Role of Lactobacillus plantarum 299v versus Placebo in symptomatic improvement of irritable bowel syndrome patients.

Objectives: To find the efficacy of lactobacillus plantarum 299v compared to placebo in symptomatic improvement of irritable bowel syndrome patients. METHODS: The randomised control trial was conducted at the Lady Reading Hospital, Peshawar, Pakistan, from July 20, 2014, to January 20, 2015, and comprised irritable bowel syndrome patients who were randomised into intervention group A treated with lactobacillus plantarum 299v and control group B treated with placebo. Symptoms, like abdominal pain, bloating and complete rectal emptying, were noted and compared between the groups. Data was analysed using SPSS 19. RESULTS: Of the 190 patients assessed, 120(63%) were included; 60(50%) in each of the two groups. After loss to follow-up, the study was completed by 55(91.7%) in group A and 53(88.3%) in group B. The mean age in group A was 37.53±9.02 and it was 34.40±11.23 in group B (p=0.652). The male-to-female ratio and irritable bowel syndrome type in both the groups was not significantly different (p>0.055). There was no significant difference in terms of relieving abdominal pain, bloating and rectal emptying between the groups (p>0.05). CONCLUSIONS: No significant efficacy was established in favour of treating in irritable bowel syndrome with lactobacillus plantarum 299v. Trials Registration: IRCT20200504047303N1.

Frequency of De Novo Hepatocellular Carcinoma after Direct-acting Antiviral Therapy for Chronic Hepatitis C: A Prospective Follow-up.

Background: Chronic hepatitis C (CHC) management has changed tremendously after direct-acting antivirals (DAAs) availability. Sustained virological response (SVR) has improved significantly, but one of the major concerns is the chances of de novo hepatocellular carcinoma (HCC) development after DAAs. The objective of the study is to calculate the frequency of newly diagnosed cases of HCC after antiviral therapy for CHC in Pakistan. Materials and methods: This prospective, interventional research was conducted from June 2017 to September 2020. All patients after antiviral therapy for CHC were followed with an ultrasound abdomen and α-fetoprotein, six monthly. Multiphasic computed tomography (CT) of the abdomen was performed in suspected cases. For quantitative variables, the mean and standard deviations were calculated, whereas the qualitative variables were analyzed by frequencies and percentages. Results: Among 180 patients, 110 were men and 70 were women with a mean age of 45.52 ± 11.71 years. One hundred and twenty-six patients were noncirrhotic, 38 had compensated cirrhosis while 16 had decompensated cirrhosis. One hundred and sixty-four (91.11%) patients achieved SVR, of which 22 (12.22%) patients developed new HCC during follow-up. Compensated cirrhosis group had 10 patients, the decompensated group had 12 patients, and the noncirrhotic group had no new HCC cases. Among patients with the new HCC, 12 achieved SVR. Conclusion: The risk of the development of HCC after antiviral treatment is highly significant among patients with liver cirrhosis. So, a strict surveillance strategy should be adopted in every cirrhotic patient following treatment with DAA agents even if they achieve SVR. Clinical significance: Chances of developing HCC are still significantly high even after achieving SVR with DAAs in patients with liver cirrhosis.Patients with liver cirrhosis should be under surveillance for HCC even after achieving SVR after DAAs treatment. How to cite this article: Rasool S, Hanif S, Ahmad A, et al. Frequency of De Novo Hepatocellular Carcinoma after Direct-acting Antiviral Therapy for Chronic Hepatitis C: A Prospective Follow-up. Euroasian J Hepato-Gastroenterol 2022;12(2):73-76.