فهرست مطالب

Govaresh
Volume:10 Issue: 1, 2005

67 صفحه، بهای روی جلد: 10,000ريال
تاریخ انتشار: 1384/02/12
تعداد عناوین: 11

فارسی
English

انتخاب همه

Family History of Colorectal Cancer in Iran

Mahboubeh Mahdavinia, Farzad Bishehsari, Reza Ansari, Nasim Norouzbeigi, Ahmad Khaleghnejad, Mahshid Hormozdi, Naser Rakhshani, Reza Malekzadeh Page 6

Introduction and
Aims
Previous reports show a high proportion of young CRC patients in Iran. In this study we aim to look for the clustering of colorectal cancer in families of a series of CRC patients from Iran.
Materials And Methods
The family history of cancer is traced in 449 CRC patients of which 112 were 45 years or younger and 337 were older than 45years at time of diagnosis. The patients were admitted in two hospitals in Tehran, during a 4-year period.
Results
Clinical diagnosis of HNPCC was established in 21 (4.7%) probands. Family history of CRC was more frequently reported by earlyonset than by late-onset patients (29.5% vs.12.8%, pâ€¹0.001). Distribution of tumor site differed significantly between those with and without family history of CRC. Right colon cancer was the most frequent site (23/45, 35.4%) observed in patients with positive family history of colorectal cancer.
Conclusions
The relatively high frequency of CRC clustering along with HNPCC in our patients should be further confirmed with larger sample size population-based and genetic studies to establish a cost effective molecular screening for the future.
Keywords: NHPCC, Colon cancer

Abstract View Paper Original: Persian
Surface; a Better Predictor of Disease Severity in Patients with Primary Achalasia than Height of Barium Column

Ghodratollah Montazeri, Negin Nouri, Arezou Estakhri, Javad Mikaeeli, Shapour Shirani, Shifteh Abedian, Atousa Fazlollahi, Farnoush Farrokhi, Mehdi Nouraei, Reza Malekzade Page 11

Background
Subjective assessment of primary achalasia is not accurate. We aimed to evaluate surface of barium retention in the objective assessment of these patients.
Materials And Methods
Subjective and objective esophageal functions of 99 patients with primary achalasia were evaluated initially and 43 of them were reevaluated one month after balloon dilation.
Results
Predilation: Â 9cases enrolled. Mean age was 37.5Â±15.3 years. Mean score, resting LES pressure, height, and surface of barium retention at 5 minutes were 8.03Â±3.1.59.1Â±20 mmhg, 9.9Â±4.9 cm, and 23.6Â±13.9 cm2 respectively. Surface at 5 minutes had best correlation and predictive value for LES pressure.Post dilation: 43 of 99 cases reevaluated. Mean age was 36.8Â±13.6 years. 17 of them were male. Mean score, resting LES pressure, height and surface of barium retention at 5 minutes were 3.4Â±3.4, 38.6Â±22.6 mmhg, and 8.1Â±4.2 cm and 18.8Â±11.3 cm2 respectively. Variables dropped significantly after dilation. Surface at 5 minutes had best correlation and predictive value for LES pressure.
Conclusions
Surface of barium retention at 5 minutes is an accurateobjective tool to assess patients with primary achalasia. It is cheap and easy to perform; therefore it could be used more frequently in follow up.
Keywords: Achalasia, Timed Barium Esophagogram (TBE), Surface, Lower Esophageal Sphincter Pressure

Abstract View Paper Original: Persian
Prospective Evaluation of Endosonography in the Diagnosis of Biliary Microlithiasis in Patients with Normal Transabdominal Ultrasonography

Seyedamir Mirbagheri, Mehdi Mohamadnejad, Jafar Nasiri, Mohammad Bagheri, Ahmad Atefvahid, Ramin Ghadimi, Reza Malekzadeh Page 17

Introduction and

Aims

Prior investigators have proposed microlithiasis as a causative factor for occult gallbladder diseases. Endoscopic ultrasonography (EUS) is potentially far more sensitive than transabdominal ultrasonography (TUS) in visualizing small stones. The aim of this study was to investigate the role of endoscopic ultrasounography (EUS) in the diagnosis of microlithiasis in patients with upper abdominal pain and normal transabdominal ultrasonography (TUS).

