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Copyright of Journal of Dental Medicine is the property of Tehran University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Razi Journal of Medical Sciences is the property of Iran University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Ilam University of Medical Sciences is the property of Ilam University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Helicobacter pylori (H.pylori) infection is a common bacterial infection in humans. Approximately half of the people throughout the world are infected by this gastric microbial pathogen. The outcome of H.pylori infection varies from gastritis to peptic ulcers, duodenal ulcers and gastric malignancies. This study aims to estimate the prevalence of H.pylori infection and iron deficiency anemia, and the possible association between these two variables among children aged 2-12 years from Ardabil, Northwest Iran. Materials and Methods: In this analytical and cross-sectional study, we randomly selected 960 children that ranged in age from 2-12 years that referred to pediatric clinics in Ardabil during February, 2011 to February, 2012. Patients' blood and stool samples were collected to assess for H.pylori infection and iron deficiency anemia. H.pylori infection was evaluated by the Helicobacterpylori Stool Exam Antigen Test (HPAT). To determine the presence of iron deficiency anemia, we measured patients' serum levels of Hemoglobin(Hb), Serum Iron(SI), Ferritin and Total Iron Binding Capacity(TIBC). Data were analyzed by SPSS (version 18) software. Results: Of the 960 participants, we detected H.pylori infection in 360 (37.5%) cases, 140 (38.9%) were males and 220 (61.1%) were females. Iron deficiency anemia was present in 80 (7.3%) cases. Of these, only 25 (6.9%) were positive for both H.pylori infection and iron deficiency anemia. Conclusion: This study confirmed a high prevalence of H.pylori infection among 2-12 year-old children. We observed significant relationship between H.pylori infection and gender (p=0.001). There was no significant association between H.pylori infection and iron deficiency anemia (p=0.278). [ABSTRACT FROM AUTHOR]

Background: This study assessed the effects of hypnotherapy in conjunction with pharmacotherapy versus pharmacotherapy on the quality of life in patients diagnosed with irritable bowel syndrome (IBS). Materials and Methods: This clinical trial used the convenience sampling method to enroll 34 IBS patients. Patients were selected according to Rome III criteria and divided into two groups: i) hypnotherapy plusstandard medical treatmentand ii) standard medical treatment. The QOL-IBS scale assessed patient quality of life at baseline, post-treatment and at the six month follow-up. Data were analyzed using analysis of covariance (ANCOVA). Results: There were significant differences observed between both groups at the post-treatment and follow-up stages in terms of quality of life (p<0.05). Conclusion: Standard medical treatment in addition to hypnotherapy can be used to improve quality of life in IBS patients. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome (IBS) is one of the most common causes of abdominal pain, diarrhea, and constipation. This disorder results in numerous clinic visits. IBS is a health problem with a high social and economic burden due to the lack of an effective treatment. Its etiology consists of biological, psychological and social factors. There is increasing evidence that psychotherapy, in particular cognitive behavioral therapy (CBT) which is a type of self-management intervention, can significantly improve IBS symptoms and disability compared to common medical treatment. Changes to cognition rather than mood and changing the negative perception of IBS patients appears to be a particularly important treatment mechanism. In this study we review current and emerging CBT and its efficacy in IBS patients. [ABSTRACT FROM AUTHOR]

Background: Irritable bowel syndrome (IBS) is a disorder of the gastrointestinal system that presents with special gastrointestinal signs and lack of an organic etiology. Quality of life (QOL) is one of the most important outcomes of IBS. Several psychological factors are mentioned as effective in determining QOL in IBS patients. The goal of this study is to determined the relationship between illness perception and QOL in patients with IBS. Materials and Methods: This study enrolled 96 patients, 40 males(41.7%) and 56 females(58.3%) who referred to the gastroenterology clinics of Imam Khomeini and Laleh hospitals from September to December 2012 Tehran, Iran. Participants completed a Brief Illness Perception Questionnaire (Brief- IPQ) and an IBS-specific QOL (IBS-QOL-34) questionnaire. Information collected by the questionnaire swereanalyzed with Pearson'scorrelation and regression analysis. Results: Results of the analysis performed by Pearson's correlation showed a significant association between patient's illness perception and QOL among those with IBS. Among the subscales of illness perception, the Consequence (p<0.01, r=0.63), Emotion (p<0.01, r=0.55), Concern (p<0.01, r=0.31), Timeline (p<0.01, r=0.30), and Identity (p<0.01, r=0.20) subscales showed the most significant correlation with QOL. There was no relation observed between Illness Comprehensibility, Treatment Control, and Personal Control subscales with QOL. Conclusion: Patient's illness perception seems to play a role in determining QOL among IBS suffers. Therefore psychological intervention based on the patient's illness perception is recommended for IBS patients. [ABSTRACT FROM AUTHOR]

