[ Case-Control study on the risk factors of IBD in 258 Iranian patients]

Ulcerative colitis [UC] and Crohn's disease [CD] are chronic inflammatory bowel diseases [IBD] with uncertain etiology thought to be triggered by interactions between various environmental, genetic and immunologic factors. Role of different factors in IBD are controversial. The aim of this study is to determine the possible risk factors in a group of Iranian patients with IBD. Ninety five consecutive cases of CD and 163 cases of UC were included. Age matched controls were randomly selected. A total of 489 controls for UC and 285 controls for CD were enrolled. A standard record concerning many variables was completed. Logistic regression analysis was used to evaluate potential confounding variables. A statistically significant protective effect for smoking in UC was found [OR=0.18 95% CI=0.064-0.504, p < 0.05]. The risk of UC increases with prolonged exposure to OCP [OR=0.99, 95% CI=0.98-0.99, p< 0.05]. In patients with CD, 15 cases [15.8%] reported a previous history of appendectomy compared with 19 controls [6.7%] [OR=2.6, 95% CI= 1.2-5.4, p < 0.05]. Tonsillectomy was reported by 16 patients [16.8%] with CD compared with 25 controls [8.8%] [OR= 2.1, 95% CI= 1.07-4.1, p < 0.05]. The logistic regression analysis showed that both appendectomy and tonsillectomy are risk factors in CD. No association with other variables was found for either disease. Current smoking was a significant protective factor in UC. We observed a relationship between duration of OCP use and UC. Duration of using OCP in UC cases was significantly more than controls. Both appendectomy and tonsillectomy were risk factors in CD in this study

Evaluation of prevalence of LBP and its effects on lower limb amputees life referred to Helal Ahmar rehabilitation center

LBP is a problem for lower limb amputees that is often ignored despite its adverse effects on their life. This research is trying to identify the prevalence of LBP among lower limn amputees visited at Helal Ahmar Rehabilitation Center. This is a cross sectional study that was conducted on 68 lower limb amputees. Two questionnaires were used for data collection. Also, amputees were examined by the researcher for scoliosis. Then data were analyzed using spss version 11.5. 73% was suffering from LBP. Pain severity was 5-6 on VAS. LBP directly affected their life, prosthesis weight was not heavy and amputees used their prosthesis 10 hours a day. More than 62.5% of LBP amputees showed scoliosis. LBP is prevalent among lower limb amputees. Among many factors may cause LBP-such as level of amputation, time from amputation, only scoliosis showed significant relation with LBP

Time trends of gastro-esophageal reflux disease [GERD] and peptic ulcer disease [PUD] in Iran

Epidemiology of diseases changes over time with changes in socio-economic status, culture and health care systems. Gastroesophageal reflux disease [GERD] and peptic ulcer disease [PUD] are among the diseases whose epidemiology has changed over the past few decades in the west. Studies addressing the trend of GERD and PUD occurrence in Iran are lacking. We aimed to look at the time trends of GERD and PUD in a referral endoscopy clinic in Tehran, Iran. All patients with dyspeptic symptoms who underwent upper GI endoscopy from 1993 to 2005 [inclusive] in a tertiary outpatient GI referral center in Tehran were enrolled. Erosive esophagitis [EE, used as a proxy for GERD as a whole], PUD, rapid urease test [RUT] status and demographic characteristics were recorded from the endoscopy reports according to the year the endoscopy was performed. Over a period of 13 years, 8,029 endoscopic examinations were performed. The most common endoscopic diagnosis was EE that occurred in 4,808 patients [59.8%] followed by duodenal ulcer in 2,188 [27.3%] and gastric ulcer in 88 [1.1%]. Over 13 years [1995-2005], the proportion of EE increased from 14.1% in 1993 to 75.1% in 2005 among dyspeptic patients in this referral clinic. The proportion of each grade of GERD according to the Los Angeles classification was as follows: GERD-A 76.0%, GERD-B 20.9%, GERD-C 2.8% and GERD-D 0.3%. RUT positivity decreased from 71.4% to 9.5% during the study period. This study shows a remarkable increase in EE with a concomitant decrease in PUD and RUT positivity among dyspeptic patients in Tehran over a decade. This change in trend is important for future health care planning

