[Assessing and managing the risk of surgery in patients with liver disease]

Advancements in medical science have led to the development of complex surgeries that improve survival in patients with liver disease. Assessments of the indications and contraindications for surgery and risk factors are the most important steps prior to any surgery in this population. Particular attention is essential to assess for the presence of pre-surgical ascites, hepatic encephalopathy and renal dysfunction. The most important risk factors for that increase mortality include anemia, ascites, hepatic encephalopathy, hypoalbuminemia, hypoxemia, concurrent infections, malnutrition, elevated Child Pugh and MELD scores,portal hypertension, prolonged prothrombin time and type of surgery. Advancements in anesthesiology have prevented surgical complications among patients with liver disease. Increased symptoms of liver failure and complications result in high mortality following surgery. This review article presents useful recommendations for safe surgery among patients with liver disease who are surgical candidates

Correlation of quality of life with gastroesophageal reflux disease amongst Qashqai nomads in Iran

Gastoesophageal reflux disease [GERD] is one of the most common gastrointestinal diseases encountered in today's clinic practice. GERD symptoms are troublesome and disruptive to the physical, social and emotional well-being of many patients. This is a cross-sectional study performed on Qashqai nomads or Fars Province in southern Ian to determine the impact of GERD on quality of life. We randomly selected 748 subjects over the age of25 years. Subjects completed two questionnaires conducted by interviews. The first one consisted of questions on gastroesophageal reflux symptoms. The second questionnaire was the Short Form Health Survey [SF-36], a generic health-related quality of life instrument that consists of 36 items divided into eight dimensions. It has a 0-to 100 point scale where higher scores show better functioning and well-being. Of 748 Qashqai migrating nomads who participated in the study, 717 subjects [mena age: 43 +/- 14.2 years] completed the GERD questionnaire and only 372 subjects completed the SF-36 questionnaire due to their busy lifestyles, and GERD was reported in 106 subjects [28.5%]. For all dimensions of SF-36, the mean score was consistently lower in patients with GERD was reported in 106 subjects [28.5%]. For all dimensions of SF-36, the mean score was consistently lower in patients with GERD compared to non-GERD subjects [P<0.001]. The dimension most frequently impaired was role-physical [40.9 vs. 77.3] followed by role-emotional [44.7 vs. 77.5], physical functioning [66.9 vs. 84.6], and general health [46.8 vs. 63.8]. An association existed between impairment in quality of life and frequency [P<0.05], but not severity, of GERD symptoms

Migraine risk factors in Qashqai migrating nomads: an adjusted multiple correspondence analysis approach

To determine the migraine risk factors in Qashqai migrating nomads using an adjusted multiple correspondence analysis approach. In summer 2006, 750 Qashqai migrating nomads aged 25 years or older in Fars Province, Southern Iran were enrolled using a multiple-stage cluster random sampling. A questionnaire consisting of demographic characteristics, lifestyle and migraine diagnosis was used for each subject. The association of each risk factor was assessed using an adjusted multiple correspondence analysis. The prevalence of migraine was 18% in males and 28% in females. It was higher in overweight and obese subjects, those who consumed roasted foods, widows, female gender and in the age group of 35-50 years old. Multiple correspondence analyses were suitable choices to determine detailed results of complex categorical data in migraine risk factors

[Cloning and evaluation of expression of a novel overlapping region of NS3 gene of Hepatitis C virus by expressing vector]

In this project, our aim was to construct a novel expressing vector harboring a new sequence from overlapping region of NS3 gene of HCV from infected Iranian patient. The partial NS3 [pNS3] gene was amplified by Nested-RT-PCR method using sera of HCV infected patients harboring genotype 1a. After purification and cloning the pNS3 into TA-cloning vector, the best colony was selected based on Blue/White screening and colony-PCR following by confirmation with sequencing and restriction digestion with BglII. The sequenced gene was compared with other reference sequences using alignment softwares. The resultant pNS3 gene subcloned into the expression vector, IRES vector, followed by selection the suitable clones by 2 different colony-PCRs. The gene expression was evaluated using GFP detection, RT-PCR and western blotting techniques after transfection of the IRES-pNS3 vector into the 293 cell line. After pNS3 sequence amplification by RT-PCR, sequencing results showed high homology among the sequences with other reference sequences. This result also showed that it belonged to genotype 1 of HCV. Colony-PCR showed the insertion of gene into expressing vector with the right orientation. GFP expression, RT-PCR and western blotting confirmed transfection of vector, expression of pNS3 gene and production of its protein in 293 cells respectively. This novel expressing vector harboring partial region of NS3 gene in compare to full NS3 gene maybe more useful in immune induction by antigen presenting cells due to absence of genes responsible for protease activity of the protein in the setting of HCV vaccine