Zinc is an important trace element for structure, and regulation in the central nervous system, as well as the gut homeostasis. There are several mental disorders associated with zinc deficiency. The relationship between zinc nutritional status with mood states and quality of life (QoL) in diarrhea-predominant irritable bowel syndrome (IBS-D) has not been studied yet. This case–control study aimed to investigate the association between zinc nutritional status with mood states and QoL in IBS-D patients. Sixty-one newly diagnosed patients with IBS-D and 61 matched healthy controls were enrolled. Dietary zinc intakes and serum zinc levels were measured. Mood states and QoL were evaluated by validated questionnaires. Logistic regression was used to estimate the odds of IBS-D in relation to zinc deficiency. Decreased serum zinc levels were observed in the IBS-D group than in the controls (p = 0.001). There were higher scores of depression (p = 0.014), anxiety (p = 0.005), and stress (p = 0.001) among IBS-D patients. Moreover, overall QoL, physical and psychological health were lower in IBS-D patients compared to the controls (p < 0.001). “Food avoidance” had the lowest, while the “relationship” had the highest score among the patients (51.09 ± 26.80 and 78.14 ± 23.30, respectively). Dietary zinc intake was positively correlated with psychological health in the controls (r = 0.295, p = 0.022) and with body image in the patients (r = 0.266, p = 0.044). According to the logistic regression, zinc deficiency was not significantly associated with odds of IBS-D. Findings show that zinc deficiency may be associated with some parameters of IBS-D. Further clinical studies are needed to explore the causal relationship between zinc status and IBS pathogenesis.
Background:This study evaluated the clinical efficacy and tolerability of a 14-day course of bismuth-based quadruple therapy including tinidazole and levofloxacin in compare to a 14-day bismuth-based quadruple therapy including clarithromycin as first-line treatment for Helicobacter pylori infection in Iranian adults.Materials and Methods:The study was a prospective, parallel group, randomized controlled, clinical trial that conducted on 150 patients with H. pylori infection. Patients were randomly assigned to the two groups as follows: first group received pantoprazole 40 mg, bismuth subcitrate 240 mg, amoxicillin 1 g, and clarithromycin 500 mg (PBAC group), and other group received pantoprazole 40 mg, bismuth subcitrate 240 mg, amoxicillin 1 g, tinidazole 500 mg for 7 days, followed by levofloxacin 500 mg for the second 7 days (PBATL group). Main outcomes were eradication rate, tolerance of treatment, and dyspepsia severity.Results:The eradication rates for PBAC regimen was 81.1% (95% confidence interval [CI]: 71.9–90.2) and for PBATL regimen was 70.8% (95% CI: 60.1–81.6), which was not significantly different (P = 0.147). Tolerance of treatment was similar between groups. The median of severity of dyspeptic after treatment in PBAC group was 10 [9–14.75], which was similar to PBATL group 10 [9–13.5] (P = 0.690).Conclusion:There is no significant difference between PBAC and PBATL regimen, and efficacy was similar in both groups. The overall rate of treatment failure suggests that up to 18%–30% of patients will fail bismuth-based quadruple therapy and require retreatment for the infection.
Background: In this study, we summarized the data on gastrointestinal (GI) involvement and the potential association with clinical outcomes among the patients admitted to Khorshid Hospital. Materials and Methods: We investigated 1113 inpatients (≥18 years old) diagnosed with coronavirus disease-2019 (COVID-19) from March to June 2020 in Khorshid Hospital. We collected demographic details, clinical information, vital signs, laboratory data, treatment type, and clinical outcomes from patients’ medical records. The data of patients with GI symptoms were compared with those without GI symptoms. Results: A total of 1113 patients were recruited (male = 648). GI symptoms were observed in 612 (56.8%) patients (male = 329), the most common of which were nausea 387 (34.7%), followed by diarrhea 286 (25.7%), vomiting 260 (23.4%), and abdominal pain 168 (15.0%). The most prominent non-GI symptoms were cough 796 (71.5%), fever 792 (71.2%), shortness of breath 653 (58.7%), and body pain 591 (53.1%). The number of patients who were discharged, died, and were admitted to intensive care unit was significantly different in groups on the basis of GI and non-GI symptoms ( P = 0.002, 0.009, 0.003). Conclusion: While COVID-19 was predominantly diagnosed in males, GI symptoms were more commonly reported by females. The results indicated that GI symptoms in COVID-19 patients are common, and the symptoms are not correlated with the severity of the disease. Moreover, the presence of GI symptoms was positively related to milder disease. Among COVID-19 positive patients, the clinical outcomes of the GI group were promising, compared to those of non-GI group.
