Govaresh
Volume:20 Issue: 1, 2015

Pancreatic neuroendocrine neoplasms (PNENs) are increasing in the world. The annual incidence of PNETs is nearly 0.25 per 100 000 population. 1-2% of pancreatic neoplasms are PNENs.This article reviewed the available original and review literatures which had been published in Persian and English in websites of Google scholar, Iran doc and Pub Med with keywords neoplasm, pancreas, neuroendocrine and Iran since 1995 to 2014 year. The aim of this article was to compare the clinico-pathological characteristics of Iranian studies (seven articles) with other studies. Prevalence of PNENs was among 30-60 year and there was no gender preference in some studies. Abdominal pain was the most common manifestation of PNENs.60-70% of PNENs was functional in Iran. In mostly of imaging procedures, neoplasm was reported in pancreatic head. These neoplasms were with different rates of growth and aggressive behaviors. The clinical behavior of PNENs could be predicted according to clinical stage, grade and evidence of hormone syndromes. Neoplasm resection could be a cure for PNENs. Mean survival time depended on the extent of disease at diagnosis time and the differentiation of neoplasm. In one report of Iran, survival rate was 48% in non functional PNENs versus nearly 100% in functional PNENs (Insulinoma) during 3 years follow up.A team of specialists is necessary for successful and efficient treatment in PNENs field. Mean survival time in non-functional PNENs is shorter than functional form. Different results in clinical characteristics and neoplasm behavior in several studies maybe due to PNENs heterogeneity in the world. It’s unlikely that could present a prognostic model for PNENs.

Obesity was a dangerous chronic disease. Physicians recommended drug therapy just in a few of obese patients in spite of many health risks. Weight control can be improved comorbidities of obesity like hyperlipedemia, hyperinsulinoma, acanthosis nigricans and hypertension.This article reviewed the available original and review literatures which had been published in English in websites of Google scholar and Pub Med with keywords drug, obesity and adults during 2002 - 2014.Drug therapy could improve obesity treatment after an unsuccessful combination of diet, exercise, and behaviour modification. Choice of treatment was based on multiple factors including the degree of obesity and patient preference. Drug therapy should be selected for a BMI)Body Mass Index (greater than 30 kg/m2, or a BMI of 27 kg/m2 with comorbid conditions including diabetes mellitus, hypertension, dyslipidaemia and heart disease.Prescription of anti-obesity drugs should be monitored carefully. Orlistat was the only drug for the long-term treatment of obesity. The efficacy of lorcaserin appears more than orlistat. Phentermine and diethylpropion are only approved for the short term treatment of obesity. Some antidepressant, antiepileptic, and antidiabetic drugs could be caused weight loss. New generation of anti-obesity drugs were under developing and more focus on the safety and efficacy combination treatments. Weight loss > 12kg reported in few investigational drugs. Some of them were discussed in this article.Obesity treatment is selected based on the side effects risks. Mostly of the available drugs have few side effects which decrease with treatment. There isn’t a cure drug treatment for obesity now.

KRAS and BRAF gene mutations are considered as key events in carcinogenesis progression of colorectal cancer. Given the importance of these gene mutations evaluations, especially in metastatic patients, in terms of determination of therapeutic strategies, we studied the prevalence of KRAS and BRAF mutations in Tabriz city.Deoxyribonucleic Acid (DNA) extracted from Fresh tumor and normal tissues of 30 primary CRC patients. Direct sequencing method, was the method for determining the mutation points of KRAS exon 2 and BRAF exon 15 genes. After mutation analysis, the clinical and pathological associations of mutant genes were assessed.The prevalence of KRAS gene mutation was 20 %(6 out of 30 cases) in this study, and none of patients had the mutant BRAF gene. The odds ratio of the KRAS gene mutation in high grade CRCs was 2.1(95% CI: 1.34 to 3.29). The same ratio for metastasis was 1.1(95% CI: 0.93 to 1.25). There was no significant relationship between the mutation and clinical and pathological aspects of the disease.The high occurrence of early onset of colorectal cancer in Iran demands more attention to screening and prevention programs in the younger age group in the country. However further genetic studies are needed at the molecular level and large population in different geographical areas.

