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Background and Objectives: Colorectal cancer (CRC) is a prevalent form of cancer worldwide. Recent studies suggest that postbiotics derived from probiotic bacteria have the potential as an adjunct therapy for CRC. This study investigates the anti-cancer effects of Bifidobacterium breve (B. breve) and Lactobacillus rhamnosus (L. rhamnosus) postbiotics on the HT-29 cell line. Materials and Methods: Through MTT and scratch assay, we investigated the anti-proliferation and anti-migration effects of B. breve and L. rhamnosus postbiotics on HT-29 cells. Furthermore, postbiotic-mediated apoptosis was assessed by analyzing the expression of Bax, Bcl-2, and caspase-3. We also investigated the effects of B. breve postbiotics on the expression of three important genes involved in metastasis, including RSPO2, NGF, and MMP7. Consequently, we validated the expression of selected genes in twelve adenocarcinoma tissues. Results: The results demonstrated the significant impact of postbiotics on HT-29 cells, highlighting their ability to induce anti-proliferation, anti-migration, and apoptosis-related effects. Notably, these effects were more pronounced using B. breve postbiotics than L. rhamnosus. Additionally, B. breve postbiotics could inhibit metastasis through upregulation of RSPO2 while downregulating NGF and MMP7 expression in HT-29 cells. Conclusion: Our research suggests that postbiotic metabolites may be effective biological products for the prevention and treatment of cancer.

Background and Aim: One of the most important components of medical student education, it is clinical education that should always be observed because of its importance. Accordingly, the present study aimed to investigate barriers to quality of clinical education from the viewpoints of medical students of Birjand University of Medical Sciences in the academic year 2018-2019. Materials and Methods: This descriptive cross-sectional study was performed on medical students. A total of 133 students who had completed their basic sciences courses were selected by the available sampling method. The data collecting tool was researcher made questionnaire that its validity and reliability were confirmed. Data were analyzed by SPSS software (Version 16). Results: The mean score of professor’s domain was 15.06±5.69, educational environment and staff 6.1±2.38, personal characteristics of students 6.64 ± 2.43 and curriculum 7.66 ±3.05. The lack of emphasis on important points of the educational materials while presenting the lesson, master's disregard for communication between theoretical knowledge and clinical skills, inadequate knowledge and theoretical information of students, and the student’s lack of confidence in the patient's bedside they were identified as the most important barriers to clinical education. There was also no agreement between the existing and the desired conditions in the areas of interest from the viewpoint of the students and the clinical environment and staff had the highest inconsistency. Conclusion: According to the present study, Students of among master's fields, Student individual characteristics, curriculum, staff and clinical environment, the most important barriers to education knew staff and clinical environments, which could be remedied by providing equipment and facilities and creating the necessary coordination between students and staff.

The burden of gastrointestinal (GI) cancer is increasing worldwide, and in the past decade, cancer had entered the list of chronic debilitating diseases whose risk is substantially increased by hypernutrition. Obesity may increase the risk of cancer by the imbalance of various mechanisms including insulin and insulin-like growth factor1 (IGF-I) signaling, systemic inflammation, immune dysregulation, tumor angiogenesis, adipokines secretion, and intestinal microbiota that usually act interdependently. An increased understanding of the mechanisms underlying obesity-GI cancer link can provide multiple opportunities for cancer prevention. This review discusses various mechanisms involved molecular mechanisms linking obesity with GI cancers including esophagus, stomach, colorectal and hepatocellular. Furthermore, an optional intervention such as diet restriction and exercise is described, which may be preventive or therapeutic in GI cancer.

Celiac disease is an autoimmune disorder that affected 1% of all population in United State. Classic manifestations of disease consist of early childhood diarrhea, malabsorption, steatorrhea and growth retardation but disease can affects adult at any age. In adult anemia is a more frequent finding. This patient was a 40-year-old lady with progressive fatigue and lower extremities pitting edema. Iron deficiency anemia and celiac disease were diagnosed on the basis of low serum ferritin, elevated serum level of IgA endomysial and tissue transglutaminase anti-bodies and histologic findings in small bowel biopsies. Pericardial effusion in her evaluation was detected incidentally. Asymptomatic pericardial effusion in this patient was only detectable with imaging. After starting of gluten free diet and iron supplement fatigue, peripheral edema and pericardial effusion on echocardiography decreased. It should be noted that asymptomatic pericardial effusion may be seen in adults with celiac disease.