ALI BAHARI - Academia.edu (original) (raw)

Papers by ALI BAHARI

Research paper thumbnail of Diagnostic Value of the Glasgow-Blatchford Scoring System in Patients With Upper Gastrointestinal Bleeding

ACTA MEDICA IRANICA, 2021

There are disagreements about the diagnostic value of the current risk stratification systems in ... more There are disagreements about the diagnostic value of the current risk stratification systems in patients with acute upper gastrointestinal bleeding (UGIB). The present study aimed to determine the diagnostic value of the Glasgow-Blatchford score in UGIB patients. This study was conducted on 182 patients with UGIB who underwent endoscopy in the

Research paper thumbnail of SEPHYRES: A Medical Diagnosis Model based on Semantic Pseudo-Fuzzy Plan and Radar-form Interface

Applied Medical Informatics, 2017

Clinical decision support systems have emerged to help users and patients. Despite the exciting d... more Clinical decision support systems have emerged to help users and patients. Despite the exciting developments, physicians still have not fully accepted and included the decision support systems in daily practice. Some of resistance is related to expressivity and user interface. After publishing SEPHYRES 1, a medical diagnostic assistant focused on only detailed pain descriptors, a more explicit advanced plan has been recommended to relieve above mentioned barriers. Having combined the pseudo-fuzzy and semantic layers could improve expressivity challenge in using diagnostic terms. In addition, applying visual-pain-area module in detailed granularity along with natural language processing module and radar-form interface, a new point of view for the user-interface-related problems has been addressed for future researchers.

Research paper thumbnail of Frequency and risk factors of primary sclerosing cholangitis among patients with inflammatory bowel disease in North-East of Iran

Gastroenterology and Hepatology From Bed to Bench, 2015

Aim: To identify primary sclerosing cholangitis (PSC) predisposing factors in order to prevent in... more Aim: To identify primary sclerosing cholangitis (PSC) predisposing factors in order to prevent inflammatory bowel disease (IBD) progression to PSC. Background: IBD is commonly associated with PSC and there is no effective therapy for PSC except for liver transplantation. Patients and methods: This retrospective study was conducted on 447 IBD patients from IBD Clinics of Ghaem and Emam Reza Hospitals. Data were collected by interview and through a review of the patients' medical records. Patients were divided into two groups: those with IBD and PSC (IBD-PSC) and those without PSC. Variables were compared between two groups and those with statistically significant differences in IBD-PSC group were considered as predictive factors for the development of PSC. Results: The frequency of PSC in IBDs was 4.3% and all were ulcerative colitis. The mean age of patients with PSC was 39.1±11.33 years. The male to female proportion in PSCs was 3.8:1 and in IBDs was 0.9:1. There were statistic...

Research paper thumbnail of Effect of Cryptococcal Capsular Compounds on Blood Coagulation in Animal Models

Iranian Journal of Public Health, 2005

Glucoronoxylomannan (GXM) is the most important compound of polysaccharide capsule in Cryptococcu... more Glucoronoxylomannan (GXM) is the most important compound of polysaccharide capsule in Cryptococcus neoformans that causes infection in its recognition as a foreign agent by immune system. Because of its similarity with some naural compounds such as heparin and hyaloronic acid, this study was undertaken to determine the effect of polysaccharide compounds on blood coagulative process and renal performance in two groups of laboratory animals including Guinea pig and rat via interaperitoneal injection of cuture filtrate Cryptococcus neoformans’s var. gattii. The results of coagulation tests (PT, PTT, CT and BT) and the renal histopathological changes compared with control group. Insignificant difference between related tests in control and test groups were observed, therefore results of this research proposed capsular compounds have no effect on blood coagulative process and renal performance in persons who involved in cryptococcosis.

Research paper thumbnail of Significance of Response to Hepatitis B Recombinant Vaccine in Subjects with Isolated Antibody to Hepatitis B Core Antigen

Middle East journal of digestive diseases, 2015

BACKGROUND It is important to differentiate whether isolated anti-HBc is due to false positive re... more BACKGROUND It is important to differentiate whether isolated anti-HBc is due to false positive results or the prior exposure to hepatitis B virus, because individuals with false-positive anti-HBc can benefit from vaccination and their blood can be safely transfused. To distinguish between these two conditions, we evaluated the serologic response to hepatitis B vaccine. METHODS Ninety subjects with isolated anti-HBc (cases) and 100 subjects with totally negative hepatitis B serologic markers (controls) were recruited to receive three doses of hepatitis-B (HB) vaccine. Thirty days after the first dose of the vaccine, anti-HBs titers were checked and individuals with anti-HBs titer >50 mIU/mL did not receive additional doses of the vaccine. However, others completed the vaccination course, and another blood sample was collected 30 days after the third dose to measure anti-HBs level. RESULTS Nineteen (21.1%) cases and three (3%) controls had no sero-conversion (anti-HBs titers <10...

Research paper thumbnail of HLA-DQ2 and HLA-DQ8 Genotyping in a Sample of Iranian Celiac Patients and Their First-Degree Relatives

Govaresh, Feb 18, 2014

Recent studies have shown a critical role for HLA-DQ2 and HLA-DQ8 in the pathogenesis of celiac d... more Recent studies have shown a critical role for HLA-DQ2 and HLA-DQ8 in the pathogenesis of celiac disease. No study has been performed on the prevalence of these two HLA types in Iranian celiac patients. Materials and Methods: logic tests. HLA typing for HLA-DQ2 (DQB1*02), HLA-DQ8 (DQB1*03), HLA-DQ B1*05 and HLA-DQ B1*06 was performed using polymerase chain (PCR) reaction. Results: Twenty two (91.7%) celiac patients and twenty seven (73%) controls were positive for the HLA-DQ2 and/or HLA-p=0.068). However, celiac patients were statistically more positive for homozygote HLA-DQ2, whereas non-celiac participants were more positive for homozygote HLA-DQ8 (p<0.05). Conclusion: other hand, the higher prevalence of homozygote HLA-DQ2 in celiac patients shows its stronger role in disease pathogenesis. Further studies on larger populations are needed in Iran.

