Liver Fibrosis and Cirrhosis in Patients with Non-alcoholic Fatty Liver with and without History of Cholecystectomy: A Pilot Study.

Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases in the world. Previous studies revealed that cholecystectomy may be considered a risk factor for the development of NAFLD. The aim of this study was to compare the amount of liver fibrosis, determined by elastography, between patients with NAFLD with and without a history of cholecystectomy. Methods: In this descriptive-analytical cross-sectional study, 50 patients with NAFLD were divided into two groups: one with a history of cholecystectomy and the other without. No significant differences were found between these two groups in terms of age or sex distribution. Liver fibrosis was measured for all patients using an elastography imaging system. Subsequently, the data related to liver fibrosis, along with the demographic information of the patients, were statistically analyzed using SPSS software version 22. Results: The mean elastography score in all patients was 10.66±12.18 kPa (the elasticity scale ranging from 3.80 to 66.40 kPa). The group with a history of cholecystectomy had a significantly higher mean elastography score (13.39±16.20 kPa) compared with the group without cholecystectomy (7.93±4.99 kPa) (P=0.02). Additionally, there was a significant positive correlation between body mass index (BMI) and the mean elastography score in the group of patients with a history of cholecystectomy. Conclusion: The mean elastography score of patients with NAFLD with a history of cholecystectomy was approximately twice as high as that of non-cholecystectomy patients.

Eradication efficacy of high-dose amoxicillin and proton pump inhibitor compared with quadruple therapy contained bismuth in the treatment of Helicobacter pylori.

Background: Helicobacter pylorus is one of the most common bacterial infections affecting the world's population. Peptic ulcer disease is caused by H. pylori and the use of nonsteroidal anti-inflammatory drugs. The aim of this study was to assessment of two antibiotic regimens in the treatment of H. pylori. Methods: A total of 220 H. pylori infected patients were enrolled in the randomized clinical trial that referred to Imam Khomeini Hospital gasterointestinal clinic, Ahvaz. Patients were allocated into two groups randomly. Group 1 received the 14-day proton pump inhibitor (PPI) amoxicillin-containing high-dose therapy and group II received the bismuth-containing quadruple therapy. Basic characteristics, adverse events, and eradication rates were compared between two groups. Results: The PPI-amoxicillin-containing high-dose therapy group achieved eradication rates of 73.6% and 72.4% as determined by the intention-to-treat and per-protocol analyses, respectively (P > 0.05). The eradication rates at bismuth-containing quadruple therapy group were 77.2% and 76.1%, respectively, (P > 0.05). Also, there were no significant differences in the compliance rates and adverse effects between two groups (P > 0.05). Furthermore, the cost of medications in the PPI-amoxicillin-containing high-dose therapy was significantly lower compared with that in the quadruple therapy contained bismuth. Conclusion: PPI-amoxicillin-containing high-dose treatment regimen can be used especially in the pregnancy and lactating patient or low-economic patient because safer and less costly compared with bismuth-containing quadruple therapy.