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1.
Molecules ; 26(19)2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34641501

RESUMO

Diabetes mellitus is a global threat affecting millions of people of different age groups. In recent years, the development of naturally derived anti-diabetic agents has gained popularity. Okra is a common vegetable containing important bioactive components such as abscisic acid (ABA). ABA, a phytohormone, has been shown to elicit potent anti-diabetic effects in mouse models. Keeping its anti-diabetic potential in mind, in silico study was performed to explore its role in inhibiting proteins relevant to diabetes mellitus- 11ß-hydroxysteroid dehydrogenase (11ß-HSD1), aldose reductase, glucokinase, glutamine-fructose-6-phosphate amidotransferase (GFAT), peroxisome proliferator-activated receptor-gamma (PPAR-gamma), and Sirtuin family of NAD(+)-dependent protein deacetylases 6 (SIRT6). A comparative study of the ABA-protein docked complex with already known inhibitors of these proteins relevant to diabetes was compared to explore the inhibitory potential. Calculation of molecular binding energy (ΔG), inhibition constant (pKi), and prediction of pharmacokinetics and pharmacodynamics properties were performed. The molecular docking investigation of ABA with 11-HSD1, GFAT, PPAR-gamma, and SIRT6 revealed considerably low binding energy (ΔG from -8.1 to -7.3 Kcal/mol) and predicted inhibition constant (pKi from 6.01 to 5.21 µM). The ADMET study revealed that ABA is a promising drug candidate without any hazardous effect following all current drug-likeness guidelines such as Lipinski, Ghose, Veber, Egan, and Muegge.

2.
Molecules ; 26(12)2021 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-34199316

RESUMO

Herbs and spices have been used since antiquity for their nutritional and health properties, as well as in traditional remedies for the prevention and treatment of many diseases. Therefore, this study aims to perform a chemical analysis of both essential oils (EOs) from the seeds of Carum carvi (C. carvi) and Coriandrum sativum (C. sativum) and evaluate their antioxidant, antimicrobial, anti-acetylcholinesterase, and antidiabetic activities alone and in combination. Results showed that the EOs mainly constitute monoterpenes with γ-terpinene (31.03%), ß-pinene (18.77%), p-cymene (17.16%), and carvone (12.20%) being the major components present in C. carvi EO and linalool (76.41%), γ-terpinene (5.35%), and α-pinene (4.44%) in C. sativum EO. In comparison to standards, statistical analysis revealed that C. carvi EO showed high and significantly different (p < 0.05) antioxidant activity than C. sativum EO, but lower than the mixture. Moreover, the mixture exhibited two-times greater ferric ion reducing antioxidant power (FRAP) (IC50 = 11.33 ± 1.53 mg/mL) and equipotent chelating power (IC50 = 31.33 ± 0.47 mg/mL) than the corresponding references, and also potent activity against 2,2-diphenyl-1-picrylhydrazyl (DPPH) (IC50 = 19.00 ± 1.00 mg/mL), ß-carotene (IC50 = 11.16 ± 0.84 mg/mL), and superoxide anion (IC50 = 10.33 ± 0.58 mg/mL) assays. Antimicrobial data revealed that single and mixture EOs were active against a panel of pathogenic microorganisms, and the mixture had the ability to kill more bacterial strains than each EO alone. Additionally, the anti-acetylcholinesterase and α-glucosidase inhibitory effect have been studied for the first time, highlighting the high inhibition effect of AChE by C. carvi (IC50 = 0.82 ± 0.05 mg/mL), and especially by C. sativum (IC50 = 0.68 ± 0.03 mg/mL), as well as the mixture (IC50 = 0.63 ± 0.02 mg/mL) compared to the reference drug, which are insignificantly different (p > 0.05). A high and equipotent antidiabetic activity was observed for the mixture (IC50 = 0.75 ± 0.15 mg/mL) when compared to the standard drug, acarbose, which is about nine times higher than each EO alone. Furthermore, pharmacokinetic analysis provides some useful insights into designing new drugs with favorable drug likeness and safety profiles based on a C. carvi and C. sativum EO mixture. In summary, the results of this study revealed that the combination of these EOs may be recommended for further food, therapeutic, and pharmaceutical applications, and can be utilized as medicine to inhibit several diseases.


