ABSTRACT
Aim: The purpose of this study was to determine the efficacy of Heller myotomy for the treatment of achalasia in a referral center in Tehran, and investigate the clinical characteristics, manometric results and treatment responses among three achalasia subtypes in Iranian patients
Background: Esophageal achalasia is an unusual swallowing disorder, characterized by high pressure in the lower esophageal sphincter [LES] on swallowing, failure relaxation of the LES and the absence of peristalsis in esophageal
Patients and methods: In this cross sectional study, clinical symptom and esophageal manometry before and 2 months after treating with Heller myotomy in 20 patients with achalasia who were referred to Taleghani Hospital, Tehran, in 2013 were evaluated. Patients' demographic, clinical features and response to treatment were analyzed using SPSS software [version 20, Chicago, IL, USA]
Results: All the diagnostic criteria measured after the treatment were significantly different [P<0.05] before and after the therapy. The average decline in the length of the esophagus was 1.8 cm and dysphasia score was 7.25 units. Also an average decline in LES Resting Pressure, LES Residual Pressure, PIP, and IRP were 23.2 mmHg, 14.3 mmHg, 3.4 mmHg and 17.8 mmHg, respectively
Conclusion: Results of this study showed that the Heller myotomy is highly effective in relieving dysphasia in patients with achalasia. Also, type II achalasia is the most common subtype of achalasia with a better response to Heller myotomy compared to the other types
Subject(s)
Adult , Female , Humans , Male , Manometry , Cross-Sectional Studies , PatientsABSTRACT
Device-associated health care-acquired infections [DA-HAIs] pose a threat to patient safety, particularly in the intensive care unit [ICU]. However, few data regarding DA-HAI rates and their associated bacterial resistance in ICUs from Iran are available. A DA-HAI surveillance study was conducted in six adult and pediatric ICUs in academic teaching hospitals in Tehran using CDC/NHSN definitions. We collected prospective data regarding device use, DA-HAI rates, and lengths of stay from 2584 patients, 16,796 bed-days from one adult ICU, and bacterial profiles and bacterial resistance from six ICUs. Among the DA-HAIs, there were 5.84 central line-associated bloodstream infections [CLABs] per 1000 central line-days, 7.88 ventilator-associated pneumonias [VAPs] per 1000 mechanical ventilator-days and 8.99 catheter-associated urinary tract infections [CAUTIs] per 1000 urinary catheter-days. The device utilization ratios were 0.44 for central lines, 0.42 for mechanical ventilators and 1.0 for urinary catheters. The device utilization ratios of mechanical ventilators and urinary catheters were higher than those reported in the ICUs of the INICC and the CDC's NHSN reports, but central line use was lower. The DA-HAI rates in this study were higher than the CDC's NHSN report. However, compared with the INICC report, the VAP rate in our study was lower, while the CLAB rate was similar and the CAUTI rate was higher. Nearly 83% of the samples showed a mixed-type infection. The most frequent pathogens were Acinetobacter baumannii,Staphylococcus aureus and Pseudomonas aeruginosa, followed by Klebsiella pneumoniae andEnterococcus spp. In the S. aureus isolates, 100% were resistant to oxacillin. Overall resistances of A. baumannii and K. pneumonia to imipenem were 70.5% and 76.7%, respectively. A multiple drug resistance phenotype was detected in 68.15% of the isolates. The DA-HAI rates in Iran were shown to be higher than the CDC-NHSN rates and similar to the INICC rates. Resistance to oxacillin and imipenem was higher as well. Comparing device use, DA-HAI rates, and bacterial resistance for the primary isolated bacteria indicated a direct association between urinary catheter use and the rates of CAUTI
ABSTRACT
Aim: This study was conducted to investigate a possible association between H. pylori infection and CSR
Background: Helicobacter pylori infection is one of the most common infections worldwide. Central Serous Chorioretinopathy [CSR] is a serious macular detachment that usually affects young people. The etiopathogenesis of the disease is still not completely understood
Patients and Methods: A prospective study was performed and we evaluated a total of 35 CSR patients and control group of138 patients who referred to gastroenterology research center of Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Central serous chorioretinopathy was diagnosed on the basis of findings in ophthalmic examinations and confirmed by fluoresce in angiogram. All patients underwent a 13C-urea breath test [UBT] to detect H. pylori infection. Patients were defined as H. pylori infected, if breath test was positive
Results: The mean duration of symptoms before diagnosis was 8.3 +/- 2.5 days. Overall, no statistically significant difference was found between left and right eyes, bilateral CSR was observed in 5 patients [14.2%].The incidence of H. pylori infection was 85.7% in CSR patients and 55.1% in control subjects [p=0.001]. Odd's ratio was 4.895
Conclusion: These results indicate that the prevalence of H. pylori infection is significantly higher in patients with CSR than in controls. No effect of age or sex was seen on H.pylori test results. Further multiple centers, randomized, case control trials are necessary to confirm the potential contributory role of the H. pylori infection in the pathogenesis of CSR as a possible association between infectious agents and endothelial dysfunction
ABSTRACT
