Efficacy of standard triple therapy versus bismuth-based quadruple therapy for eradication of Helicobacter Pylori infection

Helicobacter Pylori is the main cause of gastric ulcer, adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. Up to now, different regimens have been used for Helicobacter pylori (H.pylori) eradication to find the most potent and cost-effective regimen with less side effects. The aim of this study was to investigate the efficacy of standard triple therapy versus quadruple therapy for eradication of H. pylori. In a randomized clinical trial, 110 patients with H.pylori infection were randomly assigned into two groups of triple or quadruple therapy. The first group received standard triple therapy regimen with clarithromycin, amoxicillin and omeprazole and the second group received bismuth-based quadruple therapy regimen. At the end of study, stool antigen assay was used to confirm H.pylori eradication.The mean age of patients was 41.58 ± 11.98 years and 50.9% of them were male. Side effects of treatment with triple therapy were observed in 49.1% of cases. H.pylori eradication rate with triple and quadruple therapy regimen was 54.5% and 72.7% respectively but the difference was not statistically significant.Results showed that the efficacy of triple therapy was comparable to that of bismuth-based quadruple therapy regimen. However, due to the better compliance of triple therapy regimen, it is recommended for the first line treatment. Quadruple therapy could be used as an alternative treatment when triple therapy fails.

Evaluation of Atorvastatin Safety on Liver Function Tests, a Prospective Study

Background: Although lipid lowering agents as statins are used frequently in hyperlipidemic patients as well as patients with cardiac disease, they could have major hepatic side effects, the aim of this study is to evaluate the safety of statins mainly atorvastatin on liver as estimated by liver aminotransferase assay.Materials and Methods: Patients with indication of atorvastatin were included the study. As a before and after study all the patients underwent serum level measurement of aminotransferases at the beginning and after three month of taking the drug.Results and Conclusion: HMG-COA reductase as atorvastatin should be safe in different doses 20,40 and 80 mg in patient with hyperlipidemia with and without cardiac disease without significant hepatotoxicity

The necessity of gastric mucosal biopsy in dyspeptic patients with normal upper endoscopy in Modarres hospital 2017-2018

Background: Considering the diagnostic and therapeutic costs of patients with dyspepsia and the importance of diagnosis during gastrointestinal malignancies, in this study, we investigated the necessity of gastric mucosal biopsy in dyspeptic patients with normal upper endoscopy in Modarres hospital and their 6 months follow up. We studied their endoscopic biopsies changes and some of the involved risk factors this duration.Materials and Methods: In this clinical trial study, 115 patients with dyspepsia, were referred from gastroenterology clinic of Modarres hospital during 2017-2018, were evaluated. Patients were enrolled in a study that did not have any ulcer and mass or deep mucosal lesion in the early endoscopy Surface erosions were no exception and could be included. Five biopsy samples were obtained from different stomach sites. After the pathology results, the patients who had malignancy reports, excluded from the study and other patients were treated with anti-acid drugs and, if necessary, eradicated Helicobacter pylori. After 6 months, they were again subjected to endoscopy and biopsies were taken. Data were analyzed by SPSS software version 22.Results: The rate of Helicobacter pylori in patients with endoscopic dyspepsia without mucosal lesions after 6 months of treatment was reduced compared to pre-treatment p<0.05, 20.9% vs 12.2%. The severity of chronic gastritis mild to moderate in patients with endoscopic dyspepsia without mucosal lesions after 6 months of treatment was reduced compared to pre-treatment p<0.05, 89.6% vs 80%. There was a significant difference between metaplasia in patients with endoscopic dyspepsia without mucosal lesions before and 6 months after treatment p<0.05, 33%, vs 20%. Female gender, negative family history of GI cancer and not using alcohol were factors that significantly improved the results of biopsy chronic gastritis/ H. pylori /metaplasia after 6 months.Conclusion: Regarding the reduction in the severity of chronic gastritis, Helicobacter pylori and metaplasia in this group of patients after 6 months of treatment, it is recommended that refraining from unnecessary follow-up and biopsy and imposing cost to the patient and the medical system and be limited to high-risk groups

Mortality due to H1N1 Influenza in Cases Registered at the Autopsy Halls of Kahrizak, Tehran

H1N1 swine flu is an acute disease that infects the upper respiratory tract and can cause inflammation of the upper respiratory tract, trachea, and possibly the lower respiratory tract. The known course for H1N1 swine flu is varied from one to four days, on average for most people about two days, but in some cases, it can be up to seven day

Carotid intima-media thickness and plasma fibrinogen among subjects with metabolic syndrome: Isfahan cohort study

BACKGROUND: The role of plasma fibrinogen, a key regulator of inflammation processes and increased carotid intima-media thickness (cIMT) to predict metabolic syndrome (MetS) is currently under investigation. We assessed differences in the indicators of cIMT and also plasma fibrinogen level between MetS and non-MetS subjects. We also assessed the role of these two parameters for independently relationship with MetS state. METHODS: The subjects in this cross-sectional survey were population-based samples of 93 men and women aged &ge; 35 years and over who were selected from the Isfahan cohort study, Isfahan, Iran. Fibrinogen was measured by the clotting assay of Clauss. Ultrasound studies of the carotid artery were performed to measure cIMT. MetS defined based on the National Cholesterol Education Program&rsquo;s Adult Treatment Panel III. RESULTS: The mean level of plasma fibrinogen was not different in the two groups with and without MetS (240.10 &plusmn; 27.80 vs. 242.56 &plusmn; 35.82, P = 0.714), but the mean of cIMT was considerably higher in MetS group than in non-MetS group (0.85 &plusmn; 0.06 mm vs. 0.66 &plusmn; 0.09 mm, P &lt; 0.001). Using a multivariable logistic regression model, high cIMT could effectively predict MetS state with the presence of different components of MetS (odds ratio = 17.544, 95% confidence interval: 2.151-142.860, P = 0.008). The optimal cutoff point of cIMT for discriminating these two clinical states was 0.6 mm yielding a sensitivity of 61.5% and a specificity of 59.6%. CONCLUSION: Individuals with MetS demonstrated increased cIMT values compared with those without MetS. However, high plasma fibrinogen level may not be associated with MetS state. &nbsp; Keywords: Metabolic Syndrome, Carotid Intima-Media Thickness, Fibrinogen, Prediction&nbsp;</p