Assuntos
Acetilcolinesterase/química , Antibacterianos/farmacologia , Antioxidantes/farmacologia , Carum/química , Coriandrum/química , Hipoglicemiantes/farmacologia , Óleos Voláteis/farmacologia , Antibacterianos/química , Antibacterianos/farmacocinética , Antioxidantes/química , Antioxidantes/farmacocinética , Hipoglicemiantes/química , Hipoglicemiantes/farmacocinética , Óleos Voláteis/química , Óleos Voláteis/farmacocinética , Sementes/química
3.
Molecules ; 26(12)2021 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-34204669

RESUMO

Abelmoschus esculentus (Okra) is an important vegetable crop, widely cultivated around the world due to its high nutritional significance along with several health benefits. Different parts of okra including its mucilage have been currently studied for its role in various therapeutic applications. Therefore, we aimed to develop and characterize the okra mucilage biopolymer (OMB) for its physicochemical properties as well as to evaluate its in vitro antidiabetic activity. The characterization of OMB using Fourier-transform infrared spectroscopy (FT-IR) revealed that okra mucilage containing polysaccharides lies in the bandwidth of 3279 and 1030 cm-1, which constitutes the fingerprint region of the spectrum. In addition, physicochemical parameters such as percentage yield, percentage solubility, and swelling index were found to be 2.66%, 96.9%, and 5, respectively. A mineral analysis of newly developed biopolymers showed a substantial amount of calcium (412 mg/100 g), potassium (418 mg/100 g), phosphorus (60 mg/100 g), iron (47 mg/100 g), zinc (16 mg/100 g), and sodium (9 mg/100 g). The significant antidiabetic potential of OMB was demonstrated using α-amylase and α-glucosidase enzyme inhibitory assay. Further investigations are required to explore the newly developed biopolymer for its toxicity, efficacy, and its possible utilization in food, nutraceutical, as well as pharmaceutical industries.


Assuntos
Abelmoschus/química , Mucilagem Vegetal/química , Mucilagem Vegetal/isolamento & purificação , Abelmoschus/metabolismo , Antioxidantes/química , Biopolímeros/análise , Biopolímeros/química , Suplementos Nutricionais , Hipoglicemiantes/isolamento & purificação , Hipoglicemiantes/metabolismo , Extratos Vegetais/farmacologia , Polissacarídeos/química , Espectroscopia de Infravermelho com Transformada de Fourier/métodos , alfa-Amilases/química , alfa-Glucosidases/química
4.
Oxf Med Case Reports ; 2020(10): omaa088, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33133621

RESUMO

Nocardia cyriacigeorgica (N. cyriacigeorgica) is most frequently associated with human infections, including chronic bronchitis, pulmonary disease and brain abscesses. In general, N. cyriacigeorgica causes infections in immunocompromised individuals and has been reported in clinical samples worldwide. However, the isolation and speciation of N. cyriacigeorgica in the routine diagnostic microbiology laboratory are complicated and time consuming. Recent mass spectrometry techniques such as matrix-assisted laser desorption/ionization time-of-flight-mass spectrometry (MALDI-TOF-MS) have been successfully integrated into many routine diagnostic microbiology laboratories, allowing for the rapid, accurate and simple identification and speciation of many different microorganisms, including difficult-to-identify bacterial species. Here, we present a case report of a 65-year-old female patient from the neurology ward of Prince Sultan Military Medical City in Riyadh, Saudi Arabia, who was infected with N. cyriacigeorgica. The bacterium was successfully identified by MALDI-TOF-MS, with species identification subsequently confirmed by sequence analysis of the 16S ribosomal RNA.

5.
Eur J Clin Microbiol Infect Dis ; 39(1): 85-92, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31482419

RESUMO

In order to obtain more information on the MRSA population structure in the border region of Afghanistan and Pakistan, we collected and genotyped MRSA causing bloodstream infections from a tertiary care hospital in Peshawar, Pakistan, that serves the local population as well as Afghan immigrants and refugees. Thirty-one MRSA isolates from 30 patients were included and characterized by microarray hybridisation. For 25 patients, serum samples were tested using protein microarrays in order to detect antibodies against staphylococcal virulence factors. The most conspicuous result was the high rate of PVL-positive MRSA. Twenty-two isolates (71%) harboured lukF/S-PV genes. The most common lineage was CC772-MRSA-V/VT (PVL+) to which eleven isolates were assigned. The second most common strain was, surprisingly, CC8-MRSA-[IV+ACME] (PVL+), "USA300" (9 isolates). Two isolates were tst1 positive CC22-MRSA-IV, matching the Middle Eastern "Gaza Epidemic Strain". Another two were PVL-positive CC30-MRSA-IV. The remaining isolates belonged to, possibly locally emerging, CC1, CC5, and CC8 strains with SCC mec IV elements. Twenty-three patient sera were positive for anti-PVL-IgG antibodies. Several questions arise from the present study. It can be assumed that MRSA and high rates of PVL-positive S. aureus/MRSA are a public health issue in the Afghanistan/Pakistan border region. A possible emergence of the "USA300" clone as well as of the CC772 lineage warrants further investigation.