The main purpose of the present paper is to examine the effectiveness of acceptance and commitment therapy on perceived stress, stress coping strategies and illness perception in women with Ulcerative Colitis.This is an experimental study performed as pretest and post-test. The population consists of woman suffering from Ulcerative Colitis in Isfahan. The sample includes 37 Colitis selected by multi-stage random sampling and randomly assigned to experiment and control groups (control=20, experimental=17). The acceptance and commitment therapy was performed in the experimental group within two months once a week. The tools applied by this study include Perceived Stress Scale, Brief Illness Perception Scale Stress Coping Strategies Scale and Brief Illness Perception Scale.The results of this research showed that the means of coping strategies in experimental group has changed significantly in comparison with control group (p<0/05). Thus, the acceptance and commitment therapy could be used along with other methods of the treatment for the women with Ulcerative Colitis.

Halitosis generally refers to the unpleasant odor of breath irrespective of its origin. Oral malodour could result in diverse problems in daily life such as social embarrassment and can adversely affect individuals’ social interactions. Though many oral and non-oral sources could give rise to halitosis, it was mainly associated with oral cavity conditions and volatile sulfur compounds –produced by microbial activity- were the main elements of oral malodor.Objective measurement was the first step in assessment to determine presence of malodour. Then, taken a complete history including diet and habit history and performing a comprehensive physical examination contribute to the primary two steps for evaluating a patient complaining.The oral malodor management was mainly achieved by determining and eliminating the etiology of the condition. A major step in this regard was improving the oral health by means of establishing appropriate oral hygiene measures and controlling tongue flora by brushing or scraping and also, use of antiseptics as adjuvant therapy.Current article was systematic reviews the literature on prevalence, classification, diagnosis and treatment of halitosis.

Despite the prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH), no treatment has been proven to be effective in these common diseases. Although many studies have shown that lifestyle modifications such as increasing physical activities and exercise could be effective in the treatment of these common diseases, the optimal strategy is still not determined. According to the beneficial effects of antioxidant agents in the treatment of NASH, vitamin E has been used for this purpose by some clinicians. We designed this study for assessing beneficial effects of regular physical activity on the biochemical and imaging responses in patients with NASH and comparing this with vitamin E as an accepted treatment for NASH.Randomized and single-blind clinical trials were carried out in Gonbad-e Kavus through which a total of 30 consecutive patients with the ultra sonographic diagnosis of non-alcoholic steatohepatitis (NASH) were enrolled and randomized to one of the three arms: Vitamin E 800 mg/day, regular physical activity, or both. Significant improvement in liver transaminases level and ultrasonographic grading of fatty liver occurred in all groups after 3 months of treatment although there was no considerable difference between the treatment groups in these responses (ANOVA: P>0.5).There were no significant differences between exercise and vitamin E alone or in combination regarding the reduction in the level of liver enzymes and sonographic evidences of fatty liver although both resulted in significant improvements in biochemical endpoints. This implies that physical activity could be considered as effective as vitamin E in the improvement of biochemical and ultrasonographic presentations of NASH and the addition of Vitamin E does not offer any benefits. According to the findings of this pilot study a full-powered study with a control group should be designed.

Inflammatory bowel diseases (IBD) were systemic disorders involving many organ systems. Besides intestinal manifestations, extra intestinal manifestations (EIMs) including neurologic complications have been reported among 6%-40% of IBD patients.Ulcerative colitis (UC) was a subtype of IBD only affecting the colonic mucosa and sub mucosa. Although the EIMs of UC could affect any organ system, central and peripheral neurological manifestations were relatively rare.Here, we described a case of UC and concurrent primary sclerosing cholangitis (PSC) who complained about paresthesia and weakness of his upper and lower limbs for the past two months. Through physical examination revealed decreased muscle tone in his legs and arms. Electrophysiological studies were compatible with the diagnosis of chronic mixed polyneuropathy which improved after administration of intravenous immunoglobulin (IVIG) and the patient was discharged in good general condition.Although both immunologic and non-immunologic mechanisms we considered to play a role in development of neuropathies, further investigations were still required to accurately understand the underlying mechanism.

Wernike encephalopathy(WE)caused by thiamine deficiency was a critical but reversible disorder. It can be occurred after acute pancreatitis due to prolonged fasting. WE after acute pancreatitis was rarely suspected and diagnosed at early stages. We reported a 44 year-old woman with severe acute pancreatitis who developed altered mental status and bilateral nystagmus and ophthalmoplegia soon after 14 days of fasting. The brain MRI confirmed the diagnosis. After empiric treatment with thiamine all of the neurological symptoms reversed except only some antegrade and retrograde amnesia. In this case report considering thiamine deficiency in any patients with fasting and neurological symptoms, was addressed since WE was a reversible disorder if it was diagnosed in early stage.