Shiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24305Issues 3-420170601Eventration of Diaphragm with Chronic Constipation: An Unusual Presentation: A Case Report47159ENAshwinPorwalDesignation - Consultant Colo Rectal Surgeon, Institution - Healing Hands Clinic, 105, Mangalmurti Complex, Near Hirabaug, Tilak Road, PunePareshGandhiConsulting Surgeon, Healing Hands ClinicJournal Article20201223Diaphragmatic eventration (DE) or eventration of the diaphragm is characterized by a permanent high position of 1 or rarely both<br />the leaflets of the diaphragm, providing a potential space for the displacement of abdominal viscera on the affected side(s).It is a<br />relatively rare condition with unknown etiology in adults. Prevalence of DE is less than 0.05% of the population, both children and<br />adults, and is more common in males. There is a various presentation for DE and patients are mostly asymptomatic. The diagnosis<br />of DE is vital to avoid certain serious, though rare, complications such as gastric or colon volvulus. Here is the report of an unusual<br />presentation of eventration of the diaphragm with sigmoid colon volvulus presented with complaint of chronic constipation and<br />‘fear to eat’. Patient was diagnosed in the operating room despite multiple imaging modalities. Eventration of diaphragm and<br />cachexia is a rare association and to the best of authors‘ knowledge, it is not reported in literature. It is hoped that the current case<br />report sensitizes physicians to the unusual presentation of eventration of diaphragm.<br /><br />https://colorectalresearch.sums.ac.ir/article_47159_6d65901b6789917b35499121b656dc24.pdfShiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24305Issues 3-420170601A Colorectal Unit with an Enhanced Recovery After Surgery (ERAS) Programme Improves Surgical Outcomes in a Major Metropolitan Hospital47160ENMichelleCooperDepartment of Surgery Logan HospitalGriffith UniversityAemeliaMelloyDepartment of Surgery Logan HospitalHajirNabiUniversity of QueenslandShu-KayNgGriffith UniversityChristopherGillespieDepartment of Surgery Logan HospitalUniversity of QueenslandJournal Article20201223Objectives: We aimed to assess the surgical outcomes associated with the introduction of a dedicated colorectal service and newly<br />implemented enhanced recovery after surgery (ERAS) programme at Logan Hospital.<br />Methods: A prospective database was created to include all patients admitted to Logan hospital for colorectal resections after the<br />establishment of a dedicated colorectal service with two colorectal surgical society of Australia and New Zealand (CSSANZ) trained<br />colorectal surgeons and an ERAS programme. The demographics, pathology and surgical outcomes in this patient group were compared<br />to a historical retrospective patient cohort from the same hospital with resections performed by general surgeons prior to<br />the introduction of the ERAS programme. Primary outcomes included the length of stay, readmission rate, morbidity and mortality.<br />Results: The prospective database included patients from February to November 2015 with a minimum 30 day follow-up (n = 72).<br />The retrospective patient cohort was from January to December 2012 (n = 68). The average length of stay (LOS) reduced from 10.85<br />days to 5.74 days (P = 0.037). Thirty day readmission rates decreased from 7.35% to 4.17% (P = 0.485). Morbidity reduced from 41.18% to<br />11.11% (P < 0.001). Mortality rates of 2.94% pre ERAS and nil post (P = 0.234). Demographic information, co-morbidities and pathology<br />were comparable.<br />Conclusions: Our results suggest that a dedicated colorectal service with an ERAS program is able to improve surgical outcomes<br />including length of stay, morbidity and mortality. This is in keeping with existing international literature.<br /><br />https://colorectalresearch.sums.ac.ir/article_47160_497b9dd887f624f703d8eb593da6ba43.pdfShiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24305Issues 3-420170601Bactobilia Among Patients with Uncomplicated Cholelithiasis Undergoing Laparoscopic Cholecystectomy: The Risk Factors and Effects on Postoperative Infectious Complications47161ENLeilaGhahramaniColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-5282-2212MarzieRezaeian JahromiStudent Research Committee, Shiraz University of Medical Sciences, Shiraz, IranGholamrezaPouladfarProfessor Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IranAlimohammadBananzadehColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IranAlirezaSafarpourColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IranSeyed VahidHosseiniColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-9228-3567ManliAminshahidiProfessor Alborzi Clinical Microbiology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20201223Background: Determining the rate of bactibilia among patients under going laparoscopic cholecystectomy (LC) and its correlations<br />with predisposing factors and postoperative infections, which help evaluate the need for prophylactic antibiotic.<br />Methods: In this prospective study, 85 consecutive patients with uncomplicated cholelithiasis who underwent LC were enrolled<br />from 2012 to 2013. Routine bile culture wasdoneat the time of LC. Patients were divided into 2 groups, 1 with negative bile cultureand<br />another with bactibilia. Demographic and laboratory data were compared. Patients were followedup10 days after their laparoscopy<br />and 1 month after discharge to monitor the presence of infection.<br />Results: A total of 7 cultures of bile were positive for bacteria (8.2 %). The patients’ age was the sole factor with a significant relationship<br />with the rate of bactobilia (P = 0.016). Within 10 days after surgery, fever and surgical site infection were detected in 10.6% of<br />patients, which was not significantly different in the 2 groups. There were no complications in the 30-day follow-up.