ABSTRACT
The epidemiologic studies have demonstrated that decreasing the Helicobacter pylori [H. Pylori] infection will increase the rate of gastro esophageal reflux disease [GERD]. It also, has been shown that patients suffering from GERD have less episode of the H. pylori infection. In this study 9500 patient recorded files from a private clinic were evaluated to study the prevalence of GERD after complete eradication of H. Pylori infection . The inclusion criteria were: symptoms such as dyspepsia, peptic ulcer disease or gastroduodenitis due to H .pylori infection confirmed by positive rapid urease test[RUT] with the absence of endoscopic examination or clinical signs of GERD. H.Pylori condition and signs of the GERD were considered in the second endoscopy examination. Patients with H . Pylori negative in the second endoscopy examination, were considered as case group, and those who were positive for H. pylori, considered as control group . New incidence of GERD were studied in both groups. A total of 100 patients were included in the study in which, 81 patients were nominated as case group and 19 in control group. The patient's mean age for case group and control group were 37.6+12.6 and 37.4+12.2 years, respectively. Forty-nine percent of case group and 52.6% of control group were male. The duration mean between the first and the second endoscopic examinations was 29.4+7.9 months in case and 32.1+10.1 in control group. The incidence of GERD in case and control groups was 38.3% and 15.8%, respectively. There was no significant difference in age, and gender as well as duration interval between the first and second endoscopic examinations in both the case and control groups. The incidence of the GERD in H.pylori negative patients [case group] was significantly higher than the control group [p=0.05]. Eradication of H . pylori can cause gastro-esophageal reflux . Therefore, when H . pylori positive patients treated for their infection, the GERD should be expected in a considerable number of them
ABSTRACT
Anatomically the musculocutaneous nerve C[5,6] is a branch of lateral cord of the brachial plexus and its motor nerve fibers innervates the muscles of anterior compartment of the arm. This nerve penetrates into the coracobrachialis of arm muscle and lies between biceps and brachialis muscles. At the lateral bicipital groove becomes superficial and the finally converts to lateral cutaneous nerve of the foream. Here we report a rare case of musculocutaneous nerve variation. We found a rare anatomical form of musculocutaneous nerve during upper left limb dissection of a male cropse who was in dissecting room of Rafsanjan Medical School. His body was tall with muscular limbs, weighed 65-75Kg, 175 cm height, and fifty years old. The following variations were observed after dissecting of the axillary and arm regions. 1] The Musculocutaneous nerve arised from the lateral root of the median nerve. 2] The coracobrachialis muscle was innervated by a branch of the lateral cord of the brachial plexus. 3] The Musculocutaneous nerve did not penetrate into the coracobrachialis muscle but rather passed between the brachialis and biceps muscles. At the level of lateral bicipital groove, it then became a superficial nerve as the lateral cutaneous nerve of forearm. Hense, it was very close to the brachial artery and median nerve in the upper one-third of arm. This study describes a rare innervation of the musculocutanous nerve and requires further study to understand the nature of this unique structure. This atypical innervation is extremely important for surgical procedures performed on the arm muscles and adjecent vessels