Background: Although bariatric surgery is one of the most efficient therapies in morbidly obese patients for losing weight, it may result in nutritional deficiencies, secondary hyperparathyroidism, and other complications. Objective: This study aimed to assess hyperparathyroidism in morbidly obese patients that underwent different types of bariatric surgeries. Method: In this cohort-study, patients were divided into two groups based on the outcome: patients who developed secondary hyperparathyroidism (SHPT) and those who did not develop SHPT. Factors including parathyroid hormone (PTH), calcium, and 25-hydroxyvitamin D (25(OH) D3), were examined preoperatively and one, and five years after the surgery. Result: Of the 120 patients enrolled between January 2015 and September 2020, the numbers of patients that underwent sleeve gastrectomy (GS), Roux-en-Y gastric bypass (RYGB), single anastomosis sleeve ileal (SASI) and One Anastomosis Gastric Bypass (OAGB) were 90, 15, 3 and 12, respectively. Obese subjects that underwent bariatric surgeries achieved significant Body mass index (BMI) change. During the first follow up, BMI, PTH, vitamin D, calcium, HbA1c, cholesterol, and triglyceride significantly differed between the two groups. In the next follow up, vitamin D, PTH, calcium remained significantly different. Although patients that underwent SG, lost lesser weight and had fewer side effects from the surgery in comparison to other types of bariatric surgeries. Conclusion: SG provides a safer biochemical profile than other bariatric procedures and a significantly lower number of hyperparathyroid cases, however, reduction in weight loss is also significantly lesser. The postoperative hyperparathyroid was significantly correlated to VDD, calcium deficiency, and less weight loss. Highlights:

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BackgroundColorectal cancer (CRC) is the third-most common cancer in Iran. The increasing incidence of CRC in the past three decades has made it a major public health burden in the country. This study aimed to determine any relationship of specific mutations in CRCs with clinicopathologic aspects and outcome of patients.Materials and methodsThis study was conducted on 100 CRC patients by the case-only method. Polymerase chain-reaction products were analyzed by Sanger sequencing, and sequence results were compared with the significant KRAS and BRAF gene mutations in the My Cancer Genome database. Logistic regression models were used to detect associations of clinicopathologic characteristics with each of the mutations. Kaplan–Meier and Cox regression models were constructed to estimate overall survival in patients.ResultsA total of 26 subjects (26%) had heterozygote-mutant KRAS, and mutations were not detected in the amplified exon of BRAF in both tumor and normal tissues of the 100 CRCs. Rectal tumors had 1.53-fold higher likelihood of KRAS mutations than colon tumors, and men had 1.37-fold higher odds than women. The presence of metastasis increased the likelihood of KRAS mutations 2.36-fold over those with nonmetastatic CRCs. Compared to patients with KRAS wild-type cancers, those with KRAS mutations had significantly higher mortality (hazard ratio 3.74, 95% confidence interval 1.44–9.68; log-rank P=0.003).ConclusionBetter understanding of the causality of CRC can be established by combining epidemiology and research on molecular mechanisms of the disease.

Functional dyspepsia is a common gastric disease that can be associated with Helicobacter pylori infection. The aim of this study is to evaluate antral endoscopy of individuals who presented with functional dyspepsia, H. pylori infection status and the effects of eradication therapy on the symptoms. Following the diagnosis of dyspepsia as per Rome III criteria, 260 individuals who were eligible for the study underwent upper gastrointestinal endoscopy and were divided into four groups of 65 according to the endoscopic view, grades I, II, III and IV (negative). Stool antigen test was also performed for all patients to identify H. pylori infection. The early signs of dyspepsia were assessed by a standard questionnaire. In all groups, omeprazole, amoxicillin, clarithromycin and metronidazole were used for eradication treatment, and 1 month after the treatment, a faecal antigen test was repeated to evaluate the eradication of H. pylori . There was no statistically significant difference between the groups in terms of clinical symptoms before treatment. The highest response to eradication treatment was seen in individuals with antral gastropathy grade III (66.2%) and the lowest response was in patients without antral gastropathy Grade IV (32.3%). This difference was statistically significant. There was no statistically significant relationship between the participants in terms of family history, age, gender and response to treatment. Eradicating H. pylori reduces the symptoms of dyspepsia. The response of eradication therapy was greatest among the patients with grade III antral gastropathy.

Background: Adequate bowel cleansing prior to colonoscopy is important to achieve clearer view of the bowel and ease diagnosis. Objective: This study was performed to compare colon cleansing prior to colonoscopy using one-day and two-day regimens. Method: This study is a randomized controlled clinical trial, the patients were randomly allotted in one-day or two-day colon cleansing groups Polyethylene glycol was used as a laxative agent and colonoscopy was performed either on one-day following the bowel cleansing or non-next day (two-day) after the bowel cleansing. Statistical analysis was performed by SPSS software (version 22). Results: Overall, the two groups had 52 patients and were not significantly different in terms of age and gender. The mean duration of colonoscopy in the one-day group was 9.44 min and in the two-day diet group was 10.5 min, which was also not significantly different, P = 0.098. Total colon cleansing in one-day was acceptable in 94.2% and unacceptable in 5.8% patients. The two-day clearance rate was 80.8% and unacceptable clearance 19.2% patients, which was statistically significant, p = 0.038. Conclusion: The total colon cleansing was better in one-day regime group. The two groups did not different in terms of side effects and these effects were not associated with age and the gender of the patients. Highlights: