To examine the causes of premature mortality (<70 years) and associated risk factors in the Go... more To examine the causes of premature mortality (<70 years) and associated risk factors in the Golestan Cohort Study. Prospective. The Golestan Cohort Study in northeastern Iran. 50 045 people aged 40 or more participated in this population-based study from baseline (2004-2008) to August 2017, with over 99% success follow-up rate. The top causes of premature death, HR and their 95% CI and population attributable fraction (PAF) for risk factors. After 444 168 person-years of follow-up (median of 10 years), 6347 deaths were reported, of which 4018 (63.3%) occurred prematurely. Ischaemic heart disease (IHD) accounted for 33.9% of premature death, followed by stroke (14.0%), road injuries (4.7%), stomach cancer (4.6%) and oesophageal cancer (4.6%). Significant risk/protective factors were: wealth score (HR for highest vs lowest quintile: 0.57, PAF for lowest four quintiles vs top quintile: 28%), physical activity (highest vs lowest tertile: 0.67, lowest two tertiles vs top tertile: 22%)...
Gastro-oesophageal reflux disease (GERD) is a growing health-care problem with variable distribut... more Gastro-oesophageal reflux disease (GERD) is a growing health-care problem with variable distribution. To assess GERD prevalence and risk factors and their possible correlation with pathophysiology in a population-based study. Individuals aged 18-65 years were enrolled through random cluster sampling in Tehran. Previously validated self-administered questionnaires were used. Of the 2500 questionnaires, 2057 were analysed (mean age: 34.8 +/- 13.0 years, 55.1% female). Frequent GERD was seen in 18.2%. Minor symptoms increased prevalence. Female gender (OR: 1.55, 95% CI: 1.01-2.41), BMI &gt;30 kg/m(2) (OR: 1.79, 95% CI: 1.03-3.12), less education (OR: 1.52, 95% CI: 1.02-2.27), smoking (OR: 1.83, 95% CI: 1.12-2.99), NSAID use (OR: 4.23, 95% CI: 1.66-10.74) and GERD in spouse (OR: 1.82, 95% CI: 1.18-2.82) were associated with frequent GERD on multivariable analysis. GERD in first-degree relatives (OR: 1.73, 95% CI: 1.23-2.43) and asthma (OR: 4.09, 95% CI: 1.27-13.15) correlated with infrequent GERD. Minor symptoms correlated with GERD history in first-degree relatives, coffee consumption and NSAID use. Prevalence in the past 3 months was similar to that in the past 12 months (P &lt; 0.05). Gastro-oesophageal reflux disease is common in Tehran. The association of &#39;infrequent symptoms&#39; with GERD history in first-degree relatives and &#39;frequent symptoms&#39; with GERD history in spouse may point to the presence of yet unknown precipitating environmental factors inducing GERD in a genetically susceptible host. Minor GERD symptoms seem to have independent contribution to GERD. Assessing GERD in the past 3 months predicts prevalence in the past year.
Original Article. The Normal Range of Duodenal Intraepithelial Lymphocytes. Siavosh Nasseri-Mogha... more Original Article. The Normal Range of Duodenal Intraepithelial Lymphocytes. Siavosh Nasseri-Moghaddam MD*, Azadeh Mofid MD*, Mehdi Nouraie MD PhD*,. Behnoosh Abedi MD*, Akram Pourshams MD*, Reza Malekzadeh MD*,. Masoud Sotoudeh MD *. ...
Proton pump inhibitors (PPIs) are the most effective agents available for reducing acid secretion... more Proton pump inhibitors (PPIs) are the most effective agents available for reducing acid secretion. They are used for medical treatment of various acid-related disorders. PPIs are used extensively and for extended periods of time in gastroesophageal reflux disease (GERD). A troublesome issue regarding maintenance therapy has been the propensity of PPI-treated patients to develop chronic atrophic gastritis while on therapy that could theoretically lead to an increased incidence of gastric cancer. In addition, animal studies have raised concern for development of enterochromaffin-like cell hyperplasia and carcinoid tumors in the stomachs of mice receiving high dose PPIs. Current literature does not provide a clear-cut conclusion on the subject and the reports are sometimes contradictory. Therefore, this study is a systematic review of the available literature to address the safety of long-term PPI use and its relation to the development of malignant/premalignant gastric lesions. A lite...