Research paper thumbnail of Determination of hepatitis C genotypes and the viral titer distribution in children and adolescents with major thalassemia

Iranian journal of pediatrics, 2010

Hepatitis C virus (HCV) is an etiological agent responsible for occurrence of post-transfusion he... more Hepatitis C virus (HCV) is an etiological agent responsible for occurrence of post-transfusion hepatitis in thalassemic patients. This study identified hepatitis C genotypes in pediatric and adolescent thalassemic patients and their correlation with age, blood transfusion, HCV RNA viral titer and liver function. This study considers cross-sectional data from the Center for Thalassemia in Zahedan (Iran) carried out between August 2005 and September 2007. Twenty multitransfused patients suffering from β-thalassemia major and chronic HCV infection (13 males, 7 females) were included in the study. Patients were considered eligible for the study if they were seropositive for HCV RNA polymerase chain reaction (PCR) before initiation of evaluation. Blood sample was taken for HCV genotype and viral titer as well as biochemical markers. Type specific primer and real-time RT-PCR HCV were used for determination of viral genotype and HCV-RNA titer. There was a significant positive correlation b...

Research paper thumbnail of Frequency of Three Common Mutations of CARD15/NOD2 Gene in Jordanian Patients with Crohn’s Disease

British Journal of Medicine and Medical Research, 2015

The CARD15/NOD2 gene, located on the pericentromeric region of chromosome 16 (IBD1) has been repo... more The CARD15/NOD2 gene, located on the pericentromeric region of chromosome 16 (IBD1) has been reported to have an association with IBD, especially Crohn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease. Three common mutations of CARD15 are variably associated with Crohn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease in different ethnic groups. We evaluated the frequency of these mutations (R702W, G908R and 1007fsinsC) in Iranian IBD patients and compared it with the healthy control population. One hundred patients with ulcerative colitis, 40 patients with Crohn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease, and 100 sex- and age-matched controls were enrolled from a tertiary center during a one-year period (2005-2006). The three mutations were assessed in DNA of leukocytes by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). The frequency of R702W mutation was significantly higher in Iranian patients with Crohn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001; OR 19.21; 95% CI 4.23-87.32) compared to healthy controls. No association was observed between the other mutations and Crohn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease and none of these mutations was associated with ulcerative colitis. The R702W mutation of CARD15 gene was associated with Crohn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease in the Iranian population.

Research paper thumbnail of Prevalence of celiac disease among blood donors in SÃO PAULO – the most populated city in Brazil

Clinics, 2012

OBJECTIVE: Celiac disease is a permanent enteropathy caused by the ingestion of gluten, which lea... more OBJECTIVE: Celiac disease is a permanent enteropathy caused by the ingestion of gluten, which leads to an immunemediated inflammation of the small intestine mucosa. The prevalence of celiac disease varies among different nations and ethnic backgrounds, and its diversity is determined by genetic and environmental factors. Sã o Paulo city is one of the largest cities in the world, with a vast population and an important history of internal migratory flow from other Brazilian regions, as well as immigration from other, primarily European, countries, resulting in significant miscegenation. The aim of the present study was to estimate the prevalence of adults with undiagnosed celiac disease among blood donors of Sã o Paulo by collecting information on the ancestry of the population studied. METHODS: The prevalence of celiac disease was assessed by screening for positive IgA transglutaminase and IgA endomysium antibodies in 4,000 donors (volunteers) in the Fundaçã o Pró-Sangue Blood Center of Sã o Paulo, Sã o Paulo, Brazil. The antibody-positive subjects were asked to undergo a small bowel biopsy. RESULTS: Of the 4,000 subjects, twenty-four had positive tests, although both antibody tests were not always concordant. For example, ten subjects were positive for IgA tissue transglutaminase only. In twenty-one positive patients, duodenal biopsies were performed, and the diagnosis of celiac disease was confirmed in fourteen patients (Marsh criteria modified by Oberhuber). In this group, 67% claimed to have European ancestry, mainly from Italy, Portugal and Spain. CONCLUSION: The prevalence of celiac disease is at least 1:286 among supposedly healthy blood bank volunteers in Sã o Paulo, Brazil.

Research paper thumbnail of Inflammatory bowel disease in Iran: A review of 457 cases

Journal of Gastroenterology and Hepatology, 2005

Background-Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseas... more Background-Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases of unknown etiology. Inflammatory bowel disease (IBD) was believed to be infrequent in Iran; however, unofficial reports have confessed the continuing rise in IBD. Here, we present our experience with 448 patients with IBD referred during a 10-year period, 1992-2002. Methods-Demographic and clinical features, extraintestinal manifestations, extension of disease, and complications of 401 patients with UC and 47 with CD were assessed retrospectively. The diagnosis was based on Lennard Jones criteria. The exact course of physicians' visits of 250 patients with IBD was asked through a face-to-face interview. Finally, the lag time between onset of the disease and time of definite diagnosis was determined. Results-The mean (± SD) age at diagnosis was 30.5 ± 11.8 years. Male to female ratio was 0.8:1.0 for UC and 1.3:1.0 for CD. Eighty-three percent of CD and 84.5% of UC patients were nonsmokers. Patients with UC chiefly presented with rectorrhagia (41.9%) or bloody diarrhea (31%), whereas those with CD complained of abdominal pain (47.5%) or diarrhea (27.5%). Of the patients, 14.1% had noted IBD in their family. Among UC patients, proctosigmoid was revealed to be affected in 51.9%. However, left-sided colitis and pancolitis were reported in 30% and 18.1%, respectively. Colorectal cancer was diagnosed in 2 patients (0.4%). The mean lag time between the onset of symptoms and definite diagnosis was 13.9 and 17.7 months for UC and CD patients, respectively. A total of 32.4% of patients with IBD had at least one of the five major extraintestinal manifestations. Conclusion-The demographic and clinical features of IBD are more or less the same as other developing countries. It seems as if gradual adoption of a western lifestyle may be associated with continuing rise in IBD. Higher prevalence of infectious disease and common disorders such as hemorrhoid, and lack of attention to the increased incidence of IBD in Iran are possible reasons for delayed diagnosis of IBD.

Research paper thumbnail of Coenzyme Q10 may be effective in the treatment of non alcoholic fatty liver disease (NAFLD)

Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of disorders characterized by pred... more Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of disorders characterized by predominantly macrovesicular hepatic steatosis that occur in individuals even in the absence of consumption of alcohol in amounts considered harmful to the liver. At present, there is no standard recommended treatment for NAFLD. Treatment currently focuses on gradual weight loss through diet and regular exercise. Insulin sensitizers such as thiazolidinediones and metformin show promise, and several studies have explored the role of lipid lowering agents and antioxidants. Coenzyme Q10 (CoQ) is a powerful antioxidant and has an important role in respiratory metabolism, as a mobile electron and proton carrier in the mitochondrial electron transport chain. However, to date, there is no published clinical trial on CoQ in NAFLD. We postulate the hypothesis that CoQ might be effective in the treatment of NAFLD.