Assuntos
Anticorpos Antibacterianos/sangue , Staphylococcus aureus Resistente à Meticilina/classificação , Sepse/microbiologia , Infecções Estafilocócicas/sangue , Fatores de Virulência/imunologia , Adulto , Afeganistão , Técnicas de Tipagem Bacteriana , Feminino , Genótipo , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Paquistão , Análise Serial de Proteínas , Infecções Estafilocócicas/microbiologia , Fatores de Virulência/genética
6.
Indian J Gastroenterol ; 37(6): 504-510, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30543047

RESUMO

BACKGROUND: Little is known about the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in Ladakh, a mountainous region with low population density. We, therefore, determined these and tried to identify risk factors associated with these infections. METHODS: Randomly selected residents of Ladakh region were tested for hepatitis B surface antigen (HBsAg), antibodies to hepatitis B core antigen (anti-HBc) and antibodies to HCV (anti-HCV). A subset of HBsAg-positive persons were tested for hepatitis B e-antigen (HBeAg) and HBV DNA and those with anti-HCV for HCV RNA. Viral genotype was also determined. RESULTS: Of the 2674 subjects, 141 (5.3%) tested positive for HBsAg, i.e. had current HBV infection and 339 (12.7%) tested positive for either HBsAg and or anti-HBc, i.e. had either current or past infection with HBV. Anti-HCV antibody was detected in 22 (0.8%) subjects. The HBsAg positivity rate was higher in Kargil district (8.3%) than in Leh district (3.3%). No particular risk factor was identified for either infection. Of the 141 and 22 specimens that contained HBsAg and anti-HCV, respectively (one had both), 74 and none tested positive for HBV DNA and HCV RNA, respectively. Of the 29 specimens that had sufficient HBV DNA for genotyping, 21, 7, and 1 specimens had HBV genotypes D, C, and A, respectively. CONCLUSION: The overall prevalence of HBV infection seems to be higher in Ladakh region, especially the Kargil district. The prevalence of anti-HCV was similar to that in other parts of India. ᅟ ᅟ.


Assuntos
Hepatite B/epidemiologia , Hepatite C/epidemiologia , Adolescente , Adulto , Biomarcadores/sangue , DNA Viral/sangue , Feminino , Hepatite B/diagnóstico , Anticorpos Anti-Hepatite B/sangue , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/sangue , Antígenos E da Hepatite B/sangue , Vírus da Hepatite B/genética , Hepatite C/diagnóstico , Anticorpos Anti-Hepatite C/sangue , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , RNA Viral/sangue , Fatores de Risco , Adulto Jovem
7.
PLoS One ; 13(9): e0202464, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30231071

RESUMO

Minimization functionals related to Euler's elastica energy has a broad range of applications in computer vision and image processing. This paper proposes a novel Euler's elastica and curvature-based variational model for image restoration corrupted with multiplicative noise. It combines Euler's elastica curvature with a Weberized total variation (TV) regularization and gets a novel Euler's elastica energy and TV-based minimization functional. The combined approach in this variational model can preserve edges while reducing the blocky effect in smooth regions. The implicit gradient descent scheme is applied to efficiently finding the minimizer of the proposed functional. Experimental results demonstrate the effectiveness of the proposed model in visual improvement, as well as an increase in the peak signal-to-noise ratio, compared to the PDE-based methods.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Algoritmos , Elasticidade , Aumento da Imagem , Razão Sinal-Ruído
8.
Indian J Med Microbiol ; 36(2): 265-272, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30084422