Although foreign body (FB) ingestion is relatively common,ingestion of a toothbrush is rare. We a... more Although foreign body (FB) ingestion is relatively common,ingestion of a toothbrush is rare. We are reporting on a 26-year old female who had accidentally swallowed a toothbrush, which was successfully removed via endoscopy using a polypectomy snare.
Gastro-esophageal reflux disease (GERD) has become very common in the past three decades. The rea... more Gastro-esophageal reflux disease (GERD) has become very common in the past three decades. The reason for this, as well as its exact pathophysiologic mechanisms are yet unknown. In this ecologic study we assessed the relation between water nitrate content and prevalence of GERD in Tehran, Iran. We determined the prevalence of acid regurgitation, heartburn or any of them occurring on a frequent (at least weekly) or infrequent basis in areas with different water nitrate. The areas for nitrate were defined as below: <50 mg nitrate/L, 50-74 mg/L, 75-100 mg/L, and >100 mg/L. Frequency of each symptom was assessed in each area and compared. Adjustment for age, sex, education, NSAID-consumption, BMI, smoking, history of GERD in first degree relatives and spouse was done in a multivariate model. People living in areas with water nitrate content more than 100mg/L had a higher chance of suffering from frequent AR than those living in areas with water nitrate less than 100mg/L (25.5% vs. ...
Background: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal pro... more Background: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal problems in the west while different reports indicate an increase in the prevalence in Iran. The aim of this study was to estimate the prevalence and clinical spectrum of GERD in staff of a referral hospital and evaluate the risk factors. Methods: This cross-sectional study using a modified Mayo clinic questionnaire was performed on staff of Imam Hospi-tal, Tabriz, Iran on a pilot of 50 subjects, and a randomly selected group consisted of 522 subjects in the year 2005. GERD symptoms were defined as at least weekly heartburn and/or acid regurgitation during the past year. Results: Response rate was 95%. Mean age of responders was 40.02±10.72 yr. The prevalence of recurrent heartburn and/or acid regurgitation experienced at least weekly and monthly was 26.8% and 34.1%, respectively. They were not related to age and gender. The severity of symptoms was mainly reported of a mild to moderate deg...
To estimate the prevalence and clinical spectrum of gastroesophageal reflux disease (GERD) in a y... more To estimate the prevalence and clinical spectrum of gastroesophageal reflux disease (GERD) in a young population and evaluate the risk factors. This cross-sectional study using a reliable and valid questionnaire was performed during June and July 2005, on randomized selection of 620 students form Azad University of Tabriz. Gastroesophageal reflux disease was defined as at least weekly heartburn and/or acid regurgitation. Mean age (+/- SD) of the responders was 22.48 +/- 1.98 years. The prevalence of heartburn and/or acid regurgitation experienced at least weekly was 6.3% and monthly was 13%. The severity of symptoms was mainly of a mild to moderate degree. There was no difference in prevalence of any GERD symptom between 2 genders and it was not associated with age of the study population. A frequent symptom of GERD was reported more among subjects with atypical symptoms. There was no relation between marriage status and prevalence of GERD. On the other hand, GERD was less common am...