Research paper thumbnail of A tetra-primer amplification refractory mutation system polymerase chain reaction for the evaluation of rs12979860 IL28B genotype

Journal of Viral Hepatitis, 2010

Recently, genome-wide association studies in patients affected by HCV infection have identified a... more Recently, genome-wide association studies in patients affected by HCV infection have identified a strong association between sustained virological response to peg-interferon/ribavirin and spontaneous viral clearance and common single nucleotide polymorphisms (SNPs) near the IL28B gene, encoding for interferon-lambda-3. Thus, it is anticipated that IL28B genotype determination will be integrated in clinical practice to guide treatment decisions. Here, we describe a simple tetra-primer amplification refractory mutation system polymerase chain reaction (T-ARMS-PCR) for the evaluation of the rs12979860 C>T IL28B SNP, for which strong evidence of association with clinical outcomes has been collected in subjects of European descent. Valid genotypic data were obtained for over 99% of subjects analysed, and T-ARMS-PCR procedures were validated by the analysis of DNA samples of 164 patients with chronic HCV infection. In conclusion, this method allows rapid, reproducible, inexpensive and accurate detection of rs12979860 polymorphism without need of any special equipment and is also suitable for evaluation of a low number of samples on a routine basis.

Research paper thumbnail of Development of a Framework for Assessing Professionalism in Medical Students

Background: professionalism assessment is one of the most difficult issues in medical education. ... more Background: professionalism assessment is one of the most difficult issues in medical education. In related references, it is recommended that professionalism assessment should be according to the status and attention to culture of each society. The purpose of the study was to design an appropriate framework in order to assess professionalism among medical students of Mashhad University of Medical Sciences. Methods: the professionalism assessment framework was developed in accordance with experts’ perspective. Q methodology, that is a mixed research method to study people’s viewpoint and subjectivity about the components of professionalism, was used to determine the relevant factors. The data were collected through focus group discussion and interview and analyzed quantitatively using exploratory factor analysis. In order to determine the most appropriate method, time, place and person to carry out the assessment, qualitative methods and interviews were used. Results: the factors i...

Research paper thumbnail of Diagnostic Value of ASCA and Atypical p-ANCA in Differential Diagnosis of Inflammatory Bowel Disease

Middle East journal of digestive diseases, 2013

Worldwide, the incidence of inflammatory bowel disease (IBD) is increasing. This study aims to ev... more Worldwide, the incidence of inflammatory bowel disease (IBD) is increasing. This study aims to evaluate the diagnostic value of two serological markers, atypical perinuclear anti-neutrophil cytoplasmic antibodies (atypical-P-ANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA), with the intent to determinetheir relationship to ulcerative colitis (UC) and Crohn's disease (CD), in addition to the location and extent of bowel involvement. There were 97 patients enrolled in this study, 72 diagnosed with UC and 25 with CD.The control group consisted of 40 healthy individuals. ASCA was determined by enzyme-linked immunosorbent assay (ELISA) and atypical-P-ANCA by indirect immunofluorescence assay (IIF). For data analyses, we used the chi-square and independent t-tests. Significance was considered to be p<0.05. For CD, the sensitivityof ASCA was 16% and its specificity was 97%.ASCA had a specifity of 90% in UC patients. The atypical P-ANCA test had a sensitivity of 44% and spec...

Research paper thumbnail of Seroprevalence of celiac disease in inflammatory bowel disease

American Journal of Gastroenterology, 2003

... Seroprevalence of celiac disease in inflammatory bowel disease. Mohammad Reza Zali , Rahim Ag... more ... Seroprevalence of celiac disease in inflammatory bowel disease. Mohammad Reza Zali , Rahim Aghazadeh , Ali Bahari , Mahmood Aarabi , Medical Student , MehdiHedayati &amp;amp;amp; Saeed Samie. Abstract. Purpose: The association ...

Research paper thumbnail of Association of Adiponectin rs1501299 and rs266729 Gene Polymorphisms With Nonalcoholic Fatty Liver Disease

Hepatitis Monthly, 2013

Background: Genetic and environmental factors are important for the development of nonalcoholic f... more Background: Genetic and environmental factors are important for the development of nonalcoholic fatty liver disease (NAFLD). Adiponectin is a white and brown adipose tissue hormone, and have been found to play essential roles in the regulation of energy homoeostasis. Recent reports have identified a possible role of adiponectin in NAFLD via PPARγ pathway. Objectives: The present study was designed to find out the impact of adiponectin rs1501299 (276G/T) and rs266729 (-11377C/G) gene polymorphisms in NAFLD. Patients and Methods: Eighty-three patients with diagnosis of NAFLD, and 93 healthy subjects were included in the study. Tetra ARMS-PCR was designed to detect single nucleotide polymorphisms. Results: A significant difference was found between NAFLD and control group regarding the rs266729 polymorphism (χ2 = 7.35, P = 0.025). The rs266729 polymorphism increased the risk of NAFLD in codominant (CC vs. CG: OR = 2.18, 95% CI = 1.16-4.12, P = 0.016) and dominant (CC vs. CG/GG: OR = 2.31, 95% CI = 1.25-4.27; P = 0.008) inheritance tested models. The G allele increased the risk of NAFLD (OR = 1.63, 95% CI = 1.03-2.57, P = 0.037) in comparison with C allele. No significant difference was found between the groups concerning adiponectin rs1501299 gene polymorphism (χ2 = 0.70, P = 0.697). Conclusions: adiponectin rs266729 polymorphism might be a candidate gene, which determines the susceptibility to NAFLD. Larger studies are necessary to confirm these findings in various populations.

