Effects of Ramadan fasting on dyspepsia symptoms

Background: a few studies have shown that during Ramadan, gastrin, pepsin, and acid secretion are increased and some changes in nutrition of fasting people may deteriorate dyspepsia symptoms. On the other hand stopping smoking and alcohol use and probable psychosocial factors may improve dyspepsia symptoms

Materials and Methods: the patients with uninvestigated dyspepsia were enrolled in the study during one month before Ramadan and were followed up during and after Ramadan month. The dyspepsia questionnaires including "The Leeds Dyspepsia Questionnaire [LDQ]" were filled by the patients in three consecutive months. After collecting data they were divided to two groups of fasting and non-fasting and compared using SPSS software

Results: 71 patients finished all three follow up visits [31 fasting and 40 non-fasting]. The decreases in LDQ score have been less from before Ramadan to Ramadan and more from Ramadan to after Ramadan in fasting compared with non-fasting groups, but these changes were not significant [p> 0.05]. Comparing fasting and non-fasting patients, there were not significant differences in score change from before Ramadan to Ramadan or Ramadan to after Ramadan months regarding general satisfaction and various dyspepsia symptoms [p > 0.05] except for epigastric discomfort after meal that was more in fasting group from before Ramadan to Ramadan [p =0.004]

Conclusion: Ramadan fasting has no effects on various dyspepsia symptoms except for epigastric discomfort after meal, which is aggravated. We recommend that patients with dyspepsia can fast during Ramadan but they are advised not to consume large-volume meals in Iftar and Suhur

Assessment of contrast sensitivity and aberrations after photorefractive keratectomy in patients with myopia greater than 5 diopters

This study aimed to assess changes in contrast sensitivity and aberrations in cases of myopia greater than 5.0 diopter [D] who had photorefractive keratectomy [PRK]. In this semi-experimental study, 20 eyes of ten patients were studied. Inclusion criteria were at least 5.0 D of myopia, stable refraction in the past year, no history of refractive surgery, a minimum corneal thickness of 480 micro m, and having surgery in both eyes. Exclusion criteria were the presence of any corneal condition. In addition to the routine tests, aberrometry and assessment of contrast sensitivity was done using the WaveLight Allegro Analyzer and the VectorVision CSV-1000. After PRK using the Concerto Excimer Laser [WaveLight, Alcon], patients were scheduled to have follow-up visits at 1 month, 3 months, and 1 year after surgery. Contrast sensitivity with glare showed an increasing trend only at the spatial frequency of 3 cycles per degree [cpd] [P=0.013]. Contrast sensitivity without glared increased postoperatively at special frequencies of 3, 6, and 18 cpd [P<0.05]. The preoperative level of higher order aberrations root mean square [HOA RMS] of 0.24 +/- 0.08 reached 0.71 +/- 0.25 at 12 months after surgery. Assessment of comma and trefoil showed no significant difference between preoperative and postoperative values, but the amount of spherical aberration changed from a mean preoperative value of 0.0 +/- 0.09 to 0.27 +/- 0.15 at 12 months after surgery. In the treatment of myopia greater than 5.0 D, PRK with the Concerto Excimer Laser can improve contrast sensitivity in certain spatial frequencies. This is while HOA RMS and spherical aberration increase.

[ case report of rare colorectal adenocarcinoma with skin metastasis presentation]

Skin metastasis from abdominal cancers occurs as infiltration or paraneoplastic syndromes. Liver and lung are the most common locations of distant metastases of colorectal cancer [CRC], but CRC skin metastases are very rare. We describe a 55-year old patient with wide spread cutaneous metastasis from a previously treated known case of adenocarcinoma of the colon. Interestingly, liver and lung, as the most common site of metastasis of CRC, had not been involved. Although, skin metastasis is a worse prognostic factor, its occurrence in CRC patient doesn't necessarily present end stage disease. So, it could be treated by early diagnosis of susceptible cutaneous lesions