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 Low Prevalence of Hepatitis C Virus and Human Immunodeficiency Virus Coinfection and Hepatitis C Virus Mono-Infection Among Methadone Toxicity Patients

the incidence of Hepatitis C Virus (HCV)and Human Immunodeficiency Virus(HIV) coinfection in People Who InjectDrugs (PWIDs) is a public health issue; itpresents various contentions to the healthcareproviders. Although antiretroviral therapy improvedthe life expectancy of HIV-infected people, HCV-relatedmortality turned into a greater concern among these individuals[1]. AccFurthermore, they mentioned, “injectingdrug users in the Taipei methadone maintenancetreatment program had a very high prevalence of HIV/HBV coinfection and HCV mono-infection”[2].Besides, a systematic review and meta-analysis resultssuggested a high frequency of HIV/HBV coinfection(>80%) in Intravenous (IV) drug users [3]. Althoughthe incidence of HIV among IV drug users has beendecreased, HCV is still endemic in this population [4].We aimed to estimate HCV/HIV coinfection frequencyand its related risk factors among methadone poisonedpatients who were admitted to the Loghman Hakim poisoningcenter between March 2012 and March 2017.Loghman-Hakim Hospital is a unique poisoning referralcenter in Tehran, Iran, that admits patients from all citiesin Tehran Province, Iran. Annually, around 20000 hospitalizedpatients are observed and treated in this center,with 80-100 patients daily turn-over.The required data were collected using a questionnaire,clinical examinations, and laboratory findings. The patientswith a history of infectious diseases, like hepatitisB or C, HIV, and IV drug consumption, were excludedfrom the present research. The obtained blood sampleswere screened for antibodies to HCV and HIV using acommercially available Enzyme-Linked ImmunosorbentAssay (ELISA). Furthermore, the relevant urine sampleswere analyzed for the presence of methadone with a rapidtest. Among 200 participants, 134 (67%) were male, and66 (33%) were female with the age range of 1 to 83 years.The methadone serum levels of 129 (64.5%) patients werepositive, 39 (19.5%) were negative, and 32 (16%) patientswere not examined due to the short duration of hospitalization(i.e. <2 days). Underlying diseases, such as noncommunicablediseases (11%), psychotic disorders (1.5%), andrespiratory disease (3.5%) were detected in 30 cases. ReactiveHCV-antibodies, active HIV-antibodies, and HIV/HCV coinfection were observed in 10 (5%), 2 (1%), and 2(1%) of the study subjects, respectively. Figure 1 shows theprevalence of HCV and HIV infection by gender and age

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

Assessment of the effects of increased intravenous hydration on the course of labor in nulliparous term pregnancies

Physiologists have shown that increased fluids improve skeletal muscle performance in prolonged exercise. Typical orders provide for 125 mL of intravenous fluids per hour in patients taking limited oral fluids during labor. Our purpose in this study was to determine whether increased intravenous fluids affect the progress of labor. In a prospective randomized institutional clinical trial, one-hundred ninety-four nulliparous women with uncomplicated singleton gestations at term in spontaneous active labor with dilatation 2-5 cm and a cephalic presentation were selected. 82 were designed to receive 250 mL per hour of intravenous normal saline in dextrose water (first group), and 112 to receive 125 mL per hour of the same solution (2nd or control group). Prerandomization variables such as mother's age, weight, previous pregnancy history, general health, sex and weight of the newborn, rupture of the membranes and presenting part were balanced between the two groups. The frequency of labor lasting >10 hours was statistically higher in the 125mL group (16.7% vs 7.4% p < 0.0002). This study showed that increasing fluid administration for nulliparous women in labor is associated with a shorter duration of the first stage and possibly less need for augmentation of uterine contraction (4.8% vs 6.25% p = 0.002). Thus dehydration in labor may be a contributing factor for dysfunctional labor and need for cesarean-section, and oxytocin infusion

