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Background Rheumatoid arthritis is a systemic inflammatory disease that mainly affects small joints. It has a destructive potential, then early diagnosis and treatment can prevent deformities and extra articular manifestations. According to the studies ACCP test is the most sensitive and specific biological marker of the disease, but in some studies Anti MCV is comparable with ACCP as a specific marker. Objectives In this study we compared the sensitivity and specificity of the above mentioned tests. Methods This cross sectional study was carried out on 150 rheumatoid arthritis patients and 75 controls. In the patients group there were 34 males and 116 females with the mean age of 49.57±11.98 and in the control group 17 males and 58 females with mean age of 48.85±11.98years old. For each and every subject approximately 8cc of blood was drawn, serums were separated. Then, ACCP and Anti MCV by using Elisa method were measured. The results were analyzed with SPSS software. Results In this study the sensitivity of ACCP and Anti MCV were 85% and 81%. Furthermore, the specificity of these tests was 96% and 95% respectively. The positive predictive value for ACCP, 98% and for Anti MCV 97% and negative predictive value for ACCP 76% and for Anti MCV 71%were calculated. Only 4out of 23 patients (17.39%) with negative ACCP test were Anti MCV positive and 10 out of 29 patients (34.48%) with negative Anti MCV were ACCP positive. In our study there was no significant difference between sensitivity and specificity of these two tests, although in general ACCP was superior to Anti MCV. But it does not appear that Anti MCV will help more in ACCP negative patients. Disclosure of Interest None Declared

Background and purpose: Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are both chronic gastrointestinal diseases with different pathophysiology but similar symptoms. In this study, we intend to investigate the pattern of changes in plasma levels of Fe, Zn, Se, Cu and ferritin, transferrin and ceruloplasmin, as well as oxidative and antioxidant capacity in IBD patients compared to IBS and the healthy group.Methods: This case-control study was performed on three groups of 30 patients with IBD and IBS and healthy individuals. ELISA method was used to measure the levels of ferritin and total oxidant, atomic absorption method for selenium and copper, and spectrophotometry for iron, zinc, transferrin and ceruloplasmin.Results: According to the results of this study, we showed that the levels of oxidative stress and transferrin, selenium, and zinc in men with IBD compared to IBS and control, showed a significant difference while in women no significant changes were observed in other factors except transferrin and Zn. There was also a significant increase in MDA, a decrease in TAC and a decrease in zinc and transferrin in the entire population with IBD. Also, lower levels of Fe and Se were observed in IBD patients compared to IBS and the healthy group. However, this difference was not statistically significant.Conclusion: The results of this study showed that the study of some trace elements may help us to find a more effective and easier method in diagnosing and differentiating people with IBD and IBS.

Salmonellosis is an important public health concern among children in worldwide. Extended-spectrum β-lactams (ESBLs) cause resistance to clinically important beta-lactams which are generally used to treat invasive Salmonella infections. Therefore, the aim of this study was to investigate the presence of SHV, TEM and CTX-M genes in different strains of Salmonella isolated from children with acute diarrhea and to determine their resistance profile. In this cross-sectional study, 300 fecal samples were collected from children referred to the Amirkola Children's Hospital, Babol, Iran. Antibiotic susceptibility testing was done according to the CLSI guideline. ESBLs-producing strains were identified using double disk synergy test method on the Mueller-Hinton agar plates. Multiplex-PCR was performed using oligonucleotide specific primers to detect of SHV, TEM and CTX-M genes. In total, 7% (n; 21/300) salmonella were isolated, which 61.9%, 28.6% and 9.5% were Salmonella typhimurium, Salmonella enteritidis and Salmonella typhi, respectively. The prevalence of the ESBL-producing isolates were 52.4%. M-PCR results showed that 42.8%, 38.1% and 14.3% of isolates were carried CTX-M, TEM and SHV genes, respectively. Also, 18.2% of isolates harbored CTX-M, and TEM genes, simultaneously. The high rate of ESBLs-producing Salmonella strains in the pediatric patients is an alarm. It is also recommended that alternative drugs be used with less resistance, which requires further investigation.

Background: Improvement in adenoma detection rate (ADR) reduces colorectal cancer incidence by increasing the colonoscopy quality. Using dynamic patient position changes during the withdrawal phase has shown promise in increasing ADR. We conducted this study to assess the effectiveness of the supine position on the improvement of ADR to improve its feasibility and avoid frequent patient position changes, particularly in sedated patients.Methods: This was a randomized, single-blind, parallel-group, single-center study implemented in the Mehregan private in Babol. Inclusion criteria were 40 to 85 years old, 4 L application of polyethylene glycol from the day before the procedure, no history of inflammatory bowel disease, bowel surgery, musculoskeletal problems, and negative familial history of colorectal cancer. Patients were allocated in a 1:1 ratio to the supine or left lateral positions during the withdrawal phase. All colonoscopies were performed by a single physician using a Fujifilm colonoscope. A P-value of <0.005 was considered statistically significant.Results: A total of 880 patients were assessed for eligibility, of which 472 patients were included in the final analysis; 53.4% were female, the mean age of participants was 55.86±10.30 years old, 95.1% of patients had adequate bowel preparation, and adenomatous polyps were the most common histopathologic type (63.7%). Despite the intervention group’s higher rate of ADR and PDR (19.5% vs. 17.7% for ADR and 27.2% vs. 26.5% for PDR), no statistically significant difference in ADR or PDR was detected (P=0.613 and 0.866). Conclusion: No statistical significance was observed despite the increase in ADR when the supine position was used exclusively during the withdrawal phase. As a result, we recommend that the dynamic position change method be used if a position change is required. Nonetheless, additional research is required to determine a more effective alternative to dynamic position change in obese or heavily sedated patients.Trial registration: IRCTID: IRCT20110721007080N5, registration date: 04/05/2020