GOVARESH JOURNAL
Year:2008 | Volume:13 | Issue:1 (SN.62)|Papers Count:11

Background: Functional constipation (FC) and constipation-predominant irritable bowl syndrome (CIBS) are two main subtypes of constipation that can be distinguished by the Rome II criteria. Measuring colonic transit time (CTT) is an easy and cost effective way to evaluate constipation. This study was conducted to compare the CTT in patients with FC and CIBS. Materials and Methods: Those patients who referred to our hospital with complaint of chronic constipation were studied and those with no organic disease were included in this study. Using the Rome II criteria, they were then categorized as having FC or C-IBS. All patients ingested 10 radioopaque markers daily for six days. A plain abdominal x-ray was taken on the seventh day. Markers in the right and left hemicolon and rectosigmoid were counted and the total and segmental transit times were calculated and reported in hours. Results: A total of 45 patients with FC and 45 with C-IBS were enrolled into this study. The total CTT was normal in 42% of those with FC and in 55% of those with C-IBS. The mean total CTT was not significantly different between the two studied groups. Nonetheless, the mean rectosigmoid transit time of patients with FC was significantly higher than those with C-IBS (p=0.008). There was no significant difference between the right and left hemicolon transit time. Conclusions: Although the CTT of patients with FC might be higher than those with C-IBS, it seems that applying the Rome II criteria to distinguish these two groups does not affect the selection of treatment strategy.

Background: Food and nutrient are known as main environmental risk factor of esophageal cancer. We investigated food items consumption pattern of people who live in high risk area in Golestan province. Materials and Methods: We investigated food consumption pattern of more than 30 years old Gonbad and Kalale’s people who recruited in Golestan cohort study. Assessment carried out with validated 117 items semi quantitative food frequency questionnaire. Multiple linear regressions used to compare between sex, gender, place and ethnicity. Results Among men, all 17 food groups and items consumption were more than women except for legume and green tea. Among rural dwellers, more than urban dwellers in cereal, meats, process meats, vegetable oil, green tea, sweets and salt consumption and Turkmen ethnicity had more than non-Turkmen in cereals, process meats, diary, animal and vegetable fat, fruits, green tea and salt. Conclusions: Golestan population had higher intake in Cereal and sweets and lower intake in vegetable, fruits, legume and diary in compare to optimal recommended basket.

Background Success of screening programs depends on the people belief health toward the importance and necessity of these programs. This study was conducted to determine the effect of health belief on participation of official administrative personnel of Shiraz University of Medical Sciences with an average risk (age: 40 years) for colorectal cancer in fecal occult blood test (FOBT). Materials and Methods In this sub experimental study 156 subjects were selected using a random cluster sampling and divided randomly into two groups of experimental and control (n=78 for each). In the first stage, the level of knowledge, status of willingness and barriers related to participation in screening program were examined in each of two groups. The intervention program was done according to the health belief model for the experimental group. then, 3 stool samples in different times (randomly) for checking occult blood were collected from the subjects who attended the laboratory. The results were then reported to them. The level of awareness was re-examined by a questionnaire after 3 months. Finally Comparison of level of knowledge and participation before and after intervention was implemented. Results In the two groups studied, only 19 subject (12/18%) very interesting to screening programs. Lack of time in 53 subjects (57/6%) and lack of awareness in 49 (53/2%) were the most common barriers for participation in screening programs (FOBT). In each of two groups, 8 subjects (5/2%) were aware of CRC and screening programs. The mean level of awareness in experimental group changed from1/192 in the before intervention to 11/166 in the after intervention stage. 54 subjects (69/2%) in the experimental group and 3 (3/8%) from the control group participated in the implementation of FOBT. Conclusions Application of the health belief model can significantly increase the level of awareness and participation in screening programs.

