4th Week Of Treatment Research Articles

Relation of IL28B Rs12979860 Polymorphism on Depression Symptoms in the Treatment of Chronic Hepatitis C

AIM: The presente study we aim to evaluate the relationship between the single nucleotide polymorphism (SNP) rs12979860 in the IL28B gene with the diagnosis of depression and its symptoms along the treament of HCV patients. Material and Methods: Is a convenience cohort where patients were follow-up by 12 weeks during the antiviral therapy. A sociodemographic questionnaire, psychiatric diagnostic interview and laboratorial data were applied at the baseline, 4th week and 12th week of treatment. A sample of buccal cells was collected from each patient in the baseline and IL28B rs12979860 (C/T) polymorphism was genotyped by real-time PCR. Results: 90 patients were evaluated in relation to IL28B rs12979860 (C/T) polymorphism. The rs12979860 polymorphism were not significantly associated with the diagnoses of major depression (p = 0.186) in the baseline, but along the treatment the T allele present a risk factor for irritability OR 3.75 [CI (1.22-11.57); p = 0.021]. Past depression is associated with the diagnosis of current depression pre treatment (p = 0.018). Conclusion: Our results suggest that patients carrying T-allele of rs12979860 have worst symptoms of depression related to those with CC genotype. These results indicate that genotypes of IL28B rs12979860 polymorphism should be better studied to be considered for further treatment.

Имидафенацин в лечении гиперактивного мочевого пузыря и ургентного недержания мочи: результаты открытого многоцентрового рандомизированного контролируемого клинического исследования

The analysis of the results of a multicenter, open, randomized comparative phase III clinical trial on the use of imidafenacin for treating patients with OAB was carried out. A clinical study was conducted according to GCP standards in 12 urological centers of the Russian Federation with the support of company AO "R-Pharm". A total of 296 patients (men and women) aged from 18 to 65 years with OAB and urgent urinary incontinence were included in the study. All patients were randomized into two groups. In Group 1 (n=148) patients received -cholinoblocker imidafenacin 1 tablet (0,1 mg) twice a day. Group 2 patients (n=148) were prescribed a comparison drug tolterodine 1 tablet (2 mg) twice a day, as well. The duration of treatment was 12 weeks. The analysis of results showed a significant decrease in the OAB symptoms in both groups. In Group 1 a decrease of episodes of urge urinary incontinence was more pronounce compared to Group 2, as well as amount of day-time and night-time of episodes of urge urinary incontinence by the 2nd, 4th, 8th and 12th weeks of treatment in comparison with baseline scores. There were no differences between two groups in the severity of reducing average urinary frequency per day. Reducing the severity of urinary disturbances in patients of both groups was accompanied by an improvement in the quality of life. There was a significant and similar decrease in the average total score of both OAB Awareness Tool and EQ-5D questionnaires. Tolerability of treatment was satisfactory in both groups and there were no differences in the adverse events in Group 1 and 2. Imidafenacin showed high clinical efficacy for treating patients with OAB, which is not inferior, and in some values, is superior in comparison to tolterodine. Both drugs had a similar safety and tolerability profile.

Fric Test Revisited: A Suggestion for a New Scoring System and Its Correlation with Urticaria Control Test and Dermatology Life Quality Index

