ABSTRACT
Aim: This study was aimed to evaluating the efficacy of levofloxacin based sequential therapy vs clarithromycin based sequential therapy in h.pylori [HP] eradication
Background: Several therapeutic regimen were investigated to treat HP infection. Sequential therapy is an alternative to classic triple therapy
Methods: In this randomized clinical trial, 200 HP infected patients randomly divided into two therapeutic groups .1-Levofloxacin based sequential regimen [group A]; omeprazole and amoxicillin for 7days followed by omeprazole, amoxicillin and levofloxacin for 7days. 2-clarithromycin based sequential regimen [group B]: omeprazole and amoxicillin for 7days followed by omeprazole, amoxicillin and clarithromycin for 7days. HP eradication was evaluated with urea breath test with carbon 13 [UBT] 6 weeks after the end of treatment
Results: Per protocol eradication rates of group A and B were 87.6% and 76% respectively. By intention to treat analysis, eradication rate of group A and B groups were 85.1% and 73% respectively. Levofloxacin based sequential regimen was more effective than clarithromycin based sequential regimen [Pv=0.028]. Adverse events were seen in 19.6% and 15.6% in group A and B respectively. Drug compliance was 97% in group A and 96% in group B. There was no significant difference between two groups in term of adverse events [p=0.470] and compliance [p=0.651]
Conclusion: Levofluxacin based sequential therapy was more effective than Clarithromycin based sequential therapy in HP eradication. The suggested Levofluxacin based sequential therapy could be an alternative therapy in area with high clarithromycin resistance. Further studies are needed to confirm these findings
ABSTRACT
Background: Obesity results in a chronic inflammatory state leading to long term adverse effects. The aim of this study is to evaluate effect of low calorie diet and weight loss on serum level of inflammatory markers in patients with fatty liver disease in Iranian population
Methods: In a clinical trial, 40 patients with fatty liver disease in Gastro-hepathology clinic of Tabriz Imam Reza hospital were introduced to receive a low calorie diet. Serum level of proinflammatory factors [IL-1, IL-6, TNF-alpha and Hs-CRP] were measured and compared before and after an 8 week trial of diet
Results: The mean age of the patients was 45.36+/-10.51 years [range: 23-70]. Nine [22.5%] patients were male and 41 [77.5%] was females. The mean value of weight and body mass index of participants decreased significantly after 8 weeks [a mean decrease of 6.47+/- 3.40 percent in weight]. Weight loss in men was significantly more than women. The mean level of IL-1, IL-6, TNF-alpha and Hs-CRP was significantly decreased after weight loss in both men and women. There was no correlation between amount of weight loss with degree of decrease in inflammatory markers. Decrease of TNF-alpha was significantly more in younger patients
Conclusion: Weight loss with low calorie diet can decrease the level of IL-1, IL-6, TNF-alpha and Hs-CRP of patients with fatty liver during 8 weeks independent from gender and degree of weight loss