Mentha spp. are aromatic plants and have been used in the medical, cosmetics, and food industries. These plants have been used as a traditional herbal medicine for various types of diseases. Mentha ...aquatica L. (water mint) is a perennial plant used as a wild vegetable and a culinary herb. As its name suggests, it grows in the shallow margins and channels of streams, rivers, wet meadows, etc. It has been used as a tonic plant, sedative, and soothing for intestinal parasites, constipation, diarrhea, stomach troubles, biliousness, liver diseases, impotence, low or high blood pressure, and expelling intestinal worms in children, enhancing longevity. Researchers from all over the world have studied the chemical composition and pharmacological activities of this plant, such as its anti-microbial, anti-inflammatory, and anti-oxidant activities. In addition, the neurochemical properties, larvicidal activity, and phytochemical analysis of the plant have also been reported. However, there is no review article available that gathers all the information and provides insights for future studies on M. aquatica. Against this backdrop, the present research is conducted to categorize the published studies and to offer more suggestions to researchers for future studies.
Appendiceal mucocele (AM) is a rare disease, manifested by accumulation of mucus in appendiceal lumen. The role of ulcerative colitis (UC) in the occurrence of appendiceal mucocele is not known. ...However, it is suggested that AM may be a presentation of colorectal cancer in IBD patients.
Here, we presented 3 cases of concomitant AM and ulcerative colitis. The first patient was a 55-year-old woman with 2-year history of left sided UC; the second person was a 52-year-old woman with 12-year history of pan-UC; and the third patient was a 60-year-old man with 11-year history of pan-colitis. They were all referred due to indolent right lower quadrant abdominal pain. Imaging evaluations suggested the presence of appendiceal mucocele and therefore, they all went under operation. Pathologic evaluation reported AM of mucinous cyst adenoma type; low-grade appendiceal mucinous neoplasm of appendix with intact serosa; and cyst-adenoma type AM for the three above-mentioned patients, respectively.
Although concomitant occurrence of AM and ulcerative colitis is rare, regarding the potential of neoplastic changes in AM, physicians must keep in mind the diagnosis of AM in UC patients with non-specific abdominal RLQ pain or bulged appendiceal orifice during colonoscopy.
The efficacy of first-and second-line Helicobacter pylori(H.pylori)eradication regimens varies considerably in West Asian countries,mainly due to the variable prevalence of resistant ...organisms.However,no review article has yet evaluated and compared the efficacy of different regimens among different countries of this region.Therefore,we conducted a review to select the best options and provide recommendations for H.pylori treatment in this geographic region.A search through PubMed was carried out to obtain relevant randomized clinical trials published in English language up to June2013.According to the results,among different therapeutic regimens used as the first-line protocols,10-d Bismuth-Furazolidone/Metronidazole quadruple therapy,14-d Clarithromycin-containing hybrid therapy and 14-d quadruple therapy including a proton pump inhibitor +Bismuth+Tetracycline(500 mg QID)+Metronidazole(500 mg TDS)seemed to be appropriate options.Among second-line therapeutic regimens,Bismuthbased quadruple therapies containing Tetracycline and Furazolidone/Metronidazole,triple therapy containing Amoxicillin and Gatifloxacin and Quadruple therapy including Bismuth+Azithromycin and Ofloxacin seemed to be effective options.Third-line therapies were not evaluated in West Asia;most guidelines,however,recommend choosing optimal eradication regimen according to the pattern of antibiotic susceptibility of H.pylori.Although we limited our investigation to H.pylori eradication regimens in West Asia,the clinical significance of the results goes beyond the countries situated in this geographic region.In fact,the results are transferrable to any region as long as the patterns of resistance are the same.
Some studies have shown that giardia infection is associated with some abdominal symptoms. The aim of this study was to determine the relationship between giardia duodenalis infection and irritable ...bowel syndrome (IBS). In this clinical trial study, 60 patients with non-constipation predominant IBS based on Rome III criteria were enrolled in the study. 30 patients with giardiasis who were diagnosed with stool Eliza as patients, and 30 other patients who did not have giardiasis as control enrolled to study. All patients were treated with 250 milligrams of metronidazole TDS for 5 days. Abdominal symptoms including abdominal pain, bloating, and diarrhea were determined and compared in both groups before and after treatment. The mean age and sex distribution of the two groups were similar (P>0.5). The pain, bloating, and diarrhea severity before treatment with metronidazole were not significantly different in the two groups. The pain and bloating and diarrhea severity in both groups significantly decreased after the treatment period, but reductions were significantly higher in the case group (P<0.001 and P<0.001 P<0.001, respectively). The mean score of global symptoms before treatment in both case and control groups was similar. (P=0.88), but after treatment it was 4.85±2.18 (P<0.001) and 10.48±2.14 (P<0.001) respectively and the difference between the two groups was significant (P<0.001). The recovery percentage was 0.61±0.16 in the case group and 0.14±0.17 in the control group (P<0.001). Giardia infection in patients with IBS seems to play a significant role in clinical manifestations of non-constipation IBS and treatment with metronidazole can improve these symptoms significantly.
