Reason for withdrawal from publication
Review withdrawn (December 2010) and being split in to four new reviews:


Prokinetics for functional dyspepsia


H2 receptor antagonists for functional dyspepsia


Proton pump inhibitors for functional dyspepsia


Antacids, sucralfate and bismuth salts for functional dyspepsia

Pharmacological interventions for non‐ulcer dyspepsia

Studies of Asians in Asia show relatively low incidence rates for ulcerative colitis and Crohn's disease compared with North America and Europe. The prevalence of ulcerative colitis in migrant South Asians in Europe is similar to Europeans, whereas the prevalence of Crohn's disease for migrant South Asians in Europe is decreased compared with Europeans. The prevalence for both ulcerative colitis and Crohn's disease in Japan and Korea is relatively low. There are no obvious differences in age or sex distribution or rates of familial aggregation, and there are no significant differences in the clinical characteristics and natural history of ulcerative colitis and Crohn's disease in Asians compared with other racial groups with inflammatory bowel disease.

Epidemiology of inflammatory bowel disease in Asia.

The effects of migration on ulcerative colitis: a three-year prospective study among Europeans and first- and second- generation South Asians in Leicester (1991-1994).

Background and Aims: Inflammatory bowel disease (IBD) was believed to be infrequent in Iran; however, unofficial reports have confessed the continuing rise in IBD in our country.



Methods: Demographic and clinical features, extraintestinal manifestations, extension of disease and complications of 401 patients with ulcerative colitis (UC), 47 with Crohn's disease (CD), and nine with indeterminatn colitis (IC) were assessed retrospectively. The exact course of physicians’ visits of 250 IBD patient was asked through face-to-face interview.



Results: Mean age at diagnosis was 31.9 years in UC and 30.5 years in CD patients. The male to female ratio was 0.8 for UC and 1.3 for CD. The percentage of CD and UC patients who were non-smokers was 82.9 and 84.5%, respectively. Patients with UC presented with rectal bleeding (41.9%), whereas those with CD complained of abdominal pain (46.9%). Among UC patients, proctosigmoid was affected in 51.9%. Colorectal cancer was diagnosed in two patients. The mean lag time between the onset of symptoms and definite diagnosis was 13.9 and 17.7 months for UC and CD patients, respectively. A total of 32.4% of patients with IBD had at least one of the five major extra-intestinal diseases.



Conclusion: The demographic and clinical picture of IBD is more or less the same as that of other developing countries; however, the rarity of CD in Iran is noted. Although the true epidemiologic profile of IBD in Iran is still unknown, it is not as rare as previously thought, and it seems as if gradual adoption of a Western lifestyle may be associated with the continuing rise in IBD.



© 2005 Blackwell Publishing Asia Pty Ltd

Inflammatory bowel disease in Iran: a review of 457 cases.

In view of therapeutic advances, we carried out meta-analysis of results from 18 randomized, controlled clinical studies to update a previous meta-analysis (1) and to provide an overview of clinical trials involving treatment of functional dyspepsia. The studies were included only if they satisfied

Meta-analysis of antisecretory and gastrokinetic compounds in functional dyspepsia.

Experience of 189 patients with non-specific ulcerative colitis has been reviewed. The majority of patients was in the 21–30 year age group, and neither sex predominated. Seventy-two percent had mild to moderate disease. The disease was mainly confined to the left colon (60%) and 13% had total colitis.

Ulcerative colitis in Karachi

Emergency endoscopy was done in 306 patients with acute upper gastrointestinal bleeding. Most of the patients were in the age group 20—39 years. Male to female ratio was 2.3:1. The main causes of bleeding were peptic ulcer (40.1 8%), oesophageal varices (32.4%) and superficial mucosal lesions (13.9%). Causes of bleeding remained obscure in 7.2% cases; dual lesions were seen in 2.94%. Complete follow up was available in 83.8% cases of portal hypertension and 69.10% peptic ulcers. Overall mortality in portal hypertension and peptic ulcer was 42.4% and 13.2%, respectively. Poor correlation was found between clinical and endoscopic diagnosis (JPMA 38 : 30, 1988).

/pdf/emergency-endoscopy-in-upper-gastrointestinal-bleeding-296yk4pu86.pdf

Emergency endoscopy in upper gastrointestinal bleeding.

Therapeutic effect of cimetidine in non ulcer dyspepsia was studied in a placebo controlled trial. The reduction of pain was statistically significant in both groups during the first week of treatment but no change in subsequent three weeks. It was concluded that cimetidine has no therapeutic advantage over the placebo in dyspeptic patients (JPMA 38: 168,1988). INTRODUCTION Non ulcer dyspepsia is a common clinical problem associated with upper abdominal pain of varying severity, fullness, discomfort, belching, nausea, vomiting and acid regurgitation. Exact diagnosis necessitates extensive investigations to exclude organic diseases like peptic ulcer, cholecystitis, pancreatitis and irritable bowel syndrome. As the pathogenesis of non ulcer dyspepsia is not known, no rational therapy has yet been advocated for this condition. The purpose of this trial was to assess the efficacy of cimetidine in the treatment of dyspepsia. PATIENTS AND METHODS Thirty patients of both sexes, aged 18-50 years presenting with upper abdominal pain of varying severity and a negative endoscopy for ulcer, erosions, reflux oesophagitis or atrophic gastritis were included in this trial. Investigations prior to treatment included abdominal ultrasound, haemoglobin, total leucocyte and platelet counts, serum transaminases and creatinine. Patients meeting the entry criteria were allocated to cimetidine (200mg) or a matching placebo three times a day with meals and at bed time for 4 weeks. A diary card was given for recording the intensity of pain. Intensity was scored as for no pain, 1 for mild, 2 for moderate and 3 for severe pain. No concurrent medication was allowed during the study. Patients were followed up every week for four weeks. Endoscopy and laboratory investigations were repeated at the end of the trial.

Najmuddin S. Banatwala

Papers

Ulcerative colitis in Karachi

Emergency endoscopy in upper gastrointestinal bleeding.

Lack of therapeutic effect of cimetidine in non-ulcer dyspepsia.