[Study on the frequency of various forms of p-wave in Khuzestan river buffalo]

The study of electrocardiographic parameters of buffalo in comparison to other large animals is very scanty. Electrocardiography is a very important tool to diagnose cardiac diseases. In this case, standardization of ECG of each species of animal or even each breed should be carried out. This is due to the fact that ECG parameters are related to many factors such as size, breed, sex, etc. In this study, which has been carried out for the first time on Khozestan buffaloes, variable forms of P-waves of this animal was determined. One hundred buffaloes were divided into two age and two sex groups. In this study a base apex lead was used to record ECG for studying prevalence of different forms of P wave and data analysed using chi- square method. P wave configuration varied from simple positive, notched positive, biphasic or either +/- or -/+. Statistical study showed that +/- form of P wave was significant in two sexes. Concomitant presence of simple positive, notched positive and +/- forms were statistically significant between the two sex groups [p<0.05]. Differences of various forms of P wave with or without concomitant presence in age groups were not significant. The findings of this study, like other studies showed that if base- apex lead system is used in buffalo, the frequency of simple positive P wave will be higher compared to its other forms

Chronic heat stress in Iranian fat-tailed ram lambs: clinical and paraclinical parameters

The effect of heat stress on physiological parameters has been well documented. However, there are reports of a genetic based heat tolerance in some sheep breeds. The aim of the present study was to monitor the physiological responses of an Iranian fat-tailed breed against heat stress and an acute stress insult. A total number of 15 fall-born ram lambs were selected and subjected to direct summer solar radiation throughout the day [May 2009 to February 2010]. Ten lambs were semi-castrated in October to see the physiologic response of animals to an acute stress. The general parameter as well as blood chemistry and cortisol were analyzed during the study. The results showed that all physiologic parameters had significant changes; however, their values were in normal range. The fact that the animals in the present study experienced their first exposure of heat stress and a significant increase in serum cortisol concentration in semicastrated lambs in October, compared to the respected values in the hottest months of the experiment, may indicate a genetic based adaptability of the breed in Iran. The present study shows the dynamic changes of general and biochemical parameters in response to chronic heat stress and an acute stress that raises a possible tolerance of the breed against heat stress

[ effects of age, sex, season and reproductive states on thyroid function of Arab horses in Khuzestan]

The thyroid gland, as one of the important endogenous glands of the body, controls the physiological function of other organs by secretion of T3 and T4. Alteration in thyroid hormone concentrations may influence the function of different organs and express various clinical symptoms. The purpose of the present study was to investigate the effects of different environmental and physiological parameters on serum thyroid hormones [T4, T3, FT4 and FT3] concentrations of Arab horses in Khuzestan province. Blood samples were collected from 240 horses during four different seasons. The ELISA method was used for hormone assay. The results were analyzed using SAS software. The results indicate that the serum concentrations [Least square means +/- standard error of mean] of T4, T3, FT4 and FT3 were 45.1 +/- 1.4 [nmol/L], 1.5 +/- 0.03[nmol/L], 13.6 +/- 0.31[pmol/L] and 5.5 +/- 0.12 [pmol/L], respectively. The serum levels of the hormones were higher in winter [cold season] than summer [warm season]. There was no significant difference between female and male. Foals had higher serum levels of the hormones than other age groups [p<0.05]. The environmental and physiological conditions significantly influenced the serum concentration of hormones as in pregnant horses it was less than non-pregnant females

[Effect of intravenous hypertonic solution administration on the abomasal emptying in newborn calves]

