Sadegh Massarrat

Tehran University of Medical Sciences, Tehrān, Ostan-e Tehran, Iran

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Publications (20)37.31 Total impact

  • Article: Are the Serum Biomarkers Pepsinogen I and II Good Predictors for the Detection of Subjects with Atrophic Gastritis in Areas that have Different Gastric Cancer Incidence?
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    ABSTRACT: Northern Iran (Ardabil) is characterized by a high gastric cancer (GC) rate, whereas Southern Iran (Kerman and Yazd) has a low GC rate. The aim of this study is to verify the potential for pepsinogen I and II to detect atrophic gastritis (AG) in both high and low risk populations for GC. Sera of blood donors and patients with GC from Ardebil, Kerman and Yazd were used to measure levels of pepsinogen I, II and H. pylori IgG antibody. GC rates in these cities were determined according to the Cancer Registry and upper gastrointestinal (GI) endoscopy results. There were 449 subjects with an average age of 45 ± 15 years. The GC rate in the endoscopy units of the hospital in Ardabil was four times higher than Kerman or Yazd. The mean serum pepsinogen I levels did not differ between Ardabil (102 ± 42.6 µg/mL), Kerman (103.3 ± 49.8 µg/mL), and Yazd (111.7 ± 39 µg/mL). Pepsinogen II levels were: 8.1 ± 4.7 µg/mL (Ardabil), 7.5 ± 5.3 µg/mL (Kerman), and 7.6 ± 4.4 µg/mL (Yazd), which were not different. The H. pylori infection rates were: Ardabil (61%), Kerman (55%), and Yazd (73%). A low ratio of pepsinogen I to II (≤3) was seen in Ardabil (1.3%), Kerman (1.9%), and Yazd (0.0%), which was not significant. A total of 51.9% of GC patients from Ardabil had normal pepsinogen I (≥70 µg/mL) levels and pepsinogen I/II ratios that were >5. Serum biomarkers pepsinogen I and II and their ratios are probably not sensitive predictors of AG in areas that have either a high or low GC prevalence. This finding is likely related to the lack of an association between GC and advanced AG.
    Archives of Iranian medicine 04/2013; 16(4):208-12. · 0.97 Impact Factor
  • Article: Precancerous Conditions after H. pylori Eradication: A Randomized Double Blind Study in First Degree Relatives of Gastric Cancer Patients.
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    ABSTRACT: Regression of precancerous lesions after H. pylori eradication remains controversial. This study evaluates the change and topography in first degree relatives (FDR) of gastric cancer (GC) patients following H. pylori eradication. Participants underwent endoscopy with antrum and corpus histological examinations. Subjects with pangastritis were randomly allocated to placebo or eradication therapy and followed over 4½ years. Among 989 evaluated FDR, we excluded 468 patients as follows: 108 had macroscopic lesions, 243 had no evidence of any H. pylori infection, and 117 were excluded for other reasons. The remaining subjects (n = 521) were allocated to therapy (group A, n = 261) or placebo (group B, n = 260) groups. Interim analysis of 403 subjects (201 placebo, 202 therapy) showed regression of atrophy (60 out of 97 in the antrum and 37 out of 104 in the corpus) in H.pylori-eradicated versus regression of atrophy (57 out of 184 in the antrum and 23 out of 173 in the corpus) in non-H.pylori-eradicated cases over 2½ years (P < 0.0001). No regression of intestinal metaplasia (IM) occurred in the antrum and corpus of treated subjects over 4½ years. However, progression of IM occurred in the antrum in 17 out of 90 patients in the non-H. pylori-eradicated versus 4 out of 68 H. pylori-eradicated subjects after 4½ years (P < 0.05). Eradication of H. pylori is associated with regression of gastric atrophy but not IM, even in its early stages. Gastric atrophy and IM in the antrum have shown more rapid progression in cases not treated for H. pylori infection (over 4½ years follow-up) compared to H. pylori-eradicated cases.
    Archives of Iranian medicine 11/2012; 15(11):664-9. · 0.97 Impact Factor
  • Article: "Serum Pepsinogen II as a Good Marker for Mass Screening and Eradication of H. pylori Infection in Populations at risk for Gastric Cancer".