Background: Helicobacter pylori (H. pylori) has infected about 50% of the world’s population and it is the main cause for peptic ulcer, gastric adenocarcinoma and even a major cause for gastric MALT ...lymphoma. Methods: This study was performed in Mazandaran, Sari, situated in North of Iran. Three-hundred and twenty-eight adult patients with endoscopically approved gastric or duodenal ulcers or erosions and H. pylori infection were randomly divided into 2 groups to receive either 14 days PABT (Pantoprazole 40 mg, Amoxicillin 1 g, Bismuth 425 mg (all twice daily) and Tetracycline 500 mg four times a day) and PACM (Pantoprazole 40 mg, Amoxicillin 1g, Clarithromycin 500 mg, and Metronidazole 500 mg, all twice daily). To evaluate H. pylori eradication, fecal H. pylori antigen test was performed 8 weeks after treatment. Results: The eradication rates were 94.51% in the PATB and 91.46% in PACM group based on the intention to treat analysis. Moreover, the eradication rates were 95.58% and 92.72% according to per-protocol analysis, respectively. Also, both groups had very low rates of severe side effects. Conclusion: Regarding the ideal eradication rates achieved by both treatment groups and the low rates of severe side effects, both treatment protocols can be prescribed for H. pylori eradication in North of Iran.
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder that causes abdominal pain, distension, change of bowel habit, bloating, constipation, diarrhea, and mucus discharge ...along with stools. Although the disease causes long-term and agonizing pain, no ideal cure has been found for it so far. This study aimed to investigate the efficacy and compliance of Mentha aquatica L. extract for the treatment of bloating caused by IBS. This double-blind, randomized, placebo-controlled trial study was conducted in Tooba gastroenterology clinic in Sari, Iran, during 2019 (from January to May). A total of 104 patients with IBS in the age range of 20-80 years were randomly divided into two parallel groups of herbal medicine (MAC-330) and placebo. Study period consisted of a 4 weeks of administration, and 2 weeks of follow-up. IBS-associated symptoms including severity of bloating (as primary outcome) and frequency of defecation and abdominal pain were evaluated using a questionnaire before treatment, 1, 2 and 4 weeks after beginning treatment and 2 weeks after stopping treatment. There were no significant differences between the two groups in terms of their baseline characteristics (p > 0.05). The severity of bloating was significantly reduced in the both groups at fourth week (p < 0.030) and 2 weeks after stopping intervention (sixth week) (p < 0.026). The frequency of defecation has increased with the onset of the intervention until the fourth week of the treatment which was not significant. The abdominal pain reduced during the 4 weeks’ intervention, but it was not significant. Based on the obtained results, MAC-330 could not be used as an effective treatment for patients with IBS in short time; however, it reduces the abdominal bloating and pain in these patients, especially in the long-term use.
Background
Helicobacter pylori (H. pylori) eradication has always been a concern. In our pervious study, 14‐day hybrid regimen showed ideal results. Based on these findings, we decided to compare the ...efficacy of 10‐ and 14‐day hybrid regimens for H. pylori eradication.
Methods
Two hundred and seventy patients with peptic ulcer disease and H. pylori infection were enrolled in the study. One hundred and thirty‐four patients received 10‐day hybrid regimen (PACT‐10): pantoprazole, 40 mg, and amoxicillin, 1 g, both twice daily for 10 days; plus clarithromycin, 500 mg, and tinidazole, 500 mg, both twice daily just during the last 5 days. One hundred and thirty‐six patients received 14‐day hybrid regimen (PACT‐14): pantoprazole, 40 mg, and amoxicillin, 1 g, both twice a day for 14 days; plus clarithromycin, 500 mg, and tinidazole, 500 mg, both twice daily just for the last 7 days. Eight weeks after treatment, 14C‐urea breath test was performed to evaluate H. pylori eradication.
Results
Two hundred and fifty patients (124 patients in PACT‐10 and 126 patients in PACT‐14 regimens) completed the study. The intention‐to‐treat eradication rates were 77.6% (95% confidence interval (CI): 70.6–84.6%) and 86% (95% CI: 80–92%) for the two regimens, respectively (p = .17). Per‐protocol eradication rates were 83.8% (95% CI: 80–86%) and 92.8% (95% CI: 88–96%), respectively (p < .01). There were no significant intergroup differences in compliance to treatment or discontinuation of therapy due to severe side effects.