It has been shown that the rate at which a meal leaves the abomasum is influenced by the volume, constituents and pH of the chyme through duodenal receptors. A direct correlation between tonicity of oral solutions and abomasal emptying has been observed. It has been noted that if the osmolarity of an oral solution is increased, the rate of emptying from the abomasum decreases. Nowadays Hypertonic solutions are widely used to treat septic shock and diarrhea. Determination of the effects of intravenous hypertonic Dextrose and Sodium Chloride solutions on the abomasal emptying in neonatal calves. The present study was carried out on Six 5 to 8 day-old colostrum-fed Holstein-Friesian calves. Calves were administered each of 4 treatments in a crossover study. Each calf was weighed and then assigned to one of the following treatments at 1 ml/kg body weight [BW] IV in random order: 1] 0.9% NaCl, equivalent to 308 mOsm/L [volume control]; 2] 7.2% NaCl, equivalent to 2500 mOsm/L [osmolality control]; 3] 5% dextrose, equivalent to 0.05 g dextrose/kg BW at 250 mOsm/L; and 4] 50% dextrose, equivalent to 0.5 g dextrose/kg BW at 2500 mOsm/L. All 4 solutions were injected over 1 minute at a smooth rate, and time = 0 minutes was the start of injection. Immediately after administration of each treatment, the calves were allowed to suckle 2Lof fresh cow's milk at room temperature [19[degree sign] to 22[degree sign]C] that contained a dose of acetaminophen [50 mg/kg BW]. Abomasal emptying rate was measured by use of the acetaminophen absorption technique as previously described. Venous blood samples for determination of plasma acetaminophen, glucose and insulin concentration were collected. The results of the current study revealed that there was no difference in abomasal emptying rate between the 4 treatments. The results indicate that IV isotonic and hypertonic solutions, unlike the oral route have no effect on abomasal emptying

[Induction of experimental type 2 diabetes using olive and rump oils in rat]

Too much fat in the diet can cause insulin resistance. This study was conducted to provide a suitable experimental model of type 2 diabetes and to compare the potency of olive and rump oils in the induction of insulin resistance. The study was done in three phases, each with 15 male Sprague dawley rats. The control, olive oil, and rump oil, groups were fed the commercial diet, and diets supplemented by 31% olive or rump oils for three weeks, respectively [first stage], and then diabetes was induced by IP injection of 35 mg/kg STZ [stages 2 and 3]. The oral glucose tolerance test [OGTT] showed glucose intolerance in both oil groups, compared to the control group [p<0.05], in stage 1, but increases in blood glucose levels were higher in the olive oil group in the second stage. TC and LDL-C levels increased by both the oils, especially olive oil. Insulin level was higher in the rump oil groups, especially after diabetes induction. Insulin sensitivity, as shown by the insulin tolerance test [ITT] and HOMA-IR, were decreased by both oils, especially rump oil. Although both oils had significant effects on metabolism, olive oil use was accompanied by more dyslipidemia, whereas rump oil increased insulin resistance more effectively. It seems that rump oil may be a more appropriate model for studies investigating disorders of carbohydrate metabolism of type 2 diabetes and olive oil, for induction of dyslipidemia and probably the metabolic syndrome

[ effects of sesame oil on some reproductive parameters of male rats]

Sesame seeds contain large amounts of antioxidants and phytoestrogens, and it has been shown that the leaf extract of this plant may have some beneficial effects on the reproductive parameters of male rats. Thus we tested the effects of the sesame oil on these parameters of re productivity in male rats. Fifteen mature male Wistar male rats were divided into the control and sesame oil groups. For eight weeks the control and sesame oil groups were fed the basic rat diet and basic rat diet supplemented with 5% sesame oil respectively. Following blood collection and euthanasia the epididymal sperm were counted, the morphology of testes was accessed, and leydig, sertoli, spermatogonia and spermatocyts cells were counted in histological sections of the testes. The level of testosterone and estradiol 17-beta were measured. Consumption of 5% sesame oil compared to control group, decreased blood glucose and increased the epididymal sperm count and progressive motility and the number of spermatogonia of seminiferous tubule [P<0.05], but had no effect on weight and testicular morphology. This study showed that the sesame oil consumption improves some reproductive parameters, which may be related to the antioxidative and phytostrogenic properties of the sesame oil or insulin action improvement

Association of vitamin D receptor polymorphism [VDR rs 2238136] with colorectal cancer

Many studies have demonstrated that Vitamin D has an important role in cell growth and proliferation and vitamin D receptor polymorphism has significant relationship with colorectal cancer [CRC]. The aim of this study was to assess the incidence of VDR rs 2238136 polymorphism in Iranian population and to investigate the relationship between this single nucleotide polymorphism [SNP] and increased risk of CRC. In this case-control study, genotyping of vitamin D receptor gene polymorphism [VDR rs2238136] was determined in a series of 112 colorectal cancer patients and 112 controls by using polymerase chain reaction and restriction fragment length polymorphism genotyping assays [PCR-RFLP]. Statistical analysis was done through SPSS 16. VDR polymorphism [rs 2238136] had no significant relationship with CRC risk. The result of statistical analysis for the genotype AG compared with GG was OR=0. 59, CI=0.33-1.03 and for AA versus GG was OR=0.8, Ct=0.29-2.17. Incidence of mutant allele in patients and controls did not show significant difference [OR=0.74, CI=0.49 -1.13]. These findings suggest that VDR [rs 2238136] is not associated with increased risk of CRC. Moreover age, sex and smoking are not predisposing factors for increased risk of CRC

