samaneh mortezaei; Mitra Ahadi; seyedmorteza valayi
Abstract
This case report documents a unique presentation of hepatic encephalopathy induced by the reactivation of chronic hepatitis B due to Cytomegalovirus (CMV) infection in a 76-year-old female patient. The patient was admitted with a diminished level of consciousness subsequent to a week of anorexia, intermittent ...
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This case report documents a unique presentation of hepatic encephalopathy induced by the reactivation of chronic hepatitis B due to Cytomegalovirus (CMV) infection in a 76-year-old female patient. The patient was admitted with a diminished level of consciousness subsequent to a week of anorexia, intermittent fever, chills, postprandial nausea, and vomiting. Laboratory tests revealed significant hepatocellular injury, while imaging suggested cirrhosis. The presence of hepatitis B surface antigen and a detectable hepatitis B virus (HBV) DNA qualitative analysis was noted, alongside an elevated CMV viral load, indicating reactivation of chronic hepatitis due to CMV infection. Therapeutic interventions included Ganciclovir for CMV infection, Colistin for an Enterococcus urinary infection, and Tenofovir for hepatitis. Upon stabilization, the patient was discharged for continued medical management. The case highlights the significance of considering reactivation of chronic viral hepatitis in the differential diagnosis of hepatic encephalopathy. It underscores the critical role of comprehensive diagnostic investigation in patients presenting with reduced consciousness, especially those with a history of liver disease. Moreover, it emphasizes the importance of managing concurrent infections in the context of liver disease, and serves as a reminder of the potential for CMV to reactivate chronic hepatitis, leading to serious complications such as hepatic encephalopathy.
Mitra Ahadi; Sina Fazel Hashemi; Farima Farsi; Zahra Mazloum khorasani; Vahid Reza Dabbagh Kakhki; Negar Morovatdar
Abstract
Objective: The prevalence of inflammatory bowel diseases (IBDs) has increased in recent decades. The incidence of osteoporosis in the population with IBD is higher than in the normal population. Therefore, it seems necessary to carefully examine the risk factors associated with decreased bone mineral ...
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Objective: The prevalence of inflammatory bowel diseases (IBDs) has increased in recent decades. The incidence of osteoporosis in the population with IBD is higher than in the normal population. Therefore, it seems necessary to carefully examine the risk factors associated with decreased bone mineral density (BMD) among these patients.Methods and Materials: Patients with IBD completed a questionnaire including demographic data, drug history, underlying disease (past medical history), and family history, then their bone density was measured with a DEXA device. Also, laboratory samples were prepared. Densitometry results were placed in three groups: normal, osteoporotic, and osteopenia. All of the data was analyzed by SPSS version 23 software.Results: This study was conducted on 63 patients (58 patients with ulcerative colitis (UC) and 5 patients with Crohn's disease (CD)). The bone density was normal in 40 patients, 16 had osteopenia and 7 had osteoporosis. There was a significant relationship between bone density and age (P < 0.001), smoking (P=0.049), past medical history (P< 0.001), extraintestinal involvement (P=0.008), duration (P=0.023) and menopause (P=0.002). Also, the amount of use of corticosteroid drugs (P=0.014), the level of calcium (P=0.017), and vitamin D (P< 0.001) in the blood had a significant relationship with bone density.Conclusion: In our study, we showed that age, smoking status, underlying conditions, extraintestinal involvement, corticosteroid use, levels of vitamin D and calcium, and menopause are risk factors for an increased risk for decreased BMD in IBD patients.
Mitra Ahadi; Ali Beheshti Namdar; Samaneh Bakhshi; Elham Mokhtari Amirmajdi; Mohammad Derakhshan; Atieh Yaghoubi; kiarash Ghazvini
Abstract
Introduction: Based on serological studies, the prevalence of Helicobacter pylori infection in Iranian adults is up to 80%. Gastritis, peptic ulcer, and gastric adenocarcinoma are common clinical outcomes of this infection in Iran. Since antibiotic resistance patterns of Helicobacter pylori are geographically ...
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Introduction: Based on serological studies, the prevalence of Helicobacter pylori infection in Iranian adults is up to 80%. Gastritis, peptic ulcer, and gastric adenocarcinoma are common clinical outcomes of this infection in Iran. Since antibiotic resistance patterns of Helicobacter pylori are geographically different, local studies are highly required.Methods: Eighty isolates of Helicobacter pylori were obtained from patients referred to the endoscopy unit of Ghaem Hospital in Mashhad. Demographic features including age, gender, and symptoms were recorded before the sampling. The antibiotic susceptibility patterns of isolates were determined for the five common antibiotics used for the treatment of Helicobacter pylori infection. The agar dilution method was used to evaluate the antibiotic resistance patterns.Results: The patterns of antibiotic resistance were determined, and 41.2%, 13.7%, 8.7%, 6.6%, and 6.6% of isolates were resistant to metronidazole, clarithromycin, amoxicillin, tetracycline, and furazolidone, respectively.Conclusion: Our study demonstrates that the overall rate of antibiotic resistance of Helicobacter pylori especially in the case of metronidazole has increased over time. The resistance rates are generally higher in the age range of 30-60 years and in females for the case of metronidazole. This reminds us of the need for a continuous monitoring program of antibiotic susceptibility patterns.
