Effect of Ursodeoxycholic Acid Alone and Ursodeoxycholic Acid Plus Domperidone on Radiolucent Gallstones and Gallbladder Contractility in Humans

Background/Aims. The aim of this study was to compare the effects of ursodeoxycholic acid (UDCA) alone and UDCA plus domperidone on dissolution of solitary or multiple gallstones. Methods. Fifty-three patients with cholesterol gallstones were randomized into three treatment groups: group I (n = 22) was given UDCA (15 mg/kg/day) alone and group II (n = 18) was treated with domperidone (30 mg/day) in addition to UDCA. The control group (n = 13) was followed without a medical treatment. Gallbladder volumes and ejection fractions were measured sonographically in all patients before and after treatment. Results. After 12 months of treatment, stone dissolution was found in 9 (40.9%) of the patients in group I and 7 (38.8%) of the patients in group II. The difference was statistically significant compared to controls in both treatment groups (P < 0.05) but the two groups did not show a difference between each other (P > 0.05). All the patients that achieved dissolution had multiple gallstones except for one patient with a solitary stone in group I. Neither monotherapy of UDCA nor the combination with domperidone affected the ejection fraction of gallbladder. Conclusions. Combination with domperidone did not potentiate the efficacy of UDCA. It has been observed that both UDCA alone and UDCA plus domperidone treatment did not affect ejection fraction of gallbladder

The pain symptoms and mass recurrence rates after ovarian cystectomy or uni/bilateral oophorectomy procedures in patients over 40 years old with endometriosis

Objectives: To evaluate the rates of pain and mass recurrence of the patients over 40 years old with endometriosis who underwent ovarian cystectomy or uni/bilateral oophorectomy. Material and methods: A retrospective study was conducted with 98 patients undergoing laparoscopic surgery for endometriosis in a tertiary referral center between the time period July 2015 and July 2019. All the patients followed every 3 months and requested to fill the Visual Analogue Scale (VAS) for evaluation of pelvic pain and an ultrasound scan was performed. The inclusion criteria for this study were as follows, patients with ages over 40, with regular menstrual periods, and who denied hysterectomy and any postoperative hormonal medical treatments. Results: When the groups were compared in terms of age, body mass index, cyst diameter, CA-125 serum concentrations, preoperative and after surgical pelvic pain scores, mean follow up periods, postoperative hospital stay. However, each of the mean numbers of gravidity and parity were significantly higher than bilateral salpingo-oophorectomy (BSO) groups compared to the other groups (p = 0.04 and p = 0.03, respectively). The laterality, the recurrence rates, and the type of recurrence did not have a significant effect in the group comparison. Conclusions: The ovarian tissue preserving procedures could be offered for the women over 40 years old suffering from endometriosis with no significant increase in pain symptom or mass recurrence rates considering beneficial effects of estrogen on cardiovascular system, vasomotor symptoms, and bone mineral density

Determination of resilience factors in individuals who tested COVID-19 positive

The main purpose of this study was to determine the protective factors that can aid people in their recovery or help maintain their well-being in the face of collective adversity, in this case, the COVID-19 pandemic, and to examine how these factors can be further strengthened. The study included 89 participants from 14 different cities in Turkey, ranging in age from 18 to 70, 46 of them men and 43 women. In light of the findings of the study, it can be said that psychosocial support and re-adaptation programmes are needed to ease the social-emotional burden of living through a pandemic on individuals (especially those who survived the virus) even after the COVID-19 pandemic ends

Measurement of choroid thickness in pregnant women using enhanced depth imaging optical coherence tomography

