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Background:Treating inflammatory bowel disease (IBD) with antidepressants might be of utility to improve patient's condition. The aim of this study was to assess the efficacy of Duloxetine on depression, anxiety, severity of symptoms, and quality of life (QOL) in IBD patients.Materials and Methods:In a randomized, double-blind, controlled clinical trial on 2013-2014, in Alzahra Hospital (Isfahan, Iran), 44 IBD patients were chosen to receive either duloxetine (60 mg/day) or placebo. They were treated in a 12 weeks program, and all of the participants also received mesalazine, 2-4 g daily. We assessed anxiety and depression with Hospital Anxiety and Depression Scale, the severity of symptoms with Lichtiger Colitis Activity Index and QOL with World Health Organization Quality of Life Instruments, before and just after the treatment. The data were analyzed using Paired sample t-test and ANCOVA.Results:In 35 subjects who completed the study, the mean (standard error [SE]) scores of depression and anxiety were reduced in duloxetine more than placebo group, significantly (P = 0.041 and P = 0.049, respectively). The mean (SE) scores of severity of symptom were also reduced in duloxetine more than the placebo group, significantly (P = 0.02). The mean (SE) scores of physical, psychological, and social dimensions of QOL were increased after treatment with duloxetine more than placebo group, significantly (P = 0.001, P = 0.038, and P = 0.015, respectively). The environmental QOL was not increased significantly (P = 0.260).Conclusion:Duloxetine is probably effective and safe for reducing depression, anxiety and severity of physical symptoms. It also could increase physical, psychological, and social QOL in patients.

Background:It is believed that the Helicobacter pylori (H. pylori) vacA gene, as a major virulence determinant (One of the major virulence determinant, not major), may be a risk factor for the development of gastroduodenal diseases. The frequency of vacA genotypes varies in different human populations. This study evaluated the prevalence of vacA alleles/genotypes among dyspeptic patients in Isfahan.Materials and Methods:One-hundred H. pylori-positive adult patients were examined in this study. After culture of gastric biopsies and DNA extraction from individual H. pylori isolates, the (all H. pylori strains harbor vacA alleles, please replace “presence” with “genotypes”) of the vacA s and m alleles were determined using polymerase chain reaction (PCR).Results:There were four vacA mosaicisms, including 28 for s1a/m1 (28%), 23 for s1b/m1 (23%), 26 for s1a/m2 (26%) and 23 for s1b/m2 (23%). The s2 allele was not found. The predominant vacA genotype in patients with non-ulcer dyspepsia and duodenal ulcer was s1a/m2, whereas in patients with adenocarcinoma was s1a/m1.Conclusion:The results showed there was no significant correlation between different genotypes of the vacA and the clinical outcomes and appears to vacA genotypes were not useful determinants for gastrointestinal diseases in our area.

Bacterial infections are one of the important agents in the creation of gallstones in the gallbladder. In recent years the spread of antibiotic-resistant bacteria such as extended-spectrum ?-lactamases (ESBL) is increasing and of concern in hospitalized patients worldwide. The purpose of this study was to investigate the antibiotic susceptibility patterns of isolated bacteria from the bile specimens of patients with chronic and acute cholecystitis who had been operated by single-incision laparoscopic cholecystectomy (SILC) in Isfahan (Iran) 2 using an antibiogram susceptibility test and molecular technique. The bile fluids of 91 patients were obtained from the Al-Zahra hospital and were cultured on specific media for the isolation of Gram-negative and positive bacteria and the disk diffusion test was done to determine the antibiotic susceptibility patterns of isolated bacteria. Finally, bacterial DNA was extracted from the bile samples and polymerase chain reaction (PCR) was performed to investigate extended-spectrum ?-lactamases genes. The bacteria Escherichia coli, Klebsiella pneumoniae, Proteus spp. and Staphylococcus aureus were detected in bile specimens cultured with high frequency, and the results showed that biliary infection increased with aging in patients with gallstone disease operated by SILC. The results showed a high frequency of ESBL genes including TEM, SHV, and CTX-M in isolated bacteria (especially Escherichia coli and Klebsiella spp.). Thus, evaluating the antibiotic susceptibility patterns and screening of ESBLs bacteria in patients with gallstones are essential. Prescribing suitable drugs, designing good strategies, and informing the medical community could decrease bile infection and antibiotic-resistant bacteria in clinical centers and hospitals.

Background:Inflammatory bowel disease (IBD) might be an immunodeficiency rather than an excessive inflammatory reaction. IBD, suspected to primary immunodeficiency diseases biobank (IBDSPIDB) as a resource for researches can help improve the prevention, diagnosis, and illness treatment and the health promotion throughout the society. Therefore, we launched the biobank of IBDSPID for the first time in Iran.Materials and Methods:This study was designed to provide the IBDSPIDB to have a high-quality DNA, RNA, and cDNA. Among of 365 patients, 39 have inclusion criteria that were as below: (1) IBD diagnosis before 5 years of age. (2) Resistance to conventional therapy of IBD. (3) Severe IBD. (4) Signs of SPID (including ear infections or pneumonia or recurrent sinus within the 1-year period; failure to thrive; poor response to the prolonged use of antibiotics; persistent thrush or skin abscesses; or a family history of PID).Results:Out of 39 patients, 51.3% were males. The mean age was 32.92 ± 15.90 years old. Ulcerative colitis (79.5%) was more than Crohn's disease. The majority of patients (50.0%) had severe IBDSPID. Resistance to drugs and consanguinity was 12.9% and 47.4%, respectively. Age at onset in 65.8% of patients was after 17 years old. Patients with autoimmune, allergy, and immunodeficiency disease history were 33.3%, 33.3%, and 10.36%, respectively. RNA and cDNA yields large quantities of high-quality DNA obtained and stored.Conclusion:Our biobank would be valuable for future genetic and molecular study to be more about the relation between IBD and PID.