Adaptation of a quality of life questionnaire for Iranian patients with esophageal cancer.

INTRODUCTION: Evaluation of quality of life is very important in cancer patients. Esophagus-specific quality of life questionnaire (QLQ-OES18) is a disease-specific questionnaire for assessing quality of life in esophageal cancer (EC). So we aimed to translate and evaluate the reliability and validity of the QLQ-OES18 when applied to Iranian patients. MATERIALS AND METHODS: This study was designed as cross-sectional study on 62 newly confirmed EC in two referral hospital in Tehran, Iran. Reliability of the subscales was evaluated by intraclass correlation coefficients. Pearson's correlations of an item with its own scale and other scales were calculated to assess convergent and discriminant validity. Clinical validity was also evaluated by known-group comparisons. RESULTS: Cronbach's alpha was higher than 0.7 in most subscales. All subscales met the standards of convergent and discriminant validity. Also QLQ-OES18 had discriminatory power for differentiation between patient's groups with different clinical status. CONCLUSION: Our results provide evidences that Persian version of QLQ-OES18 is a valid and reliable questionnaire when applied to a sample of Iranian patients with EC and is recommended for use in clinical research.

Findings of impedance pH-monitoring in patients with atypical gastroesophageal reflux symptoms.

AIM: This study was designed to investigate about findings of Impedance pH-monitoring in patients with atypical symptoms of GERD. BACKGROUND: The routine treatment with proton pump inhibitors is not very effective in patients with atypical symptoms of Gastro-Esophageal Reflux Disease (GERD). It may be due to non-acid reflux which cannot be monitored using common methods such as pH-metry. Therefore, in these patients combinational procedure of multi channel intraluminal impedance and pH monitoring has been suggested as a new approach. PATIENTS AND METHODS: Sixty patients with atypical symptoms of GERD underwent combined impedance pH-monitoring. pH of reflux episodes, type of material refluxant, blous cleaning time, proximal extension and symptoms association probability (SAP) was recorded for each patient. RESULTS: Globus sensation was reported as the most common atypical symptom. 95% of patients experienced weakly acid reflux. Mixed and pure gas refluxates were more frequent than pure liquid reflux. Bolus clearing time was pathologic in 36.7% of cases and proximal extension was detected in 43 patients (71.7%). Of the 46 symptomatic patients, 33.3% had a positive SAP and 43.3% had a negative SAP. CONCLUSION: The findings of current study showed that the combinational procedure of MII and pH monitoring could provide important information for resistant to treatment patients' with atypical GERD symptoms.

Metabolic syndrome and colorectal cancer: a cross-sectional survey.

INTRODUCTION: There is epidemiological evidence indicating that the metabolic syndrome increases the risk of colorectal cancer. Since there is little information about this issue in Iran, the present study was conducted to evaluate prevalence of metabolic syndrome and its components in patients with colorectal cancer. MATERIAL AND METHODS: This cross-sectional survey involved 200 patients with a new diagnosis of colorectal cancer. Demographic information of patients was collected through the interview with them. Components of metabolic syndrome including fasting glucose serum, triglyceride, high density lipoprotein, blood pressure and waist circumference were measured for all of the patients. RESULTS: A total of 72 colorectal cancer patients (36%) met metabolic syndrome criteria with rates of 76% for women and 24% for men. BMI in metabolic syndrome patients was higher than other colorectal cancer patients. Disease history including hypertension, diabetes and cardiovascular disease was most frequent in metabolic syndrome patients. Pathological characteristics of colorectal cancer were not significantly associated with the disease. CONCLUSION: The findings of present study indicated that the prevalence of metabolic syndrome in CRC patients is relatively high. Therefore, further analytical and multi centric studies are needed to better understand the role of metabolic syndrome in development of CRC in Iran. If this association is confirmed in future studies, metabolic syndrome patients should be considered in CRC screening programs.

Quality of life outcomes in patients living with stoma.

BACKGROUND: Despite efforts to maintain the intestinal tissue and treat gastrointestinal disease, a large number of patients undergo ostomy surgery each year. Using stoma reduces the patient's quality of life (QOL) greatly. Although there are approximately 3000 patients in Iran; there is little information about the impact of stoma on their QOL. AIMS: The study aims to evaluate QOL of stoma patients using a special measurement tool. SETTINGS AND DESIGN: This survey was a cross-sectional study that was conducted on 102 random samples of stoma patients. MATERIALS AND METHODS: The City of Hope Quality of Life-Ostomy Questionnaire was used for collecting demographic and clinical information and evaluating QOL. STATISTICAL ANALYSIS USED: Univariate and multiple regression analyses were performed to identify predictors of QOL. RESULTS: The mean score for the overall QOL for stoma patients was 7.48 ± 0.9. 70% of patients were dissatisfied with sexual activities. More than half of them reported feelings of depression following stoma surgery. Univariate analysis indicated that factors such as the type of ostomy (temporary/permanent), the underlying disease that had led to the stoma, depression, problem with location of ostomy, and change in clothing style had significant effects on overall QOL and its subscales (P < 0.05). The results of the regression analyses showed that only depression and problem with the location of ostomy were statistically significant in predicting patients' QOL and its subscales (P < 0.05). CONCLUSIONS: The findings demonstrated that living with stoma influences the overall aspect of QOL. Education for the patients and their families is important for improving the stoma patients' QOL. Sexual and psychological consultation may also improve patients' QOL.

A 12 year old boy with recurrent episodes of pneumonia: triple A syndrome.

Triple A syndrome (Allgrove syndrome) is a rare inherited autosomal recessive disease with a typical triad including adrenocorticotrophic-hormone-resistant glucocorticoid insufficiency, reduced or absent tearing (alacrima) and achalasia and a wide range of symptoms can be detected due to multi organ involvement. This report describes the case of a Triple Asyndrome, a12 year-old boy with a history of recurrent episodes of pneumonia and growth retardation due to failure to timely diagnosis of his problem.

Clinical profile and post-operative lifestyle changes in cancer and non-cancer patients with ostomy.

AIM: The aim of this was to investigate some clinical profiles and lifestyle changes in stoma patients. BACKGROUND: Stoma patients experienced multiple complications due to their ostomy formation. PATIENTS AND METHODS: A cross-sectional study performed on 102 random samples of stoma patients. Any patient with adequate physical and mental capability to participate and having had an ostomy in place for at least 3 months was eligible to enter the study. Participants asked to answer study questions concerning age, sex, type of stoma, having permanent or temporary ostomy, underlying cause of stoma formation, type of cancers cause of stoma. Patient also questioned about some lifestyle changes because of stoma including: changing diet, sexual satisfaction (if sexually active after stoma formation), sense of depression, changing job, change clothing style. RESULTS: Colostomy was the most common type of stoma followed by ileostomy and urostomy. In 80.4% of patients under study the stoma was permanent. Most patients had a stoma because of cancer (77.5%), with colon cancer (41.2%) being the most common malignant diagnosis. The mean age of cancer patients (56.1±10.9) with stoma was significantly higher than non-cancer patients (44.7±12.9) (p < 0.05). A significant differences were found regarding to sexual satisfaction after stoma formation between the two groups (p < 0.05) and the cancer group was less sexually satisfied post-ostomy. CONCLUSION: In conclusion, stoma formation can caused multiple problems for both cancer and non-cancer patients. Counseling of patient is an important component of care that could help stoma patients to adjust with new situations.