Nasser Daryani - Academia.edu (original) (raw)

Papers by Nasser Daryani

Hepatitis Monthly, Sep 30, 2011

Hepatitis C remains as an important health problem worldwide. Hepatitis C treatment, especially a... more Hepatitis C remains as an important health problem worldwide. Hepatitis C treatment, especially among patients infected with HCV genotype 1 who are considered difficult to treat, is a high priority for health policy-makers. PegInterferon alfa instead of Interferon and ribavirin combination therapy has been accepted as the standard treatment regimen for hepatitis C patients; however, only 50% of patients infected with HCV genotype 1 achieve a sustained virological response. Published data from various clinical trials of protease inhibitors suggest that new therapeutic regimens may increase the chances of a successful response in patients infected with HCV genotype 1. Triple therapy that includes boceprevir has been shown to result in high rates of sustained virological response in both naive and experienced patients with HCV genotype 1 infection. In this review, we have summarized the results obtained with this new regimen and have attempted to provide a guideline for the treatment of patients in Iran, with emphasis on cost and the occurrence of adverse events.

Hepatitis Monthly, Sep 30, 2004

Chronic hepatitis C is the leading cause of chronic liver disease and liver transplantation, affe... more Chronic hepatitis C is the leading cause of chronic liver disease and liver transplantation, affecting 170 million persons worldwide. 1, 2 It is a condition leading to life-threatening complications such as cirrhosis and hepatocellular carcinoma; two situations that are difficult and costly ...

Gastroenterology and hepatology from bed to bench, May 12, 2009

Aim: To gain recent characteristic information about inflammatory bowel disease (IBD) in Iran. Ba... more Aim: To gain recent characteristic information about inflammatory bowel disease (IBD) in Iran. Background: Inflammatory bowel disease (IBD) was believed to be infrequent in Iran; however, during the recent years its prevalence has been continuing in our country. Patients and Method: Between 1992 and 2007, a total of 803 IBD patients (671 ulcerative colitis (UC), 109 Crohn's disease (CD) and 23 indeterminate colitis (IC)) referred to our research centre. We evaluated the demographic data, extraintestinal manifestations, chief complaints and extension of disease in this group of patients. Results: The mean age at diagnosis was 33.01, 33.18, and 34.52 years in UC, CD, and IC patients, respectively. The male to female ratio was 0.78 for UC patients while it was 1.18 in CD patients. Patients with UC chiefly presented by hematochezia (54.24%), whereas those with CD and IC complained of abdominal pain (55.96% and 47.82%, respectively). Totally, 67.51% UC patients, 70.64% CD patients and 73.90% IC patients reported extra intestinal manifestations. The most involved section was left colon in UC (90.49%) and colon in CD patients (75%). Conclusion: The demographic and clinical picture of IBD is more or less the same as other developing countries; however, the rarity of CD in Iran is noted. Although the true epidemiologic profile of IBD in Iran is still unknown, it is not as rare as previously thought and it seems as if gradual adoption of a western lifestyle may be associated with continuing rise in IBD.

Frontiers in Microbiology

IntroductionPatients with inflammatory bowel disease (IBD) are at a greater risk for the recurren... more IntroductionPatients with inflammatory bowel disease (IBD) are at a greater risk for the recurrence of Clostridioides difficile infection (rCDI) that is triggered by intestinal microbiota dysbiosis. Fecal microbiota transplantation (FMT) has emerged as a highly effective therapeutic option for this complication. However, little is known about the impact of FMT on intestinal microbiota alterations in rCDI patients suffering from IBD. In this study, we aimed to investigate post-FMT intestinal microbiota alterations in Iranian rCDI patients with underlying IBD.MethodsA total of 21 fecal samples were collected including 14 samples pre- and post-FMT and 7 samples from healthy donors. Microbial analysis was performed by quantitative real-time PCR (RT-qPCR) assay targeting the 16S rRNA gene. The pre-FMT profile and composition of the fecal microbiota were compared to the microbial changes of samples collected 28 days after FMT.Results and discussionOverall, the fecal microbiota profile of ...

