[Show abstract][Hide abstract] ABSTRACT: Aim:
This retrospective study is aimed to review demographic and clinical characteristics of IBD to elucidate the probable factors associating with IBD development in Taleghani Hospital in Iran since 2001 during a 12-year-period.
Ulcerative colitis (UC) and Crohn's disease (CD) are two major idiopathic entities of inflammatory bowel disease (IBD). Previous studies have reported an increased incidence of IBD in Middle East countries.
Patients and methods:
In the present study 1914 patients with UC, 318 patients with CD and 25 with indeterminate colitis (IC) were included. Demographic information, clinical features, extraintestinal manifestations, complications and extension of disease were collected and interpreted for all participants. According to the time of registration, patients were divided into seven groups. Statistical analysis was performed using the chi-square test.
In seven groups of IBD patients, disease registry was estimated for UC, CD, and total IBD during a 12-year-period. From 2001 to 2005, a relative increased registry was observed among UC patients. However, in the years 2006 and 2007 a significant reduction in the number of patients was reported. Then an increasing trend was observed in UC patients. UC presented mostly with diarrhea, hematochezia and bloody diarrhea, while most of CD patients complained of abdominal pain.
Evaluation of data related to registered IBD patients in Iran shows that probable incidence and prevalence of IBD (UC and CD) is increasing compared to previous decades.
Preview · Article · Oct 2015 · Gastroenterology and hepatology from bed to bench
[Show abstract][Hide abstract] ABSTRACT: Inflammatory bowel disease (IBD) is a chronic disease of unknown etiology, in which genetic factors, seem to play an important role in the disease predisposition and course. Assessment of tumor necrosis factor (TNF-α) gene polymorphisms in many populations showed a possible association with IBD. Considering the genetic variety in different ethnic groups, the aim of the present study was to investigate the association of five important single nucleo-tide polymorphisms (SNPs) in the promoter region of (TNF-α) gene with IBD in Iran.
In this case-control study, 156 Ulcerative colitis (UC) patients, 50 Crohn's disease (CD) patients and 200 sex and age matched healthy controls of Iranian origin were enrolled. The study was performed during a two year period (2008-2010) at Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. DNA samples were evaluated for (TNF-α) gene polymorphisms (including -1031, -863, -857, -308 and -238) by PCR and RFLP methods.
The frequency of the mutant allele of -1031 polymorphism was significantly higher in Iranian patients with Crohn's disease compared to healthy controls (P=0.01, OR=1.92; 95% CI: 1.14-3.23). None of the other evaluated polymorphisms demonstrated a significant higher frequency of mutant alleles in Iranian IBD patients compared to controls.
Among the five assessed (SNPs), only -1031 polymorphism of (TNF-α) gene may play a role in disease susceptibility for Crohn's disease in Iran. This pattern of distribution of (TNF-α) gene polymorphisms could be specific in this population.
Preview · Article · May 2014 · Iranian Journal of Public Health
[Show abstract][Hide abstract] ABSTRACT: Hepatitis A virus (HAV) and hepatitis E virus (HEV) are enteric hepatotropic viruses and their prevalence is related to the sanitary conditions of the region under investigation. There are only a few studies on the seroepidemiology of these two viruses in the general Iranian population. The purpose of this investigation was to measure the prevalence of hepatitis A and E infections in the general population. Between 2006 and 2007, a cross sectional study was performed in Tehran, Iran. Blood specimens were collected and questionnaires were filled in for 551 persons. Patient sera were tested by ELISA for anti-HEV and anti-HAV IgGs. The χ(2) test and independent t-test were used for statistical analysis and p<0.05 was considered significant. The overall seroprevalence rates of anti-HEV IgG and anti-HAV IgG were 9.3% and 90%, respectively. The prevalence of antibodies to HAV and HEV was greater among men than women and increased with age. However, there was no significant relationship between age and gender with the existence of anti- HAV and HEV IgG antibodies. Our results show the seroprevalence of HAV and HEV antibodies are high and both viruses are endemic in this region. These findings are in accordance with results obtained from previous studies. We recommend that foreign travelers to Iran are vaccinated against HAV.
