Tehran University Medical Journal

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Inflammatory bowel diseases are one of the important reasons of the referral to GI practitioners in our country and Ulcerative Colitis is the more frequent type of these disease in Iran. In this study 200 cases of Ulcerative Colitis, which has been referred to Imam Khomeini Hospital during that last 5 year, were studied. Data was collected using the patient's records and face to face interview with them and their relatives. Majority of the patients were female (55 percent). Positive family history was seen in 28 percent of patients, autoimmune disease history in 8 percent, smoking history in 11 percent and smoking cessation history in 13 percent of patients. Most prevalent symptoms in the patients were nocturnal bleeding, rectal bleeding and bloody diarrhea. The most common involved area were recto sigmoid (58 percent) and descending colon (42 percent). Pan colitis was seen in 8 percent. Most people had complications and the most common complications was fissure (14 percent). Recurrence was seen in 83.5 percent of patients. With logistic regression analysis the only variable which showed significant relation with recurrence was male sex. According to the results of this study, it seems that ulcerative colitis clinical and epidemiological pattern in Iran is similar to many other countries, but the higher rate of recurrence and extra intestinal manifestations in patients shows that there is a growing need to reconsider the treatment efficacy in patients and correct the treatment methods.

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Background: Infants and children present with a wide range of congenital chest wall deformities which have both physiologic psychologic consequences and are often associated with other abnormalities. Surgical intervention offers excellent cosmetic results with minimal morbidity and mortality. In order to investigation of chest wall deformities, and surgical results, this study was performed.

Materials and Methods: A descriptive study on existing data on 60 consecutive patients with chest wall deformity during 10 years carried out. Patient's characteristics such as age, gender, signs and symptoms type of operation, associated disorder, syndrome, and surgical complications were considered.

Results: Pectus excavatum 60% and pectus carinatum 30% Poland syn 6.7% 9 sternal cleft 3.2. Inpectus, M/F: Was 3/1 and others were 1:1. Age of admission 4 to 27 years 13.4±6.82) and association syndromes were, turner, Morgue and marfan, most patients were operated in delayed time (75) and hence, scoliosis was common than others.

Conclusion: Pectus excavatum was the most common deformity and if scoliosis was prominent and most operation was done in old age but surgical result was excellent no anyone expired and complication was a little. So we recommended that all of the chest deformities must be operated in anytime.

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Background: Botulinum toxin (Dysport) is a powerful semi-biological toxin. It has proved to be a remarkable therapeutic agent for treatment of benign anal disorders. Different results have been achieved from injection of botulinum toxin in order to treatment of anal fissure since 1993. The aim of this study was to evaluate the efficacy of botulinum toxin injection in the treatment of chronic anal fissure Comparing with lateral internal anal sphincterotomy (LIS).
Methods: 36 patients entered into two groups, Dysport injection and Lateral Internal Sphincterotomy, randomly. Dysport group were treated by injection of 50 units of botulinum toxin, 25 units of drugs in each side, and LIS was done in surgery group by open method in left side. Pain, recovery and incontinency were compared between two groups during six months of follow up.
Results: Based on this study, treatment of anal fissure does not affected by age and gender. Regarding to location of fissure, there was no difference between two different genders. Mean of age and ratio of gender were similar in both groups. The severity of pain in surgery group was lower than Dysport group six months after treatment (0.4±0.7 and 3.2±2.6 respectively, p<0.001). Recovery ratio in surgery group was higher than Dysport after six months (95% Vs. 44.4% p<0.001). Gas or fecal incontinency did not reported after six months in both groups.
Conclusion: Botulinum toxin is not efficacious in patients with chronic anal fissure, comparing with LIS. More future studies are necessary for final judgement.