Background: Hepatocellular carcinoma (HCC) is a primary liver cancer that frequently causes mortalities. Transarterial chemoembolization (TACE) is a new palliative treatment for advanced stages of HCC. In this study, we have assessed the results of TACE on a group of Iranian patients with advanced HCC treated at Imam Khomeini General Hospital. Materials and Methods: This was a case series, cohort study conducted on 36 patients with HCC who met the study criteria. Patients underwent two sessions of TACE at a 4-6 week interval. All patients underwent triphasic computerized scans (CT scan) before treatment and at six weeks after the second session. Results: After at least a one year follow up period, 20 (55.6%) patients died and 16 (41.7%) survived. Survival at 6 months was 58% and at 12 months, it was 33.3%. Post-TACE tumor necrosis (>50%) was significantly associated with 6 (p= 0.029) and 12 (p= 0.00) month survival. There was a significant association between 6 and = 12 month survival and Okuda stage (p-V 0.001 and 0.003), ascites (p-V = 0.058 and 0.012) and branch portal vein thrombosis (p-V= 0. 036 and 0.024). There was no association of WHO criteria to 6 (p-V = 0.139) and 12 (p-V --0.139) month survival. Conclusion: Tumor necrosis less than 50%, presence of ascites and thrombosis of the portal branches are associated with lower survival. Suitable selection and taking into consideration post-TACE tumor necrosis is suggested to enhance survival. [ABSTRACT FROM AUTHOR]

Background : Muscle cramps are painful manifestations that occur in many cirrhotic patients. This study aims to evaluate the risk factors for developing muscle cramps. Materials and Methods: This cross-sectional study evaluated 24 cirrhotic patients (18 male, 6 female) during 15 months. Patients underwent careful examinations administered by the same person to determine the underlying cause of disease, presence of ascites, jaundice and encephalopathy as possible causes for muscle cramps. A specific questionnaire that contained demographic information, frequency, location, duration and time of muscle cramps was completed for each patient. Results: Patients' mean ages were 45.1 years for females and 48.3 years for males. The frequency of muscles cramps was 37.5% (6 males, 3 females). The most frequent time for the occurrence of cramps was at night and when patients were at rest (88%). The calf muscle (77%) was the most involved muscle group that experienced cramping. Patients with muscle cramps had lower serum albumin level (p<0.01) and higher PT (p<0.05) compared to those who did not experience cramps. Conclusion: Lower serum albumin level as well as increased PT was associated with muscle cramps in cirrhotic patients. However further studies are mandatory to confirm the findings of this study. [ABSTRACT FROM AUTHOR]

Background: Upper endoscopy, as an important diagnostic and occasional therapeutic tool is invasive. Sedation of patients during the endoscopy procedure with minimal side effects could raise patient tolerability, allowing for ease and increased effectiveness of this procedure. Materials and Methods: In this study, 105 patients who were candidates for the upper endoscopy procedure were randomly divided into two groups: (A) midazolam (n=53) and (B) placebo (n=52). Group A patients received 5 mg of midazolam dissolved 5 cc distilled water and group B received 5 cc of distilled water, via an intra-nasal drip. After 40 to 45 minutes, the upper endoscopy was performed. During the endoscopy, patients were monitored and the endoscopy time, gag reflex stimulation, heart rate, arterial oxygen saturation (SPO2), amnesia and patient justification were recorded and compared. Results: The average age in group A was 39.3 years; for group B, it was 39.9 years. There were no statistically significant results for average endoscopy time (p=0.23), gag reflex stimulation (p=0.27), heart rate (p=0.09), SPO2 (p=0.49), amnesia (p=0.12), and patient justification (p= 0.1) between both groups. Conclusion: According to the results of this study, it seems that intra-nasal midazolam is not effective for patient sedation. This field needs additional evaluation. [ABSTRACT FROM AUTHOR]

Gastrointestinal disorders are common complaints for which endoscopy is one of the most important diagnostic procedures. Anxiety is an unpleasant, ambiguous feeling of apprehension and fear of an unknown origin that occurs during anxious and previously stressful situations or during an injury. Lack of sufficient information and fear of pain can cause anxiety prior to an endoscopy, reducing the trend of patients and increasing the endoscopy time. This study aims to evaluate the effectiveness of various teaching methods (oral, written, oral-written) on patient anxiety prior to an endoscopy. Materials and Methods: This was a case-control study that enrolled 100 patients, 18-80 years of age, who had at least reading and writing literacy. Patients who referred to a specialized clinic at Tabriz University of Medical Sciences for their first endoscopy between December to March 2011 were selected. We randomly divided patients into four groups (oral, written, oral-written teaching, and control) after their first anxiety assessment with the Beck questionnaire. The information was given to patients by the investigator using the training packages. The next day, 30 minutes prior to the endoscopy, patients completed another Beck Anxiety questionnaire and the effectiveness of the different methods was evaluated. Results: Mean anxiety scores decreased in all three teaching groups after intervention, which was statistically significant compared with the control group (p<0.001).The difference in anxiety scores between the teaching groups (written, oral, oral-written) was not statistically significant (p<0.32). Conclusion: The provision of adequate information to patients about the endoscopy procedure, independent of the teaching method, can reduce patient anxiety. [ABSTRACT FROM AUTHOR]