[Evaluation of low level laser therapy in recurrent aphthous stomatitis]

Recurrent aphthous stomatitis is one of the most common ulcerative lesions of the oral cavity, but up to now no cure has been recognized for it. In some studies low level lasers had good efficacy in reducing pain intensity and healing time in recurrent aphthous stomatitis but in some other studies the results were controversial. The aim of this study was to evaluate the efficiency of LLLT in treatment of RAS as compared with the placebo effect. In this double blind clinical trial, 24 patients with minor RAS who didn't use any drugs for it or didn't have any other related systemic disease to RAS were selected and randomly divided into 2 groups of 12 cases and 12 controls. In the case group, laser was irradiated but for the control group, the procedure was similar but laser wasn't irradiated to lesions. In this research, diode laser [660 nm, 3 J/cm[2], continuous] was applied. The pain intensity [VAS], the time of pain relief and healing time were evaluated. The data were analyzed by T-test, pair-T-test and covariance. This study showed that healing time was 5 +/- 1.41 days in the laser group and 8.25 +/- 0.96 days in the placebo group. Difference between the two groups was significant statistically [p<0.001]. According to covariance analysis, the pain difference at the end between the two groups by considering the pain difference before treatment was significant [p=0.009]. According to the results of this study, low level laser can decrease the healing time, pain intensity and the time of pain relief in patients with aphtae

Prevalence of orofacial complications in Iranian patients with beta thalassemia major

Major beta-thalassemia is the most common monogenic known disorder in Iran and about 15000 persons are affected. The purpose of this study was to evaluate the prevalence of orofacial complications. In this cross-sectional study during 2003-2004, 300 patients with major beta -thalassemia referring to 8 hospitals for routine examinations, blood infusion and treatment in cities of Tehran, Isfahan, Sari, Zahedan, Shahre Kord and Sanandag were studied. The questionnaires included general information, medical and dental history. The prevalence of orofacial complications in major beta-thalassemia was: saddle nose [67%], maxillary protrusion [49/7%], color change of oral mucosa [41/7%], rodent face [34/7%], deep bite [21/7%], spacing [20/7%], and open bite [8/7%], respectively. There was not any relationship between the complications and sex. Most of the patients [91%] were in the first and second decade of life. Early diagnosis and blood infusion caused less prevalence of rodent face. The most observed type of occlusion was class 1, 2 and 3, respectively. Knowing the prevalence of complication can help the dentists to do properly for these patients to solve their problems and improve knowledge of the parents about their children's dental health

[ relationship between opium dependency and stroke]

Stroke is the 3[rd] cause of death and although it is a common disease, its incidence is not the same in different parts of the world and depends on various factors. Opium dependency apart from being a social and cultural problem has several effects on physiological, immune and coagulation systems and consequently the risk of stroke. This case-control study was designed to determine the associations between opium dependency and stroke. The study was done in Kerman Shafa Hospital during 2003-2004 on 105 patients with stroke [case group] and 105 patients with urologic problems [control group]. Data were collected using patients history, physical examinations and diagnostic protocols and were analyzed using Chi-Square test. Both groups contained 55 females and 50 males. In the case group 31 ones [29.5%] and in the control group 18 ones [10.5%] were opium dependent that shows a significant difference between the two groups [P<0.001]. The relation between cigarette smoking and stroke was also determined [P<0.0001] and since both factors showed significant relation with stroke, logistic regression analysis was done. Odds ratio was 2.207 [P<0.012] for cigarette smoking and 2.36 [P<0.04] for opium dependency respectively

[Determination of DMFT index in patients with end stage renal disease being treated by hemodialysis in Ali Asghar medical center]