Background: Fric test is a useful tool for the diagnosis and threshold testing for symptomatic dermographism. When threshold testing is not available, Urticaria Control Test (UCT) and Dermatology Life Quality Index (DLQI) might be used to assess disease control and quality of life (QoL) impairment, respectively. Objectives: In this study, we aimed to describe a new scoring system for the Fric test and evaluate the correlations of Fric scores with UCT, DLQI, and other disease activity assessment scores. Method: Provocation test with Fric Test 4.0 was performed in all patients at referral and at the 4th week. We considered a 4-grade rating score for Fric Test (0–4) [Total Fric Score (TFS)]. A positive response with all of the four pins suggested severe dermographism (TFS = 4), while a wheal with only the largest pin (4.5 mm) was considered as milder disease (TFS = 1). Treatment responses were evaluated with Fric Test 4.0, UCT, patient’s global assessment of disease severity (PatGA-VAS), the physician’s global assessment of disease control (PhyGA-VAS), and DLQI at baseline and at the 4th week of treatment. The correlations of TFS with UCT, DLQI, PatGA-VAS, PhyGA-VAS at baseline as well as the changes in the mean scores after treatment (week 4) were performed. Results: The mean UCT and DLQI scores were 8.69 ± 3.40 and 7.88 ± 6.02 at the first visit. At the second visit, TFS decreased from a mean of 2.79 ± 1.68 to 1.91 ± 1.85 (p < 0.001), and UCT scores and PhyGA-VAS were increased (p < 0.001), while DLQI scores, PatGA-VAS, and pruritus scores decreased significantly (p = 0.002; p = 0.001; p = 0.012). There was a positive correlation between TFS and pruritus scores (r = 0.378) and DLQI scores (r = 0.392). TFS was found to have a negative correlation with UCT score (r = –0.283) and PhyGA-VAS (r = –0.347). Conclusions: This new Fric scoring system allows comparison with other tools and shows moderate correlations with most of the tools. Using disease-specific tools is recommended since they provide a subjective evaluation of disease severity, QoL impairment, and disease control.

Hepatocurative Effect of Saussurea lappa, C.B Clarke and Artemisia absinthium, Linn in Chronic Hepatitis B

: Objective: Repeated immune attacks in chronic hepatitis B produce recurrent inflammation in the liver and render it to develop fibrous tissue and carcinoma. Hence, present study aims to evaluate the hepatocurative effect of qust (Saussurea lappa) and afsanteen (Artemisia absinthium) in the chronic hepatitis B patients. Method: In a single arm pilot clinical study, 30 patients of chronic hepatitis B with ALT (alanine aminotransferase) >2 times of upper limit of normal were treated with decoction of qust (Saussurea lappa) and decoction of afsanteen (Artemisia absinthium) daily orally for 3 months. Patients were evaluated for liver function test at baseline, 6th week and 12th week of treatment. Result: Test drug reduced the mean serum bilirubin, ALT, AST highly significantly at 12th week of treatment. (p Conclusion: We reviewed the literature related to the test drug, Saussurea lappa and Artemisia absinthium used for the treatment in these cases. The observed hepatocurative effect could be due anti-inflammatory, hepatoprtotective, antioxidant and immunomodulator properties of these drugs, substantiated in various animal studies. These findings indicate the hepatocurative effect of Saussurea lappa and Artemisia absinthium in chronic hepatitis B cases. Randomized controlled clinical studies should be conducted to explore the further efficacy.Key words: Saussurea lappa, Artemisia absinthium, Hepatocurative, Unani medicine, Liver tonic, Hepatitis.

Comparison of the effects of sertraline and agomelatine on sleep quality, sexual functioning and metabolic parameters in patients with major depressive disorder

ABSTRACTOBJECTIVE: This research aims to compare the effects of sertraline and agomelatine on outpatients diagnosed with a “major depressive episode” in terms of sleep quality, sexual functioning, and metabolic parameters related to metabolic syndrome.METHODS: This observational, open-labelled, 12-week follow-up study was carried out in the outpatient psychiatry clinic of a state research hospital. Included in the study were 60 outpatients admitted to the adult psychiatry clinic diagnosed with a “major depressive episode” who were subsequently prescribed agomelatine (25 mg/day) or sertraline (50 mg/day). Arizona Sexual Experience Scale (ASEX) and Pittsburgh Sleep Quality Index (PSQI) were performed during the 1st, 2nd, 4th, 8th and 12th weeks of treatment. The metabolic parameters; Body Mass Index, waist circumference, systolic and diastolic blood pressure, fasting blood glucose, liver enzymes (Alanine transaminase (ALT), Aspartate transaminase (AST) and lipid profiles – total cholesterol and total trigly...

