Ten-day hybrid regimen could not achieve acceptable eradication rate. However, 14-day hybrid regimen seems to be an acceptable option for H. pylori eradication in Iran.

BACKGROUND Helicobacter pylori (H. pylori) is one of the most common bacterial infections worldwide. We designed a study to compare the efficacy of 14-day hybrid regimen with 10-day concomitant therapy for H. pylori eradication in Iran. METHODS 252 patients with naïve H. pylori infection were randomly divided to receive either hybrid regimen (pantoprazole 40 mg, and amoxicillin 1 gr twice daily for 14 days, accompanied by clarithromycin 500 mg, and metronidazole 500 mg, twice daily just during the last 7 days) or concomitant regimen (pantoprazole 40 mg, amoxicillin 1 gr, clarithromycin 500 mg, and metronidazole 500 mg, all twice daily for 10 days). 8 weeks after therapy, 14C- urease breath test was performed to confirm eradication. RESULTS According to intention to treat analysis, the eradication rates were 87.3% (95% CI: 81.4–93.1) and 80.9% (95% CI: 74-87.8) in hybrid and concomitant groups, respectively (p=0.38). Per-protocol eradication rates were 89.3% (95% CI: 83.8-94.7) and 83.1% (95% CI: 76.3-89.8), respectively (p=0.19). The rates of severe side effects were not statistically different between the two groups (4% vs. 8.7%). CONCLUSION 14-day hybrid therapy can be considered as a nearly acceptable regimen with few severe side effects in Iran. However, it seems that the efficacy of this therapy is decreasing as the resistance rates to antibiotics are increasing. We suggest further studies to assess the efficacy of a more prolonged concomitant therapy for H. pylori eradication in Iran.

Ulcerative colitis (UC) is a chronic, idiopathic, inflammatory large bowel disease with recurrent variable periods of exacerbation. The aim of the current study is to evaluate the correlation of UCEIS with fecal calprotectin (FC) level to assess disease activity in UC patients in order to determine whether FC can prognosticate clinical outcome and disease activity of UC instead of colonoscopic evaluation. Our endoscopic investigations revealed the extension of UC as the following: proctitis (11.6%), procto-sigmoiditis (18.5%), left-sided colitis (15.8%), extensive colitis (11.7%), and normal endoscopy (42.4%). Conclusively, we suggest that FC can be used as a reliable tool to evaluate disease activity in ulcerative colitis patients. Moreover, our findings indicate a significant correlation between FC level and mucosal healing.

Gastric cancer (GC) is one of the most prevalent cancers and a major cause of cancer related mortality worldwide. Incidence of GC is affected by various factors, including genetic and environmental factors. Despite extensive research has been done for molecular characterization of GC, it remains largely unknown. Therefore, further studies specially conducted among various ethnicities in different geographic locations, are required to know the precise molecular mechanisms leading to tumorigenesis and progression of GC. The expression patterns of seven candidate genes, including β-catenin, Notch1, GATA6, CDX2, miR-34a, miR-181a, and miR-93 were determined in 24 paired GC tissues and corresponding non-cancerous tissues by quantitative Real-Time PCR. The association between the expression of these genes and clinicopathologic factors were also investigated. Our results demonstrated that overall mRNA levels of GATA6 were significantly decreased in the tumor samples in comparison with the non-cancerous tissues (median fold change (FC) = 0.3143; P = 0.0003). Overall miR-93 levels were significantly increased in the tumor samples relative to the non-cancerous gastric tissues (FC = 2.441; P = 0.0002). β-catenin mRNA expression showed a strong positive correlation with miR-34a (r = 0.5784; P = 0.0031), and miR-181a (r = 0.5652; P = 0.004) expression. miR-34a and miR-181a expression showed a significant positive correlation (r = 0.4862; P = 0.016). Moreover, lower expression of Notch1 was related to distant metastasis in GC patients with a borderline statistical significance (p = 0.0549). These data may advance our understanding of the molecular biology that drives GC as well as provide potential targets for defining novel therapeutic strategies for GC treatment. Gastric cancer (GC) is one of the most prevalent cancers and the second leading cause of cancer-associated deaths worldwide. GC is a multifactorial disease affected by various genetic and environmental factors, including Helicobacter pylori infection, lifestyle, socioeconomic factors, dietary behavior, and aging 1,2. This matter reflects an imperative need for conduction of studies among different geographic locations and ethnicities to detect

Gastrointestinal bleeding is one of the reasons that patients referred to the emergency department. In the majority of these patients, the bleeding stops spontaneously but some of them are high risk patients who may experience complications and may need endoscopic and surgical treatment. Mismanagement of these cases leads to high mortality. Different studies evaluated the causes of Upper GI bleeding but there is not any information about the distribution of these reasons in north of Iran. Methods and material. This prospective study included patients with history of upper gastrointestinal bleeding between January 2017 and December 2018. A total of 249 patients underwent endoscopy for UGIB and the data were studied. Follow up was done for occurrence of re-bleeding or mortality. Results. Our study revealed that the most common cause of upper GI bleeding was duodenal ulcer and gastric ulcer. Antrum was the main anatomical site for gastric ulcer. After the 15 days follow up in 17 (6.8 %) patients mortality existed and rebleeding was found in 11 (4.4 %) patients and the need for surgery in 3 (1.2 %) patients. Conclusions. Like many parts of the world the most common source of upper gastrointestinal bleeding in our study was peptic ulcer diseases. Our study revealed that despite all diagnostic and treatment procedures still there is mortality (6.8 % mortality existed) due to GI bleeding. Ендоскопічні дані та наслідки кровотечі з верхніх відділів шлунково-кишкового тракту в пацієнтів у північній частині Ірану, яких направили у відділення невідкладної допомоги