Objetivo: Investigar a espessura da coroide em gestantes saudáveis durante os diferentes trimestres utilizando tomografia de coerência óptica com profundidade de imagem aprimorada (EDI-OCT). Métodos: Este estudo prospectivo incluiu 90 gestantes saudáveis nos primeiro, segundo e terceiro trimestres da gravidez (grupos 1, 2 e 3, respectivamente) e 30 mulheres saudáveis não-gestantes (grupo 4) com faixa etária de 18-40 anos de idade. Foi realizada tomografia de coerência óptica espectral para estimar a espessura média da coroide. A espessura da coroide foi medida manualmente da borda externa do epitélio pigmentar da retina até o limite interno da esclera nas regiões subfoveal, 3 mm temporal e 3 mm nasal à fóvea utilizando EDI-OCT. As diferenças entre os grupos foram analisadas com o teste ANOVA unicaudal. Resultados: Houve diferença estatística significativa na espessura média da coroide entre os grupos 2 e 4 nas regiões subfoveal, temporal e nasal à fóvea (p=0,007; p<0,001; p=0,026, respectivamente). A espessura média da coroide no grupo 2 foi: 395 ± 80 µm, 338 ± 77 µm e 233 ± 61 µm nas regiões subfoveal, temporal e nasal à fóvea, respectivamente. Em comparação, a espessura média da coroide no grupo 4 foi de: 335 ± 86 µm, 275 ± 54 µm e 200 ± 53 µm, nas regiões subfoveal, temporal e nasal à fóvea, respectivamente. Não foi encontrada diferença estatística significativa entre os grupos 1-4 (p=0,214, p=0,177, p=0,094, respectivamente) e os grupos 3-4 (p=0,105, p=0,261, p=0,695 respectivamente), para todas as medidas. Conclusão: Nossos resultados sugerem que há espessamento da coroide nas regiões subfoveal, temporal e nasal à fóvea no segundo trimestre gestacional

Effect of clopidogrel on the hydroxylation and sulfoxidation of omeprazole

Based upon the known potential interaction between omeprazole (OMP) and clopidogrel (CLOP), the current study was designed to evaluate the effect of CLOP on disposition of OMP and its two major metabolites, 5-hy- droxyomeprazole (5-OH-OMP) and omeprazole sulfone (OMP-S) in healthy clinical subjects. A randomized, open label, 2-period, crossover study was designed. Twelve volunteers were selected, of whom eight were extensive metabolizers (EM) of CYP2C19 and 4 were poor metabolizers (PM). They received single dose of OMP either alone or in combination with CLOP (single dose) and samples were collected periodically to calculate various pharmacokinetic parameters. Changes in most of the pharmacokinetic parameters of OMP, 5-OH-OMP and OMP- S were insignificant (P ˃ 0.05) both in EM and PM except for the maximum concentration (Cmax) of 5-OH-OMP and OMP-S in EM. The OMP Cmax and AUC0-∞ was increased both in EM and PM after concomitant administration of OMP with CLOP. The 5-OH-OMP Cmax was decreased in both EM and PM, demonstrating that CLOP inhibits hydroxylation of OMP. The OMP-S Cmax and AUC0-∞ were increased both in EM and PM showing that CLOP may induce sulfoxidation of OMP. It was concluded that CLOP may inhibit hydroxylation of OMP to a greater extent in EM than in PM, leading to higher OMP Cmax and AUC0-∞. Furthermore, the sulfoxidation of OMP may also be induced by CLOP. So, it is suggested that both these drugs should be carefull prescribed together to avoid any harm to the patients. (Application number13/EC/Pharm. Ref number 12/Pharm)

Short-term Efficacy of Dienogest in Improving Pain in Patients with Endometriosis: A Single-center Experience

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Evaluation of peripapillary choroidal and retinal nerve fiber layer thickness in eyes with tilted optic disc

Purpose: This study was performed to evaluate the retinal nerve fiber layer (RNFL) and peripapillary choroidal thickness in eyes with tilted optic disc in order to identify characteristic RNFL and peripapillary choroid patterns verified by optical coherence tomography (OCT). Methods: Twenty-nine eyes of 29 patients with tilted optic discs were studied with spectral-domain (SD)-OCT and compared with age and sex-matched control subjects in a prospective design. The imaging of RNFL was performed using circular scans of a diameter of 3.4 mm around the optic disc using OCT. For measurements of peripapillary choroidal thickness, the standar d protocol for RNFL assessment was performed. Results: SD-OCT indicated significantly lower superotemporal (p<0.001), superonasal (p=0.001), and global (p=0.005) RNFL thicknesses in the tilted disc group than those of the control group. Peripapillary choroid was significantly thicker at the site of the elevated rim of eyes with tilted disc (p<0.001). Conclusion: This study demonstrated a clinical characterization of the main tilted disc morphologies that may be helpful in differentiating a tilted disc from other altered disc morphologies. Further studies are recommended to study the comparison between glaucoma and tilted disc groups