    Sadegh Massarrat, Arghavan Sheykholeslami
    Archives of Iranian medicine 04/2012; 15(4):265-6. · 0.97 Impact Factor
  • Article: Comparison of the effect of non-antifungal and antifungal agents on Candida isolates from the gastrointestinal tract.
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    ABSTRACT: Non-antifungal drugs appear promising in treatment of opportunistic infections of Candida spp. that are often resistant to current antifungals. The broth macrodilution method (NCCLS M27-P document) was used to compare the antifungal activity of trifluoperazine, propranolol, and lansoprazole with that of ketoconazole and amphotericin B, using 50 yeast isolates from the GI tract. The minimum fungicidal concentrations (MFCs), resistance rates and the time required for fungicidal activity of the drugs (2 - 48 hours) were determined. The most effective antifungal activity was exhibited by trifluoperazine. Its MFC was 32 µg/mL for Candida albicans (3.3% resistance) and Candida spp. (0% resistance) yeasts, and 64 µg/mL for Candida tropicalis with 10% resistance. The MFC for C. albicans and Candida spp. was comparable to that of ketoconazole. However, the time required for the inhibitory effect (6 hr) was shorter than that of ketoconazole (48 hr) or amphotericin B (24 hr). The time required for the inhibitory activity on C. tropicalis was 24 hr, which was shorter than that of ketoconazole and amphotericin B (48 hr). A considerable number (40%) of Candida spp. showed resistance to ketoconazole, and 20% of C. tropicalis showed resistance to amphotericin B. Trifluoperazine, an antipsychotic drug, exhibited effective antifungal activity with the MFC, comparable to ketoconazole (32 µg/mL). Among the three yeast groups, C. tropicalis showed resistance to trifluoperazine and amphotericin B, and Candida spp. was considerably resistant to ketoconazole. Trifluoperazine could be considered as an alternative antifungal when encountering Candida spp. resistant to current antifungals.
    Archives of Iranian medicine 01/2012; 15(1):27-31. · 0.97 Impact Factor
  • Article: Critical assessment of progress of medical sciences in Iran and Turkey: the way developing countries with limited resources should make effective contributions to the production of science.
    Sadegh Massarrat, Shadi Kolahdoozan
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    ABSTRACT: Scientific progress is an important indicator for the social and economic developments of any country. According to various reports, worldwide, Iran has the most growth in the field of science due to a high increase in the numbers of publications during the past decade. The aim of this study is to assess not only the quantity, but also the quality of publications of indexed Iranian journals and compare them to Turkey, as an Islamic neighboring country, in addition to the contributions of these two countries to our knowledge. A number of international journals with high impact factors were selected to assess the contributions of scientists from Iran and Turkey to the medical sciences. English medical journals from Iran and Turkey indexed by the ISI Web of Sciences with known impact factors (IF) announced at the beginning of 2010 were included for evaluation. We calculated the number of all articles published from the beginning of 2007 until the October 2010, the number of total citations, and citations from authors outside both countries for each journal. In addition, we selected all articles cited at least six times by authors outside of both countries and discussed their content with regard to originality and novelty, as well as their contributions to current knowledge. Furthermore, 60 international journals in basic or clinical research with IF greater than 6 were selected for the magnitude of contributions of both countries to our scientific knowledge. In 2010, out of a total of 21 Iranian journals indexed in ISI since 2007, only 12 have a known IF with a mean of 0.39 (range: 0.07-0.97), whereas out of 28 Turkish medical journals indexed in ISI, 15 have a known IF (mean: 0.35, range: 0.05-0.82). The total number of articles published since 2007 from Iran, total citations and total citations by authors from outside Iran were 2080, 1218, and 463, respectively. The same data related to Turkish journals were 4876, 2036, and 1331, respectively. Indeed, the mean citations per article by foreign authors for Iranian and Turkish researchers were 0.19 and 0.3, respectively. Of the total articles during this period, only seven from Iran and nine from Turkey have been cited at least six times by authors outside the two countries. Iran had 23 and Turkey 37 original publications in highly reputable international journals. Turkey was more represented in basic research and clinical observational studies than Iran. Despite high numbers of published articles, both countries have medical journals with very low comparable citation rates and IF. Only one out of three Turkish articles is cited once by authors outside of Turkey and one of five Iranian articles is cited by authors outside Iran. The few high-cited articles address new therapies and interventional studies or diseases commonly encountered regionally, and are the results of the efforts of a few individuals in highly specialized fields. Turkish scientists are inclined to publish their scientific works more than Iranians in distinguished international journals. These articles deal more with regional diseases that are not common in Western countries. Developing countries can only contribute to world science when they focus their efforts on teamwork in order to research ways to solve country-specific diseases and their own health problems.
