ABSTRACT
According to the reports of World Health Organization [WHO] and Centers for Disease Control and Prevention, the prevalence of chronic hepatitis B infection in Iran has decreased from 2-7% in 2001 to 1.3-0.8% in children aged 2-14 years. In 2010 the Institute of Medicine recommended more comprehensive screening by primary care physicians [PCPs] for evaluation, vaccination, and management of infected patients for further decrease in the prevalence of chronic HBV infection. Thus, with contribution of the Health Department, we developed a practical flowchart for PCPs to start active screening of hepatitis B virus [HBV] in all visited patients and refer the positive cases for further evaluation and management to Taleghani Hospital. With collaboration of Health Department of Shahid Beheshti University of Medical Sciences, physicians of health centers were asked to screen all their patients for HBsAg. Positive cases were referred to Taleghani Hospital. They were first registered and educated about their disease, life style, and prevention methods. Their first degree families were screened for HBV infection too and were referred for vaccination if needed. According to the results of lab tests, appropriate management was done by a hepatologist. Since implementation of this program, we have encountered a significant rise in patient detection [even in high risk groups]. Many of them were not aware of their disease and most of those who were aware of their disease were not managed appro priately. Family screening and vaccination were inadequate and need more emphasis
ABSTRACT
The aim of this study was to determine the prevalence of HDV infection between HBV chronic patients referred to gastroenterology ward of Taleghani hospital Tehran, Iran and also investigating the risk factors in acquiring the HDV infection. Hepatitis B virus [HBV] and Hepatitis D virus [HDV] are major public health issues. Worldwide there are approximately 350 million individuals chronically infected with the HBV. A significant part of them, including 15 to 20 million coinfected with HDV. Hepatitis Delta virus is transferred mostly through blood and body fluids. HBV and HDV infections were evaluated by Enzyme-linked immunosorbent assay [ELISA]. Liver functional tests were assessed through auto analyzer. Patients were interviewed and data along the test results were entered into SPSS program. We used chi-square, independent t-test and logistic regression for statistical analysis. 278 [54.6%] patients of the study group were male and 231 [45.4%] were female and the mean age of patients was 40.03 +/- 14.93. From 509 patients, 39[7.7%] had anti-HDV antibody. In a uni-variable analysis, age [p=0.001], periodontal procedures [p=0.015], endoscopy [p=0.024] and colonoscopy [p=0.012] were significantly related to HDV seropositivity. After adjustment by logistic regression, age remained the only significant factor in acquiring HDV infection. We highly recommend the health care workers to strictly follow the disinfection protocols of medical instruments. Since HDV seroprevalence changes over time, regular epidemiological studies are necessary to monitor the epidemiological trend of infection
ABSTRACT
Selection of the best approach for the treatment of Helicobacter pylori [H. pylori] infection that encompasses higher eradication and lower failure rates leads to a decline in its related complications and disorders. To understand the relative efficacy of new sequential therapy compared with standard triple therapy as two common regimens, we have performed a randomized, controlled trial to compare these two treatment protocols in an Iranian population. This study enrolled 220 patients aged 18-81 years old with dyspepsia or peptic ulcers who were candidates for endoscopy and referred to Taleghani Hospital, Tehran, Iran. Patients were randomized to receive one of two treatment regimens, a 14-day new sequential therapy that consisted of omeprazole [20 mg], amoxicillin [1.0 g], and ciprofloxacin [500 mg] administered twice daily for the first seven days, followed by omeprazole [20 mg], amoxicillin [1.0 g], and furazolidon [200 mg] administered twice daily for the remaining seven days. The second regimen comprised a proton pump inhibitor [PPI]-based triple therapy of omeprazole [20 mg], amoxicillin [1.0 g], and clarithromycin[500 mg] administered twice daily for 14 days. Overall, 10 patients in PPI-based triple therapy group and 16 patients in the 14-day new sequential group stopped treatment and did not undergo 13C-urea breath testing [UBT]. Among the remaining patients, the eradication rate with the PPI-based triple therapy was 89.0%, whereas it was 91.5% with the 14-day new sequential therapy which was not significantly different. No significant differences were found in eradication rates between genders in each treatment group. Adverse effects were mainly mild and comparable between the two treatment regimens. It seems that sequential regimen is at least as effective as standard therapy and can be used as an alternative treatment for H pylori eradication.
ABSTRACT
This study was designed to evaluate the frequency of antibody against these viruses in individuals attending the endoscopy ward of Taleghani hospital Tehran, Iran. Blood-borne viruses such as hepatitis B and hepatitis C virus and HTLV-1 virus are among the world's public health problems. Hepatitis viruses cause liver problems and HTLV-1 infection can lead to adult T-Cell lymphoma [ATL]. Blood samples of 219 individuals attending the endoscopy ward of Taleghani hospital between years 2009-2011 were collected. A questionnaire containing demographic data was completed for each subject. Blood samples were tested for antibody against HTLV-1, HCV and HBc by ELISA [Dia.pro Italy]. In case of positive results for anti-HBc, samples were also tested for HBs Ag antigen. Ninety two subjects were male and 127 were female. Mean age of the population was 39.87 +/- 16.47. None of the subjects had anti-HCV antibody, while 4 of them had anti-HTLV-1 antibody and 26 anti-HBc antibody; which only two of these individuals had HBs Antibody. The results of this study show that frequency of anti-HCV and anti-HTLV-1 antibodies are very low, while the frequency of anti-HBc was higher in the population. Since HTLV-1 is the causative agent of a type of blood cancer, it seems that screening of donated bloods in this region should be considered