Research paper thumbnail of Appendectomy, tonsillectomy, and risk of inflammatory bowel disease: a case control study in Iran

International Journal of Colorectal Disease, 2005

There is some controversy about the prevalence of appendectomy and tonsillectomy among patients w... more There is some controversy about the prevalence of appendectomy and tonsillectomy among patients with Crohn's disease and a lower rate of appendectomy among patients with ulcerative colitis (UC). The objective of this study was to elucidate the role of appendectomy and tonsillectomy in Iranian patients with inflammatory bowel disease (IBD). Three hundred and eighty-two consecutive cases of UC and 46 cases of CD were included. Age and sex-matched controls were randomly selected. A total of 382 controls for UC and 184 controls for CD were enrolled. A standard record concerning smoking habit, history of appendectomy and tonsillectomy, OCP, and NSAID use was completed. Logistic regression analysis was used to evaluate potential confounding variables. Twelve patients (3.1%) with UC reported a previous history of appendectomy compared with 30 controls (7.9%) (OR=0.38, 95% CI=0.19-0.76, P<0.004). Appendectomy was reported by five patients (10.9%) with CD compared with four controls (2.2%) (OR=5.49, 95% CI=1.41-21.34, P<0.02). The logistic regression analysis showed that appendectomy is a risk factor in CD but has a modest protective effect for development of UC. No association with tonsillectomy was found for either disease. A statistically significant protective effect for smoking in UC was found (OR=0.2, 95%CI=0.13-0.32, P<0.0001). We have found an inverse association between OCP and NSAID use with UC, but not CD (P<0.0001 and P<0.001, respectively). Appendectomy is protective in UC, but a risk factor in CD among Iranian population. Tonsillectomy was not associated with either UC or CD disease. UC, but not CD, is a disease of nonsmokers. The inverse association between ulcerative colitis and OCP or NSAID in the Iranian population is noted.

Research paper thumbnail of Bone mineral density in Iranian patients with inflammatory bowel disease

International Journal of Colorectal Disease, 2006

Patients with inflammatory bowel disease (IBD) are at increased risk of developing osteopenia and... more Patients with inflammatory bowel disease (IBD) are at increased risk of developing osteopenia and osteoporosis. The aim of the study was to investigate the prevalence of decreased bone density and related risk factors in Iranian IBD patients. A total of 126 ulcerative colitis (UC) and 39 Crohn's disease (CD) patients were enrolled. Dual-energy x-ray absorptiometry technique was used to measure bone density, and blood samples were obtained to measure biochemical markers. To find predictive variables for bone mineral density (BMD), stepwise regression analysis was carried out. A total of 53 IBD patients (32.1%) had diminished bone mineral density at either lumbar spine (L1-L4) or femoral neck. Of these, 9 (5.4%) had osteoporosis; however, 44 (26.7%) were osteopenic. Femoral neck bone density was significantly decreased among CD patients (p<0.04). There was no significant difference in BMD between men and women. We have found significant differences in BMD T scores at lumbar L1-L4, L2-L4, and femoral neck in corticosteroid ever-users (p<0.002, p<0.001, p<0.003, respectively). There was no significant difference in biochemical markers between UC and CD patients, except that more CD patients were hypocalcemic (p<0.001). Stepwise regression analysis has revealed lumbar spine T score was predicted by age (p<0.0001), corticosteroid use (p<0.002), and body mass index (BMI) (p<0.005); however, femoral neck was predicted by age (p<0.0001), BMI (p<0.0001), smoking (p<0.009), and corticosteroid use (p<0.028). Low bone density in Iranian UC and CD patients is in accordance with Western societies. Treatment with corticosteroid has increased this possibility in both groups. Corticosteroid use, age, smoking, and BMI are predictive factors for low bone density.

Research paper thumbnail of A decision tree-based approach for determining low bone mineral density in inflammatory bowel disease using WEKA software

European Journal of Gastroenterology & Hepatology, 2007

Background Decision tree classification is a standard machine learning technique that has been us... more Background Decision tree classification is a standard machine learning technique that has been used for a wide range of applications. Patients with inflammatory bowel disease (IBD) are at increased risk of developing low bone mineral density (BMD). This study aimed at developing a new approach to select truly affected IBD patients who are indicated for densitometry, hence, subjecting fewer patients for bone densitometry and reducing expenses. Materials and methods Simple decision trees have been developed by means of WEKA (Waikato Environment for Knowledge Analysis) package of machine learning algorithms to predict factors influencing the bone density among IBD patients. The BMD status was the outcome variable whereas age, sex, duration of disease, smoking status, corticosteroid use, oral contraceptive use, calcium or vitamin D supplementation, menstruation, milk abstinence, BMI, and levels of calcium, phosphorous, alkaline phosphatase, and 25-OH vitamin D were all attributes. Results Testing showed the decision trees to have sensitivities of 65.7-82.8%, specificities of 95.2-96.3%, accuracies of 86.2-89.8%, and Matthews correlation coefficients of 0.68-0.79. Smoking status was the most significant node (root) for ulcerative colitis and IBD-associated trees whereas calcium status was the root of Crohn's disease patients' decision tree. Conclusion BD specialists could use such decision trees to reduce substantially the number of patients referred for bone densitometry and potentially save resources.

Research paper thumbnail of Association of Genetic Polymorphisms of Glutathione-S-Transferase Genes (GSTT1, GSTM1, and GSTP1) and Susceptibility to Nonalcoholic Fatty Liver Disease in Zahedan, Southeast Iran

DNA and Cell Biology, 2012

Oxidative damage is thought to play a pivotal role in the pathogenesis of nonalcoholic fatty live... more Oxidative damage is thought to play a pivotal role in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). Glutathione-S-transferases (GSTs) are involved in cell protection against oxidative stress. We examined whether GSTM1, GSTT1, and GSTP1 polymorphisms are associated with NAFLD in a sample of the Iranian population. The current case-control study included 83 patients with NAFLD and 93 healthy subjects. The GSTM1 and GSTT1 polymorphisms were analyzed by multiplex polymerase chain reaction (PCR). The GSTP1 polymorphism was detected by tetra amplification refractory mutation system-PCR assay. The GSTM1-null genotype was significantly associated with the development of NAFLD (odds ratios [OR]=2.171, 95% confidence intervals [CI]=1.188-3.970, p=0.015). The GSTP1 Val allele was shown to be a risk factor for NAFLD (OR=1.739, 95% CI=1.089-2.777, p=0.024). The GSTT1 polymorphism was not significantly different between control and patient groups (p=0.221). This study showed that GSTM1 and GSTP1, but not GSTT1, genetic polymorphisms are associated with NAFLD in a sample of the Iranian population, and may be used to determine the risk of development of NAFLD.

