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Gastroenterology and Hepatology From Bed to Bench Journal - Volume:7 Issue: 3, Summer 2014

Gastroenterology and Hepatology From Bed to Bench Journal
Volume:7 Issue: 3, Summer 2014

  • تاریخ انتشار: 1393/04/10
  • تعداد عناوین: 10
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  • Gabriel Samasca, Genel Sur, Iulia Lupan, Diana Deleanu Page 139
    Many recent studies overshadow the effects of gluten-free diet. Gluten-free diet positive effects were observed in celiac disease patients: increase in body mass index, higher energy intakes, reducing adiposity gain, moderates the risk of the associated complications. However, adhering to a gluten-free diet is difficult for many people. A new solution is needed for quality of life of celiac disease patients, not for celiac disease treatment. Health education on gluten-free diet at home and in society seems to be the solution. The aim of our study is to evaluate the recent research on gluten-free diet as anutritional therapy for patients with celiac disease. To achieve this purpose we have analyzed the published studies from 2008 to the present on nutrition in celiac disease.
    Keywords: Celiac disease, Gluten, free diet, Quality of life
  • Seyed Mohammad Ebrahim Tahaei, Seyed Reza Mohebbi, Pedram Azimzadeh, Abbas Behelgardi, Azar Sanati, Parvaneh Mohammadi, Mahsa Khanyaghma, Armin Hosseini Razavi, Afsaneh Sharifian, Mohammad Reza Zali Page 144
    Aim
    The aim of this study was to determine the prevalence of HDV infection between HBV chronic patients referred to gastroenterology ward of Taleghani hospital Tehran, Iran and also investigating the risk factors in acquiring the HDV infection.
    Background
    Hepatitis B virus (HBV) and Hepatitis D virus (HDV) are major public health issues. Worldwide there are approximately 350 million individuals chronically infected with the HBV. A significant part of them, including 15 to 20 million coinfected with HDV. Hepatitis Delta virus is transferred mostly through blood and body fluids. Patients and
    Methods
    HBV and HDV infections were evaluated by Enzyme-linked immunosorbent assay (ELISA).Liver functional tests were assessed through auto analyzer. Patients were interviewed and data along the test results were entered into SPSS program. We used chi-square, independent t-test and logistic regression for statistical analysis.
    Results
    278 (54.6%) patients of the study group were male and 231 (45.4%) were female and the mean age of patients was 40.03 ± 14.93. From 509 patients, 39(7.7%) had anti-HDV antibody. In a uni-variable analysis, age (p=0.001), periodontal procedures (p=0.015), endoscopy (p=0.024) and colonoscopy (p=0.012) were significantly related to HDV seropositivity. After adjustment by logistic regression, age remained the only significant factor in acquiring HDV infection.
    Conclusion
    We highly recommend the health care workers to strictly follow the disinfection protocols of medical instruments. Since HDV seroprevalence changes over time, regular epidemiological studies are necessary to monitor the epidemiological trend of infection.
    Keywords: Prevalence_Hepatitis B virus_Hepatitis D virus_Iran
  • Mohammad Javad Ehsani Ardakani, Mohammad Aghajanian, Amir Ahmad Nasiri, Hamid Mohaghegh, Shalmani, Homayoun Zojaji, Iradj Maleki Page 151
    Aim
    The aim of this study was to compare the half-dose and full-dose triple therapy regimens for Helicobacter pylori (Hp) eradication in patients with end-stage renal disease.
    Background
    H. Pylori is one the most important causes of dyspepsia in patients with end-stage renal disease (ESRD).Patients and
    Methods
    Sixty-six patients with ESRD were enrolled in the study with Hp infection and peptic disease with a need of Hp eradication. Patients were randomly assigned to full-dose (A=35 patients) or half-dose group (B=31 patients). Patients received clarithromycin 500 mg, amoxicillin 1000 mg and omeprazole 20 mg twice daily in group A and clarithromycin 250 mg and amoxicillin 500 mg twice daily and omeprazole 20 mg once daily in group B for two weeks. Patients provided stool samples 4 weeks of completing study to assess the success of Hp eradication by Hpspecificstool antigen. Finally, the rate of eradication and complications were compared between two groups.