Quality of life among hepatitis C patients on treatment, Minia, Egypt

Background: Hepatitis C is a highly prevalent infectious disease among Egyptian population. Different types of interferon and antiviral drugs are used in the treatment and have significant side effects which may alter quality of life of the treated chronic hepatitis C patients. The aim of the study was to identify the course of and factors associated with HRQOL in HCV patients given standard treatment based and to assess its relation to socio-demographic and clinical characteristics.Methods: This prospective consecutive hospital based study included 120 chronic hepatitis C patients in El-Minia city and by using SF-36V2 questionnaire.Results: HRQOL baseline scores, general health had the lowest score, followed by vitality, while Role emotional had the highest score. Physical component summery scores (PCS) was slightly higher than mental component summery scores (MCS) for PCS. Subjects showed significantly lower SF-36 scores at the 12th week of treatment Compared to the pretreatment values. Mean scores of all SF-36 domains improved by the end of treatment, (p&lt;0.01). Scales most affected during therapy were vitality (VT), general health (GH) and bodily pain (BP). The effect size (ES) observed on SF-36 subscales, the most affected dimensions at the 12th week of treatment were (PF, SF, VT and BP) (they were ≥0.8) could be considered large change, according to Cohen’s criteria.Conclusions: Subjects showed significantly lower SF-36 scores at the 12th week of treatment. Mean scores of all SF-36 domains improved by the end of treatment.

Efficacy of combination of Viola odorata, Rosa damascena and Coriandrum sativum in prevention of migraine attacks: a randomized, double blind, placebo-controlled clinical trial.

BackgroundMigraine is the second most common type of headache after tension headaches. In Iranian traditional medicine several herbal drugs are used for the treatment of headache. Including, a product of Iranian traditional medicine, a combination of Viola odorata L. flowers, Rosa damascena L. flowers and Coriandrum sativum L. fruits.ObjectiveTo determine the effectiveness of a combination of Viola odorata flowers, Rosa damascene flowers and Coriandrum sativum fruits on severity, duration and frequency of migraine headaches.MethodsThis randomized, double blind, placebo-controlled clinical trial was performed on 88 patients who had migraine and visited Besat Neurology Clinic No. 4 at Kerman University of Medical Sciences, Kerman, Iran, from September 2016 to march 2017. Patients were randomly divided into the intervention (n=44) or placebo group (n=44). The intervention group received a product of Iranian traditional medicine, a combination of Viola odorata L. flowers, Rosa damascena L. flowers and Coriandrum sativum L. fruits in 500 mg capsules three times a day and propranolol 20mg tablet twice a day, and the control group received placebo capsules (500mg) three times a day and propranolol 20mg tablet twice a day for four weeks. Patients were asked to report the frequency, duration and severity of their headaches in designed forms at home. Then at the end of the 2nd and 4th weeks of treatment, patients were followed for clinical efficacy.ResultsIn terms of duration, frequency and severity of headaches between the two groups of herbal medicine and placebo, the behavior of the two protocols was changed over time (p<0.001). During the 4 weeks, the time and drug interactions, were significant (p <0.001). In other words, the pattern of changes to the two protocols over time, was different. Also, at the end of the 4th week, there was a significant difference between the two groups (p<0.001).ConclusionThe study findings suggest that the Iranian traditional product combination of Viola odorata flowers, Rosa damascena flowers and Coriandrum sativum fruits may be effective in improving headaches in patients with migraine.Clinical trial registrationThe trial was registered at the Iranian registry of clinical trials (IRCT: www.irct.ir) with registered NO. IRCT 2016110830776N1.FundingThe authors received no financial support for the research, authorship, and/or publication of this article.