RESUMO

Background: Helicobacter pylori infection is recognised as type 1 carcinogen by the International Agency of Research on Cancer. Previous studies in our hospital have revealed high prevalence of H. pylori in our population with a high recurrence rate after completion of treatment. This prompted us to undertake this study. Aim: This study aimed to determine common gene mutations leading to resistance to clarithromycin, metronidazole, tetracycline and quinolones in H. pylori in patients attending our hospital. Settings and Design: This is a cross-sectional hospital-based study. The study was approved by the Institutional Ethics Committee. Materials and Methods: This study was conducted on 196 adult dyspeptic patients with an indication for upper gastrointestinal endoscopy. Gastric biopsies collected from them were subjected to histopathological examination, rapid urease test (RUT) and culture. Of the 196 patients, 95 met the inclusion criteria. Drug susceptibility testing (DST) by various polymerase chain reaction-based methods was done for 47 RUT-positive biopsies and 13 H. pylori isolates. Results: Maximum resistance was seen to metronidazole (81.66%) followed by clarithromycin (45%) and quinolones (3.33%). No high-level resistance was seen to tetracycline. In clarithromycin-resistant cases, A2142G mutation was more prevalent than A2143G mutation. Multidrug resistance (resistance to metronidazole and clarithromycin) was seen in 41.66% of patients. Conclusions: Tetracycline and quinolones could be the antibiotics of choice in the eradication of H. pylori in this region, while recurrence of the infection with H. pylori could be expected among patients receiving either metronidazole or clarithromycin, for eradication therapy. DST should be done on a routine basis utilising both phenotypic and genotypic methods to prevent further emergence of resistance in this region.


Assuntos
Helicobacter pylori/efeitos dos fármacos , Helicobacter pylori/patogenicidade , Claritromicina/farmacologia , Estudos Transversais , Farmacorresistência Bacteriana/genética , Farmacorresistência Bacteriana Múltipla/genética , Helicobacter pylori/genética , Humanos , Índia , Metronidazol/farmacologia , Reação em Cadeia da Polimerase , Quinolonas/farmacologia , RNA Ribossômico 16S/genética , Centros de Atenção Terciária/estatística & dados numéricos , Tetraciclina/farmacologia
9.
PLoS One ; 12(1): e0161787, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28141802

RESUMO

This paper proposes a new variational model for joint multiplicative denoising and deblurring. It combines a total generalized variation filter (which has been proved to be able to reduce the blocky-effects by being aware of high-order smoothness) and shearlet transform (that effectively preserves anisotropic image features such as sharp edges, curves and so on). The new model takes the advantage of both regularizers since it is able to minimize the staircase effects while preserving sharp edges, textures and other fine image details. The existence and uniqueness of a solution to the proposed variational model is also discussed. The resulting energy functional is then solved by using alternating direction method of multipliers. Numerical experiments showing that the proposed model achieves satisfactory restoration results, both visually and quantitatively in handling the blur (motion, Gaussian, disk, and Moffat) and multiplicative noise (Gaussian, Gamma, or Rayleigh) reduction. A comparison with other recent methods in this field is provided as well. The proposed model can also be applied for restoring both single and multi-channel images contaminated with multiplicative noise, and permit cross-channel blurs when the underlying image has more than one channel. Numerical tests on color images are conducted to demonstrate the effectiveness of the proposed model.


Assuntos
Algoritmos , Artefatos , Animais , Cor , Processamento de Imagem Assistida por Computador , Modelos Teóricos , Análise Numérica Assistida por Computador , Imagens de Fantasmas , Razão Sinal-Ruído
10.
Brain Circ ; 3(1): 35-40, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-30276302

RESUMO

PURPOSE: Nonalcoholic fatty liver disease (NAFLD) is a frequently encountered clinical condition in clinical practice, particularly in obese and diabetic patients. Carotid atherosclerosis is regarded as surrogate marker of coronary atherosclerosis. We aimed to know whether evaluation for carotid atherosclerosis should be done in all patients of NAFLD. MATERIALS AND METHODS: A total of 200 NAFLD patients and 100 age- and sex-matched controls were enrolled into the study. Ultrasound was done to document fatty liver and carotid intimal thickness, and relation between these two was observed. RESULTS: Grade 1 fatty liver was seen in 36% patients while Grade 2 fatty liver was found in 39% and Grade 3 fatty liver in 25%. Patients with Grade 1 fatty liver had left intima-media thickness (IMT) in the range of 0.4-0.6 mm (mean IMT - 0.69 mm) and had right IMT in the range of 0.5-0.8 mm (mean IMT - 0.71 mm). In patients with Grade 2 fatty liver, left IMT was in the range of 0.6-1.0 mm (mean IMT - 0.80 mm) and right IMT in the range of 0.7-1.0 mm (mean IMT - 0.84 mm), while in patients with Grade 3 fatty liver, left IMT was in the range of 0.8-1.2 mm (mean IMT - 0.93 mm) and right IMT in the range of 0.9-1.4 mm (mean IMT - 0.99 mm). Among controls, the mean left IMT was 0.579 mm and mean right IMT was 0.575 mm. CONCLUSION: The level of carotid intimomedial thickness was more in cases than in controls and progressively increased with the grade of fatty liver which was statistically significant.