    Archives of Iranian medicine 11/2011; 14(6):370-7. · 0.97 Impact Factor
  • Article: Sequential metronidazole-furazolidone or clarithromycin-furazolidone compared to clarithromycin-based quadruple regimens for the eradication of Helicobacter pylori in peptic ulcer disease: a double-blind randomized controlled trial.
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    ABSTRACT: Furazolidone is a much cheaper drug with a very low resistance against Helicobacter pylori compared to clarithromycin. We aim to evaluate safety and efficacy of a sequential furazolidone-based regimen versus clarithromycin-based therapy in H. pylori eradication for ulcer disease. Patients with proven peptic ulcer or duodenitis were randomized into three groups: OAB-M-F; metronidazole (M) (500 mg bid) for the first 5 days, followed by furazolidone (F) (200 mg bid) for the second 5 days; OAC-P; clarithromycin (C) (500 mg bid) for 10 days; and OAB-C-F; clarithromycin (500 mg bid) for the first 5 days and furazolidone (200 mg bid) for the second 5 days. All groups received omeprazole (O) (20 mg bid) and amoxicillin (A) (1 g bid). Groups OAB-M-F and OAB-C-F were also given bismuth subcitrate (B) (240 mg bid), whereas a placebo (P) was given to group OAC-P. Adverse events were scored and recorded. Two months after treatment, a C(13) -urea breath test was performed. Three hundred and ten patients were enrolled and 92 (OAB-M-F), 95 (OAC-P), and 98 (OAB-C-F) completed the study. The intention-to-treat eradication rates were 78.5% (95% CI = 69-85), 81.1% (95% CI = 73-88), and 82% (95% CI = 74-89), and per-protocol eradication rates were 91.3% (95% CI = 83-96), 90.4% (95% CI = 82-95), and 88.7% (95% CI = 81-94), for group OAB-M-F, OAC-P, and OAB-C-F, respectively. Eradication rate differences did not reach statistical significance. The most common adverse event, bad taste, occurred in all groups, but more frequently in groups OAC-P (34%) and OAB-C-F (32%), than OAB-M-F (14%) (p < .05). Adverse symptoms score were 0.88 ± 2.05 in group OAB-M-F, 1.15 ± 1.40 in group OAC-P, and 1.87 ± 1.62 in group OAB-C-F. Furazolidone can replace clarithromycin in H. pylori eradication regimens because of lack of development of resistance and very low cost.
    Helicobacter 12/2010; 15(6):497-504. · 3.15 Impact Factor
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    Article: Topography of gastritis and its severity in 864 first degree relatives of gastric cancer patients.
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    ABSTRACT: Studies on gastric mucosal histological findings among first degree relatives (FDR) of gastric cancer (GC) patients are scarce. The aim is to evaluate the topography and the severity of gastritis among FDR of GC patients. A total of 989 subjects who were FDR of GC patients, ages 40-65 years underwent gastroscopies. When no gross lesion was found, five specimens were evaluated according to the Sydney Classification and one for urease testing in order to determine the type of gastritis and its severity. Of the 989 subjects, 107 had significant lesions, including two with GC and one with esophageal cancer. The 864 subjects who had complete morphological data taken from five gastric areas (two from the antrum and three from the corpus) comprised 419 males (mean age 48.5±7 years) and 445 females (mean age 47±6.4 years). The H. pylori rate was 76.6%. Normal mucosa was seen in 6.9%, antrum-restricted gastritis in 7.4%, antrum-predominant gastritis in 63.5% and corpus-predominant gastritis in 20% (both had >80% H. pylori infection) and corpus-restricted gastritis in 2%. More atrophy was seen in the antrum and corpus of FDR females than males. The severity did not differ between those with one or more GC patients' relatives. Forty-nine percent of FDR had atrophy and 9.4% intestinal metaplasia (IM) in the corpus. After the age of 40, there was progression of intestinal metaplasia from 12.2 to 27.3% in the antrum and from 6.7% to 26.2% in the corpus during two decades. No high grade dysplasia was found in this mid-age population. Only one-fifth of FDR have H. pylori-induced corpus-predominant gastritis who are at risk for cancer and suitable for eradication. Corpus-restricted gastritis is a rare disease in this area.