Esophageal cancer is the second most common malignancy in Iranian men; it is the third in women. It is killing about 5800 Iranians each year. Squamous cell carcinoma (SCC) is presently the most common type of esophageal cancer accounting for about 90% of all esophageal cancers in Iran. Recent studies in Iran have shown that there is a gradual increase in the incidence of adenocarcinoma of the distal esophagus along with gastric cardia adenocarcinoma. Thirty-five years ago, the age-adjusted incidence rate (ASR) of SCC of esophagus in Gonbad city, Golestan province, Northeast of Iran (>100 per 105 people per year), was found to be one of the highest rates for any single cancer ever reported in the world. Recent studies have shown that the incidence of SCC in Gonbad has declined to less than half of what it was in the past. This decline in the incidence of esophageal SCC is in parallel with improvement in socioeconomic status of people living in this region. According to the recent cancer registry data in Iran, there is still an obvious intra-country variability between the incidence of esophageal cancer in South with an ASR of 3 for men and 2 for women in Kerman and 43 and 36, respectively, in northeastern province of Golestan. The reasons for this very high rate of SCC in northeastern Iran have been the subject of several studies during the last 35 years. According to the results of these studies, the suspected risk factors include low intake of fruits and vegetables, drinking hot tea, consumption of opium products and tobacco, H.pylori infection in stomach, using unhealthy drinking water from cistern and genetic susceptibility. The main suspected mutagens are polycyclic aromatic hydrocarbons (PAH) and N-Nitroso compounds. In order to embark on a primary and secondary prevention of this fatal cancer further prospective studies are presently going on in the northeastern Iran. Golestan cohort study of esophageal cancer with enrollment of 50,000 subjects is now in its follow-up phase. We expect simple and feasible evidence based preventive strategies to be implemented in future from the results of these studies.

Vascular neoplasms are the most common primary splenic tumors that include both benign and malignant variants. One of these variants is hemangioma which is a benign vascular tumor. Hemangiomas are slow growing and large tumors are rare. These tumors are most often incidental findings during imaging studies, laparotomy, or at autopsy. Herein, we report a young lady presented with nausea, vomiting, epistaxis and huge splenomegaly. Imaging studies suggested a hemangioma that was confirmed after splenectomy and pathologic study. In the follow-up, the patient was doing well.

Inflammatory bowel disease (IBD) may begin as early as the first year of life. The objective of the present study was to determine the characteristics and clinical course of children with early-onset IBD. Materials and MethodsThe records of patients with IBD admitted to Children Medical Center Hospital during 2003– 2006 were screened for those with disease onset before the first year of life and who had a follow-up of at least 2 years.Results 12 patients (8 boys, 4 girls) were identified. 9 had Crohn’s disease. All of the patients had colitis. One of parents had IBD in 9 patients; 2 had a positive family history for IBD. 7 patients had weaned of breast fed when the gastrointestinal symptoms started. 10 patients had a severe onset of disease requiring total parenteral nutrition, and steroid followed by azathioprine. 3 patients with Crohn’s disease needed surgery; another 3 with Crohn’s disease died during the study. Of those with ulcerative colitis, one is in complete remission.Conclusions The prevalence of inflammatory bowel disease in infancy is unknown, but appears to be increasing. The course of the disease seems more severe.

Lower gastrointestinal bleeding (LGIB) in children has many different etiologies and is a serious problem that warrants careful diagnostic work-up. Materials and Methods164 colonoscopies were done during one year for determining the etiologies of LGIB in children who was referred to Children's Medical Center Hospital. Analyses of results were based on age, sex, etiology and clinical presentations. Results Of 164 colonoscopies, 34.7% of LGBI were due to polyps which was the most common etiology. Lymphoid nodular hyperplasia (LNH) had a prevalence of 22.5%; in 15.8% of patients, colonoscopic findings were normal. The peak age group of polyps was 4–6 yr; for LNH, itwas 1 yr. Conclusions LNH is more common than polyps in patients presenting with LGIB younger than 3 yrs. In older children, however, polyps are the major cause. Therefore, the diagnostic approach and the need for colonoscopy are different in these two age groups.

BackgroundLindane is an insecticide which is used in commercial insecticides and food containers. Case presentationHerein, we reported on a 62-year-old man with liver cirrhosis 12 years after continuous exposure to lindane gas.The diagnostic workup showed no other possible cause, and findings of liver scintigraphy and clinical manifestations were probably compatible with substance-induced cirrhosis.ConclusionChronic exposure to lindane probably may cause hepatotoxicity and cirrhosis in human.