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Spontaneous bacterial peritonitis (SBP) is a frequent and sever complication of cirrhotic patients with ascites. The aim of this study was to assess diagnostic value of leukocyte esterase reagent strip test (Medi-Test Combi) for the rapid diagnosis of SBP in cirrhotic patients with ascites in the University Hospital of Imam Reza in Tabriz, Iran. In this study, 132 consecutive samples from cirrhotic patients who underwent abdominal paracentesis were evaluated. These samples were tested by 3 methods: i) manual cell count with differential study, SBP was defined as having poly-morphonuclear cells count of ≥250/mm3; ii) culture of ascetic fluid samples; iii) all samples were tested by leukocyte esterase dipsticks. The sensitivity, specificity, positive and negative predictive values of two different colorimetric cut-off scales (1+ and 2+) were calculated and compared. The sensitivity, specificity, positive and negative predictive values of 1+ and 2+ cut-off scales to diagnose SBP were 97.5%, 84.6%, 74% and 98.7% for the 1+ cut-off scale and 87.8%, 96.7%, 92.3% and 94.6% for the 2+ cut-off scale. Leukocyte esterase reagent strip test can be used as a rapid test for screening of SBP. The higher cut-off colorimetric scale has a better specificity and positive predictive value but a lower sensitivity

BackgroundThe aim of the present study was to determine subsites of gastric cancer in East Azerbaijan, Iran—a high incidence region for gastric cancer and Helicobacter pylori infection.MethodsData were collected from 2002 through 2007 from patients who sought treatment for gastrointestinal symptoms or signs at a university clinic and subsequently underwent upper gastrointestinal endoscopy.ResultsCancer was diagnosed and histologically confirmed in 362 patients (352 adenocarcinomas). The mean age of the patients was 64.57 ± 11.32 (range, 16–94 years) and the male-to-female ratio was 2.8:1. The gastric cardia was involved in 40.3% of patients with gastric adenocarcinoma, while the gastric fundus was involved in 3.7%, the gastric body in 49.1%, and the gastric antrum in 24.1% of patients. Complete evaluation for metastasis was possible in 144 patients; 61 were free of metastasis, and most of these patients underwent surgical therapy. Cardia involvement was not associated with the sex or age of patients.ConclusionsNoncardia gastric cancer is still more frequent in East Azerbaijan, which is likely due to the very high prevalence of infection with Helicobacter pylori. The low rate of cancer involving the fundus is a target for further research on the etiology of gastric cancer.

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Background. ERCP is the gold standard procedure for diagnosis and potential treatment of biliary-pancreatic disorders with various distributions in different areas of the world. The study aimed to evaluate the findings, outcome, complications and technical experiences of ERCP, also by considering the correlation of findings with liver function tests (LFT) and imaging. Methods. In this descriptive – cross sectional data-based study for 12 years from 2007, 626 (43.9% male and 56.1%female; mean age 60 Ys) consecutive patients were subjected with therapeutic purpose at two referral hospitals. Results. Epigastric pain (40%), jaundice (39.4%) and pruritus (38.1%) were the most common indications. CBD was cannulated by optimal wire- guided sphincterotomy in 486(77.6%) patients. Precut was performed in 65(10.6%) with successful cannulation in 61 cases (93.8%) and 7.7% of complications, including perforation. A total success rate of 98% was obtained. The most common diagnoses were CBD stone(s) in 322 (51.4%) and biliary-pancreatic cancers in 114 (18.2%) of cases. No LFT (ALT, ALP and Bilirubin) predicted the diagnoses. The higher concordance rate of imaging studies in comparison with ERCP was 75% for stone(s) and the lower rate of 11.1% for tumors. Metallic stents were used in 15(2.4%) of inoperable malignant cases with life expectancy of more than 6 months. Complications occurred in 29 cases (4.6%) including duodenal perforation (0.8%), pancreatitis (1.6%) and bleeding (1.2%). Mortality rate was 0.4%. Conclusion. Although no single laboratory or imaging can exactly predict the finding or outcome, but by considering judicious case selection, appropriate use of available tools and standard techniques, the procedure could be safe with a few complications and higher success rates.