    Archives of Iranian medicine 11/2010; 13(6):469-75. · 0.97 Impact Factor
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    Article: Increase in resistance rates of H. pylori isolates to metronidazole and tetracycline--comparison of three 3-year studies.
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    ABSTRACT: Antimicrobials have been useful in the treatment of H. pylori-related dyspeptic diseases. However, emergence of resistant strains often decreases the eradication rates of H. pylori infections. Large-scale use of antimicrobials will lead to the diminishment of susceptible strains while allowing resistant survivors to outgrow and spread resistance genes. The aim of this study was to assess the change in antimicrobial resistance rate of H. pylori isolates from 2005 to 2008 and indicate the consequences of indiscriminate and widespread use of antimicrobials against H. pylori- and non-H. pylori-related infections. A total of 110 H. pylori strains were isolated from dyspeptic patients during 2005 to 2008 and tested for their susceptibility to antimicrobials using the disk diffusion method. MICs were determined for metronidazole (8 microg/mL), tetracycline (0.5 microg/mL), clarithromycin (2 microg/mL), amoxicillin (1 microg/mL) and furazolidone (0.5 microg/mL). Since the rates of resistance to metronidazole and tetracycline were remarkably high, another 50 isolates were tested for their susceptibility to metronidazole at the same MIC (8 microg/mL) and tetracycline at MICs of 0.5,1 and 2 microg/mL. Resistance rates were compared to those obtained in our two previous studies between 1997-2000 and 2001-2004. The resistance rates of 110 H. pylori isolates to clarithromycin, amoxicillin and furazolidone were 7.3%, 7.3%, and 4.5%, respectively. Among 160 H. pylori isolates, 55.6% exhibited resistance to metronidazole and 38.1% to tetracycline. Compared to our two previous studies, the resistance rates of H. pylori isolates to current antimicrobials has changed over time. The change in resistance rates of clarithromycin, amoxicillin and furazolidone was not statistically significant. However, resistance to metronidazole and tetracycline showed a considerable increase from 33-36.3% to 55.6% and 0-0.7% to 38.1%, respectively. Emergence of resistance due to the intensive use of antibiotics has become a global public health problem. It appears that plasmid-carried genes are involved in the spread of resistance traits among bacteria. Results obtained in this study indicate that the increase in resistance rates of H. pylori isolates to metronidazole and tetracycline could be the indication of indiscriminate and frequent use of antibiotics in Iran.
    Archives of Iranian medicine 05/2010; 13(3):177-87. · 0.97 Impact Factor
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    Article: Ethnic and geographic differentiation of Helicobacter pylori within Iran.
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    ABSTRACT: The bacterium Helicobacter pylori colonizes the human stomach, with individual infections persisting for decades. The spread of the bacterium has been shown to reflect both ancient and recent human migrations. We have sequenced housekeeping genes from H. pylori isolated from 147 Iranians with well-characterized geographical and ethnic origins sampled throughout Iran and compared them with sequences from strains from other locations. H. pylori from Iran are similar to others isolated from Western Eurasia and can be placed in the previously described HpEurope population. Despite the location of Iran at the crossroads of Eurasia, we found no evidence that the region been a major source of ancestry for strains across the continent. On a smaller scale, we found genetic affinities between the H. pylori isolated from particular Iranian populations and strains from Turks, Uzbeks, Palestinians and Israelis, reflecting documented historical contacts over the past two thousand years.
    PLoS ONE 01/2010; 5(3):e9645. · 4.09 Impact Factor
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    Article: Production of polyclonal antibody against alkyl hydroperoxide reductase of Helicobacter pylori and its antigenicity.
