RESUMO
Helicobacter pylori is an important risk factor for chronic gastritis, peptic ulcer, and gastric cancer. Three-drug regimen is the first-line treatment for this infection, but the response rate to treatment varies in different geographical regions. This study was conducted to comparatively determine the effect of amoxicillin and metronidazole on three-drug regimen to treat H. pylori infection in 1-15-year-old children. This clinical trial was conducted on 82 patients aged 1-15 years with convenience sampling referring to the Endoscopy Unit of Hajar Hospital, Shahrekord. Group 1 was administered with clarithromycin, amoxicillin, and omeprazole (CAO), and Group 2 with, clarithromycin, metronidazole, and omeprazole (CMO). One month after completion of the treatment, stool antigen test was used to study the eradication of H. pylori. Data were analyzed using SPSS software by Chi-square test. Three of the 82 patients were excluded from the study because of side effects caused by drugs. Nearly 87.2% of the patients in CAO-treated group and 92.5% in CMO-treated group had response to treatment. There was no significant difference in eradication rate between the two regimens (P = 0.43). The two regimens displayed no superiority over each other for eradicating H. pylori infection and response rate to treatment in children aged 1-15 years.
RESUMO
Herpes simplex virus (HSV) is the most common identifiable cause of serious or life threatening sporadic, endemic encephalitis. Typical HSV encephalitis in patients outside neonatal age is caused by HSV-1. A 23-month-old girl was referred to our hospital with a three-day history of fever, listlessness, slurred speech, and suspicious oesophageal foreign body impaction. Laboratory evaluations showed white blood cell count of 10900 /mm3 with 65% neutrophils. Upper endoscopy revealed diffuse severe ulceration in middle to distal third of oesophagus and no foreign body was found in oesophagus or stomach. Parenteral acyclovir was prescribed for herpes encephalitis in addition to antibiotics for central nervous system infection. Chest X-ray and brain MRI was unremarkable. Lumbar puncture revealed normal protein and glucose with 10 white cell count. She developed a raising liver enzyme tests. Total and direct bilirubin was 1.2 mg/dc and 0.2 mg/dc respectively. Because of neurological symptoms, acyclovir was adopted for our patient from the beginning. The girl did not respond to medication and died after 28 days. Progression of her disease prior to referral appears to contribute to the administered treatment inefficacy. Severe rapid progression of disease prior to referral and potential resistance to acyclovir could cause treatment failure.