Microbiology Spectrum

In the light of severe outbreaks caused by multidrug-resistant microorganisms due to contaminated... more In the light of severe outbreaks caused by multidrug-resistant microorganisms due to contaminated GI endoscopes, understanding to what extent GI endoscopes are inadequately reprocessed is crucial. Several studies assessed contamination of GI endoscopes with various outcomes across the world; however, the prevalence and risk factors of contaminated GI endoscopes and potential subsequent nosocomial spread are still unknown in Iran.

Archives of Physiology and Biochemistry

Archives of Iranian medicine, 2016

BACKGROUND The burden of inflammatory bowel disease (IBD) hasn't been reported in Iran. We ai... more BACKGROUND The burden of inflammatory bowel disease (IBD) hasn't been reported in Iran. We aimed to estimate the prevalence and incidence of IBD and its trend in Iran at national and subnational level from 1990 to 2012. METHODS We conducted a systematic review of English and Persian databases about the epidemiology of IBD. We also collected outpatient data from 17 provinces of Iran using almost all public and private referral gastroenterology clinics. Prevalence and incidence rate was calculated at national and subnational levels. The Kriging method was used to extrapolate provinces with missing data and GPR model to calculate time trends of rates at subnational level. RESULTS We found 16 case series, two population-based studies, and two review articles. We collected 11,000 IBD cases from outpatient databases. Among them, 9,269 (84.26%) had ulcerative colitis (UC), 1,646 (14.96%) had Crohn's disease (CD), and 85 had intermediate colitis (IC). A total of 5,452 (49.56%) patie...

Wernike encephalopathy(WE )caused by thiamine deficiency was a critical but reversible disorder.... more Wernike encephalopathy(WE )caused by thiamine deficiency was a critical but reversible disorder. It can be occurred after acute pancreatitis due to prolonged fasting. WE after acute pancreatitis was rarely suspected and diagnosed at early stages. We reported a 44 year-old woman with severe acute pancreatitis who developed altered mental status and bilateral nystagmus and ophthalmoplegia soon after 14 days of fasting. The brain MRI confirmed the diagnosis. After empiric treatment with thiamine all of the neurological symptoms reversed except only some antegrade and retrograde amnesia . In this case report considering thiamine deficiency in any patients with fasting and neurological symptoms, was addressed since WE was a reversible disorder if it was diagnosed in early stage.

Background and Aims: The incidence of Inflammatory bowel disease (IBD), including Crohn’s disease... more Background and Aims: The incidence of Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and Ulcerative colitis (UC), is rising in Asian populations. We undertook a cross-population study to explore whether genetic risk scores (GRS) of IBD, CD and UC could explain their occurrence, and whether they can be used to predict disease occurrence in general populations from East Asia (EA) and Central Asia (CA). Methods We studied 9,698 subjects – 4,733 IBD patients (2,003 CD; 2,730 UC) and 4,965 matched controls – who had been genotyped using Immunochip. The subjects were from three East Asian (Japan, South Korea and China) and two Central Asian populations (India and Iran). We generated GRS for each population by combining information from up to 201 genome-wide significant IBD-associated variants to summarize the total load of genetic risk for each phenotype. We then estimated the explained variance and predictability of IBD using the GRS. Results IBD GRS could explain up to...

Middle East Journal of Digestive Diseases, 2019

BACKGROUND The anti-TNF drugs are shown to be highly effective in treatment of patients with mode... more BACKGROUND The anti-TNF drugs are shown to be highly effective in treatment of patients with moderate-tosevere inflammatory bowel disease (IBD). Here, we aimed to assess the efficacy and safety of antiTNF therapy at the national level. METHODS IBD patients aged 15 > years who received Infliximab and/or CinnoRA® between 2013 to July 2018 were identified. The data extracted from medical dossier and telephonic interview. The efficacy of therapy was defined as time to drug discontinuation or need for IBD-related surgery. The safety was assessed based on patient’s reported adverse events. RESULTS We included 315 patients. The mean age of patients was 37.2 years and 62.2% of them developed the disease before age 30 years. Involvement of masculoskeletal system was reported in 7.3% of patients. Partial and complete response to Anti-TNF therapy was seen in 67% of patients. About 16% of patients did not respond to induction therapy and 16.9% of patients lost their response to Anti-TNF duri...

