Govaresh
Volume:27 Issue: 2, Summer 2022

The incidence of complications after endoscopic retrograde cholangiopancreatography (ERCP) is a worrying and costly factor for the patient and the medical staff. Few studies have examined the complications of ERCP and its prevalence in Iran. This study aimed to investigate these complications in Imam Khomeini Hospital in Ahvaz in 2018-2019.

This was a retrospective study based on hospital information. The information of the patients referred to Imam Khomeini Hospital in Ahvaz, who had undergone ERCP, was examined from 2018 to 2019.

In 300 patients studied, the observed complications were 1.7% bleeding, 12.7% pancreatitis, 4.7% perforation, 0.3% breaking and trapping of the guidewire, 1.3% cardiopulmonary complications, and 0.7% decreased level of consciousness following low O2Sa. In 78.7% of the patients, there were no complications. Two patients died of ERCP-induced complications, both due to esophageal rupture. There was no significant difference between the mean age of the patients and their sex according to the type of complication.

This s tudy showed that pancreatitis, bleeding, perforation, cardiopulmonary complications, guidewire fracture, occlusion, and decreased level of consciousness following low O2Sa were among the most crucial ERCP complications in patients undergoing ERCP in Imam Khomeini Hospital in Ahvaz

Eps tein-Barr virus (EBV) primary infection and/or reactivation are suggested to play a significant role in the incidence of pos t-transplantation lymphoproliferative disorders (PTLD( and some other complications in immunocompromised patients, especially organ recipients. We assessed EBV viral load in EBV/PTLD suspected liver transplant recipients at specified times after transplantation and evaluated the respective clinical findings and post-transplant complications.

Of 696 patients who underwent liver transplantation, the EBV viral load of 127 patients suspected of EBV infection/disease was examined intermittently in this retrospective study. Sampling was performed over a 4-year period from July 2013 to May 2017 using Taq-Man Real-Time Polymerase chain reaction (PCR( assay. Clinical and pathological data were gathered through the review of medical records.

The most common and leading cause of liver transplantation was HBV end-stage with 12% frequency; however, in 39% of patients, the underlying disease was unknown. In total, 78 out of 127 (61%( suspected patients exhibited EBV-DNemia, and 19 of them were associated with PTLD. The median viral load in patients with PTLD was significantly higher than in non-affected patients )4035 copy/mL vs. 500 copy/mL, P<0.05(. Among the PTLD cases, 13 were living, and six expired. Of the non-PTLD cases, 57 were living, and two expired. Totally, PTLD was diagnosed clinically in 34 subjects (4.9%(. The estimated mortality rate in patients with PTLD was 35% during 1.5 years post-transplantation follow-up.

We concluded that monitoring of EBV load might detect EBV infection/disease in liver transplant suspected recipients even several weeks before the onset of any manifestation, especially in pediatric cases in whom PTLD incidence and its mortality are high.

The purpose of this study was to examine the effectiveness of logotherapy on mental pain, adherence to treatment, and abdominal pain in patients with irritable bowel syndrome.

The design of the current s tudy was quasi-experimental, which included three s tages of evaluation. In the firs t stage, the research questionnaires were completed by patients of both groups (pre-test). In the second stage, logotherapy was performed for eight sessions of 90 minutes with an interval of once a week on the experimental group by a psychotherapist (Ph.D in psychology and trained in therapy), and then the questionnaires were completed by the patients in both groups (post-test). In the third stage, 2 months after the end of the treatment sessions, the ques tionnaires were finally completed by the patients of both groups (follow-up).

There was a significant difference in reducing abdominal pain and increasing treatment adherence between the experimental and control groups in the post-test phase. These results were also stable in the follow-up phase (P>0.05).

Logotherapy reduced the mean of mental pain and abdominal pain and increased the mean of adherence to treatment in the post-test s tage. The effectiveness of treatment in the follow-up stage has also been stable. According to the results of the study, logotherapy is effective on the variables of mental pain, adherence to treatment, and abdominal pain in patients with the constipation-dominant type of irritable bowel syndrome. This type of psychotherapy can be used to examine other variables in such patients or in patients with other symptoms (diarrhea and mixed)

The outbreak of a novel coronavirus in Wuhan, China, in December 2019 led to a global crisis and a critical threat to the health of millions of people worldwide. Existing research indicates that besides typical respiratory symptoms and signs of COVID-19, gastro- intestinal manifestations are also caused by coronavirus disease 2019 (COVID-19) and the main intention of this article is to compare the gastrointestinal disorders seen in patients infected by the virus as well as study the possible and logical mechanisms that may lead to these situations. The high rate of contagion of the virus and the number of current patients reveal the importance of this research and all other studies related to this subject.

Non-alcoholic fatty liver disease (NAFLD) is a common disorder leading to severe medical conditions such as liver failure or malignancy. Given the potential relation between sleep disturbance and NAFLD, we aimed to investigate the association between the deterioration of sleep and liver stiffness with NAFLD.

