[Comparison between quadruple therapy and triple therapy for eradication of Helicobacter pylori in patients with chronic dyspepsia]

Helicobacter pylori treatment is advised in all cases of chronic dyspepsia recently but despite several new drugs, treatment failure is probable yet and the choice method to eradicate Hpylori is contraversial. We studied all patients with chronic dyspepsia who referred to endoscopic ward of Imam Reza hospital. After demonstration of Helicobacter pylori infection by rapid urea's test [RUT], these cases were divided into two groups randomly. The first group was treated by Metronidazole, Amoxicillin and Omeprazole and the second group was treated by previous drugs plus Bismuth Substrate for 2 weeks. Then drug side effects were asked during the first and second week and Helicobacter pylori eradication was evaluated by UBT [Urea Breath test] six weeks after the treatment. Among 56 cases in this study 39.3% were male and 60.7% were female and 41-50 years cases were more frequent. 27 cases [48.2%] were treated by triple therapy and 29 patients [51.8%] were treated by quadruple therapy. Most common symptoms during the first week were abdominal pain and flatulence but during the second week the common side effect was flatulence. Although, treatment side effects were rare in the second week and only 25% of patients had significant symptom. Finally the total treatment success rate was 49% and Helicobacter pylori was eradicated according to UBT in 50% by triple therapy and 48% by quadruple therapy. The difference between two methods was not significant, although treatment success ratio was higher in young people. Triple therapy [Omeprazole, Amoxicillin and Metronidazole] is an effective regimen for the first line therapy in eradication of Helicobacter pylori especially in young people

[Two cases of hepatotoxicity due to ketokonazole]

Ketoconazole is an antifungal agent of Imidazole group which is used in different parts of the body, such as skin, nails, vagina, and etc. Hepatotoxicity is one of its potentially fatal complications which can be manifested as cholestasis, hepatitis, and fulminant hepatic failure. Hepatic complications of this drug are usually started during 6 weeks, but also they have been reported up to 6 months after the treatment. If the LFT changes are mild, the treatment can be continued cautiously, however, it is necessary to stop it evident hepatitis and jaundice are to be occurred. In this group, Fluconazole as a new agent doesn't have severe hepatic complications, so it is preferred in many cases. In this study two cases of 36 year old women, died because of fulminant hepatic failure due to Ketoconazole induced hepatitis are reported. In both cases, viral and autoimmune hepatitis have been ruled out. Despite the rarity and irreversibility of Ketoconazole induced fulminant hepatic failure, it is essential in most cases to pay attention to the hepatotoxicity symptoms carefully

[Comparing the incidence and intensity of constipation in pregnant house wives and workers who refered to health centers in boujnord in 2001]

Constipation occurs in 11- 40 pregnant women and has side effects like hemorrhoid, fissure, depression and anorexia. Because of the believe in movement and hyper activity with decreasing effect, in pregnant employed women and tension of the job with increasing effect in contrast with housewives and also lack of research in this field, this research is accomplished by the objective of comparing the occurrence and intensity of constipation in pregnant housewives and employed women. This analytic, profile sectional research was done on 150 pregnant employed women and 310 pregnant housewives that each group is in three different sections, in first, second and third trisemester of pregnancy and has become constipated for at least 2 weeks and with no diseases, no medical therapy, and no suitable condition for constipation in the winter of 2000. Sampling was done by multi-stages method and data was gathered by utilizing interview form and measuring the rate of constipation by researcher for both of two groups in the health care center and gynecologist offices. Data was analyzed by using of descriptive and analytical statistics by X2 test, on way analysis of variance, log-linear and co-variance analysis by% 95 coefficients, and utilizing SPSS software Rate of occurrence in employed women was 32.6 percent and in housewives%20.9, so there was a significant difference between two groups [p= 0.009], the constipation occurrence mean in employed women group was 15.9 + 6.6 and in housewives 12.23 + 4.14 then, there were significant differences between two groups as well [p= 0.01]. Also chance of constipation occurrence in pregnant employed women was doubled in contrast with housewives [raods Ratio = 2]. Job should be considered as "risk factor" in pregnancy constipation. So researchers propose doing similar researches by provident method prospective and study of manner of job -effect on this process