فهرست مطالب

Govaresh
Volume:19 Issue: 3, 2014

  • تاریخ انتشار: 1393/08/04
  • تعداد عناوین: 8
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  • Maryam Hashemian, Fatemeh Mohammadi Nasrabadi, Azita Hekmatdoost, Hosein Poustchi, Reza Malekzadeh* Pages 155-166
    Irritable Bowel Syndrome is the most common functional gastrointestinal disease and is among the most common reasons for outpatients doctor visit both in primary and specialty clinics. Except for some changes in functional brain imaging and some mild GI mucosal inflammation there is no gross structural changes or pathological finding. Patients suffer from lifelong chronic abdominal pain, diarrhea, constipation, bloating and flatus often associated with anxiety depression with significant opposing effect on the quality of life and will force the patients to use the healthcare system repeatedly and induce a huge cost for health care system. It will also result in abstinence from work and its economic consequences. There are no known underlying cause, but stress, childhood problems, infections and neurotransmitter changes in brain and genetic susceptibility, have been implicated as potential risk factors. The diagnosis is challenging but could almost always be made positively without extensive work up. A minimal preliminary work up in patients who don’t have the alarming symptoms may be necessary. Treatment of irritable bowel syndrome is symptom based and  is one the most challenging aspect of clinical practice. Recently there is accumulating evidence in favor of dietary therapy as one of the cheapest and most effective therapy for IBS. We aimed to look at the recent literatures about the role of diet in therapy of IBS.Â
    Keywords: Irritable Bowel Syndrome, Nutrition Therapy, Diet, Oligosaccharides, Glutens, Dietary Fiber, Prebiotics, Probiotics, Phytotherapy
  • Samaneh Khorrami, Ahmad Zavaran Hosseini, Seyed Javad Mowla, Reza Malekzadeh Pages 167-174
    Background
    Proliferation and expansion of cancer stem cells as spheroids were proved in previous studies. But, capability of primary tumor-derived stem cells to keep their unique properties in vitro is still disputed. So, the goal of this study was to isolate, expand and characterize of colon cancer-derived stem cells.
    Material And Methods
    In the present work, colon cancer stem cells markers including CD44 and EPCAM in spheroid and parental cells were analyzed by flow cytometry. The expression levels of stemness genes in both spheroid and parental cells were investigated using real-time PCR. Tumorigenic potential of spheroid cells was evaluated and used implantation of tumor xenografts into nude mice.
    Results
    Our data shows 79% of spheroids were CD44+/EpCAM+, while parental cells only expressed 20% of CD44/EpCAM markers (p< 0.01). In compared with the parental cells, the expression levels of ‘‘stemness’’ genes, like Sox2, Oct4, Nanog, C-myc, and Klf4 were significantly increased in spheroid cells (p< 0.05). Furthermore, as little as 1000 spheroid cells were sufficient to obtain tumor growth in nude mice, while 1x106 of parental cells was needed to generate tumor.
    Conclusion
    Sphere formation assay is a useful method to enrich cancer stem cells. Spheroid cells showed increasing expression of stemness genes and tumorigenic activity in nude mice.
    Keywords: Cancer stem cells, Colon cancer, Spheroid, CD44, EPCAM
  • Somayeh Allahkarami *, Mohammad Hassan Shahhosseiny, Nasim Hayati Roodbari, Davood Esmaili Pages 175-181
    Background
    Helicobacter pylori (Pylori) was the most common cause of chronic gastritis and was linked to peptic ulcer disease and gastric cancer. Environmental factors such as water a reservoir of H.pylori which infect human. a Non-culture bacteria in coccoid forms widespread in aquatic environments.The objective of this study was elevating the diagnostic value of PCR and culture methods for for diagnosis coccoid forms of H.pylori.
    Materials And Methods
    To induce coccoid forms, ten different strains of H.pylori (H1-H10) were inoculated into 30 drinking water samples. Then, the samples were incubated at three different temperatures of 4°C, 22°C and 37°C for the durations of 30 and 60 days. The samples were cultured on brucella blood agar and DNA was also extracted also from them and PCR performed on samples
