[Randomized prospective trial comparing a 48 hour infusion to a five-day infusion of octreotide in patients with acute variceal bleeding]

Background: to compare the efficacy of a 48 hour infusion of octreotide with a five-day infusion to prevent rebleeding and mortality at one week and one month in patients who present with acute esophageal variceal bleeding

Materials and Methods patients who presented to Emam Hospital of Ahwaz Jundishapur University of Medical Sciences that were diagnosed with acute variceal bleeding were commenced on octerotide [50 micro g bolus] followed by a continuous infusion of octerotide at a rate of 50 micro g/h. All patients underwent emergency endoscopy within eight hours of admission. Only patients diagnosed with bleeding due to esophageal varices that were treated with endoscopic variceal band ligation were randomized to the study. Patients in group A continued the octerotide infusion for 48 hours and those in group B continued octerotide for a total of five days. Rebleeding and mortality was defined according to standard recognized criteria

Results a total of 70 patients were randomized, of which 35 were assigned to group A and 35 to group B. Primary hemostasis was achieved in all patients. The mean age of patients in group A was 45.4 years and in group B, it was 46.3 years. There was no rebleeding within one week, however there were three patients who rebled in group A and 2 from group B within one month, which was not statistically significant [p=0.62]. The overall effect was not significant between the two treatment groups. In terms of mortality, within one week the p value was 0.14, whereas it was 0.56 at one month

Conclusion as there is a significant difference in terms of cost, need for infusion pumps and duration of patient stay if octerotide is to be given for a duration of five days, our data suggests that octerotide can be given for 48 hours with no differences in terms of rebleeding and mortality

[ prevalence of small intestinal overgrowth in irritable bowel syndrome vs. healthy controls by using glucose-hydrogen breath test in Khuzestan province]

Background: To estimate the prevalence of small intestine bacterial overgrowth [SIBO] among patients with irritable bowel syndrome [IBS] versus healthy subjects with the use of a glucose breath test [GBT] in our geographical area

Materials and Methods: This study included a total of 80 consecutive patients; 40 with IBS based on Rome III criteria and 40 healthy controls with similar age and sex distribution. Patients and controls underwent 50g GBT for the diagnosis of SIBO. The test was considered positive if the hydrogen concentrations in the expired air increased more than 20 ppm over basal values within 90 minutes or there were two distinct peaks during the test

Results: Of the 40 patients with IBS and 40 healthy controls, there were 14 males and 26 females in each group. Patients ages ranged from 22 to 66 years [mean 34 years]. The majority of patients with IBS had either constipation predominant [42.5%] or mixed type IBS [30%] and 17.5% were diarrhea predominant. The prevalence of an abnormal GBT result was higher in patients diagnosed with IBS [47.5%] with respect to controls [20%, p=0.009]. A positive GBT was seen in 47% of IBS constipation predominant patients, 42.9% of diarrhea predominant and in 50% of the mixed group IBS patients [p=0.85]

Conclusion: This study showed that approximately half of the IBS patients had SIBO. A significant difference of SIBO, however, was not detected amongst IBS subgroups. Therefore, SIBO should be suspected in patients diagnosed with IBS and in these patients GBT might be requested

study for determination of relationship between serum testosterone concentration and dermatophytosis due to Epidermophyton floccosum

Physiological mediators of human host such as androgenic hormones interfere pathogenic fungal growth. It has been revealed that the growth of yeasts as well as of dermatophytes is influenced by human androgenic hormones in vitro. In this reason for in vivo condition, the andrgenic hormones level must be measured in patients with dermatophytosis and healthy individuals. To this purpose we measured the levels of testosterone, androstendione dihydroepianderosterone sulfate [DHEA-S] of 46 male patients with dermatophytosis due to Edidermophyton floccocosum by ELISA method. After determination of mentioned hormone concentration in serum statistical analyses were conducted. Using SPSS for windows, version 10. The most important result in our study was the low serum testosterone concentration in patients with Epidermophyton floccosum. Therefore the measuring of this hormone in patients with chronic dermatophytosis can be useful in treatment and control the disease