and other up to cecum were normal.But in all these studies the origin of bleeding was notfound. Barium follow through of the small intestinealso failed to show any lesions. RBC scan & meckel’sscan was normal too. Therefore, the source ofgastrointestinal bleeding was suspected to be smallintestine and thus he was referred to our hospital.Forty days had passed from the last gastrointestinalbleeding. In new admission in our hospital hishemoglobin was 10.5 g/dl. On the next day of hisadmission, written informed consent was obtainedfrom him and he underwent per oral double balloonendoscopy. DBE under anesthesiologist supervisedwas done. The total time of the procedure was 130min. the source of GI bleeding was not found. At themost distal site, the small intestinal mucosa wasmarked with a tattoo by a submucosal injection ofsterilized ink through an injection catheter. A fewhours later the procedure, the patient complainedfrom severe abdominal pain. The pain wasgeneralized that was most intense in the left upperquadrant. An abdominal examination revealedmoderate LUQ tenderness. His laboratory findingswere as follows: white blood cells, 16,100/µL; serumamylase, 550 U/L (normal up to 100 U/L).Abdominal CT revealed an inflammation of the bodyof pancreas. There was amount fluid around the



Category: 19 ENDOSCOPY AND IMAGING19.4 EndosonographyF-T-148

Incidental findings on uppergastrointestinal endoscopic ultrasonography

Rasoul Sotoudehmanesh1*, Payman Arab1,Ali Ali-Asgari1, Maryam Farsinejadmarj1

1 Digestive Disease Research Center, Tehran University ofMedical SciencesIntroduction: The issue of incidental findings inmedicine gains attention due to rapid progress inaccurate diagnostic technologies and the agingpopulation. The aim of this prospective study was toassess the frequency and clinical significance ofincidental findings on upper gastrointestinalendoscopic ultrasonography (EUS).Method: Patients who referred for uppergastrointestinal EUS, were consecutively enrolled totake part in this prospective study. Any coincidentalabnormality found during the standard EUS wasconsidered an incidental finding. Significantincidental findings were defined as abnormalities thatrequired further medical, surgical or endoscopicintervention including surveillance.Results: In 552 patients who underwent EUS, 44 IFwere detected in 41 patients (7.4%). Twenty four ab-normalities had high clinical significance. The fre-quency of IF increased significantly with increasingage (p=0.001). The most frequent If were gallstones,subepithelial lesions and pancreatic lesions.Conclusion: Incidental findings on EUS are notuncommon in clinical practice and might be a clue toa significant pathology. The appropriate extent ofevaluation in a standard EUS procedure warrantsfurther research to be defined.Send Date: 2011/07/12


Impact of EUS in Patientswith Thickened Wall Stomach in CT scan

Rasoul Sotoudehmanesh1*, F Mirza Agha1,Shadi Kolahdoozan1, Maryam Farsinejadmarj1

1 Digestive Disease Research Center, Tehran University ofMedical SciencesIntroduction: Endoscopic ultrasound (EUS) is oftenused in patients who have gastric wall thickening in

computed tomography (CT). HoweverMethod: All patients referred for endoscopicultrasound because of thickened gastric folds on CTwere included. UGIE followed by EUS performed inall patients. Data were recorded prospectively.Results: Twenty-eight patients enrolled the study.The mean ± SD age was 50.8±15.9. The prevalencewas higher in men (60.7% were male). Most of thepatients (78.6%) had symptoms. Ten patients (35.7%)finally diagnosed as gastric neoplasm. The presenceof dyspepsia or constitutional symptoms is correlatedwith the presence of gastric abnormality. Elevenpatients (39.3%) had normal UGIE, and 17 patients(60.7%) had normal EUS. If UGIE was abnormal (17patients), EUS was abnormal in 10 (58.8%) cases. Inall patients with normal UGIE (11 patients), the EUSwas normal. Accuracy, specificity, sensitivity,positive predictive value and negative predictivevalue of EUS for detecting a lesion in thickened wallstomach on CT were: 89.3%, 88.8%, 90.0%, 81.8%and 94.1% respectively.Conclusion: In all patients with normal EUS, UGIEis normal. The presence of symptoms predicts orincreases the likelihood of abnormal EUS. In patientswith thickened gastric wall in CT, UGIE should bedone before EUS.Send Date: 2011/07/12


Endoscopic Ultrasonography in Patients withChronic Liver Disease: A Case-Control StudyRasoul Sotoudehmanesh1*, S Ainechi1, Ali Ali Asgari1,

Shadi Kolahdoozan1, Maryam Farsinejadmarj1

1 Digestive Disease Research Center, Tehran Universityof Medical SciencesIntroduction: The portal system and azygos vein arethe main drainage systems during portalhypertension. We aimed to compare the diameter ofthese veins by EUS in patients with and withoutchronic liver disease.Method: During one year, patients with chronic liverdisease were enrolled as study group. Patientsundergoing endoscopic ultrasonography (EUS) forother reasons in the same period served as controls. In



Results: The amount of gastric foam/air bubbles wassignificantly lower in the simethicone groupcompared with the placebo group (P = 0.002). Nodifference was found between the two groups withregard to duodenal foam/air bubbles (P > 0.05).Duration of endoscopy was, on average, one minuteshorter in the simethicone group compared with theplacebo group (P < 0.001). Patients’ satisfaction withthe procedure was the same in the two groups. Noadverse effect was observed with simethicone.Conclusion: Administration of simethicone prior toEGD reduces the amount of gastric foam and bubblessignificantly and provides better visibility forevaluating the mucosa. It also decreases the durationof endoscopy. Further trials are required to find theoptimal dosage and timing, as well as the final effectof the drug on diagnosis of pathological lesions.Send Date: 2011/08/05

Category: 19 ENDOSCOPY AND IMAGING19.1 Endoscopy - Upper GIF-T-146

Comparison of viscose and spray lidocainefficacy for through anesthesia in endoscopy

Ahmad Shavakhi Shavakhi1,Mohamad Minakari1, Fatima Asaf1*

1 Alzahra Hospital, Isfahan University of Medical SciencesIntroduction: lidocaine should be used for diagnosticupper gastrointestinal (GI) endoscopy in deeplysedated patients, investigators recommend.Manyendoscopists prefer of lidocain gel and othee prefferlidocaine spray. Probably The efficacy of localanesthesia is very important for an easy endoscopynot only for patients butalso for endoscopist . Thisstudy was down to comparison of two form oflidocaine (Gel and spray) that used befor endoscopyMethod: This is a clinical trial study that conductedin Alzahra Isfahan hospital in 2009. With use of spe-cial sample size formula we selected 135 patients thatcandidate fro endoscopy. This patients wererandomly selected in two groups . In the first groupwe use spray and in second group we use lidocain gelfor local anesthesia. After 30 minutes we evaluatedof deep anesthesia for two groups. The data collectedwith special check list and entered to computer andanalyzed By spss soft ware.

Results: Exellent Patients satisfaction for spray andgel was 21.5% and 20% respectively. relative patientssatisfaction for lidocaine spray and gel was 41.5%and 52.3% and there is no statistically differencebetween two form of lidocaine (P=0.46),also anxietyin gel group was less than spray group (p<0.05).Conclusion: According to idea of patients andendoscopist no difference between spray and gel andphysicians can apply any form of lidocaine for localanesthesia according to patients preference. lidocaingel may be better for anxious patient.Send Date: 2011/08/22


Endoscopic UltrasonographyFindings in Patients with Achalasia

Rasoul Sotoudehmanesh1*, Javad Mikaeli1,D Mohamad1, A Modirzadeh1,

Narges Mehrabi1, Maryam Farsinejadmarj1

1 DDRC, Tehran University of Medical SciencesIntroduction: Patients with achalasia may have athicker muscularis propria layer than normal subjects.The aim of our study was to determine the prevalenceof increased muscle thickness in patients withachalasia measured by endoscopic ultrasonography(EUS) and evaluation of its relationship with diseasecharacteristics.Method: During one year period we studied 16nonachalsia patients and 16 consecutive achalasiapatients before pneumatic dilation. Esophagealmuscle thickness was measured at EGJ, 5th, and 10thCm far from EGJ. Patients’ symptom scores and theirrelieves were evaluated 1, 3 and 6 months aftertreatment.Results: Nearly all patients with well-definedachalasia, revealed an increase in the musclethickness relative to controls. There was a correlationbetween the thickness at 5, 10th Cm above the EGJand the age of patients with achalasia. None ofsymptom scores, mean lower esophageal pressure,disease duration and response to treatment werecorrelated with rate of increase in muscle thickness.Conclusion: Increased esophageal muscle thickness byEUS is likely to be an important marker of achalasia.Send Date: 2011/07/12




Double pylorus in a cirrhotic patient:A case report and review of the literature

Mohammadreza Fattahi1, KatayoonHomayoon1, Laleh Hamidpour1*

1 Gastroenterohepatology Research Centre, ShirazUniversity of Medical Sciences,Shiraz,IranIntroduction: Double pylorus is an uncommoncondition that is characterized by two communicatingchannels between gastric antrum and the first part ofduodenum. Endoscopically, two separate openings ofthe pylorus can be seen leading to the duodenum, mostof them were complication of peptic ulcer disease,although it may also be a congenital condition.Case Report: A 66 year old cirrhotic gentleman wasreferred to the endoscopy ward for evaluation ofcirrhosis and possibility of esophageal varices.Thepatient was asymptomatic and looked healthy; he hadno history of epigastric pain, previous gastrointestinalbleeding or peptic ulcers. In endoscopy doubleorifices in pylorus lead to duodenal bulb withmultiple erosions and deep anterior ulceration wasfound. Double pylorus is a rare finding which most ofthe times is an incidental finding during endoscopyor radiology. The male: female ratio is about 2:1 andthe mean age of the patients was 59.6 years. It may beacquired or congenital .Acquired form is morecommon than congenital form that is usually resultsfrom a gastric ulcer eroding through and creating afistula between the lesser curve of the gastric antrumand duodenal bulb near the anatomic pylorus .Rarelyit has been described in patients with malignantulcers. The reasons for development of the fistularemain unclear, but many systemic diseases, longhistory using corticosteroids, NSAIDs, and alcoholconsumption may be associated with it. The trueincidence of congenital double pylorus may beunderestimated, because great majority of them mayremain undetected for decades of life. It’s etiologyprobably is the failure of the pyloric lumen torecanalize during the early stage of embryonic life .Acongenital origin depends on normal histology inboth channels that shows the presence of mucosa,lamina propria, and muscularis mucosa, with no signsof chronic penetrating ulcer or chronic gastritis.

Furthermore, it seems that congenital duplicationsusually are located in the greater curvature rather thanlesser curvature.Discussion: Our case had a deep peptic ulcer atanterior wall of the bulb, which makes the possibilityof a peptic etiology for the additional opening to theduodenum more likely. On the other hand the roundor regular shape of the rim of the two openings maybe in favor of a congenital etiology .In either casedouble pylorus itself and particularly in combinationwith cirrhosis is a rare finding. To our knowledgeonly one other case of double pylorus and cirrhosis isreported in the literature.Send Date: 2011/08/16


Simethicone for the Preparation beforeEsophagogastroduodenoscopy-

Updated Data on Patient’s Satisfactionand Duration of the Procedure

Majid Ahsan1*, Leila Babaei1, Ali Gholamrezaei2,Mohammad Hassan Emami3

1 Medical Student Research Center, Isfahan University ofMedical Sciences2 Poursina Hakim Research Institute, Medical StudentResearch Center, Isfahan University of Medical Sciences3 Poursina Hakim Research Institute, Department ofGastroenterology, Isfahan University of Medical SciencesIntroduction: The presence of air bubbles and foamin stomach and duodenum during esophagogastro-duodenoscopy (EGD) is a common problem whichcan lead to decreased diagnostic accuracy, prolongedendoscopy time, and decreased patient’s tolerance.We evaluated the effectiveness of simethicone inreducing the amount of gastric and duodenal foam/airbubbles, duration of endoscopy procedure, andpatients’ satisfaction during EGD.Method: Patients who were candidates of electiveEGD received 40 mg chewable tablet of simethicone(n = 90) or placebo (n = 83), with 30mL water, 15–30min before the EGD. Foam/air bubbles duringendoscopy were assessed and graded on a 4-pointscale by a single endoscopist, and the duration ofendoscopy procedure was recorded. Patients’satisfaction with the endoscopy was scored from 0 to 10.



Comparison the effects of doxepin, nortriptylineand placebo on diarrhea-predominant irritable

bowel syndrome: a triple-blind, randomized,placebo-controlled trial

Mohammad-Reza Ghadir1*, Hosein-Ali Habibinejad2,Akram Heidari1, Maryam Vaez-Javadi3, Farshad

Sheikhesmaeli4, Naser Khanahmadi5

1Shahid Beheshti Hospital, Qom University of MedicalSciences, Qom, Iran2Shahid Beheshti Hospital, Qom Azad University of Med-ical Sciences, Qom, Iran3Immunology Department, Qom University of MedicalSciences, Qom, Iran4Sanandaj University of Medical Sciences, SanandajUniversity of Medical Sciences, Sanandaj, Iran5Ayatollah Golpayegani Hospital, Qom, IranIntroduction: Irritable bowel syndrome is importantbecause of its high prevalence, substantial morbidity,and enormous costs. Several trials have demonstratedbenefits of tricyclic antidepressants for irritablebowel syndrome, especially when pain is a prominentsymptom but the efficacy of antidepressants inirritable bowel syndrome is controversial. The aim ofthis study was to compare the effects of doxepin,nortriptyline and placebo on diarrhea-predominantirritable bowel syndrome.Method: Seventy-five patients with IBS according toRome III criteria were treated for 2 months. Thepatients were randomly assigned to one of threegroups treated with doxepin, nortriptyline orplacebo.Subjects were assessed clinically one monthand two months after treatment. The symptoms andadverse effects of the drugs were recorded in thequestionnaire.Results: Improvement in abdominal pain andbloating in doxepin group was significantly higherthan nortriptyline and placebo groups (p=0.001 andp=0.012, respectively). Improvement in diarrhea innortriptyline group was significantly higher thanother groups (p=0.018). The mean of improvementdegree of the patients after 2 months of treatment indoxepin group, nortriptyline group and placebo groupwere 2.56, 2 and 0.6, respectively(p<0.05).Conclusion: Doxepin or nortriptyline is effective fortreatment of diarrhea-predominant irritable bowelsyndrome in a period of two months. Doxepin is moreeffective than nortriptyline for treatment ofdiarrhea-predominant irritable bowel syndrome.Send Date: 2011/07/22

Category: 16 IMMUNOLOGY/MICROBIOLOGY16.1 Host defence mechanisms - immune reactionsF-T-143

Single nucleotide polymorphisms in IFN-αreceptor1 gene and its association

with outcome of combination therapyin Iranian HCV infected patients

Kiana Shahzamani1*, Zohreh Heidari1, Arghavan HjSheykholeslami1, Shadi Kolahdoozan1, Shahin Merat1

1Digestive Disease Research Institute, Tehran Universityof Medical SciencesIntroduction: Hepatitis C virus (HCV) is one of themain reasons for chronic liver disease andhepatocellular carcinoma. Combination therapy withPegylated interferon-α (IFN-α) and ribavirin hasbecome the gold standard for treatment of HCVinfection, although the achievement of sustainedvirological response (SVR) has not been verysatisfactory. The treatment outcome depends on viralgenotypes and host genetic polymorphisms in thegenes involved in the IFN-α signaling pathway. Theaim of this study was to identify host geneticpolymorphisms of IFN-α receptor 1(IFNAR1) geneassociated with the efficacy of IFN-basedcombination therapy.Method: Participants were treated with pegylatedinterferon-α and ribavirin during therapy. Subjectswith undetectable HCV RNA at week 72 wereconsidered to achieve SVR. Subjects with detectableHCV RNA at week 24 were considered as non-responders. DNA was extracted from collectedperipheral blood mononuclear cells (PBMCs). Foursingle nucleotide polymorphisms (SNPs) belong toIFNAR1 gene were detected in 30 Iranian healthyvolunteers and 270 chronic hepatitis C patients.Genotypes were assessed by TaqMan assays andanalyzed with related software. This analysiscompares genotypes for participants with an SVR tonon-responder.Results: Logistic analysis revealed that low viralload, viral genotype 3 and a lower degree of liverfibrosis but none of studied SNPs were significantlyassociated with SVR.Conclusion: Genetic polymorphisms in IFNAR1gene were not associated with SVR. In contrast theefficacy of recombinant therapy was largelydependent on viral factors and liver fibrosis.Send Date: 2011/07/21



assess the incidence of IBS in women undergoinghysterectomy and tubular ligation (TL).Method: Participants were patients of Alzahra andTaleghani hospitals of Tabriz University ofMedicalSciences.Three hundred thirty six healthywomen were included in the study.One hundredseventy two of cases underwent TL and 164 of themhad hysterectomy.Patients were assessed every 3months after having aforementioned surgeries, duringa 12-month period. IBS was evaluated using aquestionnaire based on Rome II criteria. Individualsdiagnosed with Irritible Bowel Syndrome, based onthis criteria, underwent complementary evaluationsby gasteroenterologist for IBS confirmation.Results: The mean age of patients underwent TL was37.85± 5 years; and 47.14 ± 6.57 years inhysterectomy group. During 12 months aftersurgeries, 19 (11%) patients in TL group and 19(11%) in hysterectomy group had abdominal pain(> 12 weeks) with at least two symptoms of IBS;However, IBS was confirmed in 9 (5%) patients ofTL and 13 (8%) patients of hysterectomy groups (p >0.05). In both groups of study, the most prevalentsymptoms along with abdominal pain were chronicconstipation and abnormal stool passage.The leastprevalents were diarrhea and passage of mucus.There were no significant differences in prevalenceof symptoms among IBS positive patients of twogroups.Conclusion: Our results suggest that gynecologicalsurgeries (TL and Hysterectomy) could predisposepatient to IBS. Therefore awareness of physicians andgynecologists about this issue may preventunnecessary surgeries.Send Date: 2011/07/15

Category: 15 NERVE GUT AND MOTILITY15.5 Functional gastrointestinal disorders (clinical -management)F-T-141

Anxiety, depression, and quality ofLife in Irritable Bowel Syndrome Subtypes

Raika Jamali1*, Arsia Jamali2, AbdollahOmidi3, Reza Ansari4

1Anatomical Sciences Research Center, Students ScientificResearch Center, Kashan University of Medical Sciences,2Students′ Scientific Research Center, Tehran University

of Medical Sciences3Department of Clinical Psychiatry, Kashan University ofMedical Sciences4Digestive Disease Research Center, Tehran University ofMedical SciencesIntroduction: Irritable Bowel Syndrome (IBS) is acommon gastrointestinal disorder that affects Qualityof life (QOL). IBS subtypes may have differentexpression of the symptoms of depression andanxiety with different outcomes on QOL indices. Theaims of study are: 1) to compare anxiety anddepression symptoms and QOL between IBSsubtypes, 2) to determine the factors independentlyassociated with QOL in IBS patients, 3) to access thecorrelation between generic QOL (WHOQOL-BREF) with disease specific QOL tests (QOL-IBS).Method: Two hundred and fifty IBS patients (121males) referred to gastroenterology clinic and 250controls were included. IBS and its subtypes weredefined according to ROME 3 criteria. “WHOQOL-BREF”, “QOL specific for IBS”, “Stait-Trait AnxietyInventory,” and “Beck Depression Inventory-2”questionnaires were used for evaluation of QOL,Anxiety, and Depression symptoms.Results: The mean depression scores were higher inmixed subtype than constipation subtype however,QOL, psychological and social relationships scoreswere lower in mixed subtype than constipationsubtype. (All P values<0.05) Factors associated withQOL-BREF scores were symptom severity, anxiety,and depression symptoms. (Regression coefficients= -0.2, -0.31, and -0.28 respectively; All P values <0.001). There was correlation between WHOQOL-BREF and QOL-IBS scores. (R2 = 0.79; P value <0.001)Conclusion: QOL was not affected by IBS subtype.Proper management of disease, anxiety, anddepression symptoms in IBS patients may affect theirQOL. WHOQOL-BREF and QOL-IBSquestionnaires were correlated and either test mightbe applied for evaluation of QOL in IBS patients.Send Date: 2011/05/30

Category: 15 NERVE GUT AND MOTILITY15.5 Functional gastrointestinal disorders (clinical -management)F-T-142



differentiated tumors.They can involve stomach,intestine, appendix, colorectal and lung. In formerthey accounted for 2% of all gastrointestinalcarcinoids, but in more recent studies, 10% to 30%of all carcinoids are reported in the stomach. Theycan be sub classified into 3 distinct groups: thoseassociated with chronic atrophic gastritis/perniciousanemia (type 1)70%-80%, those associated withZollinger-Ellison syndrome (ZES) with multipleendocrine neoplasia type I (MEN I) (type 2) 5%, andsporadic NETs of the stomach (type 3)15-20%.Case Report: Patient is a 53-years old woman withepigastric pain, bloating and sometims night painfrom 5-6 months ago. Physical examination is N.l. Inher F.H her father had gastric cancer and died at his62 years old. Lab data (CBC, LFT, Biochemistry) areN.L. In endoscopy, moderate gastritis in antrum wasseen and B.X was taken.pathological report in twodifferent centers with expert pathologists after IHCrevealed carcinoid tumor. CT scan, reported thicknessof lesser curvature of the stomach withoutmetastasis.Discusion: Increased use of endoscopy and advancesin imaging have led to a relative increase in detectionof gastric carcinoid tumors. Based on uppergastrointestinal studies using single contrasttechnique Balthazar et al had reported four differentradiographic patterns of carcinoid tumors, Singleintramural defect, large gastric ulcer, multiple gastricpolyps and polypoidal intraluminal lesions .Endoscopic finding were studied and evaluated inpatients with gastric carcinoid tumors.patients had asingle or multiple mass(nodule) in stomach. Overallin endoscopy results, mass or nodule had reported instomach in over world study, but in presented caserepo rt, endoscopy detected only gastritis in antrumand abdominal CT scan reported thickness of lessercurvature. Therefore we suggest that in patients withrisk factor and positive family history althoughendoscopy was near normal or gastritis without mass,B.X is mandatory and probably CT scan orendosonography is complementary.Send Date: 2011/08/17

Category: 14 ONCOLOGY-CLINICAL

Category: 15 NERVE GUT AND MOTILITY15.2 Brain-gut and gut-brain axes - neuro-hormonal- neural-immune and visceral sensitivityF-T-140

The Incidence of Irritable Bowel Syndrome inWomen Undergoing Hysterectomy

Manouchehr Khoshbaten1*, Manijeh Sayyah Melli2,Monireh Jabar Fattahi1, Neda Sattarnezhad1

1Liver and Gastrointestinal Disease Research Center,Tabriz University of Medical Sciences2Obstetrics and Gynecology Department, Tabriz Universityof Medical SciencesIntroduction: Many studies confirm the highprevalence of IBS and its impact on the working life,social activities and well-being of sufferers.Theresults of previous investigations have shown anincreased incidence of IBS after gynecologicalsurgeries such as hysterectomy. However, most ofthese studies did not use validated symptom-basedcriteria like Rome II. The aim of this study was to

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Category: 14 ONCOLOGY-CLINICAL14.1 Malignant disease - epidemiology - screeningand preventionF-T-136

A Meta-analysis of Epidemiologyof gastric cancer in Iran

Mohammadhosein Somi1*, Pooya Paknejad1,Morteza Ghojazadeh2, Ardalan

Golbahar Haghighi1, Masood Bagheri1

1Liver and Gastrointestinal Diseases Research Center,Tabriz University of Medical Sciences2Physiology Department, Tabriz University of MedicalSciencesIntroduction: Gastric cancer is still an importanthealth problem in Iran. The aim of this meta-analysisis studying the incidence of gastric cancer, its subtypes and male to female ratio in Iranian population.Method: After an extensive search in almost allEnglish and Persian medical databases for epidemiologyof gastric cancer in Iranian population, we find 173articles. These articles were appraised by threeindividuals independently. The articles that have ourfactors to be concerned in the meta-analysis havebeen selected. The data was analyzed by CMA.2software.Results: The incidence of gastric cancer in Iranianpopulation was 23.9 per 100000 in males and 10 per100000 in females by ASR. Adenocarcinoma has themost incidence and followed by lymphoma. The maleto female ratio was 2.4:1.Conclusion: According to its high incidence,developing a gastric cancer early detection programis seriously recommended.Send Date: 2011/07/21


Physical Activity and Reduction inthe Risk of Colorectal Cancer: a

Population-Based Case-Control StudyParastoo Golshiri1, Mohammad Hassan Emami2*,

Reyhaneh Rasooli3, Mehdi Rowshandel3

1Department of Community Medicine, Isfahan Universityof Medical Sciences2Poursina Hakim Research Institute, Department of

Gastroenterology, Isfahan University of Medical Sciences3Isfahan University of Medical SciencesIntroduction: The incidence and mortality rates forcolorectal cancer (CRC) are among the highest of allmalignancies worldwide. The possible association ofphysical activity with reduced risk of various typesof cancer has generated much interest recently. Thegoal of this research was, examining the relationshipbetween physical activity and CRC in Isfahan, Iran.Method: We designed a double-blind, population-based case-control study with 100 cases and 100controls. Newly diagnosed male and female cases ofCRC, aged 30 to 82 were included into the study,which were referred to Poursina Hakim Institute inIsfahan, Iran, between the years 2006 to 2008. Dataon recreational, occupational and household physicalactivities was obtained based on a Modified versionof Kriska Standard Physical Activity Questionnaire.Samples were matched based on age and sex.Multivariable logistic regression was used to estimatethe Odds Ratio.Results: After adjustment for marital status, bodymass index (BMI), cigarette smoking, hormonereplacement therapy (HRT), educational status, pasthistory of cancer and family history of cancer, wefound odds ratio of 0.83 for the relationship betweenrecreational activity & colorectal cancer in the twogroups (p=0.03, 0.95% CI=0.692, 0.985), but therewas no significant association between CRC andoccupational (p =0.232) and household activities (p=0.226).Conclusion: Recreational physical activity is associatedwith reduced risk of colorectal cancer but occupationaland household physical activities are not.Send Date: 2011/08/05

Category: 14 ONCOLOGY-CLINICAL14.2 Diagnosis of malignant diseaseF-T-138

Gastric carcinoid tumorwith normal (gastritis) endoscopy

Rahim Mehdioghli1, Jila Hazrati1*

1Imam Khomeini Hospital, Urmia University of MedicalSiencesIntroduction: Carcinoid tumors arise fromgastrointestinal neuroendocrine cells and can besubdivided into well differentiated &poorly



Introduction: Colorectal cancer is a major cause ofworldwide morbidity & mortality and is the secondmost common cause of cancer death. Colorectalcancer is often diagnosed at a late stage with poorprognosis. Vascular endothelial growth factor(VEGF) is a neo-angiogenesis with great importancefor tumor growth, which has a direct effect onvascular endothelial cell proliferation and migration.C3a is also diagnostic factor in determining coloncancer. The aim of the study was to measure the VEGFand C3a level in patients with colorectal cancer.Method: One hundred and ten patients withcolorectal cancer, including 66 Men and 44 women.(At an average age of 54 years) were enrolled into thestudy. VEGF and C3a level of 110 patients withcolorectal cancer were determined using ELISAmethod. Only 55 Patients with elevated serum VEGFand C3a were followed up after 3 months, because ofdeath of the rest.Results: our result demonstrate that C3a is a suitablediagnostic tumor marker in patients with colorectalcancer. A combination of the serum tumor markersC3a and VEGF can significantly increase thepre-operative diagnostic. VEGF and C3a serum levelslowed significantly difference pre- and post –treatment (mean 509.1 pg/ml, 480pg/ml; 2.5 ng/ml2.3 ng/ml) (p=0.8) (p=0.002).Conclusion: Combination VEGF and C3a are usefulmarkers to predict future metastasis, survival, and re-sponse to the treatment.Send Date: 2011/08/17


Diagnostic Value of Fecal Calprotectinas a Screening Biomarker forGastrointestinal Malignancy

Manouchehr Khoshbaten1*, Mohammad Nouri1,Parinaz Pishahang1, Alireza Lashkari1,

Neda Sattarnezhad1

1Liver and Gastrointestinal Disease Research Center,Tabriz University of Medical SciencesIntroduction: The protein calprotectin constitutesapproximately 60% of the soluble cytoplasmicproteins in neutrophilic granulocytes and has been

found in increased concentrations in feces fromsymptomatic patients with gastrointestinal (GI)cancers (including colorectal and gastricmalignancies), inflammatory bowel disease, andcertain infections. Calprotectin in feces seems to be amore sensitive marker for GI cancers than fecaloccult blood, but its specificity may be too low forscreening of average risk populations.This study aims at evaluating the diagnostic value offecal calprotectin as a screening biomarker of gas-trointestinal malignancies.Method: In a case-control study, 100 patients with GImalignancies (50 patients with colorectal cancer and50 patients with gastric cancer) and 50 controls wererecruited from Imam Reza and Sina hospitals ofTabriz University of Medical Sciences, during a24-month period.One to two weeks after the last endoscopy/colonoscopy , 5gr of fecal specimen was collected bythe patient and examined by ELISA method for quan-titative measurement of itscalprotectin content. The results were comparedbetween the three groups.Results: The mean fecal calprotectin level was109.1±105.3 (2.3-454.3, median:74), 241.1±205.2(3.4-610.0, median:19.3) and 45.9±55.1µg/g(1.3-257.1, median:19.3) in gastric cancer, colorectalcancer and control group,respectively. The meanlevel of fecal calprotectin was the highest in patientswith colorectal cancer and the lowest in the controls(p<0.001). This difference still remained afteradjusting for age. The optimal cut-off point for fecalcalprotectin was ≥75.8µg/g for distinguishingcolorectal cancer from normal cases (sensitivity andspecificity of 80% and 84%, respectively). This valuewas ≥41.9µg/g for diffrentiating gastric cancer fromnormal cases (sensitivity and specificity of 62%).Conclusion: Our results revealed that fecalcalprotectin might be a useful and noninvasivebiomarker for discriminating colorectal cancer fromnon-malignant GI conditions.However, due to low sensitivity and specificity, thisbiomarker may not help physicians distinguishinggastric cancer cases from healthy subjects.Send Date: 2011/07/15



carcinoma and its correlation with clinicopathologicvariables.Method: 101 patients with adenocarcinomas ofstomach and gastroesophageal junction wereincluded in this study.Biopsy specimens wereassessed by immunohistochemistry (IHC) staining forHER-2/neu,using tissue microarray method (TMA).Results: Mean age of patients was 60.13±11 (32-82)years. Male to female ratio was 2.4:1. HER2/neuoverexpression was positive in 13 cases (12.9%).Thefrequency of HER2/neuoverexpression in tumors≥5cm was significantly higher than tumors< 5cm(20% vs. 2.4%; p=0.01).There was no statisticallysignificant correlation between HER2/neuoverexpression and other pathological featurs such asgrade, stage,lymph node involvement, tumorlocation,histopathological type,nor with age and sex.Conclusion: The prevalence of HER-2/neuoverexpression in our study was slightly lower thanthe range found in most of the other publishedstudies.There was a significant correlation betweentumor size and HER-2/neu protein overexpression.But it hasn’t any correlation with other pathologicalfeaturs of tumor.Send Date: 2011/08/01

Category: 13 ONCOLOGY-BASIC13.2 Molecular biology/genetics/pathologyF-T-133

The Relationship between Size of colonAdenocarcinoma and Lymph Node Involvement

Nasser Rakhshani1*, Roshanak Derakhshandeh2,Seyed Amir Mirbagheri3, Farhad Zamani1,

Ahad Atef Vahid4, Mitra Mehrazma5

1Gastrointestinal & Liver Disease Research Center(GILDRC), Tehran University of Medical Sciences(TUMS)2Department of Hemathology & Oncology, Tehran Univer-sity of Medical Sciences (TUMS)3Department of Gastroenterology, Tehran University ofMedical Sciences (TUMS)4Department of Surgery, Tehran University of Medical Sci-ences (TUMS)5Department of Pathology, Tehran University of MedicalSciences (TUMS)Introduction: Involvement of lymph nodes is animportant prognostic factor in most cancers,

including colorectal cancers. Recent studies havebeen showed that invasion to blood and lymphaticvessels may predict involvement of lymph nodes butthe number of involved nodes has been less studied .The aim of this study was to determine therelationship between the size of colorectaladenocarcinoma and lymph node involvement.Method: In this cross-sectional study, 116 patientswere enrolled with colorectal cancer fromRasoul-e-Akram and Mehr Hospitals in 2002-2008.Data analysis was performed by SPSS-15 software.Results were expressed as frequency, percent, andmean ±SD. We used Chi2, student test and correlationtests for statistical analysis.Results: 54.3% of patients were male and 45.7%were female. Mean age of them was 59.4± 12.9 years.Mean size of tumor (longest diameter) was 5.4± 2.2(range: 1.5 to 12) cm. Mean number of involvedlymph nodes was 4.9± 3.5 (range: 1-14). There wasno correlation between number of lymph nodeinvolvement and tumor size. There was no correlationbetween lymph node involvement and type of tumoror age, sex, location and depth of tumor. Poorlydifferentiated tumors significantly correlated tolymph node involvement (p=0.001).Conclusion: There is no correlation between tumorsize and number of involved lymph node in colorectalcancer. However, poor histopathologic grade isassociated with lymph node involvement.Send Date: 2011/08/0


Investigation of plasma vascular endothelialgrowth factor & complement C3a level in

patients with colorectal cancer in southern IranSeyedeh Azra Shamsdin1*, Mehdi Saberifiroozi2,

Davood Mehrabani 1, Seyed Taghi Heydari 3

1Gastroenterohepatology Research Center (GEHRC),Shiraz University of Medical Sciences, Shiraz, Iran2Gastroenterohepatology Research Center (GEHRC),Shiraz University of Medical Sciences and DigestiveDisease Research Center, Shariati’s Hospital, TehranUniversity of Medical Sciences, Tehran ,Iran3 Department of Biostatistics, Shiraz University of Med-ical Sciences, Shiraz, Iran



reductase gene (b=0.41, p<0.01).Conclusion: A combination of environmental factors,number of polymorphisms in phase 1 xenobioticmetabolism genes and DNA repair capacity can bestexplain inter-individual variability in PAH-DNAadduct levels.Send Date: 2011/07/24


CXCR4 is Expressed at Low Level onAtrophic Lesions and its Expression isIncreased Along With Progression to

Metaplasia and AdenocarcinomaFarshad Sheikhesmaeili1*,Mohammadreza Ghadir2,Mehrnoosh Nikzabn 3, Bahram Nikkhou 4, Hiresh

Ayoubian5, Mohammad Saeed Hakhamaneshi5, Ali Jalili1

1Liver &Digestive Research Centre , Kurdistan Universityof Medical Sciences2Qom University of Medical Sciences , Qom University ofMedical Sciences ,Qom,Iran3Cellular & Molecular Research Center, Department ofGenetic, Tabriz University, Tabriz,Iran4Kurdistan University of Medical Sciences, KurdistanUniversity of Medical Sciences, Sanandaj. Iran5Kurdistan University of Medical Sciences,Kurdistan University of Medical SciencesIntroduction: Stromal derived factor-1 (SDF-1 orCXCL12), a member of the alpha chemokines (CXC)and the ligand for the CXCR4 receptor, has beenshown in the past to be an effective chemoattractantfor various CXCR4-expressing cells. SDF-1 issecreted by stromal and endothelial cells in bonemarrow, lung, skeletal muscle, liver, kidney andbrain. It is therefore important for metastasis ofcancer cells to these organs. Recent studies haveshown that CXCR4 plays an important role in cancerdevelopment and tumor growth, apoptosis inhibition,angiogenesis promotion, cellular proliferation,invasion and cancer metastasis in many cancers.Method: Herein, we studied the expression ofCXCR4 on gastric samples from patients withprecancerous lesions (atrophy, metaplasia anddysplasia) and gastric adenocarcinoma as well ashuman gastric carcinoma epithelial cell line (AGS)by employing RT-PCR, immunehistochemistry (IHC)

and Fluorescence Activated Cell Sorting (FACS)techniques.Results: RT-PCR data show that CXCR4 is highlyexpressed on AGS cells. This was confirmed by IHCand FACS as CXCR4 is detected in cell membraneand cytoplasm of AGS cell line. More importantly,we found that CXCR4 is strongly expressed onprimary gastric cancer cells from patients, but not onnormal gastric cells from normal individuals (asdetected by IHC staining and RT-PCR). Furthermore,our data show that CXCR4 is expressed at low levelon atrophic lesions and its expression is enhancedalong with progression to metaplasia andadenocarcinoma.Conclusion: In conclusion; we present evidence thatCXCR4 is expressed on gastric carcinoma and thusCXCR4 may be a suitable marker for diagnosis ofgastric cancer. In addition, we demonstrate for thefirst time that CXCR4 expression is enhanced aspremalignant lesions progress to malignant tumors,indicating that targeting CXCR4 could be a newapproach for treatment of gastric cancer.Send Date: 2011/07/30


Immunohistochemistric evaluation ofHER-2/neu overexpression in 101 cases ofgastric carcinoma using tissue microarray

Nasser Rakhshani1*, Hadi Bakhti2, HosseinAjdarkosh3, Mahmoud reza Khansari1, Ali Basi4

1Gastrointestinal & Liver Disease Research Center(GILDRC), Tehran University of Medical Sciences(TUMS) (pardis, hemmet)2The Department of Pathology, Tehran University ofMedical Sciences, (TUMS) (pardis, hemmet)3Gastroenterologist,Gastrointestinal & Liver DiseaseResearch Center (GILDRC), Tehran University of MedicalSciences (TUMS) (pardis, hemmet)4Medical oncologist,Gastrointestinal & Liver DiseaseResearch Center (GILDRC), Tehran University of MedicalSciences (TUMS) (pardis, hemmet)Introduction: HER-2/neu overexpression hasprovedpredictive value in breast cancer patients, respondingto Trastuzumab. We wanted to investigate thefrequency of HER-2/neu overexpression in gastric



members should be informed to consult theirphysician before discontinuing the medication.Send Date: 2011/08/17

Category: 10 NUTRITION10.2 Nutrients and gut functionF-T-129

Vit B12 deficiency, a realproblem in elderly in Shiraz

Mohammadhassan Kazemi1*, Kamran BagheriLankarani1, Seyed Alireza Taghavi1,

Laleh Hamidpour1

1Gastroenterohepatology Research Center (GEHRC), Shi-raz University of Medical Sciences, Shiraz, IranIntroduction: Vit B12 deficiency is common inelderly population. That is due to malabsorption ofcobalamine in food. This deficiency can induce someproblem such as hematologic and neuropsychiatricdisorder, with non-specific signs and symptoms.Therefore in elderly population, B12 deficiency is ofthe important differential diagnosis that everyphysician should pay attention. To see prevalence ofdeficiency of cobalamine in subjects over 50 yearsold in our region.Method: From 340 subjects over 50 years old, thatchase randomly from all area over the city, Shiraz,5cc whole blood was taken in fasting condition. Thenserum was separated and stored at minus 20 cc.Serum folate and cobalamine was measured byradioimmunoassay and homocystein was determinedby ELISA. We consider serum cobalamine levelbelow 200 pg/ml as deficient and below 100 pg/mlas severe deficiency with clinical significance. Serumhomocystein over 21.3µmol/ml is also considered asabnormal.Results: Cobalamine level was below 200 pg/ml in36.2%, and below 100 pg/ml in 12.4%.Cobalaminedeficiency plus metabolic evidence (cobalaminebelow mean and homocystein over 21.3 µmol/ml)were seen in 5.25% of samples.Conclusion: Prevalence of cobalamine deficiency is36.2% and severe deficiency of cobalamine withclinical significance is 12.4% in subjects over 50years old in city, Shiraz. Therefore prevalence ofcobalamine deficiency is high in elderly and shouldbe considered in clinical practice.Send Date: 2011/08/18


Modeling genetic determinants of nucleotideexcision repair and PAH-DNA adduct levelamong non-smokers in a high risk area for

esophageal squamous cell carcinomaArash Etemadi1*, Farhad Islami1, Frederik-Jan van

Schooten2, David Phillips3, Akbar Fazel-TabarMalekshah1, Akram Pourshams1, Paolo Boffetta4,

