Effect of oral N-acetyl cysteine on eradication of Helicobacter pylori in patients with dyspepsia

AIM

Using mucolytic agents that decrease viscosity of the gastric mucous and therefore, increase the permeability of antibiotics through gastric membrane has been offered as an additive treatment to achieve a higher rate of eradication of Helicobacter pylori (H. Pylori) infection. The aim of this study was to determine the efficacy of oral N-acetyl cysteine (NAC) on eradication of H. pylori infections in patients suffering from dyspepsia.

METHODS

In this randomized double-blinded clinical trial, 60 H. pylori positive patients who were suffering from dyspepsia were included. They were divided into two groups. Both groups received three-drug regimen including pantoprazole 40 mg BD, ciprofloxacin 500 mg BD and bismuth subcitrate 120 mg two tablets BD. Experimental group (30 cases) received 600 mg of NAC besides three-drug regimen. Control group received placebo. The results of therapy were tested by 14C-UBT and were compared with each other two months after the first visit.

RESULTS

H. pylori infection was eradicated in 21 (70%) and 17 (60.7%) patients in experimental and control groups, respectively (P=0.526). Regarding clinical and endoscopic variables, no significant difference was observed between the two groups except for erosive gastritis (0.041) and erosive esophagitis (0.031).

CONCLUSION

Our findings offer that NAC has an additive effect on H. pylori triple therapy with pantoprazole, ciprofloxacin and bismuth subcitrate. Although NAC does not have any known activity against H. pylori, it can reduce the thickness of the mucus layer and increase the permeability of antibiotics at the site of infection. To evaluate this effect, more studies with larger sample size should be performed.

Blood pressure lowering effect of Nigella sativa L. seed oil in healthy volunteers: a randomized, double-blind, placebo-controlled clinical trial

Nigella sativa L. seeds (N. sativa) have been used as a traditional remedy for a wide range of diseases including hypertension. The present study was performed to explore the effects of N. sativa oil on blood pressure (BP) in healthy volunteers. In a double-blind, randomized study, 70 healthy volunteers aged 34 to 63 years with systolic BP from 110 to 140 mmHg and diastolic BP from 60 to 90 mmHg were randomly allocated to receive 2.5 mL N. sativa oil or placebo two times a day for 8 weeks. The systolic and diastolic BPs, body mass index and blood levels of aspartate transaminase, alanine transaminase, alkaline phosphatase, creatinine and blood urea nitrogen were determined at baseline and endpoint. Results showed that in N. sativa oil treated group the systolic and diastolic BPs decreased significantly compared with baseline and placebo group at the endpoint. Other parameters did not significantly change in both groups at the endpoint. No adverse effects were reported. In conclusion, oral daily administration of 5 mL N. sativa oil to healthy volunteers for 8 weeks lowers systolic and diastolic BPs without any adverse effects.

Microtensile bond strength of self-etch adhesives in different surface conditionings

AIM

Self-etch bonding systems have been introduced recently and have the advantage of reduced operating time. Because of patient management and isolation difficulties in children, the present study aimed to evaluate microtensile bond strength of two self-etch bonding systems (AdheSE and Xeno® III) on cleaned only, ground and sandblasted enamel.

MATERIALS AND METHODS

Thirty intact primary molars were selected and randomly divided into two groups according to the type of bonding used (Xeno® III and AdheSE). The teeth were divided into three subgroups according to enamel surface conditioning method: prophylaxis with pumice, grinding with coarse finishing and polishing disc, and sandblasting with aluminum oxide particles. Tetric Ceram composite then was applied. Samples were sectioned coronally and axially. The interface area of dental sticks was measured and specimens were subjected to a tensile force of 0.5 mm/min until failure.

RESULTS

Microtensile bond strength of Xeno® III-sandblasting, AdheSE-sandblasting, AdheSE-grinding, and AdheSE- cleaned only were 25.5±7.7, 21.2±2.3, 12.9±2.2, and 9.1±1.1, respectively. During sectioning, all specimens of Xeno® III-cleaned only and Xeno® III-grinding groups were fractured.

CONCLUSIONS

Two step AdheSE yields higher mTBS in comparison to one step Xeno ® III. In regard to surface conditioning, sandblasting increases the mTBS relative to grinding with finishing and polishing disc, and the cleaned-only enamel has the lowest mTBS.

Serum levels of sodium valproate in patients suffering from bipolar disorders: comparing acute and maintenance phases of mania

OBJECTIVES

Bipolar disorders (BD) are characterized by episodes of mania and depression. There is evidence that states of psychiatric disorders impact on neurotransmitters, endocrine system and membrane transport and, therefore, it is possible that specific phases of BD differentially influence the pharmacokinetics of some drugs. The aim of the present study was to investigate the drug-disease interaction between sodium valproate, one of the major drugs used in the treatment of bipolar disorder, and acute versus maintenance states of manic episodes.

METHOD

37 patients (mean age ± SD = 37.54 ± 11.27 years; 23 males, 14 females) suffering from bipolar disorder completed the study. Blood samples were taken during both acute and maintenance states.

RESULTS

Neither the trough concentration (p = 0.567) nor the internal clearances (p = 0.729) of sodium valproate in the acute phase of mania differed statistically or descriptively from those in the maintenance phase. Marginally significant phase by gender interactions were observed.

CONCLUSION

No significant effect of the acute phase of mania was observed in bipolar patients and no relationship could be found between drug pharmacokinetics and disease phase. This may be explained by specific pharmacokinetic features of the drug such as low extraction ratio values. However, phase by gender interactions indicate possible gender-related issues.

