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Celiac disease is one of the most common cause of malabsorbtion syndrom. The symptom of this disease associated secondary to malabsorbtive problems. Celiac can be accompanied with liver enzyme dysfunction with various extra intestinal findings. This case was a 27-year old man presented with abnormal liver function test over period of 1 year. He did not have another symptom such as diarrhea, weight loss or skin lesion. In medical examination, there was no ascites, peripheral edema or jaundice. Diagnostic re-examination of the paitent include serology tests and Viral hepatitis, Wilson disease and auto Imuune respones showed to be normal. Abdominal and biliary sonography had normal results. Liver biopsy revealed no sign of any pathology, but duodenal biopsy and serologic findings were compatible by Celiac disease. The symptom improved on a gluten-free diet and his liver enzyme function tests became normal subsequently.

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Background and Objective: The staging of gastrointestinal cancer has an important role in the treatment of tumor. This study was done to determine the efficacy of endosonography method for determining the stage and deepth of esophagus and stomach cancers. Materials and Methods: In this descriptive study, endosonographic staging was performed in 23 patients (15 male and 8 female) with esophagus and stomach cancers, confirmed with pathologic findings in Taleghani hospital, Tehran, Iran during 2002-04. The results of surgical staging compared to preoperative endosonographic method. Results: Mean age of 23 patients was 57.2 years (43-72 years). 30% and 70% of the patients had esophageal and gastric cancers, respectively. The accuracy of endosonographic staging of esophagus and stomach cancers was 82%. The accuracy of diagnosis, positive and negative predictive value of cancers in assessment of the depth of the tumor by endosonography procedure were 79.4%, 69.6% and 84.9%, respectively. Conclusion: Endosonography is a precise method for evaluating depth and staging of tumor and lymph node involvement.

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Background and Objective: Surgical wound infection is the most common complication following surgery. This study was done to determine the incidence risk factors of surgical wound infection following abdominal hysterectomy. Materials and Methods: This descriptive study was done on 400 patients who underwent abdominal hysterectomy in Babol, North of Iran, during 2008-10. Age, underlying disease, BMI, use of immunosuppressive drugs hospitalization period prior to surgery, shaving and bath time, prophylactic antibiotic, duration of surgery, diagnosis and pathology were recorded for each patient. Evidence of surgical location of infection including surgical discharge, erythema and dehiscence of surgical wound with and without fever during 10 days after surgery were recorded. Results: Surgical wound infection was seen in 26 patients (6.5%) following abdominal hysterectomy. Regression analysis determined, use of immune-suppressive (95% CI: 1.71-480.30, P=0.020, OR:28.70) and emergency operation (95% CI: 1.42-14.39, P=0.011, OR: 4.52), diabetes (95% CI: 1.23-11.26, P=0.020, OR:3.72) were risk factors for surgical wound infection. Conclusion: Immuno-suppressive agents, emergency operation and diabetes increased surgical wound infection in post- abdominal hysterectomy.

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Background and Objective: Cardioembolic stroke account for one-fifth of ischemic stroke and atrial fibrillation is the most common underlying cause. Taking an oral anticoagulation (Warfarin) is an effective way of preventing ischemic stroke but bleeding complication is common. This study was carried out to evaluate the validation of HASBLED score in prediction of hemorrhagic complications in patients with brain ischemia and atrial fibrillation under warfarin therapy. Methods: In this cohort study 112 patients with non-valvular atrial fibrillation in term of major and minor bleeding complications were followed to the predictive value of HASBLED criteria for one year. Major bleeding complications defined as intracranial bleeding, bleeding leading to hospitalization, drop of hemoglubin of more than 2gr/dl or requiring transfusion. HASBLED criteria were defined as hypertension, abnormality in liver and renal function tests, history of stroke, history of bleeding, large fluctuations in coagulation tests results, age more than 65 years and an Anti-platelet and non steroidal anti-inflammatory drugs and alcohol use one point is awarded to each of the aboves. Results: During one year follow up, 10 (9.1%) of patients had major bleeding and 28 (25%) patients had minor bleeding. The risk of major bleeding was significantly related with a history of minor bleeding and HASBLED scores (P<0.05). The risk of minor bleeding was significantly related with warfarin toxicity and high INR (P<0.05). HASBLED score>3 was associated with the likelihood of major bleeding in future. Conclusion: Patients with HASBLED score>3 should be causious in initial stage of taking oral anticoagulant.