Christian Abnet5, Reza Malekzadeh1, Sanford Dawsey5

1Digestive Disease Research Institute, Tehran Universityof Medical Sciences, Iran2Department of Health Risk Analysis and Toxicology,Maastricht University3Section of Molecular Carcinogenesis, Institute of CancerResearch4The Tisch Cancer Institute, Mount Sinai School of Med-icine5Division of Cancer Epidemiology and Genetics, NationalCancer InstituteIntroduction: The aim of this study was to develop agenetic model to explain inter-individual variabilityin the blood level of polycyclic aromatic hydrocarbon(PAH)-DNA adducts and nucleaotide excision repair(NER) capacity.Method: Among participants in the Golestan CohortStudy, 111 female non-smokers were randomlyselected. Twenty-one SNPs in 14 genes related toxenobiotic metabolism and 13 SNPs in 9 DNA repairgenes were studied. NER capacity was evaluated bythe comet assay, and DNA adduct level was measuredby 32p-postlabelling. Multivariate regression wasused to assess the simultaneous effects of the numberof mutant SNPs in each gene, NER capacity, andenvironmental exposures on the PAH-DNA adductlevels. Models were compared by Akaike’sinformation criterion (AIC).Results: The model including environmentalexposures, phase 1 xenobiotic metabolism SNPs andNER capacity had the lowest AIC. Among all SNPs,NA2 (b=-0.21; p<0.05), myeloperoxidase (b=-0.17;p<0.05) and ERCC-5 genes (b=0.15, p<0.05) hadsignificant associations with PAH-DNA adductlevels. NER capacity itself was affected by apolymorphism in the methylenetetrahydrofolate



or Gastroenterology Research Center of ShirazUniversity of Medical Sciences were enrolled. Thepatients were asked to eat 20 g lactose and after 30minutes until 3 hours were examined for lactoseintolerance using a breath hydrogen test. The clinicaland demographic information of all patients wererecorded. Probiotic yogurt was administered forpatients with lactose intolerance symptoms for 3weeks and again underwent the breath hydrogen test(Group 1). A control group was considered of patientswith lactose intolerance symptoms but received anon-probiotic yogurt identically.Results: In patients of control group, the breathhydrogen test did not show any significant change butin the other group, the change was statisticallysignificant (p=0.011).Conclusion: It seems that probiotics may be effectivein treatment of lactose intolerance based on breathhydrogen test. A longer time of follow up mayprovide the opportunity to follow the symptoms too.Send Date: 2011/08/12


case report: Severe Neurological Crises afterInterruption of NTBC Treatment in 3

Patients with Hereditary Tyrosinemia Type 1Naser Honar1*, Mohsen Dehghani1, Mahmood

Haghighat1, Mohammad-Hadi Imanieh1, Sara Japoni1

1 Gastroenterology and Hepatology Research Center,Shiraz University of Medical Sciences, Shiraz, IranIntroduction: Tyrosinemia type 1 is a hereditarydisorder that results from deficiency of the enzymeFumaryl acetoacetate hydroxylase. This disorderinvolves multiple organs including liver, kidney andperipheral nerves. Studies indicate that the outcomeand prognosis of tyrosinemia type 1 significantlyimproves after introduction of NTBC [2-(2-nitro-4-trifluoro-methyl-benzoyl)-1,3 cyclohexanedione].Case Reports: Patient A: A 2.5 years old boy waspresented with hepatomegaly since 8 months of age.NTBC was started at the age of 8 months. The patientwas referred to Pediatric Gastroentrology andHepatology ward at Nemazee hospital, Shiraz for pretransplant evaluation. During this time, his parentsmistakenly discontinued NTBC treatment. Finally he

developed lethargy, floppiness and mechanicalventilation was started due to respiratory distress.Treatment with NTBC was introduced again andabdominal respiration continued. After 72 hours, hereceived liver transplantation but developedrespiratory arrest and expired. Patient B: A 3.5 yearsold healthy boy developed abdominal protrusionsince 8 months of age. After 6 months hepatomegalywas detected. NTBC medication was startedimmediately after diagnosis of tyrosinemia type1.After NTBC interruption by the parents, the patientdeveloped respiratory insufficiency and diaphrag-matic paralysis, and mechanical ventilation was im-mediately started. Treatment with NTBC was startedagain. The patient developed partial improvementand slowly regained normal neurological functionsand recovered after 2 months. Patient C: A 2 yearsold boy was referred to a pediatric hepatologist at his1st month of age due to nausea, vomiting, fever, di-arrhea, abdominal protrusion and Cholestasis. Afterreceiving paraclinical results tyrosinemia was diag-nosed. NTBC treatment was introduced at 6 monthsof age. Before admission NTBC treatment was inter-rupted by his parents. Subsequently after 3 weeks, hedeveloped abdominal pain, irritability, muscle weak-ness, diaphragmatic paralysis and two episodes oftonic generalized convulsion. After admission due torespiratory failure, intubation and mechanicalventilation was started and NTBC medication wasintroduced again. After 2 weeks mechanicalventilation was stopped but NTBC treatmentcontinued. The patient finally regained normalneurological functions and recovered.Discussion: Before the NTBC era, 42% of childrenwith tyrosinemia type 1 developed neurologic crises.NTBC abolishes hepatic and neurologiccomplications and protects against the developmentof hepatocellular carcinoma with treatment within thefirst months of life. A report demonstrated thatinterruption of NTBC treatment in one patientdeveloped acute neurologic crises and concluded thatdiscontinuity of medication in tyrosinemia type 1patients can be life threatening. The current reportindicates interruption of NTBC can induce severeneurologic crises, diaphragmatic paralysis and evendeath. In conclusion, due to the side effects causedby the interruption of NTBC, parents and family



Ghazaleh Eslamian1*, Azita Hekmatdoost2,Kevan Jacobson3

1 Department of Clinical Nutrition; Student ResearchCommittee, School of Nutrition and Food Technology,Shahid Beheshti University of Medical Sciences, Tehran,Iran2Department of Clinical Nutrition, School of Nutrition andFood Technology, Shahid Beheshti University of MedicalSciences, Tehran, Iran3Divisions of Gastroenterology, Department of Pediatrics,British Columbia Institute for Children's and Women'sHealth, University of British Columbia, Vancouver, BritishColumbia, CanadaIntroduction: Increasing evidence suggests that highdietary intake of n-3 fatty acids attenuate theinflammation in chemically induced colitis, but thereis no study to evaluate the effect of different dietaryoils on Citrobacter rodentium induced colitis. Theaim of this study was to determine the effect of fishoil, canola oil, and safflower oil on Citrobacterrodentium induced colitis.Method: Thirty-six mice were fed isocaloric dietsvarying only in fat composition for three weeksbefore and 10 days after Citrobacter rodentiuminoculation. Mice were randomized into thefollowing diet groups: a) standard chow diet, or b) asemi-synthetic diet, with 20% energy from thefollowing lipid diets: safflower oil high in 18:2n-6,canola oil high in 18:1n-9 and 18:3n-3, and fish oilhigh in 20:5n-3, 22:6n-3. Mice were orally inoculatedwith 100µl of wild-type C. rodentium (formerly C.freundii biotype 4280), strain DBS100 (n=9/group).Control mice received 100µl of Luria broth(n=9/group). The distal colon was assessed forhistopathology score, bacterial count, and some hostimmune response factors. Statistical significance wascalculated using ANOVA followed by post hoc.P-value of <0.05 was considered significant.Results: Fish oil prolonged the mice survival mildlyfollowed by canola, and safflower oil. While thebacterial count was similar in all groups, thehistopathology score was at minimum level in fish oilgroup followed by canola oil, safflower oil, and chowdiet group (p<0.01). Also, fish oil reduced theinflammatory cell recruitment and the epithelial cellproliferation significantly (p<0.01). IL-10 wasexpressed at similarly low levels in colon tissuestaken from uninfected mice, and IL-6 gene

expression was very low in all infected groups.Conclusion: Our results indicate that in Citrobacterrodentium induced colitis model, the lower intake ofn-6 to n-3 fatty acids ratio results in the lessinflammatory response, whereas the Citrobacterrodentium count is not affected by dietary fatty acidintake. Future studies are recommended to evaluatethe effect of these dietary oils on transgenic mice tobe able to address the exact mechanism of action ofthese oils.Send Date: 2011/07/22


Efficacy of probiotics in lactoseintolerance patients in Shiraz, Southern Iran

Seyed Jalil Masoumi1*, Davood Mehrabani2,Abdolamir Barootkoob3, Mohammad Amin Hanifpoor3,

Mohammad Sadegh Khosravi3, Fariba Moradi4,Najaf Zare5, Mehdi Saberi-Firouzi6

1 Gastroenterohepatology Research Center/ Department ofNutrition, School of Nutrition and Health, ShirazUniversity of Medical Sciences, Shiraz, Iran2 Gastroenterohepatology Research Center/ Stem Cell andTransgenic Technology Research Center, Shiraz Universityof Medical Sciences, Shiraz, Iran3 Iran Dairy Industries co, Iran Dairy Industries co, Iran4 Vice Chancellor for Health Affairs, Shiraz University ofMedical Sciences, Shiraz, Iran5 Department of Biostatistics,School of Medicine, ShirazUniversity of Medical Sciences, Shiraz, Iran6 Gastroenterohepatology Research Center, ShirazUniversity of Medical Sciences, Shiraz, IranIntroduction: The prevalence of lactose intolerancewas reported 3-90 percent in different parts of theworld. Unabsorbed lactose in large intestine causesdigestive problems including bloating, flatulence,nausea, diarrhea and abdominal pain. In the recentyears, many studies have been done to find a way todecrease the symptoms such as prescription ofprobiotics. They are live microorganism that havebeneficial effects in reduction of symptoms, somediseases and improve the microbial balance of thehost. The aim of this study is to determine theefficacy of probiotics in patients with lactoseintolerance in Shiraz, Southern Iran.Method: 54 Referral patients from Motahari Clinic



Abolfazl Iranikhah2, Fatemeh Attari3

1 Gastroenterology Section, Department of InternalMedicine, Faculty of Medicine, Kordestan University ofMedical Sciences, Sanandaj, Iran2 Gastroenterology Section, Department of InternalMedicine, Faculty of Medicine, Qom University ofMedical Sciences, Qom, Iran3 Digestive Disease Research Center, Tehran University ofMedical Sciences, Tehran, IranIntroduction: The primary presentation ofautoimmune pancreatitis (AIP) as the cancer of thehead of pancreas is rare in Iran and has not beenreported previously in PUBMED site.Case Reports: The patient was a seventy-year-oldman with recurrent abdominal pain and jaundice,elevated Bilirubin and elevated Alkaline Phosphatase(ALKP) in association with the presence ofheterogeneity of the head of pancreas and dilatedintra and extra hepatic bile ducts in the abdominal CTscan. The common bile duct stent had been placed forhim with the diagnosis of the head of pancreas cancer.The patient came back with continuation of recurrentabdominal pain and normal Bilirubin, ALKP andtumor markers, but remarkable elevated IgG4 andanti nuclear antibody. A biopsy was taken fromheterogeneity of the head of pancreas under the guideof Endoscopic Ultra Sonography (EUS). Pathologicsamples showed fibrosis associated withlymphoplasmacitic infiltration without the evidenceof malignancy.Finally, the patient was placed on the treatment ofautoimmune Pancreatitis and the bile duct stent wastaken out.Discussion : AIP should be considered in suspectedcases of cancer of pancreas. So the biopsy of pancreashelps us to differentiate these and preventscomplications of the disease progression andunnecessary surgery.Send Date: 2011/07/17

Category: 9 PANCREAS9.5 Malignant disease and endocrine tumors of thepancreasF-T-125

Diagnostic Yield of EUS- FNA forPatients with Solid Pancreatic NeoplasmBijan Shahbazkhani1*, Mahmoud Baghbanian1,

Hadi Ghofrani1, Hossein Forutan1, NasserEbrahimi-Dariani1, Mohammad Jafar

Farahvash1, Mohammad Kalani1, Najmeh Aletaha1

1Digestive Disease Research Center, Shariati Hospital,Tehran University of Medical Sciences, Tehran, IranIntroduction: Endosonography is a distinct methodin evaluating GI structural lesions, particularlyPancreatobiliary system. This procedure has made afundamental change in the diagnosis of pancreaticmass lesion through providing fine needle aspiration.This study aims at evaluating the results and efficacyof EUS-FNA in patients with pancreatic solid mass.Method: The present study which is of a descriptive,prospective and case series nature has been studingpatients with pancreatic solid mass referred to ImamKhomeini educational hospital in Tehran for durationof one year since November 2010. In order todetermine the false negative cases, the patients havebeen fallowed form 6 to 12 months.Results: EUS-FNA was carried on all 53 patientswithout any complication .The majority of whom wasmale (68%) and 81% had mass in the head ofpancreas. The result of cytopathology revealed 36(68%) Adenocarcinoma, 7 (13%) other malignancylike N.E.T., 3 (6%) benign lesion like autoimmunepancreatitis and 7 (13%) non-diagnostic cases. Thefrequency of non-diagnostic results was significantlyhigh in masses smaller than 3cm (6 vs. 1: p<0.002).Patients with non-diagnostic result were younger thanthose with malignant cytopathology (52±7.5 vs.66±7.5 years: p<0.001). Sensitivity, specificity, PPV,NPV and accuracy of this procedure concerningAdenocarcinoma were 88%, 100%, 100%, 70% and90%, respectively.Conclusion: Overall EUS-FNA was diagnostic in87% of cases. EUS-FNA is an effective and safeprocedure in histopathologic diagnosis of pancreastumors. This procedure is recommended in allpancreatic mass cases including resectable and nonresectable ones.Send Date: 2011/08/09


The effect of different dietary oilson C.rodentium induced Colitis



with cholestasis due to billiary stone.Method: Forty six patients with extra hepaticcholestasis (26 patients with choledocholithiasis and20 patients with malignant cholestasis) were studiedprospectively. Bile fluid was obtained by aspirationthrough ERCP catheter or percutaneus derainage inpatients with choledocholithiasis and colangiocarcinomarespectively. Then concentration of biochemicalprofile: TG, cholesterol, Billirubin, LDH, and CA19-9 of bile fluid was measured in these two groups.Results: Bile concentration of TG, cholesterol, HDL,direct bilirubin and CA19-9 were significantly higherin patients with benign cholestasis in comparisonwith malignant cholestasis: p=0.001, p=0.001,p=0.001, p=0.012, and p=0.03 respectively. Serumlevels of AST, ALT, were nonsignificantly higher inpatients with choledocholithiasis but serum totalbilirubine and ALP were nonsignificalty higher inmalignant cholestasis than choledocholithiasis.Conclusion: Our study showed that measurement ofbile fluid level of lipid profile speciallyTG, HDL anddirect billirubin may be a useful complementary testin differentiation between malignant and beingcholestasis.Send Date: 2011/07/20

Category: 9 PANCREAS9.2 Pancreatitis - experimentalF-T-123

Black grape seed extract effect inprevention of post Endoscopic RetrogradeCholangiopancreatography pancreatitis

Seyed-Mohsen Mousavi1, ManouchehrKhoshbaten2, Mehrdokht Najafi1*

1Gastrointestinal & Liver Disease Research Center (GILDRC),Firoozgar Hospital, Tehran University of Medical Sciences,Tehran, Iran2 Department of Gastroenterology, Imam Reza Hospital, TabrizUniversity of Medical Sciences, Tehran, IranIntroduction: Acute pancreatitis is one of the majorcomplications of endoscopic retrogradecholangiopancreatography (ERCP), which is knownas post-ERCP pancreatitis (PEP). Although the exactunderlying cause of this entity is yet to be determined,the role of oxidative stress has been emphasized inseveral studies. Accordingly, using an antioxidantsubstance as a preventive mean seems reasonable.

Many different antioxidants have been introduced.The black grape seed extract is one of these novelpotent antioxidants. This study aimed to evaluate theprophylactic effect of this substance against PEP incandidates of ERCP.Method: In this triple-blind controlled clinical trial,100 candidates of ERCP were recruited during a 11-month period in Tabriz Imam Reza Hospital. Thesepatients were divided randomly into two groups: theintervention group consisted of 53 patients whoreceived prophylactic black grape seed extract (six200-mg capsules every 8 hours before ERCP) and 47controls receiving placebo in the same manner.Thenboth groups underwent ERCP.The rate of PEP wascompared between these two groups.Results: The intervention group was comprised of 16males and 37 females with a mean age of 63.6±15.2years vs. the controls including 19 males and 28females with a mean age of 61.4±15.5 years (p=0.284and 0.475, respectively). After ERCP, pain orexacerbation of epigastric pain was reported in 26.4%and 14.9% of patients in the intervention and controlgroups (p=0.158). Similar rates were 1.9% and 2.1%for the PEP (p=0.722); 22.6% and 21.3% for thehyperamylasemia (p=0.869); 94.3% and 100% for the“discharge in good condition” (p=0.245); and 3.8%and 0% for expiration (p=0.278), respectively. Themean serum amylase level increased significantlyafter ERCP in the control group (p=0.035) withborderline nonsignificant increase in the interventiongroup (p=0.053).Conclusion: This study showed no benefit for thepre-ERCP administration of black grape seed extractin prevention of PEP; however, it seems that thisapproach may ameliorate the increase of serumamylase in receiving patients.Send Date: 2011/08/10

Category: 9 PANCREAS9.4 Pancreatitis-chronic (including hereditary pancre-atitis)F-T-124

Autoimmune pancreatitis mimickingcancer of the head of pancreas

Farshad Sheikhesmaili1, Mohammad-RezaGhadir2*, Seyed-Saeed Sarkeshikian2,



of CBD stones. Recommendation: We believe that forsurgeons familiar with open common bile ductexploration and laparoscopic cholecystectomy, thenext logical step is laparoscopic exploration of thecommon bile duct at the time of cholecystectomy,which is safe and readily mastered. It is hoped thatLCBDE will be adopted so that patients can undergoa single procedure to remove their gallstones andcommon bile duct stones in one approach. If thesurgeon is not familiar with this approach of theappropriate instruments are not available, ERCP/ESis the treatment of choice.Send Date: 2011/05/15

Category: 8 BILIARY8.2 GallstonesF-T-121

Association between common bileduct stones and Thyroid dysfunctions

Hossein Ajdarkosh1, Mahmoud-reza Khansari1,Siamak Khaleghi1, Mitra Ameli1,

Farhad Zamani1*, Mehrdokht Najafi1

1 Gastrointestinal & Liver Disease Research Center(GILDRC), Firoozgar Hospital, Tehran University ofMedical Sciences,pardis hemmat, Tehran, IranIntroduction: It has been previously shown that T4reduces prorelaxation of sphincter of oddi. Besidesthyroid dysfunction specialy hypothyroidism affectslipid metabolism and changes bile duct excretion rate.Recent studies revealed that the prevalence ofdiagnosed hypothyroidism is significantly higher inCommon Bile Duct (CBD) stone patients comparedwith gall bladder stone patients. This study comparesthe prevalence of thyroid dysfunction among CBDstone patients with healthy controls consideringconfounding factors.Method: 100 patients with CBD stones diagnosed byEndoscopic Retrograde Cholangio Pancreatography(ERCP) at Firoozgar hospital 2010-2011 and 100controls among the same hospital staff and patientsadmitted for other reasons than CBD stone withnormal Liver Functiom Tests (LFT) were enrolled.Pregnancy, carbamazepine and phenytoinconsumption and having a history of previouslydiagnosed thyroid disease were considered asexclusion criteria for both groups. Fasting BloodSugar, Trigelyceride, Cholesterol, LDL, HDL, LFT,

Thyroid Stimulating Hormone and T4 were checkedin both groups. Blood samples from patients weretaken before ERCP was done.Results of tests wereassessed by an expert endocrinologist who was blindto both groups. Participants were divided into 5groups according to their thyroid function: Normal,Subclinical hypothyroidism, hypothyroidism,subclinical hypothyroidism and hyperthyroidism.Results: There were 51 and 38 males and 49 and 62females in patients and control groups respectively.The mean age and BMI of controls were 43± 13.34years and 25± 3.67 kg/m2, and 59± 17.44 years and25± 3.58 kg/m2 for patients. There was a significantrelationship between thyroid dysfunction generallyand CBD stones prevalence with a p.value of 0.012and OR: 2.4 (CI: 1.25-4.7). Cochoran’s test results ofGender and DM show that this relation is significantonly in men (p =0.002) (30% VS 4%) and nondiabetic participants (p=0.027) (17% VS 6.5%).Although univariate analysis showed a significantrelation between CBD stone and thyroid dysfunctionbut after multivariate logestic regressions the bestmodel for predicting CBD stone incidence were gender(p =0.022), DM (p =0.015) , thyroid dysfunction(p =0.005) and age>50 years old (p<0.001).Conclusion: To be concluded, CBD stone patientshave a 2.4 fold higher risk of thyroid dysfunction andthis risk is much higher in non diabetic men.Send Date: 2011/08/16

Category: 8 BILIARY8.3 Malignant hepato-biliary diseasesF-T-122

Biochemical profile and tumor markerin bile fluid of patients with obstructive

jaundice for differentiation betweenbenign and malignant cholestasis

Javad Shokry-Shirvany1, Yasser Taghavi1*, HssanTaheri1, Mehrdad Kashifard1, Shahriar Savadkoohi1

1 Gastroenterology, Babol University of Medical SciencesIntroduction: Diagnostic accuracy of conventionalmethod such as CT scan, cholangiography andcytology is low in diagnosing of cholangiocarcinoma.We aimed to evaluate the diagnostic value ofbiochemical profile and tumor marker of bile fluid inpatients with malignant cholestasis in comparison



Tghyzadyah3, Ali Khodadady2, Babak Hajypour1

1 Liver and Gastrointestinal Diseases Research Center,Tabriz University of Medical Sciences2 Department of Veterinary Medicin, Islamic AzadUniversity Tabriz Branch3 Department of Pathology, Islamic Azad University TabrizBranchIntroduction: There are many ongoing researchesemphasizing on the role of free radicals in pathogenesisof cholestasis and associated liver damage. This isbelieved to be due to concentrated biliary acids whichin turn, increase the rate of lipid peroxidation.Likewise, it is previously shown that the aggregationof biliary acids may induce lesions in hepatic andintestinal tissues. So it makes sense that antioxidantsmight have a preventive role in this regard. The lipoicacid is one the most potent known antioxidants whichhas received enthusiasm from the scientist. This studyaimed at evaluating the effect of oral lipoic acid inprevention of bile duct obstruction induced liver andintestinal damage in a rat model.Method: In this experimental study, 45 Wistar malerats were randomized in three 15-rat groups: group A(sham) consisted of rats underwent only laparotomy;group B (controls) consisted of rats underwentlaparotomy plus induced-cholestasis; and group C(intervention) consisted of rats underwent laparotomyplus induced-cholestasis and received oral lipoic acid.Lesions of liver and intestine were assessedhistopathologically as well as the hepatic andintestinal superoxide dismutase (SOD), glutathioneperoxidase (GPX) and malondialdehyde (MDA) 2weeks later.Results: All the studied variables were significantlybetter in group A comparing with groups B and C.The median hepatic score was significantly lower(better) in group C comparing with that in group B(5 vs. 11; p=0.001). The median intestinal score wascomparable between the two groups (2 in group B vs.1 in group C; p=0.029). The median hepatic SOD (1.7vs. 2.6; p=0.001) and GPX (2.8 vs. 3.6; p=0.009) andthe median intestinal SOD (1.2 vs. 2.5; p=0.004) andGPX (2.6 vs. 3.3; p=0.014) were significantly higher(better) in group C than those in group B. The medianhepatic (2.4 vs. 1.3; p<0.001) and intestinal (2.7 vs.1.9; p=0.014) MDA were significantly lower (better)in group C than those in group B.Conclusion: Based on our findings, oral lipoic acid is

effective against hepatic and intestinal injuries afterbile duct obstruction in the rats.Send Date: 2011/07/20

Category: 8 BILIARY8.2 GallstonesF-T-120

Concomitant Laparoscopic Common BileDuct Exploration as a new Treatment Modality

of CBD Stones in the New MillenniumShahram Nazari1*

1 Erfan Hospital, TehranIntroduction: CBD stones are found inapproximately 16% of LC. In the beginning oflaparoscopic era, because of an obvious lack ofexpertise in laparoscopic surgery, if the diagnosis ofcholedocholithiasis was established during IOC, thesurgeons preferred postoperative ERCP instead ofconversion to open surgery. With increasingexperience of laparoscopic surgeons, it seemedlogical to develop a mini-invasive one-stagelaparoscopic approach.Method: This study evaluates our results of laparoscopiccommon bile duct exploration (LCBDE) in a series of803 patients treated over 68 months and we evaluate thefeasibility and safety LCBDE during LCs.Results: CBD stones were demonstrated in 98patients by routine IOC. For 7 patients, ERCP/ESwas performed, with successful stone clearance aftercompletion of LC. LCBDE was done in 91; allLCBDEs were completed laparoscopic. In 21patients, CBD closed on a C-Tube and in 14 com-pleted with T-tube insertion. In 31 cases no CBDdrainage was performed.In 84 cases flexible choledochoscopy was done.Laparoscopic choledochoduodenostomy and chole-dochojejunostomy was done in 24 and 1 casesrespectively. The mean operative time was 90-130

minutes (mean 95), which is significantly greater thanconventional LC (range 20-40 minutes, mean 30).LCBDE was performed without immediate or latecomplications.Conclusion: There are no debates in the detectionand the management of CBD stones in the era of LC.Concomitant LCBDE is a cost-effective, efficient,and minimally invasive modality in the management



Iran. Information about genotypes of hepatitis C virus(HCV) may have important to therapeutic implications.Method: Across sectional study was conducted among384 of drug addicted patients. ELISA testing for HCVantibody (HCV- Ab) was carried out. Positiveanti-HCV samples were tested by RT-PCR. HCV geno-types were determined by restriction fragment lengthpolymorphism of the 5'-untranslated region.Results: Thirty-nine (60.9%) out of 64anti-HCV-positive were HCV RNA positive. HCVgenotyping by RFLP test showed that genotype 3 wasthe predominant genotype with 25 cases (64 percent)fallowed by 12 (30.8%) for type 1, and one for type2. There was also a case with genotypes 1 and 3. Thehighest percentage of genotype 3 was amongilliterates with 6 (75%). There was no statisticalsignificant association between residency place andgenotype. The highest proportion of genotype 3belongs to Urmia with 18 cases (58.1%). 28 of HCVpositive people stated heroin as the most used drug.Opium, Crack and Crystal were the other used drugs.Genotype 3 was observed among (%60.7) 17 casesof heroin users that were the highest percentage.However this was not statistically significant.Genotype 3 was more prevalent in intra-venous drugabusers with %68 (among 25 injection drug usersHCV positive. There was no statistically significantrelationship between being injection drug user andgenotype (P=0.882)Conclusion: The results show a high prevalence ofHCV infection and predominance of genotype 3followed by genotype 1 among drug users in westAzarbaijan. These findings highlight the need forharm-reduction strategies to reduce HCV transmission.

Category: 7 LIVER7-13 MiscellaneousF-T-118Effects of obstructive sleep apnea syndrome on

serum aminotransferase levelsand insulin resistance

Seyed Hamid Moosavy1*, Hossein Froutan2,Nader Faiazi1, Parisa Adimi3, Yasir Andrabi2,

Mohsen Nasiri Toosi2

1 Gastroenterology, Bandar Abbass2 Gastroenterology, Tums3 Gastroenterology, SbumsIntroduction: Patients with obstructive sleep apnea(OSA) are at risk of developing the fatty liver as aresult of being overweight. Several studies suggestthat OSA per se could be a risk factor for liver injury;and ischemic hepatitis with OSA. The OSA is anindependent risk factor for Insulin resistance.Therefore, we investigated liver enzymes and insulinresistance in patients with OSA, and compared withcontrols.Method: Eighty-one consecutive patients withclinical suspicion of OSA were referred to the SleepUnit of Masih Daneshvary hospital. On the basis ofPolysomnography results patients were divided intotwo groups: The OSA and non-OSA cases, and alsopatients without OSA were used as internal controls.The Serum levels of liver enzymes were measured inall patients and abdominal ultrasound examinationperformed for screening the fatty liver and itsgrading. Insulin resistance was calculated via home-ostasis model assessment (HOMA).Results: The OSA was present in 41 and absent in 40patients. Age, sex and body mass indices were notsignificantly different in two groups. The mean ofalanine aminotransferase (ALT) was 31.24±14.05 IU/Lin OSAand 29.97±8.9 IU/L in non-OSA(p=0.349) andaspartate aminotransferase (AST) was 29.07±9.6 IU/Lin OSA and 26.85±6.7 IU/L in non-OSA (p=0.389).The mean of HOMA was 2.05±18.2 in OSA and1.5±0.54 in non-OSA (p< 0.001).Conclusion: This study shows that OSA, independentof overweight conditions, is not a risk factor forabnormal liver enzymes. However, the OSA per seseems to be associated with increase in insulinresistance and severity of fatty liver.Send Date: 2011/05/03

Category: 8 BILIARY8.1 Bile acids-transport-cholestasisF-T-119

Study of lipoic acid role in preventionof liver and intestinal damage due

to bile duct obstruction in ratMohammad Hossein Somi1*, Hassan Kalagheichi azar 1,

Ghafour Mousavi2, Nser Ahmadi asl2, Mohammad

OBoüiAouBë:0931/40/72



between platelet count and spleen diameter andsplenic vein diameter. A significant relation betweenvarice formation and portal vein velocity (pvv) tosplenic vein diameter also noted (P=0.05).Conclusion: Endoscopy is still a gold standardprocedure for detection of gastroesophageal varicesin cirrhotic patients. Some splenoportal dopplerparameters (eg: portal vein to splenic vein diameter)seems promising further investigation warranted.Send Date: 2011/07/23

Category: 7 LIVER7.12 Imaging - radiology (incl. interventionalradiology)F-T-116

FibroScan in patients with beta-thalassemiawith and without hepatitis C: relation to

T2*magnetic resonance imaging and liver biopsyFarhad Zamani1, Hossein Poustchi2*, Masoumeh

Eslami2, Amirhossein Modabbernia3, Mehrdokht Najafi1

1 Gastrointestinal & Liver Disease Research Center(GILDRC),Firoozgar Hospital, Tehran University Of Med-ical Sciences, pardis hemmat2 Gastrointestinal & Liver Disease Research Center(GILDRC), Tehran University Of Medical Sciences,pardishemmat3 Digestive Disease Research Center(DDRC), Tehran Uni-versity Of Medical SciencesIntroduction: The primary aim of this study was toevaluate the effect of iron overload, measured by T2*Magnetic Resonance Imaging (T2*MRI) and liverbiopsy in thalassemic patients on the TransientElastography(TE) and to determine whether this ef-fect is mediated through fibrosis.Method: 81 HCV-RNA positive thalassemic patientsand 89 HCV-RNA negative thalassemic patientsunderwent T2*MRI within three months of transientelastography (TE). In addition78 patients from theHCV-positive group underwent liver biopsy withinthree months of TE. All of the patients had laboratorymeasurement at the time of TE, including bloodcount, liver enzymes and liver function tests, ferritin,lipid profile, and blood sugar.Results: In HCV PCR(polymerase chain reaction)negative patients, TE values were significantly higherin patients with severe iron load than in those withiron loads less than severe (mean± SD, 6.6±4.0 vs.

8.5±2.8, P value of Mann-Whitney U test<0.05). InHCV PCR positive patients, those patients withmoderate to severe iron load had higher TE scores,but this difference did not reach statisticalsignificance (p-value of Mann-Whitney U test=0.09).Stage and HAI (histologic activity index) did notdiffer significantly between patients with differentiron load degrees while inflammatory grade wassignificantly higher in patients with moderate tosevere iron load compared to patients with normal ormild hepatic iron load (7.1±3.0 vs. 8.7±3.5,P<0.05).Best model for prediction of ascendingscores of TE in those who had liver biopsy is asfollow: hepatic iron load, ALT, stage, gender, andbilirubin (adjusted R squared=.510). ROC curveanalysis showed that TE is more accurate for thediagnosis of patients with cirrhosis (stage six) thanpatients with other stages of liver fibrosis(AUC=82%). A cut-off score of 10.55 had a sensitiv-ity of 80%, specificity of 88.5%, and PLR of 6.95 fordiagnosing cirrhosis in HCV PCR positive patientswith beta thalassemia.Conclusion: Although iron deposition may affect theresults of TE in these patients irrespective of otherfactors,these changes in TE can be explained viabiopsy parameters, and TE can serves as a promisingnoninvasive tool in evaluation of liver fibrosis inthese patients.Send Date: 2011/08/02

Category: 7 LIVER7-3 Metabolic/genetic disordersF-T-117

Hepatitis C Virus Genotyping among drugaddicted Patients,Urima, West-Azerbaijan

Introduction: More than 170 million people arecurrently infected by the hepatitis C virus (HCV),which represents a serious cause of chronic liverdisease that may progress to cirrhosis liver andhepatocarcinoma. The aim of this study was todetermine the prevalence of HCV among drug usersreferring to treatment center in Urmia, northwest of

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remission, responsive, relapse, nonresponsive andcompletely nonresponsive.Results: 87 patients (72 females, 15 males) with themean age of 33.5 years were enrolled. The mean timeinterval between start of the symptoms and definitediagnosis was 7.84 months. Coincidence of otherautoimmune disease was seen in 18.4% of thepatients. The 1, 6, 12, and 18 months survivalprobability of AIH patients were 67.4%, 91.1 %,94.1% and 95.6% respectively. None of the clinical orlaboratory variables had a significant relation withthese patients survival.Conclusion: In summary clinical and laboratorycharacteristics of AIH patients in our study weresimilar to those in other countries. We propose moreinvestigations to be done regarding time of relapse ofAIH patients and their survival.Send Date: 2011/08/22

Category: 7 LIVER7.11 Acute liver failure - transplantation/surgeryF-T-114

Causes and Risk Factors for Liver InjuryFollowing Bone Marrow Transplantation

Rasoul Sotoudehmanesh1*, SA Moosavi1,Ebrahim Sarsar1, Maryam Farsinejadmarj1

1 DDRC, tehran university of medical sciencesIntroduction: Liver injury is one of the major causesof morbidity and mortality following bone marrowtransplantation (BMT). Determination of the factorsthat are likely to lead to liver injury may allow earlierdiagnosis after BMT and may possibly its preventionand finally improve the prognosis.Method: In this retrospective study, the risk factorspredisposing to liver injury following bone marrowtransplantation was evaluated. Medical records ofBMT patients were reviewed, and results of serialliver function tests and HBV/HCV serology duringthe pre- and post-transplantation with 1-year followup period were noted. Presence of liver injury wasassessed and analyzed in 167allogeneic and 50autologous BMTs, performed during 3 years.Results: One-year survival was 85.7% (222 of 259patients) for allogeneic BMT and 98.1% (104of 106patients) for autologous BMT. The most frequentcauses of liver injury were graft-versus-host disease

and drug hepatotoxicity for allogeneic BMT and drughepatotoxicity for autologous BMT. Fulminanthepatic failure occurred in 5 allogeneic transplantrecipients who had a pretransplantation HBV carrierand led to death. Multivariate regression analysisshowed that the age of patients underwent BMT,fever, immunosuppressive therapy and the use ofnon-absorbable antibiotics were predictive riskfactors for post-BMT liver injury.Conclusion: Early diagnosis and proper treatment ofsepsis, cautious use of non-absorbable antibiotics andimmunosuppressive agents may have an importantrole for the prevention of post-BMT liver injury.Send Date: 2011/07/12

Category: 7 LIVER7.12 Imaging - radiology (incl. interventionalradiology)F-T-115

Doppler Parameters in Cirrhotic Patientswith and without Esophageal Varices

Fariborz Mansour-Ghanaei1*, Ahmad Alizadeh1,Afshin Shafaghi1, Kambiz Akhavan Rezayat1,

Farahnaz Joukar1, Reyhane Jafarshad1

1 Gastrointestinal & Liver Diseases Research Center(GLDRC) , Guilan University of Medical SciencesIntroduction: Portal hypertension is one of cirrhosiscomplications that leads to gastroesophageal variceformation. Bleeding from these varices has a highmortality rate. Upper gastrointestinal endoscopy isthe gold standard procedure for varice diagnosis.There are some efforts to substitute endoscopy withnoninvasive procedures including splenoportaldoppler. The aim of this study was to comparedoppler findings in cirrhotic patients with and withoutesophageal varices.Method: 66 patients with documented cirrhosis wereenrolled in our cross sectional study. All patientsunderwent endoscopy and an informational form wascompleted. Subsequently all of them referred to oneradiologist to undergo splenoportal doppler.Laboratory information including platelet count wastaken.Results: Of 66 patients, 44 were men. 46 patients hadesophageal varice. There was no significant relationbetween esophageal varices and any of dopplerparameters. A negative correlation was found



diagnosis is very important to prevent complications.Treatment is effective even in cases with advancefibrosis.Send Date: 2011/07/16

Category: 7 LIVER7.10 Immunology - autoimmune liver diseaseF-T-112The Efficacy of Tacrolimus and MycophenolateMofetil in Refractory Autoimmune Hepatitis:

Systematic Review and Meta-AnalysisMohammadhossein Somi1*, Mohammadreza

Abdollahi1, Samaneh Esfahanian1, AysanGasemi Oskouyi1, Morteza Ghojazadeh2

1 Liver and Gastrointestinal Diseases Research Center,Tabriz University of Medical Sciences2 Physiology Department, Tabriz University of MedicalSciencesIntroduction: Conventional treatment ofautoimmune hepatitis consists of either prednisonealone or in combination with azathioprine. Ten to20% of patients do not respond to or are intolerant ofthis treatment. Novel drug treatments includeimmunosuppressive drugs such as tacrolimus (TAC),mycophenolate mofetil (MMF), methotrexate andcyclosporine. So we conducted a systematic reviewof the literature to determine the efficacy oftacrolimus and mycophenolate mofetil in thetreatment of steroid refractory autoimmune hepatitis.Method: All published articles from 1978 up to 2011that were related to the topic were searched from theresources. We also conducted a manual search of thereference lists in the review articles. The censor datewas up to April 2011. The inclusion criteria used werearticles on patients with autoimmune hepatitis thatwere resistant to conventional therapy and then hadour choice therapy. All calculations and statisticaltests were performed using CMA ver.2.0 software.Results: 12 related articles involving 230 patients thatfulfilled our inclusion criteria were selected to beconsidered in the Meta-Analysis. There were threearticles about tacrolimus and nine were aboutmycophenolate mofetil. The mean age in TAC groupwas 56.39±4.13 years and in MMF group was44.16±1.27 years. In TAC group we had 23 patientsthat 19 were responded to the drug. The efficacy ofTAC was 83%.The mean follow up period in TAC

group was 21.18±16 months. In MMF group we had207 patients that 140 were responded to the drug. Theefficacy of MMF was 71.6%.The mean follow upperiod in this group was 34.24±8.31 months.Conclusion: Tacrolimus and Mycophenolate Mofetilis effective and well tolerated by patients withautoimmune hepatitis who do not respond to, or areintolerant of, conventional immunosuppressiveagents, and can be alternative choices forconventional therapy.Send Date: 2011/07/21

Category: 7 LIVER7.10 Immunology - autoimmune liver diseaseF-T-113

3 years Survival of Autoimmune hepatitispatients referring to Rasool Akram hospital

and Tehran Hepatitis Center 2004-2010Amir-hossein Faghihi1, Seyed-Moayed Alavian2,

Seyedeh-Hoda Alavian2*

1 Gastrointestinal & Liver Disease ResearchCenter(GILDRC),Firoozgar hospital, Tehran University ofMedical Sciences2 Gastrointestinal & Liver Disease Research Center,Baghiat-allah Hospital, Tehran University of MedicalSciencesIntroduction: Autoimmune hepatitis (AIH) is rela-tively common among chronic liver disease patients(11-23%) and is responsible for 6% of all liver trans-plantation worldwide. There are few studies concern-ing factors affecting these patients survival. Thisstudy aimed to examine AIH patients’ survival andits related factors.Method: In this historical cohort study records of allpatients diagnosed as AIH via serologicalexaminations, biopsies and ruling out otherdifferential diagnosis, referring to Rasool Akramhospital and Tehran Hepatitis Center were evaluated.Patients with a history of medicine administrationbefore definite diagnosis of AIH as well as those whowere on other treatment regimens than our standardtreatment regimen for AIH were excluded.Information regarding clinical conditions, laboratorydata (AMA, ALKM-1, ASMA, ANA) and pathologicstudies of all patients were assessed before and 3years after beginning of the treatment.According totheir AST level, patients were divided into 5 groups:



Category: 7 LIVER7.9 Viral hepatitis C: clinical aspectsF-T-110

Is statin effective in treatmentof hepatitis c patients with genotype 1Ahmad Shavakhi1, Mohammad Minakari1,

Naser Khamisi1*

1 Alzahra Hospital, Isfahan University of Medical SciencesIntroduction: Statins my be helpful in treatment ofnon alcoholic steatohepatitis.we assessed the effectof Statins in combination with standard antiviraltreatment on Hyperlipidemic genotype I HCVpatients who had been referred to educational andTherapeutic Centers of Isfahan University of MedicalSciences from 2009-2010.Method: Our study was a prospective clinical trial.All samples (n=40) were tested to confirm HCVviremia( Cobas Amplicor HCV Monitor test, version2 Roche Diagnostics). patients weekly received 180µg PEG-INFa2a(Pegasys, roche Company) andribaverin. 20 Hyperlipidemic hepatitis c Patientsreceived 20 mg Atorvastatin (Farabi co,Tehran Iran)nightly for three months and placebo was prescribedfor 20 control patients. Liver enzymes, CBC werechecked monthly and TSH checked every threemonths. We also did quantitive HCV-RNA test in 4th,12th week of therapy, at the end of treatment and 6months after therapy for all samples.Results: We didn’t find any significant differences inthe mean of HCV-RNA numbers in case and controlgroups in 4 th, 12th week of treatment, in the end oftreatment and 6 months after treatment. In this studyearly response to treatment (EVR) in case and controlwere 80 and 70 % and end of treatment response were90 and 95%. Sustain response to treatment (SVR) incase and control were 95 and 95% respectively.Conclusion: There was no effect of statins on themean of HCV virus number in this analysis. Furtherstudies are necessary to examine the possible antiviralproperties of statins and their potential role asadjuncts to standard HCV therapy.Send Date: 2011/08/22Category: 7 LIVER7.10 Immunology - autoimmune liver diseaseF-T-111

Epidemiologic features ofautoimmune hepatitis in Ahwaz

Seyed Jalal Hashemi1*, Eskandar Hajiani1,

Abdolrahim masjedizadeh1, Aliakbar shayesteh1,Maryam Belladi behbehani1

1 GI ward, Ahvaz Jondishapoor universityIntroduction: Autoimmune hepatitis (AIH) is definedas a kind of recurrent and unresolving hepatocellularinflammatory process with unknown etiology. It is agrowing diagnosis in the setting of liver diseases inIran. there is limited data on the epidemiology andclinical course of AIH in our region . so we studiedclinical and epidemiologic characteristics of patientswho diagnosed in GI and hepatology ward and clinicsof Ahwaz jondishapoor university during 2005 to2009 .Method: In this study the demographic and clinicaland histological characteristics of patient with AIHwere studied .The lag time between first presentationto diagnosis and its relation to the severity of diseaseevaluated also .The diagnosis of AIH made accordingto the scoring system of International autoimmunehepatitis group.Results: A total of 106 patients (77 women and 29men) was eligible for inclusion. the mean age was34.8 y (9-62 y) . the most common presentingsymptom was fatigue (66.9 %) fallowed by loss ofappetite (55.6 %), Icter (50.9%) and abdominal pain.17.9 % of our patients presented with evidences ofliver cirrhosis. 15 patients (14.1%) had overlapsyndrome the most and common one overlap diseasewas PBC. 17 patients (16%) shows otherautoimmune disorders among them lupus disease wasthe most common one. According to the duration ofdiagnosis after first presentation The patients dividedinto two groups: 1- early diagnosed (less than 6 mo)and 2- late diagnosed (after 6 mo). The degree offibrosis was compared in the two groups. in earlydiagnose group 45% had stage ≤ 2 , 45% had stages3 0r 4 and 9,1 % had stages > 4 of fibrosis scores . inthe late diagnosis group 28% had stages ≤ 2 , 17 %had stages 3 or 4 and 53, 6% had stages > 4(p=0.001). Inflammatory indices in biopsy samples(grading) was not different between two group(p=0.97). After starting therapy normalization oftransaminases was achieved after 3.3 mo in early andafter 3.1 mo in late diagnosed group (p=0.82).Conclusion: Autoimmune hepatitis is not anuncommon disease in our region .The manner ofpresentation is the same as other regions. Early



ribavirin is the standard regimen for treatment ofindividuals with chronic HCV infection, but there islimited evidence of its effectiveness in hemophiliaand major thalassemia patients.Method: A single center prospective cohort study wasdone from 2009 through 2011. A total of 51 patients,aged 16-53 years, chronically infected with HCV,anti-HCV treatment naive or previously treated, andseronegative for human immunodeficiency virus(HIV) and hepatitis B virus (HBV) were included.The subjects had absolute neutrophilic counts of atleast 1500/mm3, hemoglobin ≥12g/dL and plateletcounts of ≥100,000/mm3. They did not have liver cir-rhosis, hepatocellular carcinoma, and were notaffected by any other liver diseases. HCV genotype 1and genotype non-1 infected subjects receivedweekly subcutaneous peginterferon alpha-2a andweight adjusted daily oral ribavirin for 48 and 24weeks, respectively. Negative HCV RNA at the endof treatment was considered to be the end oftreatment response (ETR). Negative HCV RNA at 48weeks (genotype 1) and 24 weeks (genotype non-1)post-treatment was considered as sustainedvirological response (SVR).Results: 26 hemophila and 25 thalassemia patientswere enrolled. Eight subjects were lost at follow-upin each group. ETR was achieved in 12 of 18 (67%)of hemophilia and 14 of 17 (82%) of thalassemiapatients. SVR was achieved in 12 of 18 (67%) and14 of 17 (82%) of hemophilia and thalassemiapatients, respectively. No Relapse after ETR wasseen. ETR and SVR were not significantly higher inthalassemia patients. Genotype, previous treatment,and age were not statistically significant independentpredictive factors for ETR or SVR.Conclusion: Efficacy of treatment of hemophilia andthalassemia patients with peginterferon alfa-2a plusribavirin is similar to that in the general populationwith chronic HCV infection.Send Date: 2011/08/17


Relationship between interferon Aphaand bone mass density in hepatitis C patients

Abbas Arj1*, Mohsen Razavizadeh1, KamalEsalatmanesh1, Alireza Moravveji2, Shahrzad Karimi1

1 Department of Internal Medicine, Kashan University ofMedical Sciences2 Department of Community Medicine, Kashan Universityof Medical SciencesIntroduction: Chronic hepatitis is a variety of liverdysfunctions with different causes and severities inwhich inflammation and necrosis last for at least 6months. Choice treatment for all chronic viralhepatitis is interferon Alpha (IFN-α). Decreasingbone mass density (BMD) may lead to somecomplications such as non-traumatic spontaneousfractures. Regarding the decreased bone masscomplications and existed dilemma, we have done thecurrent study to compare the BMD in chronichepatitis patients before and after the IFN-α treatment.Method: In a cohort study 22 patients with chronichepatitis need to treat with IFN-α were evaluated byBMD in a 6 months period. All the patients were ex-amined by BMD before the treatment. The BMD re-sult was recorded in information sheet. Six monthsafter the treatment patients were evaluated again byBMD. All the necessary information such as age, sex,co-morbidity and another medication history wereasked and recorded. IFN-α dosage was 3 million IU3 times a week. The gathered data were enteredSPSS14 and analyzed through Chi-Square andWilcoxon to compare the means.Results: Among 22 patients 21 subjects (95.5%) weremale and 1 subject (4.5%) was female. Mean age was34.04±7.83 years and half of the subjects were in 30to 35 years age group. The subjects had notsignificant difference in bone mass density indices(Z-score and T-score) before and after treatment withIFN-α (P-value>0.05). The bone mass density indiceshad not significant difference between different agegroups of hepatitis C patients before and aftertreatment with IFN-α (P-value>0.05).Conclusion: In the current, as mentioned above,IFN-α used in the treatment of Hepatitis C patients,had no significant effect on the BMD in them. Toevaluate the long term effect of IFN-α its suggested todo more studies with longer duration, however, theBMD may improve when the inflammation beenalleviated long term.Send Date: 2011/08/21



Introduction: This study attempts to evaluate sero-prevalence of Hepatitis C(HCV) , Hepatitis B(HBV)and Human immunodeficiency Virus (HIV) amongpatients with β-Thalassemia major receiving multipletransfusions in Amol thalassemia center.Method: This is a cross-sectional study in which 371Talassemia major patients were assessed for HCV Ab(by ELISA 3rd generation ), HBs Ag and HIV Ab .Patients with positive HCV Ab were checked forHCV –RNA and positive cases were considered astrue infection .Patients were divided into 2 groups(before and after 1375) and the seropositivity ofHepatitis C was checked separately in order toevaluate the efficacy of donor blood screeningprogram which started in 1375.Results: HCV Ab and HCV – RNA were positive in168 (45.3%) and 118 (31.8%) cases respectively .Before 1375,HCV- Ab was positive in 53.4% andHCV-RNA in 37.5% of cases in contrast with , 16%and 11.1% respectively after 1375. There were 2positive HBs-Ag (0.53%) cases.None of the patientshad positive HIV Ab .In spite of significantdecrement of HCV infection after the screeningprogram( P-V <0.005) , it is still high in comparisonwith other countries (16% versus 0.1%).Conclusion: The sensitivity of HCV Ab ElISA mustbe improved or more sensitive and specific pre-trans-fusion screening tests (HCV-RNA) should be intro-duced in blood banks.Send Date: 2011/08/03


Long term outcome of sustained viral responsein hemophilic patients with chronic Hepatitis C

Siamak Khaleghi1*, Salma Ahi1, Shahin Merat2,Mahshid Talebi-Taher1

1 Gastrointestinal & Liver Disease Research Center(GILDRC), Firoozgar Hospital, Tehran University ofMedical Science,pardis hemmat, Tehran, Iran2 Digestive Disease Research Center(DDRC), Tehran Uni-versity of Medical Science, Tehran, IranIntroduction: There are few published data regardinglong-term outcome of hemophilic patients withchronic hepatitis C(HCV) who obtain sustained

virological response (SVR) to pegylated interferon(PEG-IFN) and ribavirin therapy. The objective ofthis study was to evaluate the durability of thevirological response in these patients after 5 years offollow up.Method: Thirty five patients (34 male) with mean ageof 26.20±8.48 (13-48y) were treated with PEG-INFalfa 2a and ribavirin for 48 weeks from 2002 to 2003in Iranian Hemophilic Center. HCV genotypedetermination was done in 20 patients of whom 12were 1a (60%), 4 were 1b (20%) and 4 were 3a(20%). 33 patients accomplished the treatment andSVR was achieved in 27 patients (81.8%). Patientswith SVR were followed for the next 5 years.Results: Twenty five of 27 patients were available for5 year follow up. HCV PCR was negative in all ofthese patients and no evidence of clinical orbiochemical relapse was detected.None of thepatients developes hepatocellular carcinoma.Conclusion: This study reveals that combinationtherapy with PEG-INF and ribavirin in hemophilicchronic hepatitis C patients has been associated witha high rate of SVR (81%) and 100% durability ofvirological response with no clinical relapse. Thesedata provoke the hypothesis that SVR is probablyassociated with HCV infection cure in this group.Send Date: 2011/08/05


Peginterferon alfa-2a plus ribavirin fortreatment of hepatitis C infection in hemophiliaand thalassemia patients (preliminary report)

Mohammad Reza Fattahi1*, Faezeh Sadeghian2,Farzan Abdolahi3, Samaneh Mahmoodi3, Sara Japoni1

1 Gastroenterology and Hepatology Research Center,Shiraz University of Medical Sciences, Shiraz, Iran2 Department of Internal Medicine, Shiraz University ofMedical Sciences, Shiraz, Iran3 Medical School, Shiraz University of Medical Sciences,Shiraz, IranIntroduction: Hemophilia and major thalassemiapatients who receive regular blood transfusions arehighly susceptible to chronic hepatitis C virus (HCV)infection, which results in great morbidity andincreased mortality. Peginterferon alfa-2a plus



1 Digestive Disease Research Centre, Tehran University ofMedical Science2 Biochemistry Department, Tabriz University of MedicalScience3 Epidemiology and social medicine department, Ilam Uni-versity of Medical Science4 Gastroenterology Department, Tabriz University of Med-ical ScienceIntroduction: B cells represent as much as half of theintrahepatic lymphocyte population. IgD is expresseson mature B cells and it is not well understoodwhether IgD-positive B cells are phenotypicallydifferent with the stage of chronic hepatitis B. APRIL(a proliferation-inducing ligand, TNFSF 13a) is amember of the TNF superfamily that hasco-stimulatory activity on B cells.Method: IgD expression in liver biopsy has beencarried out by immunohistochemisty and serumAPRIL was performed with ELISA on 57 patientswith chronic hepatitis B.Results: The intensity and extended of IgDexpression was scored and there was no difference inphenotypic expression of IgD receptor on B cellsbetween all patients. We found a positive correlationbetween serum ALT, liver fibrosis stage and liver IgDexpression with HBV DNA level (r= 0.4, p=0.001; r=0.4, p=0.002 and r= 0.3, p=0.01). Liver IgD expres-sion revealed negative relationship with serumAPRIL but positive with liver fibrosis stage (r=−0.26, p=0.04 and r= 0.27, p=0.03).Conclusion: Our preliminary results suggestdecreased serum APRIL levels in chronic hepatitispatients in accompany with increased intrahepaticIgD-positive B cells associated with higher stage ofliver fibrosis.Send Date: 2011/07/23


The Impact of Illicit Drug Use onSpontaneous Hepatitis C Clearance: Experience

from a Large Cohort Population StudyHossein Poustchi1*, Saeed Esmaili1, Ashraf Mohamad-khani1, Aghbibi Nikmahzar1, Akram Pourshams1, SadafGhajarieh Sepanlou1, Shahin Merat1, Reza Malekzadeh1

1 Digestive Diseases Research Center, Tehran University

of Medical SciencesIntroduction: Acute hepatitis C infection usuallyends in chronic infection, while in a minority ofpatients it is spontaneously cleared. The currentpopulation-based study is performed on a large cohortin Golestan province of Iran to examine thedemographic correlates of Spontaneous Hepatitis CClearance.Method: Serum samples used in this study had beenstored in biorepository of Golestan Cohort Study.These samples were evaluated for anti hepatitis CVirus by third generation Enzyme-linkedimmunosorbent assay (ELISA). Subjects who testedpositive were then invited and tested by RecombinantImmunoblot Assay (RIBA) and Ribonucleic AcidPolymerase Chain Reaction test (PCR). If testedpositive for RIBA, subjects were recalled and the twotests were re-done after 6 months. Those subjects whoagain tested positive for RIBAbut negative for PCR weremarked as cases of spontaneous clearance (SC).Results: 49,338 serum samples were evaluated. Theprevalence of Chronic Hepatitis C Virus (CHCV) in-fection based on PCR results was 0.31%. Amongthose who had acquired hepatitis C, the rate of SCwas 38%. In multivariate analysis, illicit drug useboth Injecting Use (OR=3.271, 95% CI: 1.784-6.000,p-value<0.001) and Non-Injecting Use (OR=1.901,95% CI: 1.068-3.386, p-value=0.029) weresignificant correlates of CHCV infection versus SC.Conclusion: Illicit drug use whether intravenous ornon-intravenous is the only significant correlate ofCHCV, for which several underlying mechanisms canbe postulated including repeated contacts withhepatitis C antigen.Send Date: 2011/08/01


Prevalence of Hepatitis C in Multi transfusedThalassemia major patients in Thalassemia

clinic of Amol in 1363- 1383Farhad Zamani1*, Masoumeh Eslami1, Hossein

Ajdarkosh1, Mahmoud reza Khansari1

1 Gastrointestinal,Liver and Digestive Diseases ResearchCenter (GILDRC), Tehran University Of Medical Sci-ence,pardis hemmat, Tehran, Iran



Length Polymorphism) in single laboratory.Results: The mean (±SD) of age of patients was 37±4years. Eighty one (54%) were male and 70(46%)were female. Eight cases (5.3%) out of 151 hadYMDD mutations. The type of mutation in all ofthese patients was YSDD. There was no significantrelationship between YMDD mutation and viral loadand HDV Ab (p>0.05).Conclusion: The mutant strains of the YMDD motifof HBV polymerase can be found in some patientswithout lamivudine treatment. However, in view ofrather clinically insignificant YMDD mutationfrequency, routine testing for YMDD mutations priorto antiviral therapy is not recommended in thesepatients.Send Date: 2011/05/03

Category: 7 LIVER7.8 Viral hepatitis B: clinical aspectsF-T-103

Hasan Saadatnia1, Abbas Esmaeelzade2, BahramMemar3, Kamran Ghaffarzadegan4, Azita Ganji5,

Ahmad Khosravi1, Ali Mokhtarifar5, HasanVosoughinia1, Mahmood Farhoodi5, Davood Sharifi1,Moosarreza Hoseini5, Ali Bahari5, Hamid Reza Sima5,

Faride Moradimoghaddam6, Mitra Ahadi1

1 ghaem Hospital Internal Medicine Department, MashhadUniversity of Medical Sciences (MUMS)2 Emam Reza Hospital, Department of Internal Medicine,Mashhad University of Medical Sciences (MUMS)3 Emam Reza Hospital Department of Pathology, MashhadUniversity of Medical Sciences (MUMS)4 Razavi Hospital Pathologymedicine Department, EmamReza University5 Emam Reza Hospital Internal Medicine Department,Mashhad University of Medical Sciences (MUMS)6 Ghaem Hospital, Mashhad University of MedicalSciences (MUMS)

Send Date: 2011/07/23

Category: 7 LIVER7.8 Viral hepatitis B: clinical aspectsF-T-104

Intrahepatic IgD-positive B Cells populationwith Lower Serum APRIL Associated with

Higher Liver Fibrosis in Chronic Hepatitis BAshraf mohamadkhani1*, Faegh Bastani2,

Mohammad Rahbani 2, Kourosh Sayehmiri3,Masoud Sotoudeh1, Mohammad Hossein Soomi 4,

Masoud Darabi 2, Hossein Poustchi1

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ìÛlìú:ôüpôxøLBOýQBüßþAqyBüÐOpüòKBOõsðùBÿìrìòkðýBuQ.uBæðúclôküàìýéýõóð×pAqcBìéýòìrìòGúkèýêÎõAoÅðBâõAoAGPçFGú@óìTêuýpôqôÞBouýñõïøLBOõuéõæoÖõRìþÞññl.koAüpAóAÞTpüQÒBèIìõAokøLBOýQBAqðõÑgAebHìñ×þìþGByñl.GBOõWúGúuýpGBèýñþôKý{@âùþGlOpôðýBqGúkoìBóÆõæðþOpÿAüòðõÑøLBOýQ,GñËpìþoulìÇBèÏúWBìÏþÞúWñHúøBÿìhPéØüBÖPúøBÿ@qìBüzãBøþoAkoAüòGýíBoAóGpouþÞñl,AqÂpôoüBRWBìÏúìBuQ.

Deyhim2, Shahin Merat1*

1 Digestive Diseases Research Center, Tehran Universityof Medical Sciences, Tehran, Iran2 Research Center, Iran Blood Transfusion Organization,Tehran, IranIntroduction: Little is known about HEV seroprevalenceand its determinants in Iran. Considering the fact thatIran is among the countries in which HEV infectionis endemic, a large-scale population based study inthis regard is justified.Method: This survey was conducted in 2006 inTehran and Golestan Provinces, Iran. Stored sera ofsubjects were tested for serological markers ofanti-HEV. The baseline data were recorded instructured questionnaires. Weighted seroprevalenceand weighted logistic regression coefficients werecalculated.Results: A total of 1423 samples were included. Theoverall seroprevalence in two provinces was 7.4%.Age with an odds ratio equal to 1.59 (95% CI:1.26-2.02) and history of traditional phlebotomy withan odds ratio equal to 2.28 (95% CI: 1.13-4.60) wereindependent predictors of HEV seropositivity.Conclusion: Considering the high rate of HEVseroprevalence in Iran, further studies on the cost-effectiveness of vaccination among vulnerable groupsare mandatory.Send Date: 2011/07/25

Category: 7 LIVER7.8 Viral hepatitis B: clinical aspectsT-S-101Comparison between efficacy of ,lamivudine ver.

Interferon in treatment of Hepatitis BMohsen Akhondi-Meybodi1*, Azar Rabei1

1 Shahid Sadoughi University of Medical Sciences-Yazd, IranIntroduction: Hepatitis B is a global health problemthat caucuses cirrhosis and hepatocellular cancerthrough the world .Because of great health problemtreatment of hepatitis B is important. We evaluatedthe effect of lamivudine and interferon in thetreatment of hepatitis B wild type and precormutantvariant in Yazd 2007-2010.Method: Patient with chronic hepatitis B who haselevated liver enzyme two times than normal ,wholast from six month and elevated HBV DNA included.Patients who treated previously or have co-infected

with HCV or HIV and patients who diseased wasprogressed were excluded. Seventy patents dividedin two groups one group received lamivudine 100 mgdaily and other group received convention interferonfive million unit every day.Results: 70 patients were included. Negative resultof HBV DNA was negative in 61.9% with interferonand 61.1% with lamivudine in wild type subgroup ofHepatitis b and negative HBV-DNA result was 64.3%in interferon treatment and 68.8% in patient thatreceived lamivudine in precoer-mutant subgroup ofhepatitis B.Conclusion: Virological response was better in pre-core muton groups to lamivudine than interferon.Send Date: 2011/07/20

Category: 7 LIVER7-8 Viral hepatitis B: clinical aspectsT-S-102

Frequency of YMDD mutations inpatients with chronic hepatitis B

untreated with antiviral MedicinesSeyed Hamid Moosavy1*, Hussein Froutan2,Mohsen Nasiri Toosi2, Yasir Andrabi2, Hadi

Ghofrani2, Hamid Vahedi2, Mehrnoosh Rezaee1

1 Departement of Gastroenterology, Bandar Abbass, Iran2 Departement of Gastroenterology, Tehran University ofMedical Sciences, IranIntroduction: Investigators were suspicious YMDDmutations occurred only in patients who were treatedby lamivudine. But YMDD mutations of hepatitis Bvirus gene (HBV DNA) in patients with chronichepatitis B (CHB) untreated with antiviral medicineswas reported in some studies. The aim of this studywas to evaluate YMDD mutations in Iranian Patientswith chronic hepatitis B (CHB) untreated withantiviral medicines.Method: In a cross sectional study,151 adult patientswith positive Hepatitis B surface antigen (HBs Ag)(78 asymptomatic hepatitis B virus carriers, 73 activechronic hepatitis B patients or cirrhosis patients) wereevaluated for YMDD mutants. The patients who weretreated with interferon in recent one year andLamivudine or Adfovier before the study wereexcluded. YMDD mutations of HBV DNA weredetected by PCR-RFLP (PCR Restriction Fragment



and HBV in Kerman city during 2010Mohammad Javad Zahedi, Sodaif Darvish Moghaddam1,

Mohammad Mehdi Hayatbakhsh Abasi1, MaryamParniyan2, Mohammad Javad Zahedi1*

1 Physiology Research Center, Afzalipour Hospital,Kerman University of Medical Sciences, Kerman, Iran2 Afzalipour Hospital, Kerman University of MedicalSciences, Kerman, IranIntroduction: Infection with HIV, HCV and HBV iscommon worldwide. These viruses have similar routsof transmission; through blood products, sharing ofneedles for drug injections and sexual activity.Therefore, confection with these viruses is common.Coinfection with HCV and HBV in HIV positivepatients may lead to hepatic complications andconsequently decreased life expectancy. This studywas designed to assess the prevalence of HCV andHBV coinfection in HIV positive patients in Kerman,Iran during 2010.Method: In this cross sectional study, 165 HIVpositive patients were evaluated for demographicfeatures and history of high risk behaviors. Thepatients were tested for HBS Ag, and HCV Ab byusing EIA method. Statistical analysis wereperformed by SPSS 18 software.Results: Out of total 165 HIV positive patients82.4%were men and 17.6% were women with a meanage of 40.4 ± 9 years. The prevalence of HCV andHBVcoinfection were 73.8% and 3.7% respectively.A simultaneous coinfection of three viruses was1.8%. The main risk factors for HCV coinfectionwere history of being in jail and drug injections.Conclusion: Prevalence of HIV- HCV coinfection inKerman city is much more common than otherstudies, due to high prevalence of injecting drug usersin this study.Send Date: 2011/07/02

Category: 7 LIVER7.7 Viral hepatitis: basic aspectsT-S-099

Development of a SYBR Green Real timemultiplex RT-PCR technique for

simultaneous detection of HCV andGBV-C Co-infection in plasma samples

Seied Hossein Mosavi fard1, Kiana Shahzamani2*,Shahin Merat1, Farzaneh Sabahi3

1 Digestive Disease Research Institute, Tehran Universityof Medical Sciences2 Department of Biology, Lorestan University3 Department of Virology, Tarbiat Modares UniversityIntroduction: HCV and GBV-C belong to theFlaviviridae family of viruses and GBV-C is theclosest virus to HCV genetically. Accumulativeresearch is in progress all over the world to clarifyclinical aspects of GBV-C. Possibility of interactionbetween HCV and GBV-C and also its consequencewith other liver diseases are the most importantclinical aspects which encourage researchers todevelop a technique for simultaneous detection ofthese viruses. In this study a SYBR Green Real timemultiplex RT-PCR technique as a new economicaland sensitive method was optimized for simultaneousdetection of HCV/ GBV-C in HCV positive plasmasamples.Method: After designing and selection of two pairs ofspecific primers for HCV and GBV-C, SYBR GreenReal time RT-PCR technique optimization wasperformed separately for each virus. Establishmentof mulitiplex PCR was the next step. Finally ourtechnique was performed on positive and negativeplasma samples.Results: 56 non cirrhotic HCV positive plasmasamples (29 of genotype 3a and 27 of genotype 1a)were collected from patients before receivingtreatment. 20.6% of genotype 3a and 18.7% ofgenotype 1a showed HCV/ GBV-C coinfection. As aresult, 19.6% of 56 samples had HCV/ GBV-Ccoinfection that was compatible with other resultsfrom all over the world.Conclusion: SYBR Green Real time multiplexRT-PCR technique can be used to detect HCV/GBV-C co-infection in plasma sample. Furthermore,with application of this method more time and costcould be saved in clinical-research settings.Send Date: 2011/07/21Category: 7 LIVER7.7 Viral hepatitis: basic aspects

T-S-100A Population-based Seroepidemiological

Study on Hepatitis E Virus in IranSadaf Ghajarieh Sepanlou1, Hoori Rezvan2,

Sedigheh Amini-Kafiabad2, Mohammad-Reza



in class ‘C’ category.Conclusion: HBV infection was the major risk factorfor cirrhosis in our study. Ascites was the commonestcomplication. Patients with child-Pugh’s class ‘C’cirrhosis were more frequent than patients withchild-Pugh’s class ‘B’ and ‘A’. A multidisciplinaryapproach for prevention and control of everincreasing HBV infection must be adopted and tomake the public awareness through the mass mediaabout its drastic complications, and possible modesof its transmission.Send Date: 2011/07/21

Category: 7 LIVER7.6 Cirrhosis and complications: clinical aspectsT-S-096

Correlation between MELD Score andChild-Pugh-Turcott Score in Patients

with End Stage Liver DiseaseMohammad-Hossein Somi1*, Masood Bagheri1,

Zahra Rashe1, Morteza Ghojazadeh2

1 Liver and Gasteroenterology Diseases Research, TabrizUniversity of Medical Sciences2 Physiology Department of Medical Faculty, TabrizUniversity of Medical SciencesIntroduction: MELD Score and Child-Turcotte-Pughscore are used to assess the prognosis of chronic liverdisease, mainly cirrhosis.Although the Child-Turcottescoring system was the first of scoring in stratifyingthe seriousness of end-stage liver disease,MELDscore is used increasingly to assess patients for livertransplantation.We wanted to find a relationshipbetween these scoring systems to examine patientssurvival more precisely.Method: In a cross sectional study we collect the datafrom 105 cases of end stage liver disease caused byviral hepatitis,autoimmune hepatitis and other causesfrom Emam Reza academic hospital-Tabriz-Iran fromJanuary 2007 to February 2011 .Relationshipbetween two scoring systems was appreciated bycalculating the correlation coefficient by SPSS.16.Results: Strong correlation between MELD score andChild-Turcotte-Pugh score shows in this study(P<0.001),so that according to the results of regressiontest in 70 percent Child-Turcotte-Pugh score variationsrelated to the MELD score variations.Conclusion: The present study demonstrates that

although MELD score was the primary predictor ofoverall survival in multivariate analysis,therelationship between these scoring systems shows wecan use both of them to predict patients' prognosiswith equal accuracy.Send Date: 2011/07/21


Send Date: 2011/08/18

Category: 7 LIVER7.7 Viral hepatitis: basic aspectsT-S-098

Prevalence of HIV coinfection with HCV



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Predicting Factors of Rebleeding andMortality in Variceal Bleeding in PatientsHospitalized in Gastroenterology Ward of

Emam Khomeini Hospital 2007-2008Ebrahim Fattahi1*, MohammadHosseian Somi1,

Raha Pishdad1, Parisa Rezaeifar1, GolnarMajidi1, Shahnaz Naghashi1

1 Liver and Gastrointestinal Diseases Research Centre,Tabriz,University of Medical SciencesIntroduction: Esophageal variceal bleeding isassociated with high mortality rate and hospitalizationcosts. By diagnosing predicting factors of rebleeding

at admission, with sufficient actions, we canminimize the mortality and rate of rebleeding. Theaim of this study is to determine predicting factors ofrebleeding and death in patients hospitalized becauseof variceal hemorrhage.Method: In a case control study, 100 patients withvariceal bleeding were studied whom were admittedat Emam Khomeini Hospital from June 2007 to May2008. There demographic characteristics were age,gender, etiology, CTP classification and variousclinical, laboratory and endoscopic criteria of patientswere recorded. Patients were divided into case andcontrol groups (with and without variceal bleeding).Predictive values of all criteria were surveyed.Results: 32 patients with age (mean±SD)54.22±19.81 and 68 with age (mean±SD)49.88±16.42 were in case and control group,respectively. There was no relation between age,gender, treatment (p=0.30), etiology (p=0.68),concomitant disease and portal hypertension withrebleeding. Size of varices (p=0.046), encephalopathy(p<0.05), ascites (p<0.005), bilirubin seric level andCTP classification (p<0.0005) had predictive effecton rebleeding. Of patients, 12 were CTP class A, 59CTP class B and 29 CTP class C. CTP and bilirubinsensitivity with the aid of ROC evaluation was found>85% and >62%, respectively. No deaths were seenin the period oh hospitalization.Conclusion: Determining the class and grade of theCTP at admission in patients with variceal bleeding,will afford useful prognostic information. In thisstudy, patients with CTP class B were stronglysusceptible for rebleeding. Also, we found that there

is correlate between the higher bilirubin , severity ofascites , encephalopathy and rebleeding rate. In thesepatients intensive care is recommended.Send Date: 2011/07/20


Evaluation of frequency of Etiology andclinical profile of liver Cirrhosis in GI

clinics of Ahvaz city in 1377-1386Eskandar Hajiani1*, Seyed Jalal Hashemi1,

A Ahmadzadeh1

1 GI ward, Ahvaz - Jondishapoor UniversityIntroduction: Liver cirrhosis is the end-stage ofmany different chronic liver diseases. Limited dataexists on the epidemiology, natural history andcomplications of liver cirrhosis in Ahvaz city. In aCross-sectional study we retrospectively evaluated165 patients in our set up from 1377 to 1386.Method: Patients having an evidence of cirrhosis ofliver on ultrasound examination of abdomen wereenrolled. The diagnosis was based on clinical,functional and morphological data, and theetiological profile was established by determiningviral markers, autoimmune markers and by metabolicscreening. All those patients who were not confirmedto be cirrhotic excluded from this study. All caseswere studied to determine the etiological factors,complications and prognosis of disease. All data wererecorded on a questioner.Results: Total 165patients were studied, 114(67%)males and 51(33%) females. Their mean age was 47years. Majority of patients (63.6%) had HBVinfection, (29.9%) had Autoimune Hepatitis, (13.6%)HCV infection,(1/8%) had Wilson’s disease and noetiological factors were recorded in (23%) patients.Ascites was present in (32%) cases, splenomegaly in(29%), esophageal varices in (38%), acute varicealhemorrhage in (8%), hepatic encephalopathy indifferent grades in (1%), fundal varices in (2%),peptic ulcer in (8%) and hepatocellular carcinoma in(6%) patients. All patients with acute varicealepisode(s) were adequately and timely treated in GIdepartment. When cirrhotic patients were groupedinto child-Pugh’s classification, (19 %) were in class‘A’ category, ( 30 %) in class ‘B’ category, and (51%)



Introduction: Chronic Liver diseases (CLD)especially liver cirrhosis (LC) is one of the mostimportant causes of death in Iran. 39 percent ofpatients admitted in Shariati hospital during2000-2004, have had chronic liver diseases, cirrhosisand hepatic failure. We decided to compare theetiologic causes of CLD and LC admitted in this largereferral hospital during two time periods of2000-2004 and 2004-2009.Method: The discharge sheets of 5880 patients hadbeen admitted in Shariati hospital GI ward during two5 years periods of 2000-2004 and 2004-2009 werereviewed. The final diagnosis and etiology of chronicliver disease and /or chronic liver failure on the basisof ICD-10 extracted and evaluated statistically.Results: Among the 956 patients in the 1st groupduring 2000-2004 period, the rate of the mostcommon etiologic agents were hepatitis B virus(41.1%),cryptogenic cirrhosis(21.96%), AutoimmuneHepatitis (12.97%), HCV (11.71%),and primarybiliary cirrhosis(PBC)(5.12%). While among 861patients in the 2nd period, during 2005-2009, therates of the most common agents were HBV (29.5%),cryptogenic cirrhosis (27.75%), HCV (15.91%), AIH(15.79%), and PBC (4.64%).Conclusion: The rate of HBV has decreased andcryptogenic and HCV have increased in this group ofpatients. These changes may be due to improvementsin the sanitation status and the rising rate of obesityand metabolic syndrome in our community. We sug-gest more study in other referral centers.Send Date: 2011/08/22


Effect of non-alcoholic fatty liver diseaseon carotid artery intima-media thickness

as a risk factor for atherosclerosisManouchehr Khoshbaten1*, Maryam Zaare1, Reza

Javadrashid2, Koorosh Masnadi Shirazi1,Neda Sattarnezhad1

1 Liver and Gastrointestinal Disease Research Center,Tabriz University of Medical Sciences2 Department of Radiology, Tabriz University of MedicalSciencesIntroduction: The prevalence of non-alcoholic fatty

liver disease (NAFLD) is increasing worldwidesecondary to the rise of obesity and diabetes mellitus(DM) incidence. There are various non-invasivemethods for determining the atherosclerosis, ofwhich, non-invasive assessment of carotidintima-media thickness (CIMT) by high-resolutioncarotid Bmode ultrasonography is widely used in thisregard.This study aimed at evaluating the effect ofNAFLD on CIMT as a risk factor for atherosclerosis.Method: In this case-control setting, 151 subjectsdivided to three groups: Group 1 including 49patients with NAFLD and DM; Group 2,including 50nondiabetic NAFLD patients; and the controlsincluding 52 normal subjects. The right and leftCIMTs and its maximum reading (CIMTmax) weremeasured by a skilled sonographist blind to thegrouping. Demographic and other atherosclerosis riskfactors were compared between groups, as well.Thesonographic grading of the NAFLD was determinedin group 1.Results: Median CIMTmax was significantly higherin the case 1 group comparing with that in the case 2and control groups (0.6mm, 0.5mm and 0.4mm,respectively, p<0.001). This difference between thecase 1 and case 2 groups was not significant afteradjusting for age and previous history of hypertensionand hyperlipidemia (p=0.089). Between the case 1and control groups, the difference was againsignificant after controlling the confounders(p=0.018). Similar result was attained in comparisonbetween the case 2 and control groups (p=0.043).Comparing the median CIMTmax between thepatients in case 1 group with and without elevatedliver function tests, there was no significantdifference (0.6 mm in both groups, p=0.402).Comparing the median CIMTmax between thepatients in case 1 group according the sonographicgrading of NAFLD, there was no significantdifference (0.5mm, 0.6 mm and 0.6 mm in grade 1, 2and 3, respectively; p=0.438).Conclusion: Based on our findings, there is a signif-icant association between the presence of NAFLDand atherosclerosis. This association was independentfrom the DM presence. The grade of NAFLD andelevated lever function tests had no effect on severityof atherosclerosis.Send Date: 2011/07/15



disease. To date, no medical treatment has beenproven. We aimed to compare the effect of aerobicexercise along with diet and diet alone on serumaminotransferases levels, anthropometric indices, andcardio respiratory fitness in patients with NASH.Method: Twenty-three NASH patients with the ageof range of 25 to 50 years old were randomly dividedin two groups and underwent aerobic exercise alongwith diet (n=12) or diet alone (n=11). In this study,low-caloric diet in both groups included 500kilocalories of energy less than estimated dailyenergy requirement. In addition to diet, the first groupwere participated in aerobic exercises consisted ofwalking, jogging and running, for a period of 8weeks, 3 days a week with 55–60% heart rate reserve.Serum aminotransferase levels, anthropometricindices, and peak oxygen consumption weremeasured before and after eight weeks of theintervention. Data were analyzed by Paired Samplesand Independent-Samples T Test, at a significancelevel of P<0/05.Results: Although, no significant difference wasnoted in patients on diet alone, serum ALT and ASTlevels were significantly decreased in patientsunderwent diet and exercise. Anthropometricmeasurements were decreased and peak oxygenconsumption was increased significantly in bothgroups; however, there were significant differencebetween two groups in variables WC, WHpR, WHtRand VO2 peak.Conclusion: Aerobic exercise along with low-caloricdiet may be more effective than low-caloric dietalone-in treatment of patients with nonalcoholicsteatohepatitis.Send Date: 2011/08/19

Category: 7 LIVER7.4 Hepatotoxicity/alcohol - regeneration - apoptosisT-S-091

TB Drugs hepatotoxisity, Abundance and out-come (7 years study on 324 patients with

smears positive TB in Qazvin)Reza Ghasemi Barghi1, Ali Akbar Haj AghaMohammadi2*, Rasoul Samimi2, Ali Zargar2

1 Infectious Disease Unit, Qazvin University of MedicalSciences2 Gastroenterology & Hepatology Unit, Qazvin University

of Medical SciencesIntroduction: Hepatotoxicity is a major concernduring treatment of tuberculosis. Its prevalence rangefrom 1- 4% in developed countries to 11.5% indeveloping countries and more in some countriessuch as India. Mortality appears to 5%, but can beprevented by early detection. This study wasconducted to reveal prevalence and outcome ofdrug-induced hepatitis in smear positive tuberculosispatients taking anti-TB drug therapy in Qazvin,central of Iran.Method: This observational descriptive retrospectivecross-sectional study was done on 324 patients(newlydiagnosed cases) with smear positive TB takinganti-TB drugs as 6 months classic regimen, DOTSmethod (isoniazide+ rifampin+ pyrazinamide+ethambutol or streptomycin for 2 months and thenisoniazide +rifampin for 4 months) during 2004-2010.Results: Mean age of the cases was 42±12.1 y/o(mean± SD). 194 cases (60%) were female and theremaining were male. drug-induced hepatitis wereseen in 16 cases (4.9%). mean age of affected caseswas 52 y/o. liver enzyme had begun to rise 13-45days after drug therapy (mean=25.25), the altitude ofenzyme rise were 287-605 i.u. the enzyme levelreturned to normal after 14-43 days (mean=23.45)after drugs discontinuation. There was no mortality.Conclusion: the prevalence of drug-induced hepatitisin our study was 4.9%. Although it was seen more infemales and, age over 50 years but no statisticallysignificant relations were found betweendrug-induced hepatitis and sex or age of the patients.With base line and 2 week periods Liver enzymecheck and rapid drugs discontinuation in raised casesin this study, was not observed any mortality.Send Date: 2011/05/19

