فهرست مطالب

Govaresh
Volume:16 Issue: 3, 2012

  • تاریخ انتشار: 1390/11/11
  • تعداد عناوین: 8
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  • Nasim Abedimanesh, Mohammadhosein Somi *, Alireza Ostadrahimi, Saeid Abedimanesh Page 151
    Background
    Ulcerative Colitis (UC) is a chronic inflammation of the colon. Patients with UC face numerous physical، psychological، and social problems that are associated with health related quality of life. The aim of this study is to determine the mental stress level and quality of life among UC patients in comparison with a healthy control group، and their relation with clinical and demographic factors.
    Materials And Methods
    This study was a case control، cross-sectional study of 106 patients (53 with UC and 53 healthy people as controls). Patients were selected from the Tabriz Medical Science University Clinic in 2010. Clinical and demographic features data were collected. The general health questionnaire (SF36) was used for the assessment of health related quality of life (HRQOL) and mental stress was measured by the Cohen stress scale.
    Results
    Statistical analyses showed that the quality of life in UC patients was lower than healthy individuals (p=0. 006). There was a direct positive relationship between quality of life and stress levels. Stress levels among women were higher than men in the case group. Disease severity، period of disease، and level of stress were the most important factors that determined the quality of life among patients with UC (p ‹ 0. 05).
    Conclusion
    Perceived HRQOL is impaired in UC patients compared with age- and sex-matched controls. Psychological distress and disease severity are powerful predictors of HRQOL in UC patients.
    Keywords: Quality of life, Ulcerative colitis, Stress
  • Afshin Hoshyar *, Abbas Yazdanbod, Firouz Amani, Samira Matin, Amin Bagheri, Elmira Matin Page 158
    Background
    Colorectal cancer is the most common cancer and the second leading cause of cancer deaths. Annually it is the cause of more than 500000 deaths worldwide. Therefore، detection and treatment of these tumors could potentially enhance recovery and improve prognosis. This study determines the frequency of colorectal tumors among patients who underwent colonoscopies in Imam Khomeini Hospital، Ardabil، Iran.
    Materials And Methods
    This retrospective cross-sectional study was performed on 853 patients who underwent colonoscopies in Imam Khomeini Hospital from November 2008 to September 2010. All patients were evaluated for demographic variables، location and size of tumors by a checklist. The collected data were statistically analyzed by tables، graphs and student''s t-test with SPSS v. 16 software.
    Results
    Among 853 patients who were studied، 432 (50. 87%) were females and 419 (49. 13%) were males. Of these، 45. 4% were less than 50 years of age. The most common cause for patient visits were rectal bleeding (34. 5%) and abdominal pain (20. 2%). The most common complaint among patients with colorectal lesions seen in colonoscopies were rectal bleeding (54. 2%)، abdominal pain (18. 75%)، anemia (10. 4%)، diarrhea (8. 3%)، and constipation (8. 3%). Of all colonoscopies performed، 37. 2% were normal. Lesions of the right colon were seen in 27. 08% and 72. 9% were in the left colon.
    Conclusion
    According to results of this study and the frequency in detecting colorectal tumors، the performance of retrospective studies based on disease risk factors could be effective in decreasing future disease cases.
    Keywords: Colorectal, Colonoscopy, Secum, Sigmoid, Rectum
  • Mahmoud Ebrahimi *, Abbas Esmaeilzadeh Page 163
    Background
    Budd-Chiari syndrome (BCS) is a rare syndrome caused by hepatic venous outflow obstruction. The etiology of BCS differs between western and eastern countries. This article is a review of all published articles in Iranian and international journals regarding different aspects of BCS (prevalence، etiology، and conventional treatments) in Iran.
    Materials And Methods
    In this review، by accessing Med-line and Iran-medex، we have analyzed all relevant articles of BCS. In Iranian and international journals، two original articles and five case reports have been published regarding diagnosis and treatment of BCS in Iran.
    Results
    Some Iranian articles have discussed BCS in Iran. According to these articles، nowadays it is not possible to estimate the prevalence and incidence of BCS in Iran، nor is it possible to define the underlying etiology.
    Conclusion
    The current overview of BCS treatment in Iran is unclear. However، it seems that angioplasty treatment for the removal of mechanical obstructions، such as web obstruction، has been developed in Iran and is generally accepted by Iranian physicians. Web obstruction، according to one Iranian article is the most common underlying cause of BCS among Iranian patients. The lack of available investigations about the status of BCS in Iran necessitates multi-center studies.
    Keywords: Budd, Chiari syndrome, Inferior vena cava, Iran
  • Seyedamir Mousavian, Farhad Mansouri, Ahmad Saraei, Anahita Sadeghei, Shahin Merat* Page 169
    Background
    Hemophilia is a congenital disease resulting in deficiency of clotting factors. For this reason they have a constant need of clotting factors which makes them one of the largest consumers of blood products. Through this blood product use، many of these patients have become infected by hepatitis C virus (HCV). We have studied the seroprevalence of anti-HCV antibody and HCV infection in hemophilic patients refereeing to Iran Hemophilia Society center in Tehran.