Conclusion
Ten‐day hybrid regimen could not achieve acceptable eradication rate. However, 14‐day hybrid regimen seems to be an acceptable option for H. pylori eradication in Iran.
infection is one of the most common bacterial infections, affecting almost half of the world's population. It is associated with peptic ulcer disease, gastric adenocarcinoma, and lymphoma. In Iran, ...the prevalence of
infection has been reported to be between 36% and 90% in different geographic regions. Several studies have assessed the efficacy of different therapeutic options for firstline and second-line
eradication in Iran; however, the results are conflicting. Therefore, we conducted a review to evaluate different studies in order to select the best options and to provide recommendations for
eradication in Iran. Accordingly, we searched through PubMed to obtain relevant randomized clinical trials published in English language up to June 2017. According to our study, among first-line eradication regimens, bismuth-based furazolidone- or clarithromycin-containing quadruple therapies, hybrid regimen, and concomitant therapy seem to be appropriate options. Also, 10- or 14-day clarithromycin-containing triple therapy can be used if local
resistance to clarithromycin is known to be less than 15%. For second-line
eradication, bismuth-based quadruple therapies and 14-day levofloxacin-based triple therapy can be used, provided that antibiotics other than those used in the first-line regimen are used. Third-line
eradication regimens have not been addressed in Iranian studies. However, most guidelines recommend treatment according to the results of culture and susceptibility testing. Although we limited our investigation to
eradication regimens in Iran, the results are transferrable to any region as long as the patterns of antibiotic resistance are the same.
Background and purpose: Suitable sedation during gastrointestinal (GI) tract endoscopy leads to the patient’s and the physician’s satisfaction and enhances the quality and the adequacy of the ...procedure. Materials and methods: In a clinical trial, 140 patients were randomly assigned into two groups in order to compare the adequacy of upper GI tract endoscopy after choosing the type of sedation by either the physician or the patient who were provided with educational pamphlets. Results: Among 70 patients for whom the type of sedation was chosen by the physician, 15.7% received just local Lidocaine spray, 65.7% received Lidocaine spray + intravenous (IV) Midazolam, and 18.5% received Lidocaine spray + I.V. Midazolam + I.V. Pethidine. No patient needed any change in the dose or type of sedation. From 70 patients in the second group 13 (18.5%) chose just Lidocaine spray, but almost half of these patients could not tolerate the procedure and received I.V. Midazolam. Also, 41 (58.5%) chose Lidocaine spray + I.V. Midazolam, but 2 of them received I.V. Pethidine due to intolerance. Furthermore, 16 patients (22.8%) chose Lidocaine + I.V. Midazolam + I.V. Pethidine, but one of them received I.V. Propofol due to intolerance. Conclusion: Patient’s right to make decisions is an important issue in choosing the type of sedation for endoscopy, nevertheless, a considerable number of patients cannot make an appropriate decision independently. (Clinical Trials Registry Number: IRCT201606062499N4)
BACKGROUND Proton pump inhibitors (PPIs) are now widely prescribed for the management of patients with acute upper gastrointestinal bleeding; although its optimal dose and route of administration has ...remained a controversial issue. The aim of this study was to assess the clinical effectiveness of high dose oral versus intravenous (IV) PPI after successful endoscopic therapy in patients with bleeding peptic ulcer disease. METHODS 178 patients with active upper gastrointestinal bleeding due to a peptic ulcer with stigmata of high risk for re-bleeding entered the study. After successful endoscopic hemostasis, they were randomized to receive either high dose oral pantoprazole (80 mg stat and 80 mg twice daily for 3 days) or high dose intravenous pantoprazole (80 mg IV infusion within 30 minutes and 8 mg per hour for 3 days). After the 3rd day, the patients in both groups received oral pantoprazole 40 mg twice daily for one month. The end points were comparing the rate of re-bleeding or mortality, and the need for blood transfusion or surgery during the first month between the two groups. RESULTS There were not significant statistical differences between the two groups in the volume of blood transfusion, mean duration of hospital stay, need to surgery, or mortality rates. However, the rates of re-bleeding were 2.3% (2:88) in the IV group and 3.3% (3:90) in the oral group (
= 0.6). CONCLUSION According to our findings, it seems that high dose oral PPI can be a good alternative to high dose IV PPI in patients with bleeding peptic ulcer who are at high risk of re-bleeding. Due to the lower cost and the availability of oral PPIs, their use can be economically much more affordable.
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