Vascular access (VA) complications are the leading cause of morbidity in the hemodialysis (HD) population and responsible for high health care costs. This study was designed to compare the profile of VA use for HD in Isfahan dialysis units in 2003 and 2013. A cross-sectional observational study was conducted between January and March 2013 on 536 HD patients in seven units. The patients data about VA type, number, survival, and demographic characteristics were collected and compared with the data collected in year 2003 on 320 patients in the same city units. The mean age of patients increased from 51 ± 17 to 58 ± 15 years (P < 0.001). The most common etiology of end-stage renal disease was diabetes mellitus, but the percentage increased in 2013 (P = 0.001).The use of an arteriovenous fistula (AVF) as a first dialysis access fell from 60.6% in 2003 to 35.4% in 2013 (P < 0.001). At the time of study, AVFs were used in 92.2% of patients in 2003 versus 56.5% in 2013 (P < 0.001). The 1, 2, 3 and 5 years AVF survival was 80%, 78%, 73%, and 69%, respectively in 2003 versus 79.4%, 61.2%, 47.3%, and 31.5% in 2013. The AVFs proportions decreased and the tunneled catheters proportions increased while the proportion of temporary catheters decreased in 2013 compared with 2003.
Covid-19 disease is a pandemic disease that maybe more severe and mortal in people with immunodeficiency, such as those with inflammatory bowel disease (IBD), who are taking immunosuppressive drugs. On the other hand, no definitive treatment has been identified for it and the best way to control it is wide spread vaccination. The aim of this study was to evaluate the benefits and side effects of different vaccines in patients with IBD. Three Electronic databases [Medline (accessed from PubMed), Scopus, Science Direct, and Cochrane] were searched systematically without time limit, using MESH terms and the related keywords in English language. Considering the titles and abstracts, unrelated studies were excluded. The full texts of the remained studies were evaluated by authors, independently. Then, the studies' findings were assessed and reported. Total of 212 articles were obtained within the first step of searching, and 147 ones remained after removing the duplications. Through the title and abstract screening, 127 were removed. Finally, after reading the full text of the remained articles, 15 ones included in data extraction. All included studied were research study, and most of them (12/15) had prospective design. Totally, 8/15 studies were performed in single-center settings. In 8/15 studies, patients with IBD were compared with a control group. The results were summarized the in two categories: 1) the effect of vaccination, and 2) side effects. The effect of vaccination were assessed in 13/15 studies. Side effects of Covid-19 vaccination in patients with IBD were reported in 7/15 studies. Patients with IBD can be advised that vaccination may have limited minor side effects, but it can protect them from the serious complications of Covid-19 disease and its resulting mortality with a high success rate. They should be also mentioned in booster doses.
Covid-19 is a pandemic disease that is more severe and mortal in people with immunodeficiency, such as those with inflammatory bowel disease (IBD). On the other hand, no definitive treatment has been identified for it and the best way to control it is wide spread vaccination. The aim of this study was to evaluate the benefits and side effects of different vaccines in patients with IBD. Three Electronic databases [Medline (accessed from PubMed), Scopus, Science Direct, and Cochrane] were searched systematically without time limit, using MESH terms and the related keywords in English language. We focused on the research studies on the effect and side effects of Covid-19 vaccination in patients with IBD. Articles were excluded if they were not relevant, or were performed on other patients excerpt patients with IBD. Considering the titles and abstracts, unrelated studies were excluded. The full texts of the remained studies were evaluated by authors, independently. Then, the studies' findings were assessed and reported. Finally, after reading the full text of the remained articles, 15 ones included in data extraction. All included studied were research study, and most of them (12/15) had prospective design. Totally, 8/15 studies were performed in single-center settings. In 8/15 studies, patients with IBD were compared with a control group. The results were summarized the in two categories: (1) the effect of vaccination, and (2) side effects. The effect of vaccination were assessed in 13/15 studies. Side effects of Covid-19 vaccination in patients with IBD were reported in 7/15 studies. Patients with IBD can be advised that vaccination may have limited minor side effects, but it can protect them from the serious complications of Covid-19 and its resulting mortality with a high success rate. They should be also mentioned in booster doses.
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