Materials And Methods

Thirty-five patients with biliary-type abdominal pain and normal TUS were prospectively studied. All patients underwent radial EUS by means of an echoendoscope (Olympus, GF-UM20).

Results

Of 35 patients, 33 revealed to have gallbladder sludge or small stones, and 21 had common bile duct (CBD) sludge or microlithiasis. Nine patients dropped during the follow-up, however, of the remaining, 13 underwent combined endoscopic biliary sphincterotomy and cholecystectomy, 10 subjected for cholecystectomy and 3 received biliary sphincterotomy alone. In a postoperative follow-up of 9.2 months, 25 patients (96.2%) became symptom-free.

Conclusions

EUS is an important diagnostic tool in patients with unexplained biliary colic. Cholecystectomy with or without ES are effective treatment modalities in these settings.

Keywords: Endoscopic ultrasonography, Microlithiasis, Transabdominal ultrasonography

Abstract View Paper Original: Persian
Frequency and Risk Factors of Hepatitis D Virus in Hepatitis B Patients

Seyedmoayyed Alavian, Shervin Assari, Hasan Manzoori, Joybari, Maryam Moghanilankarani, Taher Doroudi, Bashir Haji, Beigi, Behzad Hajarizade Page 21

Introduction and
Aims
Although a few studies have done in our country in the field of hepatitis D, its risk factors are not clearly known. This study was conducted with the aim of assessing the relative frequency and risk factors of HDV and the correlation between HDV and severity of liver damage.
Materials And Methods
This was a cross sectional study. 280 HBsAg positive subjects (including 102 inactive carriers, 155 patients with chronic active hepatitis and 23 cirrhotic subjects were assessed for Anti HDV Ab, risk factors (blood transfusion, surgery, tattoo, war injury, dentistry interventions and endoscopy) and severity of liver damage (ALT, AST, Platelet).
Results
From all subjects, 16 patients (5.7%) were affected with HDV. 2 inactive carriers (2%), 12 patients with chronic active hepatitis (7.7%) and 2 cirrhotics (8.7%) were Anti HDV Ab positive. History of tattoo (p=0.054), war injury (p=0.025), dentistry interventions (p=0.064) and endoscopy (p=0.028) were more reported in Anti HDV Ab positives than negatives. Anti HDV Ab positive was correlated with higher pathological score (p=0.017) and grade (p=0.012) and lower platelet count (p=0.083).
Conclusions
Our results indicate that the severity of liver disease is independent of serum levels of hepatitis D virus. The correlation between serum titers of hepatitis B virus and severity of liver disease clearly require further investigation.
Keywords: Hepatitis B, Hepatitis D, Risk factors, Liver damage

Abstract View Paper Original: Persian
A Case Report of a Gastric Adenocarcinoma in a Patient with Ataxia-Telangiectasia

Ali Sadeghikhasraghi, Babak Noorinayer, Rahim Aghazadeh, Amirhoushang Mohammadalizadeh, Reza Mashayekhitabrizi Page 27

The patient was a 22-year-old female with ataxia-telangiectasia presented with progressive dysphagia to solid food from 2 months ego. She had lost 17 kg in that period. Physical findings were cachexia, telangiectasias of sclera, ataxia in limbs movements and epigastric tenderness.There was a tumoral lesion in gastric lesser curvature with extension to esophagogastric junction in endoscopy. Pathologic report of biopsy was signet cell adenocarcinoma which confirmed by IHC. Aortic involvement was detected in endoscopic ultrasonography and tumor was unresectable so we only inserted a metal stent for paliation.
Keywords: Ataxia, Telangiectasia, Adenocarcinoma

Abstract View Paper Original: Persian
Case Report: A 39-year-old Man with AIDS Cholangiopathy and Chronic Diarrhea Due to Cryptosporidium Infection

