[ case report of gastrointestinal bleeding due to gastric lipoma]

Benign Gastric tumors are rare and generally account for less than 10% of all stomach tumors. Gastric lipoma is a rare tumor that constitutes approximately 3% of all benign tumors of the stomach and mainly is seen as a submucosal mass. Most gastric lipoma are asymptomatic and are found accidentally. Occasionally they can cause symptoms such as gastrointestinal bleeding, obstruction, abdominal pain and intussuception. CT scan and endoscopy are helpful in diagnosis. The main modality of treatment is surgery. Diagnosis is confirmed by histology. In this article, a patient with weakness, fatigue, and melena complaints is presented. On gastric endoscopy a yellowish submucosal mass was seen in antrum. Abdominal CT scan disclosed a mass with fat density resembling lipoma. The patient underwent surgery and diagnosis of lipoma was confirmed by histology. Although gastric lipoma is rare, it should be considered in the assessment and differential diagnosis of hemorrhagic submucosal masses in the stomach

Two-year experience of orthotopic liver transplantation in Afzalipoor Hospital, Kerman, Southeastern Iran

End-stage liver diseases are common in Iran. The only therapeutic option for these patients is liver transplantation. To present our 2-year experience of liver transplantations in Afzalipoor Hospital, Kerman, southeastern Iran. From November 2009 to September 2011, 12 patients underwent orthotopic liver transplantation in our center. Their data including demographics, indications for transplantation, MELD scores, post-operative complications and their management were collected. Patients [7 women and 5 men] aged between 14 and 55 years. Indications for the transplantation included HBV infection [n=5], cryptogenic cirrhosis [n=2], Wilson's disease, alcoholism [n=1], HCV infection [n=1], Budd-Chiari syndrome [n=1], and autoimmune hepatitis [n=1]. MELD score of patients ranged from 16 to 30. All patients received tacrolimus, mycophenolate mofetile and corticosteroid, post-operatively. 2 patients died of pulmonary and intra-abdominal infections with resultant to multiple organ failure. Nonfunctioning of transplanted liver and ongoing bleeding resulted in death in another patients. 9 patients are well doing and have excellent liver functions. We had relatively successful results in our experience of orthotopic liver transplantation. Vicinity of our center to Shiraz Transplant Center would be an important factor in this success

[Antibiotic-resistance patterns of helicobacter pylori isolates obtained from patients in Kerman- 2009]

Background and Aims: Based on serological studies the prevalence of Helicobacter Pylori infection in Iranian adults is up to 80%. Gastritis, peptic ulcer and gastric adenocarcinoma are common clinical outcomes of this infection in Iran. Since antibiotic resistance patterns of Helicobacter pylori are different geographically, local studies are highly required

Method: From April to December 2009, 63 isolates of Helicobacter pylori were obtained From 191 patients referred to the endoscopy unit of Afzalipour hospital in Kerman. Demographic features including age, gender, symptoms, were recorded before the sampling and sensitivity to six common antibiotics used for the treatment of H.pylori infection was determined. Modified disk diffusion test was used to evaluate antibiotic resistance pattern. Data analysis was done through SPSS 16 and using Pearson chi-square test

Results: The patterns of antibiotics resistance were as below: metronidazole 55.5%, clarithromycin 30.1%, tetracycline 3.1%, amoxicillin 26.9%, ciprofloxacin 7.9% and no resistance to furazolidone was detected. While 12.7% of the isolates were susceptible to all the six antibiotics, 55.6% were resistant to one antibiotic, 25.4% to two antibiotics, 6.3% to three antibiotics and there was no resistance to more than three antibiotics at the same time

Conclusion: According to the obtained antibiotic resistance rates in this study, performing antibiogram tests before starting the treatment is necessary

[Report of a case with obscure GI bleeding in extramural pedunculated GIST]

Obscure gastrointestinal [GI] bleeding is defined when the source of GI bleeding could not be determined by upper endoscopy, colonoscopy or barium small bowel transit. In this report, a 41 year-old man presented with a history of over ten recurrent episodes of melena since four years prior to admission. The source of bleeding was not detected by multiple upper and lower GI endoscopies. During the last admission, other investigations which included small bowel transit, abdominal radioisotope scan and double balloon enteroscopy up to the mid-jejunum were all inconclusive. For more evaluation, an exploratory laparatomy and intra-operative endoscopy were planned. On laparatomy, a tumoral mass of 7 cm diameter was found on the inferior aspect of the stomach. The tumor was attached to the gastric wall by a 2 cm pedicle and connected into the gastric lumen via a small orifice which was not visible on endoscopic view. The tumor was resected with the surrounding gastric wall. Pathologic report favored pedunculated gastrointestinal stromal tumor [GIST] and confirmed with the positive CD117 antigen. Therefore, in the approach of patients with obscure GI bleeding, rare causes such as extramural pedunculated GIST should be considered

