Telepharmacy: A Systematic Review of Field Application, Benefits, Limitations, and Applicability During the COVID-19 Pandemic.

Introduction: Telepharmacy is widely known as the delivery of pharmacy care offered by registered pharmacists and pharmacies using telecommunication technologies to patients at a distance. We conducted a systematic review of the reported usages, benefits, and limitations of telepharmacy models worldwide to further clarify the pros and cons of a telepharmacy model. Methods: A total of 39 relevant articles was included after searching for articles with a fixed term on four databases, including PubMed, Virtual Health Library (VHL), Global Health Library (GHL), and Google Scholar, as of April 2021. Results: Our review suggested that telepharmacy has played an essential role in addressing pharmacist shortages and helping patients both safely and effectively administer medications in underserved areas. During the COVID-19 pandemic, remote dispensing and counseling are effective measures to avoid infection. Conclusion: Telepharmacy could potentially replace or complement pharmaceutical-related activities, facilitating future innovation in the health care industry.

A Bifunctional Copper Catalyst Enables Ester Reduction with H2: Expanding the Reactivity Space of Nucleophilic Copper Hydrides.

Employing a bifunctional catalyst based on a copper(I)/NHC complex and a guanidine organocatalyst, catalytic ester reductions to alcohols with H2 as terminal reducing agent are facilitated. The approach taken here enables the simultaneous activation of esters through hydrogen bonding and formation of nucleophilic copper(I) hydrides from H2, resulting in a catalytic hydride transfer to esters. The reduction step is further facilitated by a proton shuttle mediated by the guanidinium subunit. This bifunctional approach to ester reductions for the first time shifts the reactivity of generally considered "soft" copper(I) hydrides to previously unreactive "hard" ester electrophiles and paves the way for a replacement of stoichiometric reducing agents by a catalyst and H2.

Recent progress, challenges, and prospects of fully integrated mobile and wearable point-of-care testing systems for self-testing.

The rapid growth of research in the areas of chemical and biochemical sensors, lab-on-a-chip, mobile technology, and wearable electronics offers an unprecedented opportunity in the development of mobile and wearable point-of-care testing (POCT) systems for self-testing. Successful implementation of such POCT technologies leads to minimal user intervention during operation to reduce user errors; user-friendly, easy-to-use and simple detection platforms; high diagnostic sensitivity and specificity; immediate clinical assessment; and low manufacturing and consumables costs. In this review, we discuss recent developments in the field of highly integrated mobile and wearable POCT systems. In particular, aspects of sample handling platforms, recognition elements and sensing methods, and new materials for signal transducers and powering devices for integration into mobile or wearable POCT systems will be highlighted. We also summarize current challenges and future prospects for providing personal healthcare with sample-in result-out mobile and wearable POCT.

Improvement of Mechanical and Dielectric Properties of Epoxy Resin Using CNTs/ZnO Nanocomposite.

In this study, carbon nanotubes (CNTs)/ZnO composites had been prepared using the sol-gel method and then incorporated into an epoxy resin for reinforcement of mechanical and electrical properties. Fourier Transform Infrared (FTIR), X-ray diffraction (XRD) Field Emission Scanning Electron Microscope (FE-SEM) analyses show that the ZnO nanoparticles deposited on CNTs were crystallized in a hexagonal wurtzite structure. Average particle size of ZnO deposited on the CNT was about 8 nm. The mechanical and dielectric properties of epoxy containing CNTs/ZnO were investigated in comparison to epoxy resin and epoxy resin containing only CNT or ZnO nanoparticles. The results indicated that tensile strength and elongation at break of the nanocomposite were substantially improved with the presence of CNTs/ZnO at the equal volume. The DSC analysis associate with the dielectric results shows that the behavior of epoxy/CNTs/ZnO is identical to epoxy/ZnO composite, and the CNTs is essential to the distributed arrangement of ZnO in the epoxy resin.

Polylactic Acid/Chitosan Nanoparticles Loading Nifedipine: Characterization Findings and In Vivo Investigation in Animal.