Research paper thumbnail of Diagnostic Value of the Glasgow-Blatchford Scoring System in Patients With Upper Gastrointestinal Bleeding

ACTA MEDICA IRANICA, 2021

There are disagreements about the diagnostic value of the current risk stratification systems in ... more There are disagreements about the diagnostic value of the current risk stratification systems in patients with acute upper gastrointestinal bleeding (UGIB). The present study aimed to determine the diagnostic value of the Glasgow-Blatchford score in UGIB patients. This study was conducted on 182 patients with UGIB who underwent endoscopy in the

Research paper thumbnail of SEPHYRES: A Medical Diagnosis Model based on Semantic Pseudo-Fuzzy Plan and Radar-form Interface

Applied Medical Informatics, 2017

Clinical decision support systems have emerged to help users and patients. Despite the exciting d... more Clinical decision support systems have emerged to help users and patients. Despite the exciting developments, physicians still have not fully accepted and included the decision support systems in daily practice. Some of resistance is related to expressivity and user interface. After publishing SEPHYRES 1, a medical diagnostic assistant focused on only detailed pain descriptors, a more explicit advanced plan has been recommended to relieve above mentioned barriers. Having combined the pseudo-fuzzy and semantic layers could improve expressivity challenge in using diagnostic terms. In addition, applying visual-pain-area module in detailed granularity along with natural language processing module and radar-form interface, a new point of view for the user-interface-related problems has been addressed for future researchers.

Research paper thumbnail of Frequency and risk factors of primary sclerosing cholangitis among patients with inflammatory bowel disease in North-East of Iran

Gastroenterology and Hepatology From Bed to Bench, 2015

Aim: To identify primary sclerosing cholangitis (PSC) predisposing factors in order to prevent in... more Aim: To identify primary sclerosing cholangitis (PSC) predisposing factors in order to prevent inflammatory bowel disease (IBD) progression to PSC. Background: IBD is commonly associated with PSC and there is no effective therapy for PSC except for liver transplantation. Patients and methods: This retrospective study was conducted on 447 IBD patients from IBD Clinics of Ghaem and Emam Reza Hospitals. Data were collected by interview and through a review of the patients' medical records. Patients were divided into two groups: those with IBD and PSC (IBD-PSC) and those without PSC. Variables were compared between two groups and those with statistically significant differences in IBD-PSC group were considered as predictive factors for the development of PSC. Results: The frequency of PSC in IBDs was 4.3% and all were ulcerative colitis. The mean age of patients with PSC was 39.1±11.33 years. The male to female proportion in PSCs was 3.8:1 and in IBDs was 0.9:1. There were statistic...

Research paper thumbnail of Effect of Cryptococcal Capsular Compounds on Blood Coagulation in Animal Models

Iranian Journal of Public Health, 2005

Glucoronoxylomannan (GXM) is the most important compound of polysaccharide capsule in Cryptococcu... more Glucoronoxylomannan (GXM) is the most important compound of polysaccharide capsule in Cryptococcus neoformans that causes infection in its recognition as a foreign agent by immune system. Because of its similarity with some naural compounds such as heparin and hyaloronic acid, this study was undertaken to determine the effect of polysaccharide compounds on blood coagulative process and renal performance in two groups of laboratory animals including Guinea pig and rat via interaperitoneal injection of cuture filtrate Cryptococcus neoformans’s var. gattii. The results of coagulation tests (PT, PTT, CT and BT) and the renal histopathological changes compared with control group. Insignificant difference between related tests in control and test groups were observed, therefore results of this research proposed capsular compounds have no effect on blood coagulative process and renal performance in persons who involved in cryptococcosis.

Research paper thumbnail of Significance of Response to Hepatitis B Recombinant Vaccine in Subjects with Isolated Antibody to Hepatitis B Core Antigen

Middle East journal of digestive diseases, 2015

BACKGROUND It is important to differentiate whether isolated anti-HBc is due to false positive re... more BACKGROUND It is important to differentiate whether isolated anti-HBc is due to false positive results or the prior exposure to hepatitis B virus, because individuals with false-positive anti-HBc can benefit from vaccination and their blood can be safely transfused. To distinguish between these two conditions, we evaluated the serologic response to hepatitis B vaccine. METHODS Ninety subjects with isolated anti-HBc (cases) and 100 subjects with totally negative hepatitis B serologic markers (controls) were recruited to receive three doses of hepatitis-B (HB) vaccine. Thirty days after the first dose of the vaccine, anti-HBs titers were checked and individuals with anti-HBs titer >50 mIU/mL did not receive additional doses of the vaccine. However, others completed the vaccination course, and another blood sample was collected 30 days after the third dose to measure anti-HBs level. RESULTS Nineteen (21.1%) cases and three (3%) controls had no sero-conversion (anti-HBs titers <10...

Research paper thumbnail of HLA-DQ2 and HLA-DQ8 Genotyping in a Sample of Iranian Celiac Patients and Their First-Degree Relatives

Govaresh, Feb 18, 2014

Recent studies have shown a critical role for HLA-DQ2 and HLA-DQ8 in the pathogenesis of celiac d... more Recent studies have shown a critical role for HLA-DQ2 and HLA-DQ8 in the pathogenesis of celiac disease. No study has been performed on the prevalence of these two HLA types in Iranian celiac patients. Materials and Methods: logic tests. HLA typing for HLA-DQ2 (DQB1*02), HLA-DQ8 (DQB1*03), HLA-DQ B1*05 and HLA-DQ B1*06 was performed using polymerase chain (PCR) reaction. Results: Twenty two (91.7%) celiac patients and twenty seven (73%) controls were positive for the HLA-DQ2 and/or HLA-p=0.068). However, celiac patients were statistically more positive for homozygote HLA-DQ2, whereas non-celiac participants were more positive for homozygote HLA-DQ8 (p<0.05). Conclusion: other hand, the higher prevalence of homozygote HLA-DQ2 in celiac patients shows its stronger role in disease pathogenesis. Further studies on larger populations are needed in Iran.

