Enrichment of probiotic yogurt with broccoli sprout extract and its effect on helicobacter pylori

Background and Objective: Antibiotic consumption is the main way to cure infection induced by Helicobacter pylori. On the other hand, antibiotics have side effects on human body. So, finding an efficient way to replace antibiotic consumption seems necessary. The aim of this study was to investigate the effect of broccoli sprout extract on the viability of probiotic bacteria and yogurt's physicochemical properties, and examine the synergistic effect of this extract with probiotics on Helicobacter pylori growth inhibition

Material and Methods: Four levels of broccoli sprout extract [22.5, 45, 90 and 180 mg ml[-1]] were prepared and their effect on probiotic yogurt samples was examined. Moreover, their anti- Helicobacter pylori effect was determined

Results and Conclusion: The research results revealed that Broccoli sprout extract did not have any inhibitory effect on Bifidobacterium lactis and Lactobacillus acidophilus. The variations in acidity of the samples were not significant during storage. A positive correlation was observed between broccoli sprout extract concentration and syneresis. The findings showed the synergistic effect of broccoli sprout extract and probiotics on Helicobacter pylori growth inhibition. Therefore, using broccoli sprout extract and probiotic bacteria, we can produce a yogurt that is effective on the growth inhibition of Helicobacter pylori

Association between Helicobacter pylori infection and alopecia areata: a study in Iranian population

Background: alopecia areata is an immune mediated inflammatory hair loss, which occurs in all ethnic and age groups, and both sexes. However no significant etiology has been known for this disease.Helicobacter pylori [H. pylori], is an organism colonized in gastric mucosa. This bacterium has been associated with certain extra-digestive dermatological conditions. The causal relationship between alopecia areata and H. pylori infection has been discussed in literature. Therefore, we conducted this study to evaluate the prevalence of H. pylori infection in patients with alopecia areata and assess the risk of this infection in patients with this disease in order to determine its potential roles in the physiopathology of this disease

Methods: between 2014 and 2015, we prospectively studied 81 patients with alopecia areata and 81 healthy volunteers with similar age and sex. Patients without any history of H. pylori infection were included in the study and underwent urease breath test. All results were analyzed using SPSS software [version 21.0] and p value<0.05 was considered as statistically significant

Results: 81 patients and 81 controls with the mean age of 34.9+/-11.6 and 38.2+/-13.4 years were studied [p=0.097]. 48 [59.3%] and 45 [55.6%] individuals were male, in cases and control groups respectively [p =0.634]. The result of urea breath test [UBT] was positive in 43 [53.1%] patients in cases and 27 [33.3%] individuals in control group, which was significantly different [p =0.011]. The risk of H. pylori infection in alopecia areata was 2.263 [95% CI: 1.199-4.273]

Conclusion: the results of our study showed significant difference between H. pylori infection in individuals with and without alopecia areata, which shows that H. pylori contamination may be effective in physiopathology of alopecia areata. Therefore these results should be tested in large multivariable cohorts and controlled trials to reach more accurate evidence in the future and to generalize this idea to larger population

Reliability and validity of the Persian version of patient assessment of constipation- quality of life [PAC-QOL] questionnaire

Aim: The present study aimed to assess the reliability and validity of Persian version of patient assessment of constipation: quality of life [PAC-QOL] questionnaire in Iranian patients

Background: Chronic constipation has significant effects on daily living, wellbeing and individuals' quality of life [QOL]. Validated tools can help us to assessing QOL in affected ones and facilitating clinical management of them

Methods: The English version of Patient Assessment of Constipation: Quality of Life [PAC-QOL] was translated into the Persian language and was confirmed by back-translation. One hundred and forty patients with functional constipation, according Rome III criteria, completed the questionnaires .The questionnaires were analyzed using Cronbach's Alpha internal consistency score to determine the reliability. Twenty medical experts were then asked to evaluate the PAC-QOL and the results were used to calculate the Content Validity Ratio [CVR] and Content Validity Index [CVI]

Results: Due to obtained value for Cronbach's alpha [0.975] and also for the subscale of physical discomfort [0.930], psychosocial discomfort [0.975] and worries and concerns [0.915], the internal consistency is established. According to medical experts' opinions, the value of CVR ranged from 0.5 to 0.8 and the value of CVI was 0.81

Conclusion: The Persian version of PAC-QOL questionnaire is shown to have acceptable reliability and validity to be used for psychometric evaluation in Iranian patients complaining of functional constipation

association between modulating inflammatory cytokines and constipation of geriatrics in Iran

Background: The effect of changes in intestinal microbiota on constipation is contraversial. Constipation is more prevalent in elderly. Therefore, the current study was designed to assess the role of modulating inflammatory cytokines in old age patients with constipation by evaluating the serum levels of tumor necrosis factor alpha [TNF-alpha], interleukin 1 [IL-1], and interleukin 6 [IL-6]

