6% vs. 3.2%, p less then 0.05). Hypothyroidism was diagnosed in 30 patients and 7 controls, while hyperthyroidism was observed in 9 patients and in one control. Chi-squared test results reported a significant difference in TD prevalence between patients and controls based on gender and age (p less then 0.05). In both groups, women were significantly more affected than men, and the TD prevalence was higher in younger patients compared to adults. Conclusion There was a strong association between thyroid dysfunction and CD. In this regard, it is necessary to screen patients for TD. ©2020 RIGLD, Research Institute for Gastroenterology and Liver Diseases.Aim To assess the outcomes for an elderly population with coeliac disease and to compare with younger adults with CD. Background Coeliac disease in the elderly has been underdiagnosed due to the heterogeneity of presentation as well as lack of physicians’ awareness of CD in this population. However, the benefits of diagnosing CD in the elderly may be contentious. Methods Newly diagnosed CD patients were prospectively recruited from the Coeliac Specialist Clinic at the Royal Hallamshire Hospital, Sheffield, between 2008 and 2017. All patients had villous atrophy (VA) on biopsy with positive coeliac serology. Additionally, the patients were retrospectively recruited from 1990 to 2008 to determine the trend in elderly CD diagnostic frequency over time. Results A total of 1605 patients with CD were recruited (n=644 prospectively, n=961 retrospectively). Of these, 208 patients (13.0%) were diagnosed over the age of 65 years between 1990 and 2017. The proportion of elderly CD diagnoses increased from 0% in 1990-1991 to 18.7% in 2016-2017 (p less then 0.001). Younger patients more commonly presented with fatigue (p less then 0.001) and gastrointestinal symptoms including diarrhoea (p=0.005), abdominal pain (p=0.019), and IBS-type symptoms (p=0.008), while older people more frequently presented with B12 deficiency (p=0.037). Conclusion The prevalence of CD in the elderly has significantly increased over the last two decades, but elderly patients tend to present with fewer symptoms. Further research is required to determine whether a strict gluten-free diet in these patients is a necessity or a burden. ©2020 RIGLD, Research Institute for Gastroenterology and Liver Diseases.Aim The aim of this study was to apply two types of statistical models to determine the factors that influence the mortality rate in patients with gastric cancer. Background In Iran, gastric cancer ranks the first and second most prevalent among men and women, respectively. It is the first cause of death in Iran in both gendersival. Methods In this retrospective study, data were obtained from 339 (216 male) patients diagnosed with gastric cancer in the city of Kerman (South-East of Iran) during 2001-2015. In this study, ordinary and Bayesian Lasso (least absolute shrinkage and selection operator) logistic regression models, with goodness-of-fit indices, were compared and the models’ risk factors were also determined. Results The mean age of the participants was 62.84 ±14.53 years, and 12.4% of them were younger than 45 years. Also, the mortality rate was 57.7%. Gender, morphology of the tumor, and time of diagnosis were found to be significant factors in the mortality of the patients in both models. This study found that the Bayesian Lasso model had better fitness. Conclusion The high mortality rate of gastric cancer and its high prevalence at age below 45 years are alarming. Thus, great attention should be paid to prevention, early diagnosis, especially in females, and adenocarcinoma to improve the survival of patients with gastric cancer. ©2020 RIGLD, Research Institute for Gastroenterology and Liver Diseases.Aim Our aim was to investigate the association between two single nucleotide polymorphisms (SNPs) of SMAD7 and the risk of CRC among Iranian individuals. Background Genome-wide association studies (GWAS) have identified 18q21 as a risk locus for colorectal cancer (CRC), which maps to the SMAD7 gene. Methods This case-control study was conducted on 109 CRC cases and 109 controls in the Iranian population to evaluate the influence of two SNPs of SMAD7, rs2337106 and rs6507874, on the risk of CRC as well as on clinicopathological features. Genotype determination was performed by TaqMan assay via an ABI 7500 Real Time PCR System (Applied Biosystems) for the DNA of peripheral blood. Descriptive analysis and logistic regression model were used for statistical analyses. Results Genotyping of the SNPs in the SMAD7 gene revealed that the frequency of G allele of rs2337106 was 53.7% in controls and 56.4% in cases (p-value=0.564) while the frequency of C allele of rs6507874 was 55.5% in controls and 56.3% in cases (p-value=0.772). Further, there were no significant differences in genotype frequencies of these SNPs between CRC patients and controls. The SMAD7 genotypes were not associated with the risk of CRC or with any clinicopathological characteristics such as tumor site, tumor grade, and stage TNM in CRC patients (p-value>0.05), even after adjustment for sex, age, and smoking status. Conclusion Our results provided the first evidence that SMAD7 genotypes, rs2337106 and rs6507874, could not be predisposing markers in genetic susceptibility to CRC in an Iranian population, at least in the studied population. ©2020 RIGLD, Research Institute for Gastroenterology and Liver Diseases.Aim This study examined the healing potential of royal jelly on the acetic acid induced wounds healing in male rat’s gastric mucosa. Background Scientific reports suggest