Modified PPIs [a search for the better]

'Modified PPIs' is the term given to proton pump inhibitors [PPIs] introduced after the fourconventional PPIs - omeprazole, lansoprazole, pantoprazole, and rabeprazole - all of which havesimilar actions and limitations and are produced by similar technologies. Modified PPIs includeisomeric PPIs, dual delayed release PPIs, immediate release PPIs, and long halfe life PPIs,which are manufactured by different technologies to overcome certain limitations of conventional PPIs. This modified category includes esomeprazole [Nexium], dexlansoprazol [Dexilent], omeprazole sodium bicarbonate mixture [Zegred], and S.tenatoprazole. Although some ofthese new products have better efficacy, longer duration of action, can be taken with disregard to meals, and have better nocturnal effect, we still lack the ideal PPI

Serum lipids profile in patients with idiopathic chronic constipation

In twenty patients suffering from idiopathic chronic constipation for a period up to one year, fissure in one and haemorroids complicating idiopathic constipation was included in this study and was treated surgically there was an increase in serum triglycerides [p <0.01] compared with normal control level. However, there was a reduction in total serum lipid [p < 0.01] compared with normal subjects, also a decrease in HDL level [p < 0.01] in both constipating patients and normal subjects. There was no significant change in serum cholesterol and low density lipoprotein mean values [p > 0.05]

role of somatostatin in the pathogenesis of diabetes mellitus

Fasting and two hours post-prandial blood insulin and somatostatin were measured in thirty newly discovered diabetic patients [eighteen insulin dependent and twelve non-insulin dependent] and twenty age, sex and weight matched healthy controls. The mean fasting and post-prandial plasma levels of somatostatin were increased compared to the control subjects in both insulin dependent and non-insulin dependent diabetic patients [P < 0.01]. The mean fasting and post-prandial serum insulin levels in patients with insulin dependent diabetes [IDDM] were significantly decreased compared with those of the normal controls [P < 0.05] and P < 0.01 respectively. In patients with non-insulin dependent diabetes [NIDDM] the mean fasting scrum insulin level showed no significant change compared with that of the controls [P >0.05], while the mean post-prandial level was significantly increased [P < 0.01] . The mean fasting somatostatin level in patients with NIDDM showed no significant change compared with that of patients with IDDM [P > 0.05] while the mean post-prandial level was significantly lower [P < 0.01]. In addition we found negative correlation between somatostatin and insulin levels in both the fasting and post-prandial states in the two diabetic groups. We concluded that hypersomatostatinaemia may play an important role in the pathogenesis of diabetes mellitus whether as a primary pathophysiological event or as just a secondary phenomenon to insulin dysfunction

Role of gastrin and somatostatin in the pathogenesis of gastro-esophageal reflux

Fasting and post prandial serum gastrin and plasma somatostatin were estimated in thirty five partients with reflux oesophagitis [diagnosed by upper panendoscopy, barium meal and histopathological examination] and fifteen healthy controls. The mean fasting and post prandial serum gastrin levels were significantly increased in the patients compared with the controls [p < 0.001] while the fasting and post-prandial plasma somatostation levels were significantly decreased [p < 0.005]. we concluded that gastro-oesophgeal reflux is a primary defect in the smooth muscle of lower oesophageal sphincter and blood gastrin and somatostation levels have no or minor role in the pathogenesis of this disease

Gastroduodenal mucosal biopsy versus endoscopy in non-ulcer dyspepsia

This work was done to study the histopathological changes in patients with non-ulcer dyspepsia who showed normal clinical and endoscopic examination. Thirteen normal controls and thirty three patients with chronic non-ulcer dyspepsia who were clinically and endoscopically free were chosen. Three mucosal endoscopic biopsies were taken from every patient and control. The site of biopsy was, the duodenal bulb, the gastric antrum and the gastric fundus. The histopathology of duodenal mucosa revealed the following: Eight out of thirty three patients showed normal mucosa, eleven grade I duodenitis, ten grade II and four grade III. The histopathology of the gastric mucosa showed: Nine normal mucosa, ten superficial gastritis, nine atrophic gastritis and five showed intestinal metaplasia. In the normal individuals ten cases showed normal mucosa, one case grade I duodenitis and two cases mild superficial gastritis with grade I duodenitis

Correlation between size of spleen clinically and degree of esophageal varices endoscopically

Thirty patients were examined endoscopically and proved to have esophageal varices of various degrees. All patients were clinically; examined with emphasis on the size of spleen and liver. There was no significant relationship between the size of spleen clinically and the degree of esophageal varices endoscopically. So it is possible to diagnose cases of haematemesis as due to esophageal varices in absence of palpable spleen contrary to the old impression