Adherence to Dietary Approaches to Stop Hypertension Eating Plan and Prevalence of Irritable Bowel Syndrome in Adults

Background/Aims@#Despite huge evidence on the link between adherence to dietary approaches to stop hypertension (DASH) eating pattern and several metabolic abnormalities, the association of this diet with irritable bowel syndrome (IBS) has not been investigated so far. We aim to examine the association between adherence to the DASH diet and prevalence of IBS symptoms and subtypes in adults. @*Methods@#This cross-sectional study was done among 3362 adult people in Isfahan, Iran. Usual dietary intakes were assessed using a validated 106-item dish-based semi-quantitative food frequency questionnaire. To investigate participants’ adherence to DASH-style diet, we created DASH score based on 8 main foods and nutrients emphasized or minimized in the DASH diet. Participants were classified into 3 categories according to their DASH-style diet scores. A validated modified Persian version of the Rome III questionnaire was applied for assessment of IBS. @*Results@#Totally, 22.2% of study participants were affected by IBS. After adjustment for potential confounding factors, we found that participants in the highest tertile of DASH score had lower odds of IBS (OR, 0.65; 95% CI, 0.50-0.83) compared with those in the lowest tertile. The same findings were also reached for IBS with constipation (OR for the highest vs the lowest tertile of DASH-style diet = 0.56; 95% CI, 0.38-0.85). No significant association was seen between adherence to DASH-style diet and IBS with diarrhea (OR, 1.31; 95% CI, 0.83-2.06). @*Conclusions@#We found a significant inverse association between adherence to DASH dietary pattern and odds of IBS and IBS with constipation.Further prospective studies are required to confirm these findings.

Chordoma of the Cervical Spine: A Case Report and Review of Literaturre.

Chordomas are rare low to intermediate grade malignant tumours derived from the notochordal remnants. Their location in the cervical spine is exceptional. The clinic radiologic features, anatomopathologic aspects, diagnostic difficulties, therapeutic methods and prognostic factors are discussed through a case report of a cervical spine chordoma with a literature review.

continuous glucose monitoring system [CGMS] in patients with beta-thalassemia major

Background: Blood transfusion-dependent beta Thalassemia Major [BTM] patients are at risk of hemosiderosis. Hemosiderosis of pancreas results in impaired glucose homeostasis tolerance and diabetes mellitus [DM]. Since glycosylated hemoglobin has limited role in patients with hemoglobinopathies, this study was conducted as a first attempt worldwide to understand glucose homeostasis and evaluate efficacy of Continuous Glucose Monitoring [CGM] system as a diagnostic tool of abnormal glucose homeostasis in these patients

Materials and Methods: A case series study of six non-diabetic, transfusion-dependent beta-thalassemia patients aged 9-13-year-old. Clinical and laboratory data were collected on admission for their monthly transfusion. Patients were connected to CGM systems for one day

Findings: Using CGM and based on American Diabetes Association guidelines, three patients were found to have abnormal glucose levels of diabetic range. The other three showed impaired glucose tolerance. Among all patients, glycosylated hemoglobin [HbA1C] readings have an inverse relationship to CGM and calibration readings

Conclusion: CGM could be a promising tool for evaluating BTM patients. Larger studies are recommended

Visual outcomes and patient satisfaction after implantable collamer lens and Toric implantable collamer lens correction for moderate to high myopia and myopic astigmatism

To compare preoperative and postoperative visual outcomes, determine patient's satisfaction, and evaluate visual symptoms after implantable collamer lens [ICL] implantation. One hundred and twelve patients with myopia between -2.75 and -19.50 diopter had ICL or Toric ICL [TICL] implantation. The implantations were carried out at the Cornea and Refractive Unit, Magrabi Eye Hospital, Sanaa, Republic of Yemen between September 2007 and October 2010. Preoperative and postoperative uncorrected visual acuity [UCVA], best spectacle corrected visual acuity [BSCVA], and refraction was evaluated. Patient's satisfaction and visual symptoms were evaluated using a questionnaire. The mean age was 26.74 +/- 5.6 years. The mean preoperative UCVA improved from 0.01 +/- 0.04 to 0.75 +/- 0.22. The mean postoperative UCVA [0.75 +/- 0.23] versus preoperative BSCVA [0.61 +/- 0.23] had a significant statistical change [P<0.001], and Pearson correlation of 0.818. Preoperative BSCVA versus postoperative BSCVA gained 5 lines in 2.5%, 4 lines in 4.4%, 3 lines in 14.2%, 2 lines in 32.8%, and one line improvement in 24%, whereas it was maintained in 20.1%, and lost one or more lines in 2%. The mean score for the overall satisfaction was 2.67 +/- 0.45. A total of 15.2% reported complaint of halos, 13.4% reported perception of stars around lights, and 23.2% had glare. Implantation of ICL and TICL is safe and effective and provides predictable refractive results with good satisfaction in the treatment of moderate to high myopia, suggesting its viability as a surgical option for the treatment of myopia