11.
Indian J Gastroenterol ; 32(3): 190-4, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23515980

RESUMO

BACKGROUND: Increasing resistance against Helicobacter pylori has resulted in reduced eradication rates. OBJECTIVE: This study aims to determine whether eradication rates for H. pylori infection with sequential therapy is better than standard triple therapy. PATIENTS: Patients with endoscopy documented peptic ulcer and H. pylori infection confirmed by histology and rapid urease test. INTERVENTION: Patients were randomized into two groups; 134 received standard triple therapy (pantoprazole 40 mg, clarithromycin 500 mg and amoxicillin 1 g each administered twice daily) for 10 days and 138 received sequential regimen (pantoprazole 40 mg plus amoxicillin 1 g twice daily for 5 days followed by 40 mg pantoprazole, 500 mg clarithromycin, and 500 mg tinidazole each administered twice daily for 5 days). Eradication was confirmed by histology and rapid urease test. Compliance and adverse effects were determined by the recovery of empty medicine strips and questioning. RESULTS: The eradication rates with sequential therapy were significantly greater than with standard therapy on both intention-to-treat analysis (76.0 % vs. 61.9 %, p = 0.005; difference, 14.1 % [95 % CI, 6.5-19 %] and per protocol analysis (84.6 % vs. 67.4 %, p = 0.002; difference, 17.2 % [95 % CI, 8.5-23.5 %]). The incidence of side effects did not differ between the two therapy groups. One patient in standard therapy discontinued treatment due to side effects. LIMITATION: Cultures were not performed. Loss to follow up was 5.2 % in standard therapy and 6.5 % in sequential therapy. CONCLUSION: Sequential therapy was significantly more effective than standard therapy for eradicating H. pylori infection in peptic ulcer disease in Asian patients. Side effects were similar.


Assuntos
Antibacterianos/administração & dosagem , Antiulcerosos/administração & dosagem , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/isolamento & purificação , Adulto , Relação Dose-Resposta a Droga , Esquema de Medicação , Quimioterapia Combinada , Feminino , Seguimentos , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/microbiologia , Humanos , Incidência , Índia/epidemiologia , Masculino , Estudos Prospectivos , Resultado do Tratamento
12.
J Gastroenterol Hepatol ; 28(5): 808-13, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23432600

RESUMO

BACKGROUND AND AIM: Epidemiology of Helicobacter pylori infection has regional variation. Effect of eradication of H. pylori on symptoms of functional dyspepsia is uncertain, and the data in Asian scenario are scanty. The study aimed to see H. pylori positivity rate in patients of functional dyspepsia and the effect of its eradication on symptoms. METHODS: Randomized, double-blind, placebo-controlled study was the study design used. Patients of functional dyspepsia defined as per Rome 2 criteria were tested for H. pylori infection by rapid urease test and gastric biopsy. H. pylori-positive patients were randomly allocated to triple therapy (20 mg of omeprazole, 500 mg of clarithromycin, and 1000 mg of amoxicillin orally two times daily) and omeperazole plus identical placebo for 2 weeks. Symptoms were assessed with the weekly Likert scale. RESULTS: H. pylori positivity rate in functional dyspepsia was 1160/2000 (58%). At 6 weeks, the eradication rate for H. pylori in triple therapy and placebo group was (181/259 [69.8%] and 13/260 [5.0%], P = 0.001), respectively. On intention-to-treat analysis, the symptom resolution at 1 month was (157/259 [60.7%] and 136/260 [52.3%], P = 0.38), respectively. At 12 months, H. pylori eradication and healing of gastritis in triple therapy and placebo group were (116/174 [66.7%] and 12/180 [6.7%], P = 0.001) and (132/174 [75.9%] and 11/180 [6.1%], P = 0.001), respectively. On intension to treat, the resolution of symptoms in triple therapy and placebo group was (95/217 [43.7%] and 72/195 [36.9%], P = 0.13). CONCLUSION: There is high H. pylori positivity rate in patients of functional dyspepsia. The eradication of H. pylori does not resolve the symptoms despite healing of gastritis.


