Govaresh
Volume:16 Issue: 2, 2011

Irritable bowel syndrome (IBS) is a dise ase or functional gastrointestinal disorder, which appears to be associated with mental disorders, including anxiety. IBS seems to be involved in the creation and prevalence of anxiety, which varies in different societies. The purpose of this study is to determine the prevalence of anxiety and its relationship with IBS among students of Payam-e-Nour Boiene Mieandasht University (Esfahan). This study was a cross-sectional analysis study on 144 students that used a stratified random sampling method. We used the Cattell questionnaire, Rome III criteria and the col laboration of a general physician to measure anxiety. There were 74 (51.4%) female patients. The mean age of all participants was 22.73±2.93 years. The prevalence of disease was 25%, and the prevalence of anxiety was 47.9%. Prevalence was higher in women than in men. Among anxiety disorders, marital and family history of anxiety in a statistically meaningful relationship was observed (p ‹ 0.001). We found a statistically meaningful relationship between a history of anxiety and IBS (p = 0.003). Anxiety seems to be involved in causing disease IBS. and disease prevalence was higher in these students than seen with other studies. We recommend better planning to prevent and promote improved mental health for students.

Many studies have investigated the effects of psychological factors on disease activity in patients with ulcerative colitis (UC). However, the number of studies that have assessed the correlation between immunologic markers of UC and psychological distress are few. Therefore, we designed a study to determine the association between two immuno-biological markers, peripheral/central anti-neutrophilic cytoplasmic antibodies (c-ANCA and p-ANCA), and depressive symptoms, healthy anxiety and personality traits.A total of 108 patients with UC entered the study. p-ANCA and c-ANCA were determined by enzymelinked immunosorbent assay (ELISA) and reconfirmed by indirect immunofluorescence. Severity of UC was classified based on Truelove criteria. Depressive symptoms were measured by the Center for Epidemiologic Studies-Depression (CES-D) Scale, anxiety symptoms by the Hospital Anxiety Depression (HAD) Scale and personality traits were assessed by the Revised Eysenck Personality Questionnaire. Pearson correlation was used to assess the relationship between p-ANCA/c-ANCA and psychological distress. Our results showed that 81.5% of the patients suffered from anxiety, 43.5% suffered from depression and 75% suffered from introvert personality. No patient was positive for p-ANCA. There were 16 patients (14.8%) who tested positive for c-ANCA; 85.2% were negative for c-ANCA. Anxiety was significantly higher in the c-ANCA negative patients. According to our results, only testing negative for c-ANCA correlated with anxiety. However, the high prevalence of anxiety, depression and introversion and their roles in the clinical course and outcomes of the UC shows the need for early psychological intervention in those patients.

BackgroundTo compare the efficacy of a 48 hour infusion of octerotide with a five-day infusion to prevent rebleeding and mortality at one week and one month in patients who present with acute esophageal variceal bleeding.Materials and MethodsPatients who presented to Emam Hospital of Ahwaz Jundishapur University of Medical Sciences that were diagnosed with acute variceal bleeding were commenced on octerotide (50 μg bolus) followed by a continuous infusion of octerotide at a rate of 50 μg/h. All patients underwent emergency endoscopy within eight hours of admission. Only patients diagnosed with bleeding due to esophageal varices that were treated with endoscopic variceal band ligation were randomized to the study. Patients in group A continued the octerotide infusion for 48 hours and those in group B continued octerotide for a total of five days. Rebleeding and mortality was defined according to standard recognized criteria.ResultsA total of 70 patients were randomized, of which 35 were assigned to group A and 35 to group B. Primary hemostasis was achieved in all patients. The mean age of patients in group A was 45.4 years and in group B, it was 46.3 years. There was no rebleeding within one week, however there were three patients who rebled in group A and 2 from group B within one month, which was not statistically significant (p=0.62). The overall effect was not significant between the two treatment groups. In terms of mortality, within one week the p value was 0.14, whereas it was 0.56 at one month. ConclusionAs there is a significant difference in terms of cost, need for infusion pumps and duration of patient stay if octerotide is to be given for a duration of five days, our data suggests that octerotide can be given for 48 hours with no differences in terms of rebleeding and mortality.

