[Disseminated strongyloidiasis following high-dose prednisolone administration [a case report]]

Strongyloides stercoralis is a common intestinal nematode that affects 30-100 million people worldwide. It is endemic in Guilan province, northern Iran and especially strikes the rural population. We report the case of a 65-year-old woman living in Guilan province of Iran with a history of diabetes mellitus who was treated with high-dose prednisolone for temporal arteritis. Undiagnosed infestation by this nematode led to disseminated strongyloidiasis and Gram-negative sepsis. Fortunately, early diagnosis and prompt therapy with a proper anthelmintic drug as well as supportive care resulted in an acceptable outcome. All the patients who are candidates for immunosuppressive therapy or planned to receive steroid should be evaluated for strongyloidiasis. Although a stool test is the first and simplest test for this purpose, it may be negative for the parasite despite a large parasitic burden. Thus, physician's awareness should be emphasized and a high index of suspicion required to diagnose this ominous condition by further evaluation [serology, evaluation of duodenal aspirate, endoscopy with biopsy and stool exam with proper culture by an expert, at index laboratories].

Irritable bowel syndrome [IBS] prevalence in medical students of Gilan university of medical sciences

Irritable bowel syndrome [IBS] is one of the most prevalent gastrointestinal disorders, characterized by non-specific symptoms such as abdominal pain and altered bowel habit without any organic pathology. Its prevalence varies in human communities. We performed this study to determine the prevalence of IBS in medical students of Gilan University of Medical Sciences [GUMS]. Medical students of GUMS in 2002 enrolled in this cross-sectional study. Under a schedule they were interviewed by trained general practitioners with structured questionnaire, which based on Rome II criteria. Data was analyzed by SPSS-10 software. Results were presented into percentage and mean +/- SD. Level of significance was denoted as p value less than 0.05. This study included 422 students training in various educational levels of GUMS, 148 [35.1%] males and 274 [64.9%] females whose mean age was 23.7 +/- 2.9 years. Prevalence of IBS was 12.6% [53 of 422 with 95%, CI 9.5%-16.1%]. IBS was more prevalent in females than males [15% [41 of 274] vs. 8.1% [12 of 148]] [p<0.05]. This study shows higher IBS prevalence in medical students than other published Iranian reports. Prevalence of 12.6% in students, who are in active phase of life, necessitates planning to help this population