End stage renal disease [ESRD] is the last stage of the decending process of structural and functional distruction of kidneys. This process is often combined with acute diseases like glumerulonephritis and pyelonephritis. Uremic smell of mouth, enamel hypoplasia and defects, increase in dental debries, periodontal diseases, considerable delay in bone and dental age and fair decrease in oral hygiene are of this general oral symptoms. Despite these unfavorable factors, the recent researches indicated relatively lower DMFT index in these patients. Regarding these results, this study is trying to identify the DMFT index in the above mentioned patients.In this descriptive- analytic research, 22 patients with end-stage renal disease being treated with hemodialysis were examined. This was the total number of the patients ranging from 17 to 33 years old who were referred to Ali Asghar Medical center in Isfahan. After examining and indicating the DMFT index in these patients, they were compared with a healthy control group which were identical to the study group regarding their sex, age.Comparison between the patients with ESRD being treated by hemodialysis and healthy control group showed that DMFT was lower in ESRD than in control group. In this study however, no statistically meaningful relation was seen between sex, the age of the patients at the beginning of hemodialysis treatment, duration of hemodialysis treatment and the DMFT index of patients with ESRD being treated by hemodialysis.Patients with End-stage renal disease being treated by hemodialysis had noticeably, lower DMFT index compared to the normal people and this difference is more distinct in posterior teeth. Further, more despite the fact that no statistically meaningful relation was found between the age at the beginning of hemodialysis treatment, the duration of hemodialysis treatment and the DMFT index of patients with ESRD, it is probable that meaningful statistical relation will be found in larger sample size

[Comparison of oral micro flora and coronary artery disease]

Cardiovascular disease is the most common cause of death in developed counteries and it's morbidity and mortality is also increasing in Asia. Hypertension, hyperlipidemia and smoking are majore risk factors of atherosclerosis. In recent years infectious agents such as clamidia pneumoniae, Helicobacter pylori and dental flora infections seems to be effective in development of atherosclerosis. This study was designed for finding possible relation between dental flora and coronary artery disease.This was a case-control study [40 case and 40 control patients]. Case group were the patients with 75%-one vessel coronary stenosis in angiography and control had normal angiography, oral samples were provided for microbial culture in 2 groups, and data were analyzed.Frequency of streptococcus viridance, streptococcus beta-hemoliticus, pneumococcus, gram-negative staphylococcus, gram-positive staphylococcus, Nisseria and diphteriod was 82.5, 15, 2.5, 12.5, 7/5, 17.5 and 5 percent in case group and 37.5, 27.5, 7.5, 5 and 7.5 percent for control group, respectively Statistical test showed significant difference between frequency of streptococcus viridance in case and control group. This study suggests a probable relation between streptococcus viridance and coronary artherosclerosis disease, so prophylaxis can be recommended for this purpose

Comparison of serum zinc level in recurrent aphthous patients and normal individuals

Recurrent oral aphthous is one of the most common ulcerative lesions of the oral cavity which no specific treatment has been introduced for it, sofar. Some studies suggest the zinc deficiency as one of the etiologic factors in aphthous ulcers and also in other experimental studies, zinc composition has been effective in aphthous treatment. The aim of this study was to determinate the serum zinc level in normal and aphthous individuals. This was a case-control study in which 88 individuals [44 normal and 44 aphthous patients] were studied. Both groups were equalized for age and sex. Sampling was convinence. The blood samples were taken and the zinc level of them were measured by Atomic Absortion Spectrometer and then the results were statistically analyzed with t-test. This study showed that the average serum zinc level in the case group was 70 +/- 9 microg/dlit [mean +/- SD] and in the control was 94 +/- 14 microg/dlit and there is a significant difference between two groups [P<0.001]. According to above results, serum zinc level is significantly lower in Recurrent Aphtous Stomatitis [RAS] patients, thus the determination of serum zinc level, and prescribing zinc if its serum level is low, are recommended in RAS patients