Category: 7 LIVER7.5 Cirrhosis and complications: basic aspectsT-S-092

Etiology of chronic liver disease inpatients admitted in the Shariati

Hospital Tehran during 2000-2009Shifteh Abedian1*, Mehdi Saberifiroozi1,

Reza Malekzadeh1

1 Digestive Disease Research Center, Shariati Hospital,Tehran, University of Medical Sciences, Tehran, Iran



distributed in the damaged liver. Steatosis was lessuniform (kappa=0.64), and hepatocyte ballooningwas least uniformly distributed (kappa=0.57). TheICC for NAI was 0.86 indicating good agreement.Conclusion: The individual histologic features ofNAFLD and NASH are not uniformly distributed inthe liver. Hepatocyte ballooning is especiallynon-uniform. Such non-uniformity should be takeninto account when interpreting results of studiesrelying on paired biopsies. A summary score such asNAI is less affected by sampling error.Send Date: 2011/07/25

Category: 7 LIVER7.3 Metabolic/genetic disordersT-S-089

A Report of Iranian HereditaryHemochromatosis Patients: Baseline

Characteristics, LaboratoryData and Gene Mutations

Farhad Zamani1, Zohreh Bagheri2*, Maryam Bayat3,Seyed-Mohammad Fereshtehnejad4, Hossein Ajdarkosh1

1 Gastroenterologist, Gastrointestinal & Liver DiseaseResearch Center (GILDRC), Tehran University of MedicalSciences (TUMS)(pardis-hemmat), Iran2 Medical Student, Student Research Committee,Gastrointestinal & Liver Disease Research Center(GILDRC), Tehran University of Medical Sciences(TUMS)(pardis-hemmat) , Iran3 General Physician,Gastrointestinal & Liver DiseaseResearch Center (GILDRC), Tehran University of MedicalSciences (TUMS)(pardis-hemmat), Iran4 Research Fellow, Gastrointestinal & Liver DiseaseResearch Center (GILDRC), Tehran University of MedicalSciences (TUMS)(pardis-hemmat), IranIntroduction: Hereditary hemochromatosis (HH) isthe most common autosomal recessive disorderbetween white people which is characterized withexcessive abnormal uptake of iron from thegastrointestinal tracts. Recently, mutation studieshave focused to detect the responsible genes for HH.According to rare prevalence of HH and lack ofappropriate mutation studies in Iran, we aimed toassess 12 Iranian HH patients.Method: In this cross-sectional study, 12 HH patientswere recruited who were referred to FiroozgarHospital, Tehran, Iran. In addition to the clinicalassessments, a complete laboratory evaluation,

imaging modalities, histopathologic assessment,atomic absorption spectrophotometry and genemutation study were performed. The genetic study forHFE gene mutation was examined for all of thepatients since 2006 while non-HFE mutation wasconducted since December 2010 (only for two of them).Results: Twelve patients were evaluated consistingof 11 men and 1 woman with the mean age of39.58+12.68 yr. The average of atomic iron loads was13.25±4.83 fold higher than normal standards. Fourpatients had heterozygotic mutation of H63D(33.3%), while, out of two evaluated patients forNon-HFE mutation, only one was homozygotemutant for TFR2 gene. There was not any significantdifference either in the iron load of liver (P=0.730)and heart (P=0.730) or serum concentration of ferritin(P=0.755) and TIBC (P=0.530) between the mutantand non-mutant HH cases.Conclusion: In contrast to other studies, C282Ymutation was not detected in any of our Iranian HHpatients. While, heterozygotic mutations of H63D(HFE) and TFR2 (non-HFE) genes were found to bemore common in these patients. Similar to previousreports, these mutations were not found to besignificantly associated with severity of presentationin HH patients.Send Date: 2011/07/31


Adding aerobic exercise to low-caloricdiet increases the effect of therapy in

patients with nonalcoholic steatohepatitisHossein Nikroo1*, Seyed Reza Attarzade Hosseini 2,

Hamid Reza Sima3, Mohsen Nematy4

1 MSc student of Sport and Exercise Physiology, FerdowsiUniversity of Mashhad, Iran2 Faculty of Physical Education and Sport Sciences,Ferdowsi University of Mashhad, Iran3 Department of Internal Medicine, Surgical OncologyResearch Center, Imam Reza Hospital, School ofMedicine, Mashhad University of Medical Sciences, Iran4 Department of Nutrition, School of Medicine , MashhadUniversity of Medical Sciences, IranIntroduction: Nonalcoholic Steatohepatitis (NASH)is part of a broad spectrum of nonalcoholic fatty liver



significantly and independently higher in the groupwith elevated level of serum ALT (39.2% vs. 22.3%;p=0.001). Association between elevated level ofserum ALT and grade of NAFLD was not independ-ently significant.Conclusion: Elevated level of serum ALT isassociated with metabolic syndrome and majority ofits components in NAFLD patients; however, thisassociation was not apparent with sonographic gradeof NAFLD or carotid IMT.Send Date: 2011/07/21


Eskandar Hajiani1*, Seyed Jalal Hashemi1,Hajieh shahbazian2, mohamad Salehvand1

1 GI ward, Ahvaz-Jondishapoor University2 Diabetes Investigation Center,Ahvaz-Jondishapoor University

Send Date: 2011/07/21


Sampling Error in HistopathologyFindings of Nonalcoholic Fatty Liver

Shahin Merat1*, Rasoul Sotoudehmanesh1, MehdiNouraie2, Masoumeh Peikan-Heirati1, Sadaf Ghajarieh

Sepanlou1, Reza Malekzadeh1, Masoud Sotoudeh1

1 Digestive Diseases Research Center, Tehran Universityof Medical Sciences2 Department of Internal Medicine and Center for SickleCell Disease, Howard UniversityIntroduction: Many clinical trials and natural historystudies on nonalcoholic fatty liver disease (NAFLD) andnonalcoholic steatohepatitis (NASH) rely heavily onliver histology to define their endpoints. There are manyindications that the liver is not uniformly involved inNAFLD thus sampling error is a major concern.Method: Samples from a forensic autopsy series werestudied. Subjects with NAFLD were identified.Specimens were taken from three different parts ofeach liver. Degree of steatosis, hepatocyte ballooning,lobular inflammation, portal inflammation, andfibrosis was recorded. A NASH activity index (NAI)which is the sum of scores of histologic features wasalso calculated. The agreement between the threesamples from each liver was studied.Results: Nine-hundred and forty-five autopsies wereperformed, 896 were suitable for histologicevaluation and 283 had NAFLD. Of these, 146 liverswere available to our study of which 438 sampleswere taken. Fibrosis (intra-class correlation=0.87),lobular inflammation (kappa=0.83), and portalinflammation (kappa=0.83) were fairly uniformly



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Yagoub Salek Zamani3, Javad Rashid3,Yusof Hoshyar3, Afag Garjani3

1 Liver and Gastrointestinal Diseases Research Center,Tabriz University of Medical Sciences, Tabriz, Iran2 Liver and Gastrointestinal Diseases Research Center,Tabriz University of Medical Sciences, Tabriz, Iran3 Liver and Gastrointestinal Diseases Research Center,Tabriz University of Medical Sciences, Tabriz, IranIntroduction: NAFLD has various prevalence indifferent parts of the world, though 20-30%prevalence has been reported in epidemiologicstudies in western countries. Since obesity and lowphysical activity are main risk factors for thedevelopment of NAFLD, life style modificationconsidering weight loss and physical activity isthought to be as important alternative for treatmentof this disease and to prevention of cirrhosis that willmanifest consequently if it is not treated.Method: 90 patients diagnosed by ultrasound asNAFLD was evaluated in a clinical trial, they wereevaluated in case (A) and control groups (B). Theeffect of aerobic exercise on changing in liverenzymes and liver echogenicity was assessed in casegroup and compared with control group which wereonly on medical therapy.Results: The mean age in the sample group was37.6±8.3 in the 17-56 yrs age range. 29 patients(64.4%) were male and 16 patients (35.6%) werefemale in group A, while 28 (62.2%) male and 17(37.8%) female patients were in group B. In group A,fatty liver was in stage I in 26 (57.8%) cases, stage IIin 17 (37.8%), and stage III in 2 (4.4%). In group B,fatty liver was in stage I in 30 (66.7%) patients, instage II in 14 (31.1%), stage III in 1 (2.2%). Therewas no significant difference between the two groupsevaluating fatty liver changes (p=0.23).But there wassignificant difference in liver enzymes changes ingroup A (ALT p=0.0001 AST (p=0.01)Conclusion: Considering the present study, we cansuggest that a controlled aerobic exercise schedulecan be helpful in the association of medical therapy inthe treatment of NAFLD.Send Date: 2011/07/21


Relation of alanine aminotransferase levelwith severity of atherosclerosis and

metabolic syndrome in patients withnon-alcoholic fatty liver disease

Manouchehr khoshbaten1, Lili Abbaszadeh1*, MaryamZaareh1, Faranak Dordaei1, Javad Rashid1, Elham

Ramazanzadeh1, Nasrin Gholami1, Koorosh masnadi1

1 Liver and Gastrointestinal Diseases Research Center,Tabriz University of Medical Sciences, Tabriz, IranIntroduction: The prevalence of non-alcoholic fattyliver disease (NAFLD) is increasing worldwidebecause of the rise of obesity and diabetes mellitusprevalence. This condition is closely related to insulinresistance and markers of oxidative stress andendothelial dysfunction. There have been evidencesindicating that elevated level of serum alanineaminotransferase (ALT) may reflect metabolicsyndrome and general atherosclerosis in NAFLDpatients; however, the data are not conclusive. Thisstudy aimed at evaluating possible associationbetween serum ALT level with severity ofatherosclerosis and metabolic syndrome in patientswith NAFLD.Method: In this analytic-descriptive cross-sectionalsetting, 309 patients with sonographically diagnosedNAFLD were recruited in Tabriz Imam RezaTeaching centre during a 2-year period of time.Serum level of alanine aminotransferase (ALT) wasmeasured in all patients and accordingly, they wereallocated in two groups: with normal level of serumALT (<40U/L); or with elevated level of serum ALT(>40U/L). The right and left carotid IMTs weremeasured and the maximum reading in both sideswas reported as the final result. The sonographicgrading of NAFLD was also performed. Data werecompared between the two groups with normal andelevated levels of serum ALT.Results: There were 166 cases with normal and 143cases with elevated levels of serum ALT. There wasnot a significant association between the elevation ofserum ALT level and the carotid IMT. Frequency ofcases with abnormal fasting blood sugar, increasedserum triglyceride and abnormally low serum highdensity lipoprotein was significantly lower in thegroup with elevated level of serum ALT. Frequencyof patients with central obesity and hypertension wasnot significantly different between the two groups.Percentage of cases with metabolic syndrome was



2 Private Clinic, Kurdistan University of Medical ScienceIntroduction: Increased number of intraepitheliallymphocytes (IEL) in the colon mucosa is animportant criterion for the histological diagnosis oflymphocytic colitis.As we had found a very high percentage oflymphocytic colitis (but not collagenous colitis)diagnosis in patients with chronic non bloody diar-rhea in our previous investigation in Kurdistanprovidence(39.13%), we decided to determine theaverage range of IEL in the different parts of colonin patients without chronic diarrhea in order toclarifying if this high percentage of diagnosis refersto a real high prevalence of lymphocytic colitis in thisarea or comes from a higher count of IEL betweennormal people of this area without any relation tolymphocytic colitis.Method: In this cross sectional study 150 patients withan indication for colonoscopy other than chronicdiarrhea were enrolled. We took biopsies from differentparts of colon (ascending, transverse and descendingcolon). These biopsies were stained with Hematoxylinand Eosin Staining; and the number of IEL in allpatients was counted by a singular pathologist.Results: The mean of IEL in each 100 epithelial cellswas (15/5 ± 2/8), (12/8 ± 2/5) and (11 ± 2/6) inascending, transverse and descending colonrespectively. There was no significant difference inIEL count between different age, sex, and educationalgroups. Also people in rural and urban areas hadsimilar count of IEL in this study.Conclusion: This study revealed that the meannumber of IEL in Kurdistan providence of Iran wassimilar to word and there was not any significantrelation between IEL count and socioeconomic statusof people. Also more proximal parts of colon hadhigher IEL count than distal parts.Send Date: 2011/08/22


Effects of Coenzyme Q10 on biochemicalmarkers of hepatic necroinflammation inpatients with non alcoholic steatohepatitis

Ali Bahari1*, Mohammad Hashemi2,Sara Shafieipour3, Noralla Hashemzehi4

1 Department of Internal Medicine, Mashhad University ofMedical Sciences, Mashhad, Iran.2 Department of Clinical Biochemistry, ZahedanUniversity of Medical Sciences, Zahedan, Iran.3 Department of Internal Medicine, Kerman University ofMedical Sciences,Kerman, Iran.4 Department of Internal Medicine, Zahedan University ofMedical Sciences, Zahedan, Iran.Introduction: Nonalcoholic steatohepatitis is acommon liver disease that can progress to cirrhosis.Currently, there is no established treatment for thisdisease.Method: We randomly assigned 55 adults withnonalcoholic steatohepatitis(NASH) to receiveCoQ10 60mg daily (30subjects) or vit E 800 unitdaily (25 subjects) for 3 months to assessment theeffect of CoQ 10 versus vit E on BMI, ALT, AST,ALK-P, PT, Bilirubine, ALB, Ferritin, TG, TotalCholestrol, FBS, Serum Insuline, LDL, HDL, totalAnti Oxidant Capacity before and after intervention.Results: In CoQ10 group there was a significant im-provement in weight and BMI (P value=0.001), AST,ALT, TAC (p-value<0.0001), Ferritin, Total bilirubin,GGT (p value<0.01), HDL (p value<0.05). In vit Egroup there was a significant improvement in AST,ALT, TAC, Ferritin, GGT, HDL(p value<0.01) but nosignificant difference in between the otherparameters. There was seen no significant differencein CoQ10 and vit E in improvement any demographicand biochemical parameters.Conclusion: Our study assigned that 60 mg CoQ10 iseffective on improvement of noninvasive liver pa-rameters in NASH, but not superior than 800iu vit E.Neither CoQ10 and nor vit E ara effective in insulinresistance but we suggest longer duration treatmentand with larger dosage. We also suggest a larg studywith biopy control for the assessment the effect ofCoQ10 in NASH.Send Date: 2011/07/21

Category: 7 LIVER7.3 Metabolic/genetic disordersT-S-085Effect of aerobic exercise on changing in seromiclevel of liver enzymes and liver echogenicity inpatients with non alcoholic fatty liver disease

Manouchehr khoshbaten1, Nasrin Gholami 2*,



people with high body mass index and the relationshipbetween body mass index and colorectal polyps.Method: This descriptive analytical study wasperformed. In this study subjects about their age,weight, medical history, family medical history,gastrointestinal symptoms, and colonoscopy findingswere recorded and assessed. Population was patientswere admitted to Hazrat-e-Masumeh hospital withgastrointestinal symptoms and have been undergoingcolonoscopy in Qom while November 2008 toJanuary 2009.Results: In this study, among 511 patients, 69 patients(14 percent) have polyp and 442 patients (86 percent)were in the control group. In patients with polyps, 2percent underweight, 33 percent of normal weight,38 percent overweight and 26 percent were obese andin control group, 5 percent underweight, 39 percentnormal weight, 35 percent overweight, and 21percent were obese. In the study of relationships be-tween obtained data and according to square test andthe coefficients can be claimed that between bodymass index and colorectal polyps, there is no signif-icant relationship.Conclusion: Analysis of data for this study didn’tfind a significant relationship between colorectalpolyps and body mass index.Send Date: 2011/07/17

Category: 6 COLONIC AND ANORECTAL DIS-ORDERS6.4 Other colonic and anorectal disordersT-S-082

Frequency of Urinary Tract Infectionand Nocturnal Enuresis in Children

with Chronic Functional ConstipationSeyed Mohsen Dehghani1*, Mitra Basiratnia1, AliDerakhshan1, Mahmood Haghighat1, Mohammad

Hadi Imanieh1, Mohammad HosseinFallahzadeh1, Marzieh Matin1, Laleh Hamidpour2

1 Gastroenterohepatology Research Center, Departmentsof Pediatric Nephrology, Shiraz University of Medical Sci-ences Shiraz, Iran2 Gastroenterohepatology Research Center, ShirazUniversity of Medical Sciences Shiraz, IranIntroduction: There are controversial results aboutthe role of chronic functional constipation indisorders of the urinary tract like urinary tract

infection (UTI) and enuresis. Constipation may causeUTI and enuresis due to the uninhibited bladdercontraction. The aim of this study was to investigatethe frequency of UTI and nocturnal enuresis inchildren with chronic functional constipation.Method: We included 120 children (73, 60.8%female) with chronic functional constipationaccording to Rom III criteria in the study. Detailedpast and present history of UTI or symptoms pointingto this diagnosis and enuresis was obtained.Urinalysis, urine culture and abdominal ultrasonogra-phy were performed for all patients.Results: The mean age of the patients was 7.4±3.2year (range, 1-15 year). 75% of the patients hadconstipation for more than one year. The mostcommon urinary symptoms were dysuria (15%),urinary frequency (12.5%), and dribbling (4.1%). Thefrequency of nocturnal enuresis and daytime enuresiswere 22.5% and 3.3%, respectively. Pyurias wereseen in 11 (9.2%) patients that all of them werefemale. Of these patients urine culture were positivein 7 (5.8%) cases; E.coli in 5 (71.4%), S.aureus andEnterobacter each in one (14.3%). All organismswere sensitive to ciprofloxacin. Urinary tractultrasonography was normal in these patients.Conclusion: Urinary symptoms especially nocturnalenuresis was found in a significant number of chil-dren who had chronic functional constipation but UTIis not more common than general population. There-fore, we suggest that nocturnal enuresis should bequestioned in children with chronic functional con-stipation, but screening for UTI is not recommendedin these patients.Send Date: 2011/08/17

Category: 6 COLONIC AND ANORECTAL DIS-ORDERS6.4 Other colonic and anorectal disordersT-S-083

The normal range and related factorsof the intraepithelial lymphocyte in thecolon mucosa of healthy individuals in

Kurdistan province of IranAmir Taheri1*, Farshad Sheykhesmaili1, Banafsheh

Amin daneshpoor1, Bahram Nikkhoo1, Elham Farhangi2

1 Kurdistan Digestive Research Center, KurdistanUniversity of Medical Science



following by sigmoid colon (37 cases,21.4%) andascending colon (30 cases,17.3%). Sigmoid colonwith 14 cases (26.9%) was the most commoninvolved area for synchronous polyps, following bydescending colon(10 cases,19.2%) and ascendingcolon (10 cases,19.2%).Most of the synchronouspolyps (38.5%) were <5 mm in size and 19 cases(36.5%)5-10 mm in size.67.3% of the synchronouspolyps were found to be single ,11(21.2%) patientshad two polyps and multiple polyps was reported in6(11.5%) patients .Most of the polyps were foundbefore performing surgery 30(57.7%) and the rest ofreported polyps were revealed after operation.Conclusion: In conclusion, considering the highincidence of synchronous polyps in patients withcolorectal cancer in our region, it is ideal to performa preoperative total colonoscopy in each patient withcolorectal cancer. If not possible, a postoperativecolonoscopy should be carried out to findsynchronous lesions in order to help improvingsurveillance of these patients.Send Date: 2011/08/10

Category: 6 COLONIC AND ANORECTAL DIS-ORDERS6.3 Malignant disease - managementT-S-080

Evaluation of metastatic to resectedlymph nodes ratio and factors thataffect it in gastric cancer patients

Hamidreza Saedi1, Farahnaz Joukar1, ReyhaneJafarshad1, Shima Ghasemi1, Afshin Shafaghi1*

1 Gastrointestinal & Liver Diseases Research Center(GLDRC), Guilan University of Medical SciencesIntroduction: Gastric carcinomais as the first leadingcause of gastrointestinal cancer-related mortality.Lymph node status has been considered as the majordeterminant of gastric cancer recurrence for patientsundergoing a curative gastrectomy. Metastatic lymphnode ratio (MLR), namely the number of metastaticlymph nodes to the total number of resected lymphnodes, has also been found to be an importantprognostic factor. Therefore, we decided to survey therelationship between MLR and clinicipathologicfeatures of the patients.Method: Medical records of patients with gastriccancer undergoing gastrectomy from years 2004 to

2009 were studied. Information such as demographicdata, tumor location, histologic grade and stage ofdisease and MLR were analyzed. Patients with otherpathologic reports (other than adenocarcinoma),gastrectomy with positive R1 and R2 margins andalso patients who did not undergo lymph nodedissection, were excluded.Results: Of 70 patients with mean age of 60.93 yearsold, 84% were male. There was a significantrelationship between MLR and age of the patients(p=0.01) , metastatic lymph node number (p<0.001)and stage of the disease (p<0.001) .It means that inyounger patients with high lymph node metastasisand higher stages of the disease, the MLR is higher.However, we did not find any relationship betweenMLR and sex, grade, and location of the tumor.Conclusion: MLR is a valuable prognostic factor inpredicting the patients and the disease natural history.Send Date: 2011/07/23

Category: 6 COLONIC AND ANORECTAL DIS-ORDERS6.4 Other colonic and anorectal disordersT-S-081Study of relationship between colorectal polyps

and body mass index in Qom center of IranMohammad-Reza Ghadir1*, Ali Akbar Riahin2,

Amir-Hosein Ghanooni3, Habibollah Hajian4, MaryamBolandmartabeh5, Ali Azarian5, Masoumeh Abbasi5

1 Gastroenterology Section, Department of InternalMedicine, Faculty of Medicine, Qom University ofMedical Sciences, Qom, Iran2 Department of Infectious Medicine, Faculty of Medicine,Qom Azad University, Qom, Iran3 Department of Internal Medicine, Qom University ofMedical Sciences, Qom, Iran4 Department of Internal Medicine, Qom Azad University,Qom, Iran5 Shahid Beheshti Hospital, Qom University of MedicalSciences, Qom, IranIntroduction: It seems that the most of colorectalcancer are origin of a neoplasm called adenomatouspolyp. Different factors are involved in creatingadenomatous polyps. Epidemiologic studies haveshown that a significant number of risk factors exist forcolorectal adenomas Such as red meat and alcohol,smoking and obesity. In this study we decided thatinvestigate the prevalence of colorectal polyps in



agents in order to overcome the immunosuppressionassociated with advanced malignancy.Send Date: 2011/08/19

Category: 6 COLONIC AND ANORECTAL DIS-ORDERS6.2 Malignant disease - diagnosis/histopathologyT-S-078

Evaluation of P53 gene mutation andabnormal P53 protein accumulation

in colon adenocarcinoma byImmunohistochemistry method

Ashraf Fakhrjoo1*, Seyed KazemMirinezhad2, Kyhan Saefari 1

1 Pathology of Imam Reza Hospital, Tabriz University ofMedical Science2 liver and Gasrointestinal Diseases Research Centre,Tabriz University of Medical ScienceIntroduction: Colorectal cancers and at the head of it,adenocarcinoma is one most frequent causes ofmortality due to cancers in the world. Colorectaladenocarcinoma is accompanied with differentalterations at the genetic level of the cell. amongthem, are mutations of P53 gene. The occurrence ofthis mutation is the introduction of irreversiblemalignant changes of the cells and are diagnostic bydifferent procedures namely immunohistochemistryone. The purpose of this study is the survey onpositive cases of colorectal adenocancinoma, for P53protein by the immunohistochemistry procedure.Method: 100 paraffin blocks with diagnosed ascolorectal adenocarcinoma were collected; and fromall blocks, the 4 micron sections were prepared, andafter deparaffining immunohistochemistry stainingwith the help of antibody single specific anti P53,avidin biotin steroptovidin procedure performed onall specimens. In every specimens nucleus andcytoplasma staining in more than 10% of cells of thespecimens, it was regarded as positive results. In allpositive cases, with segregation the sexes, and in twogroups patients over and under 50 years defined andcompared with the statistic method (chi square).Results: The positive staining was 60% in allpatients, for protein P53. Between two sexes, in allthe rates, there were not any significant statisticdifference. The P53 positive rate in female patientsover 50 years were clearly more than the male

patients over 50 years. (p value=0.03)(orderly were100% and 73.1%). This rate, also, in patients over 50years in both male and female were significantlyhigher than patient below 50 year.Conclusion: The results of our study were as near asthe other previous studies; (among the higer ratebeing in the older patients). According to this study,between two sexes, from pointview of P53 positiverate, there was not any significant difference.(however, in over 50 years age group, this rate wasmore in female). More studies are suggested in futurewith more and newer specimens and also applyingadditional parameters like feeding diets and women'shormone situation.Send Date: 2011/08/08

Category: 6 COLONIC AND ANORECTAL DIS-ORDERS6.2 Malignant disease - diagnosis/histopathologyT-S-079

Synchronous Polyps in patientswith colorectal cancer

Siamak Khaleghi1, Farhad Zamani1,Mehrnaz Rezghi1*, Mehrdokht Najafi1

1 Gastrointestinal & Liver Disease Research Center(GILDRC),Firoozgar Hospital, Tehran University ofMedical SciencesIntroduction: The frequency of synchronousadenomatous polyps in patients with colorectal cancerhas been appraised to be 15%-50%. This study wasperformed to estimate the accompaniment ofsynchronous polyps in patients with colorectal cancer.Method: In this retrospective study, previouslyprepared questionnaires were used to collect theessential information from the medical records ofpatients with colorectal cancer admitted during1999-2009 for whom total colonoscopy has beendone. The information required including age,gender, presence or absence of synchronous polyps,location of polyps, location of cancer, size of polypsand number of polyps were extracted.Results: Totally 173 patients with colorectal cancerenrolled in this study and total colonoscopy revealed52(30.1%) synchronous polyps. The mean age ofpatients was 57±13 years and 53% (92) of them weremale. Rectum with 71(41%) cases was the mostcommon involved area of colorectal cancers,



Send Date : 2011/08/18

Category: 6 COLONIC AND ANORECTAL DIS-ORDERS6.1 Malignant disease - pathogenesisT-S-077

Impaired perforin-dependent NK cellcytotoxicity and proliferative activity

of peripheral blood T cells is associated withmetastatic colon cancer

Hamid Kalantari1, Hadi Ghazanfari2*, NiloofarHassannejad3, Marjan Gharagozloo2, Abbas

Rezaei2, Mohammad reza Marasi 4

1 Department of Gastroenterology and Hepathology, Isfa-han University of Medical Sciences

2 Department of Immunology, Isfahan University of Med-ical Sciences3 Department of Cellular and Molecular Biology, IslamicAzad University, Olum Tahgigat, Tehran4 Department of Biostatistics and Epidemiology, IsfahanUniversity of Medical SciencesIntroduction: Patients with metastatic colon canceroften have defects in the percentage and function ofperipheral blood NK cells, and T cells. The aim ofthis study was to investigate in more detail not onlythe percentage but also the activation status andfunction of NK and T cells in patients with metastaticcolon cancer(n=15) in comparison to controlgroup(n=15).Method: The percentage of peripheral bloodCD3-CD56+ NK cells, and CD3+CD56- T cells aswell as the expression of the perforin within thesecells were analyzed by flow cytometry. Thefunctional capacity of NK cells was evaluated by theflowcytometric cytotoxicity assay, while theproliferative activity of T cells was measured by thelymphocyte proliferation assay (LPA) to mitogenphytohemagglutinin (PHA).Results: The results obtained in this study haverevealed a new aspect of NK and T cell dysfunctionthat is not, as commonly reported about colon cancer.Interestingly, a significant number of the investigatedpatients had a higher percentage of NK cells that didnot lead to improved NK cell cytotoxicity as a resultof the detected defect in the NK cell cytotoxicmechanism of tumor cell lysis. Also, Perforinexpression was decreased in metastatic patients.Moreover, we observed that in metastatic coloncancer patients in comparison to control group wasin hyporeactive status T cell proliferation anddecrease of perforin expression.Conclusion: The novel finding in this study ofmetastatic colon cancer patients in compared withcontrol group is the impaired functional capacity ofNK cell, which was recently shown to be primarilyresponsible for preventing metastasis, andhyporeactive status of T cells, possibly resulting frompersistent antigenic stimulation. Likely, these results arecorrelated with decrease of perforin expression withinNK and T cells. It appears that the observed dysfunctionof NK and T cells in patients with metastatic coloncancer prior to therapy point to the need to supplementchemotherapy with appropriate immunotherapeutic



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Shahryar Semnani1, Hamidreza Joshaghani1,Gholamreza Roshandel1, Mahsa Besharat1

1 Golestan University of Medical Sciences, GolestanResearch Center of Gastroenterology and Hepatology2 Golestan University of Medical SciencesIntroduction: Vitamin D deficiency is common amongpatients with inflammatory bowel disease, even whenthe disease is in remission. This study was designed toevaluate the serum level of 25-hydroxy vitamin D inpatients suffered from ulcerative colitis and the controlgroup in Golestan province, Northeast of Iran.Method: In this case-control study, serum samples of60 patients with definite histopathologic diagnosis ofUlcerative Colitis were recruited. Control group wasselected among healthy blood donor. 25(OH)-D3performed by ELISA method (ids- UK). Data wereentered into SPSS-16 software and analyzed by t-testand Chi-square.Results: The mean serum levels of vitamin D inpatients was significantly lower compared to controlgroup (P-value <0.01). Differences of 25-OH-D3were statistically significant between the two sexes,in both groups. All cases in proctitis group hadnormal vitamin D levels, while only 20% ofrectosigmoiditis group had normal levels of vitaminD and in pan-colitis group, this figure had reached tozero. The difference was statistically significant(P-value <0.01).Conclusion: It can be concluded that serum levels ofvitamin D in patients with ulcerative colitis is low andinflammatory bowel disease can be a target forspecific vitamin D therapy.Send Date: 2011/07/14

Category: 5 IBD5.7 ManagementT-S-075

Effect of vitamin A supplementation onwhite blood cell subtypes in patients

with ulcerative colitisMohammad hossein Somi1, Nasim Abedi

Manesh1*, alireza ostadrahimi2, Beitollah Alipour3

1 Liver and Gastrointestinal Disease Research Center,Tabriz University of Medical Sciences2 Nutritional Sciences Research Center, Tabriz Universityof Medical Sciences3 Health and Nutrition Faculty, Tabriz University of

Medical SciencesIntroduction: Ulcerative colitis (UC) is a disease ofunknown etiology caused by an inappropriatemucosal immune response to antigens from theintestinal flora. Its etiology has not yet been resolved,but immunological and genetic factors are known toplay a very important role. Active UC is oftenassociated with elevated peripheral bloodgranulocytes and imbalanced inflammatory cells(CD4,CD8 Th cells). As these cells are major sourcesof inflammatory cytokines, selective changes of thesecells in patients with UC should alleviate inflammation.According to the anti inflammatory role’s of vitaminA,we decided to evaluate the effect of vitamin Asupplementation on circulatory white blood cell(WBC) subtypes and inflammatory cells in this study.Method: Fourty three patients with ulcerative colitiswere included in a before and after, interventionalsurvey in a university health clinic of Tabriz. Allparticipants were at clinical remission stages. Theseverity of disease activity was assessed by colitisactivity index (CAI).Vitamin A supplement wasinjected twice (50000 IU) with two weeks interval.Study period was considered 45 days. Total WBCcount was performed by using an automatic bloodcell counter. The serum levels of hs-CRP wereevaluated by immunoturbidimetry.CD4 and CD8 Tcells were analysed by flow cytometry.Results: In UC, neutrophil lymphocyte ratio (NLR)and hs-CRP levels positively correlated with CAI (p<0.05).There was a negative correlation between CD4T-cell and CAI (p=0.01).We found no significant ef-fect of vitamin A supplementation on CD4 and CD8T-cell subsets, neutrophil and monocyte count aftersupplementation.NLR and hs-CRP levels decreasednot considerably,while platelet count decreasedsignificantly (p= 0.004).Conclusion: Vitamin A supplementation seems tohave a slight effect on peripheral inflammatory cells.Send Date: 2011/08/18




GpouþÞý×ýQqðlâþôuÇeAuPpxoôcþkoGýíBoAóÞõèýQAèvpôqôAoOHBÉ@óGBÎõAìêkìõâpAÖýàôGBèýñþ

Taghi Amiriani1*, Sima Besharat1, GholamrezaRoshandel1, Mahsa Besharat1, Shahryar Semnani1,

Mohammadzaman Kamkar1

1 Golestan University of Medical Sciences, GolestanResearch Center of Gastroenterology and HepatologyIntroduction: Some mood disorders are moreprevalent in chronic medical conditions compared tothe general population. The relationship betweeninflammatory bowel disease (IBD) and psychiatricdisorders has been raised an area of interest forinvestigation. In this study, we aimed to assess theprobable relationship between depression and diseaseactivity in patients suffered from inflammatory boweldisease (IBD) in Golestan province, Northeast of Iran.Method: During February 2008 to February 2010, fiftypatients recently diagnosed as IBD cases attended toGolestan Research Center of Gastroenterology andHepatology (GRCGH), Northeast of Iran. SimpleClinical Colitis Activity Index (SCCAI) was used toevaluate the disease activity. Beck DepressionInventory (BDI) was used to assess the severity ofdepressive symptoms. Depression was assumed whenthe BDI score was 13 points or higher. Data wereanalyzed using SPSS-16 software. Chi-square andPearson correlation test were used to assess therelationship between variables. P-value less than 0.05considered significant.Results: Sixteen cases (32%) had depressivecharacteristics. Simple Clinical Colitis Activity Indexand Beck score were not significantly differentbetween the two sexes. There was a non-significantcorrelation between Simple Clinical Colitis ActivityIndex, Beck score and age.Conclusion: We reported a relatively high percent ofdepression in IBD patients, although no significantrelationship was seen. Mental health should beconsidered more in the routine evaluation of IBD cases.Send Date: 2011/07/14


Anemia in InflammatoryBowel Disease cases, Northeast of IranTaghi Amiriani1*, Reza Mohammadi1, Sima

Besharat1, Gholamreza Roshandel1,Mahsa Besharat1, Honey Sadat Mirkarimi1

1 Golestan University of Medical Sciences, GolestanResearch Center of Gastroenterology and HepatologyIntroduction: Anemia is a common complication ofinflammatory bowel disease (IBD). One third of IBDpatients suffer from recurrent anemia. Both irondeficiency (ID) and anemia of chronic diseasecontribute most to the development of anemia in IBD.The prevalence of anemia in IBD is high (30%) andprevalence of ID is even higher (45%).Anemia inpatients with IBD results primarily from irondeficiency because of chronic intestinal blood lossfrom inflamed mucosa, although in active diseasemore complex mechanisms involving absorption arealso important. In this study, we aimed to assess theprevalence of anemia in patients suffered from in-flammatory bowel disease (IBD) in Golestanprovince, Northeast of Iran.Method: During February 2008 to February 2010,131 ulcerative colitis patients were registered in theIBD data bank, Golestan Research Center ofGastroenterology and Hepatology (GRCGH),Northeast of Iran; from whom 50 were new cases(less than 2 years past from the diagnosis). SimpleClinical Colitis Activity Index was used to assess theseverity of bowel disease. All 50 cases wererequested to give blood samples. Data were analyzedusing SPSS-16 software. Chi-square and Pearsoncorrelation test were used to assess the relationshipbetween variables.Results: Mean age (±SD) of the studied subjects was38.74 (±15.4) years (range=17-86 years) and they hadmean (±SD) hemoglobin of 12.64± 2.92 gram/dl. Therewas no significant relationship between hemoglobinlevel and the activity index of the disease.Conclusion: There was an acceptable level ofhemoglobin in our IBD patients with no correlation tothe activity of disease, but further studies with largersample size are needed to evaluate this condition.Send Date: 2011/07/14


Serum level of 25-hydroxyvitamin D in Ulcerative colitis

Taghi Amiriani1*, Somayeh Barzanooni1, SimaSedighy2, Sima Besharat1, Afsaneh Borghei2,

Sasan Seyyedein2, Fatemeh Nejhadi Kelarijani1,



syndrome and therapeutic effect of emotionalawareness on the symptoms and severityAlireza Farnam1*, Mohammad Hossein Somi2,

Sara Farhang 1, Nafise Mahdavy2

1 Department of Psychiatry, Tabriz University of MedicalSciences2 Liver and Gastrointestinal Diseases Research Center,Tabriz University of Medical SciencesIntroduction: The strong evidences for the role ofpsychological factors in Irritable bowel syndrome(IBS) are supporting the categorization of thissyndrome as a psychosomatic disorder. Somatizationmay be a key point in its manifestation. We examinedthe role of emotional awareness on the symptoms andthe severity in these patients.Method: Patients were selected according to ROMEIV criteria for IBS and randomly divided to twogroups. Both groups received standard medical carefor the syndrome, while the intervention groups wereeducated to increase conscious awareness about theiremotions and level of arousal after two sessionsfocusing on eight basic emotions. Patients thenrecorded their emotional amalgam, three times a dayfor one month. Severity of pain (measured by visualanalogue scale) and the frequency were recordedbefore and after the intervention.Results: Two groups were matched by gender andage. Patients with IBS scored significantly higher inall aspects of Alexithymia comparing to healthycontrols (Difficulty identifying feelings, difficultydescribing feelings and externally oriented thinking).The mean frequency of symptoms significantlydecreased from 5.4±1.9 to 3.7±2.6 episodes per weekin the intervention group and from 4.9±2.4 to 1.9±2.5in the controls, with a significant effect for the inter-vention. The severity for pain was also decreasedsignificantly in both groups, significantly affected bythe intervention.Conclusion: Emotional awareness may promote theeffects of pharmacological treatment in patients with IBS.Send Date: 2011/07/20

Category: 5 IBD5.5 TreatmentT-S-071Nonadherence to treatment in 500 inflammatorybowel diseases patients; prevalence and reasons

Meghedi Chaharmahali1, Homayoon Vahedi1*,Mohammad Bagheri1, Mohammad Reza Ghadir1,

Shadi Kolahdouzan1, Naser EbrahimiDaryani1, Reza Malekzadeh1

1 Medical Sciences, University of TehranIntroduction: Nonadherence with medication ininflammatory bowel diseases (IBDs) increases therisk of colorectal cancer and clinical relapses. Thepurpose of this study was to find probable reasons ofnonadherence to treatment among IBDs patients in agroup of Iranian patients.Method: In 9 months a total of 500 patients wereenrolled in the study (225males, 275females;150Crohn’s disease (CD), 341Ulcerative colitis (UC),9Intermittent).Patients were interviewed about theirnonadherence behaviors. After collecting answers,we analyzed answers using factor analysis.Results: The overall rate of nonadherence wasreported 33.3 % (27.6%intentional nonadherence,5.7% unintentional nonadherence). (33.6%) had atleast one relapse after discontinuing treatment. Themost reason of intentional nonadherence reported bypatients was: discontinuing the treatment afterrecovering symptoms (42.7%).The most frequentunintentional nonadherence reason was forgetfulness(5.2%). There were patients who didnt visit theirgastroenterologist on time and they just refilled drugsfrom drugstore, which the most reason reported was;these clinics were too far and hard for them to access.We didn’t find any significant relationship betweennonadherence and demographic factors.Conclusion: We expected to find pregnancy as afactor of increasing women’s nonadherence. Butthere was no difference between males and femalesand nonadherence. The reasons for nonadherence aremultiple and widespread. They could be differentform one population to another. If we coulddetermine the reasons of nonadherence then it will bepossible to find the strategies for reducing orpreventing them.Send Date: 2011/08/02


