Microsatellite instability markers status in colorectal cancer

Colorectal cancer [CRC] is the third most prevalent and the third leading cause of cancer-related deaths in Iran. Our aim was to investigate five mononucleotide statuses among Iranian patients with sporadic colorectal cancer. In this experimental study investigation 80 sporadic CRC patients were evaluated for Microsatellite instability [MSI]. The pentaplex panel including 5 quasi mononucleotide microsatellite markers [NR-21, BAT-26, BAT-25, NR-27 and NR-24] was used. The MSI analysis was performed on paired tumoral DNA from cancerous tissues and genomic DNA from whole blood. MSI carriers were identified by analysis of tumor tissue using polymerase chain reaction. Our findings showed that microsatellite instability was detected in 36 of 80 cases [45%] with colorectal cancer. MSI analysis revealed that 17 cases of MSI-H [21%], 19 MSI-L [23%] and 44 MSS [55%]. Instability is observed in the tumoral DNA compared to the DNA from the normal DNA sample. The most instable markers were NR-21, NR-24 in which instability was detected in 45% of patients. Using a panel including 3 mentioned MSI markers should be more promising markers for identifying MSI status in patients with sporadic colorectal cancer

Penbactam for Helicobacter pylori eradication: a randomised comparison of quadruple and triple treatment schedules in an Iranian population

Selection of the best drug regimens for eradication of Helicobacter pylori infection especially in patients at risk of peptic ulcer relapses and the development of complications is challenging. This study assessed and compared the efficacy of the two common PPI based triple therapies to a quadruple therapy including PPI, metronidazole, amoxicillin and a bismuth compound in Iranian population. Three hundred and thirty patients with peptic ulcer and H. pylori infection were included in the study. Patients were randomly assigned to one of the three treatment protocols all given twice daily: [a] A 14-day quadruple therapy [OMAB group] comprising omeprazole 20 mg, metronicazole 500 mg, amoxicillin 1 g, and bismuth subcitrate 240 mg; [b] A 14-day triple regimen [OCP group] comprising omeprazole 20 mg plus clarithromycine 500 mg and penbactam 750 mg and [c] A 14-day triple regimen [OCA group] comprising omeprazole 20 mg plus clarithromycine 500 mg and amoxicillin 1 g. Cure was defined as a negative urea breath test at least six weeks after treatment. The per-protocol eradication rates achieved with both OCP regimen [87.0%] and OCA treatment [90.8%] were significantly higher than the OMAB treatment protocol [56.0%]; however, no significant difference emerged in eradication rates between the two triple treatment schedules. No significant differences between the groups were found in most side-effects. Two-week quadruple therapy showed a lower eradication rate compared to common triple treatment schedules when used as first-line eradication treatment for H. pylori infection in Iranian population

Correlation between creatinine clearance and Helicobacter pylori infection eradication with sequential and triple therapeutic regimens: a randomised clinical trial

Uraemic patients show susceptibility to gastrointestinal mucosal lesions and colonisation by Helicobacter pylori [HP]. Antibiotic resistance constitutes a problem in treatment and bismuth preparations are toxic in uraemic patients. This study aimed to assess the correlation between creatinine clearance [CrCl] and eradication of HP infection with new sequential and standard triple therapeutic regimens. A total of 120 HP-positive patients with renal function impairment and 60 control patients with HP infection were enrolled in this study. Patients were divided into four groups on the basis of CrCl and were randomly assigned to one of the two different regimens: A 14-day standard triple therapy with 20 mg omeprazole bid, 1000 mg amoxicillin bid and 500 mg clarithromycin bid and a new sequential regimen with 20 mg omeprazole bid and 1000 mg amoxicillin bid both for 14 days, 500 mg ciprofloxacin bid for the first 7 days and 200 mg furazolidone bid for the last 7 days. Doses of amoxicillin, clarithromycin and ciprofloxacin were reduced to 50% in the cases of CrCl <30 mg dl[-1] One hundred and sixty two out of 180 HP-positive patients [54.3% male, 51.6 +/- 12.1 years] completed treatment in the four groups and were studied. According to renal function they were classified into group A [n = 39], haemodialysis [HD] patients; group B [n = 37], CrCl <30 mg dl[-1] without HD; group C [n = 36], CrCl between 30 and 60 mg dl[-1]; and group D [n = 50], control subjects with CrCl >90 mg dl[-1]. HP was successfully eradicated in 77.7% of patients with standard triple therapy and in 81.4% of patients with the sequential therapy. There was no significant difference among the study groups in the rate of HP-infection eradication with both regimens. HP eradication rates did not differ with both sequential and standard therapeutic regimens in uraemic and non-uraemic patients. We, therefore, prefer the standard triple therapy due to its simplicity and reported

Quadruple versus common triple-treatment regimens for Helicobacter pylori eradication in the Iranian population: a randomized study

