Probiotics and their role in gastrointestinal cancers prevention and treatment; an overview

Cancers of the gastrointestinal [GI] track are a serious global health problem. The human GI tract is home to trillions of microorganisms that known as gut microbiota and have established a symbiotic relationship with the host. The human intestinal microbiota plays an important role in the development of the gut immune system, metabolism, nutrition absorption, production of short-chain fatty acids and essential vitamins, resistance to pathogenic microorganisms, and modulates a normal immunological response. Microbiota imbalance has been involved in many disorders including inflammatory bowel disease, obesity, asthma, psychiatric illnesses, and cancers. Oral administration of probiotics seems to play a protective role against cancer development as a kind of functional foods. Moreover, clinical application of probiotics has shown that some probiotic strains can reduce the incidence of post-operative inflammation in cancer patients. In the present narrative review, we carried out update knowledge on probiotic effects and underlying mechanism to GI cancers. Currently, it is accept that most commercial probiotic products are generally safe and can used as a supplement for cancer prevention and treatment. Nevertheless, well-designed, randomized, double blind, placebocontrolled human studies are required to gain the acceptance of the potential probiotics as an alternative therapy for cancer control.

[Prevalence of Helicobacter pylori and intestinal metaplasia in consecutive gastritis patients; over the period of 7 years]

Helicobacter pylori [H. pylori] is the cause of most cases of peptic ulcers and gastric cancers and cause some of the most important cause of stomach cancer and lymphoma. The objective of this study was to evaluate the time trend of Helicobacter pylori prevalence and presence of intestinal Metaplasia over the period of 7 years in gastritis Iranian patients

Materials and Methods: In this cross-section study data related to H. pylori and intestinal Metaplasia [IM] among 14,860 consecutive gastritis patients, who referred to the gastrointestinal department of Tehran's Taleghani Hospital in Iran, was examined across the sex and age group

Results: The overall prevalence rate among patient with H. pylori infection was 83.5% [12406/14860] and 11,394 [84.1%] of them were related to the gastritis. The prevalence rate of H. pylori among patient with gastritis significantly higher [p<0.05] compared to patients without gastritis. In addition, the prevalence decreased with age while the presence of intestinal metaplasia increased with age [p<0.05]

Conclusion: The results of this study showed that the prevalence of H. pylori infection in Iranian population has declined in recent years; nevertheless it seems to be highly prevalent in Iran. We also find a significant positive relationship between H. pylori infection and IM with gastritis. There is no association between sex and infection but in contrast with the most studies its prevalence decreased with age

Endoscopic findings in patients with upper gastrointestinal bleeding referred to Taleghani hospital, Tehran, Iran

Upper gastrointestinal bleeding [UGIB] remains a common medical problem worldwide. It is an emergency medical condition, which may require hospital admission. UGIB also increases the risk of morbidity, and mortality and uses health care resources. The aim of this study was to determine the endoscopic findings and their frequencies in patients with UGIB with regard to age in Tehran's Taleghani Hospital

Materials and Methods: The medical records and endoscopy reports of 990 patients, who underwent endoscopy for UGIB in Tehran's Taleghani Hospital over a period of 2 years from 2010 to 2012, were retrospectively analyzed

Results: A total of 990 patients consisted of 594 [60%] men and 396 [40%] women had endoscopy for UGIB. Mean [+/-SD] age of the patients was 54 [+/-17.2] years. The commonest [45.5%] cause of UGIB was peptic ulcer disease, which included; duodenal ulcer [26.4%], gastric ulcer [19.1%], followed by esophageal and gastric varices [19.5%]. Malignant conditions [cancers] contributed to 14.7%, which included gastric cancer [7.2%], esophageal cancer [5.5%], and duodenal cancer [2%]. Other less frequent causes of UGIB were esophageal ulcer [6.7%], erosive gastritis [6.3%], Mallory-Weiss syndrome [5.4%], and Dieulafoy's lesion [1.2%]. Normal endoscopic findings were recorded in 0.7% of the patients with UGIB.