Methods:This case-control study was done on 100 participants, aged 65 years or higher, with and without functional constipation according to ROME III criteria [50 participants in each group]. Baseline demographic, clinical characteristics, and serum levels of TNF-alpha, IL-1, and IL-6 were compared between the case and control groups. Independent t test and Chi-square test were used for analysis of data

Results:Mean levels of TNF-alpha, IL-1, and IL-6 were [666.80 +/- 101.40 pg/mL vs. 489.20 +/- 53.68 pg/mL, p < 0.001], [435.96 +/- 52.31 pg/mL vs. 296.44 +/- 45.50 pg/mL,p < 0.001] and ]438.18 +/- 59.57 pg/mL vs. 290.14 +/- 36.39 pg/mL,P < 0.001] in the case and control groups, respectively. A reverse correlation was found between the aging process and TNF-a [r = -0.26; p = 0.04], as well as IL-1 level [r = -0.41; p = 0.003] in the control group. A direct correlation was observed between the aging process and TNF-alpha [r = 0.40; p = 0.004] and IL-6 [r = 0.44; p = 0.002] levels in the case group

Conclusion: This study showed a significant association between the serum level of modulating inflammatory cytokines and age-related constipation in Iranian subjects. It seems that the serum level of modulating inflammatory cytokines can be affected by diversity and abundance in the gut microbiota. The role of diversity in microbial population and their abundance in gut must be evaluated in further studies

Fever ,weight loss and early satiety due to gastric inflammatorymyofibroblastic tumor; case report and literature review

Gastric inflammatory myofibroblastic tumor [IMT] is a rare tumor with and unpredictable prognosis usually find in young adults. We present an 18-year-old man with gastric IMT. He complained of epigastric pain, intermittent fever and night sweating associated with weight loss since two years ago. Physical examination showed anemic and cachestic features with mild abdominal tenderness in palpitation as well as an abdominal mass in epigastrium. Abdominal CT scan revealed a huge mass that was arising from the stomach. Upper endoscopy revealed a submucosal lesion in fundus of stomach of approximately 8cm. Endoscopic ultrasound showed a large sub-mucosal non homogenous fundal mass with areas of calcification. The patient underwent laparoscopic partial gastrectomy. Histopathologyand immunohistochemistryevaluation revealed an IMT

[Review of current anti-obesity drugs in obese adults]

Obesity was a dangerous chronic disease. Physicians recommended drug therapy just in a few of obese patients in spite of many health risks. Weight control can be improved comorbidities of obesity like hyperlipedemia, hyperinsulinoma, acanthosis nigricans and hypertension. This article reviewed the available original and review literatures which had been published in English in websites of Google scholar and Pub Med with keywords drug, obesity and adults during 2002 - 2014. Drug therapy could improve obesity treatment after an unsuccessful combination of diet, exercise, and behaviour modification. Choice of treatment was based on multiple factors including the degree of obesity and patient preference. Drug therapy should be selected for a BMI] Body Mass Index [greater than 30 kg/m[2], or a BMI of 27 kg/m[2] with comorbid conditions including diabetes mellitus, hypertension, dyslipidaemia and heart disease.Prescription of anti-obesity drugs should be monitored carefully. Orlistat was the only drug for the long-term treatment of obesity. The efficacy of lorcaserin appears more than orlistat. Phentermine and diethylpropion are only approved for the short term treatment of obesity. Some antidepressant, antiepileptic, and antidiabetic drugs could be caused weight loss. New generation of anti-obesity drugs were under developing and more focus on the safety and efficacy combination treatments. Weight loss > 12kg reported in few investigational drugs. Some of them were discussed in this article. Obesity treatment is selected based on the side effects risks. Mostly of the available drugs have few side effects which decrease with treatment. There isn't a cure drug treatment for obesity now

Efficacy of clarithromycin containing bismuth-based regimen as a second-line therapy in helicobacter pylori eradication

The eradication of Helicobacter pylori infection, commonly prevailing in the stomach, has been important since its introduction. Adequate preparations should be made in finding alternatives when faced with first-line treatment failures. Currently, ideal second-line treatments are indistinct and varied among countries as result of different antibiotic resistance patterns. We aimed to evaluate the safety and efficacy of a clarithromycin-containing bismuth-based quadruple regimen as a second-line treatment. Forty-eight H.pylori-positive patients with proven gastric or duodenal ulcers and/or erosions who had previously failed to respond to furazolidone-containing regimens were enrolled. They received pantoprazole [40 mg-bid], amoxicillin [1gr-bid], bismuth subcitrate [240 mg-bid], and clarithromycin [500mg-bid] for 10 days. Eight weeks after treatment, a 14C-urea breath test was performed for the re-evaluation of H. pylori eradication. Forty-three patients completed the study. H.pylori eradication rates were 79.2% [95% CI=65.00-89.53] and 88.4% [95% CI=74.91-96.11] according to intention-to-treat and per-protocol analyses, respectively. All patients had excellent compliance to treatment and one did not continue therapy because of adverse effects. In developing countries such as Iran, a ten-day clarithromycin-containing bismuth-based quadruple regimen is encouraged as a second-line treatment because of the acceptable rate of eradication and low adverse effects