    Materials And Methods
    In a cross-sectional study we reviewed files of all hemophilic patients registered in Iran Hemophilia Society center in Tehran from 2003 to 2005. Subjects with available results of anti-HCV antibody were included.
    Results
    Among the 1170 files examined، 1095 contained data on HCV infection status. From these، 802 subjects (72. 3%) had anti-HCV antibodies. Genotype 1 was most common (60%) followed by genotype 3 (38%). Almost 10% of patients with anti-HCV antibodies had a negative HCV RNA by PCR.
    Conclusions
    HCV is very common among hemophilic patients and considering the risk for the patients and their contacts it is necessary to screen all hemophiliacs for HCV and treat if indicated.
    Keywords: Hepatitis C, Hemophilia, Iran
  • Amirali Sohrabpour, Reza Malekzadeh* Page 175
    Gastrointestinal (GI) and hepatic manifestations are not uncommon in patients with systemic lupus erythematosus (SLE). They include nonspecific symptoms as well as serious، life-threatening complications necessitating urgent، aggressive therapy. In addition to direct involvement of the GI system by the disease، many drug-induced side effects and opportunistic infections have GI and hepatic manifestations in these patients. Moreover، autopsy studies indicate a high prevalence of subclinical GI involvement in lupus patients. In this manuscript، the more clinically significant gastrointestinal and hepatic complications are reviewed.
    Keywords: Gastrointestinal manifestations, Hepatic, Systemic lupus erythematosus
  • Rasoul Sotoudehmanesh*, Ali Aliasgari, Morteza Khatibian, Zohreh Movahedi, Zahra Heidari Page 195
    Background
    To compare the efficacy of metronidazole versus placebo in the control of gaseous symptoms inpatients with functional bowel disease.
    Materials And Methods
    In the absence of organic or systemic diseases، all cases with chief complaints of bloating and normal laboratory tests were consecutively enrolled in this double-blind study. Lactase deficiency and bacterial overgrowth were ruled out by the lactose breath test. Patients were randomly assigned to receive either metronidazole or placebo. Demographic characteristics as well as frequency and severity of the patients'' scores (mean total symptom score) before and after therapy، their compliance and drug adverse effects were evaluated. A 50% decrease in the total symptom scores was defined as effective treatment.
    Results
    During one year، 46 patients (17 males، 29 females، mean age: 38. 9 ± 9. 9 years) were enrolled in the study. A total of 23 patients received metronidazole (cases) and 23 received placebo (controls). Two patients in the metronidazole group did not tolerate the drug and one patient in the placebo group did not continue with follow-up. Patients responded similarly to both regimens: 59% of patients in the placebo group and 52. 2% of patients in the metronidazole group had a 50% decrease in their total symptom score (p = 0. 64). Side effects of metronidazole were frequent، but tolerable. Bad taste in the mouth and anorexia were the most common complaints in the metronidazole group.
    Conclusion
    This study showed no difference between placebo and metronidazole in relief of bloating and other related complaints in patients with functional bowel disease.
    Keywords: Irritable bowel syndrome, Antibacterial agents, Colonic Diseases, Functional
  • Hosein Ajdarkosh, Samira Shirzad, Mohammad Taher, Naser Ebrahimidaryani *, Farhad Zamani Page 200
    Lipoid proteinosis (LP) is a rare autosomal recessive disease characterized by the deposition of an amorphous hyaline material in the skin، mucosa and viscera. The classic manifestation is onset in infancy with a hoarse cry due to laryngeal infiltration. Skin and mucous changes develope، and the disease follows a slowly progressive course. In this case report، a 49 year-old man presented with a longstanding hoarseness since childhood، dysphagia and asymptomatic skin lesions. Esophageal biopsy showed the deposition of homogenous eosinophilic hyaline-like material compatible with LP.
    Keywords: Lipoid proteinosis of Urbach, Wiethe, Hoarseness, Skin
  • Hamid Tavakkoli *, Hedyeh Adilipour, Mahboubeh Tavakkoli, Atousa Adibi Page 204
    Flutamide is a non-steroidal antiandrogen commonly used in the treatment of prostate cancer. Severe hepatotoxicity occurs in few patients، yet may be fatal. To date، none of the reported cases of flutamide hepatotoxicity has demonstrated thrombocytopenia and chronic liver disease. We report the case of a 55-year-old male with prostatic adenocarcinoma who developed liver failure after six months of flutamide therapy. The patient was referred with complaints of drowsiness، weakness، fatigue، and nausea in addition to jaundice، ascites، leg edema، splenomegaly، and bilateral pleural effusion. Laboratory findings included thrombocytopenia، hypoalbuminemia، and prolonged prothrombin time، with elevated aminotransferase and bilirubin. Abdominopelvic spiral computed tomography (CT) scan showed ascites and bilateral plural effusion. He discontinued flutamide and ursodeoxycholic acid (UDCA) was started. The patient completely recovered within four months. This was a rare case of flutamide-induced hepatotoxicity in a patient who referred with signs of advanced liver disease and thrombocytopenia. It appeared that UDCA was an effective therapy for flutamide hepatotoxicity.
    Keywords: Hepatotoxicity, F lutamide, Prostatic cancer, Ursodeoxycholic acid