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Background and Objective: Stress has been known as an important causative factor in irritable bowel syndrome. Various studies have indicated the relationship between serum leptin levels and stress levels. This study was undertaken to investigate the relationship between serum leptin levels with irritable bowel syndrome. Materials and Methods: In This case-control study, eighty irritable bowel syndrome patients and 80 controls were recruited. All participants were asked to fill in a questionnaire included demographic information and medical history as well as a stress questionnaire. Serum leptin level was measured by ELISA method. Chi-square, student t-test, pearson correlation and logistic regression were used for investigating the relationships between variables. Results: Participants in irritable bowel syndrome group had significantly higher stress levels than controls (p<0.05). In the other hand, Serum leptin levels were significantly lower in irritable bowel syndrome group than the other one (p<0.05). Multivariate logistic regression analysis showed that after adjustment of stress level and body mass index, serum leptin level was still significantly lower in irritable bowel syndrome group (Odds ratio=0.9 CI95%:0.85-0.94). Conclusion: The present study indicated that there is a relationship between leptin and irritable bowel syndrome and serum leptin level is significantly lower in irritable bowel syndrome group than controls. This relationship is independent of other variables such as stress levels, BMI.

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Background and Objective: Celiac is a hereditary disease presented with chronic inflammation of small intestine. Several studies supposed a relationship between Celiac disease and Inflammatory Bowel Disease (IBD). Tissue trans-glutaminase antibody is one of the best serological markers in Celiac disease. This study was designed to evaluate the association of Celiac and IBD using tissue trans-glutaminase antibody.

Materials and Methods: In this descriptive study 127 confirmed IBD patients who were referred by gastroentrologists 2005-08 enrolled into the study. A questionnaire was completed and tissue trans-glutaminase antibody was evaluated with ELISA method with a Cut-off=12 U/ml.

Results: Among 127 referred patients, serum samples of 102 patients were collected. Mean±SD of age was 36.17±15.2 years and 48% were males. Ulcerative colitis, Crohn’s disease and other colitis were observed in 76 (74.5%), 7 (6.9%) and 19 (18.6%) of patients, respectively. Tissue trans-glutaminase antibody was positive (19.8 U/L) in one 46-years-old male patient with ulcerative colitis.

Conclusion: Tissue trans-glutaminase antibody titer was not significantly different between IBD patients and controls, thus it seems not appropriate to suggest as one of the routine tests in IBD patients.

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Background and Objective: Gastrointestinal polyps have pre-carcinomatous potential. In regard to increasing rate of gastrointestinal cancers and the relation between polyps with cancers, this study was done to determine the anatomical and histopathological distribution of gastrointestinal polyps in Gorgan, Iran. Materials and Methods: This cross-sectional study was conducted on 290 patients with gastrointestinal polyps were undergoing colonoscopy or endoscopy in 5th Azar teaching hospital in Gorgan, northern Iran during 1999-2008. The diagnosis was confirmed by histopathologic method. Gender and age was recorded for each patient. Results: 56.6% of patients were males 19.3% of polyps was diagnosed in the sixth decade of patient's age. The most frequent pathological type of gastrointestinal polyps was adenoma (54.1%) followed by hyperplastic (19.7%), acute inflammatory (13.8%) and young polyps type (11.4%). Tubular type with 63% was the most common type of adenoma polyp followed by various villouses (19.1%) and tubulovillous (17.9%). 87.2% and 12.8% of polyps were in colon and stomach, respectively. The most frequent anatomical position of polyps was rectum (30%) followed by sigmoid with 26/1%. Conclusion: Adenoma polyp in colon was the most common type in gastrointestinal tract.

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Background and Objective: Colonoscopy is the best method for management of patients with Hematochezia or lower gastrointestinal bleeding (LGIB). This study was conducted to assess the endoscopic and histopathologic findings in patients with hematochezia. Methods: This descriptive –analytical study was done on 117 (50 males, 67 females) patients whom referred to 5th Azar hospital in Gorgan, northern Iran during 2010. Demographic characteristics, medical history and colonoscopic and histopathologic findings were recorded for each patient. Results: Hemorrhoid was the most common finding in colonoscopic examination. Inflammatory bowel disease (IBD) and cancer were the most common feature in the under and higher than 43 age old patients, respectively (P<0.05). Ulcerative colitis (22.2%) was the most common finding in histopathological examination. Rectosigmoid was the most common anatomical location of involvement in IBD cases. Cancer and IBD were occurred in the left colon. Conclusion: Flexible sigmoidoscopy can be a selected procedure for evaluation of hematochezia in the <43 age old patients but in >43 age old subjects sigmoidoscopy or colonoscopy should be made based on patients' status.