Mohammad Minakari, Mahsa Molaee, Rahim Aghazadeh Page 30

Cholangiopathy and chronic diarrhea are relatively common manifestations of AIDS. Cryptosporidium parvum infection is the most common cause of AIDS cholangiopathy globally. This is the first report of documented Cryptosporidium parvum infection in a patient with AIDS in Iran. The patient was a 39-year-old man from Afghanistan with watery diarrhea, crampy periumbilical abdominal pain and 20 kg weight loss during the past 6 months. He was cachectic with a distended, tympanic abdomen. Laboratory findings were significant for hypokalemia, markedly elevated serum alkaline phosphatase and lymphopenia. Bilirubin and other liver function tests were in normal range. Stool exam was positive for giardia cysts, WBC and trace RBCs. Sonography showed dilated common bile duct and normal intrahepatic ducts. In ERCP there was papillary stenosis, dilated common bile duct and multiple small strictures in intrahepatic ducts. Endoscopy showed candida esophagitis, gastritis and duodenitis. Oocysts of cryptosporidium parvum were seen on duodenal biopsy. His HIV-Ab was positive. He was treated with fluconazol, metronidazol, paramomycin and UDCA and referred to a special center for antiretroviral therapy.
Keywords: AIDSl, Cholangiopathy, Diarrhea

Abstract View Paper Original: Persian
Gastroesophageal Reflux Disease in Iran

Akram Pourshams, Alireza Rahmani, Khadijeh Hatami Page 48

Introduction and
Aims
Gastroesophageal reflux disease (GERD) is very common in western countries. GERD is increasing, has profound effects on health economics, disturbs the patient's health-related quality of life, and increases the risk for development of esophageal adenocarcinoma. GERD is considered to be infrequent in developing countries. This study was performed to determine the prevalence of GERD among Iranians.
Materials And Methods
Major GERD symptoms (heartburn and acid regurgitation) were assessed through an interview by trained general practitioners in three different Iranian populations in 2002: Tehran University freshmen (n=3008), healthy blood donors in Tehran (n=3517), and participants in Golestan cohort study on esophageal carcinoma in Gonbad, north-east of Iran (n=1066). Presence of heartburn or acid regurgitation was considered as GERD and their frequencies were calculated during the last 12 months prior to recruitment.
Results
Three episodes per week or more of GERD symptoms were recorded in 2.1% of university freshmen (mean age 19.1Â±2.1 years), 4.7% of blood donors (mean age 37.3Â±10.8 years), and 18.4% of the cohort study participants (mean age 51.3 Â± 11.7 years). One to two episodes of GERD symptoms a week were reported in 5.1% of the university freshmen, 5.6% of blood donors and 12.7% of the cohort study participants.
Conclusions
GERD symptoms are frequent among Iranians. There was also a trend toward increasing frequency of GERD with increasing age. A GERD symptom is more prevalent in Iran than other Asian countries and is comparable to that of western countries.
Keywords: Gastroesophageal reflux disease, Heartburn, Acid regurgitation, Iran, Prevalence

Abstract View Paper Original: English
Hepatitis-Associated Aplastic Anemia

Fatemeh Farahmand, Gholamhossein Falahi, Touran Shahraki, Gholamreza Khatami, Mina Izadiar, Gholamali Ramiar Page 54

There is a well-recognized relationship between aplastic anemia and viral hepatitis. Clinically apparent hepatitis precedes aplastic anemia by a period of weeks to months. Hepatitis is an infrequent cause of aplastic anemia and is usually severe and fatal if untreated. The clinical features and, particularly the response to immunosuppressive therapy strongly suggest that immune mechanisms mediate the marrow aplasia. The cause of the hepatitis is unknown, but it does not appear to be due to any of the known hepatitis viruses. In this study we present two cases of hepatitis associated aplastic anemia (HAAA) at the ages of 10-11 years old. They both received immunosuppressive therapy, Anti thrombocytic globulin and Cyclosporine. They achieved a persistent clinicohematological remission.

Abstract View Paper Original: English

علمی مصوب

Govaresh

نشریه گوارش

فصلنامه پزشکی

آخرین شماره | آرشیو

ISSN: 1560-7186 eISSN: 2008-7578

صاحب امتیاز:

انجمن متخصصین گوارش و کبد ایران

مدیر مسئول:

دکتر سید حسین میرمجلسی

سردبیر:

دکتر ناصر ابراهیمی دریانی

تلفن نشریه: ۰۲۱-۸۸۳۳۵۰۶۳

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فهرست مطالب

Govaresh Volume:10 Issue: 1, 2005

Govaresh

نشریه گوارش

Govaresh
Volume:10 Issue: 1, 2005