[Preventive effect of Iranian green and black tea on diet induced obesity in rats]

Traditional medicine can be considered as a method to reduce dietary obesity. The aim of the present study was to assess the protective effect of Iranian green and black tea on diet induced obesity. Twenty four male Wistar rats [180 +/- 20 g] were divided into four groups. Control group was fed with rat regular diet [4% fat], and the three reminder groups were fed by high fat diet [25% fat]. While control [C] and a high fat group [HF] had ad libitum access to water, the rest high fat groups had free access to drinking black tea [HF+BT] or green tea [HF+GT] instead of water. Eight week later rats were euthanized, weighed and their abdominal fat and organs separated and weighed. While Feed intake showed significant decrease in HF group compared with the control group [99.25 +/- 12.03 vs. 113.59 +/- .14.40 g/day; p<0.05], the levels of energy intake [454.54 +/- 55.09 vs. 405.52 +/- 51.43 kcal/day; p<0.05] and weight showed increase [283.33 +/- 13.84 vs.223.33 +/- 15.11g; p<0.05]. Green and black tea made decrease in body weight gain compared to the HF group [71.67 +/- 1.61g and 57 +/- 12.95 vs. 104.33 +/- 21.75 g; p<0.05]. However, the abdominal fat was just lower in HF+BT group than the HF group [2.90 +/- 0.56 vs. 4.19+.77g; p<0.05]. Consumption of Iranian black and green tea may help to regulate body weight and reduce weight gain induced by high caloric food

Family history as a risk for upper gastrointestinal tract cancer: a case control study

Although, family history of cancer is an important risk factor for upper gastrointestinal cancers development, but limited information is available on the upper gastrointestinal cancers associated with family history in Iran. The purpose of this study was to define upper gastrointestinal cancers risk associated with family history of cancer. This study was conducted as a case control study. A total number of 1,010 cases of upper gastrointestinal cancer and 1,010 healthy controls were recruited. For family history of cancer, questions were asked about any malignant tumor in first and second degree relatives. Adjusted odds ratio estimates for the association family history and upper gastrointestinal cancers risk and corresponding 95% confidence intervals were obtained. A family history of any malignant tumor in relatives was associated with 1.3 fold increased risks of upper gastrointestinal cancers. A first-degree family history of esophageal and gastric cancer was significantly associated with upper gastrointestinal cancers development, with an adjusted OR of 4.7 [CI 95%: 2.6-8.4]. Our findings suggested that risk for upper gastrointestinal cancers increases among individuals with family history of cancer. Therefore, appropriate screening strategies especially in relatives of patients should be considered to prevent and control of disease

[Investigation of influential factors affecting survival rate of patients with colorectal cancer using copula function]

Competing risk data is one of the multivarite survival data. Competing risk data can be modelled using copula function. In this study we propose a bayesian modelling approach of competing risk data using the copula function. We used the data from colorectal cancer registyrarty in Tehran. After constructing likelihood function using Clayton copula by choosing appropriate prior distribution for parameters, we obtained the posterior distribution of parameters using the Metropolis-Hastings algorithms and Slice sampling. The results of univariate analysis showed that sex, histology of tumor, extent of wall penetration, lymph node metastasis, distant metastasis and pathological stage of tumor were significantly associated with colon cancer and sex, histology of tumor, lymph node metastasis, distant metastasis and pathological stage of tumor were were significantly related to rectal cancer. In the multivariate analysis, age at diagnosis, tumor grade and distant metastasis were significant prognostic factors for colon cancer and tumor grade and size of the tumor were significant prognostic factors of rectal cancerAs we showed some variables may have different impacts on colon and rectum cancers, consequently, further studies are needed to be conducted considering risk factors of these cancers separately