Research paper thumbnail of Determination of hepatitis C genotypes and the viral titer distribution in children and adolescents with major thalassemia

Iranian journal of pediatrics, 2010

Hepatitis C virus (HCV) is an etiological agent responsible for occurrence of post-transfusion he... more Hepatitis C virus (HCV) is an etiological agent responsible for occurrence of post-transfusion hepatitis in thalassemic patients. This study identified hepatitis C genotypes in pediatric and adolescent thalassemic patients and their correlation with age, blood transfusion, HCV RNA viral titer and liver function. This study considers cross-sectional data from the Center for Thalassemia in Zahedan (Iran) carried out between August 2005 and September 2007. Twenty multitransfused patients suffering from β-thalassemia major and chronic HCV infection (13 males, 7 females) were included in the study. Patients were considered eligible for the study if they were seropositive for HCV RNA polymerase chain reaction (PCR) before initiation of evaluation. Blood sample was taken for HCV genotype and viral titer as well as biochemical markers. Type specific primer and real-time RT-PCR HCV were used for determination of viral genotype and HCV-RNA titer. There was a significant positive correlation b...

Research paper thumbnail of Frequency of Three Common Mutations of CARD15/NOD2 Gene in Jordanian Patients with Crohn’s Disease

British Journal of Medicine and Medical Research, 2015

The CARD15/NOD2 gene, located on the pericentromeric region of chromosome 16 (IBD1) has been repo... more The CARD15/NOD2 gene, located on the pericentromeric region of chromosome 16 (IBD1) has been reported to have an association with IBD, especially Crohn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease. Three common mutations of CARD15 are variably associated with Crohn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease in different ethnic groups. We evaluated the frequency of these mutations (R702W, G908R and 1007fsinsC) in Iranian IBD patients and compared it with the healthy control population. One hundred patients with ulcerative colitis, 40 patients with Crohn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease, and 100 sex- and age-matched controls were enrolled from a tertiary center during a one-year period (2005-2006). The three mutations were assessed in DNA of leukocytes by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). The frequency of R702W mutation was significantly higher in Iranian patients with Crohn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001; OR 19.21; 95% CI 4.23-87.32) compared to healthy controls. No association was observed between the other mutations and Crohn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease and none of these mutations was associated with ulcerative colitis. The R702W mutation of CARD15 gene was associated with Crohn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s disease in the Iranian population.

Research paper thumbnail of Prevalence of celiac disease among blood donors in SÃO PAULO – the most populated city in Brazil

Clinics, 2012

OBJECTIVE: Celiac disease is a permanent enteropathy caused by the ingestion of gluten, which lea... more OBJECTIVE: Celiac disease is a permanent enteropathy caused by the ingestion of gluten, which leads to an immunemediated inflammation of the small intestine mucosa. The prevalence of celiac disease varies among different nations and ethnic backgrounds, and its diversity is determined by genetic and environmental factors. Sã o Paulo city is one of the largest cities in the world, with a vast population and an important history of internal migratory flow from other Brazilian regions, as well as immigration from other, primarily European, countries, resulting in significant miscegenation. The aim of the present study was to estimate the prevalence of adults with undiagnosed celiac disease among blood donors of Sã o Paulo by collecting information on the ancestry of the population studied. METHODS: The prevalence of celiac disease was assessed by screening for positive IgA transglutaminase and IgA endomysium antibodies in 4,000 donors (volunteers) in the Fundaçã o Pró-Sangue Blood Center of Sã o Paulo, Sã o Paulo, Brazil. The antibody-positive subjects were asked to undergo a small bowel biopsy. RESULTS: Of the 4,000 subjects, twenty-four had positive tests, although both antibody tests were not always concordant. For example, ten subjects were positive for IgA tissue transglutaminase only. In twenty-one positive patients, duodenal biopsies were performed, and the diagnosis of celiac disease was confirmed in fourteen patients (Marsh criteria modified by Oberhuber). In this group, 67% claimed to have European ancestry, mainly from Italy, Portugal and Spain. CONCLUSION: The prevalence of celiac disease is at least 1:286 among supposedly healthy blood bank volunteers in Sã o Paulo, Brazil.

Research paper thumbnail of Inflammatory bowel disease in Iran: A review of 457 cases

Journal of Gastroenterology and Hepatology, 2005

Background-Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseas... more Background-Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases of unknown etiology. Inflammatory bowel disease (IBD) was believed to be infrequent in Iran; however, unofficial reports have confessed the continuing rise in IBD. Here, we present our experience with 448 patients with IBD referred during a 10-year period, 1992-2002. Methods-Demographic and clinical features, extraintestinal manifestations, extension of disease, and complications of 401 patients with UC and 47 with CD were assessed retrospectively. The diagnosis was based on Lennard Jones criteria. The exact course of physicians' visits of 250 patients with IBD was asked through a face-to-face interview. Finally, the lag time between onset of the disease and time of definite diagnosis was determined. Results-The mean (± SD) age at diagnosis was 30.5 ± 11.8 years. Male to female ratio was 0.8:1.0 for UC and 1.3:1.0 for CD. Eighty-three percent of CD and 84.5% of UC patients were nonsmokers. Patients with UC chiefly presented with rectorrhagia (41.9%) or bloody diarrhea (31%), whereas those with CD complained of abdominal pain (47.5%) or diarrhea (27.5%). Of the patients, 14.1% had noted IBD in their family. Among UC patients, proctosigmoid was revealed to be affected in 51.9%. However, left-sided colitis and pancolitis were reported in 30% and 18.1%, respectively. Colorectal cancer was diagnosed in 2 patients (0.4%). The mean lag time between the onset of symptoms and definite diagnosis was 13.9 and 17.7 months for UC and CD patients, respectively. A total of 32.4% of patients with IBD had at least one of the five major extraintestinal manifestations. Conclusion-The demographic and clinical features of IBD are more or less the same as other developing countries. It seems as if gradual adoption of a western lifestyle may be associated with continuing rise in IBD. Higher prevalence of infectious disease and common disorders such as hemorrhoid, and lack of attention to the increased incidence of IBD in Iran are possible reasons for delayed diagnosis of IBD.

Research paper thumbnail of Coenzyme Q10 may be effective in the treatment of non alcoholic fatty liver disease (NAFLD)

Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of disorders characterized by pred... more Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of disorders characterized by predominantly macrovesicular hepatic steatosis that occur in individuals even in the absence of consumption of alcohol in amounts considered harmful to the liver. At present, there is no standard recommended treatment for NAFLD. Treatment currently focuses on gradual weight loss through diet and regular exercise. Insulin sensitizers such as thiazolidinediones and metformin show promise, and several studies have explored the role of lipid lowering agents and antioxidants. Coenzyme Q10 (CoQ) is a powerful antioxidant and has an important role in respiratory metabolism, as a mobile electron and proton carrier in the mitochondrial electron transport chain. However, to date, there is no published clinical trial on CoQ in NAFLD. We postulate the hypothesis that CoQ might be effective in the treatment of NAFLD.

