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Saneian H.,Isfahan University of Medical Sciences | Tavakkol K.,Azad University | Adhamian P.,Poursina Hakim Research Institute | Gholamrezaei A.,Poursina Hakim Research Institute
Journal of Research in Medical Sciences | Year: 2013

Background: Functional constipation is one of the most prevalent childhood gastrointestinal disorders. We evaluated effects of adding a probiotic to mineral oil in the treatment of functional constipation in children. Materials and Methods: This controlled trial was conducted on 60 children (2 to 14 years old) with functional constipation (Rome III criteria). Children were allocated to receive the synbiotic (Lactol®, composed of Lactobacillus Sporogenes, 1 Tab/20 kg/d) plus mineral oil (Paraffin 1 ml/kg/d) or the mineral oil alone for two months. Symptoms of constipation including defecation frequency, stool form, strain and pain at defecation, incomplete evacuation and soiling were assessed and compared before and after the intervention. After the treatment period, the two groups were also compared with regards to subjective global assessment of improvement. Results: After the treatment, stool frequency increased in both groups (P < 0.001), with greater increase in synbiotic + mineral oil group (P = 0.001). Frequency of hard/very hard stool and frequency of painful defecation decreased similarly in both groups (P < 0.001). Straining at defecation, incomplete evacuation, and soiling decreased in both groups (P < 0.001), but more decrease was seen in the synbiotic + mineral oil group (P < 0.05). Finally, there was a better global improvement in the synbiotic + mineral oil group (P < 0.05). No severe side-effects were observed in any group. Conclusion: Adding the synbiotic Lactol® (containing Lactobacillus Sporogenes) to mineral oil can increase the improvement in the constipation symptoms of children without specific side-effects. Source


Nemati A.,Isfahan University of Medical Sciences | Rahmatabadi Z.K.,Poursina Hakim Research Institute | Fatemi A.,Isfahan University of Medical Sciences | Emami M.H.,Isfahan University of Medical Sciences
Journal of Research in Medical Sciences | Year: 2012

BACKGROUND: There is a lack of data on familial aggregation of colorectal cancer (CRC) in Iran. We aimed to determine the frequency of hereditary nonpolyposis colorectal cancer (HNPCC) and familial colorectal cancer (FCC) and to determine the frequency of extracolonic cancers in these families in Isfahan. METHODS: We reviewed documents of all patients with a pathologically confirmed diagnosis of CRC admitted to Isfahan referral hospitals between 1995 and 2006. We also studied our CRC registry at Poursina Hakim Research Institute from 2003 to 2008. We found HNPCC and FCC families based on the Amsterdam II criteria and interviewed them for family history of CRC and extracolonic tumors. The family history was taken at least up to the second-degree relatives. RESULTS: During 1996 to 2008, a total of 2580 CRC cases have been diagnosed. We found 14 HNPCC and 53 FCC families. Mean age of CRC at diagnosis was 48.0 ± 14.6 and 49.0 ± 13.9 years in the HNPCC and FCC families, respectively (p > 0.05). The total numbers of observed extracolonic tumors were 70 (21.6%; mean age = 53.6 ± 11.0 years) and 157 (13.8%; mean age = 54.8 ± 18.0 years) in HNPCC and FCC families, respectively (p > 0.05). CRC was respectively found in 52 and 76 members of the HNPCC and FCC families, revealing the frequency of HNPCC and FCC as 2.0% (52/2580) and 2.9% (76/2580), respectively. CONCLUSIONS: We found a relative high frequency of HNPCC (2.0%) and FCC (2.9%) among CRC cases in our society and high incidence of extracolonic tumors in their families. Further studies focusing on molecular basis in this field and designing a specific screening and national cancer registry program for HNPCC and FCC families should be conducted. Source


Solouki R.,Isfahan University of Medical Sciences | Solouki R.,Poursina Hakim Research Institute | Emami M.H.,Isfahan University of Medical Sciences
Journal of Research in Medical Sciences | Year: 2014

