RESUMO
Background:After the introduction of the Rome IV criteria for the diagnosis of irritable bowel syndrome [IBS], studies on the clinical significance of the new criteria in the settings of a large study has been scarce
Objective: Herein we used the infrastructures provided by one the largest cohort studies in Iran to evaluate the epidemiological features related to IBS
Methods:A total of 9264 participants, were enrolled in the initial registry. Diagnosis of IBS was done using the Rome IV criteria. Individuals with IBS were compared with a control group. Since the study included a large sample size of patients, we used the penalized smoothly clipped absolute deviation [SCAD] regression analysis to construct a model for the evaluation of factors associated with IBS
Results:Overall, data of 9163 participants entered the final analysis. In total, 1067 [11.6%] individuals were diagnosed with IBS, among which 57 [5.3%] were diarrhea dominant [IBS-D], 380 [35.6%] were constipation dominant [IBS-C], and 630 [59%] did not mention having any of the two [IBS-U]. In the regression model, back pain/arthralgia [OR: 1.98, 95% CI: 1.65 - 2.40], insomnia [OR: 1.65, 95% CI: 1.40 - 1.93], depression [OR: 1.64, 95% CI: 1.38 - 1.95], female sex [OR: 1.58, 95% CI: 1.27 - 1.96], anxiety [OR: 1.43, 95% CI: 1.21 - 1.69], and being married [OR: 1.23, 95% CI: 1.03 - 1.48], were associated with higher rates of IBS. We found that IBS prevalence displays a peak at the age of 41 years for both men and women
Conclusion:The present study provides a background for follow-up studies to be conducted in order to evaluate causality between IBS and some major diseases such as liver disease. We also found that opium use, although not statistically significant, in addition to sex, education, back/joint pain, depression, insomnia, anxiety, and marital status might be a contributing factor in IBS
RESUMO
Aim: In this study we tried to find out the accuracy of biliary tract brushing cytology in our center as the largest referral center in the south of Iran
Background: Common bile duct brushing cytology has been introduced as the method of choice for the diagnosis of pancreaticobiliary malignancies. However, there have been controversial reports about the sensitivity, specificity and overall accuracy of this method in the English literature
Methods: During the study period [2012-2016] there has been 166 cases of common bile duct brushing cytology taken during endoscopic retrograde cholangiopancreatography [ERCP]. One case has been excluded because of inadequate number of cells in the cytology smear. All the smears have been stained by routine cytologic stains and screened by cytotechnologists and diagnosed by expert cytopathologist. Final diagnosis by biopsy has been considered as the gold standard
Results: According to the final histologic diagnosis as the gold standard, there were 22 false negative and 7 false positive cases. All of the false positive cases have been suspected cases in the background of primary sclerosing cholangitis. The most common final diagnosis of false negative cytologic diagnoses has been intrahepatic cholangiocarcinoma in which no malignant cell has been identified in the presence of adequate number of normal ductal epithelial cells
Conclusion: Common bile duct brushing cytology is the method of choice for the diagnosis of pancreaticobiliary tract malignancies; however, having high specificity [90%], the sensitivity is low [56%]. Cytologic diagnosis of biliary tract malignancies should be made with caution in the patients with primary sclerosing cholangitis. Also it is important to know that high false negative rate is present in common bile duct brushing cytology especially in the cases of intrahepatic cholangiocarcinoma without extension into extrahepatic ducts
RESUMO
Background: The users' satisfaction is a method for evaluating the efficacy of healthcare system. We aimed to evaluate the association between the users' socioeconomic status [SES] and satisfaction with the healthcare system in Shiraz, Iran
Methods: This cross-sectional study was conducted from December, 2013 to March, 2014, in Shiraz, Iran. 3400 households were recruited by multi-stage cluster random sampling. Information about demographic, insurance status, and users' satisfaction was derived from face-to-face interviews. Satisfaction with healthcare system was assessed by using 5-point Likert scale statements, which ranged from "very dissatisfied" to "very satisfied". All statistical analyses were performed using SPSS-21
Results: Overall, 1.6% [55] of the respondents were very satisfied, while 6% [203] were very dissatisfied with healthcare system. Participants were classified into high SES [26.3%], middle SES [47.9%] and low SES [25.8%]. It was discovered that the better the SES, the more frequent were the respondents dissatisfied with healthcare system [P<0.001]. Also, dissatisfied respondents were significantly older [P=0.036]. Moreover, women were more dissatisfied with healthcare system [P=0.005]. Also, dissatisfied respondents had significantly a higher level of education than satisfied ones [P<0.001]. Furthermore, logistic regression revealed that age [P=0.04], marital status [P=0.01], insurance status [P<0.001], SES [P<0.001], and having supplemental insurance [P=0.02] were determinant factors of satisfaction with healthcare system
Conclusion: This study demonstrated that users' sex, age, educational level, and SES were related to dissatisfaction with healthcare system. Meanwhile, clients' age, SES, insurance status and marital status were recognized as determinant factors