ABSTRACT
Background: Ideal bowel preparation regimen for a suitable colonoscopy should be safe, and well tolerated, and should rapidly clear gastrointestinal tract. Soluble polyethylene glycol [PEG] is the most common cleansing drug and Senna or C-Lax [Cassia angustifolia Vahl] is an alternative herbal one. This study was designed to compare the efficacy of PEG and C-lax in bowel preparation
Methods: In this randomized double blind trial [registry number in IRCT.ir: IRCT201601161264N7], 320 patients were randomly assigned in PEG or C-lax groups. PEG solution was prepared from 5><70 gr sachets in 20><250cc water [250 ml every 15 minutes], prescribed 24h before the colonoscopy. In the other group 3x60 ml C-lax syrup glasses [each containing 90 mg senozid B] was given in two divided doses [1.5 glasses of 250cc every 12 hours], 24h before the colonoscopy. Ottawa score was used to evaluate the quality of bowel preparation. Chi-square test, Student t test, Mann-Whitney test and multivariate analysis were used to analyze the data
Results: Of these patients with the mean [SD] age of 50 [15.16] years, 162 [50.8%] were men. Mean [SD] Ottawa score was 2.57 [0.2] and 3.15 [0.31] in the PEG and C-lax group, respectively [p value = 0.81]. Multivariate analysis showed that less opium consumption [p < 0.001] and higher educational level [p =0.005] were associated with better bowel preparation
Conclusion: C-Lax is non-inferior to PEG solution in cleansing colon. The quality of bowel preparation was lower in opium consumers and better in those with higher educational level
Subject(s)
Humans , Male , Female , Middle Aged , Polyethylene Glycols , Cathartics , Gastrointestinal TractABSTRACT
Background: Upper gastrointestinal bleeding [UGIB] is a major healthcare problem and is the most frequent gastrointestinal reason for admission to hospital. We aimed to investigate the prognosis of patients with UGIB referred to a referral hospital in northern Iran in 2013
Methods: All patients with UGIB who admitted to Sayyad Shirazi Hospital, in Gorgan, northern Iran, in 2013 were enrolled. The patients' demographic data as well as data about admission, diseases, drug history, and patients' prognosis were collected by structured questionnaire using information in hospital files. The relationships between different factors with the proportion of mortality and recurrence were assessed using Chi-square test
Results: In total, 168 patients were enrolled of whom 109 [64.9%] were male. The mean [SD] age of the patients was 59.4 [18.2] years. Mortality and recurrence occurred in 23.2% and 34.5% of the subjects, respectively. We found significant relationships between older age and diagnosis of malignancy with mortality [p =0.03 and p <0.01] and recurrence [p<0.01 and p <0.01]
Conclusion: We found relatively high rates of mortality and recurrence among patients with UGIB. Our results suggested older age and diagnosis of malignancy as the most important indicators of mortality and recurrence in such patients. Considering these factors in clinical settings may result in better and more effective management of patients with UGIB
ABSTRACT
BACKGROUND Only a few studies in Western countries have investigated the association between gastroesophageal reflux disease [GERD] and mortality at the general population level and they have shown mixed results
This study investigated the association between GERD symptoms and overall and cause-specific mortality in a large prospective population-based study in Golestan Province, Iran
METHODS: Baseline data on frequency, onset time, and patient-perceived severity of GERD symptoms were available for 50001 participants in the Golestan Cohort Study [GCS]
We identified 3107 deaths [including 1146 circulatory and 470 cancer-related] with an average follow-up of 6.4 years and calculated hazard ratios [HR] and 95% confidence intervals [CI] adjusted for multiple potential confounders
RESULTS: Severe daily symptoms [defined as symptoms interfering with daily work or causing nighttime awakenings on a daily bases, reported by 4.3% of participants] were associated with cancer mortality [HR 1.48, 95% CI: 1.04-2.05]
This increase was too small to noticeably affect overall mortality
Mortality was not associated with onset time or frequency of GERD and was not increased with mild to moderate symptoms
CONCLUSION: We have observed an association with GERD and increased cancer mortality in a small group of individuals that had severe symptoms. Most patients with mild to moderate GERD can be re-assured that their symptoms are not associated with increased mortality
ABSTRACT
Cholelithiasis rarely occurs in children but the increased use of ultrasonography has led to increased detection of gallstones in patients. The epidemiology and predisposing factors of cholelithiasis vary in different populations. The aim of this study was to describe the clinical presentation, predisposing factors and to evaluate management and outcome of patients referred to Amirkola Children's Hospital jn Babol. This cohort study was performed on children with cholelithiasis referred during 2000 to 2011. Cholelithiasis was diagnosed with ultrasonography. The data was obtained based on history, physical exam, clinical and paraclinical investigations and analyzed by SPSS version 18. P-value <0.05 was considered being significant. From the 66 patients with cholelithiasis, 39 [59.1%] were males. The mean age at diagnosis was 6.6 +/- 4.5 years. The most common predisposing factor included ceftriaxone therapy [27.3%], hemolytic diseases [13.6%], hepatobiliary diseases [7.5%] and cystic fibrosis [7.5%]. In 30.3% of patients, no predisposing factor was detected. The most common complaint was abdominal pain [67%]. Among the patients in whom abdominal X-Ray was performed, only 20% had radiopaque gallstones; 6 [9%] patients underwent cholecystectomy. According to this study, ceftriaxone therapy and hemolytic diseases were the most common predisposing factors in children with cholelithiasis in our area and cholecystectomy had not been needed in most patients
ABSTRACT
Hepatocellular carcinoma [HCC] is very rare during pregnancy and has a worse prognosis in pregnant women compared to those who are not pregnant. We present a case of HCC in a 41- year-old pregnant patient who was referred to our academic hospital. The patient presented with chief complaints of abdominal pain, jaundice, ede-ma and hypertension. Laboratory results were notable for elevated liver enzymes and features of microangiopathic hemolytic anemia with normal alpha fetoprotein [AFP] and elevated cancer antigen 125 [CA125]. At laparotomy for termination of pregnancy, multiple massive lesions were detected in the liver. Histologic evaluation showed features of HCC. HCC must be included in the differential diagnosis of any pregnant patient who presents with elevated liver enzymes and hemolysis.
ABSTRACT
Scientomery is one of the common methods for the assessment of scientific activity of researchers and research organizations, usually using databases. In this study, Web of Science, as one of the authoritative scientific databases, was reviewed to explore science production of IUMS researchers from 1976 to 2006. This was a descriptive cross-sectional study, using a checklist for data collection. The checklist was validated by experts. A total of 488 scientific documents produced by IUMS researchers from 1976 to 2006 were retrieved from Web of Science Database. Data were analyzed using descriptive analysis and book-assessment method. Findings showed that most publications were made during the year of 2006. The most common subject was [peripheral circulation]. The science production of IUMS researchers appeared in ISI journals is not considerable. More incentives should be provided to encourage researchers for more publication in ISI journals