American Journal of Gastroenterology, 2006

Journal of Crohn's and Colitis, 2019

Poster presentations for the SDS for IBD and controls (7 vs. 7; p = 0.49), meaning the reliabilit... more Poster presentations for the SDS for IBD and controls (7 vs. 7; p = 0.49), meaning the reliability of responses was homogeneous. IBD patients reported a poorer SQoL (men: 77.3 vs. 83.8, p = 0.007; women: 70.4 vs. 81.6, p < 0.001) and a higher incidence of depression (6 vs.5; p < 0.001) than controls. 189 patients scored for moderate-severe depression indicators. For IBD, SQoL was correlated with health-related QoL (HRQoL) measured by the SIBDQ (men: r = 0.48, women: r = 0.45; p = 0.00), and negatively correlated with depression symptoms (men: r = −0.47, women: r = −0.48; p = 0.00). Similarly, perianal disease was associated with a poorer HRQoL and a higher incidence of depression. However, perianal disease did not impact SQoL for male or female patients. Looking closer into the IBD and controls' SQoL scores, male patients struggled with frustration, depression, anxiety and embarrassment. As for female patients, frustration, depression, anxiety, embarrassment, lack of pleasure and confidence loss were reported. In linear regression analysis for men, SQoL was associated with age, marital status and depression (β −1.87 [IC 95% −2.20 −1.53]; p < 0.001). In women, SQoL was associated with depression (β −1.81 [IC 95% −2.11 −1.51]; p < 0.001) only. Conclusions: IBD patients reported a poorer sexual QoL than healthy controls. Moderate-severe depression was highly reported in IBD and was negatively correlated with SQoL. Similarly to what is reported for disease activity in other studies, perianal disease did not impact SQoL. Patients concerns on sexuality were mostly about emotional issues and self-esteem.

Hepatitis Monthly, 2016

Context: Hepatitis C virus (HCV) infection is a major public health issue worldwide, including Ir... more Context: Hepatitis C virus (HCV) infection is a major public health issue worldwide, including Iran. The new direct-acting antiviral agents (DAAs) with high efficacy have changed the landscape of HCV treatment. This guideline provides updated recommendations for clinical management of HCV infection in Iran. Evidence Acquisition: The recommendations of this guideline are based on international and national scientific evidences and consensus-based expert opinion. Scientific evidences were collected through a systematic review of studies that evaluated efficacy and safety of DAA regimens, using PubMed, Scopus and Web of Science. Expert opinion was based on the consensus of Iran Hepatitis Scientific Board (IHSB) in the 3 rd national consensus on management of Hepatitis C in Iran, held on 22 nd of July 2016. Results: Pegylated Interferon alpha (PegIFN), Ribavirin (RBV), Sofosbuvir (SOF), Ledipasvir (LDV) and Daclatasvir (DCV) are currently available in Iran. Pre-treatment assessments include HCV RNA level, HCV genotype and resistance testing, assessment of liver fibrosis, and underlying diseases. In HCV genotype 1 and 4, DCV/SOF and LDV/SOF are recommended. In HCV genotype 2, SOF plus RBV and in HCV genotype 3, DCV/SOF is recommended. Additional care for underlying diseases should be considered. Conclusions: Affordable new HCV treatment regimens are available in Iran, providing an opportunity for HCV elimination. Recommendations provided in this current national guideline can facilitate evidence-based management of HCV infection.