The liver is a vital organ that plays an important role in the metabolism of nutritional agents, drugs and hormones, synthesis of various proteins, coagulation factors and maintenance of hemostasis between calcium, and phosphorous. Biochemical changes in the skeletal system such as osteopenia and pathologic fractures may follow hepatic failure. This research evaluates metabolic bone changes in non-alcoholic cirrhotic patients. Materials and Methods: We evaluated 50 known cases of nonalcoholic cirrhosis in the Internal Medicine Clinic and Ward of GhaemHospital during the second half of 2004. Inclusion criteria were: age >14 years and a Child-Pugh score of A or B. Exclusion criteria were: history of previous bone metabolic disorders; endocrine disease; hepatocellular carcinoma; liver metastasis; previous use of calcium, vitamin D, calcitonin, bisphosphonates, hormone replacement therapy, and prednisolone; and alcoholics. Patients underwent clinical and laboratory studies in addition to bone densitometry analyses of the femoral neck and second to fourth lumbar spine area. Results: Patients' mean age was 41.18± 15.94 years and the male to female ratio was 1.5 to 1. Cases presented with the following types of non-alcoholic cirrhosis: post-hepatitis B (58%), cryptogenic (26%), autoimmune hepatitis (10%), post-hepatitis C (4%) and primary biliary cirrhosis (2%). There were 68% of our cases classified as Child-Pugh score A; 32% were Child-Pugh score B. Osteoporosis and osteopenia were more common in the Child-Pugh B group. T-score of the femoral neck was normal in 39 (78%) cases. The lumbar spine Z-score was normal in 46 (92%) and the femoral neck Z-score was normal in 48 (98%) cases. There were more post-hepatitis B and cryptogenic cirrhosis cases that had decreased bone density. The Child-Pugh A group had more increased calcium, phosphorous, and PTH levels and decreased ALP levels compared to the Child-Pugh B group. Conclusion: Progression of liver failure (according to Child-Pugh) in patients with non-alcoholic cirrhosis to some extent causes increased osteoporosis and osteopenia. It is necessary to place increased emphasis on the importance of mineral supplementation in cirrhotic patients. [ABSTRACT FROM AUTHOR]

Helicobacter pylori (H. pylori) is classified as a class I carcinogen. The low infection rate seen in developed countries (8.9%) compared with a high infection rate (52%-98%) in developing countries indicates a strong association between infection prevalence and socioeconomic status. Adhesion of H. pylori to gastric epithelial cells is an important aggressive factor. One of the genes that encodes for an adhesive protein is babA2, which facilitates the location of bacteria on gastric epithelial cells and delivery of toxic proteins (CagA, VacA) into the host cells. BabA2 is a 78 KD protein that binds to the Le antigens on gastric epithelial cells. Some studies have shown an association between babA2 and peptic ulcer disease or gastric cancer. The cagA gene which encodes an immunodominant protein has a mosaic structure composed of protected and various regions. The C-terminal region of CagA, which includes multiple numbers of EPIYA (Glu-Pro-Ile-Tyr-Ala) motifs, is tyrosine-phosphorylated. Western and East Asian strains represent EPIYA-C and EPIYA-D motifs, respectively. The C- and D- types serve as low-affinity and high-affinity SHP-2-binding sites and interfere with SHP-2 phosphatase activity. A majority of East Asian strains have shown strong conservation and lack of duplication in the D region while the Western strains have shown multiple numbers of the EPIYA-C motif, which increase gastric cancer risk. CagA, either tyrosine-phosphorylated (in its C-terminal motifs) or not in host cells, alters the expression of certain genes to cause gastric cancel. The importance of these genes in predicting clinical outcomes is related to the phylogeographical origins of the bacterium. If the mechanisms by which H. pylori causes cancer are elucidated, they can assist in achieving effective strategies for the prevention and treatment of gastric cancer. [ABSTRACT FROM AUTHOR]

Hepatitis includes a wide range of clinical and pathological conditions. The beta-2 microglobulin (β2M), as part of the HLA complex, is responsible for transmission of viral antigens on the surface of liver cells. The purpose of this study is to determine the concentration of salivary β2M as a marker of viral proliferation in subjects who are HbsAg+, HBV DNA PCR+ compared with those who are HbsAg+ HBV DNA PCR-. Materials and Methods: In this case-control study, we enrolled 25 patients who were Hbs Ag+ HBV DNA PCR+ in addition to 21 patients who were Hbs Ag+, HBV DNA PCR-. We obtained sputum samples from all patients and measured salivary β2M levels by nephelometry. Data analyses were performed by the descriptive, student's t- and chi-square tests. Results: There were 25 men (54.3%) and 21 women (45.7%) with a mean age of 35.72 ±11.86 years who participated. Of PCR+ patients, 72% were on medication, however 85.7% of the PCR- patients did not take medication (p<0.001). Salivary β2M concentration in the PCR+ patients (5.284±5.45) was greater than observed in the PCR- patients (1.51: ±0.77), of which this difference was statistically significant (p<0.003). Conclusion: Salivary β2M levels, as a marker of viral replication, could be used in patients with hepatitis B. [ABSTRACT FROM AUTHOR]