Background: The prevalence of gastroesophageal reflux disease (GERD) in Asian populations is repo... more Background: The prevalence of gastroesophageal reflux disease (GERD) in Asian populations is reported to be lower than that in the West. Population-based data on the prevalence and symptom profile of GERD in developing Caucasian countries is lacking. Our objective was to determine the prevalence of gastrointestinal symptoms and clinical spectrum of GERD in Tehran, northern Iran and their association with
BACKGROUND Symptoms of gastro-esophageal reflux disease (GERD) affect health-related quality of l... more BACKGROUND Symptoms of gastro-esophageal reflux disease (GERD) affect health-related quality of life (HRQOL). When a questionnaire is translated into a new language, linguistic validation is necessary, yet insufficient, unless the psychometric characteristics have been verified. The aim of this study is to document the translation and psychometric validation of the Persian translation of the Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire. METHODS After translation and cultural adaptation of QOLRAD to Persian, fifty patients with clinical GERD from the Prospective Acid Reflux Study of Iran (PARSI) database who had at least one of the symptoms of acid regurgitation, heartburn, non-cardiac chest pain, or dysphagia for at least four weeks over the past three months completed the QOLRAD and Short Form Health Survey-36 (SF-36). After two weeks, QOLRAD was again completed by the patients. Cronbach alpha and Intra-class Correlation Coefficient (ICC) were used to test reliabi...
BACKGROUND Early diagnosis and endoscopic resection of adenomatous polyps is the main approach fo... more BACKGROUND Early diagnosis and endoscopic resection of adenomatous polyps is the main approach for screening and prevention of colorectal cancer (CRC). We aimed to assess polyp detection rate (PDR) and to characterize demographic, clinical, and pathological features of colorectal polyps in an Iranian population. METHODS We retrospectively analyzed the data from 5427 colonoscopies performed during 2007-2012 at Masoud Clinic, the main endoscopy center associated with Sasan Alborz Biomedical Research Center, in Tehran, Iran. RESULTS Our sample included 2928 (54%) women and 2499 (46%) men, with the mean age of 48.3 years (SD=16.1). The most common reasons for colonoscopy included screening in 25.0%, and gastrointestinal bleeding in 15.2%. Cecal intubation was successful in 86% of patients. The quality of bowel preparation was fair to excellent in 78.1% (n=4235) of colonoscopies. Overall PDR was 42.0% (95% CI: 40.6-43.3). The PDR in men (51.1%, 95% CI: 49.1-53.1) was significantly higher...
To examine the causes of premature mortality (<70 years) and associated risk factors in the Go... more To examine the causes of premature mortality (<70 years) and associated risk factors in the Golestan Cohort Study. Prospective. The Golestan Cohort Study in northeastern Iran. 50 045 people aged 40 or more participated in this population-based study from baseline (2004-2008) to August 2017, with over 99% success follow-up rate. The top causes of premature death, HR and their 95% CI and population attributable fraction (PAF) for risk factors. After 444 168 person-years of follow-up (median of 10 years), 6347 deaths were reported, of which 4018 (63.3%) occurred prematurely. Ischaemic heart disease (IHD) accounted for 33.9% of premature death, followed by stroke (14.0%), road injuries (4.7%), stomach cancer (4.6%) and oesophageal cancer (4.6%). Significant risk/protective factors were: wealth score (HR for highest vs lowest quintile: 0.57, PAF for lowest four quintiles vs top quintile: 28%), physical activity (highest vs lowest tertile: 0.67, lowest two tertiles vs top tertile: 22%)...
