GOVARESH JOURNAL
Year:2003 | Volume:8 | Issue:4|Papers Count:9

Background and Aim: The purpose of present study was to evaluate endoscopic features, prevalence of complications, response to treatment and necessity of the endoscopy in the patients with gastroesophageal reflux disease (GERD) symptoms. Materials and Methods: We selected the patients with GERD symptoms in Amiralmomenin hospital from 1381 to 1382. 277 cases were tested in this study. Group 1, (116 cases) after endoscopy and RUT, Group 2, (161 Cases) without endoscopy were treated by nonpharmacological recommendations and omeprazole 20 mg – bid for three months. Multiple visits were performed after one, two and three months after initiation of treatment.The presence of GERD symptoms was mentioned in the questionnaire. The result of treatment (absence of heartburn, regurgitation) was evaluated in two groups.Results: In the first group, Treatment responses after one, two and three months were 82.8%, 83.6%, 84.5% and in the second group were 83.9%,83.2%,85.7% (P= 0.810, P= 0.931, P= 0.776).Endoscopic features in the first group were normal esophagus (75%), esophagi is G.A (11.3%), esophagi is G.B (6%), esophagi is G.C (1.7%), esophageal ulcer (3.4%), and Barrett's esophagus (2.6%). Treatment responses in the patients with normal esophagus after one, two and three months were 83.9%, 85.1%, 86.2% and in the patients with abnormal esophagus was 79.3% (P= 0.570, P= 0.469, P= 0.374).Conclusions: Normal esophagus was the most prevalent endoscopic feature in the GERD patients. Endoscopic findings have no role in the response to treatment in the patients with GERD symptoms. They can be treated without endoscopy and the successful result is usually obtained.

Introduction: Dyspepsia, gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS) are the most common gastrointestinal diseases. Their prevalence is 18-30%, 25-30% and 10-15% in western communities and 8-14%, 3-7% and 3-5% in eastern countries, respectively. There is no adequate data about their prevalence in our country. The aim of this study is to determine the prevalence of these diseases among Iranian healthy blood donors.Materials and Methods: A total of 3517 [M=3115 (88.6%), F=402 (11.4%)] randomly selected blood donors were enrolled in the study at Tehran blood donation center in 2001. Trained general physicians interviewed them for symptoms of IBS based on Rome I criteria, GERD based on heart burn or acid regurgitation and dyspepsia based on classic symptoms over the past 12 months.Results: Prevalence of ulcer-like dyspepsia was 7.3% (n=259) [M=227 (7.3%), F=32 (8%)]. Prevalence of dysmotility-like dyspepsia was 2.8% (n=98) [M=75 (2.4%), F=23 (5.8%), P<0.001]. Prevalence of GERD at least once a week and once a month was 11.3% and 8/8% respectively without any difference between sex groups. Prevalence of IBS was 4.9% in men and 11.3% in women (P<0.001).Conclusions: All of these diseases are common among Iranian blood donors. Prevalence of dyspepsia is less than the western countries but similar to those of Southeast Asia. Prevalence of IBS and GERD among Iranian blood donors is similar to the western reports but higher than those of Southeast Asia. Prevalence of these diseases in our general population is expected to be higher, because blood donors are usually healthier than the general population.

Introduction: Helicobacterpylori (H. pylori) is a gastric pathogen of primates and causes active chronic gastritis as well as peptic ulcers. A wide range of studies is in effect to prevent or cure Helicobacter infection and thus its associated disorders. In order to test various drug regimens as well as potential vaccines against H. pylori infection, a suitable animal model is required which should be cost-effective, easy to handle, and available in statistically significant numbers. In addition the induced disease should closely mimic that of human disease in both nature and chronicity. Since H. pylori is not a feline pathogen, it does not readily colonize the feline stomach. Various groups have been able to adapt different H. pylori strains to the mouse stomach and create varying degrees of Helicobacter-associated gastritis. However, increasing evidence has demonstrated that there are significant differences among H. pylori strains infecting various populations in the world. Therefore, in order to test different drug treatments or potential vaccines for use in a particular population, it is crucial for the animal model to be inhabited by strains from the target population. Hence the model shall mimic the actual environmental situation very closely.Materials and Methods: In order to perform this task, through repeated attempts various clinical isolates of H. pylori have been adapted to the stomach of C57BL/6 mice and the colonization have been confirmed via PCR.Results: Clinical isolates of H. pylori have been adapted to the stomach of C57BL/6 mice and represented different levels of gastric inflammation. Induced infection was treated with routine anti-H. pylori drugs regimens and the histopathological changes were removed.Conclusions: Histopathologic studies demonstrated that the resulting gastric inflammation mimics that of humans and consists of both an active as well as a chronic inflammatory component. Furthermore application of anti-H. pylori antibiotic treatment in the H. pylori infected mice resulted in the eradication of infection and the resolution of the gastritis. Therefore, the resulting mouse model possesses most if not all of the required characteristics for a suitable animal model for H. pylori infection and can thus be used for testing various preventive and/or therapeutic regimens.

