Prevalence of dyspepsia and its correlation with demographic factors and lifestyle in Shiraz, Southern Iran

Dyspepsia is a common disorder that can present many clinical dilemmas in patient management. Although not life-threatening, the symptoms are long-lasting, interfere with daily activities and have a significant impact upon quality of life. The aim of this study was to determine prevalence of dyspepsia and its relationship with demographic and socioeconomic factors, and lifestyle in an apparently healthy population in Shiraz, southern Iran. In a population-based study, 1978 subjects aged 35 years or older were interviewed from April to September 2004. A questionnaire consisting of demographic factors, lifestyle data and gastrointestinal symptoms was completed for each participant. The validity and reliability of the questionnaire were determined. The prevalence of dyspepsia was 29.9%. The dyspeptic patients were classified as having ulcer-like [27.9%], dysmotility-like [26.2%] or unspecified dyspepsia [45.9%]. The prevalence was higher in females, water-pipe smokers, NSAIDs users, and in those with psychological distress, recurrent headache, anxiety, nightmares and past history of gastrointestinal disease. Dyspepsia had an inverse relationship with consumption of pickles, fruits and vegetables, and with duration of meal ingestion. Subjects with dyspepsia symptoms were more likely to restrict their diet, take herbal medicine, use over-the-counter drugs, consult with physicians and consume medication advised by their friends. This study reveals that dyspepsia has a high prevalence in Shiraz, southern Iran and is associated with several demographic factors, lifestyle and health-seeking behavior

Association between PPD and quanti FERON gold TB test in TB infection and disease among HIV-individuals in southern Iran

Tuberculosis is one of the most common diseases among HIV-infected patients. A person with a positive tuberculin skin test [TST] acquiring HIV infection has a 3-13% annual risk of developing active tuberculosis. The diagnosis of TB in HIV infected patients may be difficult. QuantiFERON-TB Gold [QFT-G] test is a novel method as an aid for diagnosis of Mycobacterium tuberculosis infection. We evaluated the association between TST and QFT-G test in latent TB infection [LTBI] and TB in HIV-infected patients. One hundred and seventy six HIV-infected subjects from Shiraz Consultation and Behavioral Modification Center [SCBMC] entered our study. The individuals were screened for TST, using 5TU purified protein derivative [PPD]. Also, blood sample was provided for QFT, measuring INF-gamma response to M. tuberculosis antigen. Of 176 participants, 98.3% returned for evaluation of TST results. Among them, 63% and 37% were negative and positive for TST, respectively. All the participants returned for QFT-G sampling. Of them, 64.8% and 27.8% were respectively negative and positive for the test and 7.4% showed undetermined results. The agreement between PPD and QFT-G in their negative results was 39.9% and 8.1% in their positive results and the overall agreement was 50%. Disagreement of TST-/QFT[+] was noticed in 19.7% of the subjects and TST[+]/QFT- disagreement in 24.9%. CD4[+] count <100 mm[3] was seen in 5.9%, >/= 100 and < 200 mm[3] in 17.1% and CD4[+] T cell count >/= 200 mm[3] in 76.9% of subjects. As the agreement rate between QFT-G and TST in HIV-infected patients was fair, a strategy of simultaneous TST and QFT-G testing would maximize the potential for LTBI diagnosis in HIV-infected subjects

Outcome and characteristics of patients on the liver transplant waiting list: Shiraz experience