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    ABSTRACT: Stool-antigen detection kits for diagnosis of Helicobacter pylori infection have been widely used because of their full non-invasive nature. Because Helicobacter pylori strains show a distinctive genetic diversity, it is important to find a protein that is a common antigen of various strains and shows a strong immunogenicity for the development of a stool- antigen detection kit. Alkyl hydroperoxide reductase (AhpC) of Helicobacter pylori strongly reacts with the sera of patients with gastritis and peptic ulcer. Therefore, AhpC seems to be an excellent candidate as a target protein for this study. Accordingly, polyclonal antiserum against AhpC was produced in adult New Zealand white rabbits by using AhpC in the gel bands without adding Freund's adjuvant. In addition, isolation and purification of AhpC were perfomed by preparative sodium dodecyl sulfate polyacrylamide gel electrophoresis and electroelution. In this study, a simple method was used for rapid production of polyclonal antibody against AhpC of H. pylori, which avoids both the long-term AhpC purification and the addition of Freund's adjuvant. One-dimensional preparative gel electrophoresis allows a single and short purification step; the high-resolution capacity of this technique leads to a high level of purity of the protein and consequently to a very high specificity of the antibody. Moreover, this method avoids contamination by other non-specific proteins, which often appear during the purification process by column chromatographic techniques, which may also decrease the purity of the immunogen. The present method is simple, rapid and cost-effective, and also makes it possible to produce antibody for stool-antigen enzyme immunoassay in a short time and at low cost.
    Hybridoma (2005) 01/2009; 27(6):481-5. · 0.42 Impact Factor
  • Article: Synthesis and anti-Helicobacter pylori activity of 5-(nitroaryl)-1,3,4-thiadiazoles with certain sulfur containing alkyl side chain.
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    ABSTRACT: A series of 5-(nitroaryl)-1,3,4-thiadiazoles bearing certain sulfur containing alkyl side chain similar to pendent residue in tinidazole molecule were synthesized and evaluated against Helicobacter pylori using disk diffusion method. The synthesized compounds were also evaluated for their antibacterial, antifungal and cytotoxic effects. Study of the structure-activity relationships of this series of compounds indicated that both the structure of the nitroaryl unit and the pendent group on 2-position of 1,3,4-thiadiazole ring dramatically impact the anti-H. pylori activity. While compound 7a containing 2-[2-(ethylsulfonyl)ethylthio]-side chain from nitrothiophene series was the most potent compound tested against clinical isolates of H. pylori, however, nitroimidazoles 6c and 7c were found to be more promising compounds because of their respectable anti-H. pylori activity besides less cytotoxic effects.
    Bioorganic & medicinal chemistry letters 07/2008; 18(11):3315-20. · 2.65 Impact Factor
  • Article: Smoking and gut.
    Sadegh Massarrat
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    ABSTRACT: Smoking has not only enormous deleterious effects on cardiovascular, cerebral, and bronchial organs but also profoundly alters the function of all parts of the gastrointestinal tract through various mechanisms. Except the sole curiously observed benefit of smoking on the course of ulcerative colitis, it increases the prevalence of the common gastrointestinal diseases namely gastroesophageal acid reflux, peptic ulcer, and Crohn's diseases. It also increases the incidence of cancer of oral cavity, esophagus, stomach, pancreas, and liver mostly in a dose-response relationship and worsens the prognosis of colon cancer. The cessation of smoking is associated with the reduced incidence of cancer in the reported organs, but its effect on the regression of benign disease is not generally studied. The physicians must be aware not only of the harmful effect of smoking on the cardiovascular and bronchial systems, but also about the detrimental consequences of life-long smoking on the gastrointestinal tract and the increase of its benign and malignant diseases.
    Archives of Iranian medicine 06/2008; 11(3):293-305. · 0.97 Impact Factor
  • Article: Serum pepsinogen I, pepsinogen II, and gastrin 17 in relatives of gastric cancer patients: comparative study with type and severity of gastritis.
