Long-term efficacy of treatment with lamivudine in HBeAg-negative patients with decompensated cirrhosis due to chronic Hepatitis B

The prognosis of patients with decompensated cirrhosis due to hepatitis B is very poor. It has been shown that lamivudine can improve liver function and delay the need for liver transplantation in HBeAg-positive patients with decompensated cirrhosis. However, information regarding long-term use of lamivudine in HBeAg-negative patients with cirrhosis is limited. The primary objective of this study was to evaluate the long-term efficacy of lamivudine in HBeAg-negative/HBeAb-positive patients with decompensated cirrhosis. 54 consecutive HBeAg-negative/HBeAb-positive patients with decompensated cirrhosis were enrolled into this study. All patients were treated with 100 mg lamivudine per day. Significant clinical improvement was defined as a decrease of at least 2 points in Child-Pugh-Turcotte [CPT] score. Repeated-measure one-way analysis of variance was used to evaluate the effect of time interval of lamivudine treatment on different variables. Kaplan-Meier survival analysis and Mantel-Cox test were used to further analyze the data. The mean+/-SD age of patients was 50.6+/-13.2 years. There were 40 male and 14 female patients. The median follow-up was 29 [range: 6-64] months. CPT score, MELD score and blood chemistries changed significantly after 6 months of therapy. The favorable changes were continued up to 2 years. In spite of worsening after 3 years, within subject effects measured by repeated-measure ANOVA, were significant for patients who have received lamivudine for 4 years or more. Long-term lamivudine therapy improves liver function in HBeAg-negative/HBeAb-positive patients with decompensated cirrhosis

Job satisfaction in basic and clinical faculty members in Shiraz University of medical sciences, Iran

Shiraz University of Medical Sciences as one of the oldest and largest universities of medicine in Iran with 50 years history has more than 450 faculty members and 5000 students. This study is an attempt to find out the level of job satisfaction among Shiraz University of Medical Sciences' faculty members. In midterm of 2003-2004, data on job satisfaction level among 404 faculty members from all schools of Shiraz University of Medical Sciences were collected. The translation of Spector's job satisfaction score was used including 34 questions in 9 items of job satisfaction and each one based on Likert's Scale with score an of 1-5. A question related to overall job satisfaction of faculty members was added. Of all faculties,, 252 responded to the questionnaire and 70.1% expressed satisfaction in response the added question. The mean scores of job satisfaction in items of coworkers, work nature, supervision, management methods, academic relations, promotion, salary and suitable benefits were 3,771, 3.265, 2.557, 2.454, 2.395, and 2.376 out of 5 respectively [F=223. 8, p=0.0001]. In the promotion item, the satisfaction of female faculty was lower than male subjects. The level of job satisfaction was not different between clinical faculty members of Medical School with or without private activity. The results of linear regression analysis between the items of job satisfaction revealed that reimbursement and fringe benefits could predict the overall job satisfaction [r[2]=0.70, p<0.01].. As a whole, the faculty members of the university were satisfied with their jobs, but a correction in reimbursement, benefits and promotion regulations especially in lower academic ranks is needed to improve the level of job satisfaction in this group

Effect of eradicating Helicobacter pylori on gastroesophageal reflux disease

The effect of helicobacter pylori either in provoking or protecting GERD is unclear and the results of studies are conflicting. We aimed to study the effect of H.pylori eradication on GERD by 24-hour ph monitoring. 14 patients with duodenal ulcer or erosive duodenitis without any endoscopic and clinical evidences of GERD were enrolled. 24-hour ph monitoring were performed before and 12 month after H-Pylori eradication. The score was based on DeMeester scoring system. H.Pylori was diagnosed by rapid urease test before eradication and by urea breath test [UBT] after eradication. The mean age was 41.6..10.2 years. The mean scores of 24-hour ph monitoring were 6.8..4.3 and 5.4..3.9 before and after eradication, respectively. The differences were not statistically significant [NS]. Epigastric pain changed significantly before and after the therapy [p<0.01]. H.pylori eradication did not have any effect on scores of 24-hour esophageal ph monitoring. Epigastric pain significantly decreased after eradication