Penbactam for Helicobacter pylori eradication: A randomised comparison of quadruple and triple treatment schedules in an Iranian population

Background & study aims: Selection of the best drug regimens for eradication of Helicobacter pylori infection especially in patients at risk of peptic ulcer relapses and the development of complications is challenging. This study assessed and compared the efficacy of the two common PPI based triple therapies to a quadruple therapy including PPI, metronidazole, amoxicillin and a bismuth compound in Iranian population. Patients & Methods: Three hundred and thirty patients with peptic ulcer and H. pylori infection were included in the study. Patients were randomly assigned to one of the three treatment protocols all given twice daily: (a) A 14-day quadruple therapy (OMAB group) comprising omeprazole 20. mg, metronicazole 500. mg, amoxicillin 1. g, and bismuth subcitrate 240. mg; (b) A 14-day triple regimen (OCP group) comprising omeprazole 20. mg plus clarithromycine 500. mg and penbactam 750. mg and (c) A 14-day triple regimen (OCA group) comprising omeprazole 20. mg plus clarithromycine 500. mg and amoxicillin 1. g. Cure was defined as a negative urea breath test at least six weeks after treatment. Results: The per-protocol eradication rates achieved with both OCP regimen (87.0%) and OCA treatment (90.8%) were significantly higher than the OMAB treatment protocol (56.0%); however, no significant difference emerged in eradication rates between the two triple treatment schedules. No significant differences between the groups were found in most side-effects. Conclusion: Two-week quadruple therapy showed a lower eradication rate compared to common triple treatment schedules when used as first-line eradication treatment for H. pylori infection in Iranian population. © 2012 Arab Journal of Gastroenterology

Proinflammatory cytokines and thrombomodulin in patients with peptic ulcer disease and gastric cancer, infected with Helicobacter pylori

Backgrounds: Helicobacter pylori infect more than half of the global population. It is suggested to be related with gastritis, peptic ulcer disease (PUD), and gastric cancer. Aims: The aim of this present study was to evaluate proinflammatory cytokines including interleukin 1, 6, 8, 10, and thrombomodulin in H. pylori-infected patients with PUD and gastric cancer. Patients: This cross-sectional study was conducted in Taleghani Hospital on 111 patients with H. pylori infection. Materials and Methods: Patients were divided into three groups of PUD, cancer, and control (normal on endoscopy), according to the results of endoscopy. The serum levels of interleukins 1, 6, 8, and 10 and thrombomodulin was determined using enzyme-linked immunosorbent assay (ELISA) technique. H. pylori infection was diagnosed by histological examination of the endoscopic biopsy. Results: One hundred eleven patients were included in the study; 30 as PUD group, 30 as gastric cancer group, and 51 as controls. There was no significant difference between the means of IL-1 and IL-10 levels among the three groups (P = 0.744 and 0.383, respectively). IL-6, IL-8, and thrombomodulin levels were found to be statically different among the three groups (P < 0.05). The level of IL-6, IL-8, and thrombomodulin in cancer group was significantly higher than PUD and control groups (P < 0.05). Conclusion: There is a significant association between H. pylori infection and serum IL-6, IL-8, and thrombomodulin but such relation is not present between H. pylori and IL-1 and IL-10. Immunity response (IL-6, IL-8 and thrombomodulin) is more severe in cancer patient than PUD

Relation between Helicobacter pylori and nausea and vomiting in pregnant women

Abstract Background: Gestational nausea and vomiting in pregnant women have a high prevalence. The disorder will usually be better after the third trimester but, in some cases, it persists throughout pregnancy and makes the life of pregnant women disturbed. Purpose: This case-control retrospective study was conducted to determine the relation between Helicobacter pylori and nausea as well as vomiting in pregnant women referring to the healthcare centers affiliated to Mashhad University of Medical Sciences in 2006. Methods: 187 pregnant women at the third trimester of their pregnancy were selected. According to the experience of nausea and vomiting from the first trimester, they were divided into two groups: 89 women with the disorder and 98 women without it. A questionnaire in three parts was used for data collection: demographic information, history of nausea and vomiting, and socioeconomic status.The questionnaire was validated by context validity and reliability by test-retest method.Anti-Hp immunolobin G (IgG) serum antibody wastested by ELISA ti determine seropositivity. (r=0/89)  Results: The result showed a significant relation between helicobacter pylori and nausea and vomiting during pregnancy. The subjects did not have significant differences in terms of height, job, education of spouse, husbands’ job, pregnancy and BMI except for age and socioeconomic status (P=0.037 and

Calculation Of Residual Volume By Spirometric Data

Background: The current practice to measure RV is either by BPG or helium dilution methods which may not be available in all clinics due to their cost. Methods: This paper outlines a method for both direct and indirect calculation of RV via PFT with acceptable sensitivity (81 %, 60% ), specificity (71 %, 94%) and validity (76%, 78%) for obstructive and restrictive lung disease respectively at a much lower cost

Antibiotic Susceptibility Profile of Helicobacter pylori Isolated from the Dyspepsia Patients in Tehran, Iran

Background/Aim: Helicobacter pylori is an important pathogen for gastroduodenal diseases. Infection with H. pylori can be limited by regimens of multiple antimicrobial agents. However, antibiotic resistance is a leading cause of treatment failure. The aim of this study has been to determine the resistance patterns of H. pylori strains isolated from gastric biopsies of patients with dyspepsia by agar dilution method, in Tehran, Iran. Patients and Methods : H. pylori isolates from patients with gastrointestinal diseases were evaluated for susceptibility testing by agar dilution method. Susceptibility testing was performed to commonly used antibiotics including clarithromycin, tetracycline, amoxicillin, metronidazole and ciprofloxacin. Results: Among 92 patients with dyspepsia, H. pylori strains were isolated from 42 patients. Seventeen (40.5%) of the isolates were resistant to metronidazole (MICs ≥ 8 μg/l), whereas one isolate (2.4%) was resistant to amoxicillin (MICs ≤ 0. 5 μg/ml) and ciprofloxacin (MICs ≤ 1μg/ml). The resistance rates to other antibiotics in H. pylori isolates are recorded as follows: clarithromycin 6 (14.3 %), tetracycline 2 (4.8%). In 5 of 42 resistant cases, combined resistance was found. Conclusions: These data suggest that metronidazole should be used among Iranian patients in first-line therapy with caution, and ciprofloxacin in association with amoxicillin and a proton pump inhibitor is more recommended

Celiac disease and Hp infection association in Iran Enfermedades celiacas e infección por Hp en Irán

Background: we assessed the prevalence, the related symptoms, and the endoscopic and histologic gastric features of celiac disease (CD) in patients with Helicobacter pylori (Hp). Methods: 450 dyspeptic patients were studied. Biopsies of gastric antrum and duodenum, CD serology, and total IgA were obtained. Histological findings were scored with the Marsh-Rostami criteria. Results: 411 (91.3%) patients were Hp positive. Duodenal histology was normal in 385 (85.6%) patients, 124 (27.5%) had duodenitis and 28 (6.2%) showed duodenal abnormalities (Marsh I-IIIc). Twenty three/28 (82.1%) patients with malabsorption pattern were also Hp positive. Serological analysis: 12 of 31 (38.7%) positive patients had abnormal histology (Marsh I,-IIIc). Nine out 450 patients were IgA deficient; none of them was serologically positive for CD. Conclusion: although a high prevalence of Hp infection was found in this study, the relationship between Hp infection and CD was similar to that reported in other geographic areas