Full-text · Article · Jul 2012 · Transactions of the Royal Society of Tropical Medicine and Hygiene
[Show abstract][Hide abstract] ABSTRACT: While few population-based studies on the economic burden of functional bowel disorders (FBD) have been published from developing countries like Iran, this study aimed to estimate their direct and indirect costs for five groups of patients: irritable bowel syndrome (IBS), functional constipation (FC), unspecified-FBD (U-FBD), functional abdominal bloating (FAB) and functional diarrhea (FD).
Up to 18,180 adults randomly sampled from Tehran, Iran (2006-2007) were interviewed using two questionnaires based on the Rome III criteria to detect FBD patients and to estimate their medical expenses (such as visiting the doctor, drugs, hospitalization and laboratory tests) and productivity loss in the previous 6 months. All costs were converted to dollar purchasing power parity (PPP$) to facilitate cross-country comparisons.
The mean total 6-month costs were approximately: 160, 147, 103, 96 and 42 PPP$ for IBS, FC, U-FBD, FAB and FD, respectively. The highest proportion of drug consumption was found in IBS patients. The highest mean duration of absence from work was seen in IBS patients (2.26 days). Overall, doctor visit costs accounted for approximately 1/3 of the total costs for FBD, followed by hospitalization. A higher indirect cost of illness was found in IBS (54 PPP$), whereas it was zero in FD.
The economic burden of FBD seems to be moderately high in Iran and it imposes a relatively heavy financial burden on the Iranian national health system because of its high prevalence and its impact on quality of life, productivity and waste of resources.
Full-text · Article · Oct 2011 · Journal of Digestive Diseases
[Show abstract][Hide abstract] ABSTRACT: Gastro-oesophageal reflux disease (GERD) and dyspepsia are common digestive disorders that inflict serious harm, burden and economic consequences on individuals worldwide. The aim of this study was to estimate the direct and indirect economic burden of GERD and dyspepsia in the whole population of Tehran, the capital of Iran.
The study was performed on a total of 18,180 adult subjects (age>18 years) taken as a random sample in Tehran province, Iran (2006-2007). A valid and reliable questionnaire was used to enquire about the symptoms of GERD, dyspepsia and the frequency of the utilization of health services including physician visits, hospitalisations and productivity loss due to GERD/dyspepsia symptoms in the preceding 6 months.
GERD was found in 518 (41.9% males) patients and dyspepsia in 404 patients (38.9% males). Further 1007 subjects had both GERD and dyspepsia. The total direct costs of disease per patient for GERD, dyspepsia and their overlap were PPP$97.70, PPP$108.10 and PPP$101.30, respectively (PPP, purchasing power parity dollars). The total indirect cost of disease per patient was PPP$13.7, PPP$12.1 and PPP$32.7, for GERD, dyspepsia and their overlap, respectively.
According to our results, hospitalisation and physician visits were the main cost of disease that could be minimised by revision of the insurance business in Iran.
Full-text · Article · Jun 2011 · Arab Journal of Gastroenterology
[Show abstract][Hide abstract] ABSTRACT: The NOD2 gene is known to have a strong association with Crohn's disease, but different trends were reported in occurrence of NOD2 variants in distinct ethnicities. The aim of this study was to assess all exonic sequences of the NOD2 gene in Iranian Crohn's disease patients and healthy controls to identify any existing variation and evaluate their association with Crohn's disease.
A total of 90 non-related Crohn's disease patients and 120 sex- and age-matched healthy controls of Iranian origin were enrolled in this study. The participants were referred to a tertiary center in a 2-year period (2006-2008). The exonic regions of the NOD2 gene were amplified by polymerase chain reaction and evaluated by direct sequencing.
A total of 21 sequence variations were identified among all exonic regions of the NOD2 gene, of which eight had an allele frequency of more than 5%. Eight new mutations (one in exon 2 and seven in exon 4) were observed. The three main variants (R702W, G908R, and 1007fs) showed allele frequencies of 13.3%, 2.2%, and 1.7%, respectively. Three new variations (P371T, A794P, and Q908H) and R702W mutation were significantly more frequent in Crohn's disease patients compared to controls.
