GOVARESH JOURNAL
Year:2014 | Volume:19 | Issue:3|Papers Count:10

Background: Irritable Bowel Syndrome (IBS) has the most common functional gastrointestinal disease and has among the most common reasons for outpatients doctor visit both in primary and specialty clinics. Patients suffer from lifelong chronic abdominal pain, diarrhea, constipation, bloating and flatus often associated with anxiety depression which significant opposing effect on the quality of life and have to use the patients to use the healthcare system and induce a huge cost for health care system. It has also result in abstinence from work and its economic consequences. Treatment of irritable bowel syndrome has symptom base which were most challenging aspect of clinical practice. Recently there was accumulating evidence in favor of dietary therapy as one of the cheapest and most effective therapy for IBS. However, there was need for a review which concludes these results.Purpose of this study was to look at the recent literatures about the role of diet in controlling IBS symptoms.Materials and Methods: Studies published in recent 5 years in Pub med and SID databases were searched with relevant keywords. Human studies, English or Persian and original articles were included. Studies which were not relevant to medical nutrition therapy were excluded. From 81 studies, 31 studies were included.Results: Foods containing gluten, lactose, fructose, galactane, sorbitol, fructane and allergen foods should be limited or omitted.Patients should be advised to use fibers, prebiotics and probiotics more often.Conclusion: Medical nutrition therapy is a useful method for controlling symptoms of these patients and should be advised.

Background: Proliferation and expansion of cancer stem cells as spheroids were proved in previous studies. But, capability of primary tumor-derived stem cells to keep their unique properties in vitro is still disputed. So, the goal of this study was to isolate, expand and characterize of colon cancer-derived stem cells.Material and Methods: In the present work, colon cancer stem cells markers including CD44 and EPCAM in spheroid and parental cells were analyzed by flow cytometry. The expression levels of stemness genes in both spheroid and parental cells were investigated using real-time PCR. Tumorigenic potential of spheroid cells was evaluated and used implantation of tumor xenografts into nude mice.Results: Our data shows 79% of spheroids were CD44+/EpCAM+, while parental cells only expressed 20% of CD44/EpCAM markers (p< 0.01). In compared with the parental cells, the expression levels of ‘‘stemness’’ genes, like Sox2, Oct4, Nanog, C-myc, and Klf4 were significantly increased in spheroid cells (p< 0.05). Furthermore, as little as 1000 spheroid cells were sufficient to obtain tumor growth in nude mice, while 1x106 of parental cells was needed to generate tumor.Conclusion: Sphere formation assay is a useful method to enrich cancer stem cells. Spheroid cells showed increasing expression of stemness genes and tumorigenic activity in nude mice.

Background: Helicobacter pylori (Pylori) was the most common cause of chronic gastritis and was linked to peptic ulcer disease and gastric cancer. Environmental factors such as water a reservoir of H.pylori which infect human. a Non-culture bacteria in coccoid forms widespread in aquatic environments.The objective of this study was elevating the diagnostic value of PCR and culture methods for for diagnosis coccoid forms of H.pylori.Materials and Methods: To induce coccoid forms, ten different strains of H.pylori (H1-H10) were inoculated into 30 drinking water samples. Then, the samples were incubated at three different temperatures of 4oC, 22oC and 37oC for the durations of 30 and 60 days. The samples were cultured on brucella blood agar and DNA was also extracted also from them and PCR performed on samples.Results: percentage of H.pylori cells detected at specified temperatures by the culture were 0%, 10% and 0% in the first month and were 0%,10%,30% in the second month whereas by the PCR molecular method were 30%, 80%, and 30% in the first month and were 20%, 20%, and 40% in the second month, respectively.Conclusion: finding show PCR methodis more capable than culture fordetect the coccoid forms of H.pylori, therefore this method could be used to detect non- culture forms.

Background: Dyssynergic defecation disorder (DD) has recognized as the main factor for chronic functional constipation. This was a debilitating disease effective on diverse aspects of physical, psychological and social functions as well as patients’ quality of life generally. Modern studies show positive impact of biofeedback therapy on dyssynergic defecation. This study was evaluated the efficacy of biofeedback on quality of life in patients with dyssynergic defecation.Material and Methods: A total of 30 patients with dyssynergic defecation disorder visited tertiary care centers who were selected. Among them, 15 subjects underwent 8 biofeedback therapy sessions as experimental group and remaining subjects were placed into control group without biofeedback intervention. Both groups participated in pre-test and post-test of 36-item short form survey (SF-36) of quality of life. Data were analyzed and compared by analysis of covariance (ANCOVA).Results: Findings shows that biofeedback therapy was effective on quality of life patients with dyssynergic defecation (p= 0.001) Also, index effect suggested that 53% increased of QOL patients with dyssynergic defecation in experimental group can be related to biofeedback therapy. Also in 8 cases, results indicated that biofeedback therapy was effect on quality of life in patients with DD (p<0.05).Conclusion: Given the results in this study, biofeedback is a long-term effective method to treat with limited side effects in dyssynergic defecation and patients QOL.

