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

managers decision-making strategies and the staffs job satisfaction in Isfahan hospitals

To run a hospital effectively, managers need to have proper decision-making strategies. The managers' decision-making strategies and the staffs job satisfaction are two major factors that allow the manager to achieve the planned objectives. Therefore, in this paper, these two factors were studied. It was a descriptive study in which the population of the study consisted of 7607 people among whom 384 people were selected based on stratified random sampling. Two questionnaires were used to collect data and the data were analyzed based on descriptive and inferential statistics. The managers' decision-making strategies were determined as follows: individual decision-making [-3.01], consultation decision-making [- = 2.51], collective decision-making [- = 2.32] and cooperative decision-making [- = 2.16]. There was no significant relationship between the staffs job satisfaction in public hospitals [- = 2.29] and their job satisfaction in private hospitals [- = 2.82]. The findings of the study revealed that in running hospitals, the managers' most frequently used individual decision making strategies. Furthermore, the staff were less safisfied with this kind of decision making and more satisfied with other types of decision-making strategies used by hospital managers

[Prevalence of glaucoma among peptic ulcer patients with or without helicobacter pylori infection]

Purpose: to compare the prevalence of glaucoma among peptic ulcer patients with or without helicobacter pylori infection

Methods: among 352 patients with an indication of gasterointestinal endoscopy for peptic problems, 120 patients in 18-88 years of age were included for evaluation of glaucoma. According to the results of histopathologic and urease test, they were divided into two groups: Helicobacter pylori positive and negative. All cases were evaluated by expert ophthalmologists for presence or absence of glaucoma in a double blind fashion. These patients were examined for IOP, visual field, and fundoscopic evidence of glaucoma

Results: glaucoma was detected in 43.1 % of patients with positive histopathology for helicobacter pylori vs 22.5% in patients with negative histopathology for helicobacter pylori [P= 0.016]. All cases of glaucoma were normal tension glaucoma

Conclusion: prevalence of normal tension glaucoma in peptic ulcer patients with positive histopathology for helicobacter pylori is significantly more than patients with negative histopathology for helicobacter pylori. Ophthalmologic evaluation of these patients for early onset of glaucoma is suggested

Clinical findings in patients with acute amebic proctocolitis and efficacy of combined therapy with saccharomyces boulardii

Intestinal amebiasis has a worldwide distribution and is common in tropical and subtropical areas. In this prospective 7-month study, we studied the main clinical findings in patients with acute amebic proctocolitis and the efficacy of Saccharomyces boulardii [SB] treatment of these patients. Initially, 57 cases with acute amebic proctocolitis were selected. The maximum occurrence of infection was found to be in the 30-39 year old age group. The patients were then randomized to two therapeutic regimens. The first included metronidazole 750 mg P.O. tid X 10 days and iodoquinol 630 mg P.O. tid X 10 days, and the second was the latter plus S. boulardii 250 mg P.O. tid x 10 days. The diarrhea, abdominal pain and fever were significantly decreased after initation of therapy in patients receiving regimen II as compared with patients of regimen I. Four weeks after the end of treatment, the two groups were examined for carrier states [presence of amebic cysts in stool, without symptoms]. In regimen I, the percentage of carriers was 19.4%, but in the patients who received regimen II, no carriers were found [P= 0.025]