Tehran University Medical Journal

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In a bacteriological study on 230 biopsies of patients suffering gastrointestinal disorders in Imam Khomeyni Hospital, 88 patients were selected as case and another 88 as control groups. Case group was treated by triple (Bismuth subcitrate, Metronidazole and Tetracycline) drugs for a period of 14 days. The latter treated by nonbismuth regiment eg. Amoxicillin and Ranitidine mainly. All of the patients were examined bacteriologically by biopsies in 1, 6 & 12 months after treatment. Obtaind data revealed that the Bismuth composed regiment was more effective than non-bismuth composing ones. In fact, bacterial eradication was approved in 89.8% of case group without recurrence of symptoms among them at least for entire year. Conversely, eradication occulted just in 23.5% of control group, frequent recruidescen Cl of pipriculear observed among them within one year.

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Background: Although many agents have been used for migraine prophylaxis, little evidence is available to support their efficacy in children. Sodium valporate is one of the drugs that has been proved effective in adults. To compare the effectiveness and safety of sodium valportate and propranolol in childhood migraine, this study was designed.

Methods: A 15 months open labeled crossover clinical trial was carried out having a 4 week medication free baseline phase and a 8 week treatment phase for each drug and a 4 week wash out period before crossing over. Fifty two patients started the study and we missed 4 of them due to poor compliance. Forty eight patients (23 girl and 25 boys) were randomized to sodium valporate or propranolol(1:1 ratio) treatment group.

Results: The response to treatment was evaluated on basis of frequency and severity of migraine attacks. Sixty percent of valporate treated patients and 78 precent of propranolol treated ones showed 50% or greater reduction in headache frequencies from the baseline phase. Thirthy one percent of valporate and 45 precent of propranolol treated group revealed at least one grade improvement in functional restriction. McNemar statistical analysis didn&apost show remarkable difference between groups concerning both frequency (κ2=2.4) and severity (κ2=3.36). No serious side effect was seen during treatment.

Conclusion: Sodium valporate was generally well tolerated in this study and showed favorable efficacy in childhood migraine.

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Background: The irritable bowel syndrome (IBS) is one of the most common chronic medical conditions. Various mechanisms, including altered gut flora and/or small bowel bacterial overgrowth, have been suggested to play a role in the development of gas-related symptoms aim of study. The clinical evidence of small intestinal bacterial overgrowth as an important etiology of irritable bowel syndrome continues to accumulate. Clinical symptoms of bacterial overgrowth and irritable bowel syndrome are similar however, a definitive cause-and-effect relationship remains unproven. It is unclear whether motility dysfunction causes bacterial overgrowth or gas products of
enteric bacteria affect intestinal motility in irritable bowel syndrome.

Methods: In a randomized double-blind placebo-controlled trial consisting of treatment with bismuth subcitrate. Primary efficacy variable was subjective symptoms frequency of abdominal pain, Number of bowel movement & Bloating/distension.

Results: 119 patients were enrolled (59 bismuth subcitrate and 60 placebo recipients). At the end of phase 2, all symptom scores dropped significantly both in bismuth subcitrate and placebo group (p<0.001). There was not a significant difference in symptom relief with bismuth subcitrate versus placebo administration.

Conclusions: There was not a significant difference in symptom relief with bismuth subcitrate versus placebo in IBS patients. Whether antibiotics can improve quality of life in patients with irritable bowel syndrome warrants further research.
Interventions: Participants were randomly assigned to receive 120mg bismuth subcitrate four times daily for 14 days (n=59) or placebo (n=60).