Helicobacter pylori treatment is advised in all cases of chronic dyspepsia recently but despite several new drugs, treatment failure is probable yet and the choice method to eradicate Hpylori is contraversial. We studied all patients with chronic dyspepsia who referred to endoscopic ward of Imam Reza hospital. After demonstration of Helicobacter pylori infection by rapid urea’s test (RUT), these cases were divided into two groups randomly. The first group was treated by Metronidazole, Amoxicillin and Omeprazole and the second group was treated by previous drugs plus Bismuth Substrate for 2 weeks. Then drug side effects were asked during the first and second week and Helicobacter pylori eradication was evaluated by UBT (Urea Breath test) six weeks after the treatment. Among 56 cases in this study 39.3% were male and 60.7% were female and 41-50 years cases were more frequent. 27 cases (48.2%) were treated by triple therapy and 29 patients (51.8%) were treated by quadruple therapy. Most common symptoms during the first week were abdominal pain and flatulence but during the second week the common side effect was flatulence. Although, treatment side effects were rare in the second week and only 25% of patients had significant symptom. Finally the total treatment success rate was 49% and Helicobacter pylori was eradicated according to UBT in 50% by triple therapy and 48% by quadruple therapy. The difference between two methods was not significant, although treatment success ratio was higher in young people. Triple therapy (Omeprazole, Amoxicillin and Metronidazole) is an effective regimen for the first line therapy in eradication of Helicobacter pylori especially in young people.

Background and Ëradication of Helicobacter pylori (H.pylori) is essential for the effective treatment of peptic ulcer (p.ulcer). Triple therapy as the first line of treatment in eradication of H.pylori is recommended. Ïn this study, we aimed at comparing the efficacy of quadruple and triple therapies containing low dose furazolidone versus a triple therapy containing metronidazole and bismute. Ïn this study, 150 patients under endoscopy who had deodenal ulcer and confirmed for H.pylori were randomly enrolled with one of the following three methods of ÔÂF omeprasol 20 mg BÏD, amoxycillin 1000 mg BÏD and furazolidone 100 mg BÏD or metronidazole 500 mg BÏD (ÔÂM) and/or (ÔÂBF), omeprazol 20 mg BÏD, amoxycillin 1000 mg BÏD, furazolidone 100 mg BÏD and bismuth subcitrate 240 mg BÏD for 2 weeks. Ëradication of H.pylori 12 weeks after treatment was assessed confirmed with 14-c urea breath test. 150 patients,included 88 males and 62 females with mean age group of 40.3 ± 11.5 were under study. Ïn these three groups, there was no significant difference for ratio of male to female, mean age, smoking, gastrointestinal bleeding history, using of non steroid drugs, duration of observing symptoms and size of ulcer. Drug compliance for ÔÂF, ÔÂM and ÔÂBF were 94%, 96% and 98% respectively. Severe side effects (malaise, anorexia and diarrhea) of ÔÂF were observed in 8%, in ÔÂM 4% (headache and dry mouth), in ÔÂBF group 6% (malaise, nausea and dizziness). 140 patients could complete the treatment courses. Rate of eradication based on intention to treat for ÔÂBF, ÔÂM and ÔÂF were 72%, 40% and 54% respectively, and based on completion of the study were 73.4%, 40.8% and 57.4% respectively. Çonclusion: Çonsidering the obtained result, and in spite of priority of Furazolidone, none of the three mentioned triple theray regimens had required efficacy and are not recommended for eradication of H.pylori. Ïn quaruple regimens containing low dose of furazolidone, eradication rate of H.pylori had significant increase, but was less than gold standard. Therefore in order to obtain ideal regimen, more study with low doses of furazolidone such as, moderate dose of furazolidone daily 300 mg in quadruple regimen for 2 weeks or even high dose of furazolidone 400 mg daily. Ïn quadruple regimen furazolidone only in the first week and rest of drugs, are recommended. for 2 weeks.