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    ABSTRACT: First-degree relatives of gastric cancer patients are at risk for developing precancerous conditions. The aim of this study was to investigate the potential of biomarkers pepsinogen I (PGI), pepsinogen II (PGII), their ratio (PG I:II), as well as gastrin 17 for screening of precancerous conditions and corpus predominant gastritis. First-degree relatives of gastric cancer patients underwent endoscopy. Three biopsy specimens from the antrum and 3 from the corpus were evaluated according to the Sydney classification. Serum was taken for the measurement of fasting PGI, PGII, and gastrin 17 by enzyme-linked immunosorbent assay kits. A total of 481 patients were examined (age, 47.8 +/- 6.7 y). With the extension of gastritis, PGII was increased up to 2.5 times (6.6 +/- 2.8 microg/mL in normal mucosa, 9.5 +/- 6.7 microg/mL in antral gastritis, and 16.9 +/- 12.4 microg/mL in corpus-predominant gastritis; P < .01), PGI increased slightly (88.3 +/- 29.4 microg/mL in normal mucosa and 111.2 +/- 71.4 microg/mL in corpus-predominant gastritis), and gastrin 17 was increased substantially in corpus-predominant gastritis (15.3 +/- 19.5 pmol/mL vs 3.8 +/- 5.7 pmol/mL in normal mucosa). By using a cut-off value of 7.5 microg/mL for PGII, any type of gastritis from normal mucosa can be diagnosed with a sensitivity and specificity of 80%. The sensitivity and specificity of the PG I:II ratio (< or =3) and gastrin 17 (>17 pmol/mL) together were 9.4% and 99% for screening corpus-predominant gastritis and 14.8% and 97.8%, respectively, for screening intestinal metaplasia in the corpus. PGII is a suitable marker for screening any gastritis from normal mucosa, but neither PGI, the PG I:II ratio, gastrin 17, nor their combination were able to select those with precancerous conditions and corpus-predominant gastritis among the first-degree relatives of gastric cancer patients.
    Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 03/2008; 6(2):174-9. · 5.64 Impact Factor
  • Article: Furazolidone-based, metronidazole-based, or a combination regimen for eradication of Helicobacter pylori in peptic ulcer disease.
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    ABSTRACT: Furazolidone has been effective against Helicobacter pylori in Iran, with no resistance, but with intolerable side effects in the second week. One-week regimens have not been useful here. We compared the efficacy and side effect profiles of three anti-H. pylori regimens. Patients with peptic ulcer disease and positive H. pylori infection were randomly allocated into three groups. The patients in group A received omeprazole 20 mg + amoxicillin 1g + metronidazole 500 mg, and bismuth subcitrate 240 mg twice daily each, for two weeks; the patients in group B received the same regimen but metronidazole was replaced by furazolidone 200 mg twice daily; and the patients in group C received regimen B for the first week and regimen A for the second week. H. pylori eradication was verified with 13C-urea breath test at the tenth week. Three hundred and fourteen patients were enrolled; 107, 104, and 103 patients in groups A-C, respectively but 278 patients completed the study. Seven, three, and six patients discontinued their medication in groups A-C, respectively. Fever, dizziness, and weakness were more common in group B than group C (P < 0.05). Vomiting, pruritus, and rash were more common in group C than group A (P < 0.05). Per-protocol eradication rates were 83.1%, 95.2%, and 95.3% in groups A-C, respectively (P = 0.005, groups A and C). Intention to treat eradication rates were 74.5%, 87.0%, and 86.6% in groups A-C, respectively (P = 0.02, groups A and C). One-week furazolidone followed by one-week metronidazole regimen is as efficient as two-week furazolidone regimen but with fewer side effects. Furazolidone-based regimens are superior to metronidazole-based ones for H. pylori eradication in Iran.
    Archives of Iranian medicine 05/2007; 10(2):161-7. · 0.97 Impact Factor
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    Article: Marshall and Warren: the Nobel Prize winners in medicine in 2005.
    Sadegh Massarrat
    Archives of Iranian medicine 05/2006; 9(2):177-80. · 0.97 Impact Factor
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    Article: Detection of Helicobacter Pylori Infection by Imported IgG ELISA Kits in Comparison with Iranian Home Made Kit
    Summer. 01/2006; 11:120-125.
  • Article: Helicobacter pylori antibiotic resistance in Iran.