Hesaneh Izadyar; Mitra Ahadi; Ahmad Khosravi Khorashad; Hassan Saadatnia; Hasan Vosoghinia; Mohamadreza Farzanehfar; Ali Beheshti Namdar; Elham Mokhtari Amirmajdi; Sahar Khorasani; Hamid Reza Akbari; Foad Faroughi Bojd
Abstract
Introduction: The present study was conducted to evaluate the prevalence of trend and use of complementary and alternative medicine in patients referring to the Gastroenterology clinics in Mashhad. Methods: The present cross-sectional study was performed at Gastroenterology clinics affiliated with ...
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Introduction: The present study was conducted to evaluate the prevalence of trend and use of complementary and alternative medicine in patients referring to the Gastroenterology clinics in Mashhad. Methods: The present cross-sectional study was performed at Gastroenterology clinics affiliated with Mashhad University of Medical Sciences. The study began in December 2015 and ended in March 2017. The study subjects (n=751) were randomly selected from patients referring to Gastroenterology clinics in the city of Mashhad. Patients responded to the questions through interviews. The collected data were analyzed by SPSS-16 statistical software.Results: This study was conducted on 751 patients referring to gastroenterologists; of whom, 274 (48.36%) were male and 476 (38.63) were female. According to the results, the most popular complementary and alternative medicine treatments were respectively herbal medicine, cupping therapy and acupuncture. A significant difference was observed in the means at is faction with complementary and alternative medicine between those who believed in it and those who did not (p=0.001); but, no significant difference was detected in mean satisfaction with complementary and alternative medicine between patients with different occupations (p=0.193). There was also a significant difference in the number of patients between the group of patients receiving chemical medication and the group of patients receiving complementary and alternative medicine therapies (p=0.005). No significant difference was found in the level of satisfaction with complementary and alternative medicine between participants referring to the Gastroenterology clinics for different causes (p=0.431); nonetheless, the highest satisfaction was observed in patients with malignancy, and the lowest satisfaction was detected in patients with esophageal disorders.Conclusion: This study indicated the high prevalence of complementary and alternative medicine in Iran. The worldwide popularity of complementary and alternative medicine should not be overlooked, therefore; current medical treatment systems need to be revised and modified
Mitra Ahadi; Negin Masoudifar; Mina Akbari Rad
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has brought unpredictable challenges to the whole world by causing Coronavirus disease2019(COVID-19). Although respiratory tract manifestations are the most commonly reported symptoms in COVID-19, early studies reported a low incidence of typical ...
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has brought unpredictable challenges to the whole world by causing Coronavirus disease2019(COVID-19). Although respiratory tract manifestations are the most commonly reported symptoms in COVID-19, early studies reported a low incidence of typical gastrointestinal (GI) symptoms, such as diarrhea, nausea, vomiting, and even liver dysfunctions. However, The prevalence and prognosis of Gastrointestinal system involvement, including gastrointestinal symptoms and liver injury, remains mostly unknown in patients with COVID-19. We aimed to review the effects of COVID-19 on the GI system. Anorexia was the most frequent digestive symptom in adults (39.9%‐50.2%), and diarrhea was the most frequent symptom in both adults and children.Moreover, vomiting was more common in children. Approximately nine percent of adult patients showed vomiting. Almost 36% of children encounter vomiting; nausea is considered for 15% of children. Gastrointestinal bleeding was presented in more than ten percent of children, while abdominal pain was more frequent in severely ill patients.
Mitra Ahadi; Negin Masoudifar
Abstract
Eosinophilic esophagitis (EoE) is a chronic immune condition affecting children and adults. Dysphagia and food impaction are the main symptoms; however, reflux-like symptoms may also be present. The diagnosis of EoE is made with endoscopic evaluation for dysphagia, and its definitive diagnosis requires ...
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Eosinophilic esophagitis (EoE) is a chronic immune condition affecting children and adults. Dysphagia and food impaction are the main symptoms; however, reflux-like symptoms may also be present. The diagnosis of EoE is made with endoscopic evaluation for dysphagia, and its definitive diagnosis requires biopsy confirmation. The criteria for active EoE are defined as the symptoms of esophageal dysfunction, eosinophilic tissue infiltration (eosinophil count of at least 15 eosinophils per high-power field), and exclusion of other possible causes of esophageal eosinophilia. EoE is more prevalent in patients suffering from atopic conditions; therefore, allergic conditions may play an important role in the development of the disease. However, the etiology and pathophysiology of the disease are not completely understood. Elimination diets are considered as the first-line therapy in children; nevertheless, this approach appears to be less effective in adults, who often require steroids. Despite medical treatments, EoE is complicated in some cases by esophageal stricture and stenosis that require additional endoscopic treatments.