[Concomitant pleural tuberculosis and aspiration pneumonia due to epiphrenic diverticula: a case report]

Aspiration pneumonia is a critical disease and can result from a various causes. Epiphrenic diverticula is a rare disorder, which can cause aspiration of food material contained in it. Mediastinal tuberculosis can also cause traction diverticula at mid-esophagus, which usually are asymptomatic and induce no complication. In this article we describe a case, suffering of all these three disorders and after seven years of surgery and medical treatment any symptom was not found in the patient

[Comparison of hepatitis C virus genotypes in hemodialysis and nonuremic patients]

Hepatitis C viruses [HCVs], which is an enveloped RNA cense positive, are classified into six major genotypes and multiple subtypes. Infection with this virus has been found to be a major cause of liver disease. Also, HCV infection is quite high among chronic hemodialysis patients. The purpose of the present study was to compare the genotypes of HCV and associated risk factors in hemodialysis patients with positive HCV non uremic patients. Sera sample were taken from population consisted of 113 non uremic patients and uremic ones with HCV who referred to Imam Khomeini nephrology clinic and Sari and Ghaemshahr Dialysis Centers: Case group was consisted of 55 patients with positive HCV hemodialysis disease. The control group consisted of 58 patients suffering from non-uremic positive HCV. Samples were tested with improved Real-Time PCR technique using the appropriate kit. In this study, the mean age of case group was 44.88 +/- 14.6 and for the control group was 46.73 +/- 11.9. Considering the sex of participants, 23 [41.8%] were female patients and 32 [58.2%] were in the case group while 13 female [22.4%] and 45 male [77.6%] were in the control group. The most common genotype of HCV in case group was 1a-b [72.7%] and in control group was 3a [50%]. Significant differences [p<0.05] were seen in HCV genotypes between two case and control groups. BUN and Cratinin in hemodialysis patients showed observable differences in comparison to control group [p<0.05], while PTT, AST, ACT in control group were higher in compare with hemodialysis patients [P < 0.05]. This study showed that the hepatitis C virus genotype and its associated risk factors in hemodialysis patients and non uremic patients is different

[ effect of esophagectomy and cervical esophagogastrostomy with or without of pyloromyotomy on emptying of intrathoracic stomach]

A gastric conduit is usually used to reconstruct the foregut after esophagectomy for cancer. The gastric emptying may be impaired after this operation, so some esophageal surgeons routinely add a pyloric drainage procedure. The aim of this study was to determine the emptying of the intrathoracic stomach after esophagectomy and cervical esophagogastrostomy with or without pyloromyotomy. Between January 2003 and April 2006, in a randomized controlled trial, 30 patients with esophageal carcinoma were randomized to have with or without pyloromyotomy as a gastric emptying procedure for the gastric conduit used for esophageal replacement. Patterns of gastric emptying in the vagotomized intrathoracic stomach were studied using radioisotope techniques. Gastric emptying [GE] was evaluated 8 weeks after the operation. Patients were available for 6 months follow-up. A total of 30 patients were enrolled in this study. Sixty percent [18] were male, and 40% [12] were female. Twenty three patients [76.7%] had squamous cell carcinoma and 7 [23.3%] had adenocarcinoma. Delayed GE was reported in 11 [73.3%] and normal GE in 4 [26.7%] of patients with Pyloromyotomy. Delayed GE was reported in 9 [60%] and normal GE in 6 [40%] of patients without Pyloromyotomy. There were not any significant differences between complications of post surgery in both groups. These findings were showed that esophageal surgery can be don't add a pyloric drainage procedure in esophagectomy and cervical esophagogastrostomy and that very few patients actually need it

Effects of psycho-education on quality of life in patients with irritable bowel syndrome

Presentations of Irritable Bowel Syndrome [IBS] is influenced by numerous cultural, racial and social factors. Some evidences indicate that psycho-education can potentially improve the Quality Of Life [QOL] in these patients. The aim of this study was to evaluate the effects of psycho-education on the QOL in a sample of Iranian patients with IBS. This clinical trial was conducted on 44 patients who were randomly assigned to an experiment group and a control one. The two groups were matched for age, sex, level of education, job status and level of stress. The control group received only drug therapy while the case group participated in a three-session educational program as well. The content of educations included information about anatomy of the intestines, pathopysiology of IBS and potential causes of symptom aggravation, as well as stress manage-ment and problem solving skills training. The QOL Short Form scale for IBS patients [IBS QOL-SF36] were administerd to both groups before the first and one month after the last session of psycho-education. Data were analysed using T-student and Chi-square tests running SPSS-10 software. The mean age of the control and the case group was 33.5 +/- 8 and 37.5 +/- 10 years respectively. Most of the patients in both groups were female, married and urban resident, with no significant differences in this regards. There was also no significant difference between the two groups regarding the mean scores of IBS-QOL-SF36. In the short term follow up psycho-education was not effective in improving the QOL in patients with IBS. A long-term evaluation as well as a large sample size is needed for more reliable conclusions

relationship between helicobacter pylori colonization in dental plaque and gastric infection

With regard to the presence of Helicobacter pylori [H. pylori] in Dental Plaque [DP] and its association with gastric infection, data from the literature are variable. The aim of this study was to determine the prevalence of H. pylroi in DP of dyspeptic patients who underwent upper gastrointestinal endoscopy and to investigate its relationship to gastric infection and oral hygiene. Dental plaque samples were taken from tooth surfaces of molars, premolars and incisors of 180 dyspeptic patients. DP samples were subjected to rapid urease test, histological examination, gram stain and culture for identification of H. pylori. During endoscopy six biopsies were taken to visualize H. pylori. Information concerning oral hygiene protocol were recorded. For statistical analysis of data chi square test was used. Clinical diagnoses included 11.3% duodenal ulcer, 46% active chronic gastritis without ulcer, 22.7% chronic gastritis with ulcer and 20% normal gastro-duodenal mucosa. Patients were divided into two groups of infected and uninfected according to H. pylori infection. Our study proved the presence of H. pylori in DP of infected and uninfected patients including subjects with normal gastric mucosa. H. pylori was identified in all three locations with different prevalence: 87% in the molars, 69% in the premolars and 61% in the incisors. There was no significant association between H. pylori colonization in DP and gastric infection. In this study oral hygiene did not have significant influence on the presence of H. pylori in dental plaque. There was no significant relationship between the presence of H. pylori in DP and gastric infection supporting the hypothesis that H. pylori may belong to the normal microflora of the oral cavity. However, factors that influence the growth and distribution of H. pylori and conditions that favour gastric infection are still unknown