This paper presents the results of zeta potential, water contact angle, atomic force microscopy image, in vitro solubility, and content of heavy metals in polylactic acid (PLA)/chitosan (CS) nanoparticles loading nifedipine. In addition, the In Vivo test of the PLA/CS nanoparticles loading nifedipine in the mice is also one of highlights of this work. The Zeta potential result shows that the charged surface of the PLA/CS nanoparticles loading nifedipine is neutral, negative or complex depending on nifedipine content. Nifedipine plays a role in increase of hydrophobic property, swelling degree and regular surface as well as decrease of surface rough of the nanoparticles. The PLA/CS/nifedipine nanoparticles are dissolved in the solutions with pH 6.8, pH 4.5 and pH 1.2. The In Vivo test of PLA/CS nanoparticles loading nifedipine on mice was evaluated by the change in diastolic pressure, systolic pressure, arterial pressure and heart rate. The obtained results confirm that the PLA/CS nanoparticles loading nifedipine is suitable to apply in the treatment of hypertension patients lately.

Association between nutritional status and dengue infection: a systematic review and meta-analysis.

BACKGROUND: Dengue infection has various clinical manifestations, often with unpredictable clinical evolutions and outcomes. Several factors including nutritional status have been studied to find the relationship with dengue severity. However, the nutritional status had conflicting effects on the complication of dengue in some previous studies. Therefore, we conducted a systematic review and performed a meta-analysis to analyze the association between nutritional status and the outcome of dengue infection. METHODS: Eleven electronic databases and manual searching of reference lists were used to identify the relevant studies published before August 2013. At least two authors worked independently in every step to select eligible studies and extract data. Dengue severity in the included studies must be classified into three categories: dengue fever (DF), dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). RESULTS: Thirteen articles that met the inclusion criteria came to final analysis. A meta-analysis using fixed- or random-effects models was conducted to calculate pooled odds ratios (OR) with corresponding 95 % confidence intervals. It has shown that there was no statistically significant association between DHF group and DSS group in malnutritional and overweight/obesity patients with OR: 1.17 (95 % CI: 0.99-1.39), 1.31 (0.91-1.88), respectively. A significantly inverse relation between DF and DHF groups of malnutritional patients was revealed (OR = 0.71, 95 % CI: 0.56-0.90). Our meta-analysis also indicated a statistically significant negative correlation between malnourished children with dengue virus infection and healthy children (OR = 0.46, 95 % CI: 0.3-0.70). When analyzing patients with normal nutrition status, we found out that there was a significantly negative relationship between DHF and DSS groups (0.87; 95 % CI: 0.77-0.99). Other comparisons of DSS with DF/DHF groups, DSS/DHF with DF groups, and DHF with DF groups in normal nutritional patients showed no significant correlation. However, the findings should be interpreted cautiously because all significant associations were lost after removing of the largest study. CONCLUSIONS: Results from previous studies failed to show any solid consistency regarding the association between the nutritional status and dengue infection. Consequently, the effects of nutritional status on dengue disease outcome has been controversial. Further studies are recommended to clarify the impact of nutritional status on dengue infection.

Ultrahigh Responsivity in Graphene-ZnO Nanorod Hybrid UV Photodetector.

Ultraviolet (UV) photodetectors based on ZnO nanostructure/graphene (Gr) hybrid-channel field-effect transistors (FETs) are investigated under illumination at various incident photon intensities and wavelengths. The time-dependent behaviors of hybrid-channel FETs reveal a high sensitivity and selectivity toward the near-UV region at the wavelength of 365 nm. The devices can operate at low voltage and show excellent selectivity, high responsivity (RI ), and high photoconductive gain (G). The change in the transfer characteristics of hybrid-channel FETs under UV light illumination allows to detect both photovoltage and photocurrent. The shift of the Dirac point (V Dirac ) observed during UV exposure leads to a clearer explanation of the response mechanism and carrier transport properties of Gr, and this phenomenon permits the calculation of electron concentration per UV power density transferred from ZnO nanorods and ZnO nanoparticles to Gr, which is 9 × 10(10) and 4 × 10(10) per mW, respectively. The maximum values of RI and G infer from the fitted curves of RI and G versus UV intensity are 3 × 10(5) A W(-1) and 10(6) , respectively. Therefore, the hybrid-channel FETs studied herein can be used as UV sensing devices with high performance and low power consumption, opening up new opportunities for future optoelectronic devices.

Improved performance and stability of field-effect transistors with polymeric residue-free graphene channel transferred by gold layer.

