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سال:1400 | دوره:26 | شماره:1 |تعداد مقالات:8

Background: Gastroesophageal reflux disease (GERD) is a common gastrointestinal complaint in the adult population worldwide; nevertheless, few studies have assessed this disorder among medical students. The stress, lifestyle, and burdensome educational curriculum exposes this particular population to GERD. To the best of our knowledge, there was no information about the frequency of GERD in Iranian medical students. We aimed to assess the prevalence of GERD as well as its risk factors among the medical students. Materials and Methods: In this cross-sectional study, the symptoms of GERD were investigated among 290 medical students using the frequency scale for the symptoms of gastroesophageal reflux (FSSG) at Isfahan University of Medical Sciences during 2018-2019. Additional information, including age, sex, body mass index (BMI), and studying grade, were entered in the checklist. Results: Among the studied population, 104 (36. 55%) students had GERD. Heartburn was associated with studying grade (p =0. 022) and BMI (p < 0. 001). Esophageal regurgitation was related to BMI only (p < 0. 001). The logistic regression evaluations revealed overweight (p < 0. 001; OR: 14. 49; 95%CI: 7. 29-28. 81), obesity (p < 0. 001; OR: 14. 16; 95%CI: 4. 38-45. 74), studying the physiopathology course (p < 0. 001; OR: 5. 05; 95%CI: 2. 07-12. 30) and being in the stagership period (p = 0. 007; OR: 3. 50; 95%CI: 1. 41-8. 64) were independent predictors of heartburn, while overweight (p < 0. 001; OR: 8. 33; 95%CI: 4. 26-16. 28), obesity (p < 0. 001; OR: 54. 87; 95%CI: 11. 31266. 10) and being in the stagership period (p = 0. 024; OR: 2. 89; 95%CI: 0. 87-6. 22) were the predictors for esophageal regurgitation. Conclusion: Based on this study, GERD was prevalent among the medical students, and factors, including BMI and studying grade, were predictors of its incidence.

Benign esophageal stricture caused by corrosive substance can be treated successfully with endoscopic dilation using bougies or balloons but approximately one-third of patients develop recurrent stenosis. We report a case of lower third benign esophageal stricture presented with severe dysphagia, passive and active regurgitation caused by ingestion of a corrosive substance (aluminium phosphide) which was refractory to multiple dilation with balloons and bougies and migration of fully covered metal stent. After two courses of intralesional 40 mg methyl prednisolone acetate injection with two weeks interval and serial dilation, symptoms improved without restenosis. So a less frequent injection-dilation schedule with longer intervals may also effective for refractory esophageal stricture induced by corrosive agents.

Background: To the best of our knowledge, we do not have enough data on the rate of intra-abdominal sarcoma (IaS) and retroperitoneal sarcoma (RPS) in Iran compared to other countries. We aimed to report a 10-year survey on the incidence and demographic characteristics or potential risk factors of RPS and IaS in Iranian patients in a population-based study setting. Materials and Methods: This descriptive-analytic, cross-sectional study was performed during 2009-2014 to evaluate the incidence of sarcomas in Iranian patients in different provinces under the supervision of the Cancer Research Center of Shahid Beheshti University of Medical Sciences. 2142 patients were included in this study. Demographic data of the patients including age, sex, and year of diagnosis, as well as primary tumor location and recurrence tumor site, tumor morphology, and tumor grade after clinical and pathological examinations were collected. Six-digit codes for histological grading and differentiation were used to evaluate the tumor grade. Data were entered into SPSS software, version 22, and analyzed. Results: In this study, data of 2142 patients were included and evaluated. Of the patients with soft tissue sarcoma, 993 (46. 4%) were women and 1149 (53. 6%) were men. Among the patients, 109 (5. 1%) were children, 1450 (67. 7%) were adults, and 583 (27. 2%) were in the elderly age group. The peak frequency of soft tissue sarcoma was 237 (11. 1%) in the 50-54 year-old age group, with the highest rate in 40-69 year-olds and the lowest in the age range of 5 to 14 years. The morphology of soft sarcomas was evaluated, gastrointestinal stromal sarcoma (16. 9%, n = 362) being the most common, followed by sarcoma (9. 9%, n = 212), spindle cell sarcoma (9. 9%, n = 211), leiomyosarcoma (7. 7%, n = 166%) and liposarcoma not otherwise specified (6. 2%, n = 133) were the four most common types. The morphology of the tumors was also evaluated by age and sex, which was statistically significant. gastrointestinal stromal sarcoma has the highest sex-specific incidence in patients with sarcoma, in other words, during the six years of our study, the sex-specific incidence rate for gastrointestinal stromal sarcoma were 163. 14 cases per 1000 patients with sarcoma for women, and the sex-specific incidence was 174. 6 for men. In patients less than 15 years old, the desmoplastic small round cell tumor morphology had the highest specific incidence, which was 201. 83 per 1000 patients with soft tissue sarcoma in this age group. Conclusion: Our study data show that the four most common types of soft tissue sarcomas in our country are gastrointestinal stromal sarcoma, followed by sarcoma, spindle cell sarcoma, leiomyosarcoma, and liposarcoma NOS and The peak age range of this sarcomas was 50-54 years.