Depressive mood and disease activityin inflammatory bowel disease



The governing committee which consists of a headand 2 other faculty members and an appointedmanager who will be responsible for decisionsregarding budget allocations and use of data. Thedesigned questionnaire includes a consent form, basichistory data, risk factors, related procedures, medicaltherapy, and follow-up data. Establishment processhas two parallel phases: In the first phase, the data iscollected from many sources including annualhospital discharge data, referral from universityaffiliated physicians and private practices, pathologicreports, death certificates, self referral and insurancesystem data. Then registry office contacts patients tobook an appointment. In the interview, thequestionnaire is completed and blood samples aretaken. The gathered data is reviewed for confirmingthe diagnosis of IBD and data are entered in thedesigned and computerized data base. Blood samplesare taken, DNA is extracted and will be kept at -70,another serum sample will be kept at -20°. In thesecond phase, follow up interviews will be done byphone or in person yearly .The new IBD patients arealso being registered. This phase will continueindefinitely to include the new incident cases.Recruitment of the new cases is being done by regularreminders to all referral sources.Results: The Inflammatory bowel disease registry ofShiraz University of medical sciences has started toregister patients whose diagnosis were confirmed tobe Inflammatory bowel diseases.Till now approximately 300 patients have been regis-tered from Fars province.Conclusion: By retrospective and prospective datacollection methods, this central database of IBD caseswill determine incidence, prevalence and demo-graphic characters of IBD in a defined population,facilitate future researches to identify etiology,disease process, new treatment options, factorsaffecting prognosis, recurrences, optimal health care,morbidity and mortality of IBD, and at last but not leastprovide educational and social support for patients byeducational materials and organizing NGOs.Send Date: 2011/08/16

Category: 5 IBD5.3 Genetics

T-S-069MEFV Common Mutations in Iranian

Azeri Turkish Patients with ulcerative colitisMohammad Hossein Somi1*, Morteza Jabbar pour

Bonyadi2, Seyyed Kazem Mirinejhad1,Mohsen Ismayeeli2, Negar Leghayeeyan2,

Maryam Soleimanpour1

1 Liver and Gastrointestinal Diseases Research Center,Tabriz University of Medical Sciences2 Department of Medical Genetic, Tabriz University ofMedical SciencesIntroduction: Ulcerative colitis (UC) and Crohndisease (CD) constitute the two major forms ofchronic inflammatory bowel disease (IBD) withunknown etiology. It is suggested that environmentalfactors and genetic background are important factorsin disease susceptibility and patient's response to ther-apy. Since there are similarities between FMF andIBD, the responsible gene for FMF (MEFV), hasbeen introduced as a modifier gene for IBD.Method: In the present study, 139 unrelated patientsreferred with UC compatible symptoms and also 200matched controls were screened for the five mostcommon MEFV mutations (E148Q, V726A, M680I,M694I, and M694V) by applying PCR-RFLP andARMS-PCR techniques.Results: Thirty one (22.3%) patients and 52 (26%)control individuals had one of the studied mutations.All studied types of MEFV mutations except M694Iand V726A could be detected in the patients. E148Qand V726A mutations were only observed in thecontrol group. E148Q was the most frequent mutationobserved in this cohort. There was a significantdifference between the two groups regarding M694Vmutation (p=0.002).Conclusion: Although the role of M694V mutationin UC susceptibility seems to be significant amongthe Iranian Azeri Turkish patients, studies in a largenumber of UC and control series and also studies onfurther MEFV mutations are needed to determine thedefinite relationship between MEFV mutations and UC.Send Date: 2011/07/20

Category: 5 IBD5.5 TreatmentT-S-070

Alexithymia in patients with irritable bowel



in a group of patients with ulcerativecolitis refering to gastroentrology clinic

Khadijeh Hatami1, Mitra Ameli2*, FatemehKia-kojuri2, Mahmoud reza Khansari1,

Mehrdokht Najafi1, Neda Rabiei1

1 Gastrointestinal & Liver Disease Research Center(GILDRC),Firoozgar hospital, Tehran University ofMedical Sciences (TUMS)2 Department of Gastroenterology, Tonekabon AzadUniversity of Medical SciencesIntroduction: Osteoporosis have been reported butunderestimated in patients with Ulcerative Colitis(U.C). The aim of this study was to evaluatefrequency of low Bone Mineral Density (B.M.D) inpatients with U.C and healthy subjects, and toestimate possible risk factors for low B.M.D, thatdeserves attention in planning treatment programs forthese patients.Method: This is a descriptive cross-sectional study.Two groups, 33 patients (mean age and SD:42.9±15.8), Male/Female ratio: 1/3 and 33 age, sexmatched healthy subjects were studied. B.M.D,relative to age standardized mean (z-score) wasmeasured by dual energy X-ray absorptiometry at thelumbar spine and left femoral neck, in patients andcontrols and results of B.M.D were compared.Patients were divided in the following groups:patients with osteoporosis (Z<=-2), osteopenia(-2<Z<=-1) normal(Z and>-1). Assessment of CRP,Hemoglobin, Body Mass Index (B.M.I), duration andextension of disease, crypt distortion in microscopicexam and the effect of taking Azathioprine andcorticosteroid was performed in all 3 groups andresults were compared. Data were analyzed by SPSSsoftware using non parametric method.Results: The rate of Osteopenia and osteoporosis was36.6% and 24.24% respectively in U.C. group versus27.27% and 3.03% in controls (p=0.005). In U.C.group femoral neck B.M.D was significantly lowerthan healthy subjects (p=0.04). Patients takingAzathioprine had significantly higher B.M.D thanpatients who were not.None of other possible riskfactors which were assessed showed significantdifference between B.M.D of osteoporotic,osteopenic and normal cases.Conclusion: Patients with U.C have reduced B.M.Din femoral neck. We found lower B.M.I in U.Cpatients compared to healthy subjects, but we didn’t

find significant correlation between low B.M.I as apredictor of low B.M.D in U.C patients. B.M.D ishigher in patients taking Azathioprine probably byincreasing duration of remission.When planningmanaging programs, evaluation of femoral neckB.M.D is recommended in patients with U.C, this ismore important in patients who are not takingAzathioprine.Send Date: 2011/08/07

Category: 5 IBD5.2 Etiology/epidemiologyT-S-068

Establishment of a Population-BasedRegistry of Inflammatory Boweldiseases in Fars, Kohgilooye and

BoyrAhmad, South Provinces of IranSeyed Alireza Taghavi1*, Kamran Bagheri Lankarani2,

Mohammadreza Fattahi3, Maryam Moini1, LalehHamidpour1, Maryam Ardebili3, Zahra Mansoorabadi3

1 Gastroenterohepatology Research Center, ShirazUniversity of Medical Sciences2 Health Policy Research Center, Shiraz University ofMedical Sciences, Shiraz, Iran3 Gastroenterohepatology Research Center, ShirazUniversity of Medical Sciences, Shiraz, IranIntroduction: Inflammatory bowel diseases (IBD)are debilitating diseases that lead to a variety ofproblems in patient’s everyday life as well as a hugeburden for the health care system. Since this group ofdiseases are multifactorial and complex, long-term,longitudinal studies are clearly needed for their betterunderstanding. A Population–Based Registry coversall residents in a given geographic area within a giventime period. It intends to include all with the diseasein the population. Even if it fails to include “all”cases, intention rather than performance defines theterm. The aim of establishing this registry is to builda reliable data source which will be of considerablehelp in future planning of the health care resourcesneeded to deal with IBD and to enable theinvestigators to test their theories on origin and/ortreatment of the diseases.Method: Registry is managed by gastroenterohepatologyresearch center (GEHRC) at Shiraz University ofMedical Sciences. The geographic area is twoprovinces of Iran, Fars, Kohkilooye and BoyrAhmad,



3 Health and Nutrition Faculty, Tabriz University ofMedical SciencesIntroduction: vitamin A deficiency in patients withinflammatory bowel disease (IBD) is contributing todefective intestinal homeostasis. To assess serumretinol and its correlation with disease activity.Furthermore to determine the correlation of serumretinol and systemic inflammatory cells numbers withclinical disease activity.Method:A total of 48 patients with ulcerative colitis(UC) were enrolled in to the cross-sectional pilotstudy.Patients were in remission according to theTruelove-Witts scale. Serum retinol was assessed byHPLC. Heparinized blood samples were collected forcomplete blood count and lymphocyte phenotypingby flow-cytochemistry and flow-cytometric analysisrespectively.Results: Approximately 55% of our patients were VAdeficient (serum retinol < 30 µg/dL).Serum retinollevels were negatively correlated with clinical diseaseactivity (p=0.033 , r=- 0.329).There was a positivecorrelation between serum retinol and peripheralCD4+ and CD8+ numbers (r=0.355, r=0.335)respectively. Neutrophil to lymphocyte (N/L) ratioand percentage of neutrophil were directly associatedwith disease activity while there was a significantnegative correlation between systemic CD4+ T cellnumbers and disease activity.Conclusion: Mild vitamin A deficiency is commonin ulcerative colitis in remission and there is anassociation between serum retinol and clinical diseaseactivity; likewise, the correlation between systemicinflammatory cells numbers and disease activity isnoticeable.Send Date: 2011/08/18

Category: 5 IBD5.2 Etiology /epidemiologyT-S-066

A Case-Control study on the riskfactors of IBD in Iranian patients

Homayoon Vahedi1*, Meghedi Chaharmahali1,Shabnam Momtahen1, Shadi Kolahdouzan1, Golrokh

Olfati1, Tahmineh Tabrizian1, Shadi Rashtak1,Reza Khaleghnejad1, Siavash Naserimoghadam1,

Fatemeh Malekzadeh1, Reza Malekzadeh1

1 Medical Sciences, University of TehranIntroduction: Ulcerative colitis (UC) and Crohn’sdisease (CD) are chronic inflammatory bowel diseases(IBD) with uncertain etiology thought to be triggered byinteractions between various environmental, genetic andimmunologic factors. Role of different risk factors inIBD are controversial.Method: The aim of this study is to determine thepossible risk factors in a group of Iranian patientswith IBD. One hundred and sixty-three consecutivecases of UC and 95 cases of CD were included. Ageand sex matched controls were randomly selected. Atotal of 489 controls for UC and 285 controls for CDwere enrolled. A standard record concerningdemographic and characteristic features, BMI, infantilenutrition, smoking habit, measles in childhood, measlesvaccination, history of appendectomy and tonsillectomy,OCP, and drugs use was completed. Logisticregression analysis was used to evaluate potentialconfounding variables.Results: A statistically significant protective effectfor smoking in UC was found (OR=0.1895%CI=0.064-0.504, p<0.05). The risk of UCincreases with prolonged exposure to OCP (OR=0.99,95%CI=0.98-0.99, p<0.05). In patients with CD, 15cases (15.8%) reported a previous history ofappendectomy compared with 19 controls (6.7%)(OR=2.6, 95% CI= 1.2-5.4, p<0.05). Tonsillectomywas reported by 16 patients (16.8%) with CD com-pared with 25 controls (8.8%) (OR= 2.1, 95% CI=1.07-4.1, p<0.05). The logistic regression analysisshowed that both appendectomy and tonsillectomyare risk factors in CD. No association with othervariables was found for either disease.Conclusion: Current smoking was a significantprotective factor in UC. We observed a relationshipbetween duration of OCP use and UC. Duration ofusing OCP in UC cases was significantly more thancontrols. Both appendectomy and tonsillectomy wererisk factors in CD in this study.Send Date: 2011/08/02

Category: 5 IBD5.2 Etiology /epidemiologyT-S-067

Osteoporosis: frequency and risk factors



evaluate the correlation between serum 25(OH)Dconcentration of IBD patients with IBD activity.Method: Sixty patients who had confirmed diagnosesof IBD were recruited for a cross sectional study.Most of the identified factors that can interfere serum25 (OH) D concentrations were considered andexcluded. Disease activity assessed using validatedquestionnaires, Including Truelove for UlcerativeColitis and crohn disease activity index (CDAI) forCrohn’s. Serum 25 (OH) D concentrations weredetermined by chemiluminescent assay.Results: Mean serum 25(OH) D was 13.1 ±11.1(ng/ml) in IBD patients in our study. Almost 95%of patient were vitamin D insufficient or deficient(<30 ng/ml). Forty one percent of IBD patients hadactive disease. Vitamin D deficiency was notassociated with IBD activity. )p=0.238 withchi-square test).However, vitamin D deficiency wassignificantly associated with having IBD relatedsurgeries. (p=0.001 with T test).Conclusion: Although most of our patients had inad-equate vitamin D, serum vitamin D concentration wasnot associated with disease activity. However, vita-min D deficiency was associated with surgical treat-ment in these patients.Send Date: 2011/07/20

Category: 5 IBD5.1 Basic/pathogenesis/pathology/T-S-064

Correlation between immunologic markersof ulcerative colitis and psychological distress

Hafez Fakheri1, Mehran Zarghami1*

1Zare Hospital, Mazandaran University of Medical SciencesIntroduction: Many studies have investigated theeffects of psychological factors on disease activity inpatients with ulcerative colitis (UC). On the otherhand, some studies have shown a correlation betweensome immuno-biological markers such as perinuclearantineutrophilic cytoplasmic antibody (P-ANCA) andsome distinct psychobiologic subtypes in UC, but theresults are inconsistent. If this correlation exists, thepresence of these biomarkers can help in selectingthose patients who need more psychological care andalso may explain why some studies failed to show therelationship between disease activity and psycholog-

ical distress. So, we designed a study to determine theassociation between 2 immuno-biological markers(p-ANCA and c- ANCA) and depressive symptoms,healthy anxiety and personality traits.Method: One hundred and eight patients with UCentered the study. P-ANCA and c-ANCA weredetermined by Enzyme-Linked ImmunosorbentAssay (ELISA). Depressive and anxiety symptomand personality traits were measured by Center forEpidemiologic Studies-Depression (CES-D) scale,Hospital Anxiety Depression (HAD) scale andRevised Eysenck Personality Questionnaire,respectively. Pearson correlation was used to assessthe relationship between p-ANCA/c-ANCA andpsychological distress.Results: Our results showed that 81.5% of the patientssuffered from anxiety, 43.5% suffered from depressionand 75% suffered from introvert personality.No patient was positive for p-ANCA. Sixteen patients(14.8%) had positive c-ANCA test, but the correlationbetween positive c-ANCA and anxiety, depression orintrovert personality was not statistically significantand did not statistically differ between those with orwithout positive c-ANCA test.Conclusion: According to our results, the presenceof c-ANCA could not distinguish a specialpsychological subtype of the patients. Since nopatient was positive for p-ANCA, the correlationbetween positive p-ANCA and psychological distresscould not be assessed. However, the high prevalenceof anxiety, depression and introversion and their rolein the clinical course and outcomes of the diseaseshows the need for early psychological interventionin those with UC.Send Date: 2011/08/17


Serum retinol in ulcerative colitis : correlationwith disease activity and inflammatory cellsMohammad hossein Somi1, nasim abedi manesh1*,

alireza ostadrahimi2, Beitollah Alipour3

1 Liver and Gastrointestinal Disease Research Center,Tabriz University of Medical Sciences2 Nutritional Sciences Research Center, Tabriz Universityof Medical Sciences



41 (54%) out of them had normal bone density inspine and 17(23.6%) had osteopenia and 14 patients(19.4%) had osteoprosis. In femoral neck 36 patients(50%) had normal bone densitometry and 25 (33.3%)patients had osteopenia and 11(15.3%) patients hadosteoporosis.Conclusion: The prevalence of osteoporosis amongceliac disease is much higher than general population(48%) .The prevalence of osteoporosis is high enoughto justify a recommendation for screening of allpatients with celiac disease for osteoporosis.Send Date: 2011/08/15

Category: 4 INTESTINAL4-2 Coeliac disease/malabsorption syndromes andfood enteropathiesT-S-062

The prevalence of Celiac Disease in Iranianchildren with Functional abdominal pain

Vajiheh Modaresi1*, Fatemeh Farahmand2,Seyedeh Zalfa Modarresi3

1 Yazd Shohada-e-kargar hospital, Yazd Medical IslamicAzad University2 Division of Pediatric Gastroenterology and Hepatology.,Children Medical Center,Tehran University of MedicalSciences3 Immunology, Asthma and Allergy Research Institute,Tehran University of Medical SciencesIntroduction: Celiac disease (CD) is a chronicinflammatory disorder of the small intestine inducedin genetically susceptible people by the irritant glutenand possibly other environmental cofactors. It ischaracterized by a diverse clinical heterogeneity thatranges from asymptomatic to severely symptomatic.However, clinical features of Iranian children withCD are still unknown and there is scant informationabout atypical presentation of celiac disease (CD)from Iran. The aim of this study was to determineprevalence of CD in Iranian children with chronicrecurrent abdominal pain (RAP) or functionalabdominal pain (FAP).Method: In this cross-sectional study, 301 childrenaffected by functional abdominal pain (FAP) werescreened for CD by antitransglutaminase antibody(tTG IgA). These antibodies were measured by enzymelinked immunosorbent assay. Diagnosis of CD wasconfirmed by duodenal biopsy that was scored according

to the Marsh classification in cases that were positivefor tTG antibody.Results: A total of 301 children (138 male, 163female) with (FAP) were studied. Endoscopicduodenal biopsy was taken for patients with positiveand borderline tTG test. Two out of 301 cases wereIgA deficient and celiac disease was suspected forone of them based on histological findings. Fourteenout of 299 patients with normal IgA had abnormaltTG titer; intermediate ranges (16-23 U/ml) andpositive ranges (=or>24 U/ml) were detected in 6 and8 cases, respectively. CD was suggested in 2 out of 6patients with intermediate and 2 out of 8 patients withpositive ranges of tTG (1.33% based on histologicalfindings).Conclusion: The prevalence of celiac disease inchildren with FAP is estimated 1.3% (nearly 2 timeshigher than normal population in Iran). It can berecommended that all children with FAP should bescreened for celiac disease particularly in those withlower growth curve.Send Date: 2011/07/27


The association between serum 25 (OH)vitamin D concentrations and

inflammatory bowel diseases (IBD) activityHassan Vossoughinia1, Siavash Abedini1* , AhmadKhosravi-Khorashad1, Maryam Sahebari1, Farid

Farrokhi2, Keyvan Haghighi2, Asieh Hatefi1, JavadPournaghi1, Hamid-Reza Sima1, Abbass Esmaeizadeh1,

Hassan Saadatnia1, Faraneh Abdolhosseinpour3

1 Medicine Faculty, Mashhad University of Medical Sciences2 Pathology Department, Razavi Hospital3 Dentistary Faculty, Mashhad University of Medical SciencesIntroduction: Inflammatory bowel diseases (IBD)are probably immune mediated diseases of unknownetiology affecting the gastrointestinal tract. Inaddition to genetic susceptibilities, one of theimportant environmental factors contributes toautoimmune diseases like IBD is vitamin D.Furthermore, the evidence points to vitamin Ddeficiency and its receptor dysfunction causeexacerbation of experimental IBD .Our aim was to



Category: 4 INTESTINAL4.2 Coeliac disease/malabsorption syndromes andfood enteropathiesT-S-060

Prevalence of Celiac Disease in Type 1 Diabeticchildren and adolescents in Eeast Azarbaijan

Robabeh Ghergherehchi1*, Mandana Rafeey1

1 Liver and Gstrointestinl Research Center, TabrizUniversity of Medical SciencesIntroduction: Celiac disease (CD) is a chronicenteropathy caused by hypersensitivity to gluten.Most studies have shown more prevalence of CD inthe patients with Diabetes Mellitus type 1. Theprevalence of CD among DM1 patients is unknownin Iranian children. The aim of this study is theprevalence survey of celiac disease in type 1 diabeticchildren in East Azarbaijan.Method:In a cross-sectional descriptive study, basedon entrance and exit criteria 135 children withDiabetes Mellitus type 1 referring to Tabriz childrenhospital endocrine department and clinic from2006 to 2008 were selected. The serumic level ofA-tTG-A-IgA and AEA-IgA were measured. In thecase that A-tTG-A either AEA was high, distal duo-denal biopsy was preformed. The data was analysedusing SPSS, ver 16 software.Results: 28 of 135 patients with diabetes mellitustype 1, were serologically positive for celiac. Four of28 (%14.28) seropositive paitients were A-tTG-Apositive, Ten (%35.71) of them were AEA positiveand Fourteen (%50) were A-tTG-A and AEApositive. Confirmed celiac prevalence based onbiopsy was %6.8.Conclusion: Celiac Disease in diabetic patients(DM1) is common. Screening of celiac disease withserologic tests in diabetic patients is necessary for thepurpose of early diagnosis and prevention fromsevere complications of celiac disease.Send Date: 2011/08/05

Category: 4 INTESTINAL4.2 Celiac disease/malabsorption syndromes and foodenteropathiesT-S-061

Prevalence of osteopenia and osteoporosisin Patients with celiac disease

Azita Ganji1*, Mohammad Reza Hatef1, Abbas

Esmaeilzadeh1, Seyedezahra Mirfeizi1, GobadAbangah1, Ali Mokhtarifar1, Hassan Saadatniya2,

Hassan Vosoghiniya3, Ahmad khosravi3,Abdolrasol Hayatbakhsh4

1 Imam Reza Hospital, Mashhad University of MedicalSciences2 Ghaem Hospital, Mashhad University of MedicalSciences3 Ghaem Hospital, Mashhad University of MedicalSciences4 Imam Hossein Hospital, Mashhad University of MedicalSciencesIntroduction: Celoac disease is an autoimmunedisorder which cause malabsorption in geneticallysusceptible patients with ingestion of gluten. Celiac isnot limited to gastrointestinal system and can makedifferent sign and symptom in other organs.Malabsorption of calcium and vitamin D can causeosteomalacia and secondary hyperparathyroidism .Celiac is not a rare disease anymore and are morefrequent in middle east. We expect to have 1% ofceliac in general population. The aim of this studywas to determine Prevalence of osteopenia and os-teoporosis in patients with celiac disease in Iranianpopulation.Method: Individuals with intestinal and extaraintestinal problem who had positive serologic testingfor antitissue transglutaminase or antiendomysialantibody were offered endoscopic duodenal biopsyto confirm the diagnosis of celiac disease .Biopsyproven celiac patients between 20 to 70 y/o of anysex were enrolled. Exclusion criteria was :1) Usingdrugs such as corticosteroid, anticonvulsant ,heparin,cyclosporine, statins , B blocker, 2) Neoplasms 3)Metabolic disorder such as diabetis , hyperthyroidism, cushings and immobility. After taking informedconsent ,we evaluated 71 patients with celiac disease. All enrolled patients had undergone BMDmeasurement of the hip, femoral neck, and spineusing dual-energy x-ray absorptiometry using aQDR-4500W densitometer (osteocore 2,) with bonedensitometry with DEXA scan . Routine laboratorytests, including a complete blood cell count, serum25-hydroxyvitamin D, parathyroid hormone (PTH),and alkaline phosphatase, were performed.Results: 72 patients with celiac disease between 20 to70 years old with mean age of 33 years old had bonedensitometry. 66 % were female and 33% were male.



for celiac disease befor marked as IBS.Send Date: 2011/07/21


The Efficacy of Herbal Medicine" Lax-asab" in Treating Constipation-aRandomized Controlled Clinical Trial

Mohammad-Hossein Somi1, Masood Bagheri1*,Zahra Rashe1, Morteza Ghojazadeh2

1 Liver and Gasteroenterology Diseases Research, TabrizUniversity of Medical Sciences2 Physiology Department of Medical Faculty, TabrizUniversity of Medical SciencesIntroduction: Chronic constipation is a commondisorder and its treatment is unsatisfactory in manypatients.We designed this study to introduce a newherbal protocol (Lax-asab) for treatment of chronicconstipation which has higher efficacy and lower sideeffects and price in comparison with other currentlyavailable chemical and herbal protocols.Method: 40 patients with chronic constipation fromEmam Reza academic hospital in Tabriz-Iran wererandomly enrolled.Data was collected by check listsand the efficacy of "lax-asab" was compared withplacebo and determined by a symptom scale duringand after stopping the study.We use Descriptivestatistics,Chi-square and Fisher's Exact test bySPSS.16.Results: Mean of weekly defecation times inintervention group was 5.33±0.7 and in placebo was2.14±0/69 (p=0.012).Diarrhea side effect was 0.66 inintervention group (p=0.09).Other side effects wasnot seen in both of them.Conclusion: Our study show we can use thisexperimental herbal drug in treating patients withchronic constipation with high efficacy, low sideeffects and price.Send Date: 2011/07/21


Normal total Duodenal IntraepithelialLymphocytes, CD3+ and CD8+ T-Cells

in Celiac Patients of Isfahan, IranMohammad Hassan Emami1*, Morad Masjedi2,

Hadi Hossein Nattajarab3, FereshtehSahebfosoul2, Mojgan Mokhtari4

1 Poursina Hakim Research Institute, Department ofGastroenterology, Isfahan University of Medical Sciences2 Department of Immunology, Isfahan University ofMedical Sciences3 Iranian Celiac association4 Poursina Hakim Research Institute, Department ofPathology, Isfahan University of Medical SciencesIntroduction: Although increased numbers ofduodenal intraepithelial lymphocytes (IEL) is a keyhistological finding in celiac disease (CD), this mayvary by the geographic area and type. There are someborderline histology and sero-negative CD caseswhich might be differentiated with other causes ofduodenal immunological reactions by measuring themean percentages of IEL expressing abTCR, gdTCR,CD3, CD4, and CD8. This study was conducted tomeasure and compare total and CD3 + and CD8+ IELin celiac patients and healthy controls in Isfahan, Iran.Method: Definite CD patients (17 cases) andage- and sex-matched healthy controls (22 cases)were included and duodenal biopsies were taken.H&E staining was done and monoclonal antibodieswere used by immunoperoxidase staining method.Results: The immunoperoxidase staining showedhigher mean of total IEL in CD cases compared withcontrols (40 vs. 19, P = 0.001). The upper normallimit of CD3+ intraepithelial T-cells was 20% whileit was 14% for CD8+ T-cells. In addition, The H&Estaining method showed cut-off of 34% for IELs inCD cases.Conclusion: This study suggests that total IEL of >34% and CD3+ IEL > 20% by immunoperoxidasestaining technique, might be considered as MARSHI among general population in Isfahan, Iran. Sincethis cut-off level may differ according to the subtypeof IEL, genetic backgrounds, and by changingsocioeconomical status, it is logical to determine nor-mal values in each area and to use immunoperoxidasestaining technique to measure subtypes of IEL insuspicious cases of CD.Send Date: 2011/08/05



BAO (33pts.) AMO (32 pts.) with response rate about67%, 87%, 81%, respectively. [p-value =0/003] {Chisquare test}.Conclusion: The intention-to-treat H pylorieradication with routine regimen BTMO is less thanother quadruple therapy in this local study. So furtherinvestigation need for best regimen with the mostresponse rate in Shiraz city.A=Amoxicillin B=Bismuth M=MetronidazoleT=Tetracycline C=Clarithromycin O=OmeprazoleSend Date: 2011/08/22

Category: 4 INTESTINAL4.1 Enterocyte biology/pathology and nutrient/watertransport/electrolyte transportT-S-056

The effects of vitamin E on smallintestine mucosal injuries in burned rats

Shahsanam Gheibi1*, MojtabaKarimipour2, Ali Soleymany2

1 Motahhary Hospital, Urmia University of Medical Sciences2 Medical College, Urmia University of Medical SciencesIntroduction: Vitamin E is a fat soluble agent thatprotects cells from damage of free radicals byneutralizing them. The aim of this study was theevaluation of vitamin E effects on small intestinemucosal changes in burned rats.Method: Mature male rats (n=32) with weight rangeof 260 ± 10 gram were used. After induction ofgeneral anesthesia, a determined area of the skin ofthe back region was exposed to 95ºC water for 8seconds in order to producing wet burns. Theevaluated four groups in our study were: rats withoutburning, rats without burning treated with vitamin E300 mg/kg/day till 15 days, burned rat without med-ication and burned ones treated with vitamin E 300mg/kg/day till 15 days. All of the rats wereeuthanized at the fifteenth day by ether inhalation.The samples were prepared from the beginning ofsmall intestine and were smeared by Hematoxylinand Eosin staining.Results: Statistical analysis revealed that in theburned rats received vitamin E, intestinal villuseswere higher than the burned ones without vitamin Etreatment, and this was near to results of unburnedrats and this was statically significant (p<0.05). Alsothe intestinal lumen diameter in burned rats

medicated by vitamin E was lower than the burnedones without medication (p<0.01). There were nosignificant differences between study groups inintestinal diameter and muscular layer thickness.Conclusion: The results show that vitamin E iseffective on intestinal villuses height and lumendiameter and its consumption at the time of burningcan protect intestine mucosa from injuries.Send Date: 2011/06/04


The prevalence of celiacdisease in patients with IBS

Aliakbar Shayesteh1*, Seyed Jalal Hashemi1, EskandarHajiani1, Abdolrahim Masjedizadeh1, Mehdi Shayesteh1

1 GI ward, Ahvaz - Jondishapoor universityIntroduction: The prototype of diffuse smallintestinal disease which presents with malabsorptionis Celiac disease (Celiac disease). Typical formpresents in childhood, but atypical forms are morecommon in adults & may presents with intestinal &extra intestinal manifestations. One of the intestinalpresentations, common in general population, is simulation of Irritable bowel syndrome (IBS). The aimof this study was to determine the value ofAntiendomysial Ab IgA in predicting celiac disease inpatients with IBS.Method: Patients full fill the Rome 3 Criteria fromApril 2007 -2009 in subspecialty clinics of AhvazJundisapur University of medical sciences enter thestudy. After exclusion of differential diagnosis of IBSscreening for CD were done by Anti tTG IgA & Antigliadine Ab IgA. CD was confirmed by duodenalbiopsy according to the modified Marsh classificationin patients with positive test results. The data wascollected & analyzed by x2 & t- test by SPSS version 19.Results: 465 patients entered the study, 40 & 31 ofthem had positive test for Anti gliadine Ab IgA &Anti tTG IgA respectively .Biopsy of 2nd portion ofduodenum showed marsh 1 or greater in 11 patients.All of them responded to gluten free diet.Conclusion: Celiac disease is a common conditionin patients with IBS. All patients should be screaned



received the same quadruple therapy (for 2 weeks Cgroup), Eradication was assessed 4-6 weeks aftercompletion of treatment by H pylori stool antigenassay.Results: The rate of H. pylori eradication in groups Aand B was 66.7% and 82.1% respectively (p =0.062).The rate of H. pylori eradication in groups Band C were similar; 82.1% and 82.3% respectively (p= 0.987).Conclusion: Na Diclofenac seem to be effective inshortening two weeks anti H Pylori regimens. Moreinvestigations must be done to better clarify theefficacy of NSAIDs for this purpose.Send Date: 2011/07/31

Category: 3 H.PYLORI3.5 Management strategiesT-S-054

Comparative of standard 14-day and 7- dayfor eradication of Helicobacter pylori

Akbar Arjmandpoor1*, Fariba Arjmandi2,Leila Adhami1, Mohammad Minakari3

1 Gastroenterology Department, Faculty of Islamic AzadUniversity Najafabad Branch, Isfahan, Iran.2 Community medicine specialist, Faculty of Islamic AzadUniversity Najafabad Branch, Isfahan, Iran.3 Gastroenterology Department, Faculty of Isfahan Uni-versity of Medical Sciences, Isfahan, Iran.Introduction: Although quadruple combinationtherapy containing a proton pump inhibitor (PPI) andthree antibiotics is considered as a standard regimenfor the first-line anti-Helicobacter pylori treatment,there are still debates on the ideal duration oftreatment. Shorter treatment duration should improvecompliance to therapy and keep an acceptable H.pylori eradication rate. The aim of this study was tocompare the efficacies of 7-day and 14-day quadrupletherapy.Method: 116 patients were randomly assigned to twotreatment groups. 62 patients received quadrupletherapy (Azithromycine 250 mg ,Amoxicillin 500mg, Bismuth subcitrate 250 mg and Omeprazole 20mg) bid for 2 weeks (A group), 54 patients receivedthe same dosage of those agents for 1 week (B group)Eradication was assessed 4-6 weeks after treatment bystool antigen assay. Infection was considered eradicatedif patients tested negative.

Results: The rate of H. pylori eradication in groupsA(14- day) and B(7- day) was 82.3% and 66.7%respectively (p=0.053). The cure rates in the standard14 days treatment was better than standard 7 daystreatment.Conclusion: A 7-day quadruple therapy withAzithromycine, Amoxicillin, Bismuth subcitrate, andOmeprazole is not effective for eradication ofH. pylori compared with the standard 14-dayquadruple therapy.Send Date: 2011/07/31


Comparison between different regimenfor H pylori eradication in Iran-shirazMaryam Hasanzarrini1*, Maryam ardabili1

1 Gasteroenterohepatology research center, shirazIntroduction: Helicobacter pylori is a gram-negativeorganism that induces gastric infection. The infectioncauses chronic gastritis and may lead to peptic ulcerdisease (PUD). H pylori is also associated withgastric adenocarcinoma and low-grade gastriclymphoma, referred to as mucosa-associatedlymphoid tissue (MALT) lymphoma. Eradication ofthe infection will prevent the recurrence of themajority of such disease. Multiple regimens havebeen evaluated for Helicobacter pylori therapy butthe optimal therapeutic regimen has not yet beendefined. We evaluated different combined treatmentin Iran – from 1388 to1390 in the patients who wasreferred to Namazi Hospital.Method: 952 patients who as APD (NUD, DU, GU)were treated with different regimen(single .double,triple, quadruple drug) for H pylori and then referredto Namazi hospital for confirmation of eradicationwith UBT were evaluated.Results: 952 patients who were enrolled in H pylorieradication test (UBT), most of them were in BAMOgroup (108 pts.) with response rate about 75.5% .[p- value=0/003] Other groups contain BTMO(31pts.) BACO (25 pts.) BAFO (10 pts.) withresponse rate about 80%, 88%, 90% respectively.[p-value=0/003]. From the patients who receivedtriple therapy, most of them were in BMO (34 pts.)



considering type of peptic ulcer in the two groups.The compliance was “complete”, ‘good” or “poor” in94.7%, 1.3% and 4% in group A and 96%, 1.3% and2.7% in group B respectively (p=0.91). HP waseradicated in 89.3% in group A and 85.3% in group B(P=0.31). There was no significant difference inH.pylori eradication and compliance rates in the twogroups.Conclusion: According to our study, we couldconclude that there’s no superiority using four drugregimen based on Ofloxacin compared toAzithromycine based regimens but the eradicationwas higher than 85% in each group. Each regimencould be prescribed considering drug complicationrates in different patients.Send Date: 2011/07/20


Comparative of standard anti Helicobacterpylori therapy with and without N-Acetylcysteine

Akbar Arjmandpoor1*, Fariba Arjmandi2,Hajar Amiri1, Peyman Adibi3

1 Gastroenterology Department, Faculty of Islamic AzadUniversity Najafabad Branch, Isfahan, Iran.2 Community medicine specialist, Faculty of Islamic AzadUniversity Najafabad Branch, Isfahan, Iran.3 Gastroenterology Department. Faculty of IsfahanUniversity of Medical Sciences, Isfahan, IranIntroduction: For eradication of helicobacter pylori(H. pylori), many regimens is offered. H. pylori isresistance to Metronidazole and duration of treatmentis long. N-Acetylcysteine is sulfidrile component andmucolytic effect. It decreases stomach's mucousbarrier and viscosity and increases efficacy ofantibiotics.Method: 173 patients were randomly assigned tothree treatment groups. 54 patients receivedquadruple therapy (azithromycine 250 mg ,amoxicillin 500 mg, bismuth subcitrate 250 mg andomeprazole 20 mg) bid for 1 weeks (A group), 57patients received the same dosage of those agentsplus N-Acetylcysteine tab 600 mg for 1 week (Bgroup) and 62 patients received the same dosage ofthose agents for 1 week (A group). Eradication wasassessed 4 weeks after treatment by stool antigen

assay. Infection was considered eradicated if patientstested negative.Results: The rate of H. pylori eradication in groups Aand B was 66.7% and 66.7% respectively (p=1). Therate of H. pylori eradication in groups A and C was66.7% and 82.3% respectively (P= 0.053). The rateof H. pylori eradication in groups B and C was 66.7%and 82.3% respectively (P= 0.053). The cure rates inthe 7days+ N-Acetylcysteine treatment was notsignificantly different with standard 7 and 14 treatment.Conclusion: N-Acetylcysteine is mucolytic agent. Itcan to decrease stomach's mucose barrier andviscosity and increases efficacy of antibiotics. Butaccording to this study, this treatment method don’thave significant different with others methods.Send Date: 2011/07/31


The efficacy of NSAIDs in shortening theH Pylori eradication period

Akbar Arjmandpoor1*, Hamed Daghaghzade2,Hojat Alah Rahimi3, Fariba Arjmandi4,

Mohammad Hassan Emami3

1 Gastroenterology Department, Faculty of Islamic AzadUniversity Najafabad Branch, Isfahan, Iran.2 Gastroenterology Department, Faculty of IsfahanUniversity of Medical Sciences, Isfahan, Iran.3 Gastroenterology Department, Poursina Hakim ResearchInstitute4 Community medicine specialist, Faculty of Islamic AzadUniversity Najafabad Branch, Isfahan, IranIntroduction: Helicobacter pylori (H. pylori)colonizes not only on the surface of mucousmembrane but also beneath the surface mucous gellayer (SMGL). Since Na-Diclofenac decreases thesecretion of SMGL, we examined this drug as anadjuvant therapy to a quadruple therapy for H Pylorieradication.Method: One hundred and seventy-two patients wererandomly assigned to three groups. 54 patientsreceived azithromycine 250 mg , amoxicillin 500 mg,bismuth subcitrate 250 mg and omeprazole 20 mg)BID for 1 week (A group) and 65 patients receivedthe same dosage of those agents plus Na Diclofenactab, 100 mg daily for 1 week (B group). 62 patients



Category: 3 H.PYLORI3.5 Management strategiesW-F-050

Comparison of helicobacter pylorieradication rate with four different

quadruple regimens in dyspeptic patients.Ebrahim Fattahi1*, MohammadHossein Somi1,

Ali Gavidel1, Alireza Ghamghar1, AsrafFaghrjo2, Shahnaz Naghashi1

1 Liver and Gastrointestinal Diseases Research Centre,Tabriz University of Medical Sciences2 Department of Patology of ImamReza Hospital, TabrizUniversity of Medical SciencesIntroduction: Helicobacter pylori (HP) wasdiscovered long time ago, but it has only been in thepast several years that the diagnosis and treatment ofthis organism has gained wide acceptance. Theoptimal regimen should have high efficacy, tolerableside effects, simple dosage and should be economical.Intensive efforts are being made to identify such anoptimal regimen, but there are many obstacles hin-dering the achievement of this goal. This study aimedat comparing the rate of HP eradication with 4quadruple regimens in dyspeptic patients.Method: In this open-label randomized clinical trial,270 patients with positive rapid urease test resultwere randomized in these four groups: the group “A”who received omeprazole+amoxicillin+bismuthsubcitrate+clarithromycin for 2 weeks (73 patients);the group ‘B” who received omeprazole+tetracy-cline+bismuth subcitrate+metronidazole for 2 weeks(46 patients); the group “C” who received omeprazole+amoxicillin+bismuth subcitrate+furazoli-done for 2 weeks (64 patients); and the group “D”who received omeprazole+amoxicillin+bismuthsubcitrate+furazolidone/metronidazole interchange-ably each one for one week (87 patients). Six-weekafter treatment halt, the compliance, eradication andcomplication rates were evaluated in each group.Results: The compliance was “complete”, ‘good” or“poor” in 83.6%, 11% and 5.5% in group A, 87%,6.5% and 6.5% in group B, 90.6%, 4.7% and 4.7%in group C, and 86.2%, 11.5% and 2.3% in group D,respectively (p=0.683). HP was eradicated in96.3%,87%, 79.7% and 79.3% of the patients in groups A, B,C and D, respectively (p=0.506). Overallcomplications were present in 37%, 63%, 32.8% and28.7% of patients in groups A, B, C and D,

respectively; significantly higher in group B(p=0.001). Abdominal pain was significantly morefrequent in group B comparing with the other groups.Vomiting was reported significantly more frequent ingroup C comparing with the other groups. The othercomplications were comparable between the fourgroups.Conclusion: The rate of compliance and HPeradication was similar in four quadruple regimens;however due to difference in rate of complications,A or D regimens are recommended.Send Date: 2011/07/20