One of the most significant issues that occurs when applying chemical-vapor deposited (CVD) graphene (Gr) to various high-performance device applications is the result of polymeric residues. Polymeric residues remain on the Gr surface during Gr polymer support transfer to an arbitrary substrate, and these residues degrade CVD Gr electrical properties. In this paper, we propose that a thin layer of gold be used as a CVD Gr transfer layer, instead of a polymer support layer, to enable a polymer residue-free transfer. Comparative investigation of the surface morphological and qualitative analysis of residues on Gr surfaces and Gr field-effect transistors (GFETs) using two transfer methods demonstrates that gold-transferred Gr, with uniform, smooth, and clean surfaces, enable GFETs to perform better than Gr transferred by the polymer, polymethylmethacrylate (PMMA). In GFETs fabricated by the gold transfer method, field-effect carrier mobility was greatly enhanced and the position of the Dirac point was significantly reduced compared to GFETs fabricated by the PMMA transfer method. In addition, compared to the PMMA-transferred GFETs, the gold-transferred GFETs showed greatly increased stability with smaller hysteresis and higher resistance to gate bias stress effects. These results suggest that the gold transfer method for Gr provides significant improvements in GFET performance and reliability by minimizing the polymeric residues and defects on Gr.

Capacity building toward evidence-based medicine among healthcare professionals at the university of medicine and pharmacy, ho chi minh city, and its related institutes.

Research capacity development enhances a country's ownership of activities aimed at strengthening its health system. In Vietnam, continuing medical education (CME) is attracting increasing attention with the establishment of legal and policy frameworks. During 2010-2013, the Japan International Cooperation Agency funded a research capacity building project targeting physicians in Ho Chi Minh City. The project had been developed in four previous courses that were conducted in collaboration with Fukushima Medical University and Ho Chi Minh City University of Medicine and Pharmacy (UMP). The project succeeded in obtaining accreditation as the city's CME course. A total of 262 physicians attended three courses that have a divided set of research competencies. Following the Kirkpatrick Model for evaluating the effectiveness of training programs, we confirmed the participants' positive reaction to the courses (Level 1 evaluation), their perceived increase in knowledge and confidence in research skills (Level 2 evaluation), and application of learned knowledge in their practice (Level 3 evaluation). Presented here is a step-by-step scaling-up model of health research capacity building. Strategies for the further expansion include: further capacity building of instructors; responding to clinicians' specific needs; building a recruiting system with authorization; and improving the Level 3 training evaluation.

The effect of behavioral therapy on dysphagia of acute ischemic stroke patients feeding with a nasogastric tube.

This prospective observational study aimed to assess the impact of behavioral therapy on dysphagia in patients with acute ischemic stroke undergoing nasogastric tube feeding. The study was conducted between June 2020 and May 2022 at the Neurological Center of Bach Mai Hospital, Vietnam, with a sample size of 230 patients divided into two groups: a normal and a behavioral therapy group. The normal therapy group received routine care and treatment based on standard protocols, while the behavioral therapy group underwent daily swallowing exercises for approximately 60 minutes. The Gugging Swallowing Screen (GUSS) was utilized to screen individuals with dysphagia, and the difference-in-differences (DID) method was adopted to estimate the effect of behavioral therapy on dysphagia patients. The study concluded that behavioral therapy improved dysphagia in patients with acute ischemic stroke undergoing nasogastric tube feeding. This study highlights the potential of behavioral therapy as an effective intervention for dysphagia rehabilitation in stroke patients.

Bio-Inspired Sensory Receptors for Artificial-Intelligence Perception.

In the era of artificial intelligence (AI), there is a growing interest in replicating human sensory perception. Selective and sensitive bio-inspired sensory receptors with synaptic plasticity have recently gained significant attention in developing energy-efficient AI perception. Various bio-inspired sensory receptors and their applications in AI perception are reviewed here. The critical challenges for the future development of bio-inspired sensory receptors are outlined, emphasizing the need for innovative solutions to overcome hurdles in sensor design, integration, and scalability. AI perception can revolutionize various fields, including human-machine interaction, autonomous systems, medical diagnostics, environmental monitoring, industrial optimization, and assistive technologies. As advancements in bio-inspired sensing continue to accelerate, the promise of creating more intelligent and adaptive AI systems becomes increasingly attainable, marking a significant step forward in the evolution of human-like sensory perception.

Utilizing a High-Performance Piezoelectric Nanocomposite as a Self-Activating Component in Piezotronic Artificial Mechanoreceptors.

