Digestive and liver diseases statistics in several referral centers in Tehran, 2000-2004

Gastrointestinal and liver diseases [GILD] are among the most common causes of morbidity and substantial proportion of mortality with enormous economic consequences in Iran. We aimed to collect and report the most recent statistics on deaths, symptoms, physician visits, and hospitalizations for common gastrointestinal and liver diseases in gastrointestinal referral centers of Tehran. Data on the leading causes of death were obtained from Iranian Ministry of Health, office of Health Statistics, [Table 1]. A total of 189,747 deaths in the 23 [out of the 28] provinces of the country] were reported during March 2003 to February 2004. Causes of death were reported on the basis of the 10th revision of the International Classification of Diseases [ICD-10; 1992]. The leading causes of hospitalizations were obtained from the database of the GI ward of Shariati hospital, one of the biggest and well known GI referral hospitals in Iran, through years 2000 to 2004. Data on the leading symptoms prompting an outpatient clinic visit and related physician's diagnosis were gathered from a large multi-physician outpatient clinic, located in Tehran, during 2000-2004. The first 5 leading gastrointestinal causes of death in the country were: stomach cancer, hepatobiliary cancers, cirrhosis of liver, esophageal cancer and colorectal cancer respectively. The first 5 leading causes of hospitalizations in GI ward of Shariati Hospital were cirrhosis of liver, hepatitis, peptic ulcer diseases, cholycystitis and cholangitis and colorectal cancer. The most common outpatient diagnosis was GERD followed by IBS, DU, Non-ulcer Dyspepsia, and chronic hepatitis B. GI and liver malignancy along with chronic liver diseases constitute the main GI and liver etiology for hospitalization and death in Iran.Gastroesophageal reflux disease, IBS, DU, Non ulcer Dyspepsia, and Chronic HBV are the most common outpatient diagnosis in Iran

[ patient with celiac disease, chronic diarrhea, hypothyroidism and membranous glomerulonephritis]

Celiac disease can be accompanied with multiorgan involvement in addition to gastro-intestinal involvement. A 16-year-old young man - known case of celiac disease - was admitted because of exacerbation of gastrointestinal complaints. During further investigations, hypothyroidism and membranous glomerulonephritis were discovered. The patient was improved with a gluten-free diet and specific treatment of hypothyroidism and glomerulonephritis

[ patient with celiac disease, chronic diarrhea, hypothroidism and membranous glomerulonephritis]

Celiac disease can be accompanied with multiorgan involvement in addition to gastro-intestinal involvement. A 16-year-old young man - known case of celiac disease - was admitted because of exacerbation of gastrointestinal complaints. During further investigations, hypothyroidism and membranous glomerulonephritis were discovered. The patient was improved with a gluten-free diet and specific treatment of hypothyroidism and glomerulonephritis

[Human papillomavirus in squamous cell carcinoma of esophagus in a high-risk population]

The role of human papillomavirus [HPV] in the etiology of esophageal squamous cell carcinoma [ESCC] is not clear. Previous studies have found highly variable [from 0% to 67%] prevalence of HPV in ESCC tumor. However, prevalence of HPV in ESCC tumor seems to be higher in areas with high incidence of ESCC, such as China and South Africa. Iran is one of the areas of the world with the highest rates of ESCC. However, no previous study has reported the prevalence of HPV in ESCC tumor tissues from Iran. In this study, we compared the prevalence of a common marker for the presence of HPV [MY09/MY11 consensus primers] and two markers for the presence of HPV-16 and HPV-18 [respective E6 /E7 primers] in tumor tissues from 38 ESCC cases and normal biopsied tissues from 38 Iranian individuals. 14 out of the 38 ESCC [36.8%] samples, but only 5 out of 38 control samples [13.2%] were positive for the common marker of HPV presence; this difference was statistically significant [p=0.02]. Five ESCC samples [13.2%] but none of the control samples were positive for HPV16 E6 /E7 gene [p=0.05]. Three of the ESCC samples [7.9%] and five of the control samples [13.2%] were positive for HPV18 E6 /E7 gene. Our data are consistent with HPV DNA studies conducted in other high-risk areas for ESCC. HPV should be considered as a potential factor responsible for the increased incidence of ESCC in Iran and other high-incidence areas of the world