From Data to Decision: Non-map-based Visualization of Geospatial Data Sets

The most common means of visualizing data sets with geospatial data is by employing map-based visualization models such as graduated symbol and choropleth. I argue that these models are in fact not the most efficient and effective visualization models for processing geospatial data, especially when the data set holds a notable quantity of location data. To support my argument I designed and developed two alternate models, one that did not use a map, and one that used an abstract version of one: a scatterplot model with geographic references, and a hexagon model. User tests were then performed to evaluate these models. This thesis describes the process, outcomes and future directions of my research. It also provides a literature review that addresses the definition and attributes of data visualization, a taxonomy of data visualization models, and a description of the mechanics of the visual cognition and colour theory employed

The Effect of Architecture and Shear Stress on Endothelialization of 3D Printed Vascular Networks

Despite significant progress in the field of tissue engineering within the last decade, a number of unsolved problems still remain. One of the most relevant issues is the lack of proper vascularization that limits the size of engineered tissues to smaller than clinically relevant dimensions. In particular, the growth of engineered tissue in vitro within bioreactors is plagued with this challenge. Specifically, the tubular perfusion system bioreactor has been used for large scale bone constructs; however these engineered constructs lack inherent vasculature and quickly develop a hypoxic core, where no nutrient exchange can occur, thus leading to cell death. Through the use of 3D printed vascular templates in conjunction with a tubular perfusion system bioreactor, we attempt to create an endothelial cell monolayer on 3D scaffolds that could potentially serve as the foundation of inherent vasculature within these engineered bone grafts

Manganese and Iron-Based Layered Oxide Positive Electrodes for Sodium-Ion Batteries

Electrical energy generation from clean and renewable energy sources is a topic of growing importance, considering the concerns over the environmental impacts and the resource constraints of fossil fuels, combined with the increasing worldwide energy demand. Development of low-cost energy storage systems is necessary to realize economical harvest of energy from intermittent renewable sources, such as the wind and solar energy. Lithium-ion battery, the state-of-the-art energy storage technology, provides high energy density and long cycle life, leading to its extensive use in portable electronic devices and its rapidly increasing application in electric vehicles. However, the large-scale application of electrical energy storage systems, to integrate renewable energy sources into the grid or to supply energy stored from local solar plants in remote areas, calls for important requirements: low-cost, material sustainability, and environmental safety. Lithium-ion batteries are presumed to fail these requirements as their cost is estimated to increase by the growth of electric vehicle market, due to the resource limitations of lithium. Owing to the large abundance of sodium, sodium-ion battery technology is emerging as a promising alternative to the lithium-ion battery for large-scale applications, where sustainability and cost-effectiveness are more important criteria than gravimetric energy. Over the past few years, many efforts have been devoted to the development of sodium-ion batteries, including exploring new materials and novel chemistries and understanding the science underlying those systems. Layered oxides are the most studied and promising materials for the positive electrode in sodium-ion batteries; among them, P2-Na0.67[Mn0.5Fe0.5]O2 has attracted much attention from the research community. P2-Na0.67[Mn0.5Fe0.5]O2 is made from earth-abundant elements and delivers high specific energy, higher than 500 Wh.kg-1, which is comparable to LiFePO4 positive electrode material in lithium-ion batteries. Despite the advantages that P2-Na0.67[Mn0.5Fe0.5]O2 offers, instability in the ambient atmosphere and capacity fading are important challenges that hinder the commercial application of this material. Understanding of those aging mechanisms and implementing tailored cation substitutions to mitigate them have been the objective of this thesis. The instability of layered sodium transition metal oxides in ambient atmosphere is known. The study presented in Chapter 3 shows the important impact of exposure of P2-Na0.67[Mn0.5Fe0.5]O2 to air on its electrochemical performance; this issue was underestimated in the previously reported studies and is probably not limited to this particular material. An air exposed P2-Na0.67[Mn0.5Fe0.5]O2 electrode demonstrates lower capacity and higher voltage polarization compared to an air-protected one. The nature of the reactivity of this material with air is investigated by a combination of thermogravimetric analysis, mass spectrometry, diffraction techniques, electron microscopy, and electrochemical measurements. A mechanism is proposed to describe this reactivity; carbonate anions are formed upon the exposure of the material to CO2, H2O, and O2 in air at room temperature and are inserted into the lattice, balanced by oxidation of Mn3+ ions to Mn4+. The Ni-substituted materials, P2-Na0.67[Mn0.5+yFe0.5-2yNiy]O2 (y = 0.1, 0.15) exhibit lower reactivity, as evidenced by the electrochemical performance. The structural evolutions of P2-Na0.67[Mn0.5Fe0.5]O2 and P2-Na0.67[Mn0.65Fe0.20Ni0.15]O2 induced by electrochemical extraction and insertion of sodium ions upon charge and discharge are investigated by Operando X-ray diffraction measurements (Chapter 4). The materials undergo similar phase transitions: one at high voltage and one at low voltage. The phase emerging at high voltage is investigated by pair distribution function analysis and Mössbauer spectroscopy; the migration of transition metals out of MO2 layers into the interlayer space is proposed to occur at high voltage, induced by the stabilization of Fe4+ ions. The phase transitions are shown to have a detrimental impact on the electrochemical performance of the materials. Similar operando X-ray diffraction characterization, pair distribution function analysis, and electrochemical measurements are performed on P2-Na0.67[Mn0.66Fe0.20Cu0.14]O2 (Chapter 5). P2-Na0.67[Mn0.65Fe0.20Ni0.15]O2 outperforms the parent P2-Na0.67[Mn0.5Fe0.5]O2 and the Cu-substituted composition, owing to its increased structural stability upon cycling and higher specific capacity achieved by Ni2+/Ni4+ redox couple. The redox processes involved in the cycling of P2-Na0.67[Mn0.66Fe0.20Cu0.14]O2 and Na0.67[Mn0.65Fe0.20Ni0.15]O2 are investigated by operando X-ray absorption spectroscopy. The evolution of the local structure of each transition metal upon charge and discharge is probed by the change in the X-ray absorption near-edge structure spectra collected at the transition metal K-edge. The data suggests the reversible contribution of oxide ions to the redox processes at high voltage