Epidemiological differences between colon cancer and rectum cancer

Clinical and epidemiological variation was seen between the colon cancer [CC] and rectum cancer [RC]. So, there is not so much data available about the epidemiological and clinicopathological differences and prognostic factors regarding to CC and CR in Iran, we aimed to perform this study. All cases of CC and RC referred to oncology and gastroenterology wards of Taleghani General Hospital, Teheran, Iran between 2002 and 2008 were retrospectively reviewed. The research group were reviewed all medical records in the study period for collecting the required data. All patients under study were followed up until end day of 2008 [closed day] from their diagnosis. There are 856 cases of CC and 427 cases of RC. Mean survival time of CC cases was relatively higher than RC cases [P <0.05]. Regarding to the age at diagnosis, about 42% of CC and 42.6% of RC patients was diagnosed less than 50 years of age. Positive family history of any cancer was relatively higher in CC [40.0%] patients than RC [31.0%] patients [P<0.05]. significant difference was seen between CC and RC regarding to depth of tumor invasion, pathologic stage and type of first treatment. RC patient were diagnosed in more advanced pathologic stages. Regarding to histology type of tumor 75.0% of CC cases and 79.4% of RC cases was adenocarcinoma. Abdominal pain [74.4%] and blood per rectum [89.7%] were the most prevalent symptoms mentioned by patients for CC and RC, respectively. Distant metastasis, lymph node metastasis, lower BMI and poor grading of tumor was related to increased risk of death due to CC. Regarding to RC, only pathologic stage was determine as prognostic factor. Results of this study emphasis that RC has a poorer prognosis comparing to CC. Up to 42 percent of patients with CC and RC are lower than 50 years of age. Patterns of CC versus RC indicate major variations in demographic and clinicopathologic characteristics that suggest possible differences in etiology and pathogenesis. So we suggest that for the analysis of cancer data, CC and RC should be investigated as separate cancers and not to be as colorectal cancer. Abdominal pain and blood per rectum should be emphasis for detection of CC and RC, respectively

[Recognition of the factors affecting survival in colon and rectal cancer patients referred to RCGLD center of Shahid Beheshti university of medical sciences: accelerated failure time parametric survival analysis with Frailty]

Different diagnostic factors of colon and rectal cancer [CRC] affect the survival of patients, prognosis and consequently treatment application. The rate of colorectal cancer is being increased in Iran, especially in younger ages, made it more valuable to study this type of cancer. However, evaluation of the risk factors of the cancer as a whole would not provide thorough understanding of the cancer. Therefore, the aim of this study was to determine specific risk factors affecting colon and rectum cancers. A total of 1219 patients with CRC diagnosis, according to the pathology report of cancer registry of RCGLD from 1 January 2002 to 1 October 2007, were entered into the study. Data were analyzed using univariate and multivariate Accelerated Failure Time [AFT] parametric survival model with frailty, utilizing STATA statistical software. Based on the results of this analysis, for colon cancer, females, patients without inflammatory bowel disease [IBD], patients with poorly differentiated tumor grade and patients pathologic with stage of I had higher survival probability. For these patients, there was not any correlation between history of alchol consumption and the size tumor. In the rectal cancer, patients with surgery as the kind of first treatment used, had higher survival probability. For these patients personal history and pathologic stage weren't statistically significant. In addition, in both types of cancers, 25-29.9 and over than 30 categories of body mass index [BMI] had higher survival probability, respectively and patients with BMI less than 18.5 had lower survival probability. In general, the survival rate in rectal cancer patients was higher than those with colon cancer. Site-specific evaluation of colon and rectum can lead to a deeper understanding of factors affecting these cancers. It may help design the clinical trials, better diagnosis of diseases and optimal administration of specific treatments

[To evaluate the prognostic factors in using Bayesian interval censoring analysis on survival rate of gastric cancer in Iran]

The Cox proportional-hazards regression and other parametric models model have achieved widespread use in the analysis of time-to-event data with censoring and covariates. However employing Bayesian method has not been widely used or discussed. The aim of this study was to evaluate the prognostic factors in using Bayesian interval censoring analysis. This cohort study was based on 178 patients with gastric cancer from January 2003 to December 2007 admitted to Taleghani teaching hospital in Tehran. Known prognostic risk factors were entered into the analysis using Bayesian Weibull and Exponential models. The term DIC was employed to find best model. The results were showed survival rate depended on age of diagnosis and tumor size. Those patients who had early diagnosis and/or had smaller tumor size were in lower risk of death. The age of diagnosis and tumor size of patients are important prognostic factors related to survival of patients with gastric cancer. Based on DIC, Bayesian analysis of the Weilbull model performed better than the Exponential model. As a result, if this cancer has been diagnosed early, the relative risk of death would reduce

