Statin efficacy in the treatment of hepatitis C genotype I

Background: Lipid metabolism is one of the hepatitis C virus (HCV) life cycle steps. Statins can reduce cholesterol level and finally can decrease HCV replication. Thus, we assessed the effect of Statins in combination with standard antiviral treatment on hyperlipidemic genotype I HCV infected patients. Materials and Methods: This study was a prospective clinical trial. 40 patients were selected from those referred to educational and Therapeutic Centers of Isfahan University of Medical Sciences from 2009 to 2010 with confirmed HCV viremia. All patients received Peg-interferon-a2a and ribavirin. 20 hyperlipidemic Patients received 20 mg atorvastatin nightly for 3 months and placebo was prescribed for 20 normolipidemic HCV infected patients as a control group. Liver enzymes and complete blood count were checked monthly and thyroid stimulating hormone was checked every 3 months. We also performed quantitative HCV-ribonucleic acid (RNA) test in 12th week of therapy, at the end of treatment and 6 months after therapy for all samples. Results: We didn't find any significant differences in the mean of HCV-RNA numbers between statin and placebo groups in 12th week of treatment, in the end of treatment and 6 months after treatment (P > 0.05). Conclusion: Atorvastatin has no effect on the mean of HCV viral load when we added it to standard treatment for hepatitis C infection. Further studies are necessary to examine the possible antiviral properties of statins and their potential role as adjuncts to standard HCV therapy

The effect of prophylactic peripapillary administration of methylprednisolone in reducing the risk and severity of postendoscopic retrograde cholangiopancreatography pancreatitis: A double blind clinical trial

Background : The most common complication of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) is acute pancreatitis. A number of therapeutic trials have been studied due to reduce the occurrence of postendoscopic retrograde cholangiopancreatography pancreatitis (PEP) but many of them were unsuccessful. Periampullary corticosteroid injection was proposed to use as prophylactic agents for PEP because of its anti-inflammatory property with relative low systemic side effects. Materials and Methods : By conducting a double blinded clinical trial study in a single center university hospital, all patients undergoing therapeutic or diagnostic ERCP in our gastrointestinal endoscopy ward, enrolled the study. During ERCP, we randomly assigned the patients in blocks of 40 to undergo a locally injection of methylprednisolone acetate (corticosteroid group) or saline (control group) on the major papilla and prospectively evaluated the occurrence of PEP pancreatitis in each groups. Clinical and laboratory findings of acute pancreatitis were collected by means of a validated questionnaire during the procedure and before discharge. At baseline and end of the study, were compared pancreatitis prevalence and also its severity by using Chi-square and t-test statistics. Results : The frequency of moderate to severe PEP pain was not significantly between the placebo and corticosteroid receiving group (13.7% ± 3.2% vs. 9.3% ± 2.1%, respectively; P = 0.8). There is no significant difference in the mean concentration of lipase and amylase between corticosteroid receiving group and placebo receiving group at the first, second, and third time. In the corticosteroid receiving group, 3 patients (10.3%) while in the control group, 11 patients (11.3%) developed pancreatitis. Conclusion: We found no significant difference in PEP rates and also severity between the corticosteroid and placebo groups. The mean increase in serum amylase and amylase level in pancreatitis patients and the frequency of abdominal pain were not significantly higher in the placebo group. Besides, there were no cases of severe PEP pancreatitis in either group

Gastric Schwannoma: A Case Report and Review of the Literature for Gastric Submucosal Masses Distinction

Schwannomas origin from Schwann cells sheath and generally are benign, slow-growing, and asymptomatic neoplasms which frequently appear in the head and neck. Although gastrointestinal schwannoma is really rare, the most affected organ in GI system is the stomach. Gastric schwannoma forms 0.2% of all gastric tumors. This neoplasm is always detected as a submucosal mass, the same as other gastrointestinal stromal tumors. Although these tumors have almost the same presentations, they are completely different at therapeutic options and prognoses. Hence, it is important to distinguish them apart and make an accurate diagnosis to optimize treatment outcomes. Herein, we report a case of 28-year-old woman with frequent vomiting and abdominal pain caused by 5 × 6 cm schwannoma in the antrum of the stomach. This is a rare case of gastric outlet obstruction due to a massive schwannoma. In addition, all other probable submucosal masses will be discussed at different aspects

Occult hepatitis B among Iranian hepatitis C patients

<ul> <li><strong>BACKGROUND</strong>: Occult hepatitis B is defined as presence of HBV DNA in tissue or serum without hepatitis B surface antigen. The aim of this study is to determine frequency of occult hepatitis B among hepatitis C patients in Tehran and compare the route of transmission and liver enzymes between positive and negative HBV DNA patients.</li> <li><strong>METHODS</strong>: In a cross sectional study, serum of 103 hepatitis C cases (79.6% men and 20.4% women) were analyzed for s, x and core genes via a nested polymerase chain reaction technique.</li> <li><strong>RESULTS</strong>: HBV DNA was detectable in serum of 20 patients (19.4%). No significant difference in age, sex and route of transmission were seen in HBV DNA positive and negative patients. In HBV DNA positive and negative groups, mean of AST was 73, 47 (p < 0.05) and mean of ALT was 76 and 36 respectively (p < 0.05).</li> <li><strong>CONCLUSION</strong>: Occult hepatitis B was observed in a considerable number of hepatitis C patients in Tehran. It was associated with elevation in liver enzyme but was not related to route of transmission.</li> <li><strong>KEY WORD</strong>: Occult hepatitis B, hepatitis C, cirrhosis.</li> </ul&gt

Seroprevalence of anti-helicobacter pylori antibodies in hepatitis B and C patients with cirrhosis: a case-control study

<strong>BACKGROUND</strong>: Cirrhosis is terminal stage of many chronic liver diseases like hepatitis C and hepatitis B. In some studies the role of helicobacter pylori has been demonstrated in progress of cirrhosis and its complications, but none of the previous studies has investigated the role of socioeconomic conditions of patients in childhood period in this issue.<br /> <strong>METHODS</strong>: In a case-control study, we examined 100 cirrhotic patients due to hepatitis (49 hepatitis B and 51 hepatitis C patients) and 101 socioeconomically matched healthy controls presenting to Taleghani Hospital for IgG antibody to helicobacter pylori.<br /> <strong>RESULTS</strong>: IgG antibody to helicobacter pylori was present in 73% of cirrhotic patients and 52% of control group (P<0.003). Odds ratio for the presence of IgG antibody to helicobacter pylori in cirrhotic men comparing with healthy men was 3.2 (95%CI: 1.4-7.4).<br /> <strong>CONCLUSIONS</strong>: The relative frequency of IgG antibody to helicobacter pylori found to be higher in cirrhotic patients than in controls with regard to socioeconomic condition in childhood.<br /> <strong>KEY WORDS</strong>: Cirrhosis, hepatitis C, hepatitis B, helicobacter pylori, liver disease