Bidirectional Association Between COVID-19 and Mental Health Disorders: A Narrative Review

Background: Fear, anxiety, and stress are natural reactions of the human body to unpredictable and potentially threatening conditions. Currently, individuals are encountering Coronavirus Disease 2019 (COVID-19) pandemic; it is caused by a virulent, partially unknown pathogen with high transmissibility, recognized as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It is conceivable to experience anxiety, stress, and subsequent mental health disorders during the pandemic. This narrative review provided a brief overview of mechanisms involved in COVID-19 and mental health disorders as well as the bidirectional association between them.Methods: Scientific electronic databases, such as PubMed, Scopus, Web of Science, and Google Scholar were thoroughly searched, based on different keywords in this study.Results: Lifestyle changes and isolation for breaking the chain of infection facilitate mental health disorders development more than before. Since the onset of the pandemic, the prevalence of mental health disorders has significantly increased. Moreover, studies suggested that the incidence of COVID-19 and the progression of the disease to a severe and life-threatening stage is higher in individuals with a history of mental health disorders. Inflammation is caused by, also may cause mental health disorders. Besides, COVID-19 is associated with cytokine storm and subsequent inflammation.Conclusion: There seems to be a bidirectional association between COVID-19 and mental health disorders, in which inflammation acts as an adaptor

Visualization of residents in long-term care centres through mobile natural user interfaces (NUI)

In this poster, we present a set of NUI designs towards creating a social media platform for caregivers, which integrates automated analysis methods and natural interaction techniques to enable caregivers to capture, store, visualize, and analyze both formal data and informal information. Our research will evaluate whether NUI’s make a difference in supporting long-term caregivers