The comparison of insulin resistance frequency in patients with recurrent early pregnancy loss to normal individuals

<p>Abstract</p> <p>Background</p> <p>Patients with ≥ 3 recurrent spontaneous miscarriages are classified as having RSM. Polycystic ovary syndrome (PCOS) is associated with insulin resistance (IR). The purpose of this study is to evaluate the association of IR and RMS.</p> <p>Methods</p> <p>Present case- control prospective study was performed on 100 women in control group (with a history of at a live birth and no history of one more abortion) and study group (with a history of ≥ 3 RMS) who were not diabetes and PCOS. Two groups matched in base of age and body mass index. Blood was withdrawn from the case and control patients for the determination of the fasting blood glucose (FG), fasting insulin (FI) levels and ultrasonography was performed on all the patients.</p> <p>Results</p> <p>The observed differences between age, FG and FG to FI ratio levels in case and control groups were not significant (<it>p </it>> 0.05) but it was significant about fasting insulin (<it>p </it>= 0.0119). FI of < 20 <it>μu/ml </it>or ≥ 20 <it>μu/ml </it>in case and control group was significant (Chi-square: 4.083, p: 0.0433, odds ratio: 4.4386, CI95% = 1.1541 to 17.0701), whereas the difference between absolute and proportional frequency of patients with FG to FI ratio of < 4.5 and ≥ 4.5 in case and control groups was not significant (Chi-square: 2.374, <it>p </it>= 0.123).</p> <p>Conclusion</p> <p>Current study showed that in women with RPL, in Iranian race like Americans, frequency of insulin resistance in high, therefore there is a probability of the degree of insulin resistance in women with RPL.</p

Clinical, endoscopic, and demographic characteristics of idiopathic duodenal ulcers compared with helicobacter pylori positive ulcers

Background: Helicobacter pylori infection is the most common cause of peptic ulcer disease. However, the prevalence rates of non-helicobacter pylori idiopathic peptic ulcers have increased over the past few years. This study aims to compare the characteristics of Helicobacter pylori-positive with idiopathic duodenal ulcers. Methods: A cross-sectional cohort study was conducted on 950 patients which were excluded from the analysis process duo to the concomitant presence of gastric ulcer, malignancy, Zollinger Ellison syndrome, Crohn&#39;s disease, esophageal varices, history of taking anti-Helicobacter pylori therapy, and history of taking NSAID or aspirin. Eventually, 647 subjects were enrolled for the analysis process. In this case, these subjects were divided into two groups: (I) Helicobacter pylori-positive ulcer group and (II) Helicobacter pylori-negative and non-NSAID (idiopathic) ulcer group. Results: The findings showed that 417 patients (64.5) had duodenal ulcers induced by Helicobacter pylori, and 111 patients (17.1) had Helicobacter pylori-negative and non-NSAID ulcers. The mean ages of patients in Helicobacter pylori-positive and idiopathic ulcer groups were 39&#177;15 and 42&#177;17, respectively. In this case, 33 patients (29.7) with idiopathic ulcers and 56 patients (25.1) with Helicobacter pylori-positive ulcers had upper gastrointestinal bleeding. Also, 22 patients (21) with idiopathic ulcers and 31 patients (16.5) with Helicobacter pylori-positive ulcers had multiple duodenal ulcers Conclusion: The present study demonstrated that the idiopathic ulcers included 17.1 of duodenal ulcers. Also, it was concluded that patients with idiopathic ulcers were predominantly male with an age range older than the other group. In addition, patients in this group had more ulcers

Relationship between β-Thalassemia minor and Helicobacter pylori infection

Background: Until now, no study has been reported investigating the association between β-thalassemia minor and Helicobacter pylori (H. pylori) infection. This study was designed to compare H. pylori infection rate between β-thalassemia minor patients and healthy controls. Methods: A number of 100 β-thalassemia minor patients (50 males, 50 females) and 100 gender-matched healthy controls were prospectively recruited in this study in a period of 3 months. The study population consisted of the people who referred to a health center in Babol, North of Iran, for premarital counseling. H. pylori status was assessed by measuring the anti-H. pylori IgG antibodies using enzyme-linked immunosorbent assay. Demographic information and informed consent were collected from all participants. Results: The overall H. pylori infection rate was 43%. The infection was significantly more prevalent in thalassemia patients (53%) than in the controls (33%) in both univariate (OR=2.29, 95% CI: 1.3-4.06) and multivariable analyses (OR=2.05, 95% CI: 1.12-3.76). Age was the only significant factor which was positively correlated with the infection in β-thalassemia minor cases (OR=1.11, 95% CI: 1.02-1.2). Gender, blood groups, residency, and education level were not related to the infection. Conclusions: According to the results, it can be concluded that β-thalassemia minor patients are possibly more susceptible to H. pylori infection than healthy people. Further studies are needed to discover more about the exact mechanisms of increased susceptibility to H. pylori infection in β-thalassemia minor patients

