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Background@#Post-dural puncture headache (PDPH) is one of the most common complications in patients undergoing spinal anesthesia. The present systematic review and meta-analysis aimed to assess the therapeutic and prophylactic effects of aminophylline and theophylline on PDPH. @*Methods@#Relevant studies were identified by searching the following electronic databases, without language restriction, until June 2020: Scopus, EMBASE, MEDLINE, Google Scholar, Web of Science, Cochrane Library-CENTRAL, and CINAHL Complete. Random effects models were used to calculate the standardized mean difference (SMD) and risk ratios (RRs) with 95% confidence intervals (95% CI) to assess the therapeutic and prophylactic effects of aminophylline and theophylline on PDPH, respectively. The Cochrane tool was used for the quality assessment of the included studies. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation method. @*Results@#Of the 1,349 initial records, 15 met our eligibility criteria (6 studies on therapeutic and 9 on prophylactic effects). A significant reduction in the pain score was observed following aminophylline/theophylline treatment (SMD = –1.67; 95% CI, –2.28 to –1.05; P < 0.001, I2 = 84.7%; P < 0.001). Subgroup analysis revealed that the therapeutic effect was significantly higher when these agents were compared to placebo than when conventional therapies were used. The risk of PDPH after aminophylline administration was not significantly reduced (RR = 0.74; 95% CI, 0.42 to 1.31; P = 0.290). @*Conclusions@#Theophylline and aminophylline have therapeutic, but not prophylactic, effects on PDPH.
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Objective: To find the relationship between Helicobacter pylori infection and iron deficiencyanemia in school-aged children. Methods: 71children with dyspepsia, epigastric and vagueabdominal pain attending a tertiary medical center in Iran underwent upper gastrointestinalendoscopy and were investigated for H. Pylori infection. Hemoglobin, mean corpuscularvolume (MCV), serum ferritin, total iron binding capacity (TIBC) and serum iron levels werecompared between children with or without H. pylori infection. Results: H. pylori infection wasdetected in 42 (59.1%) patients. Proportion of children with iron deficiency anemia was notstatistically different between two groups (26.2% vs. 14.3%; P=0.48). While hemoglobin wassignificantly lower in children with H. pylori infection (P=0.01), there were no significantdifferences in serum level of ferritin, iron, mean corpuscular volume and total iron bindingcapacity. Conclusion: Presence of H. pylori does not seem to play an important role in thepathophysiology and development of iron deficiency anemia in school-aged Iranianpopulation
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Background: Drug abusers are one of the most at risk populations for hepatitis C virus [HCV] transmission worldwide. The aims of this study were to measure the seroprevalence of HCV and to compare certain related risk factors in participants who were referred to drug rehabilitation centers affiliated to Shiraz University of Medical Sciences, Shiraz, Iran
Materials and Methods: Blood samples and interviews containing questions about age, sex, level of education, house status, jobs, history of imprisonment and psychiatric problems, age at the first drug and first intravenous [IV] drug uses, safe and unsafe sexual activity, and time and duration of IV drug use in the past 30 days were obtained from 1116 participants in rehabilitation centers. The sera were tested for anti-HCV antibody using enzyme immunoassay. The data were analyzed using independent samples t test and one way ANOVA for quantitative variables and Chi-square and Fisher's exact tests for qualitative variables
Results: Among the 844 participants who agreed to blood sampling, the prevalence of HCV infection was 14.2%. The significant positive associations were detected between anti-HCV antibody positivity and higher levels of education [p =0.008], no history of imprisonment [p<0.001], having a job [p =0.006], having a partner [p <0.001], and higher age at the first drug use [p<0.001]
Conclusion: The seroprevalence of HCV infection among drug abuser was very high in comparison with the general population of Iran. Making policies to prevent transmission of HCV infection among this high risk subpopulation is highly recommended
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Objectives: Ulcerative Colitis [UC] follows a natural clinical course of relapses and remissions. The aim of this study was to construct a risk-scoring formula in order to enable predicting relapses in patients with UC
Methods: From October 2012 to October 2013, 157 patients from Shiraz, southern Iran who were diagnosed with UC and in remission were enrolled. At 3-month intervals, multiple risk factors of hemoglobin, complete blood counts, serum iron and albumin, erythrocyte sedimentation rate, and faecal calprotectin levels, sex, age, cigarette smoking, positive family history of inflammatory bowel diseases, past history of appendectomy, extra-intestinal accompanying diseases, extent of disease at the beginning of study, number of previous relapses, duration of disease and duration of remission before the study were assessed. Univariate and multivariate logistic regression were applied to fit the final model. The new risk-scoring system accuracy was assessed using receiver-operating-characteristics [ROC] curve analysis