Assuntos
Dispepsia/epidemiologia , Dispepsia/fisiopatologia , Gastroenterite/epidemiologia , Gastroenterite/microbiologia , Infecções por Helicobacter , Helicobacter pylori , Adulto , Idoso , Método Duplo-Cego , Dispepsia/etiologia , Feminino , Gastroenterite/complicações , Gastroenterite/tratamento farmacológico , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
13.
Indian J Gastroenterol ; 32(1): 32-6, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23224792

RESUMO

BACKGROUND AND OBJECTIVES: There is no ideal therapy for eradication of Helicobacter pylori infection. We evaluated the efficacy and safety of 1-week triple therapy with rabeprazole, levofloxacin, and tinidazole in a metronidazole resistance prevalent region for eradicating H. pylori infection in patients with gastroduodenal ulcers. METHODS: This was an open-label, prospective study. Consecutive patients with endoscopy-proven duodenal or gastric ulcer and who were H. pylori-positive were treated with levofloxacin 500 mg once a day, rabeprazole 20 mg twice a day, and tinidazole 500 mg twice daily for 7 days followed by rabeprazole 20 mg OD for 8 weeks. Endoscopy was repeated 8 weeks after the end of therapy to check for ulcer healing and H. pylori status. RESULTS: One hundred and thirty-one patients with gastroduodenal ulcers (duodenal 118, and gastric 13) were included. Drug compliance was 97.7 %. The eradication rate of H. pylori by intention-to-treat analysis was 85.5 % (95 % confidence interval 79.5-91.5) (112 of 131 patients) and by per-protocol analysis was 91.8 % (95 % confidence interval 86.9-96.7) (112 of 122 patients). Adverse effects were reported in 17 %: abdominal pain in 3.05 %, metallic taste in 6.87 %, and nausea and vomiting in 4.58 %. CONCLUSIONS: Levofloxacin-tinidazole-based triple therapy was highly effective and safe as a first-line regimen in Indian patients with gastroduodenal ulcer disease associated with H. pylori infection. The regimen was well tolerated.


Assuntos
Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/isolamento & purificação , Levofloxacino/administração & dosagem , Metronidazol/administração & dosagem , Úlcera Péptica/tratamento farmacológico , Tinidazol/administração & dosagem , Adolescente , Adulto , Idoso , Antibacterianos/administração & dosagem , Antiulcerosos/administração & dosagem , Esquema de Medicação , Quimioterapia Combinada , Úlcera Duodenal/tratamento farmacológico , Úlcera Duodenal/epidemiologia , Úlcera Duodenal/etiologia , Feminino , Seguimentos , Infecções por Helicobacter/complicações , Infecções por Helicobacter/epidemiologia , Humanos , Incidência , Índia , Masculino , Pessoa de Meia-Idade , Úlcera Péptica/epidemiologia , Úlcera Péptica/etiologia , Estudos Prospectivos , Úlcera Gástrica/tratamento farmacológico , Úlcera Gástrica/epidemiologia , Úlcera Gástrica/etiologia , Resultado do Tratamento , Adulto Jovem
14.
J Gastroenterol Hepatol ; 27(6): 1078-82, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22098332

RESUMO

BACKGROUND AND AIM: Nocturnal gastro-esophageal reflux causes heartburn and sleep disturbances impairing quality of life. Lifestyle modifications, like bed head elevation during sleep, are thought to alleviate the symptoms of gastroesophageal reflux. We tested the hypothesis that bed head elevation might decrease recumbent acid exposure compared to sleeping in a flat bed. METHODS: Patients of symptomatic nocturnal reflux and documented recumbent (supine) reflux verified by esophageal pH test entered the trial. On day 1, baseline pH was measured while the patient slept on a flat bed. Then patients slept on a bed with the head end elevated by a 20-cm block for the next 6 consecutive days from day 2 to day 7. The pH test was repeated on day 2 and day 7. Each patient acted as his own control. RESULTS: Twenty of 24 (83.3%) patients with mean age of 36 ± 5.5 years completed the trial. The mean (± SD) supine reflux time %, acid clearance time, number of refluxes 5 min longer and symptom score on day 1 and day 7 were 15.0 ± 8.4 and 13.7 ± 7.2; P = 0.001, 3.8 ± 2.0 and 3.0 ± 1.6; P = 0.001, 3.3 ± 2.2 and 1.0 ± 1.2; P = 0.001, and 2.3 ± 0.6 and 1.5 ± 0.6; P = 0.04, respectively. The sleep disturbances improved in 13 (65%) patients. CONCLUSIONS: Bed head elevation reduced esophageal acid exposure and acid clearance time in nocturnal (supine) refluxers and led to some relief from heartburn and sleep disturbance.