Gastro-oesophageal reflux disease (GERD) is a growing health-care problem with variable distribut... more Gastro-oesophageal reflux disease (GERD) is a growing health-care problem with variable distribution. To assess GERD prevalence and risk factors and their possible correlation with pathophysiology in a population-based study. Individuals aged 18-65 years were enrolled through random cluster sampling in Tehran. Previously validated self-administered questionnaires were used. Of the 2500 questionnaires, 2057 were analysed (mean age: 34.8 +/- 13.0 years, 55.1% female). Frequent GERD was seen in 18.2%. Minor symptoms increased prevalence. Female gender (OR: 1.55, 95% CI: 1.01-2.41), BMI &gt;30 kg/m(2) (OR: 1.79, 95% CI: 1.03-3.12), less education (OR: 1.52, 95% CI: 1.02-2.27), smoking (OR: 1.83, 95% CI: 1.12-2.99), NSAID use (OR: 4.23, 95% CI: 1.66-10.74) and GERD in spouse (OR: 1.82, 95% CI: 1.18-2.82) were associated with frequent GERD on multivariable analysis. GERD in first-degree relatives (OR: 1.73, 95% CI: 1.23-2.43) and asthma (OR: 4.09, 95% CI: 1.27-13.15) correlated with infrequent GERD. Minor symptoms correlated with GERD history in first-degree relatives, coffee consumption and NSAID use. Prevalence in the past 3 months was similar to that in the past 12 months (P &lt; 0.05). Gastro-oesophageal reflux disease is common in Tehran. The association of &#39;infrequent symptoms&#39; with GERD history in first-degree relatives and &#39;frequent symptoms&#39; with GERD history in spouse may point to the presence of yet unknown precipitating environmental factors inducing GERD in a genetically susceptible host. Minor GERD symptoms seem to have independent contribution to GERD. Assessing GERD in the past 3 months predicts prevalence in the past year.
Original Article. The Normal Range of Duodenal Intraepithelial Lymphocytes. Siavosh Nasseri-Mogha... more Original Article. The Normal Range of Duodenal Intraepithelial Lymphocytes. Siavosh Nasseri-Moghaddam MD*, Azadeh Mofid MD*, Mehdi Nouraie MD PhD*,. Behnoosh Abedi MD*, Akram Pourshams MD*, Reza Malekzadeh MD*,. Masoud Sotoudeh MD *. ...
Proton pump inhibitors (PPIs) are the most effective agents available for reducing acid secretion... more Proton pump inhibitors (PPIs) are the most effective agents available for reducing acid secretion. They are used for medical treatment of various acid-related disorders. PPIs are used extensively and for extended periods of time in gastroesophageal reflux disease (GERD). A troublesome issue regarding maintenance therapy has been the propensity of PPI-treated patients to develop chronic atrophic gastritis while on therapy that could theoretically lead to an increased incidence of gastric cancer. In addition, animal studies have raised concern for development of enterochromaffin-like cell hyperplasia and carcinoid tumors in the stomachs of mice receiving high dose PPIs. Current literature does not provide a clear-cut conclusion on the subject and the reports are sometimes contradictory. Therefore, this study is a systematic review of the available literature to address the safety of long-term PPI use and its relation to the development of malignant/premalignant gastric lesions. A lite...
Although foreign body (FB) ingestion is relatively common,ingestion of a toothbrush is rare. We a... more Although foreign body (FB) ingestion is relatively common,ingestion of a toothbrush is rare. We are reporting on a 26-year old female who had accidentally swallowed a toothbrush, which was successfully removed via endoscopy using a polypectomy snare.
Gastro-esophageal reflux disease (GERD) has become very common in the past three decades. The rea... more Gastro-esophageal reflux disease (GERD) has become very common in the past three decades. The reason for this, as well as its exact pathophysiologic mechanisms are yet unknown. In this ecologic study we assessed the relation between water nitrate content and prevalence of GERD in Tehran, Iran. We determined the prevalence of acid regurgitation, heartburn or any of them occurring on a frequent (at least weekly) or infrequent basis in areas with different water nitrate. The areas for nitrate were defined as below: <50 mg nitrate/L, 50-74 mg/L, 75-100 mg/L, and >100 mg/L. Frequency of each symptom was assessed in each area and compared. Adjustment for age, sex, education, NSAID-consumption, BMI, smoking, history of GERD in first degree relatives and spouse was done in a multivariate model. People living in areas with water nitrate content more than 100mg/L had a higher chance of suffering from frequent AR than those living in areas with water nitrate less than 100mg/L (25.5% vs. ...
