RESUMO
Patients with liver cirrhosis are frequently prone to dyspeptic symptoms. The exact cause of these symptoms is unknown. GIT hormones were suggested to have a role in dyspepsia in these patients. The aim of this study was to evaluate the role of vasoactive intestinal polypeptides [VIP] and gastrin in dyspeptic symptoms in cirrhotic patients, and their impaction on the occurrence of esophageal motility disorders and GERD in such patients. Three groups of patients were included in this study, group I includes 20 cirrhotic dyspeptic patients, group 11 includes 10 cirrhotic asymptomatic patients and group III includes 10 non-cirrhotic patients with dyspepsia. Upper GIT endoscopy, 24 hour ambulatory esophageal PH monitoring, esophageal manometric study, and estimation of gastrin and VIP serum levels were done to all patient groups. GERD [acid score > 22] was found in 16[80%], 5 [50%] and 3 [30%] in groups I, I1 and III, respectively with a statistically significant difference between the groups. Serum gastrin and VIP were found to be elevated in group I [175.4 +/- 41.9 and 15,l +/- 3.8] compared with groups II and III [150.7 +/- 35.1 , 9.2 +/- 3.2 and 101.7 +/- 33.3 , 533 +/- 2.5, respectively] with a statistically significant increase in symptomatic cirrhotic patients compared with asymptomatic cirrhotic and symptomatic non-cirrhotic patients. Non-specific esophageal motility disorders [NEMD] was found in 7 [35%], 2 [20%] and 3 [30%] in groups I, II and XII respectively. There are positive correlation between VIP and gastrin and negative correlation between pH and both VIP and gastrin. In conclusion, dyspepsia in cirrhotic patients may ba attributed to elevated GIT hormones as these hormones are elevated in cirrhotic symptomatic patients co~nparcd to, asy~nptomntic cirrhotic paticnts and symptomatic non-cirrhotic patients with dyspepsia. These symptoms are due to increased incidence of GERD, NEMD in cirrhotic symptomatic patients and increased gastric acid production due to elevated serum gastrin. The increased VIP s e m level has an inhibitory effect on GIT motility sharing in dyspeptic symptoms
RESUMO
Cisplatin [CDDP] is a widely used chemotherapeutic agent. However, it results in severe oto and nephro-toxicity. Sodium thiosulphate [STS] and melatonin were suggested to protect against CDDP-induced toxicity. This study was carried out to evaluate the effect of both agents on this toxicity. Seventy adult albino rats were comprised in this work they were classified into seven groups each involved ten rats. The first group received nothing [negative control]. The second, third and fourth groups received intraperitoneally one milliliter distilled water [positive control], STS [800 mg/kg/day] and melatonin [5 mg/ kg/day], respectively. The fifth group received CDDP [5 mg/kg/week] alone, sixth group concurrently received CDDP and STS and the seventh group is co-treated with CDDP and melatonin. After 6 weeks for all rats glutathione [GSH], glutathione reductase [GR], catalase [CAT], supperoxide dismutase [SOD], malondialdehyde [MDA] as an index of lipid peroxidation, blood urea and serum creatinine were determined spectrophotometrically. Also, histopathological examination of the cochlea of the inner ear and renal tissue was carried out. The results revealed that CDDP induced elevation of urea, creatinine and MDA, and decreased GSH and antioxidant enzymes. These biochemical changes were associated with severe damage in cochleas and renal tubules. No significant changes were found with STS and melatonin when received alone. With the use of STS and melatonin with CDDP the biochemical changes were significantly improved as compared to CDDP group. Although no significant difference was found between CDDP/STS and CDDP/melatonin groups, the changes were normalized in CDDP/STS group, but still a significant difference was present between CDDP/melatonin group compared to control group indicating that STS has protective effect better than melatonin. These results were associated with improved histopathological changes of the cochlea and kidney. In conclusion CDDP-induced oto- and nephro-toxicity that may be related to increased lipid peroxidation associated with reduced level of GSH and activity of antioxidant enzymes. Also, this study revealed that STS is superior for melatonin, in short term protection against CDDP-induced toxicity and prevention of lipid peroxidation and oxidative stress and in improving antioxidant status. It is recommended to use both thiol agents and melatonin during treatment of human cancer to ameliorate the oxidative stress produced by the drug. However, further studies are required to evaluate the impact of these agents on antitumoral efficacy of CDDP