[Effect of lactobacillus acidophilus on adults habitual constipation in gastrointestinal clinic of Ghaem Hospital in Mashhad: a pilot study]

Constipation is a common problem in elderly subjects. Probiotics have been suggested to improve intestinal motility and to reduce fecal enzyme activity. In this study, the effect of lactobacillus acidophilus tablets on elderly subjects was compared with placebo. Elderly subjects [n = 48] with chief complaint of constipation were enrolled in a randomly double-blind study. The subjects were divided into 2 groups: control group, receiving placebo every 8 hours for one month, and study group, receiving lactobacillus acidophilus tablet every 8 hours for one month. Subjects with lactose intolerance and other pathologic conditions were omitted. At the end of 4 weeks, all subjects were questioned on the relief of constipation and other symptoms. Response to treatment and complications were compared between the two groups. In subjects receiving lactobacillus acidophilus, 50%[13 subjects] responded well and had relief of constipation, 23.1%[6 subjects] showed relative response and 26.9%[7 subjects] did not respond. In subjects receiving placebo, 40% [6 subjects] had relief of constipation, 13.3% [2 subjects] responded relatively well and in 46.7% [7 subjects] no response was seen [p=0.388]. New signs were observed in 5 subjects [19.2%] receiving lactobacillus acidophilus and 1 subject [6.7%] receiving placebo. After 4 weeks, 2 subjects [7.7%] receiving lactobacillus acidophilus and 1 subject [6.7%] receiving placebo re-experienced constipation. Some relief of constipation could be observed with lactobacillus acidophilus tablets, but there was no significant difference between the two groups

[Two cases of hepatotoxicity due to ketokonazole]

Ketoconazole is an antifungal agent of Imidazole group which is used in different parts of the body, such as skin, nails, vagina, and etc. Hepatotoxicity is one of its potentially fatal complications which can be manifested as cholestasis, hepatitis, and fulminant hepatic failure. Hepatic complications of this drug are usually started during 6 weeks, but also they have been reported up to 6 months after the treatment. If the LFT changes are mild, the treatment can be continued cautiously, however, it is necessary to stop it evident hepatitis and jaundice are to be occurred. In this group, Fluconazole as a new agent doesn't have severe hepatic complications, so it is preferred in many cases. In this study two cases of 36 year old women, died because of fulminant hepatic failure due to Ketoconazole induced hepatitis are reported. In both cases, viral and autoimmune hepatitis have been ruled out. Despite the rarity and irreversibility of Ketoconazole induced fulminant hepatic failure, it is essential in most cases to pay attention to the hepatotoxicity symptoms carefully

causes of upper gastrointestinal bleeding in patients with esophageal varices report of 161 nonalcholic cases

Introduction: It is generally appreciated and continues to be cited in standard textbooks of medicine that the source of Upper gastrointestinal bleeding [UGIB] in-patients with Esophageal Varices [EV] is usually nonvariceal. Although some recent reports are not in agreement with this conclusion, these reports come from western countries in which ethanol is the leading cause of cirrhosis and [EV]. Alcohol per se has many acute and chronic effects on esophagogastroduodernal mucosa, which may be a source of [UGIB]. Therefore conclusions regarding the source of [UGIB] in these patients may not be necessarily true in nonalcoholics with portal hypertension [PH] and [EV]

Material and Method: The aim of this study is to define the sources of [UGIB] in nonalcoholic patients with [PH] an [EV]. Emergency endoscopy was carried out in 161 nonalcoholic patients with cirrhosis and [EV] within 24 hours of a major [UGIB] during a nine years period [1994 - 2002]. Accepted endoscopic criteria for definition of [PHG] mucosal erosions were used

Results: In 153 cases [95%] endoscopy was successful and source of [UGIB] was Clearly documented. In 124 cases [81.1%] varices were the source of bleeding and 29 patients [18.9%] had nonvariceal bleeding

Conclusion: A variety of acute and chronic lesions made up the non-variceal group [DU=41.37%, Garstric and/or duodenal erosions - 27.58% PHG - 20.68%, GU - 10.36%]. In contrast to western reports, source of [UGIB] in Iranian nonalcoholic patients with [PH] and [EV] is usually variceal

[Studying the cause-effect relation between helicobacter pylori and SCC of larynx and hypopharynx]

Objective: helicobacter Pylori has a precipitating role in the ethiopathogenesis of several benign or malignant gastrointestinal and extra- gastrointestinal diseases. The purpose of this study is determining the correlation between Helicobacter Pylori and SCC of larynx and hypopharynx

Method: serum samples of 30 patients with documented laryngeal and hypopharyngeal SCC were analyzed in search of IgG anti-H pylori using Elisa technique. Moreover, as an adjunct study we examined the presence of Helicobacter pylori in the laryngeal tumor mass using appropriate stain and specific culture medium. We did the serologic test in 30 properly matched controls who did not have carcinoma of larynx/hypopharynx

Results: sixty-three percent of the patient group and 26% of the control group were seropositive, which supports the role of H Pylori in the genesis of laryngeallhypopharyngeal cancer [P<0.005, t-test]. The organism was also isolated in one-third of tumoral tissues

Conclusion: helicobacter Pylori infection can be a risk factor for laryngeallhypopharyngeal cancers in the same way as gastric cancer. This might be through a contributing effect with cigarettes and alcohol, or it may be an independent factor. More extensive studies in various communities are recommended

Effects of cisapride on constipation due to spinal cord injury: report of five warfare spinal cord injured patients

Five warfare spinal cord injured patients with intractable constipation are described. Treatment with cisapride [4x10 mg daily] was undertaken. The agent cisapride significantly reduced the oral-anal transit time from 25.2 days to 14.4 days. It also improved other subjective complaints of these patients markedly. No side effects were seen during the tria

Eosinophilic gastroenteritis: report of two cases and review of the English literature

Eosinophilic gastroenteritis is a rarely reported condition. The disease is characterized by peripheral blood eosinophilia, eosinophilia infiltration of the bowel wall to a variable depth, and gastrointestinal complaints. Allergic diathesis can be found in most of the cases. In this article we report two cases with interesting epidemiological characteristics and we will have a brief review of reported cases in the English literature

Phenothiazine-induced severe hypothermia

A fatal case of hypothermia following administration of phenothiazine with subsequent development of pneumonia and sepsis is described. Clinical course is discussed in correlation with characteristic electrocardiograph changes encountered in hypothermic state