    Results
    percentage of H.pylori cells detected at specified temperatures by the culture were 0%, 10% and 0% in the first month and were 0%,10%,30% in the second month whereas by the PCR molecular method were 30%, 80%, and 30% in the first month and were 20%, 20%, and 40% in the second month, respectively.
    Conclusion
    finding show PCR methodis more capable than culture fordetect the coccoid forms of H.pylori, therefore this method could be used to detect non- culture forms.
    Keywords: Helicobacter pylori, coccoid, PCR, Culture
  • Sasan Zarrabi, Omid Rezaei, Nasser Ebrahimi Daryani Pages 182-190
    Background
    Dyssynergic defecation disorder (DD) has recognized as the main factor for chronic functional constipation. This was a debilitating disease effective on diverse aspects of physical, psychological and social functions as well as patients’ quality of life generally. Modern studies show positive impact of biofeedback therapy on dyssynergic defecation. This study was evaluated the efficacy of biofeedback on quality of life in patients with dyssynergic defecation.
    Material And Methods
    A total of 30 patients with dyssynergic defecation disorder visited tertiary care centers who were selected. Among them, 15 subjects underwent 8 biofeedback therapy sessions as experimental group and remaining subjects were placed into control group without biofeedback intervention. Both groups participated in pre-test and post-test of 36-item short form survey (SF-36) of quality of life. Data were analyzed and compared by analysis of covariance (ANCOVA).
    Results
    Findings shows that biofeedback therapy was effective on quality of life patients with dyssynergic defecation (p= 0.001) Also, index effect suggested that 53% increased of QOL patients with dyssynergic defecation in experimental group can be related to biofeedback therapy. Also in 8 cases, results indicated that biofeedback therapy was effect on quality of life in patients with DD (p<0.05).
    Conclusion
    Given the results in this study, biofeedback is a long-term effective method to treat with limited side effects in dyssynergic defecation and patients QOL.
    Keywords: Biofeedback, Dyssynergic defecation, Quality of life, Functional constipation
  • Mina Pazouki, Mohammad Mehdi Sepehri, Mehdi Saberifiroozi Pages 191-197
    Background
    Liver cirrhosis was one of the most important liver diseases. Other chronic liver diseases could be lead to liver cirrhosis. Liver cirrhosis could be lead one kind of liver cancers named hepatocellular carcinoma. Cirrhosis in the early stages just by laboratory and imaging testes could be diagnosed. In this study cirrhotic patients were classified based on laboratory symptoms. For this purpose data mining approach has been used in this research. Data mining was an interdisciplinary science that discovers the hidden knowledge in the data.
    Materials And Methods
    We used K-Means algorithm to categorize the statues of cirrhotic patients. In order to determine the quality of clustering results and to find the best number of clusters, we have used silhouette indices.
    Results
    Our data consists of 410 records which have been collected from Dr. Shariati hospital The number of features in this study are. 1 items and sampling were divided into two main groups.
    Conclusion
    At first, we have done clustering based on 21 attributes and the average silhouette was 41 percent. We improved the model, in order to reach a reasonable structure. Finally, based on 7 attributes, a reasonable clustering model was derived. The new model provides 64 percent average silhouette, and based on patients'' status, patients are divided into 2 main categories. The risk of HCC in the first cluster is 23 percent and in the second cluster is 14 percent.
    Keywords: Liver cirrhosis, Data mining, clustering, K, means, Silhouette
  • Mohammad Asad Pour, Vahid Mirzaei, Reza Bidaki*, Ali Asghar Ghorbani, Seyed Ali Mostafavi, Mohammad Hossein Salehishahrbabaki, Alireza Arab Alidousti, Zahra Rajabi, Mohammad Ali Abdolkarimi Dawarani Pages 202-207
    Background