Surgical treatment of rhinophyma, conventional vs. diode laser technique

Rhinophyma has been observed from the ancient times in Greece; Rhino Greek for nose, Phyma: Greek for growth]. This condition is part of a skin disease, rosacea, which develops on top of a normal nose skeleton of bone and cartilage, being the continuous proliferation of sebaceous glands. To evaluate and compare laser surgery with the conventional techniques including cold knives and dermobraders in the treatment of rhinophyma. The study included 7 patients who were treated surgically for rhinophyma in the Ear, Nose and Throat [ENT] Department of Al-Yarmouk Teaching Hospital in the period between 1997-2004. All the patients were suffering from moderate to major rhinophyma. Four patients were treated by sharp blade excision, while the other three by laser surgery. Follow up periods extended between 1-4 years post-operatively. The parameters employed for the evaluation were the length of the procedure, preservation of normal tissues, the need for skin grafting, intra-operative bleeding, post-operative pain and discomfort, post-operative bleeding, as well as the cosmetic end results. With regards to the parameters we followed; the laser surgery in rhinophyma consumed relatively longer time than the conventional excision, but laser was a far better preservative procedure, reduced intraoperative bleeding and with no need for skin grafting. Generally, this laser surgery proved to be an easier and smoother procedure, as well as the cosmetic results being excellent. Laser surgery in the treatment of rhinophyma holds a distinct advantage over the other surgical modalities

Cerebral malaria and the prognostic indicators in children of central Sudan

Identifying children with cerebral Malaria [CM] who are at high risk of a fatal outcome depends on recognition of clinical signs, as well as laboratory variables. No comprehensive data on the clinical features and their importance in the prognosis of cerebral malaria in the Sudan are available. The aims of this study were to identify the clinical presentation of children with CM in Central Sudan and to evaluate the importance of clinical signs and laboratory investigations in determining the outcome of CM in children. 409 children [mean age 6.1 +/- 3.3 years] with CM were enrolled to the study. Comprehensive clinical and biochemical assessment were determined. The case fatality rate was 12% with the highest rate in younger children [< 2 years of age]. Univariate and multiple regression analysis identified six significant prognostic indicators in these children. These are, age /= 6.6 mmol/L [RR, 3.989; 95% CI, 2.359 - 6.746] and haemoglobin concentration

Segregation analysis of susceptibility/resistance to periportal fibrosis in Schistosoma mansoni infections in endemic area [Umzoukra village - Gezira State - Sudan]

We carried out segregation analysis of susceptibility to periportal fibrosis caused by Shistosoma mansoni. A regressive logistic model of the disease was applied to 42 pedigrees ascertained during screening of one the infection endemic area of Sudan. The affected status was defined as a presence of the fibrosis irrespectively to severity of injury. Transmission probability model indicated a significant contribution of a major gene in the control of the pathology. The susceptibility to periportal fibrosis could be described within the framework of a recessive major gene diallele model, assuming incomplete age and squared-age dependent penetrance of genotypes. According to this model, the disease was manifested in almost all homozygous carriers of the mutant allele, while the risk of the disease for normal homozygotes and heterozygotes did not exceed 0.31. The frequency of disease allele in the population studied was estimated as 0.59. We also found non-majorgene phenotypic correlations between parents and offspring in the incidence of periportal fibrosis caused by Schistosoma mansoni

Prophylactic antibiotic in cardiac surgery - does duration of prophylaxis effect the outcome?

To evaluate that duration of prophylactic antibiotics in patients undergoing open-heart surgery have an impact on deep sternal infection. [Mediastinitis]. Cross sectional comparative study on patient undergoing open-heart surgery. This study was conducted at cardiac surgery department, Mayo Hospital Lahore. It included patients operated from May 2005 to July 2006. Duration of study was 14 months. Total of 200 patients undergoing open-heart surgery were included in the study. We compared 100 patients, receiving less than 48 hours of prophylactic antibiotics [Group A] with another 100 patients, receiving more than 48 hours of prophylactic antibiotics [Group B]. The endpoint of study was development of mediastinitis requiring sternal rewiring. Ten patients were rewired for sternal dehiscence [5%]. Test of proportion was applied and it was concluded that there is no difference in proportion of infection in the two groups. [p value of 0.05]. Conclusions: The results provide evidence that there is no need to continue antibiotic prophylaxis for more than 48 hours in patients undergoing open-heart surgery

Regression of liver fibrosis in Schistosoma mansoni infected Sudanese subjects after praziquantel treatment

1-To evaluate the effect of Praziquantel [PZQ] therapy on the regression of liver fibrosis in an endemic population. 2-To determine the factors controlling the regression of hepatic fibrosis [e.g. gender, age and grade of fibrosis]. An association study of a cohort of one hundred seventy seven Sudanese patients infected with Schistosoma mansoni [82 males 46%, 95 females 54%] was conducted to evaluate the factors controlling the regression of liver fibrosis 39 months after treatment with PZQ using ultrasound evaluation. SPSS [Statistical Package for Social Science] software was used for statistical analysis. Chi- Square was used to compare the two phenotypes [regression and progression] in the study subjects. PPF was regressed in 63 patients [36%] from higher grades of fibrosis to lower ones. While in 24 patients [13%] the disease progressed to higher grades. In addition, the grade of PPF did not change in 90 patients [51%]. The mean values of portal vein diameter [PVD], splenic vein diameter [SVD], and index liver size [ILS] in subjects in whom PPF regressed after treatment were significantly lower than in subjects in whom the disease was progressed [P <.0001, P =.031, and P =.003 respectively].The progression of hepatic fibrosis in males [n = 15.18%] was greater than that of females [n = 9.9%]. Patients who showed regression of PPF or progression of the disease tend to cluster in certain families. Our study indicated that regression and stabilization of PPF after PZQ therapy is controlled by gender, age, grade of fibrosis, and possibly inherited factors