[Effect of moderate-carbohydrate and low-calorie diet on metabolic risk factors, liver enzymes and sonographic findings in patients with non-alcoholic fatty liver disease [NAFLD]]

At present, non-alcoholic fatty liver disease [NAFLD] as the hepatic manifestation of the metabolic syndrome is the most common chronic liver disease. Although there is no cure for it yet, it is considered a priority among approaches for lifestyle modifications. This study was aimed to investigate the effect of moderate-carbohydrate, low-calorie diet in patients with NAFLD. A total of 19 overweight or obese subjects with NAFLD were studied for 6 weeks in a randomized controlled clinical trial. A low-calorie moderate-carbohydrate diet [55% energy from carbohydrate] was designed based on dietary habits, age, gender, height and weight of patients. At beginning and end of the study, biochemical parameters including fasting glucose, liver enzymes, insulin, triglycerides, total cholesterol, high-density lipoprotein [HDL-C] and low-density lipoprotein [LDL-C] cholesterol were assessed and height, weight and blood pressure were measured. Data were analyzed by SPSS software. The average age was 38.94 +/- 8.56 years and body mass index [BMI] was 29.44 +/- 2.88 kg/m2. After six weeks of dietary intervention, weight, fasting glucose levels and enzyme aspartate amino transferase [AST] decreased significantly and HDL cholesterol increased. Hepatic ultrasound findings also showed a relative improvement in 6 patients, and one patient who had a complete remission, statistical significance borderline [p=0.055]. The findings of the present study suggest the role of carbohydrate in low-calorie diets, which significantly improved metabolic status of the liver in NAFLD patients, in more than one third of the subjects over a period of 6 weeks

Efficacy of metoclopramide and dexamethasone for postoperative nausea and vomiting: a double-blind clinical trial

Postoperative nausea and vomiting are common complications of anaesthesia. This double-blind clinical trial assessed the incidence of nausea and vomiting after cataract surgery with intravenous anaesthesia in 100 patients randomly assigned to preinduction placebo [saline], metoclopramide [10 mg], dexamethasone [8 mg] or the 2 drugs combined. The incidence of nausea in the recovery room was 44% with placebo, 20% with metoclopramide, 16% with dexamethasone and 8% with the combination. The incidence of vomiting was 20%, 4%, 4% and 0% respectively in the 4 groups. Metoclopramide plus dexamethasone combination significantly decreased nausea and vomiting both in the recovery room and 24 hours afterwards and is recommended for high-risk groups, especially in outpatient surgeries

[Seroprevalence of celiac disease among inpatients with chronic psychiatric disorders]

The associations between celiac disease [CD] and chronic psychiatric disorders have been reported in several studies. The aim of this study was to determine the prevalence of CD in patients with chronic psychiatric disorders. In this descriptive cross-sectional study, two hundred inpatient subjects with depression disorders and schizophrenia admitted to Razi hospital in Tabriz, Iran were studied. Five milliliters of blood were collected from each subject. IgA anti-tissue transglutaminase antibody [anti-tTG] was examined by ELISA. The total serum IgA levels were determined by turbidimetry. Patients with positive anti-tTG and IgA deficiency were referred to upper gastrointestinal endoscopy. The mean age of 200 subjects [100 depressive and 100 schizophrenic males] was 37 +/- 10.06 years [range 18-68 years]. One [1%] schizophrenic and two [2%] depressive patients were positive for anti-tTG. IgA deficiency was determined in three [3%] schizophrenic and two [2%] depressive subjects. Chronic diarrhea was not seen in any of the patients. None of the anti-tTG positive and IgA deficient subjects allowed duodenal mucosa biopsy. Seroprevalence of CD in schizophrenic [1%] and depressive patients [2%] was slightly higher than general population. Therefore, regular screening for CD is suggested in patients with chronic psychiatric disorders

[Celiac disease in type 1 diabetic patients screened by tissue transglutaminase antibodies in north-west of Iran]

High prevalence rates of celiac disease [CD] in patients with type 1 diabetes [T1D] have been reported in several countries. However, the data regarding this association are scarce in Iran. In this study, we reported the prevalence of celiac disease in type 1 diabetic patients in North-West of Iran, using tissue transglutaminase antibodies [tTGA] as a screening test. In this case-control study, one hundred T1D patients [58 female and 42 male] who admitted to endocrinology clinic of Tabriz Sina's Hospital were studied. One hundred and fifty healthy people [82 female and 68 male] who randomly selected, were used as controls. All subjects were screened for the tTGA. Total IgA was obtained to investigate IgA deficient subjects. tTGA positive and IgA deficient subjects were submitted to upper gastrointestinal endoscopy. Eight T1D patients [8%] and three of the controls [2%] were positive for tTGA [p=0.023]. Only 3 [3%] of the tTGA positive T1D patients underwent duodenal biopsy and all of them showed partial or total villous atrophy. The mean age of tTGA positive cases was significantly lower than tTGA negative ones [mean difference: 7.17; 95%CI: 0.82-13.52]. None of the tTGA positive T1D patients had a history of chronic diarrhea but 1 out of 8 tTGA positives reported history of dermatitis [p= 0.001]. Also None of the tTGA positive subjects presented IgA deficiency. There was a significant difference in the history of chronic diarrhea [p= 0.006] and autoimmune diseases [p= 0.001] between T1D patients and controls. This study showed higher prevalence of CD in T1D patients than general population in North-West of Iran and the data lend support to recommend regular screening for CD in all patients with type 1 diabetes

