Dyspepsia prevalence in general population aged over 20 in the west part of Iran.

OBJECTIVE: To estimate the prevalence of dyspepsia in the general population aged over 20 in western Iran. METHODS: The cross-sectional study was conducted among the randomly selected general population over the age of 20 years in Sanandaj city. Iran, from April to December 2009. A questionnaire containing demographic, symptoms and history variables was used. Dependent variables were self-reported gastrointestinal symptoms. The prevalence of dyspepsia in different groups was analysed using chi square test, while logistic regression analysis was done to determine dyspepsia, ulcer-like, dysmotility-like and reflux-like prevalence after controlling the confounders. RESULTS: Among 590 respondents, the prevalence of dyspepsia was 54.6% (n = 322). Among them were 243 (41.2%) cases of uninvestigated dyspepsia. According to dyspepsia classification, the prevalence of ulcer-like, dysmotility-like, reflux-like and non-specific dyspepsia were 31.5% (n = 186), 11% (n = 65), 27.3% (n = 161) and 12.4% (n = 74), respectively. Difference in dyspepsia prevalence between men and women persisted after adjustment for other factors (p =0.01) and dyspepsia prevalence was higher in over-60-years old group than the middle aged group (p = 0.008). CONCLUSIONn: The study showed high prevalence of dyspepsia in the general population. Gender, age, family history and theophylline consumption affect the prevalence of dyspepsia.

Efficacy of Zinc Sulfate in Peptic Ulcer Disease: A Randomized Double-Blind Clinical Trial Study.

INTRODUCTION: Peptic ulcer is a common disease that affects millions of people worldwide. Considering its global prevalence finding new approach for treating is important. AIM: The aim of this study was to investigate the effect of zinc sulfate on gastric and duodenal ulcer treatment. MATERIALS AND METHODS: This double-blind clinical trial study was done on 90 patients who were admitted to the gastrointestinal endoscopy clinic of Tohid hospital in Sanandaj, Iran. All patients were diagnosed with gastric and duodenal ulcers. They were randomly divided into two-intervention and control groups, using block randomization with block sizes of 4. Patients and researcher were unaware of the grouping. To assess the level of zinc, blood samples were taken. In case of positive Rapid Urease Test (RUT), triple therapy regimen including amoxicillin, clarithromycin and omeprazole was administered for two weeks. For intervention group in addition to "triple therapy", an oral dose of Zinc Sulfate 220mg capsules were administered daily, while the control group received placebo capsules. RESULTS: A total of 54.5% and 57% of the patients in the intervention and control groups had gastric ulcer respectively. The Rapid Urease Test (RUT) result of 72.7% of intervention group and 83.3% of control group was positive (p = 0.24). Serum zinc level of 20.9% of intervention group and 35.7% of control group was lower than the normal level (p = 0.13). The mean of serum zinc level of intervention group and control group were 81.9 and 78.9 mg dL respectively (p = 0.4). After intervention, peptic ulcer in 81.8% of the intervention group and 83.3% of the control groups were improved (p= 0.85). Response to treatment were higher in patients with normal zinc levels compared to patients with abnormal levels (77.5% vs. 22.5%, p=0.019). CONCLUSION: A daily dose of 220mg zinc sulfate was not significantly effective on peptic ulcer. However, patients with normal zinc levels had better ulcer treatment.

Recurrent acute pancreatitis and cholangitis in a patient with autosomal dominant polycystic kidney disease.

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder associated with multiple cyst formation in the different organs. Development of pancreatic cyst in ADPKD is often asymptomatic and is associated with no complication. A 38-year-old man with ADPKD was presented with six episodes of acute pancreatitis and two episodes of cholangitis in a period of 12 months. Various imaging studies revealed multiple renal, hepatic and pancreatic cysts, mild ectasia of pancreatic duct, dilation of biliary system and absence of biliary stone. He was managed with conservative treatment for each attack. ADPKD should be considered as a potential risk factor for recurrent acute and/or chronic pancreatitis and cholangitis.