To evaluate the possible long-term effects of Helicobacter pylori infection on Hemoglobin A1C and fasting blood sugar levels in patients with type 2 diabetes. Helicobacter pylori causes the gastrointestinal tract inflammation, which it plays an important role in distortion of glucose and lipids absorption that altered lipid metabolism and energy harvesting and develops type 2 diabetes, insulin resistance and has been linked to impaired blood glucose. In this clinical trial, patients with type 2 diabetes and confirmed Helicobacter pylori infection were recruited from the endocrinology clinic of the Shahid Beheshti University Tehran, Iran. Before and after 3 months of eradication therapy fasting blood samples were taken and glycalated hemoglobin levels and fasting blood sugar levels were measured. 85 [27 male 31.8%, 58 female 68.2%] patients with the mean age of 52. +/- 4.1 years were recruited. 52 [62%] had successful Helicobacter pylori eradication [16 male, 30.8% and 36 female, 69.2%]. The mean glycalated haemoglobin levels before successful treatment was 8.7 +/- 1.1 and after treatment was 8.3 +/- 0.9 and difference was significant [p<0.001]. Mean IgG level of serology was 3.3 +/- 1.1 and the correlation with glycalated haemoglobin was significant [p=0.02] [r=0.4]. Our results indicate that the Helicobacter pylori treatment can improve the mean glycalated haemoglobin in patients with type 2 diabetes. More investigations will be required to evaluate the effects of Helicobacter pylori eradication among different age groups and in relation to obesity status, diabetes and other disease, and it may be beneficial for patients at risk of diabetes to be checked for the presence of Helicobacter pylori infection
Subject(s)
Humans , Female , Male , Helicobacter pylori , Diabetes Mellitus, Type 2 , Blood Glucose , Glycated HemoglobinABSTRACT
Lorestan and other part of Iran are one of the important endemic focuses for the major zoonotic parasitic diseases like cystic hydatid disease where several species of intermediate host are commonly infected with Echinococcus granulosus. Meat inspection records in a slaughtered house were used to determine the prevalence of Hydatidosis in sheep, cattle, and goats in Lorestan province [Aleshtar] located in South-West of Iran. The data were collected during a 5 year period from 2002 to 2006. A total of 40,431 animals [cattle 6993; sheep 14084; goats 19354] slaughtered in the 5-year period and overall 2885 [7.13%] lungs and 2885 [7.13%] livers and 1598 [3.95%] peritoneal cavity were contaminated by hydatid cyst. One thousand and eight hundred sixty eight [26.71%] out of 6993 of cattle, 2989/14084 [21.22%] of sheep and 2511/19354 [12.97%] of goats were infected by hydatid cyst in liver, lung and peritoneal cavity respectively. This study indicates that the highest prevalence of Hydatidosis was found in Aleshtar, Lorestan as compared to the rest of Iran [p<0.05]. The annual prevalence of lung condemnations due to hydatidosis was increased from 8.3, 5 and 1.3% in Sep 2002 to Sep 2003 to 20.5, 8 and 5.5% in Sep2005 to Sep2006 for cattle, sheep, and goats, respectively. An urgent attention is required to work on lack of awareness among farmers, lack of a policy to destroy the infected organs, prevention of access of dogs to raw offal's and other responsible factors
ABSTRACT
The purpose of the present study was to evaluate the number and proportion of various causes of upper gastrointestinal bleeding and actual numbers of non-NSAID, non-Helicobacter pylori [H.pylori] peptic ulcers seen in endoscopy of these patients. The number and the proportion of patients with non- H.pylori, non-NSAIDs peptic ulcer disease leading to upper gastrointestinal bleeding is believed to be increasing after eradication therapy for H.pylori. Medical records of patients referred to the emergency room of Taleghani hospital from 2010 with a clinical diagnosis of upper gastrointestinal bleeding [hematemesis, coffee ground vomiting and melena] were included in this study. Patients with hematochezia with evidence of a source of bleeding from upper gastrointestinal tract in endoscopy were also included in this study. In this study, peptic ulcer disease [all kinds of ulcers] was seen in 61 patients which were about 44.85% of abnormalities seen on endoscopy of patients. Among these 61 ulcers, 44 were duodenal ulcer, 22 gastric ulcer [5 patients had the both duodenal and gastric ulcers]. Multiple biopsies were taken and be sent to laboratory for Rapid Urease Test and pathological examination. About 65.53% of patients had ulcers associated with H.pylori, 9.83% had peptic ulcer disease associated with NSAIDs and 11.47% of patients had ulcers associated with both H.pylori and consumption of NSAIDs. 13.11% of patients had non-NSAIDs non- H.pylori peptic ulcer disease. The results of this study supports the results of other studies that suggest the incidence of H.pylori infection related with duodenal ulcer is common, and that non-H pylori and non-NSAIDs duodenal ulcer is also common
ABSTRACT
The Beijing strain of Mycobacterium tuberculosis is responsible for more than 25% of cases of Tuberculosis in the world, it has a high transmission potential and there is a significant correlation between Beijing strain and multidrug resistance. In this study we compared the presence of Phospholipase C genes in Beijing and Nonbeijing strains of Mycobacterium tuberculosis. CTAB method was used to extract DNA from positive culture specimens from patients with pulmonary tuberculosis. Spoligotyping was used to identify Beijing from non-Beijing strains. Presence of Phospholipase C genes was ascertained by using PCR. Of 200 specimens, 19 were Beijing strain, [9.5%] and 181 non Beijing strains, [90.5%]. In Beijing strains, 16 specimens, [84.2%]were positive for plcA,17 [89.5%] were positive for plcB and 17 [89.5%] were positive for plcC genes and in non Beijing strains 17 specimens, [9.4%], were positive for plcA, 18[9.9%], for plcB and 18[9.9%] for plcC. Majority of Beijing strains have phospholipase C genes that may be responsible for the virulence of this strain