that, bee products can help in the wounds healing. Methods 96 adult male Wistar rats were divided into in 4 groups as follows control, omeprazole 20 mg/kg, and royal jelly 50 and 200 mg/kg). Wound was induced in stomach mucosa of each rat with 100% acetic acid. Samples groups received omeprazole or royal jelly from 1st to 14th day after acetic ulcer induction. Gastric ulcer healing and histopathological parameters were evaluated on 4, 7, 10, 15th days after ulceration. Both descriptive and statistical analyses were used. P less then 0.05 was considered as significant. Results The royal jelly administration significantly reduced the depth of lesion in comparison with the control group (p less then 0.05) and attuned histopathological changes in the treatment groups. The largest healing effect was demonstrated with royal jelly on 10th treatment day, at a higher concentration (200 mg/kg). Conclusion These findings supported that royal jelly had effectively contributed to the wound healing, valid gastroprotective activity, and can be used for peptic ulcer therapy. ©2020 RIGLD, Research Institute for Gastroenterology and Liver Diseases.Aim The current study aimed to identify the expression levels of SE Translocation (SET), Zinc Finger, and X-Linked Factor (ZFX) in gastric cancer tissues and their corresponding adjacent non-cancerous tissues (ANCTs). Background SET has been first identified as a component of a fusion protein produced by chromosomal rearrangement in a patient with acute undifferentiated leukemia. Subsequently, multiple functions have been attributed to this gene in different disorders such as cancer and Alzheimer’s disease. The expression of SET is regulated by ZFX, a transcription factor which has a potential role in gastric cancer. Methods In this case-control study, we evaluated the expression of SET and ZFX in gastric cancer tissues (n=28) and their corresponding ANCTs (n=28) via quantitative real-time PCR. Results SET1 gene was down-regulated in tumoral tissues compared with ANCTs (expression ratio=0.25, P=0.015). However, the expression of ZFX was similar between tumoral tissues and ANCTs (expression ratio=0.97, P=0.945). We detected a significant association between the site of primary tumor and SET1 relative expression in tumoral tissues versus ANCTs, where this gene was down-regulated in all tumors originating from cardia. Based on the area under the receiver operating characteristic curve, the diagnostic power of transcription levels of SET1 in gastric cancer was 0.68. Finally, we observed remarkable correlations between expression levels of SET1 and ZFX both in tumoral tissues (R2=0.38, P less then 0.05) and in ANCTs (R2=0.23, P less then 0.05). Conclusion Overall, our results imply the role of SET1 in gastric cancer and potentially functional associations between this gene and ZFX in gastric tissues. ©2020 RIGLD, Research Institute for Gastroenterology and Liver Diseases.A gluten-free diet is a special type of diet intended for people with celiac disease. The objective of this article is to report the past, present production, supply of gluten-free products as well as their future position in our market. In the past, there were only limited gluten-free products available and the awareness of the diet was limited to paediatric community. There were only few raw gluten-free materials and almost all the production was created in households. Later with the introduction of targeted screening into the practice, celiac diagnosis has improved, with an increase in newly diagnosed patients who have remained life-long dependents on a gluten-free diet. This was associated with an increased production of gluten-free products, referred to as weight loss diet, with their positive effects on health. Subsequently, the gluten-free diet has also been voluntarily adopted by both people with other diseases and healthy individuals. In the future, the gluten-free diet consumption is expected to increase, due to its increased popularity in populations. In this regard, gluten-free diets have been misinterpreted as a „miracle drug” that is effective on a variety of problems. The medical community will be confronting the future problems of people who are dependent on a gluten-free diet as well as the complications arising from the consumers of a gluten-free diet for no medical reasons. Compliance to the principles of a gluten-free diet should be maintained and should not be recommended to healthy individuals or those without relevant reasons. ©2020 RIGLD, Research Institute for Gastroenterology and Liver Diseases.Background. It is difficult to achieve successful pulpal anesthesia in mandibular posterior teeth with symptomatic irreversible pulpitis. The present study aimed to compare the effect of articaine/epinephrine anesthesia with articaine/epinephrine at a combination of 0.5 mol/mL of mannitol for the inferior alveolar nerve block (IANB) in patients presenting with symptomatic irreversible pulpitis in the mandibular first molar tooth. Methods. One hundred patients with symptomatic irreversible pulpitis in the mandibular first molar tooth were selected and randomly divided into two groups based on the injection method. The first group underwent an IANB technique with 1.8 mL of articaine, whereas the second group received 2.9 mL of a formulation, consisting of 1.8 mL of articaine plus 1.1 mL of 0.5 mol/L of mannitol. Fifteen minutes after injections and anesthesia of the lip, the access cavity was prepared. According to the visual analog scale (VAS) criteria, no pain or mild pain for caries removal, pulp exposure and canal instrumentation were regarded as success.