Challenges such as poor dispersion and insufficient polarization of BaTiO3 (BTO) nanoparticles (NPs) within poly(vinylidene fluoride-co-trifluoroethylene) (P(VDF-TrFE)) composites have hindered their piezoelectricity, limiting their uses in pressure sensors, nanogenerators, and artificial sensory synapses. Here, we introduce a high-performance piezoelectric nanocomposite material consisting of P(VDF-TrFE)/modified-BTO (mBTO) NPs for use as a self-activating component in a piezotronic artificial mechanoreceptor. To generate high-performance piezoelectric nanocomposite materials, the surface of BTO is hydroxylated, followed by the covalent attachment of (3-aminopropyl)triethoxysilane to improve the dispersibility of mBTO NPs within the P(VDF-TrFE) matrix. We also aim to enhance the crystallization degree of P(VDF-TrFE), the efficiency characteristics of mBTO, and the poling efficiency, even when incorporating small amounts of mBTO NPs. The piezoelectric potential mechanically induced from the P(VDF-TrFE)/mBTO NPs nanocomposite was three times greater than that from P(VDF-TrFE) and twice as high as that from the P(VDF-TrFE)/BTO NPs nanocomposite. The piezoelectric potential generated by mechanical stimuli on the piezoelectric nanocomposite was utilized to activate the synaptic ionogel-gated field-effect transistor for the development of self-powered piezotronics artificial mechanoreceptors on a polyimide substrate. The device successfully emulated fast-adapting (FA) functions found in biological FA mechanoreceptors. This approach has great potential for applications to future intelligent tactile perception technology.

Stomach-partitioning versus conventional gastrojejunostomy for unresectable gastric cancer with gastric outlet obstruction: A propensity score matched cohort study.

BACKGROUND: Stomach partitioning gastrojejunostomy (SPGJ) was introduced to deal with delayed gastric emptying (DGE). This study aimed to compare the short- and long-term outcomes of SPGJ versus conventional gastrojejunostomy (CGJ). METHOD: This cohort study analyzed 108 patients who underwent gastrojejunostomy for unresectable gastric cancer: 70 patients underwent SPGJ, and 38 patients underwent CGJ between 2018 and 2022. Propensity score-matched (PSM) analysis was used to balance the baseline characteristics. RESULTS: After PSM, there were 26 patients in each group. SPGJ group had significantly lower incidence of DGE (3.8% vs. 34.6%), vomiting (3.8% vs. 42.3%), and prokinetics requirement (11.5% vs. 46.2%). SPGJ group had significantly shorter time to solid diet tolerance (4.1 days vs. 5.7 days) and postoperative hospital stay (7.7 days vs. 9.3 days). There was no significant difference in relapse reinterventions, gastric outlet obstruction (GOO) recurrence, conversion surgery, and survival outcomes. CONCLUSIONS: SGPJ was associated with lower rate of DGE, prokinetics requirement, and shorter time of solid diet tolerance compared to CGJ in the treatment of unresectable gastric cancer patients with GOO.

Metal-enhanced fluorescence biosensor integrated in capillary flow-driven microfluidic cartridge for highly sensitive immunoassays.

Point-of-care testing (POCT) for low-concentration protein biomarkers remains challenging due to limitations in biosensor sensitivity and platform integration. This study addresses this gap by presenting a novel approach that integrates a metal-enhanced fluorescence (MEF) biosensor within a capillary flow-driven microfluidic cartridge (CFMC) for the ultrasensitive detection of the Parkinson's disease biomarker, aminoacyl-tRNA synthetase complex interacting multi-functional protein 2 (AIMP-2). Crucial point to this approach is the orientation-controlled immobilization of capture antibody on a nanodimple-structured MEF substrate within the CFMC. This strategy significantly enhances fluorescence signals without quenching, enabling accurate quantification of low-concentration AIMP-2 using a simple digital fluorescence microscope with a light-emitting diode excitation source and a digital camera. The resulting platform exhibits exceptional sensitivity, achieving a limit of detection in the pg/mL range for AIMP-2 in human serum. Additionally, the CFMC design incorporates a capillary-driven passive sample transport mechanism, eliminating the need for external pumps and further simplifying the detection process. Overall, this work demonstrates the successful integration of MEF biosensing with capillary microfluidics for point-of-care applications.

Corrigendum: Effectiveness of perindopril/amlodipine fixed-dose combination in the treatment of hypertension: a systematic review.

[This corrects the article DOI: 10.3389/fphar.2023.1156655.].

Effect of Time to Minimally Invasive Esophagectomy After Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma.

