[Results and outcomes of band ligation among 95 cases with esophageal varices in Taleghani Hospital between 2002 and 2007]

Endoscopic Variceal Ligation [EVL] is considered the selective method of therapy for patients who suffer from esophageal varices. In this article we evaluated the results and outcomes of patients who underwent EVL with multiband ligators due to their esophageal varices. We studied 95 cases of esophageal varices who underwent EVL at Taleghani Hospital between 2002 and 2007. EVL was applied because of active bleeding, primary or secondary prophylaxis for esophageal varice of grade 2 or above. The process was repeated every 3-4 weeks until the varices were occluded or become to grade 1 varices or small thrombosed ones. Their demographaic data were gathered and analyzed as well as all the 1 informations about their recent procedure. Our studied subjects had the mean age of 51.53 +/- 15.31 [ranged from 15 to 81]. The average number of sessions for performing EVL were 1.81 +/- 1.07 [ranged between 1 and 8 times]. The mostprevalent cause for applying EVL was active bleeding. Complications were significantly more in patients whom were candidated for EVL by reason of active bleeding, compared to those who underwent EVL for either primary or secondary prophylactic reasons [P=0.02]. Among cases who had developed any complications, the numbers of ligation sessions were significantly more than other patients [2.58 +/- 1.25 vs 1.40 +/- 0.66, P<0.001]. There was no case of death due to this mode of therapy. EVL as a selective mode of therapy for treatment of esophageal varices possesses a few cosequential complications and its application, therfore, is reasonable

Seroprevalence of hepatitis E in Nahavand, Islamic Republic of Iran: a population-based study

A 2-month community-based survey in February/March of 2003 was carried out to study the seroprevalence of hepatitis E virus [HEV] infection in Nahavand, Islamic Republic of Iran. From each of 6 urban regions of Nahavand, 304 inhabitants >/= 6 years were recruited through systematic random sampling [total 1824]. Participants were tested for anti-HEV IgG using ELISA. The overall seroprevalence of HEV was 9.3% [95% CI: 8.2%-10.9%]. Based on multivariate adjustment, only sex [OR = 1.61, 95% CI: 1.13-2.28] and age [OR = 1.03, 95% CI: 1.01-1.04] emerged as significant risk factors. This intermediate prevalence urges further investigations on HEV infection in the Islamic Republic of Iran

[Frequency of hepatitis A virus antibodies in patients with hepatitis B and hepatitis C in Iran]

Superinfection of hepatitis A in chronic hepatitis B and C may worsen the course of disease. This study attempted to study frequency of hepatitis A virus antibodies in patients with hepatitis B and hepatitis C. 115 hepatitis C and 56 hepatitis B patients who visited the Hepatitis Association of Hamedan province during 2004-2005 were enrolled. Hepatitis A virus antibodies [IgM, IgG] by ELISA, WBC, hemoglobin, platelet, AST and ALT were evaluated. 32 patients with hepatitis B and 39 patients with hepatitis C refused the study. In 71 [85.5%] patients with hepatitis B, IgG-HAV-Ab and in one patient IgM-HAV-Ab was detected. 36 [92.3%] patients with hepatitis C had IgG-anti-HAV. Due to high frequency of HAV Ab, it is preferable to evaluate patients with hepatitis B and C for HAV-Ab instead of vaccination of all patients

[ effect of omeprazole on the number and size of after-endoscopic band ligation ulcers of esophageal varices]

Endoscopic variceal ligation [EVL] is an effective option in treatment of esophageal varices bleeding or elective ablation. Although the after-EVL ulceration is well recognised, the effect of acid suppression on ulcer healing is not determined, definitely. In this study, we tried to evaluate the efficacy of Omeprazole as the most available protone pomp inhibitor [PPI] on the numbers and size of after-EVL esophageal ulcers in patients electively underwent this procedure. We performed a randomised placebo-controled trial of Omeprazol after elective EVL. Fifty consecutive cirrhotic patients who were cadidated for EVL randomly enrolleded in and were divided equally into case [25] and control [25] groups. After endoscopy and EVL, case subjects received Omeprazole [20 mg twice a day] for 2 weeks and control subjects received placebo for the same period as well. All the patients underwent a follow up endoscopy 13-15 days after EVL. Forty two patients [20 cases and 22 controls] completed the study. Numbers and size of ulcers were evaluated throughin the follow up endoscopy. Numbers of ulcers were significantly higher in control group [3.15 vs. 2.59, p=0.03]. The ulcers in Omeprazole group were on average half as large as in the placebo group [37.08 mm[2] vs.73.74 mm[2], p<0.0001]. After elective EVL, Omeprazol-treated Patients experienced a significant reduction in number and size of their post-banding ulcers. It seems that Omeprazole reduces the numbers and size of after-EVL ulcers

[Thyroid autoimmunity disorders in patients with chronic hepatitis C, before Interferon therapy]