Intestinal Research, 2019

Background/Aims: A recent study revealed increasing incidence and prevalence of inflammatory bowe... more Background/Aims: A recent study revealed increasing incidence and prevalence of inflammatory bowel disease (IBD) in Iran. The Iranian Registry of Crohn' s and Colitis (IRCC) was designed recently to answer the needs. We reported the design, methods of data collection, and aims of IRCC in this paper. Methods: IRCC is a multicenter prospective registry, which is established with collaboration of more than 100 gastroenterologists from different provinces of Iran. Minimum data set for IRCC was defined according to an international consensus on standard set of outcomes for IBD. A pilot feasibility study was performed on 553 IBD patients with a web-based questionnaire. The reliability of questionnaire evaluated by Cronbach' s α. Results: All sections of questionnaire had Cronbach' s α of more than 0.6. In pilot study, 312 of participants (56.4%) were male and mean age was 38 years (standard deviation = 12.8) and 378 patients (68.35%) had ulcerative colitis, 303 subjects (54,7%) had college education and 358 patients (64.74%) were of Fars ethnicity. We found that 68 (12.3%), 44 (7.9%), and 13 (2.3%) of participants were smokers, hookah and opium users, respectively. History of appendectomy was reported in 58 of patients (10.48%). The most common medication was 5-aminosalicylate (94.39%). Conclusions: To the best of our knowledge, IRCC is the first national IBD registry in the Middle East and could become a reliable infrastructure for national and international research on IBD. IRCC will improve the quality of care of IBD patients and provide national information for policy makers to better plan for controlling IBD in Iran.

PubMed, Jun 1, 2011

Background: Non-alcoholic fatty liver disease (NAFLD) has been recognized as the most common caus... more Background: Non-alcoholic fatty liver disease (NAFLD) has been recognized as the most common cause of chronic liver disease worldwide. It occurs in patients who do not consume alcohol in large amounts. Alanine aminotranferase (ALT) and aspartate aminotransferase (AST) are indicators of hepatocellular injury. Objectives: To determine correlation between histopathologic specifications of NAFLD in patients with little or no history of alcohol consumption and the serum level of ALT. Patients and methods: In a cross-sectional study carried out in two gastroenterology and hepatology clinics in Tehran, Iran, the medical records of those who had undergone liver biopsies between years 2005 and 2009 were reviewed. Clinical and laboratory information of biopsy-proven cases of NAFLD were obtained from 147 eligible medical records. The histopathologic, demographic, and laboratory data of the participants were also collected. Two groups of patients according to their serum ALT level (cut-point of 35 U/L) were defined. The quantitative pathologic grade of the biopsy specimens was determined based on Brunt scoring system. Results: We studied 147 NAFLD patients including 127 men (86.4%) and 20 women (13.6%) with a mean ± SD age of 41.4 ± 11.2 years. Considering serum ALT, the mean ± SD quantitative grade of hepatosteatosis was 1.50 ± 0.67 and 1.74 ± 0.73 (p=0.136); advanced fibrosis (consisted of grade III and cirrhosis) was found in 4.5% (1/22) and 5.6% (7/125) of patients (p=0.327). Conclusions: We found that using the cut-off value of 35 U/L for serum ALT level, it has little contribution to predict NAFLD severity.

Research in Medicine, Jun 10, 2012

Hepatitis Monthly, Sep 1, 2011

Hepatitis Monthly, Mar 6, 2016

Context: Hepatitis C virus (HCV) infection is a major cause of liver-morbidity and mortality amon... more Context: Hepatitis C virus (HCV) infection is a major cause of liver-morbidity and mortality among patients with thalassemia. Peginterferon plus ribavirin is currently the recommended therapy for hepatitis C infection in patients do not have thalassemia, but using ribavirin in patients with thalassemia is restricted due to its hemolytic effect. To evaluate the efficacy and safety of adding ribavirin to peginterferon or interferon, authors performed a systematic review on the available literatures. Evidence Acquisition: Trials were identified through electronic database, manual searches of journals and bibliographies and approaching authors of trials. Randomized trials that enrolled patients with a diagnosis of thalassemia and chronic hepatitis C infection treated with interferon or peginterferon with or without ribavirin were included. Two investigators independently evaluated the trials for inclusion criteria, risk of bias and data extraction. The primary outcomes were sustained virological response (SVR), liver-related morbidity, mortality and adverse events. The odds ratios from each trial were calculated individually and in the subgroup analysis of trials. Data were analyzed with fixed-effect model. Results: Three randomized clinical trials with 92 patients were included. All three trials had unclear risk of bias. Compared with peginterferon monotherapy, adding ribavirin to peginterferon had significant beneficial effect on sustained virological response (OR = 3.44, 95% CI: 1.18-10.06). There was no significant difference between combination therapy and monotherapy in the end of treatment achievement response. Other than about 30% increase in blood transfusion due to anemia that returned to normal level 2-3 months after treatment, there was no significant increase in side effects followed by adding ribavirin to pegylated interferon (Peg-IFN). Data were insufficient to determine the impact of genotype, viral load and age on the response to treatment. Conclusions: Compared with monotherapy, adding ribavirin to treatment is more effective in removing hepatitis C virus from the bloodstream in patients with thalassemia, it is also more effective in reducing the relapse rate after treatment. Except the increase in blood transfusion, there was no significant increase in side effects followed by adding ribavirin.

