Clinical and pathological features of ulcerative colitis in patients with and without clostridium difficile infection; an observational study

Background: A dramatic rise in the rate of clostridium difficile infection [CDI] in patients with inflammatory bowel disease [IBD] has been reported in recent years

Methods: In this observational case control study, 65 patients were included and were divided into two groups of IBD+CDI as case group and IBD without CDI as control group

Results: 35 patients who had positive test for clostridium difficile were assigned to the case group. The control group consisted of 30 patients with negative test for clostridium difficile. Pancolitis was seen in the cases more statistically significant than the controls and proctitis was seen more among the controls than the cases [p =0.001]. The cases were on immunosuppressive [p=0.001] and antibiotic [p =0.02] therapy more than the controls. Colonoscopic findings revealed more severe and extensive inflammation among the cases versus milder inflammation among the controls, but these differences were not statistically significant [p =0.2]. Colectomy was seen in 10% of controls and none of the cases and this difference was statistically significant [p value=0.05]. More fecal calprotectin were seen among the cases than the controls and this difference was statistically significant [p <0.05]

Conclusion: This study showed more clostridium difficile infection among the patients on antibiotic or immunosuppressive therapy. Pathological investigation revealed more severe and extensive inflammation among the cases than the controls. Cases had clinically more severe signs and symptoms with higher mayo scores than the controls. ESR[erythrocyte sedimentation rate] and fecal calprotectin were higher in patients with positive clostridium difficile infection and serum albumin was lower in such patients

Is it necessary to screen for celiac disease in adult idiopathic osteoporosis?

The aim of this study was to investigate the necessity of screening for celiac disease in idiopathic osteoporotic patients. Osteopenia and osteoporosis are well-known and prevalent complications of celiac disease. However, the relative prevalence of celiac disease among osteoporotic populations is not known, and the benefit of screening for celiac disease among the osteoporotic population remains controversial. We evaluated a total of 560 individuals, 460 with osteoporosis and 100 healthy subjects, from the rheumatology clinic in Imam Khomeini and Shariati hospital by IgA anti-tissue transglutaminase [anti-tTG] for celiac disease. Then individuals with positive serologic test underwent upper GI Endoscopy and 2nd part duodenum biopsies. The clinical findings were evaluated in both groups and were compared with each other. Five [1.08%] of 460 patients with osteoporosis and 1 [1%] of 100 subjects without osteoporosis had celiac disease by positive serologic and pathology results. Three patients with positive serology and pathology results were female. All patients in osteoporotic group had at least one other symptom of celiac disease. Two of them had anemia and others had chronic abdominal pain, recurrent oral aphtous lesion and chronic bloating. In the present study, the prevalence of celiac disease in osteoporotic patients is not high enough to justify recommendation for serologic screening of celiac disease in all patients with idiopathic osteoporosis; but in osteoporotic patients with other celiac or gastrointestinal symptoms and signs, for example iron deficiency anemia, chronic dyspepsia and bloating, constipation or diarrhea and recurrent aphtous lesions, it is necessary to evaluate for celiac disease

Efficacy of endoscopic ultrasound guided fine needle aspiration in patients with solid pancreatic neoplasms

Endosonography is a distinct method for evaluating the structural lesions of the gastrointestinal [GI] tract, particularly the pancreatobilliary region. This procedure has made a fundamental change in the diagnosis of pancreatic mass lesion through providing fine needle aspiration. This study aims at evaluating the results and efficacy of endoscopic ultrasound fine needle aspiration [EUS-FNA] in patients with pancreatic solid mass. The present study is an observational, prospective case series nature, evaluated patients with pancreatic solid mass referred to Imam Khomeini educational hospital in Tehran for a duration of one year since November 2010. In order to determine the false negative cases, the patients were followed-up from 6 to 12 months. EUS-FNA was conducted on all 53 patients without any complication. The majority of patients included in the study were males [68%] and 81% of patients had a mass in the head of pancreas. The result of cytopathology revealed 36 adenocarcinomas [68%], 7 other malignancies [13%], benign lesions [6%] and 7 non-diagnostic cases [13%]. The frequency of non-diagnostic results was significantly high in masses smaller than 3 cm [6 vs. 1, P < 0.002]. Patients with non-diagnostic result were younger than those with malignant cytopathology [52 +/- 7.5 vs. 66 +/- 7.5 years, P < 0.001].. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of this procedure concerning Adenocarcinoma were 88%, 100%, 100%, 70% and 90%, respectively. EUS - FNA is an effective and safe procedure in histopathologic diagnosis of pancreatic tumors. This procedure is useful in all pancreatic mass cases including resectable and non-resectable ones

Prevalence of metabolic syndrome in polycystic ovarian syndrome women in a hospital of Tehran

Polycystic ovarian syndrome [PCOS] is a condition associated with chronic anovulation, insulin resistance and androgen excess. Women with this syndrome are at increased risk of metabolic syndrome. The aim of the present study was to determine the prevalence of metabolic syndrome [MBS] in women with PCOS referred to Arash Hospital in different ages and body mass index [BMI]. A cross-sectional study was conducted in Gynecologic Clinic at Arash Hospital affiliated with Tehran University. A total of 282 women with PCOS ages between 15-40 years were included. The prevalence of Metabolic Syndrome and its components in this population were the main outcomes. Height, weight, waist circumference, blood pressure and laboratory tests [FBS, TSH, HDL-C, serum prolactin, triglycerides and total cholesterol] were measured in this population. The prevalence of MBS in PCOS women was 22.7% [64 cases]. The rate of central obesity, FBS more than 110 mg/dl, triglycerides more than 150 mg/dl, high-density lipoprotein cholesterol levels [HDL-C] less than 50 mg/dl, and blood pressure >/= 130/85 mmHg in PCOS women was 31% [87], 3.2% [9], 33% [93], 68.8% [194], and 10.6% [30], respectively. The risk of MBS was increased in older and the obese women [BMI >/= 30 kg/m[2]]. The present sample showed women with PCOS have a high prevalence of MBS and its individual components, particularly decreased HDL-C

[Gastroesophageal reflux disease in Gonbad city: the prevalence and risk factors]

Gastroesophageal reflux disease [GERD] is a common gastrointestinal disease. Although, the prevalence of GERD is high, has an adverse impact on the quality of life and there was a relationship between GERD and peptic stricture, Barrett's esophagus and esophageal adenocarcinoma, that is increasing recently, there is limited information and conflicting data for risk factors of GERD. The aim of this study was to investigate prevalence and the potential risk factors of GERD in Gonbad city [Northern Iran]. A total of 1016 randomly selected subjects aged 18-40 years, were invited to the study. Face to face interview was performed for 1000 participants. Cardinal symptoms of GERD [heartburn and/or regurgitation], frequency and severity asked. Subjects who reported heartburn and/or regurgitation, at least once a week, during the last 12 months were defined as GERD patients and controls were persons without any compliant of those symptoms. Dietary intake was assessed using a local validated Block 116 food frequency questionnaire. The prevalence for weekly GERD was 12.3%. Increasing Age [OR: 1.04, 95% CI: [1.00-1.07]], BMI