Arab Journal Of Gastroenterology[JOURNAL]
Sun
200 papers
Epidemiological and anatomopathological profile of colorectal cancer in Northern Morocco between 2017 and 2019.
El Bali M, Mesmoudi M, Essayah A … +5 more , Arbai K, Ghailani Nourouti N, Barakat A, Sellal N, Bennani Mechita M
Arab J Gastroenterol · 2024 Nov · PMID 39505674 · Publisher ↗
BACKGROUND AND STUDY AIMS: Colorectal cancer (CRC) is the third most common type of cancer worldwide and the second leading cause of cancer-related death. CRC represents a major public health problem in many countries, a...
BACKGROUND AND STUDY AIMS: Colorectal cancer (CRC) is the third most common type of cancer worldwide and the second leading cause of cancer-related death. CRC represents a major public health problem in many countries, and its incidence is increasing worldwide. In Morocco, CRC is the third most common cancer. However, epidemiological data on CRC in Morocco, especially in the north, are very limited. This study aimed to describe the epidemiological and clinicopathological characteristics of CRC in northern Morocco. PATIENTS AND METHODS: This retrospective study was conducted at the Ahmed Ben Zayed Al Nahyan Regional Oncology Center of Tangier between April 2017 and December 2019. Data were collected from the medical records of confirmed CRC patients and analyzed using SPSS computer software version 23. RESULTS: CRC was detected in 142 patients, accounting for 13.0 % of all cancers identified during the study period in the center. The sex ratio (male/female) of all patients was 1.1. The mean age was 58 years, and the most affected group was 60-69 years old (29.0 %). The rectum was the most common anatomical site (44.0 %) compared to the left and right colon. Histologically, adenocarcinomas were the most common type (91.3 %), half of the tumors were moderately differentiated, and only 4.9 % of the patients presented with poorly differentiated tumors. At diagnosis, 83.0 % of patients were already in advanced stages (stage III, or IV), including 40.3 % presenting with metastatic disease. The liver (64.8 %) was the most affected site by metastasis in our series. Relapse was observed in 11.9 % of patients. CONCLUSION: Our results showed a younger age at diagnosis and a higher incidence of cancer at the rectal site compared to the Western literature, as well as a high frequency of patients who presented with late-stage disease and other characteristics. However, larger multicenter studies are still needed to confirm our results.
Ginsenoside Rg3 enhances the anticancer effects of 5-fluorouracil in colorectal cancer and reduces drug resistance and the Hedgehog pathway activation.
Bu X, Feng H, Yan Z
Arab J Gastroenterol · 2024 Nov · PMID 39500672 · Publisher ↗
BACKGROUND AND STUDY AIMS: This study aimed to ascertain the inhibitory effect of ginsenoside Rg3 (Rg3) combined with 5-fluorouracil (5-FU) on 5-FU-resistant cells HCT116/5-FU and its molecular mechanism. MATERIAL AND ME...
BACKGROUND AND STUDY AIMS: This study aimed to ascertain the inhibitory effect of ginsenoside Rg3 (Rg3) combined with 5-fluorouracil (5-FU) on 5-FU-resistant cells HCT116/5-FU and its molecular mechanism. MATERIAL AND METHODS: The HCT116 cell line resistant to 5-FU (HCT116/5-FU) was established by repeated exposure to gradually increasing 5-FU concentrations. The effects of different concentrations of Rg3 and 5-FU on colorectal cancer (CRC) cell proliferation were evaluated, and suitable concentrations were screened for subsequent experiments. The treatment efficacy of Rg3 and 5-FU alone and in combination with CRC cell activity was observed, and the inhibitory effect of Rg3 and 5-FU on the Hedgehog pathway was verified. Finally, the effects of Rg3 and 5-Fu on in vivo tumor formation were evaluated in vivo. RESULTS: Rg3 enhanced the therapeutic efficacy of 5-FU in HCT116 cells by inducing apoptosis and suppressing cell activities and epithelial-mesenchymal transition (EMT), showing strong anti-tumor effects. Rg3 enhances the chemosensitivity of drug-resistant HCT116/5-FU cells to 5-FU. Additionally, the expression of Hedgehog pathway-relevant proteins (PTCH1, PTCH2, GLI1, and SHH) was increased in drug-resistant HCT116/5-FU cells, and Rg3 and 5-FU co-treatment downregulated the expression of PTCH1, PTCH2, GLI1, and SHH proteins in HCT116/5-FU cells. Rg3 reversed 5-FU resistance via by modulating the Hedgehog pathway. Rg3, in combination with 5-FU, repressed human CRC xenograft growth in nude mice, suppressed the expression of the proliferative nuclear factor KI67 in tumors, and promoted apoptosis. CONCLUSION: Rg3 enhances the anticancer effects of 5-FU in CRC cells that are sensitive and resistant to 5-FU, and its mechanism of action may be related to the inhibition of Hedgehog pathway activation.
Current trends and research hotspots in the study of flavonoids for ulcerative colitis: A bibliometric study.