Conclusion: Peptic ulcer diseases are the commonest cause of UGIB followed by esophageal and gastric varices

[Evaluation of critical thinking skills among medical sciences students in Shahid Beheshti and Tehran University of Medical Sciences]

Background: Today, the development of critical thinking is considered an expected outcome of graduate studies. This study was designed to determine the critical thinking skills of students of Shahid Beheshti and Tehran University of Medical Sciences

Materials and methods: In a descriptive study, evaluated critical thinking skills of 60 medical students of Shahid Beheshti University of Medical Sciences and 60 medical students of Tehran University of Medical Sciences, after completing internship. Data was gathered using California standard test of critical thinking skills [form B] which was run officially. The data was analyzed by SPSS software using T-test, ANOVA and Pearson correlation coefficient

Results: The mean and standard deviation of critical thinking scores for medical students of Shahid Beheshti and Tehran University were 13.03 +/- 5.08 and 12.63 +/- 3.27, respectively [p>0.05]. There was no significant relationship between the ranks in University entrance exam and total score of critical thinking. Among domains of critical thinking, there was just significant relationship between the domains of deductive reasoning and diploma grade, with a relatively low correlation in medical students

Conclusion: The mean scores of critical thinking skill in this research was similar to scores of some survey in our country, but were lower than other countries. This means that the educational program cannot promote critical thinking skills in University and revising the curriculum seems necessary

Systematic review of pancreatic cancer epidemiology in Asia-Pacific Region: major patterns in GLOBACON 2012

Pancreatic cancer is one of the deadliest cancers with short-term survival rates. Trends for pancreatic cancer incidence and mortality varied considerably in the world. To date, the causes of pancreatic cancer are not known sufficiently, although certain risk factors have been identified such as, smoking, obesity, life style, diabetes mellitus, alcohol, dietary factors and chronic pancreatitis. Since there are no current screening recommendations for pancreatic cancer, primary prevention is very important. Therefore, up-to-date statistics on pancreatic cancer occurrence and outcome are essential for the primary prevention of this disease. Due to the lack of information on epidemiology of pancreatic cancer in most Asian countries, and limited of statistics and registration system in this area, we conducted a systematic review study to evaluate the most recent data concerning epidemiology of pancreatic cancer in Asia-Pacific region. In this review we focused on collected recent data on incidence, mortality, survival and risk factors of pancreatic cancer in this region. In addition, we reviewed and used the data of GLOBOCAN 2012 in this paper to complete the information as a source of compiling pancreatic cancer incidence and mortality rate

Zero inflated statistical count models for analysing the costs imposed by GERD and dyspepsia

Background and study aims: Recent studies have shown that the high prevalence and the various clinical presentations of gastro-oesophageal reflux disease [GERD] and dyspepsia impose an enormous economic burden on society. Economic cost data have unique characteristics: they are counts, and they have zero inflation. Therefore, these data require special models. Poisson regression [PR], negative binomial regression [NB], zero inflated Poisson [ZIP] and zero inflated negative binomial [ZINB] regression are the models used for analysing cost data in this paper

Patients and methods: In this study, a cross-sectional household survey was distributed to a random sample of individuals between May 2006 and December 2007 in the Tehran province of Iran to determine the prevalence of gastrointestinal symptoms and disorders and their related factors. The cost associated with each item was calculated. PR, NB, ZIP and ZINB models were used to analyse the data. The likelihood ratio test and the Voung test were used to conduct pairwise comparisons of the models. The log likelihood, the Akaike information criterion [AIC] and the Bayesian information criterion [BIC] were used to compare the performances of the models

Results: According to the likelihood ratio test and the Voung test and all three criteria used to compare the performance of the models, ZINB regression was identified as the best model for analysing the cost data. Sex, age, smoking status, BMI, insurance status and education were significant predictors

Conclusion: Because the NB model demonstrated a better fit than the PR and ZIP models, over-dispersion was clearly only due to unobserved heterogeneity. In contrast, according to the likelihood ratio test, the ZINB model was more appropriate than the ZIP model. The ZINB model for the cost data was more appropriate than the other models

Estimation of average diagnosis and treatment costs of hepatitis C

the objective of this study was to estimate the average cost of diagnosis and treatment of hepatitis C among patients based on their treatment regime, during the one course of treatment and six-month after stopping that. Hepatitis C virus [HCV] infection is a major cause of liver-related morbidity and mortality worldwide and a major public health problem. All data for this cross-sectional study were collected from medical records of 200 patients with hepatitis C, who referred to a private gastroenterology clinic between years 2005 through 2009. Information related to the 200 patients was extracted from their medical records and finally, 77 patients of them, who their treatment was not interfering with any other disease entered in this study. Therefore diagnosis and treatment costs of these patients were calculated. Attributable costs were reported as purchasing power parity dollars [PPP$]. Mean costs of diagnosis and treatment in one course of treatment and six month after that with standard interferon plus ribavirin [INF-RBV] exceeds 3,850 PPP$ and for patients who treated with peg-interferon plus ribavirin [PEG-RIBV] was 16,494 PPP$. Also in both types of treatment, medication cost was found to be a dominant cost component. Hepatitis C represents a very important and potentially costly disease to managed care organizations. Patients with this disease require expensive drug therapies and consume significant health care resources