Craniospinal irradiation by rapid Arc® technique in supine position: A dosimetric and clinical analysis

Introduction: In craniospinal irradiation (CSI), prone position has been commonly used but, in some patients, especially pediatric cases where anesthesia is needed prone position may not help. In planning CSI by supine technique, beam geometry and field matching have to be considered, and immobilization is essential to ensure reproducibility of treatment. Materials and Methods: Data of four patients (3 with medulloblastoma and 1 with lymphoma) treated between March 2012 and October 2013 were included in this retrospective dosimetric study and analyzed. Patients were evaluated for dose coverage, organs at risks (OARs) sparing, number of monitor units, and daily table position shifts. Results: All patients underwent CSI by volumetric-modulated arc therapy (VMAT) technique in supine position. All four cases developed Grade 1 skin changes, and only one case developed a Grade 2 change at the end of radiotherapy; also both pediatric cases developed Grades 2 and 3 anemia and leukopenia toward their 4th week of treatment onward. The Rapid Arc®-CSI plans were able to generate dose distributions with high planning target volume (PTV) conformity and homogeneity and with sparing of OAR. The cumulative conformity index for all patients was 0.986, and homogeneity index was 0.1007. The mean PTV doses were within 108% with V110% of

Clinical research on the efficacy of self-made sichongsan in combination with gefitinib on NSCLC patients with EGFR mutation

This study is to investigate the efficacy of self-made sichongsan in combination with gefitinib on non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation. A total of 47 NSCLC patients in advanced stage with EGFR mutation who had not received any treatment before admission were divided into the control group (n = 23) and the observation group (n = 24). Patients in the control group underwent gefitinib treatment, while those in the observation group additionally took self-made sichongsan for treatment. The objective response rate of the observation group was 75%, significantly higher than 52.18% in the control group ( P &lt; 0.05). Before treatment, comparisons of the carcinoembryonic antigen (CEA) and carbohydrate antigen 153 (CA153) levels in serum showed no statistical significance ( P &gt; 0.05). At the 12th week of treatment, the levels of CEA and CA153 in the observation group were significantly lower than those in the control group ( P &lt; 0.05). In the observation group, the incidence rate of adverse reaction was 16.7%, which was significantly lower than 47.8% in the control group ( P &lt; 0.05). In conclusion, in terms of the first-line treatment for advanced NSCLC patients with EGFR mutation, the efficacy of self-made sichongsan in combination with gefitinib is superior to the single administration of gefitinib, and the former can more effectively decrease the levels of CEA and CA153 in serum of patients and reduce the incidence rate of adverse effects.

EFFICACY OF DIFFERENT THERAPEUTIC MODALITIES FOR PRIMARY MONOSYMPTOMATIC PEDIATRIC NOCTURNAL ENURESIS

EFFICACY OF DIFFERENT THERAPEUTIC MODALITIES FOR PRIMARY MONOSYMPTOMATIC PEDIATRIC NOCTURNAL ENURESIS Murtadha M Almusafer@ & Aymen Adel* @FICMS, Professor of Urology, University of Basrah, College of Medicine, Department of Surgery. *FICMS, Urology Specialist, Basrah General Hospital, Basrah, IRAQ. Abstract Primary monosymptomatic nocturnal enuresis (PMNE) is still a common bothersome complaint that makes the children and their families looking for help. Primary MNE is defined as abnormal urination that occurs involuntarily during sleep. Its incidence varies with age, with 15%-20% at 5 year old and fades with increasing age to reach 1-2% at 15 year old. Owing to its complicated pathophysiology and sharing of different body systems, multiple lines of treatment were attempted. This study aimed is to explore the efficacy of different treatment modalities for PMNE in the study patients. Ninety two patients were enrolled in this prospective randomized trial and divided into 4 groups; group A instructed to use the behavioral measures, group B given intranasal Desmopressin, group C given Oxybutynin and group D given combination of the 3 treatments. Fourteen participants were excluded because they were lost during followup and the remaining 78 patients' data were analyzed. Patients were reassessed at 4th and 12th weeks. Wet nights/week significantly reduced in all treatment groups as compared to baseline. Percentage reduction of wet nights/week for behavioral group was 38.9%, Desmopressin was 83%, Oxybutynin was 78% and for Combination was 87.8% at 12th week. According to the ICCS definitions of success there is no full response in behavioral group with partial response of 42.1%, for Desmopressin group the full response was 57.1% and partial response 28.6%, for Oxybutynin group was 50%, and 33%, for combination group 60%, 30% at 12th week of treatment. In conclusion, although behavioral therapy reduces wet nights but not reaching to a full improvement and its use is preferably combined with other treatment modalities. Desmopressin, Oxybutynin, and Combination treatment significantly decreases wet nights with high full response rate.