Li D, Ding K, Jiang W … +2 more , Lei M, Lei C
Arab J Gastroenterol · 2024 Nov · PMID 39490351 · Publisher ↗
BACKGROUND AND STUDY AIMS: Flavonoids have been shown to exhibit significant potential in treating ulcerative colitis (UC), and their mechanism of action is receiving increasing attention. This study was devoted to the b...
BACKGROUND AND STUDY AIMS: Flavonoids have been shown to exhibit significant potential in treating ulcerative colitis (UC), and their mechanism of action is receiving increasing attention. This study was devoted to the bibliometric analysis of articles and review articles in flavonoid therapy for UC research between 2011 and 2022 to show publication trends and research hotspots. MATERIAL AND METHODS: The literature search data for the bibliometric analysis were obtained from the Web of Science Core Collection by searching for the terms "Flavonoids" and "Ulcerative colitis or Idiopathic Proctocolitis or colitis gravis or Inflammatory Bowel Disease, Ulcerative Colitis Type." Three software programs, Bibliometrix, CiteSpace, and VOSviewer, were used to perform a bibliometric analysis of the retrieved literature data. RESULTS: There were 181 publications on flavonoids for UC during the 12 years, with an upward trend in annual publications and an annual growth rate of 27.11 %. China had the highest cumulative number of publications, and Kyung Hee University was the academic institution with the most publications in this research area. In recent years, intestinal flora, intestinal barrier, apoptosis, tight protein junctions, and TLR4/ NF-κB pathway have become hot spots for research on flavonoids for UC. Grape seed analogs have been extensively investigated for treating UC in the past three years. CONCLUSION: The results of this bibliometric study demonstrate the current status and trends of research on flavonoids for the treatment of UC and provide relevant researchers with hot topics and the latest research directions.
Spontaneous bacterial peritonitis recurrence on norfloxacin secondary prophylaxis.
Shetty A, Raman R, Pemmada V … +4 more , Musunuri B, Shetty S, Pai CG, Bhat G
Arab J Gastroenterol · 2024 Nov · PMID 39490350 · Publisher ↗
BACKGROUND AND STUDY AIMS: Secondary prophylaxis with norfloxacin reduces recurrence of spontaneous bacterial peritonitis (SBP) significantly. No data available from Asia-Pacific region about recurrence of SBP in these p...
BACKGROUND AND STUDY AIMS: Secondary prophylaxis with norfloxacin reduces recurrence of spontaneous bacterial peritonitis (SBP) significantly. No data available from Asia-Pacific region about recurrence of SBP in these patients. PATIENTS AND METHODS: In a retrospective cohort study, we assessed recurrence rate of SBP in patients on norfloxacin secondary prophylaxis. One year recurrence of SBP, its profile, response rate and risk factors for recurrence were assessed. RESULTS: A total of 112 patients were analysed. During first episode of SBP, culture positive rate was 39/112(34.8 %) and resistance to ceftriaxone was 51.2 %. Overall efficacy of ceftriaxone as first line antibiotic was 70.5 % (70/112), but only 49 % (19/39) among culture positive patients. E. coli is the commonest organism isolated (21/39, 53.8 %), MDR organism in 12.8 % (5/39). Cumulative incidence of SPB recurrence was 22.3 % (25/112) on norfloxacin secondary prophylaxis at 1 year. Culture positive rate in recurrent SBP was 48 % (12/25) and ceftriaxone resistance and MDR organism were seen in 66.6 % and 16.6 %. Overall response rate to ceftriaxone in recurrent SBP was 40 % (10/25) and 21 % (3/14) in culture positive patients. Risk factors for SBP recurrence were age, INR and albumin (p < 0.05). No increase cumulative incidence of death among patients with or without recurrence. CONCLUSION: Despite recent changes in bacteriological profile in SBP, recurrence of SBP on norfloxacin prophylaxis remains low. In recurrent SBP, response to ceftriaxone is significantly lower than first episode and there is trend towards increase in MDR organism in culture positive patient receiving norfloxacin.
Effect of Lactobacillus acidophilus, Calcium, and Moringa oleifera leaves extract co-administration can prevent chemical-induced carcinogenesis.
Kumawat M, Une H
Arab J Gastroenterol · 2024 Nov · PMID 39462726 · Publisher ↗
BACKGROUND: Colon cancer is the fourth leading cause of cancer deaths worldwide. The present study evaluated the chemopreventive effect of the combined treatment of Lactobacillus acidophilus, calcium citrate, and Moringa...
