Cardiometabolic protective effects of some medicinal plants in diabetic albino rats

Background and aim of the study: DM represents an important independent risk factor for the development of and mortality from coronary heart disease [CHD], increasing the risk by 2 to 4 times. According to WHO data, more than 75% of patients with DM die due to vascular accidents. This study investigated the effects of some plants used in Saudi Arabia and some other Arab countries as antidiabetic agents and explores its metabolic effects

Material and Methods: One hundred fifty adult male Albino Rats were divided into six experimental groups each consist of twenty five rats. The first group was considered as a control group. The rest of groups were affected by induction of experimental diabetes by subcutaneous injection of Alloxan. The second group consisted of diabetic rats without any treatment. The third group was treated by the aqueous extract of mixture contains Foenugreek, Nigella sativa and Termis seeds. The fourth group was treated with the aqueous extract of Nigella sativa seeds [100 mg / kg of body weight], while the fifth group was treated with the aqueous extract of Foenugreek seeds [100 mg / kg of body weight]. The sixth one was treated with the aqueous extract of Termis seeds [100 mg/kg body weight]. After four weeks of treatment, different biochemical parameters were performed including estimation of blood sugar level and serum insulin level. Pancreatic and liver samples were obtained and processed for microscopic and quantitative evaluation after staining the prepared sections with both Heamatoxylin and Eosin as well as special stain for demonstration of the different pancreatic cells in the Islet of the Langerhans

Results: The usage of the mixture or each plant alone corrected the glucose level and insulin level. Microscopically there was definite decrease in the number and diameter of beta pancreatic cells in the diabetic group while the other pancreatic cells were not affected [alpha and delta cells]. The use of medicinal plants in the different groups of this study greatly improved such cellular changes and the level of blood sugar level was corrected. Also, improve dyslipidemia present in diabetic rats. The results showed that the activity of the mixture was better when compared with Nigella, Foenugreek or Termis seeds alone

Conclusions: The water extract of the mixture is the most powerful in amelioration hyperglycemia and most of all damage effects of Alloxan on hematological parameters and lipid profile. Also, it can control most of the metabolic risk factors of CAD in diabetic rats. So it is advised to use the plant mixture as an antidiabetic agent rather than the use of each plant separately. Repeating such study with the use of variable doses may be helpful in better evaluation for the required dose

Effect of triple therapy for helicobacter pylori eradication on hepatic encephalopathy: a randomized controlled trial

Helicobacter pylori [H. pylori] infection could potentially contribute to the development and severity of hepatic encephalopathy due to strong urease activity in the stomach of H. pylori infected cirrhotic patients. To assess the effect of triple eradication therapy for H. pylori on hepatic encephalopathy. Open randomized controlled clinical trial with 4 arms. liver diseases unit in Suez Canal University Hospital - tertiary care. Forty four Hp+ [Group 1] and 44 Hp- patients [Group 2] [based on rapid urease test of gastric biopsy] with hepatic encephalopathy grade 1 - 3. Triple eradication therapy for H. pylori versus standard treatment for hepatic encephalopathy in group 1 and antimicrobial therapy [without Omeprazole] versus standard treatment in group 2 for 14 days. Blind assessment of the grade of encephalopathy before and within three days from end of treatment. One grade improvement was considered treatment success. Success rate was 18.2% in standard treatment and 63.6% in triple therapy [p< 0.001] in H pylori positive. While in H. pylori negative patients the success was 9.1% in standard treatment versus 59.1% [P< 0.001] in and antimicrobial therapy. Success rate was not significantly different between standard treatment or between triple therapy and antimicrobial therapy among both groups. Among other factors in logistic regression models both triple therapy [OR: 1.03<6.22<37.69, P= 0.047] and antimicrobial therapy [OR: 2.09<11.42<59.46, P= 0.02] were significant predictors of success in the respective groups. Both triple eradication therapy for H. pylori and antimicrobial therapy only, equally improve the outcome of management of hepatic encephalopathy. The improvement may be attributed to the effect of antimicrobial therapy on ammonia producing gut flora rather than H. pylori eradication. H pylori eradication therapy adds no benefit in hepatic encephalopathy

Upper gastrointestinal bleeding in Ismailia: agreement between clinical and endoscopic diagnosis

Thorough detailed history and clinical examinations were obtained, and early upper gastrointestinal endoscopy was performed to 632 patients presenting with upper gastrointestinal bleeding to determine the bleeding source. The Chi-square test, the student t test and Mannwitney test were used where appropriate. A "p" value less than 0.05 was considered to be significant. The statistic Kappa was computed to quantify the extent of agreement beyond chance between the clinical and endoscopic diagnosis of the bleeding source. Esophageal varices was found to be the most common source of bleeding. Duodenal ulcer and gastric ulcer occurred with decreasing frequencies. 32% of patients had more than one potential bleeding site, emphasizing the need to anticipate more than one lesion at endoscopy in patients with upper gastrointestinal bleeding and the importance of early endoscopy to identify the bleeding source. No source of bleeding was apparent in 6.7% of cases. Kappa was only 0.58 emphasising that clinical system is not able to discriminate well between the disease categories. Patients with bleeding esophageal varices were significantly younger than non variceal bleeders [36.8 +/- 12 years and 51.8 +/- 18 years, respectively]. About 86% of patients with bleeding varices and 39% of those with non-variceal source of bleeding were rural [p < 0.05]. There was a tendency for upper gastrointestinal bleeding to occur more often in the winter months regardless of the cause. The overall mortality rate was 21.4%. It was higher [29.4%] in patients with varices compared with non variceal bleeders [6.4%]. Liver status, mode of presentation and severity and activity of bleeding at presentation were fount to be predictors to the hospital outcome