Eight novel mutations were identified in the NOD2 exons, but the pathophysiological importance of these variants remains unclear. Iranian patients with their different genetic reservoirs may demonstrate some novel characteristics for disease susceptibility.
No preview · Article · Jun 2011 · International Journal of Colorectal Disease
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to describe the occurrence of self report bloating and related factors in patients with irritable bowel syndrome (IBS).
Bloating symptoms are common in patients with IBS and have significant impact on normal daily function.
This study was a community-based cross-sectional survey that conducted using a valid questionnaire base on Rome III criteria. Univariate analysis was used for investigation about distribution of self reported bloating according to demographic and psychological factors in irritable bowel syndrome patients.
Out of 18180 subjects under study, 198 cases met criteria for the diagnosis of the irritable bowel syndrome according to criteria ROME III and 61.6% reported bloating symptoms. Bloating symptoms were more prevalent among patients with intermittent symptoms and diarrhea than in patients with constipation. Catastrophic events and depression were independent risk factors for bloating.
Findings of this study support the clinical impression regarding the high prevalence of bloating symptoms in patients with irritable bowel syndrome. Further studies are needed to understand the role of physiological and psychological factors and their interaction in development of bloating in irritable bowel syndrome patients.
Full-text · Article · Feb 2011 · Gastroenterology and hepatology from bed to bench
[Show abstract][Hide abstract] ABSTRACT: Having a family history (FH) of cancer is recognized as one of the most important factors in predicting personal cancer risk. Since reports on cancer FH from developing countries are limited, the present study was conducted to provide a first report on the prevalence of familial cancers in Iran.
Cross-sectional analysis performed on self-reported FH of cancers based on data from a large population based study in Tehran, the capital of Iran. Each participant was shown a list of site-specific cancers and asked if a relative had been diagnosed with any cancer on the list, completing the question by specifying the age of diagnosis.
Stomach cancer (4.6%) was the most common condition noted for family members, followed by the cancers of the breast (4.2%), lung (3.5%), liver (3.1%), leukemia (3.0) and colorectum (2.8%). The most frequent cancer reported by the responders was breast (1.8%) in first degree relatives (FDR) and stomach (1.8%) and stomach (2.8%) in second degree relatives (SDR). A FH of cancer was more commonly reported by younger persons and females. Of all respondents with a positive FH, 28.2% had at least one affected person diagnosed at age under 50 years in their FDRs.
A substantial proportion of individuals in the Iran report having a family member affected by cancer, and thus may be recommended for early cancer screening services.
Full-text · Article · Jan 2011 · Asian Pacific journal of cancer prevention: APJCP
[Show abstract][Hide abstract] ABSTRACT: Introduction: Family history of colorectal cancer has been shown to be related to the risk of developing colorectal cancer. This risk depends on the number of affected relatives and the age at diagnosis. In this study we aimed to estimate the frequency of a positive family history of colorectal cancer in a random sample from Tehran population. Materials and Methods: This study was a community-based cross-sectional survey conducted from May 2006 to December 2007 in Tehran province, Iran. A total of 5,500 peoples (age≥20 years) drawn up randomly by random sampling according to postal codes and invited to participate in the study. All participants completed a detailed health data registry form on family history status of colorectal cancer. Results: The mean age of men with a positive family history was significantly different from men with negative family history. There was no significant difference between mean age of women responders with or without positive family history. Among all participants (n=5,500), 162 responders (2.9%) had a history of colorectal cancer. Of 162, 67 responders (1.22%) had one and 4(0.07%) had two or more first-degree relative with colorectal cancer. Of 5,500 participants, 18 subjects (0.33%) reported having two or more first-degree relative with colorectal cancer or one first-degree relative with colorectal cancer diagnosed at age <50 years. Four subjects (0.07%) had three or more first-degree relative with colorectal cancer. Conclusion: Based on the findings, we estimate that more than 570,000 subjects in the Iran in the age group≥20 years have at least two to three times increased risk of developing colorectal cancer which should be identified and encourage to participate in screening and surveillance protocols of colorectal cancer.