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    ABSTRACT: To examine the frequency of antibiotic resistance in Iranian Helicobacter pylori (H pylori) strains isolated from two major hospitals in Tehran. Examination of antibiotic resistance was performed on 120 strains by modified disc diffusion test and PCR-RFLP methods. In addition, in order to identify the possible causes of the therapeutic failure in Iran, we also determined the resistance of these strains to the most commonly used antibiotics (metronidazole, amoxicillin, and tetracycline) by modified disc diffusion test. According to modified disc diffusion test, 1.6% of the studied strains were resistant to amoxicillin, 16.7% to clarithromycin, 57.5% to metronidazole, and there was no resistance to tetracycline. Of the clarithromycin resistant strains, 73.68% had the A2143G mutation in the 23S rRNA gene, 21.05% A2142C, and 5.26% A2142G. None of the sensitive strains were positive for any of the three point mutations. Of the metronidazole resistant strains, deletion in rdxA gene was studied and detected in only 6 (5%) of the antibiogram-based resistant strains. None of the metronidazole sensitive strains possessed rdxA gene deletion. These data show that despite the fact that clarithromycin has not yet been introduced to the Iranian drug market as a generic drug, nearly 20% rate of resistance alerts toward the frequency of macrolide resistance strains, which may be due to the widespread prescription of erythromycin in Iran. rdxA gene inactivation, if present in Iranian H pylori strains, may be due to other genetic defects rather than gene deletion.
    World Journal of Gastroenterology 11/2005; 11(38):6009-13. · 2.47 Impact Factor
  • Article: Detection of Helicobacter pylori-specific genes in the oral yeast.
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    ABSTRACT: Until today, human stomach is the only recognized habitat of Helicobacter pylori. However, recruitment of DNA-based methods has made possible the detection of H. pylori in water and oral cavity, thus suggesting fecal-oral and oral-oral routes for transmission of H. pylori, respectively. In this study, yeast has been proposed as a common vector for transmission of H. pylori. Thus designed primers were recruited to target 16S rDNA and cagA genes in the oral yeasts by PCR. Eighteen yeasts were examined microscopically for the presence of bacterial-like bodies. DNAs were extracted from oral yeasts using phenol-chloroform method. Amplification conditions were optimized as 33 cycles and annealing temperatures of 63 degrees C for 16S rDNA and 51 degrees C and 52 degrees C for cagA gene which was targeted in two steps. DNAs of H. pylori and Saccharomyces cerevisiae were used as controls. Polymerase chain reaction (PCR) products of two genes from one yeast and from H. pylori were cloned in pCAP and subsequently subcloned in pSK+ and were sequenced. Bacterial-like bodies were observed in all oral yeasts. The amplified products of 16S rDNA from all oral yeasts were homologous in size with those of H. pylori. Fifteen out of eighteen (83%) yeasts contained cagA gene, homologous to H. pylori. CagA was not amplified from three yeasts and S. cerevisiae. Analysis of the sequenced products of 16S rDNA and cagA from one oral yeast showed 98% homology with those of H. pylori. The presence of H. pylori inside the yeast was indicated by light microscopy and PCR. It appears that yeasts, which are abundant in nature and thrive the mucosal surfaces of human, might serve as reservoirs and vehicles of H. pylori.
    Helicobacter 09/2005; 10(4):318-22. · 3.15 Impact Factor
  • Article: Helicobacter pylori reinfection rate 3 years after successful eradication.
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    ABSTRACT: Helicobacter pylori (HP) infection is one of the most prevalent human infections and has been implicated as a predisposing factor in gastric cancer, chronic active gastritis, duodenal ulcer, gastric ulcer and gastric lymphoma. Reinfection after successful eradication is quite uncommon in adults. In the only study carried out in Iran, a reinfection rate of 19.1% after 1 year has been reported. We studied the rate of reinfection 3 years after successful HP eradication. All patients who had undergone HP eradication 3 years before the study and had successful eradication verified by a negative (14)C urea breath test (UBT) 1 year after eradication were invited to complete a questionnaire and undergo another UBT. In addition, spouses and the offspring of those testing positive were offered an UBT. Ninety-eight patients were enrolled (49% male). Mean age was 44 +/- 13 years (range: 18-75 years). Twenty patients (20.4%) had a positive UBT. Epigastric burning (25%vs 69%) and pyrosis (50%vs 67%) were seen less commonly in those who were HP free at 3 years compared to those who tested positive for HP. According to our data, in our region the HP reinfection rate is 20.4% 3 years after successful eradication.
    Journal of Gastroenterology and Hepatology 04/2005; 20(3):401-4. · 2.87 Impact Factor
  • Article: Clarithromycin resistance in Iranian H. pylori strains before introduction of clarithromycin.
    Helicobacter 03/2003; 8(1):80. · 3.15 Impact Factor