The study of two sequential therapies forpatients with gastric and duodenal ulcer

infected helicobacter pyloriEbrahim Fattahi1*, MohammadHossein Somi1,

Manuchehr Khaoshbaten1, Turaj Rosta1

1 Liver and Gastrointestinal Diseases Research Centre,Tabriz University of Medical SciencesIntroduction: Prevalence of Helicobacter pylori (Hp)infection in adults varies in different parts of theworld depending on the social and economicstandards of the population. While the prevalenceamong the middle-aged population in developingcountries is about 80%, it is only 20-50% indeveloped countries. The sequential regimen is anovel, promising therapeutic approach for Hperadication. We aimed to compare two sequentialquadruple regimens based on Azithromycin andOfloxacin.Method: In this open-label randomized clinical trial,150 patients with H.pylori positive peptic ulcerdisease were randomized in tow groups of 75 caseseach. Group A treated with quadruple regimens basedon Azithromycin and other group (B) treated withregimens based on Ofloxacin. The eradication,compliance and complication rates were compared intwo groups.Results: Mean patients’ age was 39.3± 1.2 within theage range 18 to 85 yrs. There were 47(62.7%) maleand 28(37.3%) female patients in group A while50(66.7%) male and 25(33.3%) female patients ingroup B. There was no significant difference



52% for serology, 90% and 82% for the urea breathtest, and 46% and 80%, respectively, for the stoolantigen test. Rapid urease test and urea breath test, ifdone in combination together had the most diagnosticaccuracy.Conclusion: Rapid urease test and urea breath test incombination together showed acceptable diagnosticreliability.Send Date: 2011/08/01

Category: 3 H.PYLORI3.4 DiagnosisW-F-048

survey on results of helicobacter stoolantigen test with pathologic achievements

in children with peptic diseaseShohreh Maleknejad1*, Marjan Bordbar1

1 17 shahrivar hospital, guilanIntroduction: Helicobacter pylori had been proposedas an effective factor in peptic diseases in pastdecades.This agent has a strong role in pathogenesisof chronic gastritis and peptic ulcer;thereforeintroducing simple and cost effective tests areimportant for diagnosis of H.pylori infection .Wemeasure the sensivity,specifity,positive and negativepredictive value of stool antigen test in childreninfected with H.pylori.Method: In a cross sectional survey during 1 year,96patients with abdominal pain referred to gastrointstinalclinic in 17- shahrivar hospital in Rasht from April2009 to march 2009.l had been studied . Stool antigentest and endoscopy was performed for all patients insame laboratories .Other data had been collected andentered in SPSS software for analysis.Results: Among 96 patients ,52.1%(50 cases)wereboys and 47.9%(46 cases) Were girls.Stool antigentest result was positive in 34 subjects(35.4%)wasnegative in 62 subjects(64.6%).On the other handonly 33 children (34.4% )had positive pathologyresults according to H.pylori infection .Sensivity,specifity,positive and negative predictive value ofstool antigen test were 72.72%, 84.12%, 70.5%,85.4% respectively.Conclusion: According to negative predictive valueof this test ;we can make this decision that if the testresult become negative , in 85.4%of cases theinfection will be rules out. Send Date: 2011/08/05

Category: 3 H.PYLORI3.5 Management strategiesW-F-049

Detection of A2142C, A2142G, and A2143GMutations in 23s rRNA Gene Conferring

Hamid Abdollahi1, Mohammad Savari2,Mohammad Javad Zahedi3, Sodaif

Darvish Moghadam3*, Mehdi Hayatbakhsh Abasi3

1 Department of Medical Microbiology, Virology &Immunology,Kerman University of Medical Sciences,Kerman, Iran2 Department of Medical Microbiology, School ofMedicine,Kerman University of Medical Sciences,Ker-man, Iran3 Department of Gastroentrology, Kerman University ofMedical Sciences,Kerman, IranIntroduction: Clarithromycin resistance inHelicbacter pylori has been found to be associatedwith point mutations in 23s rRNA gene leads toreduced affinity of the antibiotic to its ribosomaltarget or changing the site of methylation. The aim ofthis study was to determine the most important pointmutations in 23s rRNA gene in H. pylori that areclosely related to clarithromycin resistance amongsuch isolates.Method: Sixty three H. pylori isolates, obtained fromgastric biopsy speciemens in Kerman, Iran, were usedto evaluate their susceptibility to clarithromycin bydisk diffusion test, and to detect the most commonpoint mutations in 23s rRNA gene associated withclarithromycin resistance by Polymerase chainreaction-amplification and restriction fragment lengthpolymorphism (PCR-RFLP) and 3'-mismatch PCR.Results: 31.7% of the H. pylori isolates were resistantto clarithromycin, and each of the resistant isolate hadat least one of the most common point mutations in23s rRNA gene associated with calrithromycinresistance.Conclusion: According to our results three commonpoint mutation in 23s rRNA gene in H. pylori areclosely related to clarithromycin resistance. Therewas an absolute relation between 23s rRNA genepoint mutations and clarithromycin resistance in thisstudy. Helicbacter pylori resistance to clarithromycincan cause failure in the eradications of the bacteria.The resistance of the bacteria is expanding in mostparts of the world including Iran.Send Date: 2011/05/25



Category: 3 H.PYLORI3.4 DiagnosisW-F-046Does Helicobacter pylori eradication in patients

with duodenal ulcer need a diagnostic test?Mohammad-Reza Ghadir1*, Jamshid Vafaeimaneh 1,

Seyed-Saeed Sarkeshikian1, Abolfazl Iranikhah1,Ali Amiri2, Maryam Bolandmartebeh3

1Gastroenterology Section, Department of InternalMedicine, Faculty of Medicine,Qom University of MedicalSciences, Qom, Iran2 Department of Internal Medicine, Qom Azad University,Qom, Iran3 Shahid Beheshti Hospital, Qom University of MedicalSciences, Qom, IranIntroduction: The damage caused by Helicobacterpylori infection and NSAIDs accounts for most casesof duodenal ulcers (DU). Treatment of Helicobacterpylori infection reduces the recurrence of DU cases toa large extent, and if the infection is left untreated,the natural trend of DU occurs in the form ofrecurrences. During the past recent years, theprevalence of H. pylori in the community and itsconsequent role in causing DU has reduced. Thepurpose of the present study is to investigate the roleof this factor in causing DU, and determine, onprevalence basis, whether H. pylori can be treated inDU cases without any diagnostic test.Method: The present study was conducted in2008-2009 and the subjects who underwentendoscopies for DU diagnosis were studied for H.pylori by means both RUT and histopathologyprocedures, and if the results of both were positive,the patients were considered as infected withHelicobacter pylori. The patients were asked aboutNSAID/ASA use, whereby taking one dose ofNSAID/ASA during the month preceding the studywas considered as intake.Results: 127 subjects were investigated in this studyof which 53 (41.7%) were female and 74 (58.3%were male). The mean age of the subjects was41.39±15.359. Of the 127 patients, there were 80(62.99%) in whom only H. pylori was the cause ofDU, 4 (3.15%) who only had a history ofNSAID/ASA use, 37 (29.1%) in whom both factorsplayed a role, and 6 (4.72%) in whom both factorswere negative.Altogether, in 117 (92.1%) of the patients the result

was H. pylori positive. There was no significantdifference between the rate of H. pylori prevalenceamong the persons who had and did not have ahistory of NSAID/ASA use.Conclusion: Given the high prevalence ofHelicobacter pylori in patients with DU in GhomProvince, Iran, whether such patients had a history ofNSAID/ASA use or not, this study showed that DUpatients can receive empirical therapy for H. pylori.Send Date: 2011/07/17

Category: 3 H.PYLORI3.4 DiagnosisW-F-047

Accuracy of diagnostic tests forHelicobacter Pylori infection

Siamak Khaleghi1*, Mahshid Talebi-Taher2,Elnaz Salimi3, Hoda taghipour3, Shabaz nekozadeh3

1 Gastrointestinal & Liver Disease Research Center(GILDRC), Firoozgar Hospital, Tehran University ofMedical Sciences (TUMS) (pardis, hemmat), Tehran, Iran2 The Department of Infectious disease, Tehran Universityof Medical Sciences (TUMS) (pardis, hemmat) , Tehran,Iran3 Medical student, Tehran University of Medical Sciences(TUMS) (pardis, hemmat) , Tehran, IranIntroduction: The diagnosis of Helicobacter pyloriinfection has been made through invasive andnon-invasive methods. The present study was carriedout to evaluate and compare the accuracy of threenon-invasive and one invasive methods of H.pyloriinfection diagnosis.Method: A total of 108 dyspeptic patients older than12 years old who were not previously treated forH.pylori infection, were selected to undergo upperGI- endoscopy. Histology was considered as a goldstandard diagnostic test. Urea breath test andBiopsy-based tests included histologic examinationand rapid urease test were done in endoscopic unit.Serology and stool antigen detection test were doneelsewhere using ELISA method. Sensitivity,specificity, positive and negative predictive valuewere calculated. The tests' results were assessed byMcNemar test.Results: According to histologic method 56 patientshad H.pylori infection. Sensitivitiy and specificitywas 89% and 71% for the rapid urease test, 94% and



7 Gastric Cancer Research Group, Young Researchers'Club, Islamic Azad University, Mashhad branch, Mashhad,Iran8 Department of Surgery, Surgical Oncology ResearchCenter, Imam Reza Hospital, School of Medicine,Mashhad University of Medical Sciences, Iran9 Department of Immunology, Immunology ResearchCenter, School of Medicine , Mashhad University ofMedical Sciences, Iran10 Department of Radiation Oncology, Mashhad UniversityCancer Research Center, Omid Hospital, MashhadUniversity of Medical Sciences, IranIntroduction: Gastric cancer is the second leadingcause of cancer-related death worldwide and the mostcommon gastrointestinal cancer in Iran.CCL5/RANTES is one of the most potent angiogenicfactors, and plays an important role in tumor growth,invasion, and metastasis. We aimed to assess theCCL5serum level in patients with gastric adenocarcinomaand its relation with histological grade and tumor stage aswell as the disease prognosis.Method: Seventy-four patients with gastricadenocarcinoma that had undergone gastrectomy and96 non-tumoral individuals in which gastric cancerwas ruled out by gastroscopy and biopsy wereenrolled. Demographic and epidemiologicalcharacteristics and patient survival data werereviewed. Histological type and grade and tumorstage (TNM) were determined by single expert GIpathologist. H pylori infection status and CCL5serum level were assessed by ELISA. Data wereanalyzed using SPSS software version 16.Results: Patient with gastric adenocarcinoma hadsignificantly higher serum CCL5 level comparingwith control group (p<0.001). Higher CCL5 serumlevels were associated with lower histologicaldifferentiation (p<0.001), higher depth of tumorinvasion (p=0.022), more frequent nodesinvolvement (p=0.028). Overall survival of patientswith CCL5 levels above 70671 pg/ml wassignificantly lower than those with lover values thanthis cut-off (p=0.043).Conclusion: Serum CCL5 levels might be utilized asa predictive marker of tumor behavior and patientprognosis. Further studies are suggested to assess tis-sue expression of CCL5 receptors and its genepolymorphisms.Send Date: 2011/08/19

Category: 3 H.PYLORI3.2 Pathogenesis: microbial factorsW-F-045Relation between serum leptin and helicobacter

pylori infection in patients with dyspepsiaFarhad Zamani1, Nafiseh Abdolahi1,

Gholamreza Roshandel2, Hossein Ajdarkosh1,Mahmoud reza Khansari1, Mehrdokht Najafi1*

1 Gastrointestinal and Liver Disease ResearchCenter(GILDRC), Tehran University Of MedicalScience,pardis hemmat, Tehran, Iran2 Golestan Research Center of Gastroenterology andHepatology, Golestan University Of Medical Sciences,pardis hemmat, Tehran, IranIntroduction: Relationship between leptin and somegastrointestinal (GI) diseases have been provedduring recent years. This study was conducted toassess the relationship between serum leptin level andHelicobacter pylori (HP) infection in patients withdyspepsia.Method: The study population included patients withdyspepsia that fulfilled the ROM II criteria and didnot have any abnormal finding on endoscopicevaluation. After recording demographic data, abiopsy was taken from the stomach for assessing HPinfection and blood samples were taken formeasuring leptin serum level via ELISA method.Results: Totally, 153 patiens were recruited. Meanage of participants was 43.12 (24-96) years. Therewas a significant positive relationship between ageand serum leptin level (p=0.03). The mean level ofserum leptin was higher in females comparing tomales (p=0.03). The results of univariate andmultivariate analysis showed that serum leptin levelwas significantly lower in HP positive patients thanHP negative ones (p<0.001).Conclusion: Our findings confirm the result of someprevious studies suggesting HP infection may reduceserum leptin level. Reducing body fat mass due toworsening of symptoms by eating which compels thepatient not to eat and releasing cytokines from theinjured gastric epithelium are possible explanationsof this effect. Determination of the exact relationshipbetween these variables in future studies may revealnewer aspects of their roles in physiology andpathogenesis of GI diseases.Send Date: 2011/07/28



Samaneh Boroumand Noghabi1*, KamranGhaffarzadehgan2, Reyhaneh Zoghian3,

Hamid Reza Sima4, Hanieh Hosseinnezhad3,Jalil Tavakol Afshari5, Vahideh Hosseinzadeh6,

Hamid Reza Raziee7, Mostafa Jafarzadeh8,Elahe Andakhshideh6, Masoud Sajjadi6

1 Gastric Cancer Research Group, Department ofPathology, Imam Reza Hospital, School of Medicine,Mashhad University of Medical Sciences, Iran2 Gastric Cancer Research Group, Department of ResearchAffairs, Razavi Hospital, Mashhad, Iran3 Gastric Cancer Research Group, Young Researchers' Club,Islamic Azad University, Mashhad branch, Mshhad, Iran4 Gastric Cancer Research Group, Department of InternalMedicine, Surgical Oncology Research Center, Imam RezaHospital, School of Medicine, Mashhad University ofMedical Sciences, Iran5 Gastric Cancer Research Group, Department ofImmunology, Immunology Research Center, School ofMedicinee, Imam Reza Hospital, School of Medicine,Mashhad University of Medical Sciences, Iran6 Gastric Cancer Research Group, Student ResearchCommittee, School of Medicine, Mashhad University ofMedical Sciences, Iran7 Gastric Cancer Research Group, Department of RadiationOncology, Mashhad University Cancer Research Center,Omid Oncology Hospital, Mashhad University of MedicalSciences, Iran8 Gastric Cancer Research Group, Department of ForensicMedicine and Toxicology, School of Medicine, TehranUniversity of Medical Sciences, IranIntroduction: As a member of TNF-family receptors,Fas (Apo1/CD95) and its ligand (FasL) play criticalroles in apoptosis as well as immune system-tumorcounter attack. Although, Fas/FasL tissue expressionhas been shown to have a prognostic impact in somemalignancies, there are conflicting reports about thecorrelation of their expression and gastric cancerbehavior. We aimed to evaluate the relations betweentissue expressions of these molecules andclinicopathological characteristics of patients withgastric adenocarcinoma.Method: Thirty newly diagnosed cases of gastricadenocarcinoma who had undergone gasterectomy atMashhad University of Medical sciences hospitals wereenrolled. Clinical and pathological characteristics werereviewed. Fas and FasL tissue expression inparaffin-embedded tumor specimens were measuredby Immunohistochemical staining. Data wasanalyzed using SPSS version 17.

Results: Nineteen patients (63%) were male withmean age of 62.5. 19 patients (63%) did not expressFas while 23 patients (79.3%) expressed FasL.Diffuse type gastric cancers expressed Fas less thanintestinal type (p=0.049). Fas expression was lower inhigh-stage tumors (p =0.038) and tumors with lymphnode metastasis (p =0.004). There were no significantrelation between Fas expression and tumor grade,location (cardia/non cardia) and history of H.pyloriinfection. FasL expression had no relation with any ofthe studied variables.Conclusion: Tissue expression of Fas might beutilized as a predictor of tumor behavior in gastricadenocarcinoma. Further studies with larger samplesize are needed to confirm this idea.Send Date: 2011/08/19

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.13 Gastroduodenal malignanciesW-F-044

Serum CCL5/RANTES level might beutilized as a predictive marker of tumor

behavior and prognosis in patientswith gastric adenocarcinoma

Ali Reza Sima1*, Houshang Rafatpanah2,Hanieh Hosseinnezhad3, Hamid Reza Sima4,

Hamid Reza Hakimi5, Kamran Ghaffarzadehgan6,Anahita Masoum7, Mostafa Mehrabi Bahar 8,

Narges Valizadeh9, Mina Erfani5, Hamid Reza Raziee10

1 Department of Internal Medicine, Imam Reza Hospital,School of Medicine, Mashhad University of MedicalSciences, Iran2 Gastric Cancer Research Group, Department ofImmunology, Immunology Research Center, School ofMedicine, Mashhad University of Medical Sciences, Iran3 Gastric Cancer Research Group, Young Researchers'Club, Islamic Azad University, Mashhad branch, Mshhad,Iran4 Gastric Cancer Research Group, Department of InternalMedicine, Surgical Oncology Research Center, Imam RezaHospital, School of Medicine, Mashhad University ofMedical Sciences, Iran5 Gastric Cancer Research Group, Student Research Com-mittee, School of Medicine, Mashhad University ofMedical Sciences, Iran6 Gastric Cancer Research Group, Department of ResearchAffairs, Razavi Hospital, Mashhad, Iran



different steps from normal mucosa to adenocarci-noma (p =0.01, Pearson correlation=0.23).Conclusion: Serum level of IL-18 correlates withserum VEGF in gastric carcinogenesis and they maybe utilized in early diagnosis of gastric adenocarcinoma.Further studies may assess diagnostic value of IL-18and VEGF gene expression in this area.Send Date: 2011/08/19


IL-18 607C/A gene polymorphism mightbe utilized as a useful biomarker indiagnosis of gastric adenocarcinoma

Mohsen Tadayon1*, Jalil Tavakol Afshari2, MahdiAfzalaghaee3, Hamid Reza Sima4, HaniehHosseinnezhad1, Ghodratollah Maddah5,

Mostafa Jafarzadeh6, Rashin Ganjali7,Sepideh Ghadri1, Monavar Afzalaghaee8, Anahita

Masoom1, Tahoora Abdolahi1

1 Gastric Cancer Research Group, Young Researchers'Club, Islamic Azad University, Mashhad Branch,Mashhad, Iran2 Gastric Cancer Research Group, Department ofImmunology, Immunology Research Center, School ofMedicine, Mashhad University of Medical Sciences,Mashhad, Iran.3 Department of Internal Medicine, Imam Reza Hospital,School of Medicine, Mashhad University of Medical Sci-ences, Mashhad, Iran4 Gastric Cancer Research Group, Department of InternalMedicine, Surgical Oncology, Research Center, ImamReza Hospital, School of Medicine, Mashhad University ofMedical Sciences, Mashhad, Iran5 Department of Surgery, Ghaem Hospital, School ofMedicine, Mashhad University of Medical Sciences,Mashhad, Iran6 Gastric Cancer Research Group, Department of ForensicMedicine and Toxicology, School of Medicine, TehranUniversity of Medical Sciences, Tehran, Iran7 Department of Immunology, Immunology ResearchCenter, School of Medicine, Mashhad University ofMedical Sciences, Mashhad, Iran8 Department of Research Affair, Mashhad University ofMedical Sciences, MashhadIntroduction: Gastric cancer is the second leadingcause of cancer-related death worldwide and the most

common gastrointestinal cancer in Iran. IL-18 playsan important role in chronic gastritis; however its rolein gastric cancer is controversial and dual; anti-cancereffects by immune cell stimulation and pro-cancerouseffects by induction of invasion, migration andmetastasis of tumor cells and also angiogenesis. Weaimed to assess the IL18 607C/A and IL18 137G/Cgene polymorphism in patients with gastricadenocarcinoma and non-tumoral individuals as wellas its relation with histological grade and tumor stage.Method: One hundred and sixty-seven casesincluding 71 patients with gastric adenocarcinomathat had undergone gastrectomy and 97 non-tumoralindividuals in which gastric cancer was ruled out bygastroscopy and biopsy were enrolled. Demographicand epidemiological characteristics and patientsurvival data were reviewed. Histological type andgrade and tumor stage (TNM) were determined bysingle expert GI pathologist. H pylori infection statusIL18 607C/A and IL18 137G/C gene polymorphismwere assessed by ELISA and Arms-PCR,respectively. Data were analyzed using SPSSsoftware version 16.Results: Patient with gastric adenocarcinomaexpressed significantly more IL18 607C/A genecomparing with non-tumoral group (p =0.002). Nosignificant difference was found in IL18 137G/Cgene expression between patient with gastricadenocarcinoma and control group (p=0.6). Therewere no significant relationship between IL18607C/A and IL18 137G/C gene expression andhistological grade and T and N stage of tumor.Conclusion: IL18 607C/A gene polymorphism mightbe utilized as a useful biomarker in diagnosis ofgastric adenocarcinoma. Further studies are neededto show any potential role of these biomarkers inprediction of tumor behavior and patients prognosis.Send Date: 2011/08/19


Tissue expression of Fas (Apo1/CD95)might be utilized as a predictor of

tumor behavior in gastric adenocarcinoma



correlation of CD34 and VEGF tissue expression ingastric adenocarcinoma and their relationship withclinicopathological features.Method: Thirty-two patients with gastric adenocarcinomawho had undergone gastrectomy at Mashhad universityhospitals were enrolled. Clinicopathological andepidemiological characteristics were reviewed. CD34and VEGF were assessed using immunohistochemicalstaining. Data were analyzed by SPSS software.Results: VEGF and CD34 were positive in all and 26(81.2%) of patients, respectively., With regard totumor subtypes classification, the tissue expressionof VEGF and CD34 were reported in 72% and 77%of intestinal type and 28% and 23% of diffuse typetumors, respectively. No significant relationship wasshown between age, gender, stage and location oftumor with expression of CD34 and VEGF, althoughthere was a significant correlation betweenexpression of VEGF and grade (p=0.008). We failedto find a significant correlation between tissue ex-pression of CD34 and VEGF in Gastric Adenocarci-noma.Conclusion: Tissue expression of VEGF may behelpful in predicting the malignant behavior of gastricadenocarcinoma. Further studies are needed to con-firm any relationship between CD-34 and VEGF inthis area.Send Date: 2011/08/19


Serum IL-18 correlates with serum VEGF ingastric carcinogenesis and they may be utilized

in early diagnosis of gastric adenocarcinomaAnahita Masoom1*, Hamid Reza Sima2, Mohsen

Tadayon1, Jalil Tavakol Afshari3, Mostafa Jafarzadeh4,Kamran Ghaffarzadehgan5, Hanieh Hosseinnezhad1,

Abbas Esmaeilzadeh6, Sepideh Ghadri1, TahooraAbdolahi1, Mostafa Abrishami7, Mostafa Parizadeh8

1 Gastric Cancer Research Group, Young Researchers'Club, Islamic Azad University, Mashhad Branch,Mashhad, Iran2 Gastric Cancer Research Group, Department of InternalMedicine, Surgical Oncology Research Center, Imam RezaHospital, School of Medicine, Mashhad University of

Medical Sciences, Mashhad, Iran3 Gastric Cancer Research Group, Department ofImmunology, Immunology Research Center, School ofMedicine, Mashhad University of Medical Sciences,Mashhad, Iran4 Gastric Cancer Research Group, Department of ForensicMedicine and Toxicology, School of Medicine, TehranUniversity of Medical Sciences, Tehran, Iran5 Gastric Cancer Research Group, Department of ResearchAffairs, Razavi Hospital, Mashhad, Iran6 Department of Internal Medicine, Imam Reza Hospital,School of Medicine, Mashhad University of MedicalSciences, Mashhad, IRAN.7 Gastric Cancer Research Group, Student Research Com-mittee, School of Medicine, Mashhad University of Med-ical Sciences, Mashhad, Iran8 Gastric Cancer Research Group, Student Research Com-mittee, School of Medicine, Mashhad University of Med-ical Sciences, Mashhad, IranIntroduction: As a pro-inflammatory cytokine,IL-18 is an important mediator in chronic gastritis.The role of IL-18 in gastric cancer is controversialand dual; anti-cancer effects by immune cellstimulation and pro-cancerous effects by induction ofinvasion, migration and metastasis of tumor cells andalso angiogenesis. IL-18 may cause cancer cells toescape from immune system by regulating theexpression of some markers such as vascularendothelial growth factor (VEGF). This study wasaimed to investigate the correlation of serum level ofIL-18 and VEGF in patients with normal mucosa, pre-cancerous lesions and intestinal type adenocarcinoma.Method: Fifty-eight non-tumoral patients withnormal gastric mucosa (n=10), chronic H.pylori-associated gastritis (n=33), atrophic gastritis andmetaplasia (n=12) and low dysplasia (n=3) plus 41patients with intestinal-type were included.Clinicopathological and epidemiological characteristicswere reviewed. The serum level of IL-18 and VEGFwere assessed using ELISA. Data were analyzed bySPSS (Version 16) at the significant level of p<0.05.Results: Serum level of IL-18 and VEGF weresignificantly higher in adenocarcinoma in comparisonwith non-tumoral (p =0.04 and p =0.02, respectively).An overall increasing pattern was seen in the serumlevel of both IL-18 and VEGF from mild gastritis toadenocarcinoma. (p =0.03 and p =0.05, respectively).A significant correlation was observed betweenincreasing level of serum IL-18 and VEGF in



manager who are responsible for decisions regardingbudget allocations and other purposes. Thegeographic area is all pathologic lab and clinicsaffiliated to Shiraz University of Medical Sciences.The designed questionnaire includes a consent form,basic history data, nutritional history data, riskfactors, related procedures, medical therapy, andfollow-up data. Establishment process has twoparallel setting phases. In the first phase all recordedpathology data as any of gastric premalignant lesionsin defined pathologic laboratories is collected from2006 to 2011. Then the collectors contact patients andask for an appointment. In the interview thequestionnaire is completed and blood samples aretaken. The gathered data are entered in the designedand computerized data base. Two blood sampleswhich is extracted DNA are kept in -70 while fourothers is kept in -20°. In the second phase, all patientswith gastric premalignant lesions who referred todefined clinics are referred to the registry office to fillthe questionnaire and ask to do another endosopy asfollow-up next year.Results: The premalignant gastric lesion registry ofShiraz University of Medical Sciences has started toregister patients with premalignant gastric lesions.Tillnow approximately 95 patients have been registered.Conclusion: It is hoped that establishment ofpopulation–based registry of premalignant gastriclesions help to determine the incidence, prevalence,demographic characters and causes of morbidity andmortality ,to facilitate future researches aimed toidentify etiology , new management and treatmentoptions, to monitor the time trends and the course ofpremalignant gastric lesions until developing cancer,to evaluate whether the surveillance practice ofpatients with these premalignant lesions matches theircancer risk and to investigate the progression andregression of these premalignant lesions that all canbe used to devise a definite follow-up model for thesepatients.Send Date: 2011/08/16


The correlation between tissue expressionof vascular endothelial growth factor

(VEGF) and angiogenic markerCD34 in Gastric Adenocarcinoma

Ezzat Haj Mola Rezaee1*, Kamran Ghaffarzadehgan2,Hanieh Hosseinnezhad3, Hamid Reza Sima4, Sepideh

Ghadri5, Mohammd Naser Forghani6, TahooraAbdolahi7, Mostafa Jafarzadeh8, Reihaneh Zoghian3,

Mahboubeh Parsa1, Samaneh BoroumandNoghabi9, Hamid Reza Raziee10

1 Gastric Cancer Research Group, Student ResearchCommittee, School of Medicine, Mashhad University ofMedical Sciences, Mashhad, Iran2 Gastric Cancer Research Group, Department of ResearchAffairs, Razavi Hospital, Mashhad, Iran3 Gastric Cancer Research Group, Young Researchers'Club, Islamic Azad University, Mashhad Branch,Mashhad, Iran4 Gastric Cancer Research Group, Department of InternalMedicine, Surgical Oncology, Research Center, ImamReza Hospital, School of Medicine, Mashhad University ofMedical Sciences, Mashhad, Iran5Gastric Cancer Research Group,Young Researchers' Club,Islamic Azad University, Mashhad Branch, Mashhad, Iran6 Department of Surgery, Mashhad University CancerResearch Center, Omid Hospital, Mashhad University ofMedical Sciences, Mashhad, Iran7 Gastric Cancer Research Group, Young Researchers'Club, Islamic Azad University, Mashhad Branch,Mashhad, Iran8 Gastric Cancer Research Group, Department of ForensicMedicine and Toxicology, School of Medicine, TehranUniversity of Medical Sciences, Tehran, Iran9 Gastric Cancer Research Group, Department ofPathology, Imam Reza Hospital, School of Medicine,Mashhad University of Medical Sciences, Mashhad, Iran10 Gastric Cancer Research Group, Department ofRadiation Oncology, Mashhad University Cancer ResearchCenter, Omid Hospital, Mashhad University of MedicalSciences, Mashhad, IranIntroduction: As a major worldwide cause ofmorbidity and cancer-related deaths, gastric cancerneeds molecular-based approaches for predictingclinical outcome and guiding treatment strategies.CD34 is a glycoprotein which present in the vascularendothelium is a new biomarker for the evaluation ofangiogenesis quantification and tumor development.CD34 were supposed to have relationship with theothers angiogenic markers like vascular endothelialgrowth factor (VEGF).We aimed to investigate the



Mortaza Gojazadeh1*, Mohammad HosseinSomi2, Aliasghar Pouri2

1 Departement Physiology Faculty of Medicine, TabrizUniversity of Medical Sciences2 Liver and gastrointestinal Disease Research Center,Tabriz University of Medical SciencesIntroduction: In Iran gastric cancer is the mostcommon cancer in male and it is reported to be thethird cancer after Breast and Colorectal cancers infemale .The incidence of gastric cancer in Iran is 14.5cases/100,000 population in men and 8.2/100,000 inwomen. Mean age at diagnosis is 52.5 years.Method: Gastric cancer is the second leading cause ofcancer deaths in men and the third in women. Therelatively high rate of gastric cancer in Iran appears tobe mainly due to dietary factors, and there areetiologic and epidemiologic differences amongregions of the country.Results: Although type of surgical resection may varyfrom center to center, D2 dissection is increasinglypreferred in experienced clinics, with an associatedmortality of about 5.2%.Conclusion: Adjuvant chemoradiotherapy is widelyused. Few chemotherapy regimens are used inadvanced disease. Gastric cancer remains animportant public health problem in Iran. With theadoption of healthier dietary practices and screeningprograms in endemic areas, the mortality from gastriccancer is expected to decrease.Send Date: 2011/07/22


Send Date: 2011/07/30


Establishment of a Population-BasedRegistry of Premalignant Gastric Lesionsin Shiraz University of Medical Sciences

from 2006 to 2011Maryam Moini1*, Kamran Bagheri Lankarani2,

Seyed Alireza Taghavi3, Mohammadreza Fattahi3,Bita Geramizadeh4, Laleh Hamidpour1, Maryam

Ardebili1, Zahra Tollabzadeh1, Zahra Mansoorabadi1

1 Gastroenterohepatology Research Center, ShirazUniversity of Medical Sciences,Shiraz,Iran2 Health Policy Research Center, Shiraz University ofMedical Sciences,Shiraz,Iran3 Gastroenterohepatology Research Center, ShirazUniversity of Medical Sciences,Shiraz,Iran4 Shiraz Transplant Research Center, Shiraz University ofMedical Sciences,Shiraz,IranIntroduction: A Population–Based Registry coversall residents in a given geographic area within a giventime period. It intends to include all with the diseasein the population. Even if it fails to include “all”cases, intention rather than performance defines theterm. Gastric cancer is usually diagnosed in anincurable stage and premalignant changes arewell-known risk factors for it, though the aim ofestablishing a population-based registry is to build areliable data source which will be of considerable helpto find a way for early diagnosis, better managementand follow-up of premalignant lesions that hopefullydecrease progression to gastric cancer.Method: Registry is managed by GastroenterohepatologyResearch Center (GEHRC) at Shiraz University ofMedical Sciences. A governing committee consists ofa head, 2 other faculty members and an appointed



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8 mg per hour) or oral Omeprazole (80mg Po initiallyand followed by 80mg BID) for 72 h.The primaryend-point was the rate of rebleeding and outcomes.Results: There were no statistically significantdifferences between the groups in rebleeding rate(p=0.21) transfusion requirement (p=0.26), Hospital days(p=0.24), mortality (p=1), but there were significantdifferences between the groups with regard to the needfor emergency surgery (p=0.04).Conclusion: Infusion Pantoperazol is not superior tooral Omeprazol as an adjunct treatment to endoscopicinjection therapy in high-risk bleeding ulcers.Send Date: 2011/07/21

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.12 Acid peptic disease (includes NSAIDS - butNOT H.pylori)- diagnosis and treatmentW-F-035

The Value of Stool Antigen Test, Urea BreathTest, Rapid Urease Test, Serology, and Histology

in Diagnosis of Helicobacter Pylori InfectionShadi Kazemi1*, Hamid Tavakoli2, Mohamad Reza

Habizadeh3, Mohammad Hasan Emami2

1 Department of Internal Medicine, Isfahan University ofMedical Sciences2 Poursina Hakim Research Institute, Department of Gas-troenterology, Isfahan University of Medical Sciences3 Amin HospitalIntroduction: The purpose of this study was tocompare the validity of five diagnostic tests ofhelicobacter pylori including stool antigen test (SAT),urea breath test (UBT), rapid urease test (RUT),serology, and histology.Method: A total of 94 patients who had indication ofendoscopy were entered into the study and the fivetests performed for each patient. When the results ofat least two tests (except serology) were positive,helicobacter pylori infection was considered to bepositive. The sensitivity, specificity, positivepredictive value, negative predictive value, accuracy,and area under Receiver Operating CharacteristicCurve of these five tests was determined.Results: The sensitivity, specificity, positivepredictive value, negative predictive value, accuracy, andarea under Receiver Operating Characteristic Curve ofthe tests were as below respectively: SAT: 96%, 83%,

98%, 96%, 91%, 0.897; ; UBT: 89%, 73%, 92%, 90%,82%, 0.892; RUT: 93%, 75%, 95%, 94%, 86%, 0.831;Histology: 89%, 78%, 93%, 91%, 85%, 0.881; Serology:50%, 54%, 46%, 61%, 52%, 0.563.Conclusion: Stool antigen test is the most accuratetest for helicobacter pylori infection diagnosis beforeeradication of this bacteria.Send Date: 2011/08/05

Category: 2.13 Gastroduodenal malignanciesW-F-036

Send Date: 2011/07/22


Peer review of gastric cancer in Iran



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Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.9 Other esophageal disordersW-F-033

Ethanolamine oleate in resistant idiopathicachalasia: A novel therapy

Javad Mikaeli1*, Ramin Niknam1, NargesMehrabi1, Laleh Mahmoudi2, Elham Elahi1, Shapoor

Shirani3, Reza Malekzadeh1

1Digestive Disease Research Center, Tehran University ofMedical Sciences2 Department of Clinical Pharmacy, Faculty of pharmacy,Shiraz University of Medical Sciences3 Departmet of Radiology, Tehran Heart Center, TehranUniversity of Medical SciencesIntroduction: Idiopathic achalasia (IA) is a chronicdisease without definite therapy. Ethanolamine oleate(EO) has multiple biological effects, includinginflammatory activities. We investigated the efficacyof EO injection in selected patients with IA.Method: 136 patients with IA evaluated prospectively.We evaluated the efficacy of EO injection in 13 patientswith IA that are resistant to or poor candidate ofpneumatic balloon dilation and/or cardiomyotomy atthe Digestive Disease Research Center, ShariatiHospital, Tehran, as the major referral center forachalasia in Iran in an interventional study. DilutedEO was injected in divided dose into each of fourquadrants of lower esophageal sphincter, using astandard sclerotherapy needle. Injection was repeatedat two and four weeks after first injection. Thepatients were evaluated with achalasia symptomscore (ASS) and timed barium esophagogram (TBE)before and after injections. Good response wasdefined as decrease in ASS ≥ 50% of baseline anddecrease in height and volume of barium ≥ 50% ofbaseline in TBE, at 1.5 months after last injection.Any side effects were recorded.Results: All patients (13 cases) had good ASS(decreased > 50%) and good TBE (decreased in

height and volume of barium > 50%) responserate.Mean ASS decreased from 11.38 (± 1.5) to 3.23(±1.96) at 1.5 months after last injection (p=0.001).Mean volume of barium in TBE decreased from81.38 (±51.11) ml to 40.69 (±61.22) ml at 1.5 monthsafter last injection (P=0.016).The mean duration offollow up was 17.83 (±1.12) months. Relapse wasoccurred in 6 patients, all successfully was treated byone re-injection.Conclusion: This study indicates that EO is welltolerated and potentially effective in patients with IAthat might be explained by the local inflammatoryproperties of EO. Since presented data are toopreliminary to support the routine use of EO in thetreatment of all patients with IA, its use in selectedcases can be considered.Send Date: 2011/07/13

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.10 Acid peptic disease (includes NSAIDS - butNOT H.pylori)-epid emiologyW-F-034

Comparison of continuous infusion ofPantoprazole versus oral Omprazole for

prevention of ulcer rebleedingEskandar Hajiani1*, Seyed Jalal Hashemi1,

Nima Aghamohamadi1

1 GI ward, Ahvaz - Jondishapoor UniversityIntroduction: PPIs have a prolonged and significanteffect on gastric acidity therefore; represent a rationalchoice for prevention of ulcer rebleeding. Afterendoscopic homeostasis in patients with peptic ulcerbleeding, rebleeding occurs in 20% of patients.Rebleeding remains the most important determinantof clinical outcomes and prognosis. We designed a trialcomparing of continuous infusion of Pantoprazole versusoral Omprazole for prevention of ulcer rebleeding.Method: 94 cases with GI bleeding due to duodenal orgastric ulcer with major sign of recent bleeding weretreated with epinephrine injection and electroquagulation.Inclusion criteria were patients with active bleedingulcer, visible vessel ulcer, adhesion clot ulcer. Afterhomeostasis was achieved, they were randomlyassigned to receive intravenous Pantaperazole (80 mgintravenous bolus followed by an infusion at a rate of



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main carcinogen(s) have not been fully identified yet.This study was aimed to assess the molecular profileof ESCC in Golestan.Method: 160 histopathologically confirmed mucosalbiopsies of ESCC cases from Golestan Case-ControlStudy (GCCS) as part of group of collaborativestudies so called GastroEsophageal Malignancies inNorthern Iran (GEMINI)( methods: Nasrollahzadehet al, 2008). with at least 70% of tumor cells wereselected for TP53 mutation analysis of exons 2through 11. The analysis was performed by directsequencing of PCR products. The mutation resultsfrom Golestan were compared with other geographicareas using the IARC TP53 mutation database(http://www.iarc.fr/p53). All statistical analyses wereconducted by Stata Version 11. Two-sided P < 0.05was considered as statistically significant.Results: DNA was successfully amplified for allTP53 coding exons in 119/160. The mean age of therecruited patients was 65.5±11 with an equal sexdistribution (F=50.4%). 54.6% were Turkmen. 43.4%reported drinking tea 4 minutes or more and 16% inless than one minute after pouring tea (hot drinkers).Only 4.2% of patients reported ever using alcohol.The use of tobacco or opium products in variousforms was reported by 43.7%, among whom 17.6%reported using both substances. The majority of thesubjects (71.4%) were from rural areas.TP53 mutations were confirmed in 107 patients(89.9%) including nine patients with two and two pa-tients with three different mutations (total: 120 muta-tions). The most common mutation type was G:C toA:T transitions (38.3%), one third of them at CpGdinucleotides, followed by G:C to T:A transversions(16.7%). The majority of the mutations (84.2%) weredetected in exons 5-8.Less than 10% of the mutations (7.5%) occurred at“hotspot” TP53 codons (codons 175, 245, 273 and282 where 20% of known TP53 mutations occur inall cancers). Among the G:C to T:A mutations, 40%occurred at codons previously described as sites ofPAH adduct formation which are commonly mutatedin lung cancer of smokers.A significant difference between the proportion oftransition mutations at CpG dinucleotides (P=00.2).was found between Tehran (Sepeher et al, 2001; Bi-ramijamal et al, 2001) and Golestan The overall pat-

tern of mutations in ESCC from Golestan was not sta-tistically different from Henan Province (China).Mutation types showed differences according to thetemperature of tea consumption, with G:C to A:T mu-tations at CpG sites and Wild-type TP53 being sig-nificantly more common among hot tea drinkers(adjusted OR: 6.40, 95% CI, 1.16-35.16 and OR:6.27, 95% CI, 1.04-37.69; respectively), suggestingan association between the temperature (and/or com-position) of tea consumption and the presence andtypes of TP53 mutation.Conclusion: ESCC tumors in people from GolestanProvince show the highest rate of TP53 mutationsever reported in any cancer anywhere with asignificantly different pattern from Tehran and closerto China. The heterogeneous mutation pattern ishighly suggestive of a causative rolefor multipleenvironmental carcinogens, including PAHs. Thetemperature and composition of tea may alsoinfluence mutagenesis.Send Date: 2011/08/01