[Show abstract][Hide abstract] ABSTRACT: Objective: The findings of studies concerning the association between obesity and psychological disorders are conflicting. Some have reported a positive association, some a negative association while some found no association at all. This study aimed to investigate the associations between obesity and perceived depression, anxiety and stress. Methods: This study was a community-based cross-sectional survey conducted from May 2006 to December 2007 in Tehran, Iran. The sample size of 3,000 people (age≥20 years) was determined using a sample size formula and participants were selected by random sampling. Survey participants were asked to state their height and weight as well as answer questions concerning whether they had experienced symptoms of depression, anxiety, and stress in the past six months. Some demographic variables such as sex, age, marital status, education and tobacco smoking habits were included in the analysis. Results: The prevalence of perceived depression, anxiety, and stress were higher in women than in men. A higher proportion of underweight and obesity was observed in women. Being underweight, overweight and obese were associated with a one to four-fold increased risk for perceived depression, anxiety and stress. Conclusions: Abnormal body weight is associated with an increased risk of perceived depression in both men and women. Prospective and experimental studies in large samples are needed to explore possible explanations of the association and the direction of causal association between BMI and psychological disorders.
No preview · Article · Jan 2011 · Italian Journal of Public Health
[Show abstract][Hide abstract] ABSTRACT: Recent studies have shown inconsistent results about the association between body mass index and symptoms of gastrointestinal disorders. The aim of this study was to assess the association between body mass index (BMI) and symptoms of uninvestigated dyspepsia in patients with gastrointestinal symptoms and their relations with age.
This study was designed as a cross-sectional and population based evaluation that was conducted in Iran. The patients were interviewed by using questionnaire which was arranged on the basis of Rome III criteria for functional dyspepsia. The association between body mass index, age and dyspepsia symptoms was determined.
A total of 790 patients with gastrointestinal symptoms (249 men, mean +/- SD of age, 49.9 +/- 19 years; mean +/- SD of BMI, 25.4 +/- 4.7) were included and among them 681 (86.2%) had symptoms of dyspepsia. The prevalence of dyspepsia symptoms among females younger and older than 50 years were 83% and 93.8% ,respectively, but these percentages among males younger and older than 50 years were 84.5% and 81.5%.In males younger and older than 50 years 42.9% and 37.6% had BMI over than 25, but these percentages were 51.3% and 54.8% for females. Among overweight and obese patients the prevalence of dyspepsia symptoms were 82.7% and 78%, respectively, compared with normal weight (90.7%).
After the age of 50, the prevalence of dyspepsia symptoms and high body mass index were increased in females, but were decreased in males. No relation between symptoms of dyspepsia and body mass index in both genders was found.
No preview · Article · Dec 2010 · East African journal of public health
[Show abstract][Hide abstract] ABSTRACT: To study the prevalence and risk factors of functional bowel disorders (FBD) in Iranian community using Rome III criteria.
This study was a cross-sectional household survey conducted from May 2006 to December 2007 in Tehran province, Iran, including 18,180 participants who were selected randomly and interviewed face-to-face by a validated questionnaire based on Rome III criteria.
In all, 1.1% met the Rome III criteria for irritable bowel syndrome (IBS), 2.4% for functional constipation (FC), and 10.9% of the participants had any type of FBD. Among participants with functional dyspepsia, 83.8% had FBD; the majority cases were unspecified functional bowel disorder (U-FBD). Of the subjects fulfilling the IBS criteria, IBS with constipation (52%) was the most frequent subtype. In the multivariate analysis, women had a higher risk of any FBDs than men, except for functional diarrhea (FD). The prevalence of FBD, FC and FD increased and IBS decreased with increasing age. Marital status was only associated with a decrease in the risk of FBD and FD, respectively. IBS subtypes compared with FC and FD. There was no significant difference between FC and IBS with constipation (IBS-C), except for self-reported constipation; while, IBS with diarrhea (IBS-D) had more symptoms than FD.
This study revealed a low rate of FBDs among the urban population of Tehran province. The ROME III criteria itself, and the problems with interpretation of the data collection tool may have contributed in underestimating the prevalence of FBD. In addition the reliability of recall over 6 months in Rome III criteria is questionable for our population.