BACKGROUND: Colon cancer is the fourth leading cause of cancer deaths worldwide. The present study evaluated the chemopreventive effect of the combined treatment of Lactobacillus acidophilus, calcium citrate, and Moringa oleifera leaves extract against DMH (1,1-dimethylhydrazine hydrochloride) induced colon cancer. MATERIAL AND METHODS: Sprague Dawley rats were grouped into 10 different groups and treated with DMH 30 mg/kg s.c. for 8 weeks, Successful induction of colon cancer was confirmed with the help of symptoms, Individual and combined treatments of Lactobacillus acidophilus (10 cfu p.o.), calcium citrate (2 mg/kg p.o.) and Moringa oleifera (100 & 200 mg/kg p.o.) leaves extracts were used for 4 weeks. RESULT: After 4 weeks of treatment, it was observed that a significant reduction in aberrant crypt foci (ACFs) count, whereas liver and kidney function, AST (aspartate transaminase), ALT (alanine transaminase), urea and creatinine biomarkers were retained in its normal range. Upon DMH treatment, liver tissue loses histoarchitecture with mononuclear cell infiltration, nuclear enlargement, and hyperchromasia, this reverts due to the combined treatment of Lactobacillus acidophilus (LA), calcium citrate (CC) and hydroalcoholic extract of Moringa oleifera leaves (ME). From the results, it was revealed that individual and combined treatment of Lactobacillus acidophilus, calcium citrate, and hydroalcoholic extract of Moringa oleifera leaves shows beneficial effects against the carcinogen. CONCLUSION: Combined treatment of Lactobacillus acidophilus, calcium citrate, and hydroalcoholic extract of Moringa oleifera leaves showed positive effects against carcinogenesis and lowered aberrant crypt foci count and shows histoarchitectural improvements in liver histology with no nuclear enlargement and hyperchromasia in liver tissue.
Hsa_circ_0008667 promotes progression and improves the prognosis of gastric cancer by inhibiting miR-9-5p.
Ding W, Li Z, Liu X … +5 more , Wang J, Wang J, Jiang G, Yu H, Wang T
Arab J Gastroenterol · 2024 Nov · PMID 39455349 · Publisher ↗
BACKGROUND AND STUDY AIM: Gastric cancer (GC) is one of the most common gastrointestinal tumors characterized by aggressive development and poor prognosis. Circular RNAs (circRNAs) have been used as prognostic biomarkers...
BACKGROUND AND STUDY AIM: Gastric cancer (GC) is one of the most common gastrointestinal tumors characterized by aggressive development and poor prognosis. Circular RNAs (circRNAs) have been used as prognostic biomarkers and therapeutic targets in many cancers, including GC. Hsa_circ_0008667 is differentially expressed in GC; however, its function and clinical significance remained unelucidated. Therefore, this study aimed to investigate the role and significance of hsa_circ_0008667 in GC and its potential as a biomarker and therapeutic target of GC. PATIENTS AND METHODS: Through quantitative reverse-transcription real-time PCR, hsa_circ_0008667 expression in GC tissues and cells were analyzed, followed by statistical analyses to assess the clinical significance. Cell Counting Kit-8 and Transwell assays were performed to examine the effects of hsa_circ_0008667 silencing on GC cell growth and metastasis. Additionally, correlation analysis was performed to assess the relationship between hsa_circ_0008667 and miR-9-5p, which was further validated through luciferase reporter assay. RESULTS: Hsa_circ_0008667 was considerably upregulated and tightly correlated with lymph node metastasis and the tumor-node-metastasis stage, which was predictive of poor prognosis in patients with GC. Hsa_circ_0008667 silencing suppressed GC cell proliferation, migration, and invasion. Furthermore, hsa_circ_0008667 negatively regulated miR-9-5p expression. MiR-9-5p downregulation enhanced GC malignancy and reversed hsa_circ_0008667 knockdown-mediated GC suppression. CONCLUSION: The findings of this study suggest hsa_circ_0008667 to be a prognostic biomarker and tumor promoter of GC via miR-9-5p modulation.
Ammonia in liver diseases: A glimpse into the controversies and consensus.
Sarin Zacharia G, Jacob A
Arab J Gastroenterol · 2024 Nov · PMID 39294031 · Publisher ↗
Ammonia is a byproduct of the metabolism of nitrogen-containing micro and macromolecules. The key source of bodily ammonia in humans is the small intestine, from diet, luminal bacterial activity, and deamination of gluta...
Ammonia is a byproduct of the metabolism of nitrogen-containing micro and macromolecules. The key source of bodily ammonia in humans is the small intestine, from diet, luminal bacterial activity, and deamination of glutamine in enterocytes. It is disposed of from the system, mainly in the liver, through the urea cycle. Physiologically, ammonia plays a minor role in acid-base homeostasis. It is the critical molecule implicated in the pathogenesis of hepatic encephalopathy. Liver disease is the most common cause of hyperammonemia, while others include urea cycle defects, infections, and drugs. The diagnostic utility of ammonia in liver diseases has met with increasing skepticism but holds good in urea cycle defects. Additionally, the accuracy of ammonia assay depends on a myriad of patient and technical factors, making the test unreliable if not performed meticulously. Most scientific societies currently fall short of recommending ammonia for diagnostic purposes in chronic liver disease. Despite this fact, ammonia continues to be one of the most frequently requested assays in patients with suspected hepatic encephalopathy, contributing to significant non-productive health expenditure. However, ammonia level does have a prognostic role in liver diseases, especially in acute liver failure. Ammonia-lowering strategies are the cornerstone of the management of hepatic encephalopathy. These strategies include medications that attenuate ammoniagenesis and ammonia scavengers. This review examines the role of ammonia in hepatic encephalopathy, its diagnostic and prognostic implications in liver diseases, challenges associated with ammonia assay, and current therapeutic strategies for ammonia-lowering in clinical practice.