Selection of the best drug regimens for effective eradication of Helicobacter pylori [H.pylori] infection, especially in patients at risk of peptic ulcer relapses and development of complications of peptic ulcer disease, is challenging. This study assessed and compared the efficacy of the two common proton pump inhibitor [PPI]-based triple therapies to a quadruple therapy including PPI, metronidazole, amoxicillin and a bismuth compound in Iranian population. A total of 330 patients with peptic ulcer and H. pylori infection were included in the study. Patients were randomly assigned to one of the three treatment protocols: [1] a 14-day quadruple therapy [OMAB group] comprising omeprazole 20 mg, metronidazole 500 mg, amoxicillin 1g and bismuth subcitrate 240 mg; [2] a 14-day triple regimen [OCP group] comprising omeprazole 20 mg plus clarithromycin 500 mg and penbactam 750 mg; and [3] a 14-day triple regimen [OCA group] comprising omeprazole 20 mg plus clarithromycin 500 mg and amoxicillin 1 g, all given twice daily. Cure was defined as a negative urea breath test at least 6 weeks after treatment. The intention-to-treat H.pylori eradication rates achieved with both OCP regimen [87.0%] and OCA treatment [88.8%] were significantly higher than the OMAB treatment protocol [56.0%]; however, no significant difference emerged in eradication rates between the two triple-treatment schedules. No significant differences were found in most side effects between the groups. Two-week quadruple therapy showed a lower eradication rate compared with common triple-treatment schedules when used as a first-line eradication treatment for H.pylori infection in the Iranian population

Evaluation of Helicobacter pylori and laryngeal lesions in patients undergoing direct laryngoscopy and biopsy in Taleghani hospital between 2008 and 2009

Few studies have evaluated association of Helicobacter pylori with benign and malignant laryngeal lesions. The aim of this study was to evaluate the coexistence of Helicobacter pylori with laryngeal lesions in patients with laryngeal growths, admitted in Taleghani hospital. In this cross-sectional study, all patients referred to ENT ward of Taleghani hospital for direct laryngoscopy and biopsy were evaluated. Biopsied specimens were sent for histologic evaluation and PCR [Polymerase Chain Reaction] to the Research Center for Gastroenterology and Liver diseases. PCR was used to detect Helicobacter pylori in biopsied specimens. Fifty-nine patients with a mean age of 46.1 +/- 18.3 years were evaluated. 27 patients had malignant laryngeal lesions and 32 had benign laryngeal lesions. The frequency of Helicobacter pylori in the malignant and benign group was 29.6 and 15.6 percent, respectively; the difference was statistically non-significant. However, a correlation was found between malignant laryngeal tumors with male gender, alcohol consumption, smoking and opioid usage. Findings of this study failed to find an association between the presence of Helicobacter Pylori and laryngeal cancers

Frequency of hepatitis C in patients with rheumatoid arthritis

Hepatitis C virus [HCV] infection has been explained as a disease that sometimes present with rheumatic manifestations indistinguishable from rheumatoid arthritis. This study has been performed to evaluate the frequency of hepatitis C virus infection in a group of patients with rheumatoid arthritis. In this study, during one year, serum samples collected from two hundred consecutive patients with rheumatoid arthritis in all affiliated hospitals of Shaheed Beheshti University, MC., were examined for anti-HCV antibody and HCV-RNA by ELISA and RT-PCR method, respectively. Using a questionnaire, the frequency of HCV infection, age and sex distribution, duration of rheumatoid arthritis, associated immune mediated disorders and risk factors for hepatitis C virus infection were assessed. A total of 200 patients [M/F=26/174] who were mainly aged 51-70 years were studied. The frequency of HCV was found to be 2% [95%CI: 0.6-7%]. All of the infected persons have had a low risk occupation in terms of exposure to the virus and none of them had HCV risk factors. No associated immune mediated disorder was found in HCV infected patients. Our results did not support any contribution of HCV infection in the pathogenesis of rheumatoid arthriti

Hemochromatosis gene [HFE] mutations in patients with type 2 diabetes and their control group in an Iranian population

To assess the frequency of 2 different forms of hemochromatosis HFE gene mutations C282Y and H63D mutations in a normal population in comparison with type 2 diabetic patients. This case control study was undertaken in Zanjan Diabetic Care Center, Zanjan, western Tehran, in 2005. Two hundred and two individuals were included in this study: 101 type 2 diabetes mellitus T2DM patients, and 101 age, and gender-matched controls. The patients were examined for mutations in the HFE gene. Nucleotide 845 C282Y and 187 H63D alleles were amplified by polymerase chain reaction PCR with lymphocyte deoxy-ribonucleic acid. The PCR products were analyzed by restriction enzyme digestion. Chi-square, student's t test, and Fisher's exact tests were used for comparison, and odds' ratio was calculated. Two hundred and two individuals were studied. The frequency of wild/C282Y alleles was 98/2% in T2DM patients, and 99/1% in controls p=0.6. The frequency of wild/H63D alleles was 68.3/31.7% in diabetics p=0.08, and 73.4/26.3% in control subjects p=0.08. The distribution of genotypes was not statistically different. Based on our data, HFE mutations were not found in excess in patients with T2DM, and there was no evidence that a population-based search for an excess of these alleles in type 2 diabetes was indicated