ABSTRACT
Background: helicobacter pylori [H. pylori] infection is a major casual factor in any peptic diseases. Clarithromycin as one of the drugs recommended for the infection eradication regimen has shown different levels of resistance. The present study is comparing the effectiveness of clarithromycin- and gemifloxacin - based quadruple regimens in H. pylori eradication
Methods: this was a prospective double blind randomized clinical trial on patients with clear indication of H. pylori eradication. The patients were randomly divided into two groups: "BPAC group" treated with bismuth subcitrate [240 mg], pantoprazole [20 mg], amoxicillin [1 gr], and clarithromycin [500 mg], all twice daily, and the "BPAG group" treated with bismuth subcitrate, pantoprazole, and amoxicillin with same doses as "BPAC group" and gemifloxacin [320 mg daily] all for 10 days. Three months after the end of therapy, 14C-Urea breath test was performed to confirm the eradication. All the patients were assessed for compliance and drug side effects. Based on per-protocol [PP] and intention-to-treat [ITT] methods, data were analyzed and a P value<0.05 was considered as statistically significant. This project has been registered in the Iranian registry of clinical trials [IRCT]
Results: three patients were excluded from the survey and finally, 179 patients [89 patients in BPAC group and 90 patients in BPAG group] including 71[39.66%] men with the mean age of 46.4+/-12.3 years completed the treatment period. The incidence of side effects between the two study groups did not differ significantly. The success rate of BPAC regimen eradication was remarkably greater than BPAG regimen [ITT analysis; 89% vs 77%, respectively; CI 95%: 1.072-5.507, P<0.015 and PP analysis; 91% vs 77.8% respectively; CI 95%:P<0.015]. There was no significant relationship between the demographic features and the eradication results
Conclusion: the results showed that gemifloxacin is not a good alternative for clarithromycin in H. pylorieradication regimens in our region
ABSTRACT
Background: Standard anti-Helicobacter pylori [H. pylori] treatment fails in the eradication of the organism in almost 10-35% of the patients and has different side effects. Recent studies have proposed that probiotic supplementations with or without prebiotic may improve the eradication rate and diminish the side effects, although it is still a controversial issue. We aimed to investigate the effect of probiotic with prebiotic supplementation on the eradication rate and side effects of anti H. pylori quadruple therapy
Methods: 76 patients with a positive biopsy specimen for H. pylori were enrolled. They were randomized to receive quadruple therapy of bismuth, clarithromycin, amoxicillin, and omeprazole for 14 days and also the synbiotic or the placebo. We asked them to answer study questionnaires at the beginning and during the treatment. Finally, urea breath test was done 8 weeks after the treatment
Results: The eradication rate was significantly better in the synbiotic group by intention-to-treat analysis [p<0.05]. Treatment side effects such as diarrhea, nausea, vomiting, epigastric pain, flatulence, constipation, and taste abnormality were similar in both groups but anorexia was significantly better in the synbiotic group [p <0.05]
Conclusion: The eradication rate was significantly better in the synbiotic group by intention-to-treat analysis [p<0.05]. Treatment side effects such as diarrhea, nausea, vomiting, epigastric pain, flatulence, but could improve the eradication by augmenting the treatment tolerance and compliance
ABSTRACT
Background: Currently, it has been demonstrated that gastroesophageal reflux disease [GERD] is one of the most important disorders of the digestive system and the commixture of regular diet has a significant influence on its incidence, symptoms, and prognosis. The purpose of this study was to evaluate the effect of zinc supplementation, in combination with PPIs [Proton pump inhibitors], on the improvement of GERD symptoms
Methods: In a randomized double blind clinical trial, patients with reflux symptoms, who had obtained Reflux Disease Questionnaire [RDQ] score more than 8, were included and all the demographic features were recorded. Then, using upper gastrointestinal [GI] endoscopy, all the patientswere divided into two groups as having non-erosive reflux disorder [NERD],or erosive reflux disorder [ERD]
At the next step, based on random block statistical method, we divided the two groups into two subgroups; the drug subgroup [treated with PPIs [40 mg pantoprazole/daily], changing life style, and 220 mg zinc capsules daily] and the placebo subgroup [treated with PPIs, changing life style, and placebo]. After 3 months, we analyzed all data and the RDQ questionnaire was filled out for each patient. This project has been registered in Iranian Registry of Clinical Trials [IRCT] and all data were analyzed using SPSS software version 2
Results: A total of 140 patients [81 women and 59 men] with mean age of 42.78+/-11.5 years were included with 70 patients in each group. The most frequent presentations were heart burn [45.7%], and acid regurgitation [39.3%]. The RDQ scores decreased after intervention in both drug [p<0.001] and placebo groups [p<0.001], which were statistically significant. But the difference of RDQ scores between the drug group and placebo group was not statistically significant [p=0,086]
Conclusion: Zinc supplementation cannot improve the severity of GERD
ABSTRACT
The geographical incidence of IBD varies considerably. This study aimed to survey the epidemiologic features of IBD in Guilan province, North of Iran, during ten years duration. In this retrospective cross-sectional study, we assessed the documents of 868 patients with IBD referred to private and governmental clinics of Guilan province between 2002 and 2012. Variables such as demographic data, risk factors, diagnosis, extraintestinal manifestations and type of treatment were collected. Among 868 patients with IBD, 756 patients [87.1%] diagnosed as UC and 112 patients [12.9%] as CD. The mean age of patients with UC and CD was 46.73 +/- 15.79 and 40.15 +/- 14.27 years respectively. Male/female ratio in UC and CD was 0.92:1 and 0.75:1 respectively. The most common age of disease initiation in UC was 40-59 years and in CD 20-39 years [p<0.001]. Extraintestinal manifestations were seen in 25.4 percent of patients with IBD. Most of patients were treated with combination of two drugs: salicylates and azathioprine [p<0.04]. The incidence of IBD gradually increased during the past 4 years in Guilan province. This study showed that CD were presented significantly more common in younger patients than UC and totally the disease was slightly more common in female