Intestinal transplantation: Significance of immune responses.
Assadiasl S, Nicknam MH
Arab J Gastroenterol · 2024 Nov · PMID 39289083 · Publisher ↗
Intestinal allografts, with many resident immune cells and as a destination for circulating lymphocytes of the recipient, appear to be the most challenging solid organ transplants. The high incidence of acute rejection a...
Intestinal allografts, with many resident immune cells and as a destination for circulating lymphocytes of the recipient, appear to be the most challenging solid organ transplants. The high incidence of acute rejection and frequent reports of fatal graft-versus-host disease (GvHD) after intestinal transplantation call for more research to describe the molecular mechanisms involved in the immunopathogenesis of post-transplant complications to define new therapeutic targets. In addition, according to the rapid development of immunosuppressive agents, it is time to consider novel therapeutic approaches in managing treatment-refractory patients with rejection or severe GvHD. Herein, the main immunological challenges before and after intestinal transplant including, brain-dead donor inflammation, acute rejection, antibody-mediated, and chronic rejections, as well as GvHD have been described. Besides, the new immune-based therapies used in experimental and clinical settings to improve tolerance toward intestinal allograft, and cases of operational tolerance have been reviewed.
Detection of early hidden carcinoma of cardia by reversely entering the esophagus with magnetically controlled capsule endoscopy: A case report.
Chang LJ, Liu HY, Ma XB … +2 more , Gao T, Liu CX
Arab J Gastroenterol · 2024 Nov · PMID 39289082 · Publisher ↗
Magnetically controlled capsule endoscopy (MCE) is a non-invasive method for gastropathy examination. However, due to the influence of gravity and lumen structure, the traditional capsule endoscopy rapidly passes through...
Magnetically controlled capsule endoscopy (MCE) is a non-invasive method for gastropathy examination. However, due to the influence of gravity and lumen structure, the traditional capsule endoscopy rapidly passes through the cardia, leading to insufficient observation of the cardia mucosa. Case Summary. The patient, a 53-year-old male, had a history of subarachnoid hemorrhage for 5 years, and it has been 5 years since the aneurysm embolization.Computed Tomography Angiography (CTA) indicated the presence of an anterior cruciate aneurysm. Given the risks associated with traditional intubated gastroscopy, magnetic controlled capsule gastroscopy was chosen for gastric examination. Following the standard operating procedure, routine magnetic controlled capsule endoscopy was performed, and no lesions were detected.We combined magnetic force and patient posture adjustment to guide the capsule to pass through the cardia slowly and return to the esophagus, successfully detecting a concealed cardia lesion.Afterwards, the lesions of the cardia were treated with a magnifying gastroscope and endoscopic submucosal dissection (ESD).Pathological findings showed that adenocarcinoma was confined to the mucosa membrane, and in the postoperative pathological study, no tumor remnants or metastasis were discovered. This paper reports a case of a patient undergoing a physical examination, but no lesion was found during a routine examination using the magnetically controlled capsule gastroscope. However, we discovered a case of hidden early cardia cancer after guiding the capsule gastroscope back into the esophagus under magnetic control.
High frequency of anti-Saccharomyces cerevisiae antibodies in chronic hepatitis C.
Ghozzi M, Mankai A, Mechi F … +5 more , Ben Chedly Z, Kallala O, Melayah S, Trabelsi A, Ghedira I
Arab J Gastroenterol · 2024 Nov · PMID 39289081 · Publisher ↗
BACKGROUND AND STUDY AIM: Chronic hepatitis C (CHC) is a liver disease caused by the hepatitis C virus. Anti-Saccharomyces cerevisiae (S. cerevisiae) antibodies (ASCA) are frequently reported in autoimmune diseases but r...
BACKGROUND AND STUDY AIM: Chronic hepatitis C (CHC) is a liver disease caused by the hepatitis C virus. Anti-Saccharomyces cerevisiae (S. cerevisiae) antibodies (ASCA) are frequently reported in autoimmune diseases but rarely in viral infections. We aimed to determine the frequency of ASCA in adult patients with CHC. PATIENTS AND METHODS: Eighty-eight patients with CHC and 160 healthy blood donors were included in this study. ASCA-IgG and IgA levels were determined using enzyme linked immunosorbent assay. For statistical analysis, we used open EPI version 3 as software. Correlations were determined by Spearman's test using IBM® SPSS® Statistics. RESULTS: ASCA (IgG or IgA) were present in 31.8 % of patients and in 3.7 % of controls (p < 10). ASCA-IgG and ASCA-IgA were more frequent in patients with CHC than in healthy subjects (23.9 % vs. 3.1 %; p < 10 and 9.1 % vs. 0.6 %; p = 0.002, respectively). In patients, mean levels of ASCA-IgG and IgA were significantly higher than in controls (9.95 ± 11.78 U/mL vs. 2.28 ± 2.86 U/mL, p < 10 and 5.96 ± 7.69 U/mL vs. 0.56 ± 0.12 U/mL, p < 10; respectively). In patients with CHC, the mean level of ASCA-IgG was significantly higher than that of ASCA-IgA (9.95 ± 11.78 U/mL vs. 5.96 ± 7.69 U/mL, p = 0.008). CONCLUSION: The frequency of ASCA was significantly higher in patients with CHC than in healthy controls.