Research paper thumbnail of A tetra-primer amplification refractory mutation system polymerase chain reaction for the evaluation of rs12979860 IL28B genotype

Journal of Viral Hepatitis, 2010

Recently, genome-wide association studies in patients affected by HCV infection have identified a... more Recently, genome-wide association studies in patients affected by HCV infection have identified a strong association between sustained virological response to peg-interferon/ribavirin and spontaneous viral clearance and common single nucleotide polymorphisms (SNPs) near the IL28B gene, encoding for interferon-lambda-3. Thus, it is anticipated that IL28B genotype determination will be integrated in clinical practice to guide treatment decisions. Here, we describe a simple tetra-primer amplification refractory mutation system polymerase chain reaction (T-ARMS-PCR) for the evaluation of the rs12979860 C>T IL28B SNP, for which strong evidence of association with clinical outcomes has been collected in subjects of European descent. Valid genotypic data were obtained for over 99% of subjects analysed, and T-ARMS-PCR procedures were validated by the analysis of DNA samples of 164 patients with chronic HCV infection. In conclusion, this method allows rapid, reproducible, inexpensive and accurate detection of rs12979860 polymorphism without need of any special equipment and is also suitable for evaluation of a low number of samples on a routine basis.

Research paper thumbnail of Development of a Framework for Assessing Professionalism in Medical Students

Background: professionalism assessment is one of the most difficult issues in medical education. ... more Background: professionalism assessment is one of the most difficult issues in medical education. In related references, it is recommended that professionalism assessment should be according to the status and attention to culture of each society. The purpose of the study was to design an appropriate framework in order to assess professionalism among medical students of Mashhad University of Medical Sciences. Methods: the professionalism assessment framework was developed in accordance with experts’ perspective. Q methodology, that is a mixed research method to study people’s viewpoint and subjectivity about the components of professionalism, was used to determine the relevant factors. The data were collected through focus group discussion and interview and analyzed quantitatively using exploratory factor analysis. In order to determine the most appropriate method, time, place and person to carry out the assessment, qualitative methods and interviews were used. Results: the factors i...

Research paper thumbnail of Diagnostic Value of ASCA and Atypical p-ANCA in Differential Diagnosis of Inflammatory Bowel Disease

Middle East journal of digestive diseases, 2013

Worldwide, the incidence of inflammatory bowel disease (IBD) is increasing. This study aims to ev... more Worldwide, the incidence of inflammatory bowel disease (IBD) is increasing. This study aims to evaluate the diagnostic value of two serological markers, atypical perinuclear anti-neutrophil cytoplasmic antibodies (atypical-P-ANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA), with the intent to determinetheir relationship to ulcerative colitis (UC) and Crohn's disease (CD), in addition to the location and extent of bowel involvement. There were 97 patients enrolled in this study, 72 diagnosed with UC and 25 with CD.The control group consisted of 40 healthy individuals. ASCA was determined by enzyme-linked immunosorbent assay (ELISA) and atypical-P-ANCA by indirect immunofluorescence assay (IIF). For data analyses, we used the chi-square and independent t-tests. Significance was considered to be p<0.05. For CD, the sensitivityof ASCA was 16% and its specificity was 97%.ASCA had a specifity of 90% in UC patients. The atypical P-ANCA test had a sensitivity of 44% and spec...

Research paper thumbnail of Seroprevalence of celiac disease in inflammatory bowel disease

American Journal of Gastroenterology, 2003

... Seroprevalence of celiac disease in inflammatory bowel disease. Mohammad Reza Zali , Rahim Ag... more ... Seroprevalence of celiac disease in inflammatory bowel disease. Mohammad Reza Zali , Rahim Aghazadeh , Ali Bahari , Mahmood Aarabi , Medical Student , MehdiHedayati &amp;amp;amp; Saeed Samie. Abstract. Purpose: The association ...

Research paper thumbnail of Association of Adiponectin rs1501299 and rs266729 Gene Polymorphisms With Nonalcoholic Fatty Liver Disease

Hepatitis Monthly, 2013

Background: Genetic and environmental factors are important for the development of nonalcoholic f... more Background: Genetic and environmental factors are important for the development of nonalcoholic fatty liver disease (NAFLD). Adiponectin is a white and brown adipose tissue hormone, and have been found to play essential roles in the regulation of energy homoeostasis. Recent reports have identified a possible role of adiponectin in NAFLD via PPARγ pathway. Objectives: The present study was designed to find out the impact of adiponectin rs1501299 (276G/T) and rs266729 (-11377C/G) gene polymorphisms in NAFLD. Patients and Methods: Eighty-three patients with diagnosis of NAFLD, and 93 healthy subjects were included in the study. Tetra ARMS-PCR was designed to detect single nucleotide polymorphisms. Results: A significant difference was found between NAFLD and control group regarding the rs266729 polymorphism (χ2 = 7.35, P = 0.025). The rs266729 polymorphism increased the risk of NAFLD in codominant (CC vs. CG: OR = 2.18, 95% CI = 1.16-4.12, P = 0.016) and dominant (CC vs. CG/GG: OR = 2.31, 95% CI = 1.25-4.27; P = 0.008) inheritance tested models. The G allele increased the risk of NAFLD (OR = 1.63, 95% CI = 1.03-2.57, P = 0.037) in comparison with C allele. No significant difference was found between the groups concerning adiponectin rs1501299 gene polymorphism (χ2 = 0.70, P = 0.697). Conclusions: adiponectin rs266729 polymorphism might be a candidate gene, which determines the susceptibility to NAFLD. Larger studies are necessary to confirm these findings in various populations.