Assuntos
Leitos , Refluxo Gastroesofágico/prevenção & controle , Posicionamento do Paciente/métodos , Adulto , Monitoramento do pH Esofágico , Feminino , Refluxo Gastroesofágico/complicações , Azia/etiologia , Azia/prevenção & controle , Humanos , Masculino , Periodicidade , Postura/fisiologia , Índice de Gravidade de Doença , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/prevenção & controle , Decúbito Dorsal/fisiologia
15.
Indian J Gastroenterol ; 30(1): 7-11, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21318425

RESUMO

BACKGROUND: There is wide variation in the incidence of colorectal cancer globally and also within the same country among different racial or ethnic groups. The present population-based study was undertaken to determine the incidence of colorectal cancer in Kashmiri population which is non-migratory and ethnically homogeneous having stable food habits. METHODS: Over a period of one year, all newly diagnosed and histological proved cases of colorectal cancer in all possible areas, where such patients are diagnosed and treated were prospectively registered. RESULTS: A total of 212 cases of colorectal cancers were registered; of them 113 (53.3%) originated in the colon and other 99 (46.7%) in rectum. Male to female ratio was 1.2:1. The crude incidence rate of colorectal cancer was 3.65/100,000; it was 3.78 in males, and 3.50/100,000 in females. The incidence rates for colorectal cancer in Muslims and Hindus were different. The crude incidence rate for colorectal carcinoma was highest for district Srinagar 6.19/100,000 (urban area) and lowest for district Kupwara (rural area) 1.59/100,000. The highest numbers of cases were detected in the age group 55-59 years (n = 34). The age-specific rate for colorectal carcinoma was highest in the age group 55-59 years (17.21/100,000), followed by 65-69 years (14.86/100,000). The age standardized incidence rate was 4.52/100,000 per year. The truncated age adjusted incidence rates in age group 35-64 years was 8.31/100,000; while that for colorectal carcinoma was 8.77/100,000 in males and 7.66/100,000 in females. CONCLUSION: We conclude that the incidence of colorectal cancer in Kashmir valley is similar to that reported in the rest of India.


Assuntos
Neoplasias Colorretais/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Incidência , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sistema de Registros , Distribuição por Sexo , Adulto Jovem
16.
J Gastroenterol Hepatol ; 24(7): 1236-43, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19682194

RESUMO

BACKGROUND AND AIMS: After successful endoscopic hemostasis in bleeding peptic ulcer, addition of proton pump inhibitors reduce the rate of recurrent bleeding by maintaining intragastric pH at neutral level. The aim of the present study was to evaluate the effect of various proton pump inhibitors given through different routes on intragastric pH over 72 h after endoscopic hemostasis in bleeding peptic ulcer. METHODS: Ninety consecutive patients who had successful endoscopic therapy of bleeding peptic ulcer underwent 72-h continuous ambulatory intragastric pH study, were randomly assigned to receive p.o. omeprazole 80 mg bolus followed by 40 mg every 12 h for 72 h or i.v. 80 mg omeprazole followed by infusion 8 mg/h for 72 h. Oral pantoprazole 80 mg bolus followed by 80 mg every 12 h for 72 h or i.v. 80 mg pantoprazole followed by infusion of 8 mg/h for 72 h. Oral rabeprazole 80 mg bolus followed by 40 mg every 12 h for 72 h or i.v. 80 mg rabeprazole followed by infusion 8 mg/h for 72 h. Five patients received no treatment after successful endoscopic therapy and underwent 72-h pH study. RESULTS: Mean 72-h intragastric pH for p.o. omeprazole was 6.56 versus 6.93 for omeprazole infusion (P = 0.48). Mean 72-h intragastric pH for p.o. pantoprazole was 6.34 versus 6.32 for pantoprazole infusion (P = 0.62). Mean 72-h intragastric pH for rabeprazole p.o. was 6.11 versus 6.18 rabeprazole i.v. (P = 0.55). Mean 72-h pH for the no proton pump inhibitor group was 2.04. CONCLUSION: There was no significant difference among various proton pump inhibitors given through different routes on raising intragastric pH above 6 for 72 h after successful endoscopic hemostasis in bleeding peptic ulcer.


