ABSTRACT
The patients with Post-Infectious Irritable bowel syndrome [PI-IBS], a subtype of irritable bowel syndrome, suffer from bacterial gastroenteritis. Since Campylobacter Jejuni [C] is one of the most common agents in this syndrome, we aimed to evaluate the prevalence of Campylobacter Jejuni in patients with Irritable Bowel Disease. This case - control study was conducted on 160 patients divided into 2 equal groups of healthy and unhealthy. The presence of Anti- CJ antibody [IgG and IgA] was evaluated by ELISA and the comparison was performed by chi-square test, The mean age of case [31.51] and control [31.84] was not statistically different [P = 0.87]. Titer of Anti- Campylobacter Jejuni antibody IgG was positive in 25% of patients and 18.8% of the healthy ones [p=0.02]. IgA Seropositivity in patients was 7.5% but no one in control group was positive [p =0.01]. The Seroprevalence of CJ in patients with IBS was higher significantly than that of control group. Thus, CJ can be known as one of the causes of Post-infection in patients with IBS in our region and it should be paid more attention in diagnostic assessment of these patients
ABSTRACT
Celiac is a hereditary disease presented with chronic inflammation of small intestine. Several studies supposed a relationship between Celiac disease and Inflammatory Bowel Disease [IBD]. Tissue trans-glutaminase antibody is one of the best serological markers in Celiac disease. This study was designed to evaluate the association of Celiac and IBD using tissue trans-glutaminase antibody. In this descriptive study 127 confirmed IBD patients who were referred by gastroentrologists 2005-08 enrolled into the study. A questionnaire was completed and tissue trans-glutaminase antibody was evaluated with ELISA method with a Cut-off=12 U/ml. Among 127 referred patients, serum samples of 102 patients were collected. Mean +/- SD of age was 36.17 +/- 15.2 years and 48% were males. Ulcerative colitis, Crohn's disease and other colitis were observed in 76 [74.5%], 7 [6.9%] and 19 [18.6%] of patients, respectively. Tissue trans-glutaminase antibody was positive [19.8 U/L] in one 46-years-old male patient with ulcerative colitis. Tissue trans-glutaminase antibody titer was not significantly different between IBD patients and controls, thus it seems not appropriate to suggest as one of the routine tests in IBD patients
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Transglutaminases/analysis , Transglutaminases/immunologyABSTRACT
Background: Hepatitis C virus [HCV] is one of the main causative factors of liver disease which can lead to chronic hepatitis C infection in 80% of cases. HCV genotypes have a special worldwide geographic distribution. The goal of the present study was to detect HCV genotypes in patients with anti-HCV positive titers in Golestan Province, Iran
Materials and Methods: In this cross-sectional study, 95 positive HCV samples as detected by RIBA were evaluated. Viral RNA was extracted with a Roche extraction kit and the Fermentase cDNA kit Random hexamer primers was used for viral genomic cDNA synthesis. PCR was performed on all samples by a general pair of primers. Second-step PCR was done with specific primers, and the results were obtained following electrophoresis in 1.5% agarose gel and ethidium bromide staining in documentation gel
Results: General primer PCR revealed 91 positive samples. Assessment of 77 samples determined that the following genotypes were present: 1 and 3 [1a [19.5%], 1b [19.5%], 3a [15.6%], 3b [24.7%]], 2a [2.6%], 4 [7.8%]. The remaining samples were a mixture of genotypes 1 and 3 [6.5%]
Conclusion: The ingmost prevalent genotypes found were types 1 and 3 in Golestan Province. This distribution pattern differed from other areas in Iran, however genotype 4 was in accordance with other studies. Genotype 2 was only reported in this study and a study in Tehran. Thus, additional, larger studies of HCV genotypes should be performed for further analysis of genotypic distribution patterns
ABSTRACT
Introduction: Constipation is one of the most prevalent causes of abdominal pain in pediatrics, with no underlying pathology. It is defined as functional constipation in 95% of cases evaluated. This study was designed to compare the therapeutic effect of polyethylene glycol [PEG] and lactulose in treating chronic functional constipation in children
Materials and Methods: In this randomized, double blind clinical trial, patients were classified into two groups: lactulose [n=65] and PEG [n=63]. During an eight week period, patients were either treated with an average of 3.5 g/day [PEG] or 7 g/day [lactulose]. Successful treatment was defined as defecation [painless and soft, or normal] three times or more per week. Analysis was performed by calculation and comparison of the success rate in both groups, followed by reporting the relative risk and number needed to treat [NNT]
Results: Response to treatment in the second week was significantly higher in the PEG group when compared with the lactulose group [P<0.0001]. There was a significant difference in the response rate between both groups in the 4th and 6th weeks [P<0.0001]. In the 8th week all patients in the PEG group were treated successfully, whereas there were five [7.7%] cases who did not respond in the lactulose group
Conclusion: These results have shown that a four week treatment period with PEG [3 g/day] lead to a response rate of 87% in children, in comparison with lactulose [7 g/day] which needed at least eight weeks of treatment
