A Novel three drug rigemen (moxifloxacin ­ omeprazole - nitazoxanide) in comparison to traditional triple therapy for treatment and eradication of naïve and resistant H. pylori infection in dyspeptic patients

Background: Helicobacter pylori is one of the most common, medically prominent infection worldwide and one of the major causative factor of peptic ulcer disease. So, eradication of H. pylori is effective in healing ulcers, reducing the ulcer recurrence and eliminating the need for maintenance therapy.Objective: The aim of the work was to compare between the efficacy of traditional triple therapy and Moxifloxacin-based triple therapy in treatment of H. pylori infection and to evaluate the efficacy of moxifloxacin-based regimens as a rescue regimen for H. pylori eradication in resistant patients. Patients and methods: This study was carried out on 100 Helicobacter pylori (H. pylori)-infected patients (within the period between septemper, 2018 to May, 2019) who were enrolled from Hepatology, Gastroenterology & Tropical Medicine Department, Al Azhar University Hospitals (El-Hussein and BAB El-Shaarea). Results: Helicobacter pylori eradication results in group III as evaluated by monoclonal H. Pylori stool Ag, 6 weeks post therapeutic regimens reported that eradication rate was 76.9% (20 patients). Regarding post treatment clinical data in group III, 42.3% of patients remained having symptoms and 57.7% had acheived symptomatic improvement. Also, the best results were recorded for H.pylori eradication (90%) in group II who received moxifloxacin based triple therapy compared to group I (with eradication rate 62.9%) who received traditional triple therapy regimen. Thus the better results (76.9%) were achieved in group III (resistant patients from group I). Conclusion: The present results could state that moxifloxacin can overcome traditional triple therapy resistance

Smoking behaviour and patterns among university students during the Syrian crisis

Background: The ongoing Syrian war has resulted in many changes in the social and economic life of Syrians. To date, no study has documented the relationship between smoking behaviour and the war. Aim: To determine the prevalence of cigarette smoking among university students during the crisis in Damascus, Syrian Arab Republic, and the impact of the war on smoking behaviour. Methods: We conducted an anonymous online cross-sectional survey of 1027 undergraduate students from all years and colleges at Damascus University. Results: The overall prevalence of tobacco smoking was 24.73% for cigarettes and 30.4% for waterpipe. Prevalence of cigarette smoking was significantly higher in men, non-health profession students, and in students living away from their families. There was no significant difference in prevalence of smoking cigarettes when comparing students according to their origin [urban vs rural], year of study, and change of residence due to war. War was associated with a significant increase in mean number of cigarettes smoked daily, and 53.1% of smokers reported that the number of cigarettes consumed per day had increased since the beginning of the war. Conclusions: Increased smoking is an additional health concern in areas of conflict and may require special consideration and efforts by public health authorities

Standard triple therapy versus sequential therapy for eradication of Helicobacter pylori in treatment naive and retreat patients

Background and study aims: Untreated Helicobacter pylori infection causes increased risk of gastric cancer, GI morbidity and mortality. Standard treatment for eradication of Helicobacter pylori infection, is the triple therapy which consists of a proton pump inhibitor; together with two antibiotics [amoxicillin 1000 mg with clarithromycin 500 mg or metronidazole 400 mg] given twice daily for 7-14 days. Recent evidence revealed, that cure rates of Helicobacter pylori infection with triple therapy had fallen below satisfactory targets. Sequential therapy consisting of a twice daily dose of a PPI for ten days with Amoxicillin given at 1000 mg twice daily in the first 5 days followed by clarithromycin 500 mg and Metronidazole 400 mg given twice daily in the subsequent 5 days, was recommended to improve eradication rates. We performed a randomised open label study to compare the efficacy of sequential against triple therapy in Helicobacter pylori naive and retreat patients

Patients and methods: In a randomised open label observational study 485 patients fulfilling inclusion and exclusion criteria were randomly assigned to be treated with triple therapy [n = 231] or sequential therapy [n = 254]. Eradication of Helicobacter pylori was documented with [14]C Urea breath test [UBT] performed 6 weeks after the treatment

Results: The intention-to-treat eradication rate was better in sequential therapy group 84.6% than triple therapy 68% [p < 0.001]. Eradication rates were significantly higher for treatment naive than retreat patients in triple therapy group [70.5% and 58.3%, respectively, p < 0.01]. A trend of a better response was observed in eradication rate for treatment naive 88.55% versus retreat 74.6% in sequential therapy group but was not statistically significant [p = 0.76]. Compliance was similar in the two groups, however side effects were less and the clinical response was better in the sequential therapy group