Irritable bowel syndrome (IBS) is a common disease; it seems that psychological factors play a role in development and maintenance of IBS. The main purpose of the current study is to compare patients with IBS and healthy individuals regarding anxiety, sensitivity, and neuroticism.Participants included 76 IBS patients (41 female and 35 male) who referred to the Qazvin Bou Ali Sina especial Center and 76 individuals not diagnosed with IBS. All participants filled out the Anxiety Sensitively Scale and Neuroticism subscale of the Eysenk Personality Questionnaire-Revised (short scale).Results showed no significant difference between the two groups in terms of psychological factors. Sampling method and the complex nature of IBS among other factors has been discussed to account for such results.It can be concluded that anxiety, sensitivity, and neuroticism cannot predict the development of IBS.

Helicobacter pylori (H. pylori) plays an important role in the development of peptic and duodenal ulcerations as well as gastric cancer. Several studies have shown a strong association between specific genotypes of H. pylori and gastrointestinal tract diseases. The vacA and cagA genes, which are the putative virulence factors of the bacterium, are important determinants of H. pylori-related diseases. Polymorphisms of the signal peptide (s), middle (m), and intermediate (i) regions of the vacA gene, presence of the cagA, and genetic heterogeneity of the C-terminal motifs of CagA might result in varying clinical outcomes in H. pylori-infected patients. In this review article, the intracellular activities of VacA and CagA proteins, the genetic diversity of the coding sequences of these proteins, their association with clinical outcomes with regard to the status of H. pylori infection in Iran, and future perspectives are discussed.

We report the case of a 40-year-old male patient admitted to the surgery ward in our hospital for recent abdominal pain, abdominal distention and fever. He had a history of similar abdominal pain and distention; for which he had undergone a laparotomy. Laboratory data revealed leukocytosis with eosinophilia (42%). Upper gastrointestinal endoscopy showed diffuse severe erythematous pangastritis. Biopsies were taken from the esophagus which showed 10-15 eosinophils in each high power field. The ascitic fluid was straw-colored and sterile with 90% eosinophils. Therefore, the patient was treated with prednisolone (30 mg/day) and was diagnosed with an eosinophilic gastroenteritis syndrome with subserosal presentation. The patient recovered and eosinophilia improved within a few days.

Hepatotoxicity is a major concern during tuberculosis (TB) drug therapy. Its prevalence ranges from 1%-4% in developed countries to 11.5% in developing countries, and is even higher in countries such as India. Disease mortality is 5%, but can be prevented by early detection. This study reveals the prevalence and outcome of drug-induced hepatitis (DIH) in positive sputum TB patients taking anti-TB drug therapy in Qazvin Province, Iran. This observational, descriptive, retrospective cross-sectional study was done on 324 patients (newly diagnosed cases) with positive sputum TB who took anti-TB drugs as the six months classic regimen Direct Observed Treatment Short course (DOTS) method of isoniazide + rifampin + pyrazinamide + ethambutol or streptomycin for two months followed by isoniazide + rifampin for four months, from 2004-2010. The mean age of the cases was 42±12.1 years (mean±SD). A total of 194 cases (60%) were female and the remaining were male. DIH was seen in 16 cases (4.9%). The mean age of affected cases was 52 years. Liver enzymes had begun to rise 13-45 days after drug therapy (mean=25.25), the peak of the enzyme rise was 287-605 i.u. The enzyme level returned to normal after 14-43 days (mean=23.45) after discontinuation of the drugs. There was no mortality. The prevalence of DIH in our study was 4.9%. Although it was seen more in females over 50, no statistically significant relations were found between DIH and sex or age of the patients. With baseline and biweekly liver enzyme checks and rapid drug discontinuation in raised cases, mortality was not observed.

Anorexia nervosa (AN) is a serious psychiatric illness marked by an inability to maintain a normal healthy body weight. The prevalence of AN comorbid with other psychiatric disorders has been reported to be quite high. Whereas depression and anxiety disorders are the most common comorbid diagnoses in anorexic patients, the dual-diagnosis of anorexia and schizophrenia is a relatively rare condition and is currently understudied. Based on the observations from single case reports or case series, several explanations have been made about the co-occurrence of anorexia and schizophrenia. Here, we present the case of a female patient who developed schizophrenia during an anorexic period, which then progressed to a pattern of disordered eating and body image. This case is rare because the patient had a comorbid diagnosis of AN and schizophrenia. To the best of our knowledge, there are only a few previous case reports in the literature describing an anorexic patient with comorbid schizophrenia. In this case report, the diagnosis of AN is addressed, the definition and significance of similar cases are discussed, and the comorbidity of AN and schizophrenia are reviewed.