Several researchers believe that thyroid autoimmunity is more prevalent in patients with hepatitis C than in the general population, however this is still a controversial issue. The aim of the current study was to determine 1] the frequency of thyroid autoantibodies, 2] the frequency of thyroid dysfunction, 3] correlation of thyroid autoantibodies and dysfunction with demographic and clinical variables, in patients with chronic hepatitis C. This cross-sectional study was conducted on 250 patients with chronic hepatitis C; patients were selected by simple non sampling from patients referring to the Tehran Hepatitis Center in 2003 and 2004. Demographic data [age, sex, educational level, job] and clinical variables [including risk factors, liver enzymes, liver histopathology, HCV RNA viral load], were obtained. Anti Thyronin [TPO Ab, 124], Anti thyroglobulin [TG Ab, n=117], TSH [n=239], T3 [n=242], T4 [n=245], T3RU [n=134] was tested. TPO Ab and TG Ab were seen in 4% and 3.4% respectively. 1.2% had the history of thyroid diorders. 4 subjects had thyrotoxicosis, 1 subject had Hashimoto thyroiditis, 3 subjects had subclinical hyperthyroidisem, and 5 patients had subclinical hypothyroidisem. Positive TPO Ab had a statistical correlation that was marginally significant correlation with cirrhosis, physical symptoms and history of traditional phlebotomy [0.05

[Frequencies of hepatitis B and C infections in hemophiliacs of Hamedan province, 2004]

Hemophilia is a x-linked deficiency of factor VIII. The aim of the present study was to determine the frequencies of hepatitis Band C infections, markers of inflammation and liver function tests and also to assess the possible association between factor VIII inhibitor and hepatitis Band C infections in hemophiliacs of Hamedan Province of Iran. Sixty-six patients with confirmed diagnosis of hemophilia were included, for whom, hepatitis Band C serology; aspartate aminotransferase [AST], alanine aminotransferase [ALT], factor VIII level and factor VIII inhibitor were evaluated. Frequencies of hepatitis C antibody and hepatitis B surface antigen were 59.1% and 5%, respectively. Frequency of factor VIII inhibitor was 47.8% in hemophilia A group, and its presence was not neither associated significantly with hepatitis B or C infections nor with AST or ALT levels. There was a significant statistical association between duration of hemophilia and development of factor VIII inhibitor [P<0.03] and hepatitis C [p<0.01]. Frequencies of hepatitis C and B are significant in hemophiliacs. Indeed, current screening of blood products might not be complete for elimination of blood-borne viruses and we strictly suggest revising this process in transfusion centers

[Safety and efficacy of stenting in malignant esophageal obstruction: a prospective study]

Palliative procedures in esophageal cancer to restore swallowing are preferable to- major surgery in most cases. The aim of this prospective study was to provide further information on treatment techniques, complications, and survival in the patients with malignant esophageal obstruction undergoing endoscopic palliative therapy using Self-Expanding Metal Stents [SEMS]. Patients with obstruction of the esophagus secondary to carcinoma who referred for stenting with SEMS between October 2004 and July 2005 were studied. In all cases the tumor was considered non-respectable and the stage of the disease was III or IV. All patients had aphagia or severe dysphagia to liquids and saliva, due to which, stenting was indicated. A follow-up in 1-11 months was taken, with physical and laboratory examinations. Symptom relief, survival rate, and complications were analyzed using Wilcoxon signed ranks test and student t-test by SPSS software version 10.0. Results were considered statistically significant for p<0.05. Between October 2004 and July 2005 twenty two stents were placed under fluoroscopic guidance in 19 patients [13 males and 6 females with mean age of 65.5+/-12.6 years] with the obstruction of the esophagus secondary to carcinoma. Technical success rate was 100%. The dysphagia score improved significantly in a month after stenting [p=0.001]. During this time period, appetite score of the patients was not improved significantly [p=0.070]. Major immediate complications including severe pain occurred in two patients [10.5%]. Eight [42.1%] patients died. The survival rate was 68.4%, 63.2% and 57.9% for 3, 6 and 9 months, respectively. Our results suggest that self-expandable metallic stent placement is a simple, quick, safe and efficient method to palliate esophageal carcinoma obstruction and its implantation will efficiently palliate dysphagia. The major problem of these patients, however, seems to be loss of appetite due to the underlying disease

Evaluation the existance of the helicobacter pylori in stomach, subgingival plaque and samples taken from periodontal pockets in dyspeptic patients by polymerase chain reaction [PCR]

Dental plaque and periodontal pockets might be a reservoir for Helicobacter pylori which is a factor for recurrence of alimentary system problems. The aim of this study was assessment of helicobacter pylori in dental plaque, periodontal pockets and stomach samples of patients with dyspepsia. In this descriptive study, 96 patients [45 Males and 51 females] refferred to Ecbatan hospital with dyspeptic complaints, were randomly selected. After filling out the questionnaire, samples of subgingival plaque and periodontal pocket were prepared in every patient. Then the patients were examined by endoscopy. All the samples were collected and were assessed for detection of Helicobactor pylori [HP] by polymerase chain reaction [PCR]. In 96 of dyspeptic patients with mean age of 37.28 yr, negative PCR in all samples was detected. It can be concluded that dental plaque and periodontal pockets could not be a reservior for HP, and do not play a role in recurrence or incidence of dyspepsia in these patients