    Irritable bowel syndrome (IBS) is identified by chronic abdominal pain and altered bowel habits in the absence of organic etiology. Premature ejaculation is the most common male sexual disorder. We aimed to evaluate the frequency of premature ejaculation disorders in patients with IBS referred to a gastrointestinal clinic in Rafsanjan, Iran, in 2012.

    Materials And Methods

    Of all the men referred to the gastrointestinal clinic, those with a diagnosis of IBS(based on Rome-II criteria)were interviewed. Premature ejaculation disorder based on DSM-IV-TR criteria was documented by psychiatry interview. History of psychiatric diseases of the patients and their family were assessed by interview done by a psychiatrist. The data were analyzed by using SPSS software (version 16). Descriptive statistics, inferential tests, and Chi-square test were used for analyses.

    Results

    One hundred and fifty two men with IBS were evaluated. Based on the Rome-II criteria, 89(58.6%) patients were suffering from premature ejaculation disorder. Fifty nine (38.8%) patients expressed drug addiction. Sixty eight (44.7%) had a history of psychiatric disease in the past and 84 (55.3%) patients stated they were not suffering from any psychiatric diseases. Forty six (30.3%) patients had a history of psychiatric disease in their family, and 106 (69.7%) did not have any history of psychiatric disorder. High frequency of premature ejaculation in patients with IBS with a family history of psychiatric disorder and severe stress during the past year suggested that there was a relationship between factors contributing to psychiatric disorders (neurotransmitters, environmental factors, and genetics) and premature ejaculation.

    Conclusion

    Premature ejaculation is more common in patients with IBS. Drug abuse, family history of psychiatric disorder, and severe emotional stress during the past year, significantly increase the frequency of premature ejaculation.

    Keywords: Premature ejaculation, Irritable Bowel Syndrome, Psychiatric disorders, Drug abuse
  • Javad Shokry Shirvani, Sepideh Siadati *, Mostafa Molai Pages 208-211
    Background
    There were few studies reporting simultaneous presence of Helicobacter pylori (H. pylori) in stomach and gallbladder stones, most of which have been conducted on bile specimens or gallbladder tissues. Presence of a chronic inflammatory disease may contribute to gall stone formation through production of inflammatory cytokines. Chronic active gastritis due to H.pylori may contribute to lithogenesis in gallbladder. In this regard, the present study aimed to investigate the frequency and association of gastric H.pylori infection and gallstones in patients who were undergoing upper endoscopy in a teaching hospital.
    Materials And Methods
    In this case-control study patients presenting with dyspeptic symptoms who underwent upper endoscopy during 2008-2012 in Shahid Beheshti Hospital of Babol, northern Iran were enrolled, 72 patients with and 136 patients without gallstones were assigned as the case and control groups, respectively. Patients with history of gastric surgery PPI, and antibiotic consumption four weeks before endoscopy were excluded from the study. Two biopsies were obtained from gastric antrum and body of each patient in both groups and examined histologically for gastritis and the presence of H. pylori. Then, endoscopic, histological and demographic features (age, gender, BMI, smoking, NSAID) in these two groups were compared. The SPSS software (version 18) was used for analysis. P-value of <0.05 was considered as statistically significant.
    Results
    Fifty-two (72.2%) and 98 (72.1%) of all patients with and without gallstone were female, respectively (p=0.7). The mean age of patients with gallstone was 51.8±14 years, while it was 51.1±15 years in patients without gallstone (p = 0.9). H.pylori was detected in gastric mucosa of 31(43.1%) and 45 (33.8%) cases with and without gallstone, respectively. Although H.pylori infection was higher in patients with gallstones, the difference was not statistically significant (p =0.19). In the group with gallstones, 21 (29.2%) patients revealed severe gastritis, and in those without gallstones, 17 (12.5%) patients were found with severe gastritis. This difference was statistically significant (p =0.003, OR=2.88, CI: 1.41-5.91).
    Conclusion
    This study demonstrates that patients with severe H.pylori induced gastritis are likely to have gallstone in comparison with mild gastritis. The frequency of H. pylori infection in patients with gallstones is more than those without gallstones.
    Keywords: Helicobacter pylori, Dyspepsia, Biopsy, Gallstone
  • Sanam Javid Anbardan, Hossein Ajdarkosh, Zahra Azizi, Nasser Ebrahimi Daryani* Pages 212-216
    Pylephlebitis was a rare condition with high rates of morbidity and mortality. It is defined as thrombosis of the hepatic and portal veins that complicates intra-abdominal infections.however prompt diagnosis plays a significant role in the treatment of pylephlebitis and the disorder can be diagnosed by means of ultrasound or contrast tomography, it was often missed due to nonspecific clinical presentation including fever, abdominal discomfort and fatigue.When it came to treatment, despite controversies about the use of anticoagulants, administration of antibiotics and anticoagulants was still the mainstay of treatment.In this report, we described a 67-year-old man with chief complaint of bouts of high fevers and mild abdominal tenderness located in right lower quadrant.The patient suffered from pylephlebitis secondary to cecal diverticulitis. Our patient’s symptoms did not resolve with antibiotic therapy thus he had surgical resection of the infection focus and received anticoagulation.To put in a nutshell, as early diagnosis and treatment are essential steps for proper management of pylephlebitis and preventing its adverse complications, it is of high importance to keep this differential diagnosis in mind in patients with abdominal sepsis sings.
    Keywords: Pyle phlebitis, Portal vein thrombosis, Abdominal infection, Diverticulitis