Background: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal pro... more Background: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal problems in the west while different reports indicate an increase in the prevalence in Iran. The aim of this study was to estimate the prevalence and clinical spectrum of GERD in staff of a referral hospital and evaluate the risk factors. Methods: This cross-sectional study using a modified Mayo clinic questionnaire was performed on staff of Imam Hospi-tal, Tabriz, Iran on a pilot of 50 subjects, and a randomly selected group consisted of 522 subjects in the year 2005. GERD symptoms were defined as at least weekly heartburn and/or acid regurgitation during the past year. Results: Response rate was 95%. Mean age of responders was 40.02±10.72 yr. The prevalence of recurrent heartburn and/or acid regurgitation experienced at least weekly and monthly was 26.8% and 34.1%, respectively. They were not related to age and gender. The severity of symptoms was mainly reported of a mild to moderate deg...
To estimate the prevalence and clinical spectrum of gastroesophageal reflux disease (GERD) in a y... more To estimate the prevalence and clinical spectrum of gastroesophageal reflux disease (GERD) in a young population and evaluate the risk factors. This cross-sectional study using a reliable and valid questionnaire was performed during June and July 2005, on randomized selection of 620 students form Azad University of Tabriz. Gastroesophageal reflux disease was defined as at least weekly heartburn and/or acid regurgitation. Mean age (+/- SD) of the responders was 22.48 +/- 1.98 years. The prevalence of heartburn and/or acid regurgitation experienced at least weekly was 6.3% and monthly was 13%. The severity of symptoms was mainly of a mild to moderate degree. There was no difference in prevalence of any GERD symptom between 2 genders and it was not associated with age of the study population. A frequent symptom of GERD was reported more among subjects with atypical symptoms. There was no relation between marriage status and prevalence of GERD. On the other hand, GERD was less common am...
Background: The prevalence of gastroesophageal reflux disease (GERD) in Asian populations is repo... more Background: The prevalence of gastroesophageal reflux disease (GERD) in Asian populations is reported to be lower than that in the West. Population-based data on the prevalence and symptom profile of GERD in developing Caucasian countries is lacking. Our objective was to determine the prevalence of gastrointestinal symptoms and clinical spectrum of GERD in Tehran, northern Iran and their association with
BACKGROUND Symptoms of gastro-esophageal reflux disease (GERD) affect health-related quality of l... more BACKGROUND Symptoms of gastro-esophageal reflux disease (GERD) affect health-related quality of life (HRQOL). When a questionnaire is translated into a new language, linguistic validation is necessary, yet insufficient, unless the psychometric characteristics have been verified. The aim of this study is to document the translation and psychometric validation of the Persian translation of the Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire. METHODS After translation and cultural adaptation of QOLRAD to Persian, fifty patients with clinical GERD from the Prospective Acid Reflux Study of Iran (PARSI) database who had at least one of the symptoms of acid regurgitation, heartburn, non-cardiac chest pain, or dysphagia for at least four weeks over the past three months completed the QOLRAD and Short Form Health Survey-36 (SF-36). After two weeks, QOLRAD was again completed by the patients. Cronbach alpha and Intra-class Correlation Coefficient (ICC) were used to test reliabi...
BACKGROUND Early diagnosis and endoscopic resection of adenomatous polyps is the main approach fo... more BACKGROUND Early diagnosis and endoscopic resection of adenomatous polyps is the main approach for screening and prevention of colorectal cancer (CRC). We aimed to assess polyp detection rate (PDR) and to characterize demographic, clinical, and pathological features of colorectal polyps in an Iranian population. METHODS We retrospectively analyzed the data from 5427 colonoscopies performed during 2007-2012 at Masoud Clinic, the main endoscopy center associated with Sasan Alborz Biomedical Research Center, in Tehran, Iran. RESULTS Our sample included 2928 (54%) women and 2499 (46%) men, with the mean age of 48.3 years (SD=16.1). The most common reasons for colonoscopy included screening in 25.0%, and gastrointestinal bleeding in 15.2%. Cecal intubation was successful in 86% of patients. The quality of bowel preparation was fair to excellent in 78.1% (n=4235) of colonoscopies. Overall PDR was 42.0% (95% CI: 40.6-43.3). The PDR in men (51.1%, 95% CI: 49.1-53.1) was significantly higher...
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