Validated and optimized RP-HPLC method for the simultaneous quantification of meloxicam and its major metabolites in biological fluids with liquid liquid and solid phase extraction technique

Meloxicam is the most commonly prescribed non-steroidal anti-inflammatory drug. In this study, a simple, rapid and cost-effective method for the analysis of meloxicam and its major metabolites (5-hydroxy meloxicam and 5-carboxy meloxicam) in biological fluids (human plasma, urine and saliva) was developed and validated using RP-HPLC coupled with UV detector. The samples were analyzed by injecting 20 μl into the HPLC system using supelco analytical C18 (150 mm ×4.6 mm, 5 μm) column, protected by a C18 (30 mm×4.6 mm, 10 μm) Perkin Elmer, guard column. The mobile phase methanol: TFA (0.05% aqueous solution) in 60:40%v/v was pumped with a flow rate of 1.3 mL/min at ambient temperature and the eluents were checked at 353nm using Piroxicam as internal standard. Meloxicam and the metabolites were extracted from biological fluids using dichloromethane and the percent recovery for meloxicam, 5-hydroxy meloxicam and 5- carboxy meloxicam were 98.8%, 97.3%, 97% in plasma, 99%, 98.6%, 95.1% in urine and 95.8%, 92.9%, 92.7% in saliva, respectively. The limits of detection of meloxicam, 5-hydroxy meloxicam and 5-carboxy meloxicam were 3 ng, 10 ng and 8 ng, whereas limit of quantification were 9 ng, 30 ng and 25 ng, respectively. The method was linear over the concentration range of 10 - 2000 ng/mL for meloxicam, 30 - 1000 ng/mL, 25 - 1000 ng/mL for 5-hydroxy meloxicam and 5-carboxy meloxicam, respectively. The developed method was validated according to standard guidelines, various experimental parameters and chromatographic conditions such as mobile phase composition, flow rate, linearity, accuracy, precision, sensitivity etc. were optimized and were successfully applied for the pharmacokinetic studies in the plasma samples of the healthy human volunteers

Comparison of the efficacy of once- and twice-daily colchicine dosage in pediatric patients with familial Mediterranean fever - a randomized controlled noninferiority trial

Background: In this study, we examined the efficacy and safety of a once-daily dosage schema of colchicine compared with a twice-daily dosage schema in pediatric patients with familial Mediterranean fever (FMF). Methods: In this 24-week, multicenter, randomized controlled noninferiority trial, pediatric patients newly diagnosed with FMF carrying a homozygous or compound heterozygous mutation and not receiving any treatment were included. Patients were randomly assigned using a block randomization method to receive treatment with a once- or twice-daily dosage. Clinical and laboratory characteristics and medication side effects were recorded and compared between groups. The study was carried out in compliance with Good Clinical Practice and the Consolidated Standards for Reporting of Trials (CONSORT) statement. Results: A total of 92 patients were selected, and 79 patients completed the study. There were 42 patients in the once-daily dosage group and 37 in the twice-daily dosage group. The results indicated that the once-daily dosage was not inferior to the twice-daily dosage regarding decrease in attack frequency and duration as well as improvement in clinical findings and Mor severity scores. Alterations in laboratory findings indicating inflammation, such as erythrocyte sedimentation rate, C-reactive protein, and serum amyloid A, were similar in both groups. The rates of drug side effects were similar between the once- and twice-daily dosage groups, implying comparable safety of colchicine, with the exception of diarrhea, which was slightly higher in the once-daily dosage group. Conclusions: Using colchicine with either a once- or twice-daily dosage provides similar clinical and laboratory improvements. Considering both efficacy and safety, colchicine can be prescribed with a once-daily dosage. Trial Registration ID: ClinicalTrials.gov identifier NCT02602028. Registered 5 November 2015