Dietary intake of benzo(a)pyrene and risk of esophageal cancer in north of Iran

One etiologic factor for high incidence of esophageal squamous cell carcinoma (ESCC) in Golestan (Northeastern Iran) might be exposure to polycyclic aromatic hydrocarbons. We examined whether food and water are major sources of benzo(a)pyrene (BaP) exposure in this population. We used a dietary questionnaire to assess the daily intake of staple food (rice and bread) and water in 3 groups: 40 ESCC Golestan cases, 40 healthy subjects from the same area, and 40 healthy subjects from a low-risk area in Southern Iran. We measured, by high-performance liquid chromatography combined with fluorescence detection, the BaP concentration of bread, rice, and water in samples obtained from these 3 groups and calculated the daily intake of BaP. Mean BaP concentration of staple foods and water was similar and within standard levels in both areas, but the daily intake of BaP was higher in controls from the high-risk area than in controls from the low-risk area (91.4 vs. 70.6 ng/day, P < 0.01). In the multivariate regression analysis, having ESCC had no independent effect on BaP, whereas residence in the low-risk area was associated with a significant decrease in total BaP intake. Polycyclic aromatic hydrocarbons might, along with other risk factors, contribute to the high risk of ESCC in Golestan. Copyright © 2008, Taylor & Francis Group, LLC

Antimicrobial susceptibility testing of Helicobacter pylori to selected agents by agar dilution method in Shiraz-Iran

Purpose: To assess the pattern of antimicrobial susceptibility profile of Helicobacter pylori isolates from patients with gastritis, duodenal ulcer (DU) and gastroesophageal reflux disease (GERD) residing in Shiraz, Iran. Methods: One hundred and six H. pylori isolates from patients with gastritis, DU and GERD undergoing endoscopy at our university hospitals and clinics were analysed for their antimicrobial susceptibility to metronidazole, clarithromycin, amoxicillin, co-amoxiclav, tetracycline, ciprofloxacin and furazolidone. The minimum inhibitory concentrations were determined by agar dilution method. Results: Overall H. pylori resistance rate was 72.6% to metronidazole, 9.4% to clarithromycin and furazolidone, 20.8% to amoxicillin and 4.7% to tetracycline and ciprofloxacin. No resistance to co-amoxiclav was detected among H. pylori isolates. No significant differences between antimicrobial resistance and clinical outcome were detected. Conclusions: With regard to the increasing resistance of H. pylori isolates to various antibiotics, susceptibility testing of H. pylori isolates prior to the treatment of infection must be performed to achieve better eradication and to reduce the risk of selection of H. pylori resistant strains

Subjective lactose intolerance in apparently healthy adults in southern Iran: Is it related to irritable bowel syndrome?

Background : The main symptoms of lactose intolerance are bloating, abdominal cramps, increased flatus and loose watery stools. These symptoms are similar to those of irritable bowel syndrome (IBS), which is a prevalent entity in the community. Objective : As there was no data available on the prevalence of LI and the correlated factors, this study aimed to determine these correlations and their relation to IBS symptoms in an apparently healthy population in Shiraz, southern Iran. Materials and Methods : A survey among 1,978 individuals older than 35 years was conducted in Shiraz, southern Iran, using a questionnaire that consisted of items regarding demographic data, life style, subjective gastrointestinal symptoms of LI and IBS symptoms according to ROME II criteria. Results : A total of 562 subjects reported LI (28.41%). The prevalence was significantly higher in females, in subjects taking NSAIDs or acetaminophen and in cases reporting IBS symptoms. Subjects with LI avoided certain foods and drinks; and in order to relieve their symptoms, they used OTC drugs, herbal medicine or visited a physician. On the other hand, no relation was found between LI and age, smoking or the number of meals per day. Conclusions : Although we found that individuals with IBS had significantly more subjective LI than those without IBS, in the absence of documented lactose malabsorption, it is hard to tell whether the reported symptoms indeed are those of LI or simply those of IBS. So, a period of dairy product avoidance and/ or requesting a test for lactose malabsorption may be beneficial in this area

Association between PPD and QuantiFERON Gold TB Test in TB Infection and Disease among HIV- Infected Individuals in Southern Iran

Abstract Background: Tuberculosis is one of the most common diseases among HIV-infected patients. A person with a positive tuberculin skin test (TST) acquiring HIV infection has a 3-13% annual risk of developing active tuberculosis. The diagnosis of TB in HIV infected patients may be difficult. QuantiFERON-TB Gold (QFT-G) test is a novel method as an aid for diagnosis of Mycobacterium tuberculosis infection. We evaluated the association between TST and QFT-G test in latent TB infection (LTBI) and TB in HIV-infected patients

Effect of Helicobacter pylori eradication or of ranitidine plus metoclopramide on Helicobacter pylori-positive functional dyspepsia: a randomized, controlled follow-up study

Background: A definitive treatment for functional dyspepsia (FD), and the role of Helicobacter pylori eradication on the course of this disease are controversial. Aim: To investigate the effect of a combination of acid-suppressing and prokinetic drugs or eradication therapy on the course of H. pylori-positive FD. Method: A total of 157 patients with endoscopically-proven H. pylori-positive FD and no response to 4 weeks of antacid therapy were randomly divided into 2 groups. 84 were placed on bismuth subnitrate plus metronidazole and amoxicillin (group A) and 73 received ranitidine and metoclopramide for 4 weeks (group B). The severity of symptoms (7 items) were assessed on a 6-point categorical scale. Group B patients who failed to respond to their medication underwent eradication therapy after 3 months. All patients were followed and assessed for 9 months after the end of therapy by the same clinicians who initiated the therapy. Results: At the end of the medication period, symptom’s score decreased significantly, and to the same extent. At 3-month follow-up moderate or complete response was achieved in 27.4% (group A) and 19.2% (group B) by intention-to-treat analysis. 34 patients of group B, not responding to treatment, underwent eradication therapy and followed as group A. Eradication of H. pylori was successful in 60 of 110 controlled patients (54%). After 9-month follow-up, complete or moderate response was observed in only 30% of 60 patients in whom H. pylori had been eradicated (intention-to-treat analysis), compared to 38% in 50 noneradicated cases (p &gt; 0.05, 95% CI: 19–43 vs. 24–52). Conclusion: Eradication therapy with bismuth compound is effective as ranitidine plus metoclopramide in a subgroup of patients with FD not responding to antacid therapy. There is no difference in improvement between patients cured or not cured from H. pylori infection. This suggests that bismuth compounds were effective in FD when used in the eradication regimen. Combination therapy with acid-suppressing drugs plus prokinetic and bismuth seems to hold promise for FD

Total pepsin activity and gastrin in sera as markers of eradication of Helicobacter pylori

The measurement of total pepsin activity by colorimetry, and gastrin by radioimmunoassay method was performed on the sera of 100 patients (80 with duodenal ulcer and 20 with non-ulcer dyspepsia) before and 4 weeks after the end of antibacterial treatment for eradication of Helicobacter pylori. While in the sera of non-HP-eradicated cases (n = 26) no change of total pepsin activity and gastrin assessing occurred, in the sera of HP-eradicated cases (n = 74), a mean decrease of 31% and 23% was observed for total pepsin activity and gastrin respectively (p <0.005). A decrease of more than 10% or more of pepsin activity in serum suggests eradication of H. pylori with an overall accuracy of 97%. Monitoring the total pepsin activity in the sera appears to be a cheap, simple and suitable test for eradication of H. pylori in underdeveloped countries