Optimizing parameters of the Pulsed Dye Laser (PDL, 585-nm) for hemangioma treatment using diffuse reflectance spectroscopy.

INTRODUCTION: The lack of objectivity options for a specific individualized therapy might cause challenges in laser treatment. In other words, we need optimally determined laser parameters for less side effects. Generally, laser treatment procedures seem to be subjective. Then, the final evaluation of the patient needs for optimized better response with less laser sections and less side effects. Therefore, employing a reliable objective technique seems to be essential for better response with less laser treatment sessions and also less side effects. METHOD: In this research, UV-visible diffused reflection spectra from normal skin and a lesion were taken. We obtained the differences in absorption intensity at 575 nm, the wavelength corresponds to the absorption peak of blood oxyhemoglobin for normal skin and hemangioma. To calibrate the measurements, after using pulsed dye laser (PDL at 585 nm), the PDL treatment response of the patients were graded as "good (>50%), moderate(25%-50%), and poor (0%-25%)," by a specialist. Finally, patients were categorized based on the energy of the laser for the best treatment response to propose the recommended laser parameters. RESULTS: Based on the differences in the absorption peak hemangioma compare with normal skin, the energy density of PDL for a good treatment response of hemangioma was obtained at peak wavelength 575 nm. CONCLUSION: The analysis of optical reflection spectroscopy can assess the correlation of absorption peak differences of vascular lesions and normal skin. According to this data, it seems to be effective in optimizing lasers parameters for the hemangioma treatment.

Association of Helicobacter pylori with central serous chorioretinopathy in Iranian patients.

AIM: This study was conducted to investigate a possible association between H. pylori infection and CSR. BACKGROUND: Helicobacter pylori infection is one of the most common infections worldwide. Central Serous Chorioretinopathy (CSR) is a serious macular detachment that usually affects young people. The etiopathogenesis of the disease is still not completely understood. PATIENTS AND METHODS: A prospective study was performed and we evaluated a total of 35 CSR patients and control group of138 patients who referred to gastroenterology research center of Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Central serous chorioretinopathy was diagnosed on the basis of findings in ophthalmic examinations and confirmed by fluoresce in angiogram. All patients underwent a 13C-urea breath test (UBT) to detect H. pylori infection. Patients were defined as H. pylori infected, if breath test was positive. RESULTS: The mean duration of symptoms before diagnosis was8.3± 2.5 days. Overall, no statistically significant difference was found between left and right eyes, bilateral CSR was observed in 5 patients (14.2%).The incidence of H. pylori infection was 85.7% in CSR patients and 55.1% in control subjects (p=0.001). Odd's ratio was 4.895. CONCLUSION: These results indicate that the prevalence of H. pylori infection is significantly higher in patients with CSR than in controls. No effect of age or sex was seen on H.pylori test results. Further multiple centers, randomized, case control trials are necessary to confirm the potential contributory role of the H. pylori infection in the pathogenesis of CSR as a possible association between infectious agents and endothelial dysfunction.

The effect of the treatment of Helicobacter pylori infection on the glycemic control in type 2 diabetes mellitus.

AIM: To evaluate the possible long-term effects of Helicobacter pylori infection on Hemoglobin A1c and fasting blood sugar levels in patients with type 2 diabetes. BACKGROUND: Helicobacter pylori causes the gastrointestinal tract inflammation, which it plays an important role in distortion of glucose and lipids absorption that altered lipid metabolism and energy harvesting and develops type 2 diabetes, insulin resistance and has been linked to impaired blood glucose. PATIENTS AND METHODS: In this clinical trial, patients with type 2 diabetes and confirmed Helicobacter pylori infection were recruited from the endocrinology clinic of the Shahid Beheshti University Tehran, Iran. Before and after 3 months of eradication therapy fasting blood samples were taken and glycalated hemoglobin levels and fasting blood sugar levels were measured. RESULTS: 85 (27 male 31.8%, 58 female 68.2%) patients with the mean age of 52.±4.7 years were recruited. 52 (62%) had successful Helicobacter pylori eradication (16 male, 30.8% and 36 female, 69.2%). The mean glycalated haemoglobin levels before successful treatment was 8.7±1.1 and after treatment was 8.3±0.9 and difference was significant (p<0.001). Mean IgG level of serology was 3.3±1.1 and the correlation with glycalated haemoglobin was significant (p=0.02) (r=0.4). CONCLUSION: Our results indicate that the Helicobacter pylori treatment can improve the mean glycalated haemoglobin in patients with type 2 diabetes. More investigations will be required to evaluate the effects of Helicobacter pylori eradication among different age groups and in relation to obesity status, diabetes and other disease, and it may be beneficial for patients at risk of diabetes to be checked for the presence of Helicobacter pylori infection.

Non-Helicobacter pylori, non-NSAIDs peptic ulcers: a descriptive study on patients referred to Taleghani hospital with upper gastrointestinal bleeding.

AIM: The purpose of the present study was to evaluate the number and proportion of various causes of upper gastrointestinal bleeding and actual numbers of non-NSAID, non-Helicobacter pylori (H.pylori) peptic ulcers seen in endoscopy of these patients. BACKGROUND: The number and the proportion of patients with non- H.pylori, non-NSAIDs peptic ulcer disease leading to upper gastrointestinal bleeding is believed to be increasing after eradication therapy for H.pylori. PATIENTS AND METHODS: Medical records of patients referred to the emergency room of Taleghani hospital from 2010 with a clinical diagnosis of upper gastrointestinal bleeding (hematemesis, coffee ground vomiting and melena) were included in this study. Patients with hematochezia with evidence of a source of bleeding from upper gastrointestinal tract in endoscopy were also included in this study. RESULTS: In this study, peptic ulcer disease (all kinds of ulcers) was seen in 61 patients which were about 44.85% of abnormalities seen on endoscopy of patients. Among these 61 ulcers, 44 were duodenal ulcer, 22 gastric ulcer (5 patients had the both duodenal and gastric ulcers). Multiple biopsies were taken and be sent to laboratory for Rapid Urease Test and pathological examination. About 65.53% of patients had ulcers associated with H.pylori, 9.83% had peptic ulcer disease associated with NSAIDs and 11.47% of patients had ulcers associated with both H.pylori and consumption of NSAIDs. 13.11% of patients had non-NSAIDs non- H.pylori peptic ulcer disease. CONCLUSION: The results of this study supports the results of other studies that suggest the incidence of H.pylori infection related with duodenal ulcer is common, and that non-H pylori and non-NSAIDs duodenal ulcer is also common.

The evaluation of interleukin-8 chemokine in chronic and acute Toxoplasma gondii infection.

AIM: We investigated whether the level of IL8 was different in patients with chronic and acute Toxoplasma gondii infection during the pregnancy compared with control group. BACKGROUND: It is well established that T.gondii infection induces a strong cell-mediated immune response. PATIENTS AND METHODS: ELISA was used to determine the level of IL8 in sera of 568 pregnant women. Patients were divided into three groups according to a T.gondii serology. The first group included 202 women with positive IgG titres, the second group was 66 women with IgM and negative IgG T.gondii serology; and the third group comprised the sera of 300 healthy pregnant women with negative T.gondii serology and served as controls. RESULTS: The level of IL8 in group I was within normal range similar to control group. However, the level of IL8 was increased in those pregnant patients with positive IgM T.gondii serology. CONCLUSION: The serum levels of pro-inflammatory cytokines such as IL8 seem to be increased in patients with serological evidence of acute T.gondii infection.