The efficacy of removal of animal milk from the diet in functional dyspepsia: A cross-sectional study.
Akpınar A, Kochan K, Kiremitci S … +3 more , Seven G, Ince AT, Senturk H
Arab J Gastroenterol · 2024 Nov · PMID 39289080 · Publisher ↗
BACKGROUND AND STUDY AIMS: We aimed to investigate the effect of removing milk and dairy products from diets on functional dyspepsia (FD) symptoms, as the aetiology remains unclear and new management approaches are neede...
BACKGROUND AND STUDY AIMS: We aimed to investigate the effect of removing milk and dairy products from diets on functional dyspepsia (FD) symptoms, as the aetiology remains unclear and new management approaches are needed. PATIENTS AND METHODS: This cross-sectional cohort study included 120 patients, with a mean age of 42.5 ± 12.3, of whom 77 (64.2 %) were female, with FD diagnosed by the Rome IV criteria. Patients were divided equally into two groups: those who eliminated milk and dairy products from their diet under the advice of a dietician without medical treatment and those who did not. The severity of symptoms was assessed using the gastrointestinal symptom rating scale (GSRS) at the beginning and end of a one-month period. RESULTS: The restricted and unrestricted diet groups showed no significant differences in age, body mass index, symptom frequency and duration, weight changes, FD subtype, and gastroscopy results (p > 0.05). The diet group had more female patients (p = 0.01) and higher GSRS scores at the beginning (p = 0.01) but similar scores at the end of the study (p = 0.99). After one month, both groups had improved GSRS scores (p = 0.01), but the diet group had a more significant decrease in total symptom scores (p = 0.01) and in 7 of the 15 subsets (p < 0.05). CONCLUSION: Of the 120 FD patients who followed up for one month, 60 who removed milk products had a more significant reduction in GSRS symptom score and 7 of the 15 symptom subset scores than 60 patients receiving an unrestricted diet.
CircFLNA facilitates gastric cancer cell proliferation and glycolysis via regulating SOX5 by sponging miR-1200.
Yang X, Li D, Sun Y … +3 more , Yi L, Chen Q, Lai Y
Arab J Gastroenterol · 2024 Nov · PMID 39278782 · Publisher ↗
BACKGROUND AND STUDY AIMS: Circular RNAs (circRNAs) are important regulators for gastric cancer (GC) progression. Our study aims to investigate the role and mechanism of circFLNA in GC progression. PATIENTS AND METHODS:...
BACKGROUND AND STUDY AIMS: Circular RNAs (circRNAs) are important regulators for gastric cancer (GC) progression. Our study aims to investigate the role and mechanism of circFLNA in GC progression. PATIENTS AND METHODS: The levels of circFLNA, microRNA (miR)-1200 and SRY-box transcription factor 5 (SOX5) were examined using qRT-PCR. Flow cytometry, cell counting kit 8 assay and EdU assay were performed to measure cell proliferation and apoptosis. Cell glycolysis ability was assessed by examining glucose uptake and lactate produce. RNA interaction was determined using RNA pull-down assay and dual-luciferase reporter assay. Mice xenograft models were constructed to evaluate the regulation of circFLNA knockdown on GC tumor growth. RESULTS: CircFLNA was upregulated in GC tissues. Functional experiments showed that circFLNA knockdown suppressed GC cell proliferation, inhibited glycolysis, and promoted apoptosis in vitro, as well as reduced GC tumor growth in vivo. CircFLNA sponged miR-1200, and miR-1200 targeted SOX5. MiR-1200 mimic reversed the promotion effect of circFLNA overexpression on GC cell growth and glycolysis, and SOX5 upregulation also abolished the inhibiting effect of miR-1200 mimic on GC cell growth and glycolysis. CONCLUSION: Our data suggest that circFLNA might exert oncogenic role in GC development, which promoted GC proliferation and glycolysis through regulating miR-1200/SOX5 axis.
Abnormal expression of autophagy proteins in the duodenum of patients with functional dyspepsia: A preliminary study.
Du L, Cen M, Cheng F … +1 more , Dai N
Arab J Gastroenterol · 2024 Nov · PMID 39278781 · Publisher ↗
BACKGROUND AND STUDY AIMS: Functional dyspepsia (FD) is a common disease with an unclear pathology. Autophagy is associated with inflammation and has been proposed to play a role in the development of FD. This study aime...