Results: Seventy four patients [48.1%] experienced a relapse. Multivariate analysis revealed that relapses could significantly be predicted by the level of fecal calprotectin [OR=8.1], age [OR=9.2], the Seo activity index [OR=52.7], and the number of previous relapses [OR=4.2]. The risk scoring formula was developed using the regression coefficient values of the aforementioned variables
Conclusion: Four predictor variables were significant in the final model and were used in our risk-scoring formula. It is recommended that patients who achieve high scores are diligently observed, treated, and followed up
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Humans , Male , Female , Middle Aged , Adult , Prospective Studies , Cohort Studies , Recurrence , Risk FactorsABSTRACT
Considering the anti-oxidant properties of Pistacia atlantica and lack of data regarding its efficacy in the treatment of ulcerative colitis, this study aims at investigating the effect of the Pistacia atlantica fruit extract in treating experimentally induced colitis in a rat model. Seventy male Sprague-Dawley rats [weighing 220 +/- 20 g] were used. All rats fasted 24 hours before the experimental procedure. The rats were randomly divided into 7 groups, each containing 10 induced colitis with 2ml acetic acid [3%]. Group 1 [Asacol], group 2 [base gel] and group 7 [without treatment] were assigned as control groups. Group 3 [300 mg/ml] and group 4 [600 mg/ml] received Pistacia atlantica fruit orally. Group 5 [10% gel] and group 6 [20% gel] received Pistacia atlantica in the form of gel as enema. Macroscopic, histopathological examination and MDA measurement were carried out. All groups revealed significant macroscopic healing in comparison with group 7 [P<0.001]. Regarding microscopic findings in the treatment groups compared with group 7, the latter group differed significantly with groups 1,2, 4 and 6 [P<0.001]. There was a significant statistical difference in MDA scores of the seven treatment groups [F[5,54]=76.61, P<0.001]. Post-hoc comparisons indicated that the mean +/- SD score of Asacol treated group [1.57 +/- 0.045] was not significantly different from groups 4 [1.62 +/- 0.024] and 6 fl.58 +/- 0.028]. Our study showed that a high dose of Pistacia atlantica fruit oil extract, administered orally and rectally can improve colitis physiologically and pathologically in a rat model, and may be efficient for ulcerative colitis
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Background: The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty
Methods: Twelve dogs, weighing 23-27 kg, were divided into three groups. After laparotomy, the volume of the primary rectum was measured so that it could be compared with that of the neorectum at the end of the study. After rectal resection in Group A, the colon was directly anastomosed to the anus. In Group B, a 5-cm longitudinal incision was made 2 cm proximal to the anastomosis and was sutured transversely [coloplasty]. In Group C, a 5-cm ileal J-pouch was interposed between the colon and anus. After 8 weeks, the neorectum was evaluated for volume, radiology, and pathology
Results: All the samples were alive until the end of the study. The healing of the anastomotic lines was acceptable [pathologically] in all. The mean volume expansion was 20.9% in Group A, 21.7% in Group B, and 118.2% in Group C, with the latter being significantly higher than that of the other groups [P=0.03]. Colon J-pouch and coloplasty after proctectomy in some situations have not been performable. This study evaluated the performance of ileal J-pouch interposition
Conclusion: This study showed that ileal J-pouch interposition might produce an acceptable reservoir function and that it seems feasible and safe in selected cases
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The prevalence of inflammatory bowel diseases [IBDs] is set to stabilize in Western Europe and North America, as opposed to its increasing trend in developing countries in Asia. The epidemiology of IBDs in areas where the incidence and prevalence are relatively low provides an opportunity for researchers to determine the unknown aspects of them. In this review article, the PubMed and MEDLINE databases were searched from 1970 to 2012 and the epidemiological aspects assessed in Iranian articles were compared with identical subjects in other Asian countries. During this period, there were 21 documented articles on IBD epidemiology in Iran and 52 in Asia. According to the present review, CTLA-gene polymorphism and male/female ratio in ulcerative colitis [UC], incidence of extraintestinal manifestations, extent of intestinal involvement, and family history in both UC and Crohn's disease [CD] seemed to be different between Asia and Iran. In contrast, the incidence of primary sclerosing cholangitis in BD patients and association between NO2/CARD15 mutation and CD as C3435-T allele and UC were nearly the same. The rate of IBD has increased significantly in Iran, as has that of other Asian countries during the last decade. A thorough, well-designed,opulation-based, multi-regional epidemiologic study seems mandatory due to the substantial demographic and characteristic variability in IBD patients in our region