Chronic dyspepsia is associated with Helicobacter pylori infection and motility disorder. Whether curing the infection actually improves the symptoms or no, remains highly controversial. In this study, we compared four regimes for eradication of H. pylori and its results on improvement of gastrointestinal symptom. This was a clinical trial which was performed on 160 volunteers from May 2007 to May 2008. Sixty five of them were excluded from our study. Using GIS score, each patient was given a score. In patients with positive Rapid Urease Test, we started the H. Pylori treatment by four regimes (triple therapy for 7 or 10 days, quadruple therapy for 1 or 3 days). The success of the treatment was confirmed by UBT test. In each group the response to treatment was recorded. Among 95 cases in this stud y, 10.5 % of the patients received quadruple therapy for one day, 22.1% for 3 days, 42.1% received triple therapy for 7 days, and 25.3% for 10 days. The eradication of H. Pylori was confirmed in 64.3% of the cases by UBT (after 6 weeks). The rate of eradication in 7 and 10 day regimes were 70% and 79.2% and in one and three days regimes were 30% and 61.9% respectively (P=0.041%). The mean GIS recovery score before and after treatment was significant (p=0.03). Although GIS score improvement didnt differ significantly in different therapeutic regimes, the best symptom improvement was recorded for patients with successful eradication.

Furazolidone has been introduced as an effective drug against helicobacter pylori infection in Iran, but intolerable side-effects may limit its use. We compared quadruple and triple furazolidone-based regimens to achieve an economically affordable regimen with acceptable efficacy rate and fewer complications.Matherials & Patients with H.pylori positive peptic ulcer disease were randomly divided into two groups. They were treated with amoxicillin 1gm/BID, furazolidone 200 mg/BID, omeprazole 20mg/BID with and without bismuth sub-citrate 240 mg/BID for two weeks (AFOB & AFO regimens, respectively) H.pylori eradication was confirmed by 13C-urea breath test 12 weeks after the end of the treatment. Eighty six patients were enrolled but 16 ones discontinued their therapy or follow-up. The eradication rates in AFOB & AFO were 85.3% and 61.1% by per-protocol analysis, respectively (P=0.02), and 67.4% & 51.2% by intention–to-treat analysis respectively (P<0.05). The most frequent adverse effects in the two study groups were weakness, nausea, anorexia and dizziness that demonstrated no significant differences.Discussion & In this study, furazolidone-based triple therapy (without bismuth) was not recommended for H.pylori eradication, due to the lower eradication rate and unchanged frequency of adverse effects.

This study aimed to compare the clinical efficacy of two-drug regimen of glucosamine and chloroquine with one-drug regimen of glucosamine in treatment of knee osteoarthritis. In this randomized clinical trial, 30 patients received glucosamine and chloroquine (trial group) and 25 cases underwent treatment by only glucosamine (control group) for 12 weeks. To evaluate pain and disability, WOMAC (Western Ontario and McMaster Universities) was used. Mean value of WOMAC index in the trial group was 3.51 at the beginning, 1.96 in week 6, and 1.84 in week 12. In the control group, this value was 3.15 at the beginning, 2.36 in week 6, and 2.35 in week 12. In week 12, mean value of WOMAC index was significantly lower in the trial group compared to the control group (P = 0.02). In females aged less than 65 years and with body mass index of equal or less than 30, a significant difference regarding mean value of WOMAC index was seen in week 12 between two groups (P < 0.05). Two-drug regimen of glucosamine and chloroquine in a 12-week period had a better clinical efficacy than one-drug regimen of glucosamine in lowering the pain and improving joint function of patients with knee osteoarthritis, especially in females with body mass index less than 30 and younger than 65 years of age.

