Background-This trial was carried out to assess the value of propranolol in the prevention of recurrent variceal bleeding when combined with longterm endoscopic sclerotherapy. Patients and methods-Two hundred patients (161 male, 39 female, age range 20-68 years) with portal hypertension resulting mainly from schistosomal periportal fibrosis or posthepatitic cirrhosis presenting with their first episode of haematemesis or melena, or both were included. This was confirmed endoscopically to result from ruptured oesophageal varices. After initial control of bleeding, patients were randomised into two groups: group 1 treated with endoscopic sclerotherapy alone and group 2 treated with sclerotherapy plus propranolol. They were followed up for two years. Results-Group (2) had a lower rebleeding rate (14.3% v 38.6% in group 1), lower variceal recurrence after obliteration (1/7% v 34% in group 1), longer period between variceal obliteration and recurrence (36 weeks v 21 weeks in group 1); but no change in mortality (12% in both groups). Conclusions-Patients treated with sclerotherapy should be given propranolol for longterm management.

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Review question / Objective: Is there an association between gene polymorphisms in MTHFR, MTR and MTRR genes and colorectal cancer risk ? Rationale: Several lines of evidence based on case-control studies suggest that MTHFR, MTR, and MTRR polymorphisms may increase the risk of colorectal cancer in the general population. To increase power and precision as well as to appraise the polished literature, we conducted this INPLASY 1

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Methylenetetrahydrofolate reductase (MTHFR) is a critical folate-metabolising enzyme and a polymorphism at position 677 (C677T), is associated with reduced enzyme activity. We investigated whether this functional polymorphism modulates the risk of developing Colorectal Cancer (CRC).We conducted a hospital-based case-control study to assess the association of MTHFR gene polymorphism C677T with risk for colorectal cancer in a Moroccan population. Odds ratios [ORs] with corresponding 95 % confidence intervals (Cis) were used to assess the association.The analysis had shown the significant elevated risk of cancer was associated with theMTHFR C677T polymorphism in recessive model (OR = 2.81, 95 % CI; (1.13-7.06), P=0.027) compared the other genetic models. Simultaneously, the T-allele genotype versus C-allele genotype was not associated with CRC risk (OR a = 1.355; 95% CI = 0.94-1.96and p = 0.10).Thusrecessive model are significantly associated in the risk of colorectal cancer. Further larger-scale studies are necessary to confirm our finding.