Background: Magnetic resonance cholangiography (MRC) has gained popularity for diagnosing primary sclerosing cholangitis (PSC). We determined the accuracy of MRC compared with endoscopic retrograde cholangiography (ERC) for diagnosing PSC. Materials and Methods: This retrospective case-control study was conducted on patients referred to an outpatient gastroenterology clinic from 2001 to 2013. Patients with established diagnosis of PSC who had undergone MRC and ERC within a 6-month interval were included. Controls were selected from patients who had undergone imaging for reasons other than PSC evaluation. Disease outcome at the study time and liver biochemistry data at diagnosis and 1-year thereafter were retrieved. Diagnostic accuracy of MRC in comparison with ERC was evaluated. Results: A total of 46 definite PSC patients (age at diagnosis = 36.8 ± 11.6 years, 33 male) were found. Diagnostic imaging for PSC was ERC alone in 12, MRC alone in 23, and ERC plus MRC in 11 patients. Controls were 89 patients mostly with bile stones. The sensitivity, specificity, and positive and negative likelihood ratios of MRC was 90.9%, 95.5%, 20.23, and 0.10, respectively. Early PSC was found more frequently by MRC compared with ERC (30.4% vs. 8.3%, P = 0.146). No significant difference was found between imaging modalities with regards to patients’ outcome (P = 0.786) or liver biochemistry at diagnosis or 1-year thereafter (P >0.05). Conclusion: Starting diagnostic imaging for PSC with MRC seems better and may provide diagnosis of PSC at its earlier phase. Further studies with larger sample of patients and longer follow-ups are warranted. © 2014, Isfahan University of Medical Sciences(IUMS). All rights reserved. Source


Roohafza H.,Isfahan University of Medical Sciences | Pourmoghaddas Z.,Isfahan University of Medical Sciences | Saneian H.,Isfahan University of Medical Sciences | Gholamrezaei A.,Poursina Hakim Research Institute
Neurogastroenterology and Motility | Year: 2014

Background: Antidepressants are effective in adults with pain-related functional gastrointestinal disorders. We investigated the effectiveness of citalopram in the treatment of childhood functional abdominal pain (FAP). Methods: Children with FAP, based on the Rome III criteria (n=115, aged 6-18years), were randomized to receive either citalopram 20mg/day or placebo for 4weeks. Treatment response was defined as ≥2 point reduction in the 6-point Faces pain rating scale or 'no pain'. Depression, anxiety, somatization, and physician-rated global severity and improvement were also evaluated. Patients were followed up for 8weeks after medication period. Key Results: Eighty-six patients completed the medication (43 in each group). Response rate in the citalopram and placebo groups based on per-protocol (intention-to-treat) analysis was 55.8% (40.6%) and 39.5% (30.3%) at week 4 (p=0.097 [0.169]) and 72.0% (52.5%) and 53.4% (41.0%) at week 12 (p=0.059 [0.148]), respectively. In per-protocol analysis, more reduction was observed in pain (F=3.84, p=0.024) and global severity scores (F=4.12, p=0.021) in the citalopram group compared with the placebo group over the study period. Such differences were not present in the intention-to-treat analysis. No difference was found between the two groups regarding change in depression, anxiety, or somatization score over the study. Conclusions & Inferences: Overall, we found a trend toward the effectiveness of citalopram in the treatment of children with FAP. Trials with longer treatment duration in larger samples of patients are required in this regard. © 2014 John Wiley & Sons Ltd. Source


Shahidi S.,Isfahan University of Medical Sciences | Moeinzadeh F.,Isfahan University of Medical Sciences | Mohammadi M.,Isfahan University of Medical Sciences | Gholamrezaei A.,Poursina Hakim Research Institute
Iranian Journal of Kidney Diseases | Year: 2011

Dermatological complications, especially skin infections, are very common following organ transplantation, and result in a lot of distress in the recipient. Herpes zoster, herpes simplex, and human papillomavirus infections are common infections in kidney transplant recipients, and therapeutic management is usually disappointing in immunosuppression state. We report here 2 cases of kidney transplant recipients who developed diffuse human papillomavirus-induced cutaneous warts with no response to conventional treatments. According to similar reports in organ transplant recipients, we modified the immunosuppressive regimen by converting to sirolimus, which led to a rapid relief from cutaneous warts in both patients. This evidence along with other case reports suggest that conversion to sirolimus may be considered as an effective strategy in cases of giant or multiple viral warts in kidney and perhaps other transplant recipients. Source

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