ABSTRACT
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. 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. 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
ABSTRACT
This study was aimed to evaluate symptomatic as well as histopathologic response to GFD in patients with gluten-sensitive enteropathies including celiac disease, lymphocytic duodenosis and non-specific duodenitis. Gluten-free diet [GFD] is the main treatment of celiac disease. However, its impact on other disorders of gluten sensitivity spectrum is less clear. In a prospective observational study in Modarres hospital Tehran, Iran, 35 patients with chronic manifestations including low BMI, diarrhea, greasy stool and bloating were evaluated using serology for anti-tTG, endoscopy and histopathology. Patients were categorized in three diagnostic groups accordingly including celiac disease [CD], lymphocytic doudenosis [LD] and non-specific duodenitis [NSD]. All patients were put on a GFD for 6 months, and subjective symptomatic response, serology, endoscopy and histopathologic tests were repeated and compared with baselines and among groups. Of the total 35 patients, 5 had CD [14.3%], 9 had LD [25.7%] and 21 [60%] had NSD. Bloating was the most common symptom followed by diarrhea. Majority of patients [80%] had low BMI. All symptoms alleviated following a GFD but bloating was the only significant one. A significant increase was found in total mean BMI [17.3+/-0.7 v.s. 17.9+/-0.9]. Histopathologic examination showed a complete resolution in 48.5% [n=17] patients, 10 in NSD group, 4 in LD group and 3 in CD group. Final prevalence of gluten-sensitive enteropathy [LD and NSD cases that responded to GFD] was 46.6%. GFD may have more implications other than celiac disease. Other gluten-sensitive enteropathies, like LD and NSD, might also respond to this treatment particularly in patients with low BMI
Subject(s)
Humans , Male , Female , Celiac Disease/diet therapy , Prospective Studies , DuodenitisABSTRACT
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