Background: Liver cirrhosis was one of the most important liver diseases. Other chronic liver diseases could be lead to liver cirrhosis. Liver cirrhosis could be lead one kind of liver cancers named hepatocellular carcinoma. Cirrhosis in the early stages just by laboratory and imaging testes could be diagnosed. In this study cirrhotic patients were classified based on laboratory symptoms. For this purpose data mining approach has been used in this research. Data mining was an interdisciplinary science that discovers the hidden knowledge in the data.Materials and Methods: We used K-Means algorithm to categorize the statues of cirrhotic patients. In order to determine the quality of clustering results and to find the best number of clusters, we have used silhouette indices.Results: Our data consists of 410 records which have been collected from Dr. Shariati hospital The number of features in this study are .1 items and sampling were divided into two main groups.Conclusion: At first, we have done clustering based on 21 attributes and the average silhouette was 41 percent. We improved the model, in order to reach a reasonable structure. Finally, based on 7 attributes, a reasonable clustering model was derived. The new model provides 64 percent average silhouette, and based on patients'' status, patients are divided into 2 main categories. The risk of HCC in the first cluster is 23 percent and in the second cluster is 14 percent.

Background: Irritable bowel syndrome (IBS) is identified by chronic abdominal pain and altered bowel habits in the absence of organic etiology. Premature ejaculation is the most common male sexual disorder. We aimed to evaluate the frequency of premature ejaculation disorders in patients with IBS referred to a gastrointestinal clinic in Rafsanjan, Iran, in 2012.Materials and Methods: Of all the men referred to the gastrointestinal clinic, those with a diagnosis of IBS (based on Rome-II criteria)were interviewed. Premature ejaculation disorder based on DSM-IV-TR criteria was documented by psychiatry interview. History of psychiatric diseases of the patients and their family were assessed by interview done by a psychiatrist. The data were analyzed by using SPSS software (version 16). Descriptive statistics, inferential tests, and Chi-square test were used for analyses.Results: One hundred and fifty two men with IBS were evaluated. Based on the Rome-II criteria, 89(58.6%) patients were suffering from premature ejaculation disorder. Fifty nine (38.8%) patients expressed drug addiction. Sixty eight (44.7%) had a history of psychiatric disease in the past and 84 (55.3%) patients stated they were not suffering from any psychiatric diseases. Forty six (30.3%) patients had a history of psychiatric disease in their family, and 106 (69.7%) did not have any history of psychiatric disorder. High frequency of premature ejaculation in patients with IBS with a family history of psychiatric disorder and severe stress during the past year suggested that there was a relationship between factors contributing to psychiatric disorders (neurotransmitters, environmental factors, and genetics) and premature ejaculation.Conclusion: Premature ejaculation is more common in patients with IBS. Drug abuse, family history of psychiatric disorder, and severe emotional stress during the past year, significantly increase the frequency of premature ejaculation.

Background: There were few studies reporting simultaneous presence of Helicobacter pylori (H. pylori) in stomach and gallbladder stones, most of which have been conducted on bile specimens or gallbladder tissues. Presence of a chronic inflammatory disease may contribute to gall stone formation through production of inflammatory cytokines. Chronic active gastritis due to H.pylori may contribute to lithogenesis in gallbladder. In this regard, the present study aimed to investigate the frequency and association of gastric H.pylori infection and gallstones in patients who were undergoing upper endoscopy in a teaching hospital.Materials and Methods: In this case-control study patients presenting with dyspeptic symptoms who underwent upper endoscopy during 2008-2012 in Shahid Beheshti Hospital of Babol, northern Iran were enrolled, 72 patients with and 136 patients without gallstones were assigned as the case and control groups, respectively. Patients with history of gastric surgery PPI, and antibiotic consumption four weeks before endoscopy were excluded from the study. Two biopsies were obtained from gastric antrum and body of each patient in both groups and examined histologically for gastritis and the presence of H. pylori. Then, endoscopic, histological and demographic features (age, gender, BMI, smoking, NSAID) in these two groups were compared. The SPSS software (version 18) was used for analysis. P-value of <0.05 was considered as statistically significant.Results: Fifty-two (72.2%) and 98 (72.1%) of all patients with and without gallstone were female, respectively (p=0.7). The mean age of patients with gallstone was 51.8±14 years, while it was 51.1±15 years in patients without gallstone (p = 0.9). H.pylori was detected in gastric mucosa of 31(43.1%) and 45 (33.8%) cases with and without gallstone, respectively. Although H.pylori infection was higher in patients with gallstones, the difference was not statistically significant (p =0.19). In the group with gallstones, 21 (29.2%) patients revealed severe gastritis, and in those without gallstones, 17 (12.5%) patients were found with severe gastritis. This difference was statistically significant (p =0.003, OR=2.88, CI: 1.41-5.91).Conclusion: This study demonstrates that patients with severe H.pylori induced gastritis are likely to have gallstone in comparison with mild gastritis. The frequency of H. pylori infection in patients with gallstones is more than those without gallstones.

Pylephlebitis was a rare condition with high rates of morbidity and mortality. It is defined as thrombosis of the hepatic and portal veins that complicates intra-abdominal infections. however prompt diagnosis plays a significant role in the treatment of pylephlebitis and the disorder can be diagnosed by means of ultrasound or contrast tomography, it was often missed due to nonspecific clinical presentation including fever, abdominal discomfort and fatigue. When it came to treatment, despite controversies about the use of anticoagulants, administration of antibiotics and anticoagulants was still the mainstay of treatment. In this report, we described a 67-year-old man with chief complaint of bouts of high fevers and mild abdominal tenderness located in right lower quadrant. The patient suffered from pylephlebitis secondary to cecal diverticulitis. Our patient’s symptoms did not resolve with antibiotic therapy thus he had surgical resection of the infection focus and received anticoagulation. To put in a nutshell, as early diagnosis and treatment are essential steps for proper management of pylephlebitis and preventing its adverse complications, it is of high importance to keep this differential diagnosis in mind in patients with abdominal sepsis sings.