    Results
    The successful Hp eradication was achieved in 26 patients (74%) in group A and in 22 patients (74%) in group B. The difference between 2 groups was not statistically significant (p=0.973) (per protocol analysis).
    Conclusion
    Half-dose triple-therapy with clarithromycin, amoxicillin and omeprazole is as effective as full-dose tripletherapy to eradicate the Hp in patients with ESRD. According to lower toxicity level, complications and cost in halfdose regimen in this subset of patients, this protocol is advised.
    Keywords: Helicobacter pylori, Triple therapy regimens, Dictation
  • Mehran Rogha, Mozhdehalsadat Zahiri Esfahani, Amir Houshang Zargarzadeh Page 156
    Aim
    We aimed to evaluate the efficacy of a synbiotic containing Bacillus Coagulans in treatment of IBS.
    Background
    Some studies have shown the efficacy of probiotics in the treatment of irritable bowel syndrome (IBS).Patients and
    Methods
    Adult IBS patients (n=85) were randomized to receive a synbiotic containing Bacillus Coagulans or placebo for 12 weeks. Frequency of IBS symptoms including abdominal pain (scored 1 to 7), and diarrhea and constipation (scored 1 to 5) was evaluated before and after the intervention and then after nine months follow-up.
    Results
    Twenty-three patients in the synbiotic group and 33 patients in the placebo group completed the study (age = 39.8±12.7 years, 78.6% female). After treatment, more reduction in abdominal pain frequency was observed with synbiotic compared with placebo (score reduction 4.2±1.8 vs. 1.9±1.5, P<0.001). Diarrhea frequency was decreased in the synbiotic group, but not in the placebo group (score reduction 1.9±1.2 vs. 0.0±0.5, P<0.001). Decrease in constipation frequency was the same between the two groups (score reduction 0.9±1.2 vs. 0.8±1.1, P=0.561). After nine months follow-up, abdominal pain frequency was decreased (P=0.016), constipation frequency was increased (P<0.001), and diarrhea frequency remained unchanged in the synbiotic group (P=1.000). In the placebo group, abdominal pain frequency was increased (P<0.001), constipation frequency remained unchanged (P=0.553), anddiarrhea frequency was increased (P<0.001).
    Conclusion
    Bacillus Coagulans improves abdominal pain and diarrhea in IBS patients. Further studies on a larger sample of patients are warranted.
    Keywords: Irritable bowel syndrome, Probiotics, Prebiotics, Synbiotics, Therapy
  • Mitra Sharbatkhori, Ehsan Nazemalhosseini, Mojarad, Fatemeh Cheraghali, Fatemeh Soghra Maghsoodloorad, Heshmatolla Taherkhani, Mohammadali Vakili Page 164
    Aim
    The present study was performed in order to differentiate E. histolytica and E. dispar in children from Gorgan city, using a PCR method.
    Background
    Differential detection of two morphologically indistinguishable protozoan parasites Entamoeba histolytica and E. dispar has a great clinical and epidemiological importance because of potential invasive pathogenic E. histolytica and non-invasive parasite E. dispar.Patients and
    Methods
    One hundred and five dysentery samples were collected from children hospitalized in Taleghani hospital in Gorgan city. The fecal specimens were examined by light microscopy (10X then 40X) to distinguish Entamoeba complex. A single round PCR amplifying partial small-subunit rRNA gene was performed on positive microscopy samples to differentiate E. histolytica/ E. dispar and E. moshkovskii from each other.
    Results
    Twenty-five specimens (23.8%) were positive for Enramoeba complex in direct microscopic examination. PCR using positive controls indicated E. histolytica and E. dispar in two (2/25, 8%) and three (3/25, 12%) samples, respectively.