Clinical Analysis of Polyethylene Glycol Interferon-α Treatment in 155 Hepatitis B e Antigen (HBeAg)-Positive Chronic Hepatitis B (CHB) Patients

PurposeThis study aims to investigate the antiviral effect of polyethylene glycol (PEG)-interferon α-2a and PEG-interferon α-2b treatment on hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) at the 48th week of treatment and the 24th and 48th week after withdrawal, in order to provide guidance on the antiviral treatment of HBeAg-positive CHB patients. Material and methodsAntiviral treatment was performed on 155 HBeAg-positive CHB patients. Among these patients, 66 patients received PEG-interferon α-2a treatment and 89 patients received PEG-interferon α-2b treatment; and these treatments were administered by subcutaneous injection, once per week, which lasted for 48 weeks. Other antiviral and hepatoprotective drugs were not used during the treatment. ResultsAt the 48th week of treatment, ALT recovery rate, HBsAg seroconversion rate, HBeAg seroconversion rate and HBV DNA titers dropped below 200 IU/mL rate were 69.7%, 6.1%, 27.3% and 50.0%, respectively, in the PEG-interferon α-2a group; and were 70.8%, 6.7%, 33.7% and 62.9%, respectively, in the PEG-interferon α-2b group. At the 24th and 48th week of follow-up after withdrawal, HBsAg seroconversion rate in these two groups did not change; and HBeAg seroconversion rate further increased. Furthermore, HBV DNA revealed a low recurrence rate. The difference between these two groups was not significantly significant. ConclusionsPEG-interferon α-2a and PEG-interferon α-2b are effective antiviral drugs for the treatment of HBeAg-positive CHB, which has a HBsAg seroconversion rate of more than 5%. Furthermore, this sustained response effect was maintained at the 24th and 48th week of follow-up after withdrawal.

Successful Use of Escitalopram for the Treatment of Visual Hallucinations in Patients With Parkinson Disease

Patients with Parkinson disease (PD) frequently experience visual hallucinations (VH). Visual hallucinations are most often viewed as an adverse effect of antiparkinsonian treatment. Possible treatments for this disturbance include a reduction of antiparkinsonian medications, adding atypical antipsychotics, or cholinesterase inhibitors. Some studies demonstrated that selective serotonin reuptake inhibitors may be an optional treatment for patients experiencing psychosis or agitation in dementia. Currently, there is no standard recommended treatment for VH in patients with PD. We present here our clinical experience with escitalopram (selective serotonin reuptake inhibitor) for treating this disturbance. Thirteen patients with PD (8 men and 5 women; age range 67-83 years) experiencing VH were openly treated with escitalopram 10 or 15 mg/d as add-on. Efficacy was assessed at baseline, then after 4 and 8 weeks of treatment using Clinical Global Impression-Severity and Clinical Global Impression-Improvement. At the end of the 4th week of treatment, of 13 patients, 11 subjects demonstrated improvement, and in only 2 patients were there no changes in their condition. After an additional 4 weeks, 2 of the responders showed very significant improvement, 6 demonstrated much improvement, and 3 patients demonstrated minimal improvement. Only 1 patient showed no change in his condition. One additional patient stopped taking escitalopram after 5 weeks because of an absence of improvement in his state. Escitalopram was well tolerated as treatment of VH in PD patients. This medication could be a promising optional therapy for this disturbance; however, further randomized controlled and bigger studies are necessary.