Full-text · Article · Jun 2010 · Saudi Journal of Gastroenterology
[Show abstract][Hide abstract] ABSTRACT: Heartburn is a highly prevalent disorder and is one of the most common gastrointestinal (GI) symptoms encountered in clinical practice. Despite the increasing importance of the early diagnosis of heartburn, there are few studies available on the prevalence of the disease and its Symptoms. The aim of this study was to estimate the frequency of heartburn in the Iranian adult population and analyze its associations with possible confounding factors.
This study was designed as an epidemiological, cross-sectional and population based study that was conducted during May to December 2006 in Firoozkou city of Iran. Participants were interviewed by using a questionnaire which included sociodemographic, health relevant life style and clinical factors and GI symptoms. Statistical analysis was performed by using chi-square test and logistic regression model.
The frequency of heartburn was 28% and is different between men and women (P < 0.05). Also there was a relationship between self report tension and anxiety, BMI and depression with heartburn in univariate analysis (p < 0.05), but in multivariate analysis only age, self report tension and anxiety had a significant relationship with heartburn.
Heartburn is very frequent in Iranian population and has a considerable impact on everyday life. Many factors that may affect the prevalence of heartburn should be considered for prevention and control of this disease.
No preview · Article · Jun 2010 · East African journal of public health
[Show abstract][Hide abstract] ABSTRACT: A case-control study was conducted to investigate the epidemiology and clinical features of Blastocystis hominis among Iranian patients with and without GI symptoms.
Six hundred and seventy patients with GI and Six hundred and seventy patients without GI symptoms were enrolled as cases and controls respectively during 2006-07. Standard microscopic examinations following in vitro culture were used to examine the stool samples for presence of trophozoites and cysts of B. hominis.
Infection with B. hominis occurred most commonly in those with GI symptoms (5.67 %) compared with those patients without GI symptoms (3.43 %). The most common symptom in case group was abdominal pain (86.84 %). B. hominis was mostly found with Giardia lamblia in case group and with Entamoeba coli in control group. In addition, there was no significant relation between the presence of GI symptoms and the incidence of B. hominis.
B. hominis has long been described as a non-pathogenic protozoan parasite until recently, when claims have been made that it could result in pathogenic conditions. Thus, to confirm the complication is needed to additional study especially on molecular pathogenesis of this organism.
Full-text · Article · Mar 2010 · East African journal of public health
[Show abstract][Hide abstract] ABSTRACT: Background: Gastrointestinal diseases are maladies that produce multiple symptoms. Suffering from these symptoms attributes people to an illness which they self-treat or seek medical care. The objective of this study is to determine the prevalence of gastrointestinal (GI) symptoms and relation between some demographic factors and GI symptoms in the Province of Tehran. Methods: This study was a cross-sectional household survey conducted from May 2006 to December 2007 in the Province of Tehran, Iran. The questionnaire included personal and family characteristics such as age, gender, and educational level. In addition to this, interviewers asked about 10 GI symptoms. Results: A total of 30,334 subjects were included in the study, there were 15,165 men (50%). Among them, 4,400 (14.5%) reported one or more GI symptom. Prevalence of GI symptoms included: heartburn 8.6%, bloating 7.6%, abdominal pain 6.2%, constipation 5.1%, anal pain 1.7%, weight loss 1.4%, diarrhea 1.1%, nausea and vomiting 1%, anal bleeding 0.8% and dysphagia 0.8%. Conclusions: The prevalence of GI symptoms in the population studied was lower than that reported in other populations. Women had higher prevalence of GI symptoms. With the increase in educational level the chance of have a GI symptom decreased. Singles reported symptoms less than married participants.