    Conclusion
    There is a warrant to performing molecular diagnosis for stool examination at least in hospitalized children in order to prevent incorrect reports from laboratories and consequently mistreating by physicians.
    Keywords: Entamoeba histolytica, Entamoeba dispar, children, dysentery, PCR, Gorgan, Iran
  • Nader Pestechian, Hamidullah Rasekh, Mohammad Rostami, Nejad, Hossein Ali Yousofi, Ahmad Hosseini, Safa Page 168
    Aim
    The aim of this study is to investigate the molecular identification of Giardia lamblia in patients with diarrhea.
    Background
    Giardiasis caused by Giardia lamblia is a common intestinal disease. Although this parasitic infection found in mammals including human, pets and livestock, but few species within the genus Giardia can infects humans. G. lamblia have seven complex genotypes termed (A-H). Genotype A and B the main causes of human infections. Patients and
    Methods
    Sixty seven microscopically positive G. Lamblia samples were collected from clinical laboratories in Isfahan province between June 2013 and February 2014. Extraction of genomic DNA was performed for 65 concentrated cysts and 2 cultured trophozoites. Partial sequences of tpi including 148-bp and 81-bp were amplified for detection the genotypes A and B using RFLP- PCR protocol respectively.
    Results
    PCR results showed that out of 67 patients with giardiasis infection, genotype A (148 bp) was detected in 40 isolates (59.70%) compared to genotype B (81 bp) isolated was detected in 25 isolates (37.31%). Also two isolates (2.98%) had mix infection infected with genotype A and B. By comparing the frequency of genotype A (81.8%) and genotype B (13.6%), we found that genotype A is six times higher prevalence than genotype B in patients with diarrhea.
    Conclusion
    We suggest that using sensitive techniques and larger sample for detection of G. lamblia genotypes and their subtypes would be necessary for investigation the immune system respond and correlation with diarrhea in the future studies in Iran.
    Keywords: Giardia lamblia, Tpi, PCR, RFLP, Iran, Isfahan
  • Sauid Ishaq, Sanaa Ismail, Saad Ghaus, Roope., Zahra, Kamran Rostami Page 173
    Here we describe the second reported case of cannabinoid hyperemesis in UK. A 42 years old patient presented on more than one occasion with vomiting, abdominal pain, fever and dehydration and treated as sepsis with antibiotics. Extensive investigations including upper GI endoscopy, colonoscopy, chest X-ray, abdominal ultrasound, abdominal CT scan, barium swallow and echocardiogram; all reported normal. Once the diagnosis ofcannabinoid hyperemesis was established, he was advised to abstain from cannabis use resulting in complete resolution of his symptoms.
    Keywords: Cannabinoid hyperemesi, Endocannabinoids, Thermoregulatory
  • Irappa Madabhavi, Apurva Patel, Mukesh Choudhary, Asha Anand, Harsha Panchal, Sonia Parikh Page 177
    Hepatocellular carcinoma (HCC) is the most common, malignant tumor of the liver. Hepatocellular carcinoma (HCC) commonly metastasizes to the lungs, abdominal lymph nodes, adrenal glands, or bones. Distant lymph node metastases are rare in hepatocellular carcinoma. A 49-year-old male patient presented with right sided neck mass. On examination there was right cervical lymphadenopathy and hepatomegaly. Excisional cervical lymph node biopsy showed metastatic carcinoma. However, further examination of the biopsy specimen for immuno-histochemistry markers, shows positivity for HepPar-1 & CD-10 suggestive of hepatocellular carcinoma. Considering the high incidence of HCC in Asia, a special attention should be given to such unusual site of presentation and metastasis of HCC; therefore, not to miss the diagnosis.
    Keywords: Metastatic, Hepatocellular carcinoma, Cervical lymphadenopathy
  • Shabnam Shahrokh, Mohammad Reza Zali Page 183
  • David Al Dulaimi Page 186