BACKGROUND AND STUDY AIMS: Functional dyspepsia (FD) is a common disease with an unclear pathology. Autophagy is associated with inflammation and has been proposed to play a role in the development of FD. This study aimed to evaluate expression of the autophagy proteins beclin1 and p62/SQSTM1 in patients with FD. PATIENTS AND METHODS: Duodenal mucosal tissues were collected from 10 patients with FD and 10 asymptomatic controls. The extent of autophagy was determined by examining expression levels of beclin1 and p62/SQSTM1 using quantitative polymerase chain reaction and immunohistochemistry techniques. RESULTS: Lower expression levels of beclin1 protein were detected in the duodenal bulb (D1) and the second portion of the duodenum (D2) in patients with FD compared with asymptomatic controls. Higher levels of p62 protein were expressed in D1 in patients with FD than in controls. No differences in mRNA expression of beclin1 and p62 were observed between patients with FD and controls. CONCLUSION: Abnormal autophagy was involved in FD, which may be associated with the pathogenesis of FD.
Introducing the Arabic inflammatory bowel disease disk as a tool for assessing disability in patients with inflammatory bowel disease in Jordan.
Mazzawi T, Yadk A, Alghneimin N … +7 more , Hmeimat S, Saleem Al-Essa M, Abed Alghafer H, Haneyah F, Alkhawaldeh H, Samara E, Ghazal B
Arab J Gastroenterol · 2025 Feb · PMID 39277517 · Publisher ↗
BACKGROUND AND STUDY AIM: Inflammatory bowel diseases (IBD) are chronic relapsing-remitting disorders of the gastrointestinal tract. IBD causes significant impairment in the patient's quality of life that should be asses...
BACKGROUND AND STUDY AIM: Inflammatory bowel diseases (IBD) are chronic relapsing-remitting disorders of the gastrointestinal tract. IBD causes significant impairment in the patient's quality of life that should be assessed and monitored in a flexible and easy way. The IBD-Disability Index (IBD-DI) is the only validated tool to assess disability in IBD patients, but it is difficult to use in clinical practice. The IBD Disk is a new shortened, self-administering version of the IBD-DI that allows quick assessment of IBD patients and tracks changes in disease burden over time. However, the IBD Disk has not been used yet in clinical practice in Jordan. The aim of the study was to translate the IBD Disk to Arabic language and introduce it in clinical practice in Jordan. PATIENTS AND METHODS: After translating the original IBD Disk to Arabic language, IBD patients referred to outpatient clinic or admitted to the medical department at the new Al-Hussein hospital, Al-Salt, Jordan, from September 2021 until March 2022, filled the translated IBD Disk. RESULTS: A total of 50 IBD patients (52 % males) were included in the study and filled the IBD Disk. The IBD Disk was easy to complete by the patients. Energy, regulating defecation, and emotions were the most disabling domains for relapsing patients. Polygonal shape area of the mean for IBD Disk scores decreased during remission. Education & work and energy had the strongest correlation at relapse. CONCLUSION: The IBD Disk is a reliable visual representation of IBD disability. In this study, a translated version of IBD Disk to Arabic language was introduced for the first time in clinical practice in Jordan. The reduction in the polygonal shape area of the scores' mean represents decreased disease burden.
Washed microbiota transplantation combined with biological agents promotes histological remission in refractory severe ulcerative colitis with recurrent intestinal infection: A case report.
Wu Q, Yang LS, Huang HL … +3 more , Li YF, Zhou YJ, Xu HM
Arab J Gastroenterol · 2024 Nov · PMID 39079826 · Publisher ↗
Ulcerative colitis (UC) is a chronic non-specific colitis disease. In recent years, fecal microbiota transplantation (FMT), including improved washed microbiota transplantation (WMT), and biological agents have helped im...
Ulcerative colitis (UC) is a chronic non-specific colitis disease. In recent years, fecal microbiota transplantation (FMT), including improved washed microbiota transplantation (WMT), and biological agents have helped improve the prognosis of patients with UC. However, a significant number of patients with moderate to severe UC do not get relief from glucocorticoids, immunosuppressants, and TNF-α antagonists. Patients with severe UC are frequently burdened with opportunistic infections and subsequent surgical interventions. Combined treatment modalities are crucial for patients with severe UC and opportunistic infections. Herein, we reported a case of a 25-year-old female with refractory severe UC complicated with recurrent Clostridioides difficile infection and recurrent cytomegalovirus infection for six years. Surgical removal of the affected bowel segment was almost unavoidable. She showed endoscopic and histological recovery after comprehensive WMT and Vedolizumab treatment. The following are our learnings from the case: 1. A combination of WMT and biological agents can potentially obviate the necessity for surgical treatment in patients with refractory severe UC and promote histological remission. 2. Personalized comprehensive treatment and chronic disease management models for patients with UC should be emphasized. 3. WMT can help treat opportunistic infections, which may also strengthen the treatment with gut-targeted biological agents when traditional TNF-α antagonists show poor efficacy.
