Background: It is generally accepted that gastric carcinomas are preceded by a sequential multistage process that includes chronic gastritis, gastric atrophy, usually with intestinal metaplasia (IM), and dysplasia. This series of changes in gastric carcinogenesis is often initiated by Helicobacter pylori (H pylori) infection. The aim of the present study was determination of gastric histopathologic changes in IM patients after at least one year in Guilan province, Iran. Materials and Methods: This case-series study was conducted in Guilan Gastrointestinal and Liver Disease Research Center (GLDRC) during 2010 to 2011. Gastric biopsy was performed for all 71 known cases of IM and precanceric lesions including gastric atrophy, IM, dysplasia and H pylori infection were determined after at least one year. Results: Of the total of 71 patients with established IM who were enrolled, 50 had complete-type IM and 21 had incomplete-type IM. Fifty two people had H pylori infection. H pylori eradication was achieved in 39 patients (75%). Secondary pathology findings of patients with IM were complete metaplasia (39.4%), incomplete metaplasia (32.4%), dysplasia (23.9%) and other precanceric lesions (4.2%). Dysplasia (20%vs 33%) occurred in patients who had complete and incomplete IM at baseline respectively (p>0.05). Age, gender, family history of gastric cancer(GC); smoking habits and NSAIDs use were not associated with gastric premalignant lesions in initial and secondary pathologies (p>0.05). The difference became statistically significant between H pylori infection in patients with more than 3 years diagnostic intervals (p<0.05). Statistical difference between eradicators and non-eradicators was not significant. Conclusions: We found that incomplete IM increased the risk of subsequent dysplasia in this study.

Background & Objectives: The most northern and northwestern regions of Iran are at a high risk for gastric cancer. The aim of this study was to assess the general population's awareness about risk factors, symptoms and signs, preventive methods and management of gastric carcinoma in a high prevalence city in the North of Iran. Methods: A cross-sectional population-based telephone survey which was conducted on 3,457 residents of Rasht, the capital city of Guilan Province, to assess their awareness regarding gastric carcinoma. The questionnaires contained demographic data and statements on respondents' knowledge about risk factors, symptoms and signs, prevention and management of gastric cancer which were filled by general practitioners after asking the subjects. Data were analyzed in SPSS14. P<0.05 was considered significant. Results: The mean knowledge score of the respondents was 5.05±1.37 regarding risk factors of gastric carcinoma, 4.39±1.99 regarding symptoms and signs, 6.0±1.22 regarding preventive strategies, and 1.6±1.16 regarding management. Totally the mean knowledge level of the respondents toward gastric carcinoma would be 17.1±3.97 from the maximum grade of 29. The age group of 45-55 y/o, bachelor degree and higher, physicians and nurses, those who had cancer history in friends or had the history of gastrointestinal diseases showed significantly higher knowledge scores (P=0.001). Conclusion: There is a general lack of awareness of cancer risk factors, symptoms and signs, methods of prevention, and importance of early diagnosis and treatment. Educational programs should be developed to promote adherence to recommended screening guidelines.

Background: Hydatid cyst disease (HCD) or echinococcosis has a worldwide distribution and is endemic in many countries of Mediterranean region. In Iran, due to various climatic conditions, the rate of the disease is diverse in different parts. The most infected regions are the domains of Alborz and Zagros Mountains where there is a high rate of ruminants and the main carrier of people are animal husbandry. Due to the importance of this zoonotic helminth and the lack of information about hydatid cyst disease in Guilan province, we conducted a retrospective study from 2000 to 2010 to evaluate the HCD inpatients in this region. Objectives: The aims of the study are to evaluate HCD inpatients and to review the clinical presentations of different organs affected by cysts and postoperative outcomes of hydatid cyst in Guilan province. Materials and Methods: A retrospective descriptive investigation was performed by reviewing the medical records of patients with HCD, admitted to four private and governmental hospitals, in Rasht, capital of Guilan province from 2000 -2010. Results: Sixty-two patients (38 males, 24 females) with a mean age of 46.38 ± 18.36 years (aged between 8 and 81 years old), with HCD were evaluated. In the 40 -60 years old group, there was highest rate of HCD (40.3%). Housewives had the highest rate of infection (40.3%) followed by farmers (22.6%), pupil (8.1%), animal husbandries (6.5%) and others (22.6%). The most prevalent complaint of the patients with liver involvement were abdominal pain (75%) and nausea and vomiting (9.1%) and the most common findings of the inpatients with lung involvement the most common complaint was cough (40%). Seventy one percent of the patients had liver involvement and 16.1% had lung involvement. The most common diagnostic method was ultrasonography (48.14%). Computed tomography was diagnostic in 43.20% of cases and chest X-ray in 8.6% of cases. Overall, 96.8% of patients were cured and the mortality rate was 3.2%. Conclusions: Echinococcosis is still an important health problem in Iran that needs further studies. Therefore, accurate information on the distribution of the disease is the first step to control and prevent it. In general, the situation of the hydatidosis in the human in Guilan shows somehow a resemblance with the other areas in Iran.