Background: About one-third of patients with cirrhosis have gallstones. Gallstones in these patients are often asymptomatic and discovered incidentally, and only 1– 2% per year will develop complications. We aimed to assess the frequency of gallstone complications in Egyptian patients with cirrhosis and compare them to gallstone complications in those without cirrhosis. Materials and Methods: Our study included 120 patients with first-time discovered gallstones. They were selected from patients admitted to the outpatient clinic or the Tropical Medicine Department of Zagazig University, Egypt. They were classified into two groups. The first group comprised 60 patients with cirrhosis with gallstones and the second group comprised 60 healthy individuals with gallstones. Risk factors of gallstones were assessed. Upon admission, all patients underwent a thorough history and clinical examination. Moreover, liver function tests and pelviabdominal ultrasound were done and triglyceride and amylase levels were measured to confirm the presence of gallstones. They were followed up for five years to assess the frequency of gallstone complications. Results: The group with cirrhosis had significantly lower gallstone complications than the non-cirrhotic group (8% vs. 41%, p < 0. 001) as regard the overall complications after 5 years of follow-up. We found that there was a significant difference regarding each complication separately. Acute cholecystitis was (5% vs. 16. 7%, p = 0. 03). Acute pancreatitis was (1. 6% vs. 13. 3%, p = 0. 01). Obstructive jaundice was (1. 6% vs. 11. 7%, p = 0. 02). Conclusion: Our study revealed that the frequency of gallstones complications in patients with cirrhosis was much lower than patients without cirrhosis with gallstones after 5 years of follow-up.

Fibrosarcoma is one of the least common primary malignant tumors of skeleton-formative tissue. Also, primary esophagus squamous cell carcinoma (SCC) is a rare tumor accounting for 0. 05– 4% of all esophageal malignancies with aggressive behavior and poor prognosis. In this study, we aimed to present a 40-year-old man with the co-incidence of SCC and fibrosarcoma. Case presentation: A 40-year-old man presented to the gastrointestinal clinic of Imam Khomeini Hospital Complex complaining about a three-month abdominal pain and progressive dysphagia. He also complained of severe pain in both flanks, dark color urine with blood clots, and a 10-kg weight loss in the past two months. A spiral CT scan revealed a 14×15×13 cm 3 lobulated solid mass in the right side of the pelvic. The pathology described malignant neoplastic tissue composed of cells with large hyperchromatic pleomorphic nuclei. Fibrosarcoma was diagnosed according to immunohistochemistry (IHC) results and morphology. The endoscopy noted a 5 cm ulcerative mass in the esophagus, which occupied less than 50% of the lumen. The pathology showed squamous cell carcinoma from the esophageal mass biopsy. Diagnostic laparoscopy denied any peritoneal seeding and liver or kidney metastases. We planned to conduct neoadjuvant chemoradiotherapy (cisplatin plus etoposide, and 40Gy external beam radiation therapy) and surgery for his esophageal SCC and radiotherapy for Fibrosarcoma. This is the first report of the second primary esophageal SCC after fibrosarcoma in a 40-year-old man with no noticeable predisposing factor (such as smoking, immune modulator drug, radiation exposure, etc. ). Further studies are needed for developing intervention strategies to reduce the risk or to improve the treatment of multiple primary neoplasms.