<br />Conclusions: Detecting bactobilia with low frequency and the lack of correlation between bactobilia and postoperative infectious,<br />complications did not support prescribing prophylactic antibiotic in respective patients. The older age was the sole predisposing<br />factor for the development of bactobilia.<br /><br />https://colorectalresearch.sums.ac.ir/article_47161_0ced1be8b2c33a3fdfca0ad760120180.pdfShiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24305Issues 3-420170601Evaluation of the Potential Antioxidant Role of High-Density Lipoprotein-Cholesterol (HDL-C) in Patients with Ulcerative Colitis47162ENMostafaVaghari TabariMolecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, IranDepartment of Biochemistry, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, IranSoheilaMoeinMolecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, IranDepartment of Biochemistry, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, IranDurdiQujeqDepartment of Clinical Biochemistry, Babol University of Medical Sciences, Babol, IranCellular and Molecular Biology Research Center (CMBRC), Health Research Institute, Babol University of Medical Sciences, Babol, IranMehrdadKashifardDepartment of Internal Medicine, Gastroenterology Division, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, IranJavaadShokri ShirvaniDepartment of Internal Medicine, Gastroenterology Division, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, IranKarimollahHajian TilakiDepartments of Biostatistics and Epidemiology, Babol University of Medical Sciences, Babol, IranGholamrezaFarshidfarDepartment of Biochemistry, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, IranJournal Article20201223Background: Ulcerative colitis is acommontype of inflammatory bowel disease (IBD). The aim of the present study was to examine<br />the relationship between lipid profile, especially high-density lipoprotein (HDL), and malondialdehyde (MDA) level in patients with<br />ulcerative colitis.<br />Methods: In this study, 45 patients with ulcerative colitis were selected, 25 of whom were diagnosed with active disease and 20<br />were in clinical remission. Moreover, 45 healthy subjects were selected as the controls. The status of serum lipid profile and MDA<br />level were measured via precise photometric methods. The obtained data were analyzed, using independent t-test and correlation<br />coefficient test. P < 0.05 was considered statistically significant.<br />Results: The serum level of HDL-C decreased, while the serum level of MDA significantly increased in patients with ulcerative colitis<br />in comparison with the healthy controls (P < 0.05). No significant correlation was observed between theMDAlevel and triglyceride,<br />cholesterol, and LDL-C levels in patients with ulcerative colitis. However, a significant inverse correlation was observed between<br />HDL-C and MDA levels (r, -0.306; P < 0.05).<br />Conclusions: The inverse correlation between HDL-C andMDAlevels can be regarded as an indicator of the protective role of HDL-C<br />against lipid peroxidation in ulcerative colitis. In patients with ulcerative colitis, the serum level of HDL-C decreased in comparison<br />with healthy subjects. Therefore, it is necessary to determine the HDL-C level in patients with ulcerative colitis.<br /><br />https://colorectalresearch.sums.ac.ir/article_47162_b432b23e976cf01c7696f22dd4cb4219.pdfShiraz University of Medical SciencesIranian Journal of Colorectal Research2783-24305Issues 3-420170601A Review of the Incidence of Colorectal Cancer in the Middle East47163ENAhmed Mohammed Ali HusseinAlhurryColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranAbbasRezaianzadehColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranSalarRahimikazerooniColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranMohammadAbdzaid AkoolColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranFaranakBahramiColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran0000-0002-1878-1883Seyedeh SaeedehShahidiniaColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranMahboobehPourahmadColorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR IranJournal Article20201223Background: Colorectal cancer (CRC) accounts for about 10% of cancers and is the third most prevalent cancer worldwide. It is also<br />one of the leading causes of cancer-related mortality. The objective of the current study was to investigate the incidence of CRC East<br />by reviewing reports on number and age standardized incidences of CRC in both genders in different areas of the Middle East.<br />Methods: All the published reports citing the incidence of CRC in the Middle East were collected by conducting a literature search<br />using Pubmed. Data was extracted from the included articles, and summarized in tables and charts, according to “country of origin”,<br />“gender”, and “ASR”. Data presented by GLOBOCAN on the incidence/prevalence and mortality rates of CRC are also showed in<br />separate charts and tables.<br />Results: This research identified 194 articles, through the Pubmed search. After removing duplicate and triplicate publications,<br />96 full-text articles were assessed for eligibility and 78 were excluded. According to data from Reviewed articles, the highest and<br />the lowest ASR for colorectal cancer were respectively 48.3 (European-American Jews) and 4.2 (Shiraz, south Iran) in males and 35<br />(European-American Jews) and 2.72 (Shiraz, south Iran) in females (1, 2). According to GLOBOCAN, the highest ASR was 35 (Israel) and<br />the lowest was 4.48 (Yemen) in both genders. Except for Jews, the mean age of patients was 53 to 54.9.<br />Conclusions: Although Middle East is generally a low risk region for CRC, the incidence rate of CRC is more in western regions,<br />including countries located on the coast of the Mediterranean sea, compared to eastern and southern regions. Moreover, males and<br />females are at risk at younger ages compared to western countries.<br /><br />https://colorectalresearch.sums.ac.ir/article_47163_0a54f0dad414222d653e03968b420889.pdf