The only curative therapy for end-stage liver disease is transplantation but due to a shortage of available donor livers the waiting list mortality is high. This study aimed to evaluate the outcome and characteristics of patients on the waiting list for liver transplantation in Shiraz, southern Iran during the period from April 2004 to March 2007. Medical records of all chronic liver disease patients >/= 14 years that were on the waiting list for liver transplantation at the Nemazee Hospital Organ Transplant Center during April 2004 to March 2007 were reviewed. Hospital records were used to retrieve demographic, clinical and laboratory data. Records of the referring gastroenterologists provided information about the etiology and complications of liver disease. The patients were followed at the end of the study period by clinic visits or telephone contact. There were 646 patients on the waiting list for liver transplant during April 2004 to March 2007. Hepatitis B was the most common etiology of liver disease [31.2%]. Of those on the waiting list, 144 patients 22.3%] underwent liver transplant and 166 [25.7%] died while waiting for a transplant. The mean waiting period for transplant was 6.6 months. Receiving a transplant was correlated with the etiology of liver disease and Rh blood group [p<0.05] but had no significant association with gender or ABO blood type. Among non-transplanted patients, survival was lower in those who had a history of encephalopathy, SBP or uncontrolled ascites and in patients with a Child-Turcotte-Puph [CTP] class C and/or a Model of End-stage Liver Disease [MELD] score >/= 15. Hepatitis B virus is the most common cause of end-stage chronic liver disease amongst patients on the waiting list for liver transplant in Shiraz, southern Iran. Patients with a MELD score >/= 15 particularly those with a history of SBP, hepatic encephalopathy or uncontrolled ascites are recommended for waiting list enrollment

Clinical characteristics of colorectal cancer in Southern Iran, 2005

Colorectal cancer is the second leading cause of cancer-related mortality and represents a major public health problem in developed countries. The objective of present investigation was to determine the epidemiologic aspects and clinical characteristics of colorectal cancer in Shiraz, southern Iran. This was a retrospective study carried out during 2000-2005, and comprised 491 subjects with pathologically documented colorectal cancer. They were registered in Fars Cancer Registry, affiliated to Shiraz University of Medical Sciences, southern Iran. A questionnaire including data on demographic information, histological types of cancer, site of primary cancer and metastasis were completed by trained interviewers. Among 491 subjects, 57.2% were male and the most common age was 65-75 years. Patients under 45 years of age represented 22.8% of all colorectal cancer cases while 32% were over 65 years old. Those with a history of cancer in their first-degree relatives included 26.9% of the patients. Adenocarcinoma was the most common reported histological type of cancer [96.1%]. Among all subjects, 60.7% suffered from abdominal pain, 28.4% abdominal distention and 28.0% rectal bleeding. Other symptoms included diarrhea/constipation, nausea/vomiting, urogenital problems and mass sensation. The most common sites of metastasis were lung, brain and ovary

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

Exfoliative cytology in the esophageal carcinoma

In this study, the results of endoscopic biopsy and exfoliative cytology in the diagnosis of esophageal carcinoma, are compared. Among one thousand cases clinically suspicious of, or at risk for esophageal carcinoma, 20 proved to be malignant on surgical specimen. Brushing cytology was positive in eighteen and biopsy, in seventeen cases. All of the negative cases [30] were diagnosed correctly by both cytology and biopsy [no false positive]. False negative cases in biopsy [3] were diagnosed by cytology and false negative cases in cytology [2 cases] were correctly diagnosed by biopsy. All benign and malignant cases were, therefore correctly diagnosed by combined cytology and biopsy. It is concluded that performing both esophageal biopsy and brushing cytology will improve the diagnostic accuracy without adding inconvenience to patient

Anti-HCV seropositivity among multiply transfused patients with B-thalassemia major in southern Iran

To evaluate the prevalence of hepatitis C in multiply transfused patients with beta thalassemia major [Cooley's anemia], 100 females and 88 males within the age range of 1-27 years were studied prospectively. Liver function tests were correlated with HCV antibody status. Fifty-one [27.1%] patients were seropositive for anti-HCV antibody; this correlated with the mean patient age, and the duration and amount of blood transfusion. No differences were detected regarding sex or history of splenectomy. Serum aspartate aminotransferase and globulin levels were significantly higher and albumin was significantly lower in infected patients. It is concluded that multiply transfused thalassemic patients are at high risk for HCV infection. Thus, routine screening of blood products for this virus is suggested