BACKGROUND: Neoadjuvant chemotherapy (NAC) with docetaxel, cisplatin, and 5-fluorouracil/capecitabine (DCF/DCX) followed by esophagectomy has been the recommended treatment for esophageal squamous cell carcinoma (ESCC). However, the optimal interval from NAC to surgery has not yet been established. This study evaluated the impact of time to surgery (TTS) in the treatment of ESCC. METHODS: Between August 2018 and September 2021, 97 patients who underwent radical esophagectomy following 3-6 cycles of NAC with DCF/DCX for ESCC at a single hospital were analyzed. TTS was categorized into three groups: 16-41 days (group 1; 33 patients), 42-55 days (group 2; 29 patients), and 56-135 days (group 3; 35 patients). Survival outcomes included overall survival (OS) and progression-free survival (PFS). RESULTS: Mean age was 59.6 ± 6.8 years, and 95 patients were male. One patient had grade-III anemia, 12 had grade-II anemia, and four had grade-II neutropenia; all other NAC-related toxicities were as grade I. Regarding pathologic tumor response, 18.6% achieved complete response, 71.1% achieved partial response, and 10.3% had stable disease. Forty-eight patients (49.5%) had a postoperative complication, but only six (6.2%) with grade IIIa and two (2.1%) with grade IVa according to the Clavien-Dindo classification. Median follow-up time was 24 months. Groups 1 and 3 had worse OS (HR [95% CI]: 3.36 [1.16-11.7] and 1.83 [0.55-6.10]) and worse PFS (HR [95% CI]: 3.27 [1.25-8.53] and 1.61 [0.58-4.45]) compared to group 2. CONCLUSION: We suggest the optimal TTS after NAC is 6-8 weeks. However, this finding must be confirmed by prospective trials.

The effect of skin-to-skin contact on early initiation of breastfeeding among women in Vietnam.

AIM: To describe prevalence of early initiation of breastfeeding and associated factors among Vietnamese mothers. METHODS: A self-administered questionnaire was used to survey 1812 mothers whose infants were aged 0 to less than 30 months in multi-center Vietnam. Multivariate logistic regression was performed to identify factors associated independently with early initiation of breastfeeding. RESULTS: Prevalence of early initiation of breastfeeding was 57.2 % and this prevalence was higher in female infants compared with male infants (p = 0.004). Factors associated with increased odds of early initiation of breastfeeding include female infants (aOR: 1.33; 95%CI: 1.06 to 1.68) living in urban areas (aOR: 1.34, 95%CI: 1.05 to 1.71), giving birth in private hospitals (aOR: 1.94, 95%CI: 1.25 to 3.03), vaginal birth (aOR: 1.70, 95%CI: 1.34 to 2.16). Factors associated with decreased odds of early initiation of breastfeeding include higher educational level, mother's weight gain during pregnancy, and infant complication at birth. Compared with mothers who had not experienced skin-to-skin contact with their babies, the prevalence of early initiation of breastfeeding was higher in mothers who experienced <15 min (aOR: 2.03, 95%CI: 1.32 to 3.14), 15-90 min (aOR: 6.33, 95%CI: 4.11 to 9.76), and >90 min (aOR: 10.98, 95%CI: 6.79 to 17.75). CONCLUSION: Focusing on modifiable factors should be a key priority to help improve early initiation of breastfeeding practice.

Rhenium(I)-tricarbonyl complexes with methimazole and its selenium analogue: Syntheses, characterization and cell toxicity.

This study explores the effect of a thione/selone ligand on the cell toxicity (in vitro) and light activity of diimine Re(CO)3+ complexes. Six rhenium(I) complexes with general formula fac-[Re(CO)3(N,N')X]+ were prepared, where X = 2-mercapto-1-methylimidazole (methimazole; MMI), and 1-methylimidazole-2-selone (MSeI); N,N' = 2,2'-bipyridine (bpy), 1,10-phenanthroline (phen) and 2,9-dimethyl-1,10-phenanthroline (dmphen). Their triflate salts were characterized using single-crystal X-ray diffraction, 1H, 13C and 2D NMR, UV-vis and vibrational spectroscopy. Their cytotoxic properties were tested, showing significant cytotoxicity (IC50 = 8.0-55 µM) towards the human breast cancer cell line MDA-MB-231. The half-inhibitory concentration (IC50) for fac-[Re(CO)3(dmphen)(MMI)]+, the most toxic complex in this series (8.0 ± 0.2 µM), was comparable to that of the corresponding aqua complex fac-[Re(CO)3(dmphen)(H2O)]+ with IC50 = 6.0 ± 0.1 µM. The fac-[Re(CO)3(bpy)(MMI/MSeI)]+ complexes were somewhat less toxic towards the human embryonic kidney cell line HEK-293 T after 48 h of exposure. The stability of the complexes upon irradiation was monitored using UV-vis spectroscopy, with no CO released when exposed to UV-A light (λ = 365 nm).