Research paper thumbnail of Appendectomy, tonsillectomy, and risk of inflammatory bowel disease: a case control study in Iran

International Journal of Colorectal Disease, 2005

There is some controversy about the prevalence of appendectomy and tonsillectomy among patients w... more There is some controversy about the prevalence of appendectomy and tonsillectomy among patients with Crohn's disease and a lower rate of appendectomy among patients with ulcerative colitis (UC). The objective of this study was to elucidate the role of appendectomy and tonsillectomy in Iranian patients with inflammatory bowel disease (IBD). Three hundred and eighty-two consecutive cases of UC and 46 cases of CD were included. Age and sex-matched controls were randomly selected. A total of 382 controls for UC and 184 controls for CD were enrolled. A standard record concerning smoking habit, history of appendectomy and tonsillectomy, OCP, and NSAID use was completed. Logistic regression analysis was used to evaluate potential confounding variables. Twelve patients (3.1%) with UC reported a previous history of appendectomy compared with 30 controls (7.9%) (OR=0.38, 95% CI=0.19-0.76, P<0.004). Appendectomy was reported by five patients (10.9%) with CD compared with four controls (2.2%) (OR=5.49, 95% CI=1.41-21.34, P<0.02). The logistic regression analysis showed that appendectomy is a risk factor in CD but has a modest protective effect for development of UC. No association with tonsillectomy was found for either disease. A statistically significant protective effect for smoking in UC was found (OR=0.2, 95%CI=0.13-0.32, P<0.0001). We have found an inverse association between OCP and NSAID use with UC, but not CD (P<0.0001 and P<0.001, respectively). Appendectomy is protective in UC, but a risk factor in CD among Iranian population. Tonsillectomy was not associated with either UC or CD disease. UC, but not CD, is a disease of nonsmokers. The inverse association between ulcerative colitis and OCP or NSAID in the Iranian population is noted.

Research paper thumbnail of Bone mineral density in Iranian patients with inflammatory bowel disease

International Journal of Colorectal Disease, 2006

Patients with inflammatory bowel disease (IBD) are at increased risk of developing osteopenia and... more Patients with inflammatory bowel disease (IBD) are at increased risk of developing osteopenia and osteoporosis. The aim of the study was to investigate the prevalence of decreased bone density and related risk factors in Iranian IBD patients. A total of 126 ulcerative colitis (UC) and 39 Crohn's disease (CD) patients were enrolled. Dual-energy x-ray absorptiometry technique was used to measure bone density, and blood samples were obtained to measure biochemical markers. To find predictive variables for bone mineral density (BMD), stepwise regression analysis was carried out. A total of 53 IBD patients (32.1%) had diminished bone mineral density at either lumbar spine (L1-L4) or femoral neck. Of these, 9 (5.4%) had osteoporosis; however, 44 (26.7%) were osteopenic. Femoral neck bone density was significantly decreased among CD patients (p<0.04). There was no significant difference in BMD between men and women. We have found significant differences in BMD T scores at lumbar L1-L4, L2-L4, and femoral neck in corticosteroid ever-users (p<0.002, p<0.001, p<0.003, respectively). There was no significant difference in biochemical markers between UC and CD patients, except that more CD patients were hypocalcemic (p<0.001). Stepwise regression analysis has revealed lumbar spine T score was predicted by age (p<0.0001), corticosteroid use (p<0.002), and body mass index (BMI) (p<0.005); however, femoral neck was predicted by age (p<0.0001), BMI (p<0.0001), smoking (p<0.009), and corticosteroid use (p<0.028). Low bone density in Iranian UC and CD patients is in accordance with Western societies. Treatment with corticosteroid has increased this possibility in both groups. Corticosteroid use, age, smoking, and BMI are predictive factors for low bone density.

Research paper thumbnail of A decision tree-based approach for determining low bone mineral density in inflammatory bowel disease using WEKA software

European Journal of Gastroenterology & Hepatology, 2007

Background Decision tree classification is a standard machine learning technique that has been us... more Background Decision tree classification is a standard machine learning technique that has been used for a wide range of applications. Patients with inflammatory bowel disease (IBD) are at increased risk of developing low bone mineral density (BMD). This study aimed at developing a new approach to select truly affected IBD patients who are indicated for densitometry, hence, subjecting fewer patients for bone densitometry and reducing expenses. Materials and methods Simple decision trees have been developed by means of WEKA (Waikato Environment for Knowledge Analysis) package of machine learning algorithms to predict factors influencing the bone density among IBD patients. The BMD status was the outcome variable whereas age, sex, duration of disease, smoking status, corticosteroid use, oral contraceptive use, calcium or vitamin D supplementation, menstruation, milk abstinence, BMI, and levels of calcium, phosphorous, alkaline phosphatase, and 25-OH vitamin D were all attributes. Results Testing showed the decision trees to have sensitivities of 65.7-82.8%, specificities of 95.2-96.3%, accuracies of 86.2-89.8%, and Matthews correlation coefficients of 0.68-0.79. Smoking status was the most significant node (root) for ulcerative colitis and IBD-associated trees whereas calcium status was the root of Crohn's disease patients' decision tree. Conclusion BD specialists could use such decision trees to reduce substantially the number of patients referred for bone densitometry and potentially save resources.

Research paper thumbnail of Association of Genetic Polymorphisms of Glutathione-S-Transferase Genes (GSTT1, GSTM1, and GSTP1) and Susceptibility to Nonalcoholic Fatty Liver Disease in Zahedan, Southeast Iran

DNA and Cell Biology, 2012

Oxidative damage is thought to play a pivotal role in the pathogenesis of nonalcoholic fatty live... more Oxidative damage is thought to play a pivotal role in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). Glutathione-S-transferases (GSTs) are involved in cell protection against oxidative stress. We examined whether GSTM1, GSTT1, and GSTP1 polymorphisms are associated with NAFLD in a sample of the Iranian population. The current case-control study included 83 patients with NAFLD and 93 healthy subjects. The GSTM1 and GSTT1 polymorphisms were analyzed by multiplex polymerase chain reaction (PCR). The GSTP1 polymorphism was detected by tetra amplification refractory mutation system-PCR assay. The GSTM1-null genotype was significantly associated with the development of NAFLD (odds ratios [OR]=2.171, 95% confidence intervals [CI]=1.188-3.970, p=0.015). The GSTP1 Val allele was shown to be a risk factor for NAFLD (OR=1.739, 95% CI=1.089-2.777, p=0.024). The GSTT1 polymorphism was not significantly different between control and patient groups (p=0.221). This study showed that GSTM1 and GSTP1, but not GSTT1, genetic polymorphisms are associated with NAFLD in a sample of the Iranian population, and may be used to determine the risk of development of NAFLD.