[Demographic and clinical features of ulcerative colitis patients in Kerman city during 2005-2007]

Ulcerative colitis is one of the inflammatory bowel diseases with unknown etiology. Genetic and environmental factors are thought to be effective in this disease. According to the limited studies in our country, general assessment of demographic features and clinical symptoms seems to be essential. In this prospective and cross-sectional study, 85 cases of ulcerative colitis referred to the 3 gastroenterologist offices in Kerman city were evaluated during 2005-2007. The diagnosis was confirmed based on clinical features, colonoscopy, pathology and ruling out of other causes. Data were collected through direct interview and analyzed by SPSS 15 software. Mean age at the time of diagnosis was 33.31 +/- 13.12. Duration of symptoms onset until diagnosis was 8 months. Male to female ratio was 0.8/1 and the most important clinical manifestations were rectorhagia and bloody diarrhea [92.9%], abdominal pain [20%], mucoid diarrhea [13.1%], weight loss [11.2%] and fever [4.4%]. The pattern of disease was chronic intermittent in 83.5%, chronic continuous in 13% and acute self-limited in 3.5%. Anatomically disease was limited to the rectum [8.3%], recto sigmoid [23.5%], recto sigmoid and descending colon [28.5%], transverse colon [21.2%] and pan colitis. [18.8%]. Extra intestinal manifestations were seen in 22.35% of cases of whom 12.96% had oral involvement, 5.85% had hepatic involvement and 3.53% had musculoskeletal involvement. Recurrent inflammatory bowel disease is one of the important reasons of referral to gastroenterologists. Ulcerative coilitis in Kerman is similar to other countries of world epidemiologically, demographically and clinically but its seems that severe clinical courses, extra intestinal manifestations and second old age peak to be less comparing to other studies

[Pancreatobiliary cancers in Iran: a population- based study]

Our knowledge regarding the epidemiology of pancreatobiliary cancers in Iran is limited. This study presents the first population-based report on pancreatobiliary cancers performed in five provinces of Iran. Data used in this study were retrieved from population-based cancer registries in five provinces of Iran [Gilan, Mazandaran, Golestan, Ardabil and Kerman] from 1996 to 2000. Crude incidence rate, age standardized incidence rate [ASR] and age specific incidence rate were calculated for each cancer sites using the direct method. Overall ASR of pancreatic cancer in five provinces was 1.18 and 0.84 per 100, 000 person-years for men and women, respectively. These values for gallbladder and biliary tract cancers were 0.42 and 0.27 per 100, 000 person-years for men and 0.93 and 0.22 per 100, 000 person-years for women, respectively. ASR of pancreatobiliary cancer is low in Iran compared to western countries

[Evaluation the effects of Bezoar on survival duration Attenuation of complications of Echis carinatus snake venom poisoning in mice]

Snakebite treatment is one of the major difficulties in medicine due to its dangerous side effects. Bezoar, a stone found in the stomach of wild goat, is widely reputed against various diseases, including snakebite, in traditional medicine among the tribes in southeast of Iran. But its efficacy against snakebite poisoning has not been determined, yet. This study was performed to evaluate the Bezoar effect on the clinical signs, mean survival duration and the autopsy findings [pathologic signs] of experimental mice receiving various doses of crude Echis carinatus snake venom. This experimental study was performed on 48, 4 week old mice. The natural crude snake venom was serially diluted and 10% and 2% concentrations of the venom were used. Various experimental doses of Bezoar [6, 50, 100 and 200 mg/kg/i.p] were injected, 20 min before 2% snake venom intra peritoneal administration. The clinical signs, mean survival duration and autopsy findings were recorded and compared with control mice which received saline, 20 min before snake venom administration. In case of using 10% concentration snake venom, mice received only 100 mag/ i.p of Bezoar, 20 min before snake venom administration. The results of this study showed that Echis carinatus snake venom caused pain, progressive edema and death in mice. The Bezoar [50 and 100 mg/kg] increased the survival duration of mice receiving 2% dilution of Echis carinatus snake venom significantly as compared to controls [p<0.01]. The dose of 100 mg/kg of Bezoar increased the survival duration from 213.8 +/- 2.7 to 705 +/- 4.3 min in comparison to control group [p<0.01]. Also the Bezoar significantly antagonized the pathologic signs induced by Echis carinatus snake venom in mice. Pretreatment of mice with Bezoar increased the survival duration of mice and decreased the pathologic signs [such as bleeding in the retroperitoneal space, thoracic cavityand CNS and lung vascular congestion] induced by Echis carinatus snake venom in mice. The exact mechanisms must be elucidated in other investigations