No preview · Article · Jan 2010 · Italian Journal of Public Health
[Show abstract][Hide abstract] ABSTRACT: Background: Individuals with a positive family history of colorectal cancer have an increased risk of developing this type of cancer. The number of affected relatives and the age at diagnosis are two factors that increase the risk of colorectal cancer. The aim of this study was to assess the prevalence of a positive family history of colorectal cancer in a random sample among the Iranian general population. Methods: Five thousand five hundred (5500) subjects' aged≥20 years were randomly selected by cluster sampling and invited to participate in an interview about the occurrence of colorectal cancer in their first- or second-degree relatives. Results: Of all the responders, 162 (2.9%) subjects reported a positive family history of colorectal cancer; 71 (1.24%) reported having one first-degree relative with colorectal cancer diagnosed before the age of 50; or reported two or more first-degree relatives with colorectal cancer. In addition, 83 (1.51%) and 14 (0.25%) subjects reported having one and two or more second-degree relatives with colorectal cancer respectively. Conclusion: The prevalence of a positive family history of colorectal cancer in Iran is lower than the United States and European countries. Identifying high-risk population for colorectal cancer and encouraging them to participate in surveillance protocols is the first step in targeting preventive measures.
Full-text · Article · Jan 2010 · Iranian Journal of Cancer Prevention
[Show abstract][Hide abstract] ABSTRACT: The prevalence of irritable bowel syndrome (IBS) is relatively high, but up to now, no population based study in Iran has used the ROME III criteria. The aim of the present study was to determine the prevalence of IBS by using the ROME III criteria in the adult population of Iran.
A face to face survey was conducted in a large area of the Tehran province. IBS was diagnosed by using a validated questionnaire based on the ROME III criteria.
The study population comprised 18,180 participants, with a female to male ratio of 1. 15.3% of participants complained of gastrointestinal (GI) symptoms, while the prevalence of IBS was estimated to be 1.1% (139 women, 59 men, p=0.000). IBS patients were more likely to be married, and older. The most common presenting symptoms of IBS were abdominal pain that was relieved by defecation (94%), change in fecal consistency (78%), and change in bowel frequency (70%). Constipation was predominant in 52% of IBS cases, diarrhea was predominant in 18%, and 8% experienced intermittent diarrhea and constipation.
The prevalence of IBS is relatively low in the Iranian adult population according to the ROME III criteria. The most probable reasons are the specificity of ROME III criteria and the characteristic low prevalence of GI symptoms in the study population.
Full-text · Article · Dec 2009 · Journal of gastrointestinal and liver diseases: JGLD
[Show abstract][Hide abstract] ABSTRACT: Aim: To determine the prevalence of constipation and its associated factors using Rome III criteria in Iranian population. Background: Due to the appearance of Amoxicillin-resistant H. pylori strains all over the world, the decreased efficacy of conventional Amoxicillin-containing treatment regimens has become a matter of concern. Patients and methods: A cross-sectional study conducted in Tehran province from May 2006 to December 2007, including 18180 adult persons. In the first part of interview, characteristics and gastrointestinal symptoms were considered Those who reported at least one symptom referred for the second interview consisted of questions about different gastrointestinal disorders based on Rome III criteria. Results: 6.33% of interviewees reported constipation and 2.41% had functional constipation (3.5% women and 1.3% men). The prevalence of constipation increases in the group older than 50 years. Constipation was more common in none or low educated than educated groups. Conclusion: It can be concluded that constipation has a less common prevalence in the general Iranian population. Women, older, obese, married and low education subjects are more likely to suffer from constipation.
[Show abstract][Hide abstract] ABSTRACT: Aim: The aim of this study was to describe the frequency of non-specific symptoms of gastroesophageal reflux and association of these symptoms with gastroesophageal reflux disease (GERD) in Iranian population. Background: GERD is a common gastrointestinal disorder, worldwide. Some patients with GERD have no symptoms while others may have non-specific symptoms. Patients and methods: This study was designed as a cross-sectional and population based evaluation that was conducted on 782 cases that selected by random sampling in northeast region of Tehran province. Relation between non-specific symptoms and GERD was assessed using χ2 test. The odds ratios (OR) and 95% CI were calculated for each symptom. Results: Most common non-specific symptom in subjects under study, was abdominal pain with a female preponderance. Abdominal pain, globus sensation, cough & dyspnea, and halitosis were statistically associated to GERD. There was no relationship between age and non-specific symptoms. Conclusion: In summary, this study showed that non-specific symptoms are common in our country that strongly related to gastroesophageal reflux disease, therefore, these symptoms should be considered as a basic in diagnostic procedure.