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سال:1396 | دوره:22 | شماره:1 |تعداد مقالات:9

Background:Providing ways for long-term feeding is essential for those who are not able to ingest. Percutaneous endoscopic gastrostomy(PEG) is a type of enteral feeding methods. The aim of this study was to evaluate the complications, indications, and one-yearsurvival of this method in patients who underwent PEG.Materials and Methods:The cross-sectional study was carried out on 97 patients (census sampling) who had referred to Shahid Sadoughi Hospital in Yazd(Iran) for PEG tube placement in the period of March 2014 to March 2016. Data were collected using a researcher-made questionnaireand were analyzed using SPSS software version 18.Results:Cerebrovascular accident (CVA) was the most reason to refer to the hospital (52 cases, [%53.6]) followed by head and necktrauma (32 cases [33%]), head and neck tumors (6 cases, [6.2%]), ischemic encephalopathy (5 cases, [5.2%]), and burning (headtrauma) (2 cases [1.2%]). Wound infection was observed in eight cases (8.2%), aspiration in three cases (1.3%), bleeding in threecases (3.1%), external leakage in two cases (2.1%), unplanned removal in two cases (2.1%), subcutaneous abscess in one patient(1%), and recurrent vomiting in one patient (1%). One year survival was measured 83.5%.Conclusion:PEG tube is a very convenient feeding method. Its complications are limited compared with its benefits and it is useful for patientswho have trouble in ingestion for a long time. Early discharge from the hospital, especially the intensive care units, reduces costsand length of hospital stay.

Background:Hepatitis delta virus (HDV) is an RNA virus that causes hepatitis. Since HDV is dependent on hepatitis B virus (HBV) for itspathogenesis, two major types of HDV and HBV infection is coinfection with HBV in anti-HBs negative individuals, or superinfectionin chronic HBV carriers. Therefore, the prevalence of HDV depends on the frequency of HBV infection in various populations.In this study, we aimed to systematically review the prevalence of HDV in Iran.Materials and Methods:A systematic literature search was performed in August 2016 in PubMed, Scopus, and Iran Medex using the following keywords(((hepatitis delta virus OR HDV)) AND (prevalence OR frequency OR distribution OR epidemiology)) AND Iran to investigatethe prevalence of HDV in Iran. After literature search and selection of appropriate documents, the desired data were extractedand described.Results:A total of 14 articles with overall 6300 study population with HDV infection were collected. The results of this study showed thatthe prevalence of HDV varied from zero in the north to 19.7% in the south of Iran (in HIV infected patients).Conclusion:The prevalence of HDV was relatively high among Iranian patients with chronic HBV infection. Furthermore, the results of thisstudy showed that the prevalence of HBV/HDV coinfection has increased during the last decade in Iran.

A 48-year-old man was found to have elevated liver enzymes and clinical manifestations of icter, itching, nausea, and vomiting. He had developed a servere hepatotoxic reaction, liver fibrosis, and cirrhosis after treatment with acitretin 25 mg daily (oral retinoid, which is the derivative of etretinate). Elevated serum aminotransferase levels, which are usually reversible, have been reported during treatment with acitretin, however; the present study indicates a warning message that severe hepatotoxic injury may follow such a treatment.

Lower gastrointestinal bleeding refers to bleeding within the lumen of the gastrointestinal tract located below the ligament ofTreitz. In this study, we present a case with bleeding from massive anorectal varices, caused by a congenital high pressure Portosystemicshunt.A 31-year-old man with a prolonged history of painless rectal bleeding was referred to our center. The onset of symptoms was atthe age of two years. Finally, he underwent semi-elective surgery due to severe bleeding and a diagnosis of portosystemic shuntwas made intraoperatively.