first population-based Cancer survey in Kerman province of Iran

Cancer is the second most common cause of non-accidental death in Iran. Geographical, racial and habitual differences have led to the variation in the incidence of cancer in different regions of this country. This study was performed to determine the incidence of cancer in the Kerman Province, central Iran. All newly diagnosed cases of cancer in the Kerman Province were recorded in a five-year period [1996-2000]. In all, 5884 new cases [55.7% males] of cancer were found after elimination of repeated cases. Based on age-standardized incidence rates [ASR] the most common cancers in men were stomach [10.2], lung [7.1], bladder [6.7], colorectal [5.9] and non-Hodgkin's lymphoma [5.8], while in women the most common cancers were breast [16.9] colorectal [5.9], stomach [5.1], leukaemia [4.6] and non-Hodgkin's lymphoma [2.8]. For all cancers, ASR was 76 for males and 68 for females. The results indicate that upper gastrointestinal cancer, especially oesophageal cancer is very rare in central Iran in contrast to northern Iran, although these types of cancers are some of the most common cancers in the Kerman Province

role of religiosity in preventing the delinquency of tehranian juvenile

The purpose of the present research has been to determine the role of religiosity in preventing juvenile delinquency [robbery] in Tehran on the basis of religiosity perspective theoretical and social integration, and the aim has been to provide the sociological analysis of religiosity as solution for confronting to juvenile delinquency. The research method is survey and a kind of causal- comparative. In tense of time, it is cross- sectional and in tense of intensive it is a kind of extensive the data, and have been collected through questionnaire. The results of this study shows that there is a significiant difference between religiousity and delinquency rate of typical [non delinquent] and confined [delinquent] juvenile group in significance of% 95. The theoretical finding of the research showed that although it is possible to describe the seperated and direct relalation between each one of independent variables [religious aspect] and the dependent variable [the rate of delinquency], based on religiousity and social integration theories, but the result of multi variable analysis shows, only consequentive aspect of religiousituy has a direct effect on delinquency and it proved to have the greatest share in explaining the preventing juvenile delinquency

[ incidence rate of gastrointestinal tract cancers in Kerman province during 1996-2000]

Cancer as the second leading cause of death following cardiovascular diseases has always been a threat to human life and due to its peculiar nature and lack of a favorable treatment, it is considered as a research priority in all communities. Understanding the geographical distribution of the incidence of various tumors, constitutes the first step in health and treatment planning. This study was carried out to review the incidence rate of gastrointestinal cancers in Kerman province and estimate disease load in this geographical area. Through a community-based registration system, all the documents related to cancer diagnosis in Kerman province from 1996 to 2000 were investigated. Among 5867 registered cases of cancer with an average age of 51.5 +/- 20.6 years, men composed 55.5% and women 44.5% of the cases and 1303 ones [22.2%] had gastrointestinal tract cancers among them gastric tumors [39%] had the highest incidence rate. Following gastric tumors, tumors of colon [29.4%], esophagus [12.5%], liver [5.83%] gallbladder [5.3%], and pancreas [2.84%] acquired the next ranks in regard to the incidence rate. The incidence pattern of aforementioned cancers in men showed the same pattern as the general population, but in women, colon tumors with the incidence rate of 35% have the highest incidence rate while tumors of the stomach [29.71%], esophagus [10.15%], gallbladder [9.8%], liver [5.26%] and pancreas [4.32%] were the next. Although, various GI malignancies have a lower incidence rate in Kerman province compared with other countries, the fact that these malignancies account for 22.4% of all malignancies, greatly enhances the need for serious planning for prevention, early diagnosis and correction of improper dietary habbits in this province. Moreover development of a versatile cancer registration system to evaluate the domestic comparisons seems essential

[ incidence rate of gastrointestinal tract cancers in Kerman Province during 1996-2000]