Investigation of chronic diseases in patients with inflammatory bowel disease: a hospital-based case-control study

Background: Inflammatory bowel disease (IBD) is a broad term that refers to a group of chronic inflammatory disorders that have an unknown origin and might be associated with other diseases. The aim of this study was to determine the frequency of chronic diseases in patients with IBD. Methods: In this case-control study, 280 patients with IBD were compared with 280 healthy individuals, frequency-matched by age, sex, place of residence and marital status. Random sampling was performed in patients that referred to the internal medicine and gastroenterology wards of hospitals affiliated to Babol University of Medical Sciences. Data collection tools included a demographic questionnaire and a checklist for chronic diseases, which were completed through interviews with the case and control groups. Results: Two hundred and twenty-nine (81.78) patients with IBD had at least one chronic disease. Patients with IBD were at increased risks of rheumatoid arthritis (OR= 4.48, 95CI: 1.48, 13.54, P= 0.008), eye diseases (OR= 3.49, 95CI: 1.68, 7.28, P= 0.001), liver diseases (OR= 2.74, 95CI: 1.40, 5.34, P= 0.003 ), anemia (OR = 2.53, 95CI: 1.56, 4.13, P= 0.000), depression (OR= 2.43, 95CI: 1.58, 3.74, P= 0.000), skin diseases (OR= 2.36, 95CI: 1.18, 4.74, P= 0.015) and hypertension (OR= 1.77, 95CI: 1.06, 2.95, P= 0.028). Conclusion:&#160; The frequency of chronic diseases associated with IBD has been high, therefore, physicians and health care professionals should consider the possibility of other chronic diseases when dealing with IBD patients

Fecal calprotectin Level in patients with IBD and noninflammatory disease of colon: a study in Babol, Northern, Iran

Background: Inflammatory bowel disease (IBD) is a chronic disease with a relapsing course of inflammation in the digestive system. Endoscopy and histopathology are the golden standard methods for detection and assessment of IBD. A distinct increase of fecal calprotectin level can be a useful marker for the diagnosis of IBD. The aim of this study was to evaluate the fecal calprotectin level in patients with IBD and without inflammatory diseases of the colon. Methods: Calprotectin levels of patients referred to the Ayatollah Rouhani Hospital of Babol, northern Iran with clinical symptoms of colon disease were evaluated. After a week, colonoscopy and biopsy were performed on all patients and they were divided into two groups. The first group included patients with confirmed IBD and the second group included patients with diseases other than IBD, patients with IBS and healthy persons. Then the measured fecal calprotectin level was compared between the two groups before colonoscopy. Results: We observed correlation between calprotection in these two groups (p<0.0001). 38 (86.8%) patients in the case group and 5 (13.2%) patients in the control group had positive fecal calprotectin test and 12 (23.1%) patients in the case group and 40 (76.9%) patients in the control group had negative results. Basad on ROC curve, the cutoff point of calprotectin was 127.65 with 73% sensitivity and 89% specificity. The area under the curve was 0.83 with 95% confidence interval, 0.74-0.91 (p<0.0001). Conclusions: The results pointed to this fact that fecal calprotectin can be a noninvasive marker in differentiating IBD from IB

The effect of psychotherapy in improving physical and psychiatric symptoms in patients with functional dyspepsia.