ABSTRACT
Esophageal and gastric cancers are among prevalent cancers in the world and it is believed that nitrate and nitrite contaminations of drinking water are important factors in increasing the risk of these cancers. This study was designed to determine the correlations between these factors and upper gastrointestinal cancers. In this ecologic study, mean concentrations of nitrite and nitrate of drinking waters in Golestan urban areas were obtained during 2004-2005. All patients with esophageal and gastric cancers during this period who resided in urban areas were recruited to estimate the incidence rate and Age Standardized Rate [ASR] of these cancers. The province was divided into three regions of low, intermediate and high incidence based on 33% and 66% quartiles of both cancers. Spearman Correlation Coefficient and regression line were used to analyze data
Subject(s)
Humans , Nitrates/analysis , Nitrites/analysis , Gastrointestinal Neoplasms , Urban Population , Upper Gastrointestinal Tract/pathology , Esophageal Neoplasms , Stomach NeoplasmsABSTRACT
Background and Purpose: P53 gene is a tumor suppressive gene and its product, P53 protein, is a protective factor against tumor formation that inhibits the extension of genetically damaged cells. P53 aggregation in tumoral cell nucleus is related with p53 gene mutations, which can be detected by immunohistochemical methods. This study was designed to investigate the protein aggregation in patients with gastric cancer in Gorgan, Iran
Methods and materials: All paraffin-embedded blocks of gastric cancer cases during the years 2000 to 2004 in the pathology ward of the 5th Azar Hospital in Gorgan, Iran [111 cases altogether] were evaluated and stained, for detecting microtome cutting. The obtained data were entered into SPSS and chisquare was used for analysis
Results: 111 cases with gastric cancer were investigated. The most frequent type of gastric tumor was adenocarcinoma [66.7%]. In 59.5% of the affected cases, P53 protein was detected. No significant relationship was observed between P53 expression and factors such as age, gender, and histological type of the tumor
Conclusions: In this study, P53 protein rate was high but it showed no significant relationship with other variables. We suggest further studies to discover the relationship between protein aggregation in tumor cells and other variables in affected cases
ABSTRACT
Introduction: The pharmaceutical care framework requires an active client-pharmacist partnership, particulary with respect to consultation about medication [dispensing process]. The educational intervention can imply to improve rational use of drugs
Objectives: In this study the effect of active group discussion and dispenser feedback in increasing the patient care indicator [dispensing time] in the pharmacies of Gorgan were examined
Materials and Methods: An interventional, semi-experimental study was designed. The study was conducted in Gorgan, thirty pharmacies and 750 pharmacy client, were randomly selected in each step [before and after intervention]. A structural questionnaire was used to interview clients. Data were collected from patients and by interviewing immediately after patient-dispenser encounter. Focused group discussion, audit feedback and distribution of educational bucklet were designed and conducted, after two months. All data were collected and analyzed with SPSS-11.5 software and were shown as mean +/- SE
Results: Data from 750 prescriptions before intervention showed that the average drug dispensing time was 19.43 +/- 5.83 seconds and the average waiting time was 4.91 +/- 1.2 minutes. In the post-intervention period, we had significant increase in the aformention indicators. Patients' satisfaction and knowledge of adverse effects and dosage information significantly increased after intervention
Conclusion: The study shows the impact of active educational intervention in improving WHO patient care indicator [dispensing time]
ABSTRACT
15-20% of TB cases are extra pulmonary tuberculosis [EPTB]. Abdominal TB is the most common type of extra intestinal TB. Signs and symptoms of abdominal TB are unspecific. In this study, we identified all GITB cases in Golestan province [Iran] between 1999 and 2003 and determined their demographic characteristics. We reviewed all new cases of TB reported during 1999-2003 from TB centers of Golestan province.Then EPTB and especially GI and abdominal TB cases were selected. We completed a questionnaire containing demographic information for each of them. The information entered the computer in SPSS-13 was used to analyze the data. 30 patients had been treated for GI and abdominal TB, most of them were females [22 cases, 73.3%]. Mean age of the patients was 32.03 +/- 13.73 with higher incidence in age before 40 years old [70%]. Most common complaints of the patients were fatigue, weight loss, anorexia, fever and abdominal pain, respectively. In 66.7% of patients the diagnosis was pathologically documented. Our data suggest that 38.46% of all TB cases in Golestan province were EPTB, and this scale is higher than other studies. In this study, 5.27% of EPTB cases were GI and abdominal TB, higher than the world reports [3%]
Subject(s)
Female , Humans , Male , Tuberculosis, Gastrointestinal/diagnosis , Surveys and QuestionnairesABSTRACT