[Comparison the role of BMI, pathologic stage and hereditary related factors on survival between colon and rectal cancers: frailty competing risks model]

Cholera is always being considered as a public health threat in poor and developing countries. However outbreaks of cholera are not very common in central area of Iran; in 2008 district health authority reported a cluster of diarrhea cases. We investigated this cluster to identify the etiological agent, source of transmission and propose control measures. We analyzed the data of total of 1219 patients with colorectal cancer who registered between 1 January 2002 to 1 October 2007. Data were analyzed using univariate and multivariate Accelerated Failure Time [AFT] parametric survival model with frailty, utilizing STATA statistical software. In the univariate analysis for age at diagnosis, gender, marital status, race and education level, the survival of patients with colon cancer were approximately between half to one fourth and for BMI, alcohol history, Inflammatory Bowel Disease [IBD], familial history of cancer and the pathologic stage of tumor, the survival of patients with colon cancer were significantly [between 0.12 to 0.56 times] shorter than those patients with rectal cancer. In the multivariate analysis, for age at diagnosis [45-65 years], there was significant difference between colon and rectum cancer. But for BMI, alcohol history, IBD and pathologic stage there were not significant differences. The adjusted survival and 1, 2, 3, 4 and 5 year survival of patients with rectal cancer were better than those with colon cancer. Site-specific evaluation of colon and rectum could give a better perspective of factors affecting these cancers. It may help to design of clinical trials, better diagnosis of diseases and optimal administration of specific treatments

[Serious lead poisoning in oral and inhaled opium abuser]

A 25 year old man who referred with abdominal pain, nausea and progressive vomiting since 2 months ago and 7kg weight loss from this time. Also he was complaining from generalized bone pain especially back pain and jaundice. The patient has a long time history of addiction with oral and inhalation form of narcotics. In physical exam pallorness and icter of mucosa was observed. In mouth examination bluish pigmentation seen at the gum-tooth line. Hepatosplenomegaly and lymphadenopathy was not detected. Upper GI endoscopy was normal. And in lab tests hepatic aminotransferases were increased but alkalin phosphatase was in normal range also indirect billirubin was increased too. CBC test non auto immune hemolytic anemia was deteded, and direct and indirect combs test was negative. BMB and BMA evaluation hyperplasia of erythroid was shown. The patient had a history of smoking and oral narcotics use from 6 years ago. According to all symptoms with clinical doubt of lead poisoning the very high level of lead in narcotic sample was reported and in blood analysis very high level of lead [350mg/dl] was detected. The patient was treated with Ca.EDTA and BAL with decreasing lead level and the symptoms were recovered. There are some reports Similar this case [due to oral narcotics contain Lead] in Iran

Pathology and prognosis of colorectal cancer

Colorectal cancer [CRC] is one of the most common cancers in the world. During the past decades, survival of colorectal cancer patients has improved worldwide, however, it is not clear what factors have contributed to this development. This study was designed to evaluate the prognostic impact of a wide spectrum of pathologic parameters on survival rate in patients with colorectal cancer. 1127 patients with colorectal cancer who registered in one cancer registry in Iran were followed from their diagnostic date to Jan 1, 2007 [as failure time]. Overall survival time was calculated by Kaplan-Meier method. The Cox proportional hazard model was used to identify the pathologic factors that could independently influence survival. The overall survival rate at 5 years after diagnosis was 61%. Histology grade, status of regional lymph node metastasis, distant metastasis and pathologic tumor stage were related to survival rate according to univariate analysis. Nevertheless, in multivariate analysis, only histology grade, distant metastasis and tumor size had influence on survival of colorectal cancer patients. Generally the prognosis of disease is not poor; however, distant metastasis, poor differentiation and higher tumor size should be considered to have additional risks of death in colorectal cancer

Clinicopathological features of gastric cancer: a study based on cancer registry data