Application of balloon occluder for specimen collection after descending duodenal ESD.
Wang M, Jiang X, Wang X
Arab J Gastroenterol · 2024 Aug · PMID 39079825 · Publisher ↗
Endoscopic submucosal dissection (ESD) is a popular technique for resecting duodenal tumors. However, there is a risk of losing resected specimens during the procedure, particularly for lesions in the descending part of...
Endoscopic submucosal dissection (ESD) is a popular technique for resecting duodenal tumors. However, there is a risk of losing resected specimens during the procedure, particularly for lesions in the descending part of the duodenum. This study aims to introduce a simple and effective method for specimen collection after descending duodenal ESD using a self-made balloon occluder. The balloon occluder, made from a spray pipe and sterile rubber glove, is utilized to prevent the loss of resected specimens. The balloon is inflated under endoscopic visualization, occluding the descending lumen. With careful timing, the resected specimen can be safely collected by grasping it from the balloon using foreign forceps. This method has been successfully applied in several cases, demonstrating its practicality and efficacy. Further evaluation and validation of this technique in a larger patient population are warranted to establish its wider application in clinical practice.
Population based treatment strategy of H pylori in Qatar: Through clinical and demographic insights.
Khan ZAW, Ab Ib Swehli H, Hani Al-Battah A … +7 more , Mahmoud M, John A, Al-Ejji K, Al Kaabi S, Varughese B, Singh R, Salim Khan S
Arab J Gastroenterol · 2024 Nov · PMID 39079824 · Publisher ↗
BACKGROUND AND STUDY AIM: Helicobacter Pylori (H. pylori), a widespread gastric pathogen, can have a range of presentations necessitating population based tailored treatment strategies. We aimed to study the clinical and...
BACKGROUND AND STUDY AIM: Helicobacter Pylori (H. pylori), a widespread gastric pathogen, can have a range of presentations necessitating population based tailored treatment strategies. We aimed to study the clinical and demographic profile of patients with H pylori in Qatar, to determine the best treatment strategy for Qatar's population. PATIENTS AND METHODS: Retrospective data collection of all patients diagnosed with H pylori from January 2017 to December 2019 in Hamad Medical Corporation (HMC) and Primary Health Care Corporation (PHCC), Qatar was done. The demographic, clinical, endoscopic and histologic characteristics of patients and H. Pylori directed therapies were documented and compared. Pearson's Chi-square test, independent samples ttest or analysis of variance (ANOVA) was used as appropriate to compare various parameters between patients. RESULTS: 2217 patients tested positive for H. Pylori over 3 yrs. of which 837 (37.8 %) were Qatari nationals. Dyspepsia was the most common indication for testing (44.6 % patients) which was positively associated with gastric erythema and atrophy on endoscopy (P = 0.000 and 0.004, respectively) and negatively associated with a normal endoscopy (p = 0.038). Most of the patients had chronic active gastritis (98.2 %). Other pre-malignancies were seen in only 85 (14.3 %) patients. Mean (SD) age of patients with premalignancies was significantly more than those without [ 53.25 (17.6) vs. 44.77 (14.8), p = 0.000]. Only 11(0.6 %) patients had a malignancy of the stomach. CONCLUSION: H pylori infection may be quite prevalent amongst Qatari nationals. Since prevalence of gastric premalignancies and incidence of gastric malignancy in patients with H pylori in Qatar may be low, generalized test and treat strategy is not economically and practically meaningful in Qatar. Symptomatic patients should be tested and treated, with endoscopy reserved for those with alarming symptoms, failure of proton pump inhibitors and older patients.
Endoscopic characterization of gastrointestinal manifestations in children with undifferentiated recurrent fever.
Şahin NÜ, Şahin N
Arab J Gastroenterol · 2024 Nov · PMID 39069426 · Publisher ↗
BACKGROUND AND STUDY AIMS: Systemic autoinflammatory diseases are characterized by recurrent or chronic inflammation, and monogenic forms are increasingly defined. However, a group of patients without genetic diagnosis i...
BACKGROUND AND STUDY AIMS: Systemic autoinflammatory diseases are characterized by recurrent or chronic inflammation, and monogenic forms are increasingly defined. However, a group of patients without genetic diagnosis is called the syndrome of undifferentiated recurrent fever (SURF). This study analyzed the clinical and endoscopic features of patients with SURF presenting with gastrointestinal (GI) symptoms. PATIENTS AND METHODS: Between 2019 and 2022, GI endoscopy were performed in patients with SURF who presented with GI symptoms. Clinical, genetic, laboratory, and endoscopy findings were analyzed. RESULTS: Fifteen patients were included in the study, eight (53.3 %) were girls. The mean age was 10.5 ± 5.80 years, and the median age at symptom onset was 4 (0.3-16) years. All patients experienced fever and abdominal pain. Thirteen patients (86.7 %) experienced diarrhea, 11 (73.3 %) reported myalgia, and 10 (66.7 %) had joint involvement. Lymphoid follicles in the terminal ileum mucosa were detected in 10 patients (66.7 %), and nodular lymphoid hyperplasia in the terminal ileum was the histopathological finding in 12 patients (80 %). CONCLUSIONS: The current study found that patients with SURF experiencing gastrointestinal symptoms have excessive lymph node formation in the terminal ileal mucosa due to an exaggerated inflammatory response. This may be the cause of their GI symptoms.