Candida parapsilosis as a Potent Biocontrol Agent against Growth and Aflatoxin Production by Aspergillus Species

BACKGROUND

Aflatoxin contamination of food and feed stuff is a serious health problem and significant economic concerns. In the present study, the inhibitory effect of Candida parapsilosis IP1698 on mycelial growth and aflatoxin production in aflatoxigenic strains of Aspergillus species was investigated.

METHODS

Mycelial growth inhibitions of nine strains of aflatoxigenic and non-aflatoxigenic Aspergillus species in the presence of C. parapsilosis investigated by pour plate technique at different pH, temperature and time of incubation. Reduction of aflatoxin was evaluated in co-cultured fungi in yeast extract sucrose broth after seven days of incubation using HPLC method. The data were analyzed by SPSS 11.5.

RESULTS

The presence of the C. parapsilosis at different pH did not affect significantly the growth rate of Aspergillus isolates. On the other hand, temperature and time of incubation showed to be significantly effective when compared to controls without C. parapsilosis (P≤0.05). In aflatoxigenic strains, minimum percentage of reductions in total aflatoxin and B1, B2, G1, G2 fractions were 92.98, 92.54, 77.48, 54.54 and 72.22 and maximum percentage of reductions were 99.59, not detectable, 94.42, and not detectable in both G1 and G2, respectively.

CONCLUSION

C. parapsilosis might employ as a good biocontrol agent against growth and aflatoxin production by aflatoxigenic Aspergillus species.

Hepatitis C virus spontaneous clearance: immunology and genetic variance

Hepatitis C virus (HCV) infection is one of the most common chronic viral infections in the world. Approximately 80-90% of acutely infected individuals develop persistent infection, which is a major risk for liver cirrhosis and liver cancer. However, a small portion of patients (10-20%) clear the virus. Clinical outcomes of HCV infection are determined by the interplay between the host immune response, and viral and environmental factors. In regulating immune responses, cytokines play an indispensable role that controls the underlying pathogenesis and the resulting outcome of HCV infection. Cytokines themselves are manipulated by polymorphisms in their genes. In fact, the majority of genetic variants that apparently confer a significant risk for chronic HCV infection have been localized in genes involved in cytokine synthesis and the ultimate immune response. So far, treatment strategies for HCV infection have remained controversial. Genotyping of different polymorphisms will aid clinical decision making for both current standard and personalized care. Genotyping can potentially be useful for future integration of other agents, which provides an opportunity for clinicians to personalize treatment regimens for HCV patients. This review summarizes findings of different studies on host immune responses after HCV infection and the association between cytokine gene polymorphisms and the likelihood of HCV clearance.

Research priorities in medical education in the Eastern Mediterranean Region

Ways are needed to effect quality improvement in medical education research in the Eastern Mediterranean Region (EMR). This study aimed to determine the principle themes and to draw up a list of priorities in medical education research in EMR. Using the nominal group technique with a group of 30 experts, a list of major themes in medical education research was prepared. In a 2-round Delphi survey the list was sent to another 47 experts in the Region with a questionnaire that included open questions about change and reform in medical education. In the final list of 20, the 5 highest priorities identified were: training physicians to be effective teachers; community-driven models for curriculum development; clinical teaching models; education about professionalism and ethics; and education for evidence-based medicine. Themes determined by this survey can help researchers in EMR to focus on priority areas in research.

Assessment of endogenous androgen levels in meat, liver and testis of Iranian native cross-breed male sheep and bull by gas chromatography-mass spectrometry

Androgenic steroids always exist in different animal tissues at trace level, with significant numbers of interfering compounds, which makes their determination difficult. To solve some of the problems in quantification of the natural steroids in those tissues, a new GC-MS method was developed in this study. By using a surrogate analyte approach, which was developed in the authors' previous studies, and extensive sample preparation procedure, which successfully eliminates many of the interfering compounds and resulting in a cleaner extract, accuracy, precision, sensitivity and selectivity of the method for the determination of steroids in complex matrices such as meat, liver and testis were improved. By aid of this method, the levels of androgens in different tissues of Iranian native cross-breed bulls and male sheep were determined. According to the results obtained in the present study, although the androgenic profile (contents and ratios of precursors and metabolites to the main hormones) is similar between the same tissues of both animals, the total androgenic content of each tissue is higher in the bull than the same tissue in male sheep. In addition, in both animals higher amount of androgens were found in liver in comparison with meat and testis.

The effect of calendula officinalis in therapy of acetic Acid induced ulcerative colitis in dog as an animal model

BACKGROUND

In patients with ulcerative colitis (UC), the repeated cycle of injury and repair of intestinal mucosa has been reported to increase the risk of colon cancer. So, a safe and efficient therapy is required for the treatment and prophylaxis for the disease.This study aims to investigate the efficacy of Calendula officinalis extract in treatment of experimentally induced ulcerative colitis in dog animal model.

METHODS

During fall 2010, 10 out-bred female German dogs (1-2 years old; weighs of 20-25 kg) were enrolled. Ulcerative colitis was induced with 6% acetic acid as enema and method of treatment was retrograde (via enema) too by C. officinalis.

RESULTS

Loose stools, diarrhea, gross bleeding and loss of body weight happened after administration of acetic acid and crypt damage, loss of epithelium, infiltration of inflammatory cells and depletion of goblet cells were noticed histologically. C. officinalis could successfully resolve the damages of UC.

CONCLUSION

Treatment with C. officinalis can broaden the current therapy options for UC.