Comparison of oral and intravenous proton pump inhibitor on patients with high risk bleeding peptic ulcers: a prospective, randomized, controlled clinical trial

Proton pump inhibitors [PPIs] decrease the rate of rebleeding following endoscopic hemostatic therapy in patients with bleeding peptic ulcers. This study compares the efficacy of oral omeprazole vs intravenous pantoprazole in decrease of rebleeding of peptic ulcer patients. One hundred and six patients with high risk peptic ulcer were randomized to receive either oral omeprazole [80 mg BID for 3 days] or IV pantoprazole [80 mg bolus and 8 mg/hour infusion for 3 days] followed by omeprazole [20 mg each day for 30 days]. All patients underwent upper endoscopy and endoscopic therapy within 24 hours. Seventeen patients were excluded from the study. Forty four patients were randomly allocated into omeprazole group and 41 patients to IV pantoprazole group. Both groups were similar for factors affecting the outcome. Bleeding reoccurred in five patients of omeprazole group and four patients in pantoprazole group [11.4% vs 9.8%]. The mean hospital stay and blood transfusion were not different in both groups. Oral omeprazole and IV pantoprazole had equal effects on prevention of rebleeding after endoscopic therapy in patients with high risk bleeding peptic ulcers

Outcome and characteristics of patients on the liver transplant waiting list: Shiraz experience

The only curative therapy for end-stage liver disease is transplantation but due to a shortage of available donor livers the waiting list mortality is high. This study aimed to evaluate the outcome and characteristics of patients on the waiting list for liver transplantation in Shiraz, southern Iran during the period from April 2004 to March 2007. Medical records of all chronic liver disease patients >/= 14 years that were on the waiting list for liver transplantation at the Nemazee Hospital Organ Transplant Center during April 2004 to March 2007 were reviewed. Hospital records were used to retrieve demographic, clinical and laboratory data. Records of the referring gastroenterologists provided information about the etiology and complications of liver disease. The patients were followed at the end of the study period by clinic visits or telephone contact. There were 646 patients on the waiting list for liver transplant during April 2004 to March 2007. Hepatitis B was the most common etiology of liver disease [31.2%]. Of those on the waiting list, 144 patients 22.3%] underwent liver transplant and 166 [25.7%] died while waiting for a transplant. The mean waiting period for transplant was 6.6 months. Receiving a transplant was correlated with the etiology of liver disease and Rh blood group [p<0.05] but had no significant association with gender or ABO blood type. Among non-transplanted patients, survival was lower in those who had a history of encephalopathy, SBP or uncontrolled ascites and in patients with a Child-Turcotte-Puph [CTP] class C and/or a Model of End-stage Liver Disease [MELD] score >/= 15. Hepatitis B virus is the most common cause of end-stage chronic liver disease amongst patients on the waiting list for liver transplant in Shiraz, southern Iran. Patients with a MELD score >/= 15 particularly those with a history of SBP, hepatic encephalopathy or uncontrolled ascites are recommended for waiting list enrollment

Prevalence and quality of life in Qashqai migrating nomads with irritable bowel syndrome in southern Iran

Irritable Bowel Syndrome [IBS] is an important public health problem, owing both to its high prevalence and its impact on the quality of life. The purpose of this study was to investigate the prevalence and risk factors of IBS and its relationship to life style in Qashqai migrating nomads with a different lifestyle in Fars province, southern Iran. In summer 2006, 748 Qashqai migrating nomads aged 25 years or more were enrolled, using a multiple-stage stratified cluster random sampling method. A questionnaire consisting of demographic data and IBS symptoms was completed for each subject. For about 50% of them, SF 36 questionnaire was also completed. The prevalence rate of IBS was 11.8% and there was a close relationship between IBS and the life quality. The prevalence of IBS in Qashqai migrating nomads was higher than the urban population in the area with a close relationship to the life quality