Development and validation of diagnosis model for inflammatory bowel diseases based on a serologic biomarker panel: A decision tree model study.
Zeng J, Huai M, Ge W … +2 more , Yang Z, Pan X
Arab J Gastroenterol · 2025 Feb · PMID 39069425 · Publisher ↗
BACKGROUND AND STUDY AIMS: Currently, an increasing amount of experimental data is available on newly discovered biomarkers in inflammatory bowel diseases (IBD), but the role of these biomarkers is often questionable due...
BACKGROUND AND STUDY AIMS: Currently, an increasing amount of experimental data is available on newly discovered biomarkers in inflammatory bowel diseases (IBD), but the role of these biomarkers is often questionable due to their limited sensitivity. Therefore, this study aimed to build a diagnostic tool incorporating a panel of serum biomarkers into a computational algorithm to identify patients with IBD and differentiate those with Crohn's disease (CD) from those with ulcerative colitis (UC). PATIENTS AND METHODS: We studied sera from 192 CD patients, 118 UC patients, 60 non-IBD controls and 60 healthy controls. Indirect immunofluorescence (IIF) assays were utilized to determine several serum biomarkers previously associated with IBD, and the decision tree algorithm was used to construct the diagnosis model. Performances of models were evaluated by prediction accuracy, precision, AUC and Matthews's correlation coefficient (MCC). The "Inflammatory Bowel Disease Multi-omics Database (IBDMDB)" cohorts were used to validate the model as external validation set. RESULTS: The prediction rates were determined and compared for decision tree models after each data was developed using C5.0, C&RT, QUEST and CHAID. The C5.0 and CHAID algorithms, which ranked top for the prediction rate in the IBD vs. non-IBD model and the CD vs. UC model, respectively, were utilized for final pattern analysis. The final decision tree model achieved higher classification accuracy than the approach based on conservative marker combinations (sensitivity 75.0% vs. 79.5%, specificity 93.8% vs. 78.3% for differentiating IBD from non-IBD; and sensitivity 84.3% vs. 73.4%, specificity 92.5% vs. 54.9% for differentiating CD from UC, respectively). The model prediction consistency was 93% (28/30) in the external validation set. CONCLUSION: The decision-tree-based approach used in this study, based on serum biomarkers, has shown to be a valid and useful approach to identifying IBD and differentiating CD from UC.
The silent epidemic: Inappropriate use of proton pump inhibitors among hospitalized patients.
Mohamed MR, Itani M, Abohelwa M … +8 more , Ahmed MA, Abdouni L, Doumat G, Azzo M, Dabdoub F, Al-Tfaili H, Elziny M, Assaf G
Arab J Gastroenterol · 2024 Nov · PMID 39069424 · Publisher ↗
BACKGROUND AND STUDY AIMS: There is an increasing trend to inappropriately prescribe proton pump inhibitors (PPIs) in different clinical settings despite the reported adverse outcomes. This study aimed to assess (1) the...
BACKGROUND AND STUDY AIMS: There is an increasing trend to inappropriately prescribe proton pump inhibitors (PPIs) in different clinical settings despite the reported adverse outcomes. This study aimed to assess (1) the prevalence of potentially inappropriate use of PPIs and its associated risk factors among hospitalized patients, at pre-admission and discharge and (2) the prevalence of valid indications of PPIs use without prescription. PATIENTS AND METHODS: A retrospective observational study was performed at a single center, examining the records of patients aged ≥18 years who were admitted to the Family Medicine inpatient service over a one-year period. The appropriateness of PPIs use was assessed against a set of pre-approved indications. RESULTS: A total of 289 patients were included in the analysis. Of these, 34.67 % were taking PPIs upon admission, increasing to 43.67 % at discharge (p < 0.001). Inappropriate PPI use was identified in 51.92 % at pre-admission and 57.25 % at discharge. Multivariate analysis identified significant factors contributing to inappropriate PPI use: polypharmacy at both admission and discharge (OR = 4.587, p = 0.031), and the presence of two or more comorbidities at discharge (OR = 5.421, p = 0.011; OR = 13.005, p = 0.037). Age ≤65 was associated with increased inappropriate use only at discharge (p < 0.003). Conversely, appropriate prescribing was noted in patients over 65 and those on antiplatelet therapy, aligning with clinical guidelines. CONCLUSIONS: This study reveals a high prevalence of inappropriate PPI use among hospitalized patients, notably increasing from admission to discharge. Key contributors to inappropriate PPI usage included polypharmacy and high comorbidity scores at discharge, particularly in patients under 65. This emphasizes the need for targeted interventions to optimize PPI prescribing practices in clinical settings.
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