Prevalence of antibodies to hepatitis E virus among male blood donors in Tabriz, Islamic Republic of Iran

Serum samples from 399 voluntary male blood donors were tested for anti-hepatitis E virus [HEV] IgG during July and August 2004 at a blood transfusion centre in Tabriz city. The prevalence of anti-HEV IgG was 7.8% [95% CI: 5.2-10.4]. Risk factors for infection included age and a low educational level. Seroprevalence increased significantly with age, from 3.3% in subjects under 30 years of age to 37.5% in individuals 50 years and over. Illiterate individuals were at significantly higher risk for infection than educated persons. The high seropositive rate among our male blood donors is compatible with endemicity of HEV in the Islamic Republic of Iran

survey of post endoscopic retrograde cholangio-pancreatography pancreatitis in Tabriz Imam University Hospital, 2004-2006

Despite the progress in the technology of endoscopy and cholangio pancreatography [ERCP], acute pancreatitis is still the common as a consequent complain. In the present study, the prevalence of panceratitis after endoscopic retrograde cholangio-pancreatography was surveyed. In this descriptive study, 112 patients referred for ERCP, aged 21 to 83 years, were studied After collection of some information about age, gender and ERCP indications, ERCP was performed. The serum amylase levels were consequently measured at 4 and 24 hours after pancreatography. Post ERCP pancreatitis was diagnosed when serum amylase level was normal before ERCP but increased in for times in 24 hours post ERCP. In 112 patients, the prevalence of panceratitis according to the post ERCP serum amylase level and abdomen pain was 12%. A higher prevalence was seen in females comparing to males. The west common diagnostic outcome of ERCP was stone in common bile duct and operation was sphancterotomy. The result of this study further confirmed that the progress in the technology of ERCP could not decrease the prevalence of post ERCP pancreatitis. The higher prevalence of post ERCP pancreatitis in females, the requirement of further notice to this group

Comparison of alfentanil and remifentanil infusion during anesthesia on recovery time and nausea and vomiting incidence after ophtalmic surgery in elderly patients

Necessity for rapid and safe recovery of patients for coming back to daily life with consideration the daily - increased development of outpatient surgeries is the main point. This study is comparing recovery time post operative nausea and vomiting after the use of two rapid-onset narcotic, alfentanil and remifentanil in anesthesia of elderly patients. In this double-blind clinical trial 40 elderly patient scheduled to cataract surgery with general anesthesia were sthdied. The patients were selected randomly into two groups and in each group alfentanil or remifentanil was injected one minute before induction of anesthesia during 30 seconds. Both two groups were under general anesthesia with same method and during the anesthesia alfentanil and remifentanil infused for each group respectively. The time intervals between end of anesthesia and spontaneous respiration, eyes opening with simulation, verbal response, nausea and vomiting incidence in recovery and the time of discharge from recovery room were recorded. The time of spontaneous respiration in alfentanil group 1.3 minute was shorter than remifentanil group, But statistically, the difference was not significant [P=0.08]. The time of eyes opening with stimulation, verbal response and discharge of recovery room were not significantly different in two groups. During recovery, nausea and vomiting in remifentanil group [30% of patients] was significantly more than alfentanil group [5% of patients] [P=0.045]. With consideration that faster return of spontaneous respiration after infusion of alfentanil than remifentanil group and especially the significantly lower incidence of postoperative nausea and vomiting in alfentanil group, the infusion of alfentanil as opioid supplement in anesthesia of elderly patients especially in out patient surgery is suggested

Frequency of antibodies to hepatitis E virus among male blood donors in Tabriz

Hepatitis E virus [HEV] causes enterically transmitted acute viral hepatitis. Hepatitis E virus infection spreads by the fecal-oral route. However, blood donors might transmit HEV during the transient phase viremia that precedes the onset of symptoms. To our knowledge, few reports on the prevalence of Hepatitis E in Iranian blood donors exist. The aim of this study was to evaluate the frequency of anti-HEV among male blood donors in Tabriz. This cross-sectional study was carried out between July and August 2004 in Tabriz. Serum samples were collected from 399 voluntary male blood donors and tested for anti-HEV IgG using EIA. All the subjects were negative for anti-HIV, anti-HBV and anti-HCV antibodies. The prevalence of anti-HEV IgG among 399 blood donors was 7.8% [95% CI: 5.2%-10.4%]. Seropositive subjects had a mean of 40.7 +/- 12.4 SD. Donors who were 40 and older [14 out of 83] had significant higher seroprevalence than those who were younger than 40 [17 of 316] [p<0.001]. 3 of 11 illiterate donors had anti-HEV IgG. Among educated donors 10 of 88, 14 of 206 and 4 of 94 in elementary, intermediate and college levels were positive respectively [p<0.025]. These findings demonstrate the high seropositive rate of anti-HEV among male blood donors in Iran that is compatible with endemicity of this virus in our country

Evaluation and comparison of clinical educational groups function and structure in Tabriz Medical Science University, 2001

Medical education of IRAN witnessed a lot of changes in recent years. Evaluation of educational activities has been one important intervention introduced in this regard. We designed a new format and evaluated the function of educational groups of Tabriz Medical Science University at 2000. Educational groups, structure and function of internal medicine ward, infectious disease group, urology ward and genecology ward were compromised with each other. There was a lot of difference between function of educational groups. In some groups, students had no pleasure from the education. it is necessary to investigate the problems of education and solve them by regular and exact program and educational intra group evaluation