Background: Helicobacter pylori (H. pylori) infection and non-steroidal anti-inflammatory drugs (NSAIDs) are two major causes of gastroduodenal mucosal damages. The results of the epidemiological studies in relation to interaction between H. pylori and NSAIDs on the development of mocusal damages are conflicting. The present study was designed to determine the association of H. pylori and NSAIDs with peptic ulcers (PU) and gastrointestinal bleeding (GIB). Materials and Methods: Patients with acute GIB and patients with dyspepsia who have referred for upper endoscopy were assessed with regard to history of using NSAIDs and H. pylori infection. In statistical analysis the frequency of gastroduodenal lesions and GIB were determined and compared. The association of peptic ulcers and GIB with H. pylori and NSAIDs was determined by calculation of odds ratio (OR).Results: 104 patients with GIB and 102 dyspeptic patients with mean ages of 48±20 and 44±18 years respectively were studied. 51% of patients with GIB and 34 % of patients with dyspepsia were taking NSAIDs (P<0.025). The risk of doudenal ulcer (DU) and bleeding in NSAIDs users was significantly higher than non-users (OR=4.3, P=0.021); and (OR=2.54, P=0.012) respectively. H. pylori infection was also associated with increased risk of DU compared with non-infected patients, (OR=23.33, P=0.000), but the risk of GU and bleeding in H. pylori infected patients was significantly lower than non-infected patients (OR=0.18, P=0.019). Presence of both H. pylori and NSAIDs significantly increased the risk of DU (OR=20.57, P<0.000) but non-significantly decreased the risk of GU (OR=0.38, P<0.193) without increasing the risk of GIB. H. pylori infection in NSAIDs users compared with non-infected users significantly increased the risk of DU (OR=4.78, P=0001) and decreased the risk of GU (OR=0.18, P=0.015), the risk of GIB did not increase significantly (OR= 0.54, P=013).Conclusions: The findings of this study show that, either H. pylori or NSAIDs increase the risk of DU and bleeding, but H. pylori infection has a protective effect in reducing GU and bleeding in NSAIDs users and non-users.

Introduction and Aim: Gastroesophageal Reflux Disease (GERD) and Irritable Bowel Syndrome (IBS) are important diseases, which are increasing in frequency and capable of impairing the quality of life to the same extent or even more than severe organic gastrointestinal diseases.These disorders have a significant burden on the health care system. The aim of this study was to determine the prevalence of GERD symptoms and IBS among Tehran University students.Materials and Methods: This study was performed in 2001. All 3100 student of Tehran University were invited to participate to the study. Interviews were conducted with 3008 students. Major symptoms of GERD (heartburn, acid regurgitation) and symptoms of IBS (based on Rome Criteria I) during the previous 12 months were questioned.Results: The mean age of participations was 19±2.1 years. The prevalence of IBS was 4.2% (n=127). About 9% (n=272) had one or more episodes of GERDa week.

Hemophiliac patients carry a high risk for blood born viruses particularly hepatitis C virus (HCV) infection. With introducing the new therapeutic modalities for HIV infection, the role of HCV in mortality and morbidity has been more prominent. HIV co-infection is a well known factor that accelerates the progression of liver injury leading to end stage liver failure. Screening of hemophiliacs has a great importance, since infected patients must be marked, evaluated, followed, and treated if required as soon as possible. The clinicians must periodically screen the patients for anti-HCV Ab in serum. Anti- HCV seropositive cases must be tested for HCV RNA. In addition, HCV genotype identification has a main role in making therapeutic decisions. Combination therapy with Interferon plus Ribavirin is recommended to treat HCV infected patients, and seems to have the comparable results in hemophiliacs as in general HCV infected patients. Recently, a new long acting generation of Interferon called Peg-IFN has been introduced showing better efficacy.

Introduction: Due to the whole network of polyposis registers worldwide and early prophylactic treatment, survival of familial adenomatosis (FAP) patients is improved. Extracolonic manifestations are remarkable feature of FAP. Two extracolonic manifestations (duodenal adenomatosis, leading duodenal cancer and desmoid tumours) play a very important role in the reasons of death in polyposis population.Materials and methods: Data from the Lithuanian Polyposis Register, containing 90 FAP cases from 38 unrelated families (as stated on 2004.01.01) was used. Indirect ophthalmoscopy (fundoscopy) was performed on 19 FAP patients, orthopantomography - on 22, upper gastrointestinal tract endospopy on 21, distal small bowel examined in 11. 42 patients were examined for desmoid tumours and epidermoid cysts.Results: In 18 (94.7%) of 19 examined CHRPE was detected, in 15 (68.2%) of 22 -mandibular osteomas. Out of 21 examined, 3 (14.3%) had fundic gland polyposis and 14 (66.7%) duodenal adenomas. Distal ileal polyposis was present in 8 (72.7%) of the 11 patients. Out of 42 live FAP patients, 4 (7.1%) had desmoid tumors and 8 (14.3%) had epidermoid cysts.Conclusions: Extracolonic manifestations are typical in FAP. Some of them have negative impact on morbidity and mortality of FAP patients and demand special surveillance and treatment.

A fifteen-year-old Torkaman girl with Turner’s mosaic kariotype is presented. She has had congenital esophageal stenosis with severe dysphagia since birth and iron deficiency anemia in addition to other classical features of the syndrome. According to authors knowledge this is the first report of a new congenital structural gastrointestinal anomaly with this disease.