Distribution of hepatitis C virus genotypes in haemodialysis patients of Guilan, northern Islamic Republic of Iran

The incidence of hepatitis C virus [HCV] infection among patients undergoing haemodialysis is high. The aim of this study was to identify the HCV genotypes among chronic haemodialysis patients who were HCV positive in Guilan province, northern Islamic Republic of Iran. All patients on haemodialysis at Guilan haemodialysis centres were enrolled. Enzyme-linked immunosorbent assay and polymerase chain reaction testing were performed. Out of 514 enrolled patients, 11.9% were serologically HCV positive and 6.2% had positive HCV-RNA. HCV genotypes were determined with HCV genotype-specific primers. The most frequent genotypes were la [59.4%] and 3a [40.6%]. There was no significant relationship between virus genotypes and sex or age. The HCV genotype pattern among haemodialysis patients in Guilan province was different from other countries of the Middle East and was more similar to North American and European countries where genotype 1 is predominant

[ young man with eosinophilic ascites: a case report]

We report the case of a 40-year-old male patient admitted to the surgery ward in our hospital for recent abdominal pain, abdominal distention and fever. He had a history of similar abdominal pain and distention; for which he had undergone a laparotomy. Laboratory data revealed leukocytosis with eosinophilia [42%]. Upper gastrointestinal endoscopy showed diffuse severe erythematous pangastritis. Biopsies were taken from the esophagus which showed 10-15 eosinophils in each high power field. The ascitic fluid was straw-colored and sterile with 90% eosinophils. Therefore, the patient was treated with prednisolone [30 mg/day] and was diagnosed with an eosinophilic gastroenteritis syndrome with subserosal presentation. The patient recovered and eosinophilia improved within a few days

Clinical manifestations of Hirschsprung's disease: a six year course review of admitted patients in Gilan, northern Iran

Hirschsprung's disease [HD] is a congenital disease in which intestinal ganglionic cells are absent, leading to intestinal obstruction. The disease has various clinical manifestations and different lengths of bowel may be involved. Our aim was to study Hirschsprung's clinical presentations and its rate of intestinal involvement in hospitalized patients in a six year course study in Gilan, a northern province of Iran. We studied patients diagnosed with HD who were referred to the Gilan Surgery Referral Center in Poursina Hospital from 1995 until 2001. In this cross sectional descriptive-analytical study, all data were collected from patients' files and questionnaires. Data included demographics, clinical presentations, diagnostic methods, involved intestinal segments, type of surgical procedure, and surgical complications. There were 58 cases of HD during this six year period that underwent surgery. Of these, 19 patients were female and 39 were male whose ages ranged from one day to 18 years old. A variety of clinical findings such as: constipation, abdominal distension, failure to pass meconium, diarrhea, and other less common manifestations were present. We found three different pathological types: rectosigmoid, ultra short segment and total colonic involved segment. No differences between disease presentations were discovered among these three types. The following surgical procedures were performed: Swenson, Soave-Boley, and Lynn. Early complications, which occurred during the first month following surgery, were anastomotic leakage, wound infection, hemorrhage and anastomosis stenosis. Late complications, occurring at least one month after surgery, comprised the following: long-term con-stipation, enterocolitis, incontinence, and obstruction due to adhesion. No significant difference between the complications of these surgical procedures and any accompanying anomalies were found. Most patients had chronic constipation and abdominal distension regardless of the types of involvement, age or clinical presentations. There were few associated anomalies amongst the patients. In some cases, surgical complications were less than those seen in other studies; therefore, it seemed that the performed procedures had fewer complications or may have been performed at the appropriate time

Prevalence of Helicobacter pylori infection among children in Rasht, northern Iran

Helicobacter pylori [H. pylori] infection usually occurs during childhood, especially in developing countries. The aim of this study was to evaluate the prevalence of H. pylori infection among children in primary schools of Rasht, a northern Iranian city. This cross-sectional study was conducted among 961 primary school students in Rasht. Samples were randomly selected and stored at -20°C until analysis. The stool assay was performed using the HP AgT kit. Overall 475 boys and 486 girls, aged 7 to 11 years were evaluated. A total of 384 [40%] children were diagnosed as H. pylori positive by the stool test. A higher prevalence of H. pylori was found in the stools of individuals who consumed well water and municipal tap water when compared to boiled water [p<0.05]. There was no significant difference between the rate of H. pylori infection and individuals' ages, gender or socioeconomic levels. The results of this study suggest that the source of drinking water may play a role in transmission of H. pylori. Transmission can be minimized with the use of boiled or mineral water

Prevalence and characteristics of irritable bowel syndrome [IBS] amongst medical students of Gilan northern province of Iran

Irritable bowel syndrome [IBS] is one of the most prevalent gastrointestinal disorders characterized by non-specific symptoms such as abdominal pain and altered bowel habits with no known organic pathology. Its prevalence varies in different communities. We performed this study to determine the prevalence of IBS in medical students who attended Gilan University of Medical Sciences [GUMS]. Medical students of GUMS were studying during 2002 academic year were enrolled in this cross-sectional study. Within a specifically designed schedule, trained general practitioners performed student interviews. The interviewers used a structured questionnaire based on the Rome II criteria. Data were analyzed using SPSS-10 software. Results were presented as percentages and the mean +/- SD and level of significance was denoted as a p-value <0.05. This study included 422 students, 148 [35.1%] males and 274 [64.9%] females, trained in various educational levels at GUMS whose mean age was 23.7 +/- 2.9 years. The prevalence of IBS was 12.6% [53 of 422]. IBS was more prevalent in females than males [15% [41 of 274] vs. 8.1% [12 of 148]; p<0.05]. Reported a Physician 37.7% of cases visit in comparsion to 17.6% of non IBS case [p<0.05]. This study shows a higher prevalence of IBS in medical students than in other sections of the Iranian population. A prevalence of 12.6% in medical students, who are in an active phase of life, requires careful planning to provide alleviation

immunologic response to anti-hepatitis B vaccination among medical students of Guilan university of medical sciences, Guilan, Iran

An important way to prevent hepatitis B infection is vaccination especially among high-risk populations including healthcare workers. Unfortunately, immunologic response to the vaccine is not perfect. Multiple different factors such as gender, age, body mass index [BMI], smoking and underlying diseases can influence the immunologic response. So, this study was conducted to evaluate the post-vaccination immunologic response of medical students of Guilan University of Medical Sciences [GUMS]. In this cross-sectional study, GUMS medical students who had received complete vaccine series at zero, one, and six months were enrolled. Their demographic data and the factors which could probably alternate the immunologic response were collected by interview. The anti-HBs Ab titer was evaluated by Enzyme-Linked-Immunoassay [ELISA]. Appropriate immunologic response was supposed to be HBsAb >=10 mIU/ml. The collected data were analyzed using SPSS 10.00.P value <0.05 was considered significant. We evaluated 233 students with mean age of 24.9 +/- 4.5 years. 74.7% were female. 4.9% did not respond properly to vaccination. Females' immunologic responses were significantly higher than males' [P=0.001]. Responsiveness was significantly lower in smokers than non-smokers [P=0.02]. Mean age in inappropriate and appropriate responder groups were 28.67 +/- 5.4 and 24.77 +/- 4.4 years, respectively [P=0.004]. 95.1% of students had a protective level of anti-HBsAb [>10 mIU/ml]. Since health-care staffs including medical students are a high risk group to be contaminated with HBV, it is preferable to be evaluated for anti-HBs titer 1-3 months after full three-dose vaccination especially when these factors are present; in this way the false sense of being immunized among them may be decreased