Tehran University Medical Journal

Background: The irritable bowel syndrome (IBS) is one of the most common chronic medical conditions. Various mechanisms, including altered gut flora and/or small bowel bacterial overgrowth, have been suggested to play a role in the development of gas-related symptoms aim of study. The clinical evidence of small intestinal bacterial overgrowth as an important etiology of irritable bowel syndrome continues to accumulate. Clinical symptoms of bacterial overgrowth and irritable bowel syndrome are similar however, a definitive cause-and-effect relationship remains unproven. It is unclear whether motility dysfunction causes bacterial overgrowth or gas products of
enteric bacteria affect intestinal motility in irritable bowel syndrome.

Methods: In a randomized double-blind placebo-controlled trial consisting of treatment with bismuth subcitrate. Primary efficacy variable was subjective symptoms frequency of abdominal pain, Number of bowel movement & Bloating/distension.

Results: 119 patients were enrolled (59 bismuth subcitrate and 60 placebo recipients). At the end of phase 2, all symptom scores dropped significantly both in bismuth subcitrate and placebo group (p<0.001). There was not a significant difference in symptom relief with bismuth subcitrate versus placebo administration.

Conclusions: There was not a significant difference in symptom relief with bismuth subcitrate versus placebo in IBS patients. Whether antibiotics can improve quality of life in patients with irritable bowel syndrome warrants further research.
Interventions: Participants were randomly assigned to receive 120mg bismuth subcitrate four times daily for 14 days (n=59) or placebo (n=60).

Background: Prostate cancer is the most common cancer and the second cause of cancer mortality in men. Although histopathological examination is the gold-standard for its diagnosis, tendency toward less invasive methods is growing. The purpose of this study was to evaluate the relationship between choline plus creatine- to-citrate ratio in magnetic resonance spectroscopy (MRS) with the invasion of prostate cancer in a series of patients with prostate cancer.
Methods: Totally, 200 patients with pathologically proven prostate cancer were enrolled in this cross-sectional study by a non-probability sampling method in Hazrat Rasul Akram Hospital in Tehran, Iran during 2009-2010. Pathological staging was the gold standard for the diagnosis of prostate cancer while the patients underwent MRS for choline plus creatine- to-citrate ratio determination. MRS and pathological results were compared and analyzed.
Results: The mean (±SD) values of choline plus creatine- to-citrate ratio in patients with Gleason scores less than 3, 3 to 4 and greater than 4 were 245.8±146.8, 427.1±173.6 and 427.1±173.6, respectively (P<0.001). The mean (±SD) values of choline plus creatine- to-citrate ratio in patients with PSA levels less than 4, 4 to 10 and greater than 10 were 180.7±58.3, 247±93.5 and 385.1±106.6, respectively (P<0.001).
Conclusion: Choline plus creatine- to-citrate ratio determined by magnetic resonance spectroscopy has a significant relationship with the degree of invasion of prostate cancer and can be used for the staging of the disease.