Distribution of hepatitis C virus genotypes in haemodialysis patients of Guilan, northern Islamic Republic of Iran.

The hepatitis C virus (HCV) infection among patients undergoing haemodialysis is high. The aim of this study was to identify the HCV genotypes among chronic haemodialysis patients who were HCV positive in Guilan province, northern Islamic Republic of Iran. All patients on haemodialysis at Guilan haemodialysis centres were enrolled. Enzyme-linked immunosorbent assay and polymerase chain reactio testing were performed. Out of 514 enrolled patients, 11.9% were serologically HCV positive and 6.2% had positive HCV-RNA. HCV genotypes were determined with HCV genotype-specific primers. The most frequent genotypes were 1a (59.4%) and 3a (40.6%). There was no significant relationship between virus genotypes and sex or age. The HCV genotype pattern among haemodialysis patients in Guilan province was different from other countries of the Middle East and was more similar to North American and European countries where genotype 1 is predominant.

Distribution of hepatitis C virus genotypes in haemodialysis patients of Guilan, northern Islamic Republic of Iran

The incidence of hepatitis C virus [HCV] infection among patients undergoing haemodialysis is high. The aim of this study was to identify the HCV genotypes among chronic haemodialysis patients who were HCV positive in Guilan province, northern Islamic Republic of Iran. All patients on haemodialysis at Guilan haemodialysis centres were enrolled. Enzyme-linked immunosorbent assay and polymerase chain reaction testing were performed. Out of 514 enrolled patients, 11.9% were serologically HCV positive and 6.2% had positive HCV-RNA. HCV genotypes were determined with HCV genotype-specific primers. The most frequent genotypes were la [59.4%] and 3a [40.6%]. There was no significant relationship between virus genotypes and sex or age. The HCV genotype pattern among haemodialysis patients in Guilan province was different from other countries of the Middle East and was more similar to North American and European countries where genotype 1 is predominant

Furazolidone, amoxicillin and omeprazole with or without bismuth for eradication of Helicobacter pylori in peptic ulcer disease.

BACKGROUND/AIMS: Furazolidone has been introduced as an effective drug against Helicobacter pylori infection in Iran, but intolerable side effects may limit its use. The aim of this study was to compare quadruple and triple furazolidone-based regimens to achieve an economically affordable regimen with acceptable success rate and fewer side effects. METHODS: Patients with Helicobacter pylori positive peptic ulcer disease were randomly allocated into two groups: amoxicillin 1 g b.i.d., furazolidone 200 mg b.i.d. and omeprazole 20 mg b.i.d. with or without bismuth subcitrate 240 mg b.i.d. for two weeks (amoxicillin, furazolidone, omeprazole, bismuth and amoxicillin, furazolidone, omeprazole regimens, respectively). Helicobacter pylori eradication was confirmed by 13C-urea breath test 12 weeks after the end of therapy. RESULTS: Eighty-six patients were enrolled, but 16 patients discontinued their therapy or follow-up. The eradication rates with amoxicillin, furazolidone, omeprazole, bismuth and amoxicillin, furazolidone, omeprazole were 85.3% and 61.1% by per-protocol analysis, respectively (p=0.02) and 67.4% and 51.2% by intention-to-treat analysis, respectively (p<0.05). The most frequent adverse effects in the two study groups were weakness, nausea, anorexia, and dizziness, and no significant differences between the groups were shown. CONCLUSIONS: Based on the results in this study, furazolidone-based triple therapy (without bismuth) is not recommended for Helicobacter pylori eradication because of the lower eradication rate and unchanged frequency of adverse effects. Thus, we recommend furazolidone, amoxicillin and omeprazole in combination with bismuth for treatment of Helicobacter pylori.

Ilizarov Versus AO External Fixator for the Treatment of Tibia Open Fractures.

BACKGROUND: In developing countries, Ilizarov or AO external fixator is usually used for treatment of tibial open fractures. The purpose of this study was to compare the efficacy of these two methods for treatment of tibial open fractures. METHODS: From April 2002 to April 2010, 120 patients with open tibial fractures admitted to the Department of Orthopedics of Babol University of Medical Sciences entered this study. In each arm, 60 subjects randomly received Ilizarov or AO external fixator. All patients were followed at least for one year. These two groups were compared regarding non-union, malunion and cure rates. RESULTS: The mean age of the patients in Ilizarov group was 32.35±11.28 and for AO were 31.3±10.99 years. Mean time for union in Ilizarov group was 5.25±1.85 and for AO external fixator was 5.85±2.13 months. Nonunion rate in Ilizarov group was 10% and for AO external fixator was 11.7%. Malunion rate in Ilizarov group was 10% and for AO external fixator was 18.3%. Totally, efficacy of treatment in the Ilizarov group was 81.7% and in AO external fixator was 65%. CONCLUSION: The efficacy of treatment in Ilizarov was higher than that AO external fixator in treatment of open tibial fractures.

Assessment of propofol usefulness as an anesthetic agent during colonoscopy.

BACKGROUND Propofol is used as a sedative drug during colonoscopy. In this study we analyzed the adverse effects of propofol (i.e., hemodynamic and respiratory) on patients who underwent colonoscopies. METHODS This study was performed in Qom Province, Iran. In this study, 125 patients (63 females, 62 males) were enrolled. Study patients were administered (0.5-1.5 mg/kg) intravenous propofol by an anesthesiologist. Oxygen saturation and blood pressure were recorded at three minute intervals. We used the American Society of Anesthesiology (ASA) classification to stratify patients by risk prior to the procedure. For statistical analysis, the chi-square and paired t-tests were used. A p -value less than 0.05 was considered significant. RESULTS Patients' mean age was 45.36 ± 16.19 years. ASA-I comprised 25.6% of study patients and 74.4% were categorized as ASA-II. Hypopnea occurred in 56.8% of patients and was prolonged in 32.4%. Of the study patients, 5.6% developed hypoxemia which was successfully controlled by the administration of nasal oxygen and no need for mechanical ventilation. The mean arterial blood pressure (p < 0.0001), oxygen saturation (p < 0.0001) and heart rate (p < 0.0001) significantly decreased during colonoscopy. The occurrence of hypopnea significantly increased in patients with pre-procedure oxygen saturation levels ≤ 95% (p < 0.02), age <50 years (p < 0.0001) and ASA class II (p < 0.0001) Agitation, hypotension and cough were seen in 1.6%, 1.6% and 0.8% of patients, respectively. CONCLUSION Propofol has a short half life that enables faster recovery of normal neurologic and social functions we recommend the use of propofol under supervision of anesthesiologist or a trained gastroenterologist.