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS



ìõÂõÑ:2.8GýíBoüùBÿGlgýîìpÿ230-F-W

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AÞHpÖBÂêOHBoìéßzBû3,âõøpyBkâõâçðþ3,oÂBìéàqAkû41kAðzýBo,ìpÞrOdÛýÛBRâõAo}ôÞHl,kAðzãBûÎéõïKryßþOùpAó,AüpAó2Ktôøzãp,ìpÞrOdÛýÛBRâõAo}ôÞHl,kAðzãBûÎéõïKryßþOùpAó,AüpAó3Ktôøzãp,ìpÞrOdÛýÛBRâõAo}ôÞHl,kAðzãBûÎéõïKryßþOùpAó,AüpAó4AuPBk,ìpÞrOdÛýÛBRâõAo}ôÞHl,kAðzãBûÎéõïKryßþOùpAó,AüpAóìÛlìú:upÆBóuéõëuñã×pyþìpÿkoypÝâévPBóüßþAqGBæOpüòìýrAóøBÿGpôqoAkoWùBókAoAìþGByl.GpAÿyñBuBüþÎéê@óìÇBèÏBRìÛÇÏþôìõok-yBølÿìPÏlkÿAðXBïylûAuQ.GBOõWúGúGpOpÿìÇBèÏBRÞõøõoR(øíãpôøþ)GpAÿyñBuBüþÎõAìêgÇpuBqGýíBoÿøB,AWpAÿüàìÇBèÏúÞõøõoR@üñlûðãpGBKýãýpÿkûuBèúìõokOõWúÚpAoâpÖQ.oô}ÞBo:42086ð×pAquBÞñBóypÝAuPBóâévPBókoìdlôkûuñþ57-04uBëGúìÇBèÏúkÎõRylðl.kooôuPBøBOíBïAÖpAkôkoyùpâñHlGúÆõoO¿BkÖþ,Gúoô}gõyúAÿuývPíBOýàGpAuBxyíBoûgBðõAo,AðPhBJylðl.üBÖPúøB:WíÏB«54005ð×pìpAWÏúÞpkðlÞú14212ð×pìpk(24%)ô40882ð×pqó(85%)Gõkðl.ìýBðãýòuñþAÖpAkìpAWÏúÞññlû1/9±21/25uBëô9/32%@ðBóyùpÿô1/67%oôuPBüþGõkðl.

presence of familial cases of achalasia, otheraccompanying diseases and treatment outcomes.Results: In our study men were affected more thanwomen. (54.3% vs. 45.7% ). Mean age was about 38years. Most frequent symptoms were : dyphagia tosolids , dysphagia to liquids , active regurgitation ,passive regurgitation , and weight loss.Conclusion: Major clinical and demographic featuresof achalasia in Iran are almost the same as in reportsfrom other parts of the world , but contrary to somereports ,we found it more prevalent in men and alsochest pain was more frequent in womenSend Date: 2011/07/13

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.8 Esophageal malignant diseaseW-F-030

4-year survival rate of esophagealcancer radiation therapy center

Seyed Kazem mirinezhad1*, Mohammed HosseinSomi1, Saeed Dastgiri2 , Amir Ghasemi Jangjo3,

Farshad Sydnzhad3, Mohammed Mohammedzadeh3,Ali Reza naseri 3, Behnam Nasiri3

1 Liver and Gastrointestinal Diseases Research Centre, ofMedical Sciences,Tabriz2 School of Medicine and liver and GastrointestinalDiseases Research Centre, of Medical Sciences,Tabriz3 Radiation Oncology Therapy of IMAM REZA Hospital,of Medical Sciences,TabrizIntroduction: Esophageal cancer in Iran as the sixthmost common cancer and third most common canceris one in east Azerbaijan. The aim of this study wasto define the prognostic factors in esophageal cancerpatients using univariate and multivariate methods.Method: In this study, all patients with esophagealcancer registered in the Radiation Therapy CenterImam Reza (AS), of Tabriz university of medicalsciences; during March 21, 2006 to March 21, 2010were analyzed.All patients were followed up and vitalstatus. The probability curves for survival werecalculated according to the Kaplan–Meier Method,then compared by the Log-rank test. Multivariateanalysis was carried out using the Cox proportionalhazard model.Results: Out of 114 patients, survival data wasobtained on 107 patients including 60 males ( 56/ 1

percent) and 47 women ( 43/9 percent).The meansurvival time in patients 15 / 2 ± 34/28 (95% CI:57/32-12/24) months, respectively. Kaplan- Meiermethod showed survival rates at 1, 2, 3 and 4 yearsold respectively 70, 53, 39 and 39 percent. Inmultivariate analysis using Cox regression model,tumor stage, chemoradiotherapy status and place ofresidence independent variables associated thesurvival of patients were identified.Conclusion: These variables as the most importantprognostic factors in esophageal cancer patients.Therefore, early detection of cancer using screeningprograms can improve survival in such patients.Send Date: 2011/07/20

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.8 Esophageal malignant diseaseW-F-031

Molecular insights of esophagealsquamous cell carcinoma in Iran

Behnoush Abedi-Ardekani1*, Farin Kamangar2,Masoud Sotoudeh3, Stephanie Villar4,Sanford Dawsey5, Christian Abnet5,Reza Malekzadeh6, Pierre Hainaut4

1Digestive Disease Research Center, Shariati Hospital,Tehran University of Medical Sciences, Tehran, Iran;International Agency for Research on Cancer, Lyon,France; Social security Organization, Tehran, Iran2 Department of Public Health Analysis, School ofCommunity Health and Policy, Baltimore, Maryland,USA, Morgan State University3 Digestive Disease Research Center, Shariati Hospital,Tehran University of Medical Sciences4 International Agency for Research on Cancer, Lyon,France, IARC5 Division of Cancer Epidemiology and Genetics, NationalCancer Institute, Bethesda, Maryland, USA,National institute of Health6 Digestive Disease Research Center, Shariati Hospital,Tehran University of Medical SciencesIntroduction: Golestan Province in Northeastern Iranhas one of the highest incidence of EsophagealSquamous Cell Carcinoma (ESCC) in the world withrates over 50/100,000 person-years in both sexes.While the etiological role for some carcinogens suchas polycyclic aromatic hydrocarbons (PAHs) hasbeen already shown (Abedi-Ardekani et al, 2010), the



Send Date: 2011/08/20

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.7 Reflux disease - complicationsW-F-028

Comparison of spirometric and oscilometricindices befor and after treatment of

Gastroesophageal reflux disease in a group ofpatients with no respiratory symptoms

Seyed Jalal Hashemi1*, Esmaeil Eidani2,Masoomeh Hosaini askarabadi1

1 GI ward, Ahvaz - Jondishapoor University2 pulmonology ward, Ahvaz - Jondishapoor UniversityIntroduction: Gastroesophageal reflux disese(GERD) is a common chronic condition that carriesa risk of respiratory disorders including asthma . Antireflux therapy appears to be useful is improvementof asthma symptoms and pulmonary functionaltests.whoever the significant of respiratory abnormalitiesin patients without symptomatic asthma is a matterof debate .Oscilometry is an objective and sensitivetools for evaluation of airway resistance and may beabnormal in patients with normal spirometry . Themain purpose of this study is comparison betweenspirometry and oscillometry results in GERD afterand before treatment .Method: This study performed on thirty patients withreflux esophagitis (16 person grad B and 14 person ingrad A) Without any pulmonary symptoms . patientsreceive omeprazol 40 mg twice a day for 12 weeks .pulmonary function tests and oscillometry wereperformed before and after treatment . impulseoscillometry (IOS) performed by force oscillation

instrument (JAEGER – Germany) and total respiratoryresistance (R5), proximal respiratory resistance (R20),resonant frequency (Fres), and distal capacitivereactance (X5) of each patient were recorded.Results: All parents had a normal spirometric results, while; 50% of them had an increased resistant of airwayes according to oscillometric finding , 60% ofpatients with abnormal aiway resistance had class Bor C of esophagitis and 40% had class A.After treatment only 16.3% of patients had abnormaloscillometry (P=0.004) Inspite of normal value ofpulmonary function tests (including FEV1, FVC ,FEV1/FVC ) and mean FEEF (25- 75%) befortherapy . the results significantly increased aftertreatment.(p=0.001) . There was no differences inrespiratory responces between patient with mild orsever classes of esophagitis .Conclusion: Abnormal airway resistance may bepresent in GERD pateints even when there is noobvious respiratory symptoms. Anti reflux therapymay improve pulmonary function tests, and oscillometrycan be shown abnormality of baseline parameters betterthan spirometrySend Date: 2011/07/22

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.8 Esophageal malignant diseaseW-F-029Demographic, Clinical Features and TreatmentOutcomes in 700 Patients with Achalasia in Iran

Javad Mikaeli1*, Abbas Hassanzadeh1, Elham Elahi1,Narges Mehrabi1, Arash Etemadi1, Reza Malekzadeh1

1 Digestive Disease Research Center, Tehran university ofMedical SciencesIntroduction: Achalasia is the most recognizedmotor disorder of the esophagus. Because it is not acommon disease, there is little information about it.Here, we report demographic, clinical features andtreatment outcomes in 700 patients with achalasiathat were referred and managed in our center from1994-2009.Method: Diagnosis of achalasia was made accordingto patient's clinical, radiographic, endoscopic andmanometric features. A questionnaire was filed foreach patient, that included patients age, sex, firstsymptoms, frequency of different symptoms,



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Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.4 Reflux disease - pathogenesisW-F-026

Correlation of quality of life withgastroesophageal reflux disease in Qashqai

migrating nomads in Southern IranSeyed Jalil Masoumi 1*, Farnaz Khademolhosseini2,

Davood Mehrabani 3, Fariba Moradi 4,Amir Ahmad Mostaghni 2, Najaf Zare 5,Ali Montazeri 6, Mehdi Saberi-Firoozi 2

1Gastroenterohepatology Research Center/ Department ofNutrition, School of Nutrition and Health, ShirazUniversity of Medical Sciences, Shiraz, Iran2 Gastroenterohepatology Research Center, ShirazUniversity of Medical Sciences, Shiraz, Iran3 Gastroenterohepatology Research Center/ Stem Cell andTransgenic Technology Research Center, Shiraz Universityof Medical Sciences, Shiraz, Iran4 Vice Chancellor for Health Affairs, Shiraz University ofMedical Sciences, Shiraz, Iran5 Department of Biostatistics, School of Medicine, ShirazUniversity of Medical Sciences, Shiraz, Iran6 Iranian Institute for Health Sciences Research, Tehran,IranIntroduction: Gastroesophageal reflux disease(GERD) is one of the most common gastrointestinaldiseases encountered in daily practice. GERDsymptoms are troublesome and disrupt physical,social and emotional well-being of many patients.This cross-sectional study was carried out on Qashqaimigrating nomads of Fars Province in southern Iranto determine how GERD affects their quality of life.Method: 748 subjects older than 25 years wereinterviewed to complete two questionnaires. Oneconsisted of questions on gastroesophageal refluxsymptoms. The second questionnaire was the ShortForm Health Survey (SF-36). This generic health-related quality of life instrument consists of 36 itemsdivided into eight dimensions. It has a 0- to 100-pointscale where higher scores show better functioningand well-being.Results: Of 748 Qashgai migrating nomads whoparticipated in the study, 717 subjects completed theGERD questionnaire, while 371 subjects completedthe SF-36 questionnaire. For all dimensions ofSF-36, the mean score was consistently lower inpatients with GERD when compared to non-GERDsubjects (p<0.001). The dimension most frequently

impaired was role-physical (40.9 vs 77.3) followedby role-emotional (44.7 vs 77.5), physical functioning(66.9 vs 84.6), and general health (46.8 vs 63.8).Quality of life impairment was associated with thefrequency (p<0.05) but not the severity of GERD.Conclusion: Health-related quality of life, asmeasured by SF-36, was significantly associated withpresence of GERD in Qashqai migrating nomads ofFars province in southern Iran. All dimensions ofSF-36 were meaningfully impaired in GERD patientsin comparison with the non-GERD group.Send Date: 2011/08/15

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.5 Reflux disease-diagnosisW-F-027

Status of GERD in IranFathali Borhanmanesh1*, Bita Geramizadeh2

1 Gastroenterohepatology Research Center, ShirazUniversity of Medical Sciences,Shiraz,Iran2 Transplantation Research Center, Shiraz University ofMedical Sciences,Shiraz,Iran



ìÛlìú:KlülûGBqâzQìdPõüBR@ÒzPúGúAuýlAqìÏlûGúìpÿ(DREG)ÞúkoAÖpAkuBèîOñùBKwAqKpgõoÿylülôüBgõokóÒnAøBÿðBuBqâBo¾õoRìþâýpkkoGÏÃþGúÎéQyêGõkókoüúìýBóìpÿôìÏlû(SEL)AüòKlülûGúÆõoìßpo¾õoRâpÖPúôGBÎUuõgPãþôqgîylóìpÿìþyõkÞúko¾õoROlAôïGýzPp,AüòKlülûìñXpGúAüXBkqgîÎíýÜôOñãþìpÿôÂBüÏBRs'tterraBôðùBüPB«upÆBóìpÿìþyõk.ðzBðúøBÿGBèýñþDREGkoÞzõoøBÿÒpGþ(@ìpüßBôyíBëAoôKB)OBclôk02%ôkoWñõJAoôKB01OB51%ôkoÞzõoøBÿ@uýBüþclôk5%ârAo}ylûAuQ.koñlìÇBèÏúAÿÞúkoAüpAóAðXBïylûAuQ(AqÆpüÜì¿BcHúOé×ñþôüBoôkooôOõuÈAÖpAkÒýpKryà)yýõÑGBèýñþAüòðBoAcPþìõokOõWúGõkûAuQô@ìBoÿkoclôk04%WíÏýQârAo}ylûAuQ.Aq@ðXBÞúcvBuýQOzhý¿þÎçDîGBèýñþDREGkoclôk06%ìþGByl,OÏýýòyýõÑÎçDîGBèýñþkoìpkïðíþOõAðlðzBðãpôAÚÏþ@ðúÞúkoìpÿìþânokGByl.GñBGpAüòìÇBèÏúDREGGlôóìÇBèÏúAðlôußõKþðBÚÀôâípAûÞññlûAuQ.GBOõWúGúAüòAìpGúìñËõoìÇBèÏúÞBìêGBèýñþôAðlôußõKþGýíBoAóìHPçGúDREGôWéõâýpÿAqGpôqôSHQAgPçÙðËpkoìzBølARGBèýñþôAðlôußõKýàGúOñùBüþìvEõèýQAðXBïKtôø{oAGÏùlûâpÖQ.oô}Gpouþ:GýíBoAðþoAÞúOõuÈÞBko@ìõqyþôAclGýíBoüùBÿâõAoyþkAðzãBûÎéõïKryßþyýpAq(GýíBouPBóðíBqÿôyùýlÖÛýùþ)kokoìBðãBûGýíBoüùBÿâõAoyþkülûylûGõkðlôGpAÿDGE@ìBkûylûGõkðlìõokGpouþÚpAokAk.ÆþìlR9ìBû(gpkAkOBAu×ñlìBû8831),376GýíBoupKBüþ(61OB48uBèú)ÞúGpAÿðBoAcPþøBÿâõAoyþGúkoìBðãBûâõAo}ìpAWÏúÞpkûGõkðl,

over-the-counter drugs, consult with physicians, andconsume medication advised by their friends.Conclusion: Dyspepsia had a high prevalence inShiraz, southern Iran and was associated with severaldemographic factors, life style, and health-seekingbehavior.Send Date: 2011/08/12

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.2 DyspepsiaW-F-025

Pattern of serum ghrelin level related tomeal-time: A comparison between functional

dyspeptic patients and normal populationMohammadhassan Kazemi1*, Seyed Alireza Taghavi1,

Abbas Rezaianzadeh1, Laleh Hamidpour1

1 Gastroenterohepatology Research Center (GEHRC),Shiraz university of Medical Sciences, Shiraz , IranIntroduction: Functional dyspepsia (FD) is the mostcommon type of dyspepsia that implies when acomplete diagnostic evaluation has been performedand obvious structural gastrointestinal disease hasbeen excluded. Ghrelin which is a ligand of growthfactor receptor is synthesized mostly in gastricmucosa. It has a wide range of function ingastrointestinal tract including motor activity, controlof appetite and healing of mucosa. The level ofghrelin is increased pre-prandial and decreasedpostprandially. The aim of this study was to comparethe change of serum ghrelin level at different timesbetween patients with functional dyspepsia andcontrol group and investigate if any differencesobserved between those two groups, maybe thishormone possibly has a role in inducing FD.Method: 18 subjects with functional dyspepsia and 8normal subjects as a control group were enrolled inthis study. Blood samples were collected 5 times , 30minutes before special breakfast, exactly be-fore,30,60 and 90 minutes after breakfast. Radioim-munoassay was done for determination of totalghrelin in serum.Results: The mean age of patients and control groupwere 33.3 ±9.8 and 24.7±1.2 respectively. Thisdifference was statistically significant. (p=0.022).Serum level of ghrelin in the two groups under study,control and patients was checked. Ghrelin level 30

minutes after breakfast was significantly higher inpatients compared to controls (751 vs. 576.9p=0.033).Although compared to controls, patientshad a higher mean of ghrelin at other times, only 30minutes after breakfast the difference was significant.Also patients had a higher level of ghrelin at all timescompared to controls, except 90 minutes afterbreakfast and shape of the curve was different in thepatients and controls after 60 minutes of study.Figure1: Serum Ghrelin level in functional dyspepticpatients and control group

Group 1:ControlGroup 2:patientsConclusion: Highest level of serum ghrelin in bothgroup was 30 minutes pre-meal time. Then serumlevel of ghrelin decreased just before meal time until30 minutes after meal time.after that the level ofserum ghrelin increased. Although statisticallysignificant differences of serum ghrelin level betweentwo groups was only at 30 minutes after meal ,butafter 30 minutes till 90 minutes of serving breakfast,pattern of the curve which showed changing of serumghrelin level in different times related to meal timewas different between two groups as showed in figure1.This time(30 till 90 minutes after meal) was thetime that dyspeptic group became symptomatic .Different pattern of changes in serum ghrelin level infunctional dyspeptic patients compared to normalcontrol group in the time which dyspeptic groupbecame symptomatic, open a new window ofpossibilities that Ghrelin as a hormone may have animportant role in inducing symptoms in patients withfunctional dyspepsia. Send Date: 2011/08/18



W-F-023Correlation of dyspepsia with quality of life in

Qashqui migrating nomads, Southern IranFariba Moradi1, Seyed jalil Masoumi2*, DavoodMehrabani3, Najaf Zare4, Ahmad Mostaghni5,

Mehdi Saberi-Firouzi5, Ali Montazeri6

1 Vice Chancellor for Health Affairs, Shiraz University ofMedical Sciences, Shiraz, Iran2 Gastroenterohepatology Research Center/ Department ofNutrition, School of Nutrition and Health, ShirazUniversity of Medical Sciences, Shiraz, Iran3 Gastroenterohepatology Research Center/Stem Cell andTransgenic Technology Research Center, Shiraz Universityof Medical Sciences, Shiraz, Iran4 Department of Biostatistics, School of Medicine, ShirazUniversity of Medical Sciences, Shiraz, Iran5 Gastroenterohepatology Research Center, ShirazUniversity of Medical Sciences, Shiraz, Iran6 Iranian Institute for Health Sciences Research, Tehran, IranIntroduction: Functional dyspepsia is a highlyprevalent gastrointestinal disorder that can presentmany clinical dilemmas in patient management.Although not life-threatening, the symptoms arelong-lasting, interfere with daily activities and have asignificant impact upon the quality of life. This studyinvestigates the correlation of dyspepsia and qualityof life in Qashqai migrating nomads in Fars province,southern Iran.Method: In summer 2009, 784 Qashqai migratingnomads aged 25 years or older were enrolled using amultiple-stage stratified cluster random samplingmethod. The questionnaire of Rome II diagnosticcriteria for dyspepsia was used for diagnosis ofdyspepsia. For about 50% of them, SF 36questionnaire was also completed.Results: The prevalence of dyspepsia was 29.9%.The dyspeptic patients were classified as havingulcer-like (27.9%), dysmotility-like (26.2%), orunspecified dyspepsia (45.9%). Difference in SF36questionnaire domains was significant in dyspepticpatients in comparison to non-dyspeptic ones.Conclusion: Dyspepsia had a high prevalence inShiraz, southern Iran and its relation to quality of lifewas very high.Send Date: 2011/08/12

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS

2.2 DyspepsiaW-F-024

Prevalence of dyspepsia in Qashquimigrating nomads, Southern IranSeyed jalil Masoumi1*, Fariba Moradi2,

Davood Mehrabani3, Najaf Zare4,Ahmad Mostaghni5, Mehdi Saberi-Firouzi5

1 Gastroenterohepatology Research Center/ Department ofNutrition, School of Nutrition and Health,ShirazUniversity of Medical Sciences, Shiraz, Iran2 Vice Chancellor for Health Affairs, Shiraz University ofMedical Sciences, Shiraz, Iran3 Gastroenterohepatology Research Center/Stem Cell andTransgenic Technology Research Center,Shiraz Universityof Medical Sciences, Shiraz, Iran4 Department of Biostatistics, School of Medicine,ShirazUniversity of Medical Sciences, Shiraz, Iran5 Gastroenterohepatology Research Center, ShirazUniversity of Medical Sciences, Shiraz, IranIntroduction: Dyspepsia is a common disorder thatoccurs in approximately 25 percent (range 13 to 40percent) of the population each year can present manyclinical dilemmas in patient management. Althoughnot life-threatening, the symptoms are long-lasting,interfere with daily activities and have a significantimpact upon the quality of life. This study wasperformed to evaluate the prevalence and risk Factorsof dyspepsia and its relation to life style in Qashqaimigrating nomads in Fars province, southern Iran.Method: In summer 2009, 784 Qashqai migratingnomads aged 25 years or more were enrolled using amultiple-stage stratified cluster random samplingmethod. A questionnaire consisting of demographicfactors, lifestyle data and gastrointestinal symptomswas completed for each participant. Thequestionnaire of Rome II diagnostic criteria fordyspepsia was used for diagnosis of the disease.Results: Among dyspeptic patients (29.9%), 27.9%had ulcer-like; 26.2%, dysmotility-like and 45.9%had unspecified dyspepsia. The prevalence washigher in females, water-pipe smokers, NSAIDsusers, and in those with psychological distress,recurrent headache, anxiety, nightmare and pasthistory of gastrointestinal disease. Dyspepsia had aninverse relationship with consumption of pickles,fruits and vegetables and with duration of meals.Subjects with dyspepsia symptoms were more likelyto restrict their diet, take herbal medicine, use



has been known as a high risk area for helicobacterpylori (HP) infection as well as upper gastrointestinal(UGI) cancers. Gastritis (G), as an outcome of HPinfection, is an important health problem in this area.Subtypes of G, including atrophic gastritis (AG) andcorpus AG (CAG) were considered as risk factors forUGI cancers. Endoscopy, as the diagnosis of choicefor these conditions, is an invasive procedure withlow acceptance rate. So, considering a noninvasivemethod such as a serum marker may help for earlydiagnosis of the conditions and result in preventionand controlling UGI cancers. We conducted this studyto evaluate the accuracy of pepsinogens I (PI) and II(PII) and the PI/PII ratio to discriminate G, AG andCAG.Method:In this diagnostic accuracy study, patientswith gastritis and its subtypes as well as normalindividuals were recruited. Endoscopic biopsy and

histopathological examination was done as goldstandard for diagnosis of gastritis. Serum levels of PIand PII were assessed by quantitative enzyme linkedimmunosorbent assay (ELISA) method. Receiveroperating characteristic (ROC) curve analysis wasused to determine the accuracy of pepsinogens foridentifying G, AG and CAG.Results: A total number of 69 normal individualswith mean age of 43 years and 126 gastritis patientswith mean age of 47 years were recruited (P=0.1). 46percent of normal group and 47% of patients weremale (p=0.9). The area under ROC curve (AUC) andits 95% confidence interval (CI) for PI to discriminateG, AG and ACG were 69% (61-77), 79% (71-88),83% (73-93), respectively. The AUC (95% CI) PI/PIIratio to distinguish G, AG and ACG were 68%(60-76), 77% (68-86), 89% (81-98), respectively.Conclusion: The accuracy of PI and PI/PII ratio wasacceptable for distinguishing G, AG and CAG withthe highest accuracy for CAG. So, pepsinogens maybe useful for conducting screening programs in highrisk areas. The epidemiology and burden of disease inthe population as well as the main goal of theprogram should be considered to make the bestdecision in the community level.Send Date: 2011/07/14

Category: 2 ESOPHAGEAL-GASTRIC AND

DUODENAL DISORDERS2.2 DyspepsiaW-F-022

Comparison of domperidone andpyridostigmine in treatment of dyspeptic

symptoms in patients with functionaldyspepsia: a randomized clinical trial

Javad Shokrishirvany1, Esrafil Shad1*,Hassan Taheri1

1Department of Gastroenterology, Babol University ofMedical SciencesIntroduction: Various drugs with unsatisfactoryresult were suggested for functional dyspepsia. Thisstudy was designed to evaluate the efficacy ofdomperidone and pyridostigminea in patients withfunctional dyspepsia.Method: This clinical trial performed on 117 patientswith functional dyspepsia (basis on ROME II criteria)for comparing the effect of four weeks of treatmentwith domperidone 10 mg TDS, pyridostigmine 60 mgTDS and placebo. VAS score was used for scoring eightindividual upper GI symptoms (fullness, early satiety,gnawing, nausea, vomiting, belching bloating andepigastric pain) before and at the end of treatment.Results:The total score decreased from 24 to 13 butin ANOVA test there was significant differences in 3of 8 symptoms score between three groups: bloating,early satiety and nausea (p=0.039, p=0.006 & p= 0.016;respectively). With post Hoc Test, domperidone weremore effective than pyridostigmine in nausea (p=0.024,)placebo had superiority in controlling of bloating thanpyridostigmine (p=0.042 ) domperidone was moreeffective than placebo in relieving bloating(p=0.023). domperidone was more effective thanpyridostigmine and placebo In improvement of earlysatiety (p=0.038 , p=0.014; respectively). In total GIsymptoms domperidone had more efficacy than othertwo treatment (p=0.045).Conclusion: Dompridone and pyridostigmine wouldbe usefull in improving early satisty and nausea. Butwere similar with placebo in controlling of epigastricpain, fullness, belching and gnowing.Send Date: 2011/07/20

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.2 Dyspepsia



Results: A total of 99 patients ended the trial,64patients (80%) of probiotcs group and 35 patients(44%) of placebo group, abdominal pain and bloatingreduced significantly in probiotics group but thisreduction was not significant in placebo group.Improving effect of probiotics remained at least forone month in 85% of patients.Conclusion: This is the first trial in Iran showed thatprobiotics can reduce the severity of pain andbloating in Iranian patients affected by pain andbloating predominant IBS and this effect will beremained at least for one month.Send Date: 2011/08/06

Category: 1 CLINICAL PRACTICE1.5 PharmacoeconomicsW-F-020The direct medical costs of colorectal cancer in Iran

Mohamad Hasan Emami1, Mohammad Reza Maracy2,Saeid Massah3, Diana Taheri1, Majid Davari4*

1 School of Medicine, Isfahan University of medical Sciences2School of Health, Isfahan University of medical Sciences3School of Pharmacy, Isfahan University of medical Sciences4School of Management and Medical Information, IsfahanUniversity of medical SciencesIntroduction: The treatment cost of cancers is one ofthe major issues globally and in Iranian healthsystem. The high cost treatment of colorectal cancer,as one of the important cancers in Iran, has affectedboth patients and the government importantly. Theaim of this study was to analyze the direct medicalcosts of colorectal cancer in Iran.Method: This study is a retrospective analysis of allpatients with colorectal cancer in Seyed-Alshohadahospital in Isfahan (a state-owned cancer hospital inIsfahan) between the years 1384 and 1389. Therelevant data including age, sex, disease stage andtreatment expenditures extracted from patients'profiles. Extracted data were analyzed usingdescriptive and inferential statistical methods(Kruskal-wallis) through SPSS software.Results: The profiles of 435 patients were reviewed.But, considering inclusion and exclusion criteria,only 320 patients were included in the study. Theresults showed that the numbers of male patients(56/1%) are higher than the females. The average ageof the patients were 56 years old which is

significantly lower than many other countries. While35.6 % of the patients categorized in stages I-III,64.4% were in stage IV. As the stages of the diseasewere increased, the diversity and frequency ofmedical services were also increased considerably.The treatment costs of the patients variedsignificantly within and between the disease stages.5FU/LV was the most chemotherapy regimen(42/5%) used for the patients. The average costs oftreatment were 86 (22.5) Million Rials in stage I and141(29.0) Million Rials in stage IV.Conclusion: Colorectal cancer treatment attractsconsiderable amount of financial resources of theIranian population each year. This is particularlyimportant when taking into account that the treatmentcosts considered in this study obtained from a statehospital. Thus, it is reasonable to expect that themarket price of colorectal cancer treatment in Iran ismuch higher than the figures presented in this study.Considering the fact that patients' age group in Iran islower than many other countries, the results mayencourage clinicians and health policy makers toconsider preventive strategies which may possiblyprovide better value for money for managingcolorectal cancer in Iran.Send Date: 2011/08/21

Category: 2 ESOPHAGEAL-GASTRIC ANDDUODENAL DISORDERS2.1 Cell/molecular biology/pathologyW-F-021

Diagnostic values of pepsinogens todiscriminate gastritis, atrophic

gastritis and corpus atrophic gastritisFatemeh Nejhadi Kelarijani1, Taghi Amiriani1*,Gholamreza Roshandel1, Abbasali Keshtkar2,

Behzad Faghani3, Atefeh Akhavan Tabib4,Ali Ahmadi3, Masoud Khoshnia1, Yazdan Sadeghi4,

Alireza Mojrian4, Sima Besharat1, Shahryar Semnani1

1 Golestan University of Medical Sciences, GolestanResearch Center of Gastroenterology and Hepatology2Endocrinology and Metabolism Research Institute, TehranUniversity of Medical Sciences3 Department of pathology, Tehran University of MedicalSciences4 Golestan University of Medical SciencesIntroduction: Golestan province in northeast of Iran



for hepatitis B surface Antigen (HBs-Ag) andantihepatitis B core Antibody(antiHBc-Ab) byEnzyme linked immunoassay (ELIZA).Results: In our study 19.7% of subjects were youngerthan 18 years which for them routine neonatalvaccination against hepatitis B has been done that isalmost compatible with the percentage of vaccinatedpopulation against hepatitis B in Kavar (24.55%).The prevalence of hepatitis B surface Antigen(HBs-Ag) and antihepatitis B core Antibody(HBc-Ab) in vaccinated population were 0.88%(18subjects) and 1.66%(34 subjects) respectively; and inunvaccinated population were 1.14%(95 subjects)and 6.56%(546 subjects) with p= 0.0001 for HBs-Agand p=0.001 for HBc-Ab that were significant.Conclusion: Although exposure rate wassignificantly decreased after vaccination(asmanifested by significantly lower rate of Anti HBcAb positivity,1.66% in vaccinated versus 6.56%inunvaccinated population),the rate of hepatitis B virusinfection was not decreased in the same rate(0.88% invaccinated versus 1.14%in unvaccinated population).This discrepancy may be indicate a significant rolefor vertical transmission of hepatitis B virus infection,which cannot be really affected by routine neonatalvaccination; although this theory needs furtherstudies to be proven (GastroenterohepatologyResearch Center at Shiraz University of medicalSciences is testing the families of HBs-Ag positivesubjects to verify this theory.)Send Date: 2011/08/19

Category: 1 CLINICAL PRACTICE1.4 Outcome studiesW-F-018

Send Date: 2011/08/22

Category: 1 CLINICAL PRACTICE1.5 PharmacoeconomicsW-F-019

The effect of Probiotics in Iranian patientswith irritable bowel syndrome:

a double-blind randomized-controlled studyHomayoon Vahedi1*, Elham Jafari1,

Shabnam Momtahen1, Aina Riahi1, Reza Malekzadeh1

1 Digestive Diseases Research center, Tehran University ofMedical SciencesIntroduction: Probiotics are Live microorganismswhich when administered in adequate amounts confera health benefit on the host. We aimed to access theefficacy of probiotics for improvement of some IBSsymptoms in a double-blind randomized trial.Method: 160 eligible patients with normal lactoseintolerant breath test were randomly assigned toreceive Probiotics (n=80) or placebo (n=80), 2 cap/day during one month. Severity of abdominal painand bloating compared before and after treatment.



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in each group; all of them completed the study. Thetwo groups were similar in age, sex, and baselinesymptoms except stool frequency. After treatment,stool frequency increased in both groups (p<0.001)with greater increase in symbiotic group (p<0.05).Frequency of hard/very hard stool and frequency ofpainful deification decreased in both groups similarly(p<0.001). Urgency was decreased in symbiotic(p<0.05) but not the mineral oil group. Straindecreased in both groups (p<0.001) but moredecrease was seen in symbiotic group (p<0.05).Mucus in stool was decrease in both groups similarly(p<0.001). Incomplete evacuation and leak of stooldecreased in both groups (p<0.05) with greater de-crease in symbiotic group (p<0.05). Finally, overallsymptoms in mineral oil group improved moderatelyin 36.7% and extremely in 40.0% of children. In thesymbiotic group, overall symptoms improved mod-erately in 13.8% and extremely in 86.2% of children.According to multivariate analyses, among factors in-cluding age, sex, baseline constipation symptoms andgroups, only receiving the symbiotic mineral oil wasassociated with greater improvement in overall symp-toms (p=0.003, t=3.1). No severe side effects wereobserved in children.Conclusion: These results indicated that addingsymbiotic (Lactole) to the routine treatment ofconstipation in children (mineral oil) can significantlyincrease the global improvement in symptoms,without specific side effects. Further studiesevaluating and comparing other symbiotic agentseither alone or along with other standard treatmentsand longer follow-ups of children with constipation iswarranted.Send Date: 2011/08/04

Category: 1 CLINICAL PRACTICE1.3 Evidence-based clinical practiceW-F-016

Send Date: 2011/08/22

Category: 1 CLINICAL PRACTICE1.4 Outcome studiesW-F-017

The prevalence of Hepatitis B virusinfection in kavar - southern of Shiraz, Iran

Mohammadreza Fattahi1, Zahra Zonubi1,Maryam Ardebili1*, Abbas Rezaianzadeh1

1 Gastroenterohepatology Research Center (GEHRC),Shiraz University of Medical Sciences, Shiraz, IranIntroduction: Hepatitis B virus infection is acommon cause of chronic liver disease in Iran andother countries. It is one of the most prevalent publichealth problems worldwide, particularly indeveloping countries. The prevalence of hepatitis Bvirus infection in Fars, Southwest province of Iran isestimated to be 1.7% based on previous researches.Routine neonatal vaccination for hepatitis B virusinfection prevention has been started since 1973 inIran. The aim of current population based cross-sectional study was to compare the prevalence ofhepatitis B virus infection in vaccinated versusunvaccinated population of this area.Method: We randomly selected 10352 subjects outof normal population of Kavar, a small town locatedin Southeast of Shiraz. Subjects enrolled in this studywere older than 7 years. Serum samples were tested



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ecneislacidemfoytisrevinuzirbaT,noitirtuN1

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GýíBoüùBÿÚéHþÎpôÚþìÇpfylûAuQ.øíñýòìÇBèÏBRAoOHBÉìPñBÚÃþGýòkoüBÖQÖõæRôgÇpGpôqupÆBóÞõèõóðzBókAkûAðl.oô}Gpouþ:GúìñËõoGpouþASpARkoüBÖQðBÞBÖþÖõæRGpGpôqôKýzpôÿupÆBóÞõèõó,ìÇBèÏBRAðXBïylûAquBë2002ìõokGpouþÚpAoâpÖQ.üBÖPúøB:ðPBüYcB¾êAqìÇBèÏBRìhPéØ,AqWíéúìPB@ðBèýrAðXBïylûkouBë0102KýzñùBkìþÞñlÞúAoOHBÉìÏßõuþGýòkoüBÖQÖõæRôgÇpGpôqupÆBóÞõèõóôWõkkAok;ÞúkooAuPBÿìPB@ðBèýrAðXBïylûkouBë5002AuQ.ðPBüYðzBóìþkølÞúkoüBÖQGBæÿÖõæRgÇpupÆBóÞõèõóoA51-8%ÞBø{ìþkøl.AgýpA«ñlìÇBèÏúÞBo@qìBüþGBèýñþkooAGÇúGBðÛ{ÖõæRkoGpôqupÆBóÞõèõóAðXBïylûAuQôðPBüYcB¾êAqüàìÇBèÏúðzBókAkûAuQÞúìßíêüBoÿ5ìýéþâpïÖõæRkooôqGúìlRuúuBëGBÞBø{ìÏñþkAoGpôqupÆBókoAoOHBÉAuQ.ko¾õoOþÞúkoüBÖQÖõæRkoìÛBküpKBüýò^ñýòASpÿoAðzBóðlAk.ðPýXúâýpÿ:koìXíõÑìþOõAóâ×QÞúkoüBÖQìÛBküpÞBÖþÖõæR^úGú¾õoRìßíêüBoÿôúkoÚBèIÒnAøBìþOõAðlgÇpupÆBóÞõèõóoAÞBø{køl;øpñlGpAÿOÏýýòìÛlAokÚýÜÖõæRìõokðýBqGpAÿkuPýBGþGúAüòølÙGúìÇBèÏBRGýzPpÿðýBqAuQ.

