Recurrent acute pancreatitis and cholangitis in a patient with autosomal dominant polycystic kidney disease

Autosomal dominant polycystic kidney disease [ADPKD] is an inherited disorder associated with multiple cyst formation in the different organs. Development of pancreatic cyst in ADPKD is often asymptomatic and is associated with no complication. A 38-year-old man with ADPKD was presented with six episodes of acute pancreatitis and two episodes of cholangitis in a period of 12 months. Various imaging studies revealed multiple renal, hepatic and pancreatic cysts, mild ectasia of pancreatic duct, dilation of biliary system and absence of biliary stone. He was managed with conservative treatment for each attack. ADPKD should be considered as a potential risk factor for recurrent acute and/ or chronic pancreatitis and cholangitis

Noradrenalin versus the combination of midodrine and octreotide in patients with hepatorenal syndrome: randomized clinical trial

Hepatorenal syndrome [HRS] is known as development of acute renal failure in a patient who usually has advanced liver disease. The aim of the present study was to determine the safety and the efficacy of noradrenalin in comparison with midodrine-octreotide in patients with HRS. This study was registered to the Iranian Registry of Clinical trials [IRCT]. This study was a single-center, randomized, clinical trial that performed in Alzahra hospital, Isfahan, Iran. Since March 2011 to January 2012, twenty-three patients were enrolled in the study. Eligible patients were allocated in 2 groups. In the first group, patients received infusion of NA with the dose of 0.1-0.7 micro g/kg/min, and in the other groups, patients received octreotide 100-200 micro g subcutaneously 3 times daily and midodrine 5-15 mg orally 3 times daily. In both study groups, patient received albumin infusion in addition to noradrenalin or midodrine-octreotide. Complete response of HRS was observed in 8 of the 11 patients [73%] treated with noradrenalin and in 9 of the 12 patients [75%] treated with midodrine-octreotide [P > 0.05]. HRS recurred after treatment withdrawal in 2 of 11 in NA and 3 of 12 in MO group. That shows no significant difference between 2 groups [P > 0.05]. We deduce that NA has the same efficacy and safety with MO and can induce a complete response in high percentage of the patients. Moreover, we observed no significant differences in the recurrence rate and outcomes after 3 months among the patients in both study groups; this result could support the use of NA in HRS management

Effect of zinc sulphate on peptic ulcer disease

In-vitro study, the effect of zinc sulfate on healing ulcers is being shown but it is a limited study which has been done to demonstrate the effect of zinc sulfate on peptic ulcer in human. This study was conducted to investigate the effect of zinc sulfate on healing peptic ulcer disease. This was a double blind randomized clinical trial in which patients who were referred to endoscopy clinic in Sanandaj Besat hospital were included. Patients were allocated to intervention group [n=46] and control group [n=58] at random. All patients received standard treatment for ulcer containing Amoxicillin, Metronidazole, Omeprazole and Bismuth. For intervention group one zinc sulfate capsule [220 mg] was added to treatment regimen [one capsule on alternate day]. After four weeks, endoscopy was repeated again. The data was analyzed by SPSS software and x[2] Fisher exact and T test were used for analysis. There was no difference between intervention and control group in the same factors like smoking, alcohol, NSAID drugs consumption and the size of ulcer. Mean size of ulcers in intervention and control group before treatment were 24.6 [ +/- 17.7]mm and 22.5 [ +/- 21.2]mm respectively. The mean percentage size reductions of ulcer in intervention and control group after treatment were 92 [ +/- 14] percent and 89.4 [ +/- 16.4] percent which did not illustrate significant difference in two groups. This study confirms that zinc sulfate with the dosage of 220 mg on alternate days doesn't have significant effect on peptic ulcer healing. More studies with higher doses needs to be undertaken to determine effective dose of zinc

Prevalence of asthma and rhinitis in bakery workers in the city of Sanandaj, Iran

Baker's asthma is one of the most common forms of occupational asthma. This study was conducted to determine prevalence of asthma and rhinitis among bakery workers in the city of Sanandaj, the provincial center of Kurdistan province in the west of Iran in the in Summer 2006. In this study 776 bread bakery workers were included. These subjects were selected randomly among 1620 bakery workers. The diagnosis of asthma was based on a medical history of episodic symptoms of cough, chest tightness, and dyspnea and spirometry. Airflow obstruction was determined with spirometry, the definition of airflow obstruction which was used in this study was an FEV1/FVC ratio<0.8, and FEV1 or FVC increases of>/=12 percent and at least 200mL after using a short-acting inhaled beta2-agonist. Rhinitis was diagnosed by typical history of work related symptoms. Analyses were performed on 776 subjects [all were men] without missing data for asthma and rhinitis. All of subjects were male with mean age of 33.69 +/- 11.09 years. Mean duration of bakery working for these subjects was 13.91 +/- 9.37 years. Prevalence of asthma at the time of study was 11.9%. 93 subjects were diagnosed as asthma with history, physical and spirometry findings. 31 [33.3%] of asthmatic workers were diagnosed as asthma previously and 62 [66.6%] workers were known as new asthmatic patients which were diagnosed in this study program. The prevalence of rhinitis was [9.9%]. Subjects with asthma had longer history of working at bakery than others [P=0.001]. Asthma prevalence among these bakery workers that were included in our study was similar and in some instances the prevalence was lower than other studies