Background:Hepatitis C virus (HCV) is a major cause of liver disease. Infection with HCV is a global public health problem. The virus is classified into 6 genotypes and more than 80 subtypes named as a, b, c, etc. HCV genotyping has been an important parameter for the treatment of HCV infection.Objectives:The main aim of this study was to estimate the prevalence of HCV genotypes in Yazd, central province of Iran. In addition, the study investigated whether there was any association between HCV load and genotypes.Patients and Methods:This descriptive cross-sectional study was performed on samples suspicious of HCV infection from March 2010 to June 2013. Peripheral blood sample was obtained and screened for anti-HCV antibodies using Enzyme-Linked Immunosorbent Assay (ELISA). Then sera of anti-HCV positive samples were analyzed using quantitative polymerase chain reaction method. Plasma samples were used to determine the HCV genotypes of 1a, 1b, 2, 3, and 4 in 191 infected patients.Results:One hundred fifty-two out of 191 (79.6%) samples were from male patients. The mean of the patients’ age was 40.7 ± 11.9 years (range 21-75 years old). Sixty- three (33%) patients were included in 31-40 years group. The mean number of HCV in infected patients was 2.92 × 106 ± 1.85 × 106 copies/mL (Min: 508; Max: 2.75 × 108 copies/mL). HCV genotype 3 was the predominant genotype (50.3%) followed by subtypes 1a (38.7%) and 1b (6.8%). The distribution of other HCV genotypes showed genotype 2 in 1.6% and mixed genotypes in 2.6% of positive samples. Genotype 3 was predominant in all age groups except 21-30 years of age group. We were unable to find any significant difference between mean viral load of the patients infected with genotype 3 and those infected with genotype 1 (1a and 1b).Conclusions:Findings of the present study showed that HCV genotype 3 was the predominant genotype followed by the subtypes 1a and 1b in Yazd, central province of Iran. In addition, there was no difference between HCV load and genotypes 1 and 3. HCV genotyping is recommended in other provinces of Iran.

We report a 36-year-old female with longstanding oily diarrhea and new-onset dysphagia that was diagnosed as celiac disease and esophagus adenocarcinoma. Celiac is a multisystemic autoimmune disease associated with a longstanding inflammatory process, especially in the gastrointestinal tract. This chronic inflammation may lead to a modest increase in neoplasia risk. There is a modest increased risk of malignancy in celiac disease, particularly adenocarcinoma and T-cell lymphoma of the small intestine and squamous cell carcinoma (SCC) of the esophagus, mouth, and pharynx. Although there is an association between SCC of the esophagus and celiac disease, there are no reports in the English literature about a relationship between celiac disease and esophageal adenocarcinoma. This case shows that as well as SCC, adenocarcinoma of the esophagus may also occur in patients with longstanding celiac disease.

Irritable bowel syndrome is the most common diagnosed gastroenteric disorder incriminated for 12% of cases of referring to gastroenterologists. Various studies have shown that the intestinal microflora of the patients affected with IBS undergoes some changes. So, it seems that the recovery of intestinal flora is a useful therapeutic approach. This study investigated the effect of probiotic Saccharomyces Boulardii on improving the symptoms of IBS. This study was a randomized double-blind clinical trial conducted on 60 IBS patients. The patients were divided into two groups of 30 (case and control groups). The patients in the case group received Yomogi and those in the control group received placebo. Demographic information and symptoms as abdominal pain, flatulence, diarrhea, constipation, gurgling, eructation (belching and burping), urgent defecation, and release of gas from the anus (farting and fizzling) were collected before intervention and three weeks after initiation of treatment, and analyzed. 43.3% of the patients in the case group were male and 56.7% were female. Also, 40% of the patients in the control group were male and 60% were female. A comparison of the mean scores of abdominal symptoms in the case group before and after intervention revealed that there was a statistically significant difference between before and after intervention values for pain severity (P=0.001), flatulence ((P=0.001), diarrhea (P=0.001), gurgling (P=0.001), eructation (P=0.023), and gas release from the anus (P=0.001). Yet, there was no statistically significant difference before and after intervention for symptoms of constipation (P=0.161), and urgent defecation (P=0.09). The consumption of Saccharomy-cesBoulardii reduces pain severity, flatulence, diarrhea, gurgling, eructation, and gas release from the anus in patients with IBS and improves life quality.

Background and Aims: Hepatitis C is a blood-borne virus that causes a liver inflammation. The prevalence of hepatitis C (HCV) in hemodialysis patients is more than the general population. Periodic screening of HCV in dialysis centers is necessary to control this viral disease. The aim of this study is the evaluation of HCV infection among hemodialysis patients living in Yazd province of Iran. Materials and Methods:In this cross sectional study, two milliliters blood sample has been taken from each of 188 hemodialysis patients. Third-generation enzyme-linked immunosorbent assay (ELISA) and RT-PCR methods were carried out for detecting HCV antibody and viral genome in patient sera. Demographic and clinical characteristics of patients were collected and data were analyzed by Fisher's exact test and Mann-Whitney U test in SPSS software v.19. Results: HCV-Ab was positive in 12 hemodialysis patients. Eight cases had a history of blood transfusion and four patients had a history of kidney transplantation. Anyone didn't have a history of skin tattooing or intravenous drug usage. HCV-RNA was positive in 4 cases and was negative in 8 patients with positive HCV-Ab. Conclusion: HCV prevalence using ELISA and RT-PCR tests among hemodialysis patients living in Yazd provenance of Iran is 6.3% and 2.1%, respectively. Risk factors are the hemodialysis duration (p<0.001) and kidney transplantation (p=0.005).

Background:Definite treatment of pancreatic adenocarcinoma is surgical resection. Absence of early symptoms in most patients leads to late diagnosis and treatment. This study aims to evaluate resectability of the pancreatic adenocarcinoma at the time of the diagnosis in Iran.Materials and Methods:The present study which is of a descriptive, prospective and case series nature, has been studying the resectability of the pancreatic adenocarcinoma by multi-detector computerized tomography, endoscopic ultrasonography, laparoscopy and/or laparotomy in 157 patients for the duration of 2 years since November 2009.Results:A total of 157 patients were enrolled in this study. Majority of them (68%) were male. The mean age was 67 years. Final diagnosis obtained 1-12 (2.7 ± 1.6) months after beginning of the symptoms. The lesion situated in the head of the pancreas in 127 cases (81%). Vascular invasion, lymphadenopathy, liver metastasis and peritoneal involvement were seen in 88%, 57%, 43% and 19% of the patients, respectively. According to imaging, tumor was resectable in 10 (6%) patients but laparoscopy and/or laparotomy revealed that only five cases (3%) were actually resectable. After 24 months, only 8 patients were alive; 5 cases of them had been treated by Whipple surgery and other 3 cases were under the chemotherapy. At 1 and 2 year survival rate of the patients was 11% and 5%, respectively.Conclusion:Majority (97%) of the pancreatic adenocarcinomas are unresectable at the time of diagnosis. Thus, meticulous preoperative assessment of patients is essential in patients to avoid major surgery in unresectable cases.