Is the prevalence of celiac disease higher than the general population in inflammatory bowel disease?

In some studies inflammatory bowel disease [IBD] and celiac disease were considered to be associated and some believe that this association may influence the prognosis of IBD. However, there is a considerable controversy regarding this association. Therefore ,we aimed to assess the association of these two common digestive diseases and evaluate the complications of this association. In this comparative study, 200 patients with ulcerative colitis [UC] and 206 patients with Crohn's disease [CD] were evaluated for celiac disease using relevant diagnostic tests and pathologic studies. Total IgA, IgA tissue transgulaminase antibody and specific IgA anti endomysial antibody were asseyed. In cases of IgA deficiency, total IgG and IgG tissue TG and IgG anti endomyseal Ab were measured. Patients with increased specific IgA and IgG antibodies for celiac disease, underwent endoscopy and 4 standard samples were obtained. Our results were compared with the results of the prevalence study of celiac disease in the general population. Data were analyzed using analytic and descriptive statistics at a significance level of 5%. Among the studied patients, 1 patient with UC had elevated IgA anti tTG antibody and IgA anti-endomysial antibody who underwent endoscopy and celiac was confirmed on pathology. Hence, of the 200 patients with UC, the diagnosis of celiac disease was confirmed in 1 patient [1:200] with no significant difference with the prevalence of celiac disease in the general population [1:166]. However, none of our patients with Crohn's disease had celiac disease [0:206]. We found no significant difference in the prevalence of celiac disease between patients with UC and the general population. Since most of our participants had a mild level of Crohn's activation, none of those with Crohn's disease had celiac disease. Complications of IBD including sclerosing cholangitis, may be more common in patients with concurrent celiac disease. Therefore, it is recommended that celiac disease be considered in patients with severe and complicated IBD

Is it Necessary to initiate antibiotic therapy in children with pharyngitis?

Streptococcuscus Beta Hemolytic Group A is the most important pathogen causing which may lead to purulent and non purulent angina. Rheumatic fever is the most important complication that is the cause of 30% to 40% of cardiac disease and disablement. This study was performed to evaluate prevalence of Streptococcuscus Beta Hemolytic Group A and estimate role of clinical findings in children with Streptococcuscus angina diagnosis. antibiotic resistance was also assessed evaluated in the patients with bacterial pharyngitis. Throat culture was performed on 104 patients referred to Amiralmomenin hospital of Semnan at the age range of 5 to 15 years having angina without begin on antibiotic treatment after the completion of the questionnaire. A frequency of 1% have been assessed for Streptococcuscus Beta Hemolytic Group A, coagulase -positive Staphylococci and non-group A Streptococcuscus frequencies were 10.6% and 17.3% respectively. 100% of patients had pharyngeal erythema, 72% had fever, 55% had exudates and 52% had cervical adenopathy. The diagnosed Streptococcuscus was sensitive against penicillin, erythromycin and amoxicillin and resistant against cotrimoxazole. In examining Staphylococcus aureus antibiotic-resistance, only 40% of cases were sensitive to clindamycin and 40% were also sensitive to vancomycin. Very low frequency of group A Streptococcuscus has undermined the routine use of antibiotic and show that the clinical based diagnosis alone is not reliable and rational use of antibiotics requires the use of other diagnostic methods such as throat culture and rapid antigen test [RATs]. Also in analyzing coagulase -positive Staphylococci antibiotic resistance, we can see increased cases of resistance against neomycin and clindamycin which indicates the necessity of rational treatment of patients afflicted by strep to coccal infections