This study was conducted to compare the clinical efficacy of two-drug regimen of glucosamine and prednisolone with one-drug regimen of glucosamine in treatment of knee osteoarthritis. In this randomized clinical trial, 30 patients received glucosamine and prednisolone (case group) and 25 cases underwent treatment by only glucosamine (control group) for 12 weeks. For considering pain and disability, WOMAC (Western Ontario and McMaster Universities) was used. Mean value of WOMAC index in the case group was 2.81 at the beginning, 1.53 in week 6, and 1.49 in week 12. In the control group, this value was 3.15 at the beginning, 2.39 in week 6, and 2.35 in week 12. In week 6 and 12, mean value of WOMAC index was significantly lower in the case group compared to the control group (P < 0.05). In patients younger than 65 years old, females, and body mass index of equal or less than 30 a significant difference was seen in both week 6 and 12 between the case and control groups (P < 0.05). Two-drug regimen of glucosamine and prednisolone in a 12-week period had a better clinical efficacy than one-drug regimen of glucosamine in lowering the pain and improving joint function of patients with knee osteoarthritis, especially females with body mass index less than 30 and younger than 65 years of age.

Helicobacter pylori treatment failure is becoming an important concern due to emergence of resistant strain. A major reason for the failure of anti-H pylori regimens in Iran is resistance to metronidazole. Studies have been shown that H pylori has lower resistant rate to ciprofloxacin and furazolidone. The aim of this open-label, randomized study was to compare the effectiveness and side effects of triple regimen containing furazolidone and ciprofloxacin with quadruple regimen containing metronidazole. Subjects and Cases were selected from patients who referred to gastroenterology clinic for evaluation of dyspepsia or other upper abdominal symptoms or signs. They included in the study if H pylori infection was confirmed by rapid urease test, or histological examination. Patients randomized into two groups (n=80 in each group) received 10 days therapy with: Regimen A: furazolidone 100 mg bid, ciprofloxacin 500 mg bid, and omeprazole 20 mg bid (FCO group). Regimen B: metronidazole 500 mg bid, tetracycline 500 mg bid, bismuth subcitrate 240 mg bid, omeprazole 20 mg bid, (MTBO group). The patients were observed for drugs complications during treatment period. Another 13C-urea breath test was performed 60 days after therapy. One hundred and sixty patients (83 females and 77 males), mean age 39.5 (range 15–78) years were included. Three patients in MTBO group and two patients in FCO group failed to complete the treatment because of side effects of drugs. The intention-to-treat eradication rates were 72.5% for CFO group and 80% for TMBO- group (P>0.05). Side effects were seen in 18.8% of CFO-group patients and 20% of TMBO-group patients (P>0.05). Nausea and vomiting were common side effects in group A and vertigo and bad taste sensation were the major side effects in the Group B. Triple regimen containing ciprofloxacin and low dose furazolidone, is a low-cost and safe alternative second or third-line therapy for H pylori eradication.

The goal of this study was to evaluate the effects of ACTH and Quercetin on preventing the development of morphine tolerance and dependence in mice. In this study different groups of mice (20 30 g) received morphine (40 mg/kg, ip), morphine (40 mg/kg, ip) + ACTH (1,2.5,5 IU/mice, ip), morphine (40 mg/kg, ip) + Quercetin (5,10,25 mg/kg, ip), morphine (40 mg/kg, ip) + Quercetin (5mg/kg, ip)+ ACTH (1 IU/mice, ip)] once a day for four days. Tolerance was assessed by administration of morphine (9 mg/kg, ip) and using hot plate test on fifth day. Withdrawal symptoms were assessed by administration of naloxone (4 mg/kg, ip) two hours after co-administration of morphine with either Quercetin or ACTH. It was found that pretreatment with Quercetin or ACTH decreased the degree of tolerance and dependence significantly. Additionally, coadministration of Quercetin and ACTH before morphine administration decreased significantly the tolerance and dependencey. From these results it may be concluded that administration of Quercetin or ACTH injection alone or in together could affect the decrease withdrawal signs and tolerance of morphine. These effects may be related to as nitric oxide inhibitor (NOI) behavior of Quercetin and the ability of Morphine and their receptors in the control of the secretion of CRH. ACTH, quercetin and co-adminstration of both drugs significantly inhibited the development of morphine induced tolerance and dependence in mice.