Gastroenterologist role in bariatric surgeries

The prevalence of bariatric surgery procedures has increased dramatically in recent years and multiple specialties encounter bariatric patients. In this article, we outline the different options in bariatric surgery and summarized the recommendations for gastrointestinal assessment of candidates before and after bariatric surgery. The role of routine endoscopy was controversial in pre surgical evaluation but may alter the operation performed. Comprehensive pre-operative screening conducted by a multidisciplinary team including gastroenterologist was essential to prepare obese patients for successful outcome following surgery. The most commonly performed procedures were Roux-en-Y gastric bypass and adjustable gastric banding. We presented the early and late complications of bariatric surgery and recommendations for post-operative cares by gastroenterologist in this review article

comparison between moderate- and high-dose furazolidone in triple regimens for Helicobacter pylori eradication in Iran

Furazolidone has been used as an alternative for clarithromycin or metronidazole in Helicobacterpylori [H. pylori] eradication regimens. In Iran, 14-day Furazolidone-containing quadruple regimens have shown promising eradication rates, but short-course, low dose therapies are always attractive. Therefore, we designed a study to compare the efficacy of two 10-day triple regimens containing moderate and high dose furazolidone for H. pylori eradication. Two hundred and ten patients with peptic ulcer disease who were naive to H. pylori treatment were included. They were randomized into 2 groups: 105 patients received omeprazole 20mg, amoxicillin 1000mg, and furazolidone 200mg [OAF-400], all twice a day for ten days. And the remaining 105 patients received omeprazole 20mg twice a day, amoxicillin 1000mg twice a day and furazolidone 200mg three times a day for ten days [OAF-600]. Urease breath test was performed 8 weeks after the treatment to confirm H. pylori eradication. The intention-to-treat eradication rate was 76.19% in group OAF-400 and 80.95% in group OAF-600 [p=0.38]. Per protocol eradication rates were 81.63% and 89.47%, respectively [p= 0.11]. Severe adverse effects were reported by 8.6% of the patients in group OAF-400 and 5.7% of the patient in group OAF-600 [p=0.1]. However, the total side effects [including mild, moderate, and severe ones] were significantly more prevalent in the OAF-600 group [p=0.001]. None of our triple furazolidone-based regimens [moderate- and high-dose] could achieve the standard eradication rate, and therefore, cannot be considered as a suitable option for first-line treatment

Lower gastrointestinal bleeding due to non-steroid anti-inflammatory drug-induced colopathy case report and literature review

The adverse effects of non-steroidal anti-inflammatory drugs [NSAIDs] on the upper gastrointestinal [GI] tract and small intestine are well established. The effect of such therapy on the large intestine, so called NSAID-induced colopathy, is less well described. NSAID-induced colopathy usually involves the right colon due to a higher concentration of the drug at this site, but the rectum may also be involved. NSAIDs possibly damage the normal large intestine, which presents as ulceration, colitis and stricture. Even though several studies found that NSAIDs can cause diverticular bleeding and perforation, flare-up of inflammatory bowel disease, and play a role as an etiologic factor in lymphocytic colitis. Inflammatory bowel diseases, malignancy and infectious colitis must be ruled out before establishing the diagnosis of NSAID -induced colopathy. Discontinuation of the offending drug is mandatory. Here, we have reported the case of a 43-year-old female, NSAID user due to low back pain, who was admitted to the hospital with painless hematochezia

Acute bleeding in duodenal gastrointestinal stromal tumor

Gastrointestinal stromal tumors [GIST] are the most common mesenchymal tumors of the gastrointestinal tract. The biological pattern of these tumors ranges from benign-appearing small lesions to malignant sarcomas. Only 3%-5% of GISTs are found in the duodenum. A duodenal GIST is a rare source of upper gastrointestinal bleeding. A remarkable percentage of duodenal GISTs are localized in the third and fourth part of the duodenum and may not be noticed on standard upper endoscopy. Push enteroscopy is sometimes advisable to find these lesions. Surgical resection either limited or pancreaticoduodenectomy can be the treatment of choice. In general, adjuvant therapy with imatinib has been proved to extend survival in patients with GIST. The current case, a 24-year-old male, presented with acute upper gastrointestinal bleeding from a submucosal ulcerated tumor located in the distal third part of the duodenum, 3 cm distal from the papilla of Vater. After primary care and blood transfusion in a local hospital, partial resection of the duodenum was performed as a definitive surgical therapy. Histopathology showed a GIST with a diameter of 3 cm and moderately malignant according to tumor grade, and <5 mitoses/10 high power field [HPF]