فهرست مطالب

Colorectal Research - Volume:6 Issue: 1, Mar 2018

Iranian Journal of Colorectal Research
Volume:6 Issue: 1, Mar 2018

  • تاریخ انتشار: 1397/01/20
  • تعداد عناوین: 4
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  • Mehdi Tahamtan, Seyed Vahid Hosseini, Seyyed Hamdollah Mosavat, Alimohammad Bananzadeh, Masoomeh Rahimi, Hajar Khazraei * Page 1
    Background
    In this text, the important points of Avicenna’s Canon of Medicine on hemorrhoidal disease and its treatment have been introduced in light of colorectal surgery.
    Objectives
    The aim of this study is to briefly explain the hemorrhoidal disease and its treatment through different sections of Avicenna’s Canon of Medicine. A unique feature of the Canon is careful and precise observations and description of the disorders and diseases. However, the recommended treatment differs from which that used today except in a few diseases.
    Methods
    The most detailed chapter regarding hemorrhoid in Canon of Avicenna, under the title of “Anal disease,” shows rather precise knowledge about anal disease and their surgical treatments in the 11th century.
    Results And Discussion
    Avicenna explained in detail about anal diseases such as perianal abscess, fissure, rectal prolapse, and hemorrhoid in the 17th chapter of the 3rd volume of the Canon. Many herbs were used in anal disease by medieval physicians such as Avicenna had antioxidant and anti-inflammatory effects. Thus, the knowledge of ancient physician can help us in developing new therapeutic methods.
    Keywords: Avicenna, Canon, Hemorrhoid, History of Medicine
  • Erfan Mohammadi, Durdi Qujeq*, Hassan Taheri, Karimollah Hajian-Tilaki Page 2
    Background
    This study aimed at evaluating oxidant and antioxidant markers (including nitrite, nitrate, total antioxidant capacity (TAC), malondialdehyde (MDA), iron, selenium, glutathione peroxidase (GPx), and glutathione reductase (GR) in patients with inflammatory bowel disease (IBD) and compare them with healthy controls.
    Methods
    Serum samples were obtained from 35 patients (19 ulcerative colitis (UC) and 16 Crohn’s disease (CD) in the active phase of the disease) and 30 healthy controls. Serum levels of nitrite and nitrate, TAC, MDA, iron, selenium, glutathione peroxidase, and glutathione reductase were measured. The results were compared between the two groups using independent t-student test. The Pearson’s correlation coefficient (for continuous data) was performed using the SPSS software.
    Results
    Serum levels of nitrite, nitrate, and MDA were significantly higher (P = 0.001) in patients with IBD, while the levels of TAC, trace elements, glutathione peroxidase (GPx), and Glutathione Reductase (GR) levels were lower (P
    Conclusions
    There is an imbalance between oxidant and antioxidant properties in patients with IBD, which highlights the role of oxidative stress in the pathogenesis of this disease.
    Keywords: Nitrites, Nitrates, Antioxidants, Malondialdehyde, Iron, Selenium, Glutathione Peroxidase, Glutathione Reductase
  • Muhammad Shamim * Page 3
    Background
    Traditional open hemorrhoidectomy is the most commonly performed operation for the third or fourth degree hemorrhoids in the developing world, despite considerable postoperative pain and bleeding complications. This modification is an attempt to reduce these complications and compare the outcome of both methods.
    Methods
    A prospective, comparative study was conducted in phase I, at Fatima hospital at Baqai Medical University, from March 2009 to August 2011. It was followed by a descriptive case-series in phase II, conducted at different hospitals from September 2011 to August 2017. The inclusion criteria were patients of both genders and all age groups, with third or fourth degree hemorrhoids requiring surgery. The exclusion criteria were patients in between blocks (operated by other surgeons), patients with complicated hemorrhoids, closed hemorrhoidectomy cases, cases operated by residents, and cases lost to follow-up. In phase I, a total of 182 patients were enrolled and randomly allocated to group A or B undergoing triple hemostatic hemorrhoidectomy and traditional open hemorrhoidectomy, respectively; 231 patients were included in phase II (group C) undergoing modified hemorrhoidectomy. The analyzed variables were operative blood loss, operative time, postoperative pain, hospital stay, time to pain-free defecation, and per-operative or postoperative complications.
    Results
    There was significantly more operative blood loss in group B patients. Pain perception was significantly high in group B patients at eight and 24 hours, as well as eighth, 15th, and 30th days. Group B patients also had longer duration of operation and more prolonged pain-free defecation. Both, intra-operative and post-operative complications were higher among the group B. The outcome of phase II (group C) was similar to those of group A.
    Conclusions
    In a limited resource setting, triple hemostatic open hemorrhoidectomy offers potential advantages of less operative blood loss, shorter duration of operation, shortened hospital stay, shorter time to pain free defecation, and less postoperative pain and other complications.
    Keywords: Hemorrhoidectomy, Surgical Diathermy, Hemostatic Techniques, Hemorrhoids
  • Tsvetelina Veselinova Velikova*, Zoya Angelova Spassova, Lyuben Mitkov Milatchkov, Dobriana Georgieva Panova, Ekaterina Ivanova Ivanova Todorova, Kalina Dinkova Tumangelova Yuzeir, Ekaterina Krasimirova Kurteva, Dobroslav Stanimirov Kyurkchiev Page 4
    Background

    Fecal and immunological biomarkers can be used to diagnose and manage patients with Crohn’s disease (CD). Anti - tumor necrosis factor (TNF) should be evaluated in addition to biomarkers to determine the response to therapy.

    Objectives

    The current study aimed at following up fecal calprotectin (FC), perinuclear anti - neutrophil cytoplasmic antibodies (pANCA), anti - Saccharomyces cerevisiae antibodies (ASCA), and anti - nuclear antibodies (ANA) in patients with CD on anti-TNF therapy.

    Methods

    A total of 57 patients with CD and the mean age of 40 ± 15 years (ranged: 20 - 75) were monitored after initiation of anti - TNFa treatment. Stool samples were tested for FC (Alegria automated the enzyme - linked immunosorbent assay (ELISA) system), and serum samples for ANCA, ANA (indirect immunofluorescence - IIF), and ASCA (ELISA) in the beginning and after six months on immunosuppressive therapy plus anti - TNFa agents.

    Results

    It was observed that all patients with CD had significantly decreased FC levels after anti - TNFa therapy (963.97 mg/kg initially vs. 268.42 mg/kg after treatment; P = 0.043). Moreover, in 75% of patients, FC levels dropped below the cutoff value of 50 mg/kg. Positive for ASCA IgA/IgG were 17/24 tested patients, but no differences were observed regarding the application of anti - TNFa therapy. However, the titers of pANCA decreased in four patients after anti - TNFa treatment.

    Conclusions

    Initial and follow - up measurements of some immunological markers such as FC and pANCA could be of benefit for patients with CD in anti - TNF therapy, whereas others such as ANA and ASCA were not useful to monitor the therapy.

    Keywords: TNFa Inhibitors, Immunological Biomarkers, Therapy Monitoring