Objective: Functional Dyspepsia (FD) is a common symptom of upper gastrointestinal discomfort. Few data are available on the role of psychotherapy in the treatment of dyspeptic syndromes. This study assesses whether brief core conflictual relationship theme (CCRT) psychoanalytic psychotherapy improves gastrointestinal and psychiatric symptoms in patients with functional dyspepsia. Methods: A randomized, controlled trial was planned in two educational hospitals in city of Babol. Forty-nine patients with FD were randomly assigned to receive standard medication treatment with CCRT psychotherapy (24 participants) or standard medication treatment alone (25 participants). The participants completed the Patient Assessment of Upper Gastrointestinal Symptom Severity Index (PAGI-SYM) and Symptom Checklist-90-Revised (SCL-90-R) questionnaires before the trial, after the treatment and at 1 and 12-month follow-ups. The mixed-effects (regression) model was used to analyze the data. Results: The results showed that CCRT psychotherapy improved all of the FD symptoms (heartburn/regurgitation, nausea/vomiting, fullness, bloating, upper abdominal pain, and lower abdominal pain) and many of the psychiatric symptoms (depression, anxiety, somatization, interpersonal sensitivity and paranoid ideation) after the treatment and at 1-month and 12-month follow-ups. Conclusion: Brief CCRT psychoanalytic psychotherapy can serve as an effective intervention for promoting gastrointestinal and psychiatric symptoms in patients with functional dyspepsia

Evaluation of the Potential Antioxidant Role of High-Density Lipoprotein-Cholesterol (HDL-C) in Patients with Ulcerative Colitis

Background Ulcerative colitis is a common type of inflammatory bowel disease (IBD). The aim of the present study was to examine the relationship between lipid profile, especially high-density lipoprotein (HDL), and malondialdehyde (MDA) level in patients with ulcerative colitis. Methods In this study, 45 patients with ulcerative colitis were selected, 25 of whom were diagnosed with active disease and 20 were in clinical remission. Moreover, 45 healthy subjects were selected as the controls. The status of serum lipid profile and MDA level were measured via precise photometric methods. The obtained data were analyzed, using independent t-test and correlation coefficient test. P < 0.05 was considered statistically significant. Results The serum level of HDL-C decreased, while the serum level of MDA significantly increased in patients with ulcerative colitis in comparison with the healthy controls (P < 0.05). No significant correlation was observed between the MDA level and triglyceride, cholesterol, and LDL-C levels in patients with ulcerative colitis. However, a significant inverse correlation was observed between HDL-C and MDA levels (r, -0.306; P < 0.05). Conclusions The inverse correlation between HDL-C and MDA levels can be regarded as an indicator of the protective role of HDL-C against lipid peroxidation in ulcerative colitis. In patients with ulcerative colitis, the serum level of HDL-C decreased in comparison with healthy subjects. Therefore, it is necessary to determine the HDL-C level in patients with ulcerative colitis

Sedation with etomidate-fentanyl versus propofol-fentanyl in colonoscopies: A prospective randomized study

Abstract Background: The combination of propofol-fentanyl for sedation during colonoscopy is characterized by the frequent incidence of side effects. Etomidate-fentanyl provides fewer hemodynamic and respiratory complications. The aim of our study was to compare the safety and efficacy of propofol-fentanyl and etomidate-fentanyl for conscious sedation in elective colonoscopy. Methods: This double-blind clinical trial was conducted on 90 patients aged between 18 and 55 years old who were candidates for elective colonoscopy. Patients were randomized to receive sedation with fentanyl plus propofol or etomidate. Two minutes after injecting 1 micro/kg of fentanyl, the patients received propofol (0.5 mg/kg followed 25 micro/kg/min) or etomidate (0.1 mg/kg followed 15 micro/kg/min). Pulse rate, mean arterial blood pressure, respiratory rate, and saturation of peripheral oxygen (SPO2) were monitored. Indeed, the patient and colonoscopist satisfaction, the recovery time, sedation and pain score in both groups were assessed. Results: Sedation score in propofol group was higher. Pain score as well as the physician and patient satisfaction showed no significant difference in two study groups. Hemodynamic changes and arterial saturation were the same in both groups. The duration of recovery was 1.27±0.82 minutes in the etomidate group whereas, it was 2.57±2.46 minutes in the propofol group (P=0.001). Hospital discharge in the propofol group was 5.53±4.67 minutes and in the etomidate group was 2.68±3.14 minutes (p=0.001). Conclusion: The combination of fentanyl and etomidate provides an acceptable alternative to sedation with fentanyl and propofol with the advantage of significantly faster recovery time, which are of relevance in the outpatient setting