Efficacy and Safety of BCD-085, a Novel Interleukin-17 Inhibitor. Results of Phase II Clinical Trial in Patients with Moderate-to-Severe Plaque Psoriasis

Recent studies on psoriasis confirmed that interleukin-17 (IL-17) plays a crucial role in the progression of the disease. Inhibition of this cytokine leads to significant improvement in the course of the disease. Russian biotechnology company BIOCAD have developed an innovative drug, a monoclonal antibody against IL-17, BCD-085. The main objective of the phase II study was to determine the optimal therapeutic dose of BCD-085 in patients with moderate-tosevere plaque psoriasis. The efficacy, safety, and pharmacokinetics of the drug have also been investigated.Materials and methods The study was an international multicenter, comparative, randomized, double-blind, placebo-controlled clinical trial of the efficacy and safety of multiple subcutaneous administration of various doses of BCD-085 to patients with moderate to severe plaque psoriasis. Patients were randomized into 4 groups in 1:1:1:1 ratio: group 1 received BCD-085 at a dose of 40 mg, group 2 – 80 mg, group 3 – 120 mg, and group 4 received placebo. Administration of BCD-085/placebo was performed subcutaneously on day 1 at weeks 0, 1, 2, and then on day 1 at weeks 4, 6, 8, 10.Results All studied doses of BCD-085 demonstrated significant superiority over placebo and high efficacy in the treatment of plaque psoriasis. PASI 75 at week 12 was reached by 92.68% of patients in group 3 (120 mg of BCD-085), 83.33% in group 2 (80 mg of BCD-085), 80.0% in group 1 (40 mg of BCD-085), and 23.08% in group 4 (placebo) (p 0.0001). In the course of the study, the dose-dependent effect of the drug was demonstrated. The drug showed favorable safety profile (no cases of serious adverse events or early withdrawal due to adverse events, no cases of adverse events with 4 grade of severity according to CTCAE 4.03). According to the results of pharmacokinetics study, the drug is characterized by a linear increase in serum BCD-085 concentration, reaching its maximum by the end of the first week of observation, and by slow elimination.Conclusion BCD-085 showed high efficiency, more than 90% of patients reached PASI 75 by the 12th week of treatment, and a favorable safety profile. Based on the results of the phase II study, the optimal therapeutic dose was 120 mg.

A comparative study on effects of tadalafil, losartan, extracts of grape seed and ginko biloba on skin inflammation induced by cisplatin in rats

We investigated the effects of cisplatin (CDDP) on inflammation in general and skin inflammation in particular with application of different treatment models using tadalafil™ (Tad), losartan™ (Los), extracts of grape seed (G.S) and ginko biloba (G.B). Ninety healthy male albino rats were used in this experiment distributed randomly into six groups (n = 15). The duration of the experiment was four weeks. At the end of 1st, 2nd and 4th weeks of treatment, blood samples were subjected to RNA extraction and RT-PCR for interleukin (IL)-1B and IL-18 genes expression. The results showed a significant increase (P < 0.0001) in levels of mRNA genes expression of IL-1B and IL-18 in CDDP exposed rats when compared with control rats. Four weeks after treatment, expression fold changes significantly decreased in all treated groups with variable degrees where Los was the best to decrease the fold changes of IL-1B and IL-18 genes expression. Numbers of blood vessels, CD31 positive proliferating endothelial cells around preexisting skin vessels, CD34 positive blood vessels, perivascular inflammatory cells and total skin inflammatory cells were higher in untreated CDDP exposed rats when compared with control rats. Pathological evaluation revealed that Los followed by Tad then G.B were able to reduce the increased inflammatory markers in blood, skin inflammation and skin blood vessel density in CDDP exposed rats.

Efficacy and Safety of Diacerein in Patients With Inadequately Controlled Type 2 Diabetes: A Randomized Controlled Trial.