An unusual endoscopic presentation of solitary rectal ulcer syndrome.

Solitary rectal ulcer syndrome (SRUS) is an uncommon rectal disorder. Massive rectal bleeding is a rare presentation of SRUS, and can pose an endoscopic challenge in differentiating from other causes of massive rectal bleeding. A 22-year-old man presented with massive rectal bleeding which had SRUS with spurting bleeding on lower endoscopic evaluation. He was treated by endoscopic hemostasis using argon plasma coagulation. He had no complaint after a month and follow up lower endoscopy proved complete healing within two months. SRUS should be considered as a potential cause of massive rectal bleeding.

Noradrenalin versus the combination of midodrine and octreotide in patients with hepatorenal syndrome: randomized clinical trial.

BACKGROUND: Hepatorenal syndrome (HRS) is known as development of acute renal failure in a patient who usually has advanced liver disease. The aim of the present study was to determine the safety and the efficacy of noradrenalin in comparison with midodrine-octreotide in patients with HRS. METHODS: This study was registered to the Iranian Registry of Clinical trials (IRCT). This study was a single-center, randomized, clinical trial that performed in Alzahra hospital, Isfahan, Iran. Since March 2011 to January 2012, twenty-three patients were enrolled in the study. Eligible patients were allocated in 2 groups. In the first group, patients received infusion of NA with the dose of 0.1-0.7 µg/kg/min, and in the other groups, patients received octreotide 100-200 µg subcutaneously 3 times daily and midodrine 5-15 mg orally 3 times daily. In both study groups, patient received albumin infusion in addition to noradrenalin or midodrine-octreotide. RESULTS: Complete response of HRS was observed in 8 of the 11 patients (73%) treated with noradrenalin and in 9 of the 12 patients (75%) treated with midodrine-octreotide (P > 0.05). HRS recurred after treatment withdrawal in 2 of 11 in NA and 3 of 12 in MO group. That shows no significant difference between 2 groups (P > 0.05). CONCLUSION: We deduce that NA has the same efficacy and safety with MO and can induce a complete response in high percentage of the patients. Moreover, we observed no significant differences in the recurrence rate and outcomes after 3 months among the patients in both study groups; this result could support the use of NA in HRS management. The IRCT ID is: IRCT201107217085N1.

Prevalence of asthma and rhinitis in bakery workers in the city of Sanandaj, Iran.

Baker's asthma is one of the most common forms of occupational asthma. This study was conducted to determine prevalence of asthma and rhinitis among bakery workers in the city of Sanandaj, the provincial center of Kurdistan province in the west of Iran in the in Summer 2006. In this study 776 bread bakery workers were included. These subjects were selected randomly among 1620 bakery workers. The diagnosis of asthma was based on a medical history of episodic symptoms of cough, chest tightness, and dyspnea and spirometry. Airflow obstruction was determined with spirometry, the definition of airflow obstruction which was used in this study was an FEV1/FVC ratio < 0.8, and FEV1 or FVC increases of > or = 12 percent and at least 200 mL after using a short-acting inhaled beta2-agonist. Rhinitis was diagnosed by typical history of work related symptoms. Analyses were performed on 776 subjects (all were men) without missing data for asthma and rhinitis. All of subjects were male with mean age of 33.69+/-11.09 years. Mean duration of bakery working for these subjects was 13.91+/-9.37 years. Prevalence of asthma at the time of study was 11.9%. 93 subjects were diagnosed as asthma with history, physical and spirometry findings. 31 (33.3%) of asthmatic workers were diagnosed as asthma previously and 62 (66.6%) workers were known as new asthmatic patients which were diagnosed in this study program. The prevalence of rhinitis was (9.9%). Subjects with asthma had longer history of working at bakery than others (P=0.001). Asthma prevalence among these bakery workers that were included in our study was similar and in some instances the prevalence was lower than other studies.