BMC Gastroenterology, Oct 16, 2003

Background: Although several studies have been performed on risk factors and natural course of NA... more Background: Although several studies have been performed on risk factors and natural course of NASH, it seems that NASH tends to be more than a disease confined to strict boundaries. The objective of this study was to assess the clinical and paraclinical features and risk factors for nonalcoholic steatohepatitis (NASH) patients in an Iranian population Methods: Patients with histologically confirmed NASH who had elevated liver aminotransaminases, negative serologic markers of viral or autoimmune hepatitis and no findings in favor of metabolic liver disease were enrolled. A careful history was taken regarding alcohol intake. Results: 53 patients consisting of 32 male and 21 female entered the study. The mean age was 37.8 ± 11.3 years. Twenty-six patients (55.3%) were overweight, 15 (31.9%) obese, 40 (75.5%) dyslipidemic, and three patients (5.7%) were diabetic. Liver biopsy showed mild steatosis in 35.7%, moderate steatosis in 53.6%, and severe forms in 10.7%. In 80.2% of patients, portal inflammation was present, and 9.4% had cirrhosis. The amount of increase in liver enzymes bore no relationship with fibrosis, portal inflammation, and degree of steatosis. Conclusions: The patients in our study showed a male predominancy and were somewhat younger than other studies.

Gastroenterology, May 1, 2012

Background: Irritable bowel syndrome (IBS) is a highly prevalent functional gastrointestinal (GI)... more Background: Irritable bowel syndrome (IBS) is a highly prevalent functional gastrointestinal (GI) disorder. Although the mucosal histology of the GI tract is normal, low grade inflammation is considered as an underlying mechanism in IBS. Imbalances in pro-and anti-inflammatory cytokines and polymorphisms of cytokines genes have been observed in some studies. However, studies on cytokine gene polymorphisms have not revealed consistent genetic features in these patients, possibily due to lack of statistical power, small sample sizes and differences in ethnicities. To overcome this problem, we performed a systematic review and meta-analysis on the case-control studies which investigated cytokine gene polymorphisms in IBS patients vs. healthy controls. Methods: A MEDLINE and EMBASE search of the literature was performed. Cytokine gene polymorphisms which had been investigated in at least 2 published studies were included. Pooled odds ratios (OR) with 95% confidence interval (95%CI) for the genotypes and allelic distributions were calculated using randomor fixed-effects models. Results: Five case-control studies were identified. IL-10 (−1082 G/ A), TGF-β1 (+869T/C and +915G/C) and TNF-α (−308G/A) were investigated in 5, 3 and 4 studies, respectively. A total of 529 IBS patients and 860 controls were included. High producer IL-10 (−1082 G/G) (OR: 0.68 [95%CI: 0.50-0.91]), intermediate producer TGF-β1 (+869T/C) (OR: 0.64 [95%CI: 0.45-0.91]) and intermediate producer TGF-β1 (+915G/ C) (OR: 0.55 [95%CI: 0.32-0.97]) genotypes were associated with a decreased risk of IBS. No associations were found between IBS and TNF-α (-308G/A) genotypes. Moreover, there was no significant association between the frequency of alleles of each polymorphism and IBS. Conclusion: Results from this meta-analysis suggest a role for IL-10 and TGF-β1 polymorphisms in IBS. Whether the changes in IL-10 and TGF-β1 producer genes translate to alterations in the levels of these cytokines in the gut wall and the nature of their protective role need further investigations.