In this cross-sectional study, 134 patients who were proven to have NAFLD were included. Liver stiffness was determined by transient elastography, and sleep patterns were evaluated using Pittsburg Sleep Quality Index (PSQI).

The results showed that sleep disorder was more prevalent in women (P = 0.007), and they had higher liver stiffness than men (P = 0.001). Habitual Sleep Efficiency: The adequate sleep time was worsened in patients with more severe liver stiffness (P = 0.037). Also, Subjective Sleep Quality that is the self-estimation of patients about sleep quality, was reversely related to liver s tiffness (P = 0.003). Categorized liver stiffness groups had a negative association between sleep quality and liver stiffness (P = 0.001), but there was no significant association between liver stiffness and sleep latency, sleep duration, and daytime dysfunction or using sleeping pills.

The present study indicates that bad sleep habits and poor sleep quality correlate with increased liver stiffness in patients with NAFLD, suggesting that patients' lifestyle modification can improve the quality of their lives and prevent more severe disorders caused by sleep dysfunction

Ulcerative colitis is a gastrointestinal disease with a chronic inflammatory condition. Therefore, psychological therapies to better adapt to this disease are considered vital and cause a significant improvement in psychological and physiological symptoms of patients with ulcerative colitis. This study aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and mindfulness-based stress reduction (MBSR) on physiological symptoms, pain perception, and the general health of patients with colitis in three independent groups: (i) ACT, (ii) MBSR, and (iii) the control. The efficacy of ACT and MBSR were also compared immediately after treatment and 2 months later.

This quasi-experimental study was performed on 45 patients with colitis after examining the inclusion and exclusion criteria and drops of the subjects. They were equally divided into three groups: ACT, MBSR, and control. They completed the McGill Pain Perception, General Health Questionnaire (GHQ-28), and the Partial Mayo Scoring Index Assessment. For statistical analysis, SPSS software version 24 with a significance of P<0.05 was used.

The results indicate that both treatments effectively affect physiological symptoms, pain perception, and colitis's general health. In reducing physiological symptoms and pain perception, no significant difference between the two treatments was reported in the post-test. However, ACT was more effective and had a longer-lasting effect on general health.

ACT and MBSR effectively reduce the symptoms of colitis, but ACT is more effective in general health.

Patients with cirrhosis need multi-dimensional care, coordinated care for their drugs, vaccinations and laboratory monitoring, scheduling of screening endoscopy, and imaging. However, with the advent of covid-19, these processes have been disrupted. The aim of this study was to review the applications of heath information technology in the management of liver cirrhosis before and after the outbreak of COVID-19.

This review study was performed without time limitation by searching ProQuest, PubMed, Science Direct databases, and Google Scholar. The study steps include identifying research objectives and defining search strategy, identifying relevant research ar- ticles, selecting research articles, extracting data, summarizing, discussing, analyzing, and reporting results.

Finally, seven articles related to the pre-epidemic of COVID-19 and two post-epidemic articles were selected and analyzed in the related tables. The results show that the used technologies have benefits such as disease improvement, prevention of disease complications and providing routine services such as virtual visits, counseling, prescribing and reminding of drug doses and also effective potential in diseases management by maintaining social distancing and preventing the spread of infection in the period before and after the COVID-19 outbreak.

The prevalence of COVID-19 epidemic is an opportunity to use information technology capabilities to manage patients with liver cirrhosis. Telehealth service providers consider that a favorable way to better management of liver cirrhosis, especially during an epidemic. IT-based approaches provide specialized liver and gastrointes tinal services for all patients, regardless of distance.

Hydatidosis, a zoonotic infection of the larval stage of Echinococcus granulosus, has a worldwide distribution. Due to the late onset of clinical manifestation, the cyst can involve the greater part of the tissue. This case study was performed on a massive hydatid cyst (HC) (85×115mm), reported in a 39-year-old woman. She was referred to the clinic with right upper quadrant pain and gastric pressure. Magnetic resonance imaging (MRI) revealed that the vast space of the liver had been occupied by the massive cyst in the right lobe of the liver. Routine liver assays were normal. IgG enzyme-linked immunoassay (ELISA) test using antibody was negative (0.19 mg/dL). Resection laparoscopic surgery was scheduled for the patient due to severe pain. The massive HC was confirmed in microscopic examination of the cyst.

The infection caused by Echinococcus can affect various organs of the body, especially the liver. A 66-year-old woman with a 5-year history of hepatic hydatid cyst was referred to the hospital with the symptoms of new-onset severe abdominal pain without abdominal tenderness and distension. The results of Doppler ultrasound and triphasic computed tomography scan of the abdomen and pelvis showed right and left hepatic venous thrombosis with portal thrombosis and giant hydatid liver cysts. The patient received treatment with anticoagulant and albendazole. The extensive involvement of the liver due to hydatid cyst, the invasion of hydatid cyst to the portal vein, and the resulting portal vein thrombosis are rare complications of hydatid cyst that have been reported in less than ten cases to date. The diagnosis and treatment of hydatid liver cyst and its rare complications in infected patients, such as thrombosis, should be critically considered.