Assuntos
Úlcera Duodenal/terapia , Duodenoscopia , Gastroscopia , Técnicas Hemostáticas , Úlcera Péptica Hemorrágica/terapia , Inibidores da Bomba de Prótons/administração & dosagem , Úlcera Gástrica/terapia , 2-Piridinilmetilsulfinilbenzimidazóis/administração & dosagem , Administração Oral , Adolescente , Adulto , Esquema de Medicação , Úlcera Duodenal/tratamento farmacológico , Feminino , Determinação da Acidez Gástrica , Humanos , Concentração de Íons de Hidrogênio , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Omeprazol/administração & dosagem , Pantoprazol , Úlcera Péptica Hemorrágica/prevenção & controle , Rabeprazol , Recidiva , Úlcera Gástrica/tratamento farmacológico , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
18.
Indian J Gastroenterol ; 26(3): 138-9, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17704585

RESUMO

We report a 55-year-old man who developed tense ascites due to vesicoperitoneal fistula. He had undergone surgery 32 years ago for excision of an infected urachal cyst, the tract and the umbilicus.


Assuntos
Ascite/etiologia , Fístula do Sistema Digestório/complicações , Doenças Peritoneais/complicações , Doenças da Bexiga Urinária/complicações , Fístula Urinária/complicações , Humanos , Masculino , Pessoa de Meia-Idade
19.
J Gastroenterol Hepatol ; 21(4): 716-21, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16677158

RESUMO

BACKGROUND AND AIM: Following successful endoscopic therapy in patients with peptic ulcer bleeding, rebleeding occurs in 20% of patients. Rebleeding remains the most important determinant of poor prognosis. We investigated whether or not administration of pantoprazole infusion would improve the outcome in ulcer bleeding following successful endoscopic therapy. METHODS: In this double-blind, placebo-controlled, prospective trial, patients who had gastric or duodenal ulcers with active bleeding or non-bleeding visible vessel received combined endoscopy therapy with injection of epinephrine and heater probe application. Patients who achieved hemostasis were randomly assigned to receive pantoprazole (80 mg intravenous bolus followed by an infusion at a rate of 8 mg per hour) or placebo for 72 h. The primary end-point was the rate of rebleeding. RESULTS: Rebleeding was lower in the pantoprazole group (8 of 102 patients, 7.8%) than in the placebo group (20 of 101 patients, 19.8%; P = 0.01). Patients in the pantoprazole group required significantly fewer transfusions (1 +/- 2.5 vs 2 +/- 3.3; P = 0.003) and days of hospitalization (5.6 +/- 5.3 vs 7.7 +/- 7.3; P = 0.0003). Rescue therapies were needed more frequently in the placebo group (7.8% vs 19.8%; P = 0.01). Three (2.9%) patients in the pantoprazole group and eight (7.9%) in the placebo group required surgery to control their bleeding (P = 0.12). Two patients in the pantoprazole group and four in the placebo group died (P = 0.45). CONCLUSION: In patients with bleeding peptic ulcers, the use of high dose pantoprazole infusion following successful endoscopic therapy is effective in reducing rebleeding, transfusion requirements and hospital stay.


Assuntos
Benzimidazóis/administração & dosagem , Endoscopia/estatística & dados numéricos , Omeprazol/análogos & derivados , Úlcera Péptica Hemorrágica/mortalidade , Úlcera Péptica Hemorrágica/prevenção & controle , Medição de Risco/métodos , Sulfóxidos/administração & dosagem , 2-Piridinilmetilsulfinilbenzimidazóis , Antiulcerosos/administração & dosagem , Quimioterapia Adjuvante , Método Duplo-Cego , Feminino , Humanos , Incidência , Índia/epidemiologia , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Omeprazol/administração & dosagem , Pantoprazol , Estudos Prospectivos , Fatores de Risco , Prevenção Secundária , Resultado do Tratamento
20.
Indian J Gastroenterol ; 25(1): 37, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16567895

RESUMO

We report a 37-year-old man with portal cavernoma who developed pericardial effusion two weeks following sclerotherapy for esophageal varices. It responded to conservative management.


Assuntos
Varizes Esofágicas e Gástricas/terapia , Derrame Pericárdico/etiologia , Escleroterapia/efeitos adversos , Adulto , Humanos , Masculino , Derrame Pericárdico/terapia
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