Send Date: 2011/08/23

Category: 1 CLINICAL PRACTICE1.2 Management strategies

W-F-014Application of Midazolam and Propofol in

Esophagogastroduodenoscopy; aTriple-Blind, Randomized Controlled Trial

Narges Soltanpour1, Fatemeh Bayat1, Vahid Mirzaee1*

1 Department of Gastroenterology, Rafsanjan University ofMedical Sciences, Rafsanjan, IranIntroduction: Use of intravenous sedatives becamecommon in gastrointestinal endoscopy. This study is toevaluate the safety and efficacy of propofol and/ormidazolam in induction of proper sedation inesophagogastroduodenoscopy (EGD) compared with acontrol group which does not receive sedation for EGD.Method: Four groups (A, B, C and D) of patientseach of which consisted of 30 patients for whomesophagogastroduodenoscopy had been indicatedwere defined. For groups A, B, C and D, no sedative,midazolam, propofol and midazolam plus propofolwere administered intravenously, respectively. Thefour groups were compared with each other regardingheart rate (HR), O2S (oxygen saturation), systolicblood pressure (SBP), diastolic blood pressure(DBP), duration of endoscopy (DE), patientcompliance (CM), retrograde amnesia (RA),antegrade amnesia (AA), patient activity (PA), skincolor (SC), patient consciousness (CS), blood flow(BF), respiration state (RS) and pain.Results: Patient compliance (CM), retrogradeamnesia (RA), antegrade amnesia (AA), patientactivity (AC), patient consciousness (CS) and painwere significantly different in our patient groups. Onthe contrary, no significant difference was found

among the four groups regarding heart rate (HR),oxygen saturation (O2S), systolic blood pressure(SBP), diastolic blood pressure (DBP), duration ofendoscopy (DE), skin color (SC), blood flow (BF)and respiratory state (RS).Conclusion: Based on our findings, on EGD nosedation is needed unless the patient feels anxiousand therefore cannot cooperate appropriately. For thiscase, administration of propofol alone is prioritizedover midazolam alone and propofol plus midazolam.Send Date: 2011/06/04

Category: 1 CLINICAL PRACTICE1.2 Management strategiesW-F-015Effect of Synbiotic in the Treatment of Children

with Functional Constipation Referring toAlzahra University Hospital in Isfahan, 2010

Hossein Saneian1*, Pardis Adhamian2,Kamran Tavakol2, Ali Gholamrezaei1

1 Medical college, Isfahan University of Medical Sciences(IUMS)2 Medical college, Islamic Azad Najafabad University ofMedical SciencesIntroduction: Constipation is one of the mostcommon gastrointestinal disorders in children and inmore than 90% of the cases there is no structuralcause for which diagnosis of functional constipationis made. We compared mineral oil plus Symbioticwith mineral oil alone in the treatment of functionalconstipation in children.Method: This controlled clinical trial was conductedin Isfahan in 2010. Children with functionalconstipation (Rome III) were included andrandomized to receive symbiotic (1 tab Lactol /20kg/d) plus mineral oil (1 ml/kg/d) or mineral oil alonefor two months. Symptoms of constipation includingfrequency of deification, stool form, urgency, strain,incomplete evacuation, pain, and leakage of stoolwere assessed and compared before and after thestudy. After the study, the two groups were alsocompared in regards to subjective globalimprovement and adequate relief of symptoms. Datawere analyzed with SPSS using t-Test, Chi-Squae,Mann-Whitney, and Wilcoxon tests and alsomultivariate analyses.Results: During the study, 30 children were included



ô5/53%@ðpAìñBuIAoqüBGþÞpkûAðl.clôk09%GBuÇeGñlÿglìBROh¿¿þâõAo}ôÞHlkoÞzõoìõAÖÜGõkûô7/88ko¾lGBÆpfAoAüúAüòglìBRko4uÇeìõAÖÜGõkûAðl.ðPýXúâýpÿ:Gh{ìùíþAqðýpôÿAðvBðþkoGh{øBÿÒýpkôèPþÖÏBèýQìþÞññl.OípÞrðýíþAqìPh¿¿ýòkoìpÞrÞzõo,ðýBqGúGpouþWlÿkAok.OñËýîOÏlAkðýpôÿAðvBðþôìýrAóKnüp}GpAÿAoADúglìBRkoùBouÇeìþOõAðlAqAølAÙoAøHpkÿAüòoyPúkoÞzõoGByl.AoADúglìBR@ìõqyþKtôøzþôkoìBðþKýzpÖPúkoìÏlôkÿAqìpAÞrOõAðíñlôâvPp}glìBRuBkûôAôèýúkoAÚ¿þðÛBÉÞzõoAqA¾éþOpüòAWrAÿAüòuÇeGñlÿìþGByñl.

period of time (since 2005 until 2012). This studyincluded all the patients who had approached to aprivate gastroenterology clinic in Mashhad and werediagnosed as IBD.Data were collected from the patients’ electronic files,encoded and then entered in SPSS. These Dataincluded age, gender, type of disease (Ulcerativecolitis and Crohn’s disease), extension of intestinaldisease and also extra-intestinal manifestation.Results: A total of 364 patients including 183 females(50.3%) were evaluated. Mean age of the patientswas 34.3 ± 13.04 years. Male to female ratio was 0.58for Crohn’s disease and 1.07 for ulcerative colitis.13.5% had Crohn’s disease and 86.5% had ulcerativecolitis. The most common sites of involvement werepancolitis, proctitis and then left-sided colitis. ForCrohn’s disease, the most common presentation wasterminal ileitis. Among extra-intestinal manifesta-tions, sclerosing cholangitis had the highestfrequency and was found in 12 (3.4%) patients.Conclusion: This study shows that in northeast ofIran, the disease is most common in the third decadeof life and it almost has the same frequency in malesand females.The most common extra-intestinalpresentation is primary sclerosing cholangitis.Send Date: 2011/08/18

Category: 1 CLINICAL PRACTICE1.1 EpidemiologyW-F-011

Prevalence of celiac dusease in osteoporoticpatients in comparison to healthy subjects

Ahmad Khoncheh1, Ahmad Reza Jamshidi2,Farza Ranjpour1, Atieh Rahmati3, Bijhan

Shahbazkhani1*

1Digestive Disease Research Center, Tehran University ofMedical Sciences2 Rheumatology Research Center, Tehran University ofMedical Sciences3 GI and liver Disease Research Center, Tehran Universityof Medical SciencesIntroduction: There is an increased prevalence ofosteoporosis among patients with celiac disease.However, the relative prevalence of celiac diseaseamong osteoporotic and nonosteoporotic populationsis not known, and the benefit of screening theosteoporotic population for celiac disease remains

controversial.Method: We evaluated 200 individuals, 100 with and100 without osteoporosis, from the rheumatologyclinic in Imam Khomeini and Shariati Hospital byserologic screening for celiac disease. The clinicalfindings were evaluated in the both groups and werecompared together.Results: 2 (2%) of 100 patients with osteoporosis and1 (1%) of 100 patients without osteoporosis testedpositive by serologic screening for celiac disease. Allpatients with positive serologic test were female andthe mean age was 56.5± 6.4 years. The prevalence ofclinical findings in 2 patients with osteoporosis wasmore than 1 patient without osteoporosis.Conclusion: The prevalence of celiac disease inosteoporosis is not high enough to justify a recom-mendation for serologic screening of all patients withosteoporosis for celiac disease; but in patients withendocrine autoimmune disease and gastrointestinalfinding it is necessary to evaluate celiac disease.Send Date: 2011/08/20

Category: 1 CLINICAL PRACTICE1.1 Epidemiology

W-F-012



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polymerase chain reaction (RT-PCR) for detection ofHCV-RNA.Results: The study population consisted of 214 men(94.7%) and 12 women (5.3%) with a mean age of35.6±7.9 years. The most prevalent risk factor wasimprisonment (88.9%) followed by injecting drug use(79.2%). The prevalence of HCV infection was88.5% by ELISA and 86.7% by RIBA, while HCVviremia was detected in 26.1% of the patients.HCV-antibody positivity was significantly associatedwith gender, age, marital status, occupation, injectingdrug use, and history of imprisonment. It wasinversely related to “having an infected or high risksexual partner”. In the logistic regression model, thepredictors of HCV-positivity were injecting drug use(OR=24.9, P=0.004) and imprisonment (OR=21.4,P<0.001).Conclusion: Prevalence of HCV infection amongHIV-positive individuals in our region is very high andthere is a need for stricter preventive actions againsttransmission of HCV among this group of patients.Send Date: 2011/08/17


The prevalence of hepatitis C infection in generalpopulation of two villages of Fars province

Mohammadreza Fattahi1, Faezeh Mohammad Doust2*,Seyed Mohammad Kazem Hosseini Asl3

1 Gastroenterohepatology Research Center (GEHRC),Shiraz University of Medical Sciences, Shiraz, Iran2 Department of Internal Medicine ,Shiraz University ofMedical Sciences,Shiraz,Iran3 Gastroenterohepatology Research Center (GEHRC),Shiraz University of Medical Sciences, Shiraz, IranIntroduction: Hepatitis C virus (HCV) infection is amajor blood-borne infection with silent epidemic andmajor global public health problem and diverseprevalence worldwide. To determine the prevalenceof HCV infection in general population of twovillages, Farmashkan and Akbarabad, of Kavar city,Fars province in Iran, and evaluate the real riskfactors in these areas.Method: A cross-sectional study was performedduring 3 years from July 2007 to April 2010. All ofIranian participants aged equal or above 7 years old

were evaluated for HCV antibody withenzyme-linked immunosorbent assay (ELISA).PCRis being done right now.Results: Fifteen out of 6095 (2218 men and 3877women with minimum age of 7 years and maximumof 95 years old, mean±SD age of 34.58±17.29)participants were anti-HCV positive (prevalence0.24%). The highest prevalence was seen in age ≤12years old (1%). A statistically significant correlationwas found between blood transfusion and presenceof anti-HCV antibody (p=0.000). Those with ahistory of blood transfusion had fifteen fold higherrisk for anti-HCV positivity (odds ratio 15.54;95%CI= 4.89-49.41). No statistically significantcorrelation was found among other variants andpositive anti-HCVConclusion: Due to non-significant correlationbetween other variants and anti-HCV+ except bloodtransfusion, further evaluation for detection of riskfactors is recommended. Moreover, it is emphasizedthat the donated bloods be evaluated with PCR andthe importance of sterility of instruments in medicaland non- medical conditions and education oftransmission routes be taken into account.Send Date : 2011/08/18


Epidemiologic profile and clinicalcharacteristics of inflammatory bowel

disease in northeast of Iran: a 7 year reviewHassan Vossoughinia1, Siavash Abedini1, Ahmad

Khosravi Khorashad1, Hamid Reza Sima2, Ali Bahari2,Mohammad Khajedaluee1, Sahar Abedini1,Maryam Golshahi3*, Fereshteh Hosseini3

1 Internal Medicine Department,Ghaem Hospital, MashhadUniversity of Medical Sciences2 Internal Medicine Department,Emam Hospital, MashhadUniversity of Medical Sciences3Razavi Hospital, Mashhad University of MedicalSciences, IranIntroduction: Few studies have been done in Iranabout inflammatory bowel disease (IBD). In thisstudy, we tried to determine the epidemiologic andclinical characteristics of IBD in northeast of Iran.Method: This was a retrospective study in a 7 year



(15.2%). The p.R761H mutation (4.7%) was foundto be the most frequent among the rare mutations.Conclusion: The results show the diversity and thefrequency of the mutations in the Iranian Azeri Turk-ish FMF patients. The p.R761Hmutation is ratherprevalent in Azeri Turks; thereforeSend Date: 2011/08/11


Prevalence of Hepatitis D VirusInfection among HBV Infected

Patients in Qom Province, Center of IranMohammad-Reza Ghadir1*, Mojtaba Belbasi2,

Akram Heidari3, Abolfazl Iranikhah4,Seyed-Saeid Sarkeshikian1, Seyed-Moayed Alavian5

1 Shahid Beheshti Hospital, Qom University of MedicalSciences, Qom, Iran2 Research Center, Iranian Blood Transfusion Organization,Qom, Iran3 Qom University of Medical Sciences, Qom, Iran4 Hazrat Masoumeh Hospital, Qom University of MedicalSciences, Qom, Iran5 Gastroenterology and Liver Research Center,Baghiatallah University of Medical Sciences, Tehran, IranIntroduction: Hepatitis D virus (HDV) is a defectiveRNA virus that depends on the hepatitis B surfaceantigen (HBsAg) of hepatitis B virus for its replication,developing exclusively in patients with acute orchronic hepatitis B. There is little data availableregarding the routes of HDV transmission in Iran.The risk factors for acquiring HDV infection in somestudies in Iran are blood transfusion, surgery, familyhistory, Hejamat (traditional phlebotomy), tattooing,war injury, dentistry interventions and endoscopy. Weplanned this study to determine the prevalence ofhepatitis D in the general population of Qom provinceand potential risk factors for acquiring HDV.Method: The present study is a cross-sectional study.A total of 3,690 samples were collected out of 7 ruralclusters and 116 urban clusters. HBs-antigen wasmeasured at the lab and if the test was positive,anti-HDV Ab would investigate. Ten teams, eachconsisting of 2 trained members, were assigned toconduct sampling and filling the questionnaires. Thedata were analyzed using the SPSS software.

Results: Totally, 48(1.3%) suffered from hepatitis B andjust one HBsAg positive case had HDV infection. Theprevalence rate of hepatitis D infection in Qom Provincewas 0.03%. The prevalence rate of hepatitis D infectionin HBsAg positive cases was 2%. Our anti-HDV Abpositive case had history of tattooing, surgery history anddental surgery history. There was no significantrelationship between tattooing, surgery history and dentalsurgery history and hepatitis D infection.Conclusion: The prevalence rate of hepatitis D inQom is low. This research showed that the prevalenceof HDV in Qom province is the lowest rate in Iranlike the similar study in Babol (North of Iran).Send Date: 2011/08/13


Hepatitis C virus infection in HIVpositive attendees of Shiraz Behavioral

Diseases Consultation Center in southern IranMohammad Ali Davarpanah1, Farnaz

Khademolhosseini2*, Abdolreza Rajaeefard3,Alireza Tavassoli4, Seyed Kamalaldin Yazdanfar4,

Abbas Rezaianzadeh3

1 HIV-AIDS Research Center, Shiraz University of MedicalSciences, Shiraz, Iran2 Gastroenterology and Hepatology Research Center,Shiraz University of Medical Sciences, Shiraz, Iran3 Department of epidemiology,School of public health,Shiraz University of Medical Sciences, Shiraz, Iran4 Fars Blood Transfusion Organization, Shiraz,IranIntroduction: The aim of this study was to determinethe prevalence of HCV co-infection and its correlationwith demographic and risk factors among HIV-infectedindividuals attending Shiraz Behavioral DiseasesConsultation (SBDC) Center in southern Iran.Method: In a cross-sectional study, 226 consecutiveHIV-positive patients who referred to SBDC Centerfrom April 2006 to March 2007 were interviewedface-to-face to record demographic data and riskfactors of HIV transmission. A 10 ml sample ofvenous blood was drawn from every subject andtested for HCV-antibodies by third generationenzyme linked immunosorbant (ELISA) andrecombinant immunoblot assays (RIBA). All sampleswere also analyzed by qualitative reverse transcriptase



whether or not significant differences exist.Method: This single-center study was conducted inTehran, Iran during 2009-2010. IBS was diagnosedon the basis of Rome III criteria. Finally 144 patientswere confirmed to have IBS and recruited to thestudy. A simple 10 point objective questionnaire wasused.Results: A total number of 144 IBS patients including44 (33.5%) males and 100 (69.5%) females with themean age of 37.50 (SD=11.50) years, were assessed.The only differently observed symptom was nauseawhich was significantly more prevalent in females(49% vs. 18.2%, p<0.001). The commonest subtypeof IBS in male patients was diarrhea predominant IBS(IBS-D) (38.6%); while, constipation predominant IBS(IBS-C) was the most frequent type among females(38%). Moreover, the frequency of loose, mushy orwatery stools within last 3 months was also signifi-cantly more common in males [2.11 (SD=1.67) vs.1.37 (SD=1.50), p=0.009].Conclusion: Gender differences can be defined asmale–female differences in the incidence, prevalence,mortality, and burden of diseases and other adversehealth conditions and the responses to those diseasesand conditions. Hereby, we report that gender isimportant in IBS. Although the debated finding ofmore women with IBS-C was confirmed, more menthan women appeared to have IBS-D, according toROME III criteria.Send Date: 2011/07/21


Evaluvation of Neoadjuvant Chemotherapy onlocally advanced Gastric Cancer: A Meta-alysis

Mohammadhossein somi1*, Rizan Ashayeri1,Yahya Alhojjat1, Morteza Ghojazadeh2,

Ardalan Golbahar Haghighi1, Farhad Shokraneh3

1Liver and Gastrointestinal Diseases Research Center,Tabriz University of Medical Sciences2 Physiology Department, Tabriz University of MedicalSciences3 Research Center for Pharmaceutical Nanotechnology(RCPN), Tabriz University of Medical SciencesIntroduction: The incidence of gastric cancer hasreduced, though; it is the 4th common cancer and 2nd

cause of cancer death worldwide. To treat patienswith unresectable gastric cancer by neoadjuvantchemotherapy we can downstage and resect thetumors.The end-points are the evaluation ofNeoadjuvant Chemotherapy on R0 resection rate ofthe tumors and 3-year survival rate of patients.Method:All published trials of Neoadjuvantchemotherapy for locally advanced gastric cancerwere searched. Only Ovid database and only Englishwritten language articles from 2008 to 2011 wereincluded in our search strategy.Results: In our study 5 trials were included. A total of131 patients with locally advanced gastric cancerwere enrolled. The 3-year survival rate withneoadjuvant chemotherapy was 53% (95%CI:43.4-62.2)And R0 resection rate was 61% (95%CI:54.06-68.5).Conclusion: According to the results it seems thatneoadjuvant chemotherapy can improve survival rateand R0 resection rate of locally advanced gastriccancer.Send Date: 2011/07/21


MEFV mutations in Iranian Azeri TurkishPatients with familial Mediterranean fever

Mortaza Bonyadi1*

1Natural Sciences, University of TabrizIntroduction: Familial Mediterranean fever (FMF)is an autosomal recessiveautoinflammatory disorderwith more than 60 disease-associated mutations in theresponsible geneMethod: Five hundred and twenty-four unrelatedpatients were tested for 15 known mutations in theMEFV gene using amplification refractory mutationsystem-polymerase chain reaction and polymerasechain reaction-restriction fragment lengthpolymorphism methods.Results: Thirty-five different genotypes werecharacterized among the studied patients. Of thealleles investigated, the most common mutation wasp.M694V (42.4%), followed by p.V726A (17%),p.E148Q (16.2%), and p.M680I (c.2040G>C)



population based, multi regional epidemiologic studyis mandatory due to substantial demographic andcharacteristic variability in IBD patients in ourregion.Send Date: 2011/07/18


Prevalence and Risk Factors ofGastro-esophageal Reflux Diseasein Urban Population of Mashhad

Hassan Vossoughinia1, Alireza Shariati1*,Siavash Abedini1, Mohammad-Taghi Shakeri1,Mohammad-Javad Shariati1, Reza Bakhtiyari1,

Reza Etemad Eslami1, Ali Aminizadeh1,Ashkan Pooyan1, Ashkan Hatami1,Arash Aryan1, Ali Ghannadzadeh1

1 Medicine Faculty, Mashhad University of MedicalSciencesIntroduction: Gastro-esophageal Reflux Disease(GERD) is a chronic and common disease whichcharacterize with heartburn and regurgitation. In lastcouple of decades lots of attention has been paid toGERD and studies have shown that its prevalence isincreasing. In Iran a few studies conducted toevaluate GERD prevalence in the population butneither of them has been done on the north east of Iran.The aim of our study is to evaluate prevalence rate ofGERD and its risk factors in Mashhad population.Method: This is a cross sectional case control studyusing a questionnaire. The modified Mayo Clinicquestionnaire distributed between 2500 randomlyselected people (50 cluster of 50 participants each,randomly selected based on power bill code). Thequestionnaire include questions about patientcharacteristics (age, gender, marital status andeducation) , and history of regurgitation andheartburn in last year. Based on the collected dataparticipants divided into two groups, patient and control.Participants with the history of GERD in last year andhaving symptoms at least once a week were put in thePatient group and the rest in the Control group. Therate of risk factors was evaluated in two groups.Results: Of 2500 distributed questionnaires 1685successfully recalled. 51 participants were excludedfrom the study for the following reasons: pregnancy,

history of surgery on the GI and age under 18. Fromtotal number of 1634 (56% female, mean age 51.3years, range 18 to 90) 420 participants had criteria forpatient group and the rest formed control group. Thecalculated prevalence of GERD is 25.7% in oursamples. The risk factors with significant effects aresmoking, NASIDs (p<0.001), excessive eating(p<0.001), chronic disease (p<0.001), tea drinking,GERD in the spouse (p<0.001), Weekly Fast foodeating (p<0.001) and asthma (p<0.001). Prevalencein the past 2 month was similar to that in the 12month.(p<0.001)Conclusion: GERD prevalence in the residents ofMashhad is above the average in other cities of Iran.However risk factors are similar to those reported inother studiesSend Date: 2011/07/20


Gender Role in Irritable Bowel Syndrome:A comparison of IBS module (ROME III)

between male & female patientsSanam Javid Anbardan1, Nasser Ebrahimi Daryani MD2*,

Seyed-Mohammad Fereshtehnejad3, Sahar Taba TabaVakili4, Mohammad Reza Keramati5, Hossein Ajdarkosh6

1Research Fellow, Gastroenterology & Hepatology Department,Tehran University of Medical Sciences, Tehran, Iran2 Professor, Gastroenterology & Hepatology Department,Tehran University of Medical Sciences, Tehran, Iran3 Research Fellow, Gastrointestinal & Liver DiseaseResearch Center (GILDRC), Firoozgar Clinical ResearchDevelopment Center, Tehran University of MedicalSciences, Tehran, Iran4 Resident of Internal Medicine, Shahid BeheshtiUniversity of Medical Sciences, Tehran, Iran5 Resident of Surgery, Tehran University of MedicalSciences, Tehran, Iran6 Gastroenterologist, Gastrointestinal & Liver DiseaseResearch Center (GILDRC),Tehran University of MedicalSciences, Tehran, IranIntroduction: Irritable bowel syndrome (IBS) is awidespread chronic health condition, characterizedby a defined symptom complex in the absence of anybiochemical or pathological structural abnormalities.We conducted a gender difference analysis bycomparing findings for men and women to determine




Prevalence of oral mucosallesions in an adult Iranian population

Fariborz Mansour-Ghanaei1*, Farahnaz Joukar1, MaryamRabiei1, Alireza Dadashzadeh1, Ali Kord Valeshabad1

1Gastrointestinal & Liver Diseases Research Center(GLDRC), Guilan University of Medical SciencesIntroduction:There is no other study about theepidemiology of all oral lesions in Iran and most of theconducted studies included only tumors and ulcers orbiopsy specimens or just some of the oral lesions indental patients. A great need is sensed in Iran forestablishment of baseline data toward the prevalenceof oral lesions in general population.To assess theprevalence and types of oral lesions in a generalpopulation in Rasht, Northern Province of Iran.Method:In this cross-sectional study, 1581 personswith the age>30 years who were resident in Rasht, Iranwere enrolled the study. A detailed questionnaire basedon the world health organization (WHO) guidelineswas filled for each individual that contained allrequired data in order to diagnosis of the lesions.Participants were divided into two groups with andwithout oral mucosal lesions. Demographiccharacteristics and clinical information were collectedand compared between these two groups.Results: The prevalence of mucosal lesions in ourstudy was 19.4%. Our data demonstrated higherprevalence of oral mucosal lesions in males (55.8%)and young adults (30-40 years) (53.9%). The mostcommon mucosal lesion among our participants wasfissured tongue (3.4%), followed by Fordyce granules(2.2%), geographic tongue (2.1%), pigmentation(2.0%), Candida (1.6%), Recurrent aphthous (1.2%),Keratosis (1.2%),Traumatic ulcer (1.1%),Infectedtooth-related Cyst (1.1%),Varices (1.1%), Herpeslabial (1.1%), White plaque (0.4%),Lichen planus(0.4%),Effusion (0.3%),Leukoplakia (0.1%) andhemorrhage (0.1%). No case of malignant lesions wasdetected. No statistically significant difference wasconfirmed between two groups regarding smoking(cigarette and tobacco), opium consumption,medication and oral and dental hygiene (use oftoothbrush, toothpick, dental floss, mouthwashes,number of filled or decayed tooth) (p>0.05).Conclusion: Our data has provided baseline

information about epidemiologic aspects of oralmucosal lesions that can be valuable in organizednational program targeting on oral health and hygienein the society.Send Date: 2011/06/27


Epidemiology of Inflammatorybowel diseases (IBD) in Iran:

A review article and comparative study with AsiaAlireza Safarpour1*, Seyed Vahid Hosseini2,

Davood Mehrabani3

1Gastroenterohepatology Research Center, Shiraz Universityof Med Sciences.2 Colorectal Surgery Research Center, Shiraz University ofMed Sciences.3 Stem Cell and Transgenic Technology Research Center,Shiraz University of Med Sciences.Introduction: The prevalence of inflammatory boweldiseases (IBD) is going to be stabilized in WesternEurope and North America but has an increasing trendin developing countries in Asia. The epidemiology ofIBD in the areas in which, incidence and prevalenceare relatively low provides an opportunity forresearchers to determine the unknown aspects of them.Method: In this review article, data bases such asPubmed, Science Direct, Scopus and Medline weresearched from 1970 to 2010.The epidemiologicalaspects which assessed in Iranian articles comparedwith the same subjects in other Asian countries. Thetotal documented articles on IBD epidemiology were21 and 52 in Iran and Asia, respectively.Results:According to present review, CTLA-gene polymorphism and male/female ratio inulcerative colitis, the incidence of extra intestinalmanifestations, extent of intestinal involvement andfamily history in both ulcerative colitis and Crohn’sdisease in Asia and Iran seems to be different.In contrast, the incidence of primary sclerosingcholangitis in IBD patients, association ofNO2/CARD15 mutation and Crohn’s disease asC3435-T allele and ulcerative colitis are nearly the same.Conclusion: The rate of IBD has increasedsignificantly in Iran as other Asian countries duringthe last decade, and an exact, well designed,



Abstract Categories

1- CLINICAL PRACTICE1.1 Epidemiology....................................................................7-121.2 Management strategies.........................................................131.3 Evidence-based clinical practice..........................................141.4 Outcome studies..............................................................14-151.5 Pharmacoeconomics.......................................................15-162- ESOPHAGEAL-GASTRICANDDUODENALDISORDERS2.1 Cell/molecular biology/pathology.........................................162.2 Dyspepsia.........................................................................17-192.4 Reflux disease - pathogenesis..............................................202.5 Reflux disease - diagnosis....................................................202.7 Reflux disease - complications.............................................212.8 Esophageal malignant disease.........................................21-232.9 Other esophageal disorders..................................................242.10Acid peptic disease (includes NSAIDS - but NOTH.pylori)-epidemiology..............................................................................242.12Acid peptic disease (includes NSAIDS - but NOTH.pylori)-diagnosis and treatment..............................................................252.13 Gastroduodenal malignancies........................................25-303- H.PYLORI3.2 Pathogenesis: microbial factors.............................................313.4 Diagnosis.........................................................................32-333.5 Management strategies....................................................33-364- INTESTINAL4.1 Enterocyte biology/pathology and nutrient/water transport/electrolyte transport....................................................................374.2 Coeliac disease/malabsorption syndromes and food en-teropathies.............................................................................37-405- IBD5.1 Basic/pathogenesis/pathology/........................................40-415.2 Etiology/epidemiology.....................................................42-435.3 Genetics...............................................................................445.5 Treatment.............................................................................455.7 Management....................................................................46-486- COLONICANDANORECTAL DISORDERS6.1 Malignant disease - pathogenesis.........................................486.2 Malignant disease - diagnosis/histopathology.....................496.3 Malignant disease - management........................................506.4 Other colonic and anorectal disorders............................ 50-527- LIVER7.3 Metabolic/genetic disorders...........................................52-557.4 Hepatotoxicity/alcohol - regeneration - apoptosis...............56

7.5 Cirrhosis and complications: basic aspect...........................567.6 Cirrhosis and complications: clinical aspects................ 56-597.7 Viral hepatitis: basic aspects............................................60-617.8 Viral hepatitis B: clinical aspects....................................61-637.9 Viral hepatitis C: clinical aspects....................................63-667.10 Immunology - autoimmune liver disease...........................677.11Acute liver failure - transplantation/surgery.......................687.12 Imaging - radiology (incl. interventional radiology)........... 68-697-13 Miscellaneous....................................................................708- BILIARY8.1 Bile acids - transport - cholestasis........................................718.2 Gallstones........................................................................71-728.3 Malignant hepato-biliary diseases........................................729- PANCREAS9.2 Pancreatitis - experimental...................................................739.4 Pancreatitis - chronic (including hereditary pancreatitis)....749.5 Malignant disease and endocrine tumors of the pancreas... 7410- NUTRITION10.2 Nutrients and gut function...............................................75-7713- ONCOLOGY-BASIC13.2 Molecular biology/genetics/pathology.........................77-7914- ONCOLOGY-CLINICAL14.1 Malignant disease - epidemiology - screening andprevention.............................................................................80-8114.2 Diagnosis of malignant disease..........................................8114.4 .................................................................8215- NERVE GUTAND MOTILITY15.2 Brain-gut and gut-brain axes - neuro-hormonal - neural-im-mune and visceral sensitivity......................................................8215.5 Functional gastrointestinal disorders (clinical -management)..8316- IMMUNOLOGY/MICROBIOLOGY16.1 Host defence mechanisms - immune reactions....................8419- ENDOSCOPYAND IMAGING19.1 Endoscopy - Upper GI...................................................85-8619.4 Endosonography...........................................................86-8719.5 Enteroscopy........................................................................8820- THERAPEUTIC ENDOSCOPY/INTERVENTIONAL RA-DIOLOGY20.1 Biliary and pancreatic stenting..........................................8920.2 Enteral dilatation and stenting (esophagus - stomach - duo-denum - colon)...........................................................................89

Day 1: Wednesday, October 5/Mehr 13W-F-001 to W-F-051...................................................................................................................... 7-34Day 2: Thursday, October 6/Mehr 14T-S-052 to T-S-102....................................................................................................................... 34-61Day 3: Firday,October 7/Mehr 15F-T-103 to F-T-153....................................................................................................................... 62-90

Schedule of Abstracts Peresentation - ICGH 2011


Abstract Categories

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Sponsor Scoieties

► Pooyesh Darou Pharmaceutica ► Arya Sun Co. (Fujinon)

► Aburaihan Pharmaceutica► Roche Pharmaceutica

►Teb Dakheli Pishro Co. (Pentax)

► Rossendarman Pharmaceutica (Tillotts)

►Arman Idehgostar Pars (AIP)

►Nikan Teb Sasan Co.

►Jahan Behbood Co. (Janssen-Cilag)

►Mavaraye Fonoon Asr (Boston Scientific)

►Zahravi Pharmaceutica

►Peyk Darou Nikan Co. (Nycomed)

►Bakhtar Bioshimi

►Behestan Darou Co.► Bayer Pharmaceutica

Scientific Committee (Alphabetical):


Agah Shahram MD (Tehran-Iran)Aghazadeh Rahim MD (RCGLD, Tehran-Iran)Alavian Seyed-Moayed MD (Baghyatallah, Tehran-Iran)Alizadeh Mohammad PhD (Tabriz-Iran)Ansari Reza MD (Tehran-Iran)Antikchi Mohammad-Hossein MD (Yazd-Iran)AshktorabHassanMD(HowardUniversity,WashingtonD.C-USA)Asvadi Iradj MD (Tabriz-Iran)Bafandeh Yousef MD (Tabriz-Iran)Baghaee – Oskui Mohammad MD (Tabriz-Iran)Bagheri Mohammad MD (Tehran-Iran)Bagheri-Lankarani Kamran MD (Shiraz-Iran)Bahari Ali MD (Mashhad-Iran)Baiat Amrollah MD (Tabriz-Iran)Behroouzian Ramin MD (Uremia-Iran)Borhanmanesh Fathali MD (Shiraz-Iran)Darvish-Mogaddam Sodaif MD (Kerman-Iran)Delavari Ali-Reza MD (Tehran-Iran)Derakhshan Faramarz MD (Tehran-Iran)Ebrahimi-Daryani Nasser MD (Tehran-Iran)Eftekharsadat Amir-Taher MD (Tabriz-Iran)Eghtesad Bijan MD (Cleveland-USA)Ehsani Ardakani Mohammad-Javad MD (Tehran-Iran)Eloubeidi Mohamad-Ali MD (Beirut-Lebanon)Emami Bahman MD (Chicago-USA)Emami Mohammad-Hassan MD (Isfahan-Iran)Esfandiari Tuba MD (Kansas-USA)Esmaeilzadeh Abbas MD (Mashhad-Iran)Faghihi Amir-Hossein MD (Tehran-Iran)Fallah Soltanali MD (Tehran-Iran)Farahvash Mohammad-Jafar MD (Tehran-Iran)Farasati Farris PhD (Kansas University-USA)Fattahi Ebrahim MD (Tabriz-Iran)Fattahi Mohammad-Reza MD (Shiraz-Iran)Forootan Hossein MD (Tehran-Iran)Forootan Mojgan MD (RCGLD, Tehran-Iran)Ganji Azita MD (Mashhad-Iran)Ghadir Mohammad-Reza MD (Qom-Iran)Ghavidel Ali MD (Tabriz-Iran)Hajiani Eskandar MD (Ahvaz-Iran)Hashemi Hasan MD (Tabriz-Iran)Hashemi Seyed Jalal MD (Ahvaz-Iran)Hashemzadeh Shahryar MD (Tabriz-Iran)Hosseini Kazem MD (Shiraz-Iran)Houshyar Afshin MD (Ardebil-Iran)Jabbarpour Bonyadi Morteza PhD (Tabriz-Iran)Jodeiri Behzad MD (Tehran-Iran)Kakaie Farzad MD (Tabriz-Iran)Khatibian Morteza MD (Tehran-Iran)Khoshbaten Manouchehr MD (Tabriz-Iran)Mahdavi Reza PhD (Tabriz-Iran)Malekhosseini Seyed-Ali MD (Shiraz-Iran)Maleki Iraj MD (Sari-Iran)

Malekzadeh Reza MD (Tehran-Iran)Mansour-Ghanaei Fariborz MD (Gilan-Iran)Mansouri Siavosh MD (Tehran-Iran)Masjedizadeh Abdolrahim MD(Ahvaz-Iran)Masnadi Koorosh MD (Tabriz-Iran)Masoudi Mohsen MD (Tehran-Iran)Masoumi Hatef MD (New York-USA)Massarrat Sadegh MD (Tehran-Iran)Merat Shahin MD (Tehran-Iran)Mikaeli Javad MD (Tehran-Iran)Mirbagheri Amir MD (Tehran-Iran)Mirmadjlessi Hossein MD (Tehran-Iran)Moaddab Seyed-Yaghob MD (Tabriz-Iran)Mohamad-AlizadehAmir-HoushangMD(RCGLD.Tehran-Iran)Mohammadnejad Mehdi MD (Tehran-Iran)Mosaddeghi Samad MD (Tabriz-Iran)Mousavi Seyed Mohsen MD (Mazandaran-Iran)Nasiri-Tousi Mohssen MD (Tehran-Iran)Nasseri-Moghaddam Siavosh MD (Tehran-Iran)Nobakht Hossein MD (Semnan-Iran)Nourbakhsh Khosro MD (Mashhad-Iran)Nouri-Nayyer Babak MD (Tehran-Iran)Ostadrahimi Alireza MD-PhD (Tabriz-Iran)Peyrin-Biroulet Laurent MD (Nancy-France)Pierre Hainaut MD (IARC, Lyon- France)Pourshams Akram MD (Tehran-Iran)Pourzand Ali MD (Tabriz-Iran)Rad Saeid MD (Tabriz-Iran)Rafeey Mandana MD (Tabriz-Iran)Saadatnia Hassan MD (Mashhad-Iran)Saberi-Firouzi Mehdi MD (Tehran-Iran)Salmanroghani Hassan MD (Yazd-Iran)Samalavicius Narimantas Evaldas MD (Vilnius-Lithuania)Semnani Shahryar MD (Golestan-Iran)Shahbazkhani Bijan MD (Tehran-Iran)Shateri Kamran MD (Uremia-Iran)Shavakhi Ahmad MD (Isfahan-Iran)Sima Hamid reza MD (Mashhad-Iran)Sobhani Iradj MD (Paris-France)Somi Mohammad-Hossien MD (Tabriz-Iran)Sotoudehmanesh Rasoul MD (Tehran-Iran)Taghavi Alireza MD (Shiraz-Iran)Tarzamani Mohammad-Kazem MD (Tabriz-Iran)Tavakkoli Hamid MD (Isfahan-Iran)Vaez Jalil MD (Tabriz-Iran)Vahedi Homayoon MD(Tehran-Iran)Vosooghinia Hassan MD (Mashhad-Iran)Yazdanbod Abbas MD (Ardebil-Iran)Zahedi Mohammadjavad MD (Kerman-Iran)Zali Mohammad-Reza MD (RCGLD, Tehran-Iran)Zamani Farhad MD (Tehran-Iran)Ziad-Alizadeh Behrooz MD PhD (Groningen, Netherlands)

ICGH 2011 Committees


President, ICGH 2011Reza Malekzadeh, MDProfessor of Medicine and GastroenterologyDirector, Digestive Disease Research Center,Tehran University of Medical Sciences

Organizing committees:

President, Iranian Society of Gastroenterologyand HepatologySeyed Hossein Mir-Madjlessi, MDInternist Gastroenterologist,Iranian Institute of Medicine

Scientific Secretary, ICGH 2011Mohammad Hossein Somi, MDProfessor of Medicine and GastroenterologyLiver and Gastrointestinal Diseae Research CenterTabriz University of Medical Sciences

Executive secretary, ICGH 2011Seyed Mohammad Mehdi Mir- Nasseri,MD, MPHResearch Fellow,Digestive Disease Research Center,Theran University of Medical Sciences

Executive Committee (Alphabetical):

• Abdollahi MR., MD• Alkhacht Y.• Ansari E., MD• Ashayeri R.• Bagheri M.• Bargi E.• Dabbagh P.• Dabiri Oskui SH, MD• Dorosti F.• Etehad F.• Faghih Dinevari M., MD

• Faramarzi E., MD• Farhang S., MD• Ghargazlou A.• Golbahar Ghadimi A.• Khodaei A.• Khoshbaten M., MD• Mirinezhad SK., MD• Mir-Nasseri MM., MD• Naghashi S., MD• Nikniaz Z.• Paknejhad P.

• Pouri AA., MD• Rashidi MR., MD• Rezazadeh R., MD• Sepehri B., MD• Shakeri R., MD• Soleimanpour M., MD• Somi MH., MD• Valizadeh H., MD• Valizadeh A.• Yghobi AR., MD

ICGH 2011 Committees

In The name of God

Abstract Submitted forIranian Congress of Gastroenterology and Hepatology - ICGH 2011

October 5-7, 2011

Contents

ICGH 2011 Committees• Executive Committee ................................................................................................................................... 3• Scientific Committee ...................................................................................................................................... 4

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

Abstracts of the ICGH 2011 ..........................................................................................................................7-90

• Author Index ............................................................................................................................................... 91

GOVARESHygolotapeHdnaygoloretneortsaGfonoitaicossAnainarIehtfolanruoJcifitneicS

pISSN: 1560-7186, oISSN: 2008-756x, eISSN: 2008-7578 Vol. 16, Supplement,Autumn 2011, No. 76-1

Iranian Association of Gastroenterology and Hepatology Mirmadjlessi SH, M.D.

Daryani NE, M.D.

Sadjadieh AH, M.D., Namazi HR, M.D.Ansari E, M. D.

Concessioner: Founder and Director:

Publisher: Editor-in-Chief:

Iranian Association of Gastroenterology and Hepatology

Aghazadeh R, M.D.Darvish Moghaddam S, M.D.Daryani NE, M.D.EmamiNajafiDehkordiSMHM.D.Hashemi SJ, M.D.Malekzadeh R, M.D.Mansour-Ghanaei F, M.D.

Masjedizadeh AR, M.D.Massarat S, M.D.Mikaeli J, M.D.Minakari M, M.D.NasiriToosi M, M.D.Sima HR, M.D.Somi MH, M.D.

International Members of Editorial Board

Adler G M.D. (Germany)

Keshavarzian AM.D. (USA)

Sobhani I M.D. (France)

Schuppan D M.D. (USA)

Scientific Editor

Mohammadnejad M, M.D.

English Text Editor

Page designing

Kim Vagharfard, M.S.

Etehad F

Publisher's AddressAddress of Editorial Office

Persian Text Editors

Iranian Association of Gastroenterology andHepatology, Unit 1, No. 13, Shahrivar Alley,Kargar-e-Shomali Ave., Tehran, Iran.Dr. Massarat SP. O. Box: 14395-163 Tehran, Iran.Telefax: +98 21 88 33 50 61-3

IranianAssociation ofGastroenterology andHepatology,Unit 1, No. 13, ShahrivarAlley, Kargar-e-ShomaliAve.,Tehran, Iran.Dr. Mirmadjlessi SHTelefax: +98 21 88 33 50 61-3E-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]

Mir-Nasseri MM, M.D., MPH

Executive Editor

Quarterly

Sayyad M, Valizadeh A, Etehad F

Office Staff

Editorial Board (In Alphabetic order) Associate Editors

Allahverdi B,M.D.Bagheri M, M.D.Falahi GH, M.D.Farahvash M, M.D.Merat S, M.D.Mir-NasseriMM,M.D.,MPHMohammadnejadM,M.D.

Montazeri GH, M.D.Pourshams A, M.D. MPHSetoodehmanesh R, M.D.Zamani F, M.D.Zaremehrjerdi A, M.D.Zendehdel N, M.D.

Documents

volume 16, Number 3, Supplement, Autumn, 2011