The effects of LactoCare synbiotic administration on chemotherapy-induced nausea, vomiting, diarrhea, and constipation in children with ALL: A double-blind randomized clinical trial.

BACKGROUND: Synbiotics are supplements containing probiotics and prebiotics and potentially have a stronger effect in modulating the gut microbiota than probiotics or prebiotics alone. The aim of this study was to determine the effects of LactoCare synbiotic administration on chemotherapy-induced diarrhea (CID), nausea, vomiting, and constipation in children with acute lymphoblastic leukemia (ALL) who receiving maintenance chemotherapy. METHODS: This double-blind clinical trial was performed on 113 children with ALL. The patients were randomly assigned into two groups to receive either 5 × 109 CFU LactoCare synbiotic administration or placebo (58 patients in the LactoCare-treatment group and 55 patients in the placebo group), twice a day for 7 days. The number of times CID, vomiting, nausea, and constipation were recorded in the first week after the beginning of receiving LactoCare and the placebo. RESULTS: In the LactoCare-treatment group, CID was present in 3.7% and 1.8% of patients on the first and second days, respectively, and no CID was observed on the third to seventh days (p < .05). While in the placebo group, the rate of patients with CID on the second, third, and fourth days was 11.5%, 13.5%, and 11.5%, respectively, and less than 10% on the first, fifth, sixth, and seventh days. It was observed that the rate of constipation in the LactoCare-treatment group was significantly lower than in the placebo group. The difference between the groups was about 14% on the third day, which increased to about 20% on the sixth day (p < .05). CONCLUSION: The use of synbiotic supplements in this study reduced CID in patients. This study supports the concept that the use of synbiotic supplements will be an easy and effective way to reduce CID in ALL patients.

Pantoprazole reduces serum ferritin in patients with thalassemia major and intermedia: A randomized, controlled study.

AIM: Complications due to iron overload exert a problematic situation in patients with thalassemia. Proton pump inhibitors (PPIs) like pantoprazole are effective agents to reduce acid gastric acid secretion and perhaps to interrupt iron absorption in conditions with increased iron absorption. Our purpose was to study effects of pantoprazole addition to chelators on iron levels in patients with thalassemia major and intermedia. METHODS: This randomized, controlled, and single center trial was performed on 60 patients with thalassemia major and intermedia in Amir Kabir hospital, Iran. Patients were randomized 1:1 to pantoprazole group (iron chelator plus pantoprazole) or control group (iron chelator) for 6 months. Serum ferritin was measured by ELISA. Iron content was measured by magnetic resonance imaging; heart T2*, and liver T2*. RESULTS: After 6 months of treatment, a significant reduction was seen in serum ferritin levels in the pantoprazole group (1444±613µg/mL to 1197±956µg/mL; P<0.001). A further reduction was seen in patients with thalassmeia intermedia. There were no significant changes in myocardial T2* values in pantoprazole group compared to control group (23.6±7.3ms to 24.1±6.4ms). Compared to the control group, pantoprazole therapy had no effect on hepatic T2* value (9.7±2.3ms to 9.8±2.6ms). However, between-group difference was significant (P<0.05). CONCLUSION: Pantoprazole therapy for 6 months has benefits for reducing serum ferritin in patients with thalassemia major and intermedia. Pantoprazole addition to iron chelators seems safe.

Addition of Neostigmine and Tramadol to 1.5 % Lidocaine for paracervical block to reduce post-operative pain in colporrhaphy.

Pain is a complex and multi-faceted human perception and several factors could dampen the pain. Therefore, we aimed to comparison of addition of neostigmine and tramadol to 1.5 % lidocaine with paracervical block in reduce of post-operative pain in colporrhaphy. This study was a randomized and double-blind clinical trial for 108 patients' as candidate for colporrhaphy. Patients were randomly divided in three groups (Neostigmine, tramadol and control).We recorded pain in 2 and 6 and 12 hours after surgery, duration of analgesia and mean of use narcotic drug in 24 hours after surgery for all patients. Mean of narcotic drug used in 24 hours after surgery in neostigmine group was more than tramadol group(p=0/01).Pain in 2 and 6 and 12 hours after surgery in neostigmine group was more than tramadol group (p=0/01). Duration of analgesia in tramadol group was over neostigmine group and also, it was in neostigmine group was more than placebo (p=0/01).Taken together, tramadol could reduce pain in 2 and 6 and 12 hours after surgery and mean of narcotic drug used in 24 hours after surgery and increase duration of analgesia.