Celiac is a digestive disease. In this disease, small bowel is damaged and the absorption of nutrients are adversely affected. These patients do not absorb gluten. There is probably a correlation between esophagus cancer and celiac. The aim of this research was to study the seroepidemiology celiac disease in this area with high prevalency of esophagus cancer. This research was a descriptive study, which was performed on blood donors in Golestan province during the year 2005-06. blood samples were taken from 2547 subjects. tTG-IgA determination were carried out using ElISA technique, the titre<4U/ml, 4-10U/ml and >10Um/l were considered to be as negative, weakly positive and positive respectively. EMA antibody assessment were carried out on all sample population with more than 4U/ml, using IFA method. 28 subjects [1.1%] had tTG-Ab positive test, out of this number 18 subjects [0.7%] were weakly positive and 10 persons [0.4%] were considered to be positive. EMA test were positive in 70% of subjects with tTG positive results. There was not any significant meaning between positive tTG test and ethnicity from weakly positive tTG, 15 subjects [83.3%] and 3 subjects [16.7%] were male and female respectively. The entire tTG positive were male subjects. In regard to high prevalency of esophagus cancer in the region and the relation of celiac disease with above cancer, it seems necessary to look more seriously at the celiac disease
Subject(s)
Female , Humans , Male , Seroepidemiologic Studies , Blood Donors , Esophageal Neoplasms , Prevalence , TransglutaminasesABSTRACT
Suicide is one of the most important causes of death in the world. The prevalence of suicide varies in different parts of Iran and the world. This study was done to determine the prevalence and types of suicide and its relation to gender, age and education in Golestan prevalence in North of Iran. This cross-sectional study was carried out on 1857 patients admitted to general hospitals in Golestan province during 2003. The data were collected through questionnaires filled by health workers and analyzed using SPSS software. The prevalence of suicide was 117.8, 88.5 and 147.4 per 10000 in general population, males and females respectively. The rate of suicide in 20-24 age groups was 285.8 per 10000. The highest rate of suicide was observed in spring. Thirty one percent of samples had high school education. 48 percent of suicide attempts were with drugs and opium. Considering the ethnicity, the rate of suicide was 177 among native Fars, 79.6 in Turkman and 270 in Sistani per 10000, respectively. This study has shown that the rate of suicide is higher in this province comparing to other studies in some parts of Iran and other countries
Subject(s)
Humans , Prevalence , Disease Outbreaks , Epidemiologic Studies , Cross-Sectional StudiesABSTRACT
In northeastern Iran there is an area of high incidence of esophageal cancer which is populated by residents of Turkmen ancestry. Several environmental risk factors for esophageal cancer have been proposed, but the roles of familial and genetic factors have not been studied extensively in the Turkmen population. We evaluated the importance of familial risk factors for esophageal cancer by performing a case-control study of 167 cases of esophageal squamous cell carcinoma and 200 controls of Turkmen ethnicity. Detailed family pedigrees of the cases and controls were constructed, which documented all cancers in first- and second degree relatives. The actuarial risk of cancer was then estimated in 2097 first-degree relatives of cases and 2783 first-degree relatives of the controls. A hazard ratio was constructed, based on a comparison of the two cumulative incidence curves. The risk to age 75 of esophageal cancer in the first-degree relatives of Turkmen patients with esophageal cancer was 34%, versus 14% for the first-degree relatives of the controls [hazard ratio = 2.3; p = 3 x 10[-8]]. 9.6% of the cases reported that their parents were related, versus 2.5% of the controls [odds ratio = 4.1; p -value = 0.006]. Familial factors are important in the etiology of esophageal cancer among the Turkmen residents of Iran. The hazard ratio of 2.3 for cancer among first-degree relatives is consistent with an important contribution of heritable factors. It will be of interest to perform marker studies to establish which genes are responsible
ABSTRACT
Introduction: Esophageal cancer is the 8th prevalent cancer [4% of all] around the world and the sixth leading cause of death from cancers .The Northeastern parts of Iran [Caspian littoral areas] are one of the most prevalent areas of esophageal cancers in the world
Objective: In this study, we examined relationship between esophageal cancer tumor histology and variables like age and sex, in pathologically confirmed cases in the Northeastern of Iran [Caspian littoral margins]
Materials and Methods: This descriptive cross-sectional study was conducted in the health care services and pathologic centers in Golestan Province. All pathologically confirmed esophageal cases were enrolled in the study and demographic data were listed. Data were analysed with SPSS-10 software. Variables were compared with one-way ANOVA and Mann-Whitney tests for continuous variables and chi-square for nominal/categorical variables. Level of significance was set at p-value less than 0.05
