This study indicated that both 0.005% tacrolimus and IFN alpha-2b are effective and appear to be safe in treatment of recalcitrant VKC.

Background:Psychiatric disorders are common in irritable bowel syndrome (IBS). We conducted this study to investigate the relationship of IBS and their subtypes with some of psychological factors.Materials and Methods:A cross-sectional study was performed among 4763 staff of Isfahan University of Medical Sciences in 2011. Modified ROME III questionnaire and Talley Bowel Disease Questionnaire were used to evaluate IBS symptoms. Hospital Anxiety and Depression Scale and 12-item General Health Questionnaire were utilized to assess anxiety, depression and psychological distress. Logistic regression analysis was used to determine the association of psychological states and IBS in the total subject and both genders.Results:About, 4763 participants with mean age 36/58 ± 8/09 were included the 2106 males and 2657 females. Three thousand and seven hundred and seventy-six (81.2%) and 2650 (57.2%) participants were married and graduated respectively. Subtype analysis of IBS and its relationship with anxiety, depression and distress comparing the two genders can be observed that: IBS and clinically-significant IBS have higher anxiety, depression symptoms, and distress than the subject without IBS (P < 0.001). Women with IBS, have higher scores than men (P < 0.001). Compared to other subtypes, mixed IBS subtype has a higher anxiety, depression, and distress score.Conclusion:A high prevalence of anxiety, depression symptoms and distress in our subjects emphasize the importance of the psychological evaluation of the patients with IBS, in order to better management of the patients and may also help to reduce the burden of health care costs.

No abstract

BACKGROUND Gastric outlet obstructions (GOO) is a disabling complication of peptic ulcer disease (PUD). The introduction of endoscopic through the scope balloon dilatation (EBD) has eased the management but there are few reports on the long term results of this modality of treatment on patients’ symptoms. METHODS Over a period of 4 years from January 2012 to December 2015 in two major referral hospitals affiliated to Shiraz university, medical endoscopy reports were reviewed retrospectively to identify those who received EBD for the treatment of GOO due to PUD .All of these patients were recalled and their current status were evaluated. RESULTS 22 consecutive patients with symptomatic GOO secondary to benign stricture underwent endoscopic balloon dilatation by a single operator. Of them, 14 had balloon dilatation twice and 6 had ballooning three times. The interval between the first referral and the last follow-up was 25.2 ± 10.3 (min: 4.8 max:43.4) months. The averages of maximum balloon size were 14.4 ± 5 mm in the first session, 14.3 ± 3.1mm in the second session, and 16 ± 2.4 mm in the third session. 73% of the patients had a significant improvement in clinical symptom with two sessions of EBD and did not require repeat dilatation. CONCLUSION EBD is a safe and efficient method in the management of GOO with good long term results.

No abstract

Background: Routine bowel preparation instructions are usually given to patients in the form of oral explanations with written instructions. The purpose of this study was to evaluate the effectiveness of multimedia training in the form of video CDs on the quality of colon preparation and other related indicators. Methods: 201 outpatients in three referral academic colonoscopy centers were randomly assigned to two groups. The first group (n=100) received supplementary video CD education besides the routine instructions (VCD group). The second group (n=101) received only routine instruction, which included oral and printed instructions (non-VCD group). Results: Complete use of colon cleansing medication was statistically and significantly better in the VCD group (P=0.038). Duration of colonoscopy was shorter in the VCD group (P=0.001), demand for conscious sedation was lesser in the VCD group (P=0.049), and the quality of colon preparation was better in the VCD group (P<0.00). There was no statistically significant difference in pain sensation (P=0.1), cecal intubation rate (P=0.3), and technical difficulty of the colonoscopy (P=0.1) in both groups. Conclusion: Supplementary education in the form of multimedia CD increases the patients’ compliance to cleansing mediation consumption, improves the quality of bowel preparation, and decreases the duration of colonoscopy with lesser demands for conscious sedation.

Aims: the purpose of this study was to assess the efficacy of prednisolone and cellcept in decreasing postoperative adhesion band formation in rats. Methods: sixty male rats were randomly divided into three equal groups. A standard midline incision was made on the abdomen of each rat, then 2 mL of 10% sterile solution talc was injected into intraperitoneal cavity in order to induce adhesion. Group 1 served as control group, while group 2 received oral cellcept (40 mg/kg/d) and group 3 received oral Prednisolone (5 mg/kg/d) for 4 weeks. results: the formation of adhesion bands in control group was significantly higher than the prednisolone and cellcept group (p <0.001). the amount of adhesion bands in the second group was similar to the third one. conclusion: Orally administered cellcept is as effective as oral prednisolone in declining chance of intraperitoneal adhesion band formation, although it causes fewer complications such as infection in rats.

Introduction: Gastric bezoars are formed by accumulation of non -digestible material in the stomach. They are found mostly in patients with delayed gastric emptying or special psychiatric diseases. Therapeutic options are medical dissolution therapy and endoscopic techniques. Surgery options are kept for refractory or emergency cases. Case Presentation: We report 2 cases of successful non surgery, endoscopic treatment of huge gastric bezoars, which were refractory to medical dissolution therapy and conventional endoscopic techniques such as bezoar fragmentation by polypectomy snare, Basket, Argon Plasma Coagulation device, and different types of foreign body retrieval forceps. In June 2015 and September 2017 in the Namazi hospital (Shiraz University of Medical Sciences, Iran) bezoars fragmentation were conducted successfully by electrohydraulic lithotripsy catheter (Nortech Aoutolith and copy, Northgate technologies, INC.) under direct visualization during the endoscopy. This instrument is primarily designed to crush urinary tract and bile ducts stones avoiding open surgery. Taking the advantages of its capabilities, we used electrohydraulic lithotripsy catheter for huge gastric bezoar fragmentation. Conclusions: In the endoscopic treatment refractory gastric bezoars, electrohydraulic lithotripsy can be used as an excellent alternative option to surgery. This technique is safe, feasible, and uncomplicated without any need for surgery.