Cancer as the second leading cause of death following cardiovascular diseases has always been a threat to human life and due to its peculiar nature and lack of a favorable treatment, it is considered as a research priority in all communities. Understanding the geographical distribution of the incidence of various tumors, constitutes the first step in health and treatment planning. This study was carried out to review the incidence rate of gastrointestinal cancers in Kerman province and estimate disease load in this geographical area. Through a community-based registration system, all the documents related to cancer diagnosis in Kerman province from 1996 to 2000 were investigated. Among 5867 registered cases of cancer with an average age of 51.5 +/- 20.6 years, men composed 55.5% and women 44.5% of the cases and 1303 ones [22.2%] had gastrointestinal tract cancers among them gastric tumors [39%] had the highest incidence rate. Following gastric tumors, tumors of colon [29.4%], esophagus [12.5%], liver [5.83%] gallbladder [5.3%], and pancreas [2.84%] acquired the next ranks in regard to the incidence rate. The incidence pattern of aforementioned cancers in men showed the same pattern as the general population, but in women, colon tumors with the incidence rate of 35% have the highest incidence rate while tumors of the stomach [29.71%], esophagus [10.15%], gallbladder [9.8%], liver [5.26%] and pancreas [4.32%] were the next. Although, various GI malignancies have a lower incidence rate in Kerman province compared with other countries, the fact that these malignancies account for 22.4% of all malignancies, greatly enhances the need for serious planning for prevention, early diagnosis and correction of improper dietary habbits in this province. Moreover development of a versatile cancer registration system to evaluate the domestic comparisons seems essential

[Ecologic study of serum selenium and upper gastrointestinal cancers in Iran]

Both observational and experimental studies have shown that higher selenium status reduces the risk of upper gastrointestinal cancers in selenium deficient populations. Recent cancer registry data have shown very different rates of esophageal cancer [EC] and gastric cancer [GC] in four provinces of Iran, namely Ardabil, Mazandaran, Golestan, and Kerman. The aim of this study was to have a preliminary assessment of the hypothesis that high rates of EC in Golestan and high rates of GC in Ardabil may be partly attributable to selenium deficiency. We measured serum selenium in 300 healthy adults from Ardabil [n=100], Mazandaran [n=50], Golestan [n=100], and Kerman [n=50], using inductively coupled plasma, with dynamic reaction cell, mass spectrometry [ICP-DRC-MS] at the US Centers for Disease Control [Atlanta, Georgia]. The median serum selenium concentrations were very different in the four provinces. The medians [IQR] for selenium in Ardabil, Mazandaran, Golestan, and Kerman were 82 [75-94], 123 [111-132], 155 [141-173], and 119 [110 -128] micro g/L, respectively [p<0.001]. The results of linear regression showed that the province variable, by itself, explained 76% of the variance in log selenium [r2=0.76]. The proportion of the populations with a serum selenium more than 90 micro g/L [the concentration at which serum selenoproteins are saturated] was 100% in Golestan, Kerman, and Mazandaran but only 29% in Ardabil. Our findings suggest that selenium deficiency is not a major contributor to the high incidence of EC seen in northeastern Iran, but it may play a role in the high incidence of GC in Ardabil province

[Study the effect of valeriana officinalis and echium amoenum on the liver and renal function tests in rats]

Nowadays herbal medicine is marketing without standard toxicological study. Although people believe that herbal medicine do have any toxic effects, there are some reports indicating the toxicity of the herbal medicine. The aim of this investigation is to study the renal and hepatic effects of Echium Amoenum [EA] and Valeriana Officinalis [VO]. Percolated extract of these plants with doses of 100 and 200 mg/kg was administered to 5 groups of rats via orogastric tube for 7 days. At the 8th days, the blood samples were taken for biochemical studies. The results showed significant variation of the levels of AST. ALT and AlkP in comparisons with control groups. AlkP was increased significantly after oral administration of two extracts with dose of 100 mg/kg and 200 mg/kg. ALT was decreased with dose of 100 and 200 mg/kg of VO significantly but AST increased significantly only with dose of 100 mg/kg. ALT was decreased with dose of 100 mg/kg of EA but increased only with dose of 200 mg/kg. [p<0.01]. AST did not change with dose of 100 mg/kg, but decreased significantly with dose of 200 mg/kg [p<0.01].Renal function tests including BYN [Blood Urea Nitrogen] and Creatinine did not change significant after oral administration of two extracts. The data of this investigation indicate that hepatotoxic effect of extract of EA was greater than VO especially at high dosage

Helicobacter pylori and rosacea

Recent reports have suggested an increased prevalence of Helicobacter pylori infection in patients with rosacea, with some evidence of dermatological improvement in patients treated with antibiotics for this infection. Our study investigates the prevalence of H. pylori infection in rosacea patients in Kerman. Serological examination was done for 29 patients with classical identification of rosacea using the enzyme-linked immunosorbent assay IgG antibody method. Comparison of antibody titres with those of a control group revealed that the prevalence of positive serological tests for H. pylori was significantly higher in the test group. This supports the suggestion of some form of relationship between rosacea and H. pylori infection, though further investigations with larger sample sizes are required for a definite conclusion