Results: Four hundred and ninety one pathologically confirmed esophageal cancer cases from 1996 through 2000 were included in this study. Squamous cell carcinoma was the dominant tumor histology in this study and it was more common in females. We found that tumor histology is highly related to gender and this association is independent of age factor. Our finding revealed that this association is only applicable to older age groups [older than 50]
Conclusion: Results from this study suggested that demographic factors might be different in esophageal cancer cases in different geographic areas. Our finding can be a reflection of distinctive etiology for esophageal cancer in the Caspian littoral areas
ABSTRACT
The northeastern region of Iran has some of the highest rates of esophageal squamous cell carcinoma [ESCC] in the world. To investigate the role of polycyclic aromatic hydrocarbons [PAHs] in the etiology of ESCC in northeastern Iran, we measured urine 1-hydroxypyrene glucuronide [1-OHPG], a stable PAH metabolite, in 99 inhabitants of this area. Results: The median urine 1-OHPG in participants of this study was 4.2 pmol/ml. Forty-two subjects [42%] had levels ranging from 1 to 5 pmol/ml, indicative of moderate PAH exposure, and 41 [41%] had levels above 5 pmol/ml, indicative of very high exposure. Further analysis showed that 1-OHPG levels were high in all subgroups of our study subjects, including both sexes; rural and urban dwellers; and smokers and non-smokers. Only 15% of the variance in 1-OHPG was explained by age, sex, residence, smoking, nass, or opium consumption. This pattern of PAH exposure parallels with the ESCC incidence pattern seen in this area. We conclude that people in northeastern Iran are exposed to widespread and very high levels of PAH, largely from unknown sources, and this may contribute to the high rates of ESCC observed in this area
Subject(s)
Humans , Male , Female , Esophageal Neoplasms/epidemiology , Esophageal Neoplasms/etiology , /adverse effects , Risk Factors , Glucuronates , PyrenesABSTRACT
Background and Objective: colorectal cancer is the most common cancer of GI and 2nd most common cause of cancer death in the world. The purpose of this study was to determine epidemiologic aspect and tumor characteristics of colorectal cancer for patients and compare them in young [<50 yr] and older [>50 yr] patients
Materials and Methods: in this cross-sectional study during 3 yr the samples of malignant colorectal cancer presented in Gorgan endoscopy and pathologic centers were collected. Data evaluated by statistically method
Results: there were 101 cases of malignant colorectal cancer. 61 cases were male and 40 cases were female. The mean age was 56+/-13.65 yr. 13.9% of patients were <40 yr. The type of tumor in 94% was adenocarcinoma, 2.9% lymphoma and 2.9% undifferentiated carcinoma. The site of involvement in 30 cases were rectum and in 71 cases were colon. The most common symptom was abdominal pain, constipation and rectal bleeding. The time interval between onset of symptom to diagnosis of disease in 58 cases was >6 mth. Family history of cancer in 36 cases was positive. Right colon cancer in young patient was significantly more than older [P<0.05]. Positive family history of cancer in right colon cancer was significantly more other than. Positive family history of cancer in young patient was more than other [P<0.05]
Conclusion: according to this study, colorectal cancer was high. Therefore, it is necessary to pay more attention to the symptom of young patient and providing a screening program in patients over 50 years old and young patients with positive family history
ABSTRACT
Background and Objective: in all of world, a portion of household income expends on health care cost. Amount and distribution of the proportion indicate financial burden of health care in the societies. WHO believes that one of the main determinants in health system efficiency is fairness of financial contribution. This study aimed distribution pattern of urban households' income, health expenditure by cost types and measuring of equality on health care costs in the Gorgan district
Materials and Methods: in order to establish the population laboratory, this cross-sectional study assessed 1014 household in the Gorgan health posts [No 4 and 8] on January 2003. health insurance status, monthly household income and monthly health care cost gathered through interviewing with the husbandmans
Results: health insurance coverage was 67% in highest and 44% in lowest income deciles [P<0.05]. Median and mean of assessed households' income and household health care cost were 1200000 Rls, [1669669+/-187300 Rls] and 80000 Rls, [281530+/-95124 Rls] respectively. Mean of median of out of pocket proportion health care cost per households' income was 0.57+/-0.03 and 0.66 respectively. 13% of total income expended health care cost through out of pocket. This proportion in highest and lowest income decile was 7% and 28% [P<0.05]. Gini coefficient of health care cost and out of pocket cost per total household income were 0.22 and 0.18 respectively
Conclusion: low income households expended almost 40% of their income in order to purchasing of health care, in comparison to richest households, they spent 9% of total income. Instead of, additive development of health insurance systems and complementary insurance mechanisms, a half of health care cost in the population spend by out of pocket. According to WHO standards of health system performance, revising health insurance system and payment mechanisms are mandatory