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Background and Objective: The diagnosis of inflammatory bowel disease (IBD) is performed by colonoscopy, sampling, and histopathology. Stool calprotectin is a test showing the presence of inflammation in the gastrointestinal tract. This study was done to determine the relationship between the calprotectin level in the feces and endoscopic findings in ulcerative colitis patients referred to the gastroenterology clinic in Gorgan, Iran.
Methods: This descriptive-analytical study was performed on 100 patients with ulcerative colitis referred to the gastroenterology clinic of Sayad Shirazi Hospital, Gorgan, north of Iran during 2020. The patients were asked to collect their stool samples one day before the procedure (just after taking the drug for bowel cleansing). Bowel cleansing was done by administering polyethylene glycol solution dissolved in water. The activity of ulcerative colitis was measured using the disease activity score. According to this criterion, a score greater than or equal to 5 is considered an active disease. Patients were classified into two groups: extensive or pan-colitis and left-sided colitis. Stool samples were evaluated for calprotectin in a single laboratory using a commercially available kit (Calprest- EuorociationspA. Trieste) at normal values of less than 50mg/g. The relationship between stool calprotectin with colonoscopic findings was evaluated.
Results: The average duration of infection was 4±3.1 years in the time range of 1-14 years. The calprotectin level was less than 50 μg/g in 16 patients. Stool calprotectin less than 50 µg/g was seen in only 16 patients. There was no significant relationship between the level of calprotectin and the either age or gender of patients. Most patients (84%) had active disease based on colonoscopic findings. Left-sided involvement was seen in 60% of patients. Fecal calprotectin level was significantly higher in those with acute phase and those with severe disease (P<0.05). Additionally, the calprotectin level had no significant relationship with the location of bowel involvement, extension, and disease duration.
Conclusion: This study showed that the fecal calprotectin level in patients with ulcerative colitis had a significant relationship with the severity and activity of the disease in north of Iran.

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Background and Objective: The co-infection of tuberculosis (TB) and coronavirus disease 2019 (COVID-19) presents a significant global health challenge. Golestan Province is considered one of the most important hubs for TB. This study was conducted to simultaneously evaluate the clinical epidemiology of TB and COVID-19 in patients admitted to the Fifth Azar Educational-Therapeutic Center in Gorgan, Iran.
Methods: This retrospective, descriptive-analytical study was performed on 22 patients (12 men and 10 women) with active or old TB and COVID-19 admitted to the Fifth Azar Educational-Therapeutic Center in Gorgan, Iran, during 2020-2022. Clinical data and real-time polymerase chain reaction (RT-PCR) results were extracted from patients’ records in the hospital. These data, encompassing nasopharyngeal swab specimens from the upper respiratory tract, as well as tracheal aspirate specimens, were compiled into a checklist format.
Results: Of the 22 patients, 13 were deceased and 9 recovered. Patient hospitalization wards included the intensive care unit (ICU) (36%), respiratory isolation (36%), surgery (4.5%), and infectious diseases (23%). All patients ICU-admitted (100%) were in the deceased group (P<0.05). The clinical symptom of dyspnea was present in all 13 deceased patients (P<0.05). Laboratory results showed that alanine transaminase (ALT) and blood urea nitrogen (BUN) values were significantly higher in the deceased group than in the recovered group (P<0.05). Hematological indices, including white blood cell (WBC) count, hemoglobin (Hb), hematocrit (Hct), and mean corpuscular hemoglobin concentration (MCHC), were significantly higher in the recovered group compared to the deceased group (P<0.05).
Conclusion: The probability of death is higher in patients with TB and COVID-19 co-infection who experience dyspnea, require ICU admission, and have increased ALT and BUN laboratory values.