Effectiveness of perindopril/amlodipine fixed-dose combination in the treatment of hypertension: a systematic review.

Background: Uncontrolled blood pressure is a major risk factor for cardiovascular diseases. Fixed-dose combination (FDC) therapy offers a promising approach to addressing this challenge by providing a convenient single-tablet solution that enhances the effectiveness of blood pressure control. In our systematic review, we assess the effectiveness of perindopril/amlodipine FDC in managing blood pressure. Methods: We conducted a comprehensive search across four primary electronic databases, namely, PubMed, Virtual Health Library (VHL), Global Health Library (GHL), and Google Scholar, as of 8 February 2022. Additionally, we performed a manual search to find relevant articles. The quality of the selected articles was evaluated using the Study Quality Assessment Tools (SQAT) checklist from the National Institute of Health and the ROB2 tool from Cochrane. Results: Our systematic review included 17 eligible articles. The findings show that the use of perindopril/amlodipine FDC significantly lowers blood pressure and enhances the quality of blood pressure control. Compared to the comparison group, the perindopril/amlodipine combination tablet resulted in a higher rate of blood pressure response and normalization. Importantly, perindopril/amlodipine FDC contributes to improved patient adherence with minimal side effects. However, studies conducted to date have not provided assessments of the cost-effectiveness of perindopril/amlodipine FDC. Conclusion: In summary, our analysis confirms the effectiveness of perindopril/amlodipine FDC in lowering blood pressure, with combination therapy outperforming monotherapy and placebo. Although mild adverse reactions were observed in a small subset of participants, cost-effectiveness assessments for this treatment remain lacking in the literature.

Levofloxacin+Tetracycline Quadruple Regimen for Eradication of Helicobacter pylori: A Multicenter Multinational Randomized Controlled Trial.

Background: The ideal combination regimen for Helicobacter pylori (HP) eradication has not yet been determined and the success rate of HP eradication has been extensively reduced worldwide due to increasing antibiotic resistance. So this multinational multi-center randomized controlled trial was designed to evaluate the efficacy of tetracycline +levofloxacin for HP eradication. Methods: During a 6-month period, all of the cases with HP infection in eight referral tertiary centers of three countries were included and randomly allocated to receive either tetracycline + levofloxacin or clarithromycin plus amoxicillin quadruple regimen for two weeks. For all of the participants, pantoprazole was continued for 4 more weeks and after one to two weeks of off-therapy, they underwent urea breath test C13 to prove eradication. Results: Overall 788 patients were included (358 male (45.4%), average age 44.2 years). They were diagnosed as having non-ulcer dyspepsia (516 cases, 65.5%), peptic ulcer disease (PUD) (234 cases, 29.69%), and intestinal metaplasia (38 cases, 4.8%). Racially 63.1% were Caucasian, 14.5% Arab, 15.6% African, and 6.1% Asian. The participants were randomly allocated to groups A and B to receive either tetracycline + levofloxacin or clarithromycin. Among groups A and B in intention to treat (ITT) and per protocol (PP) analysis, 75.2% & 82.1% (285 cases) and 67.5% & 70.1% (276 cases) of participants achieved eradication, respectively (P = 0.0001). The complete compliance rate in groups A and B were 84.4% and 83.6%, respectively. During the study, 33.5% of the participants in group A (127 cases) reported side effects while the complication rate among group B was 27.9% (114 cases, P = 0.041). The most common complaints among groups A and B were nausea and vomiting (12.6% & 9.3%) and abdominal pain (4.48% & 2.68%), respectively. The rate of severe complications that caused discontinuation of medication in groups A and B were 2.1% and 1.46%, respectively (P = 679). In subgroup analysis, the eradication rates of tetracycline+levofloxacin among patients with non-ulcer dyspepsia, PUD, and intestinal metaplasia were 79.4%, 88.1%, and 73.9%, respectively. These figures in group B (clarithromycin base) were 71.3%, 67.6%, and 61.5% respectively (P = 0.0001, 0.0001, and 0.043). Conclusion: Overall, the combination of tetracycline+levofloxacin is more efficient for HP eradication in comparison with clarithromycin+amoxicillin despite more complication rate. In areas with a high rate of resistance to clarithromycin, this therapeutic regimen could be an ideal choice for HP eradication, especially among those who were diagnosed with PUD.