To analysis the epidemiological and clinopathological aspects of gastric cancer. We retrospectively studied the characteristics of 752 gastric carcinoma patients registered in cancer registry center of Taleghani hospital from 2001 to 2006. All the patients confirmed gastric cancer histopathologically. Univariate methods [Mann-Whitney U-test, and chi-square] were used for analysis. Among 752 cases, 535 [71.1%] were male. Sex ratio [male: female] was 2.49:1. The mean age of the patients was 59.7 years [SD = 12.9] at the time of the diagnosis. Weight loss, as a frequent symptom at the time of diagnosis, was observed in 57.7% of the cases. Most of the patients were diagnosed with advanced pathologic stage. In addition, tumor grading was poorly differentiated in most cases [28.7%]; and in 49.9% of the patients, the tumors were located in the stomach, NOS; and distant metastasis was observed in 24.6% of the cases. Based on the results, earlier detection in younger ages and in primary stages of tumor, and subsequent higher quality care to cure GC and increase patients' life expectancy are recommended

[Epidemiology of colorectal cancer: study the recorded cases in 1379-86]

Colorectal cancer [CRC] is one of the most common cancers worldwide. But information regarding CRC in Iran is limited; the aim of this study was to investigate the epidemiologic features of CRC in Iran, using 6-year data from cancer registry. This survey was a descriptive-analytic study conducted on 1138 colorectal cancer patients who registered in Cancer Registry Center of Research Center for Gastroenterology and Liver Disease, Tehran, Iran. These data were gathered through interview and pathology reports recorded in cancer registry forms. Data analysis was performed by descriptive and univariate methods. Of 1138 patients, 696 cases were male. There was no significant difference between males and females regarding age at diagnosis. 400 patients [35.1%] had a family history of cancer. The most common histology type of tumor was adenocarcinoma, NOS. in most cases [39.1%] tumor grading was well differentiated and there was no significant difference between males and females. Colorectal cancer is a disease with nonspecific symptoms. Family history of cancer was evident in 35.1% of our cases and also 42.9% of patients were below the age of 50 years old, suggesting that genetic factors may play an important role in the development of this disease in our country

Clinical and diagnostic characteristics of hepatopulmonary syndrome among iranian patients with cirrhosis

Hepatopulmonary syndrome [HPS] is one of the pulmonary complications of cirrhosis, which is manifested by reduction in arterial blood oxygen. The present study was conducted to evaluate the frequency, clinical and para clinical features of HPS, and to determine their predictive values in diagnosis in a group of Iranian patients. This case series study was performed on 54 cirrhotic patients referred consecutively to the gastroenterology department of Taleghani Hospital between 2003 and 2004. Patients underwent pulmonary echo-contrast to detect intra-pulmonary and intra-cardiac shunts. Arterial blood oxygen, 0[2] gradient [A-a] and orthodoxy were measured in these patients by ABG. All patients underwent endoscopy for possible esophageal varices. Patients who met the following three diagnostic criteria including hepatic cirrhosis, arterial blood deoxygenation [P0[2]<80mmHg] and rapulmonary arterial dilation were classified as clinical HPS while those manifested solely with intrapulmonary arterial dilation were defined as subclinical HPS. Of 54 patients, 10 [18.5%] fulfilled clinical and 7 [13%] subclinical HPS criteria. Patients aged 71-80 years were more commonly affected. Hepatitis B was the most common etiologic factor. Dyspnea [100%] and cyanosis [90%] were the most prevalent clinical features. Dyspnea and clubbing were the most sensitive and specific clinical features, respectively. Pao[2]<70mmHg and arterial-alveolar gradient had the highest sensitivity for HPS diagnosis. Clubbing with the highest positive predictive value [75%] and dyspnea whit the highest negative predictive value [100%] were the best clinical features to diagnose HPS. PaO[2]<70mmHg and P[A-a]0[2]>30 and their sum, have the highest positive and negative predictive values in HPS diagnosis

[Clinical manifestation of retroperitoneal tuberculosis as psuedotumor in an 18-year-old female]

The case was an 18-year-old female with progressive crampy abdominal pain, nausea and vomiting, initiated from 4 months ago, Who had 4-5 Kg weight loss in this period. In physical examination, an ill-defined mass with mild tenderness in periumblical region palpation was detected. In upper GI endoscopy, bulging folds with a necrotic mass in D2- D3 were detected. In small bowel series study, cut off of barium in D2-D3 portions was seen. For better evaluation spiral CT was performedin which a large mass with extension to small bowel in retroperitoneum was seen. In Pathologic study, classification granuloma compatible with tuberculosis was reported. This finding was confirmed with Ziel Neelsen staining and PCR