To assess, in a randomized, double-blind, and placebo-controlled trial, the efficacy and safety of diacerein, an immune modulator anti-inflammatory drug, in improving glycemic control of patients with type 2 diabetes. Eighty-four patients with HbA1c between 7.5 and 9.5% (58-80 mmol/mol) were randomized to 48-week treatment with placebo (n = 41) or diacerein 100 mg/day (n = 43). The primary outcome was the difference in mean HbA1c changes during treatment. Secondary outcomes were other efficacy and safety measurements. A general linear regression with repeated measures, adjusted for age, sex, diabetes duration, and each baseline value, was used to estimate differences in mean changes. Both intention-to-treat (ITT) analysis and per-protocol analysis (excluding 10 patients who interrupted treatment) were performed. Diacerein reduced HbA1c compared with placebo by 0.35% (3.8 mmol/mol; P = 0.038) in the ITT analysis and by 0.41% (4.5 mmol/mol; P = 0.023) in the per-protocol analysis. The peak of effect occurred at the 24th week of treatment (-0.61% [6.7 mmol/mol; P = 0.014] and -0.78% [8.5 mmol/mol; P = 0.005], respectively), but it attenuated toward nonsignificant differences at the 48th week. No significant effect of diacerein was observed in other efficacy and safety measures. Diarrhea occurred in 65% of patients receiving diacerein and caused treatment interruption in 16%. Seven patients in the diacerein group reduced insulin dosage, whereas 10 in the placebo group increased it; however, mild hypoglycemic events were equally observed. Diacerein reduced mean HbA1c levels, with peak of effect at the 24th week of treatment. The drug was well tolerated and may be indicated as adjunct treatment in patients with type 2 diabetes, particularly in those with osteoarthritis.

Efficacy and Metabolic Influence on Blood-Glucose and Serum Lipid of Ziprasidone in the Treatment of Elderly Patients with First-Episode Schizophrenia.

BackgroundAs the age of the population in China rises, the occurrence of first-episode of schizophrenia in elderly persons is also gradually increasing. However, studies examining selection of therapeutic drugs for this population are relatively few.ObjectiveTo examine the therapeutic efficacy and metabolic influence on blood-glucose and serum lipid of ziprasidone in the treatment of elderly patients with first-episode schizophrenia.MethodsUsing randomized grouping, 38 elderly patients with first-episode schizophrenia were randomly divided into the ziprasidone treatment group (i.e. the study group) and the olanzapine treatment group (i.e. the control group), with 19 cases in either group respectively. The positive and negative symptoms scale (PANSS) was used to evaluate the efficacy, and adverse drug reaction scale (TESS) was used to evaluate adverse drug reactions, at the points prior to the treatment, at the end of 4th, 8th, and 12th weeks of treatment, respectively. Fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), and low density lipoprotein (LDL-c) were also measured.ResultsThere was no significant difference between the two groups in PANSS score at the end of week 4, week 8 and week 12. The curative effect on the two groups was similar. The results of repeated measure ANOVA showed that there were significant differences in FBG (Ftime×group=7.539, p=0.001), TC(Ftime×group=32.194, p<0.001), TG(Ftime×group=488.312, p<0.001), and LDL-c (Ftime×group=9.380, p<0.001)between the study group and the control group across the different time points.ConclusionZiprasidone in the treatment of first episode schizophrenia in elderly patients has efficacy and less effect on blood-glucose and serum lipid metabolism.

The Effectiveness Of Quadriceps Strengthening Exercises Combined With Neuromuscular Electrical Stimulation on Patellofemoral Pain Syndrome

Objective:The weakness of the quadriceps strength in patellofemoral pain syndrome (PFPS) is very evident. Therefore, quadriceps strengthening exercises are very important part of the rehabilitation program. Neuromuscular Electrical Stimulation (NMES) is considered one of the methods for increasing quadriceps muscle strength. To evaluate the effectiveness of combined NMES and strengthening exercises to improve the recovery of quadriceps strength and function in patients with PFPS.Methods:This study was planned as a randomized controlled pilot study. A total of 27 patients (mean age=38.9±10.8 years, range=20-60 years; 16 females) with PFPS were assessed and randomly assigned into 2 groups. Group I received a standard program (quadriceps strengthening, hip strengthening and hamstring stretching) and NMES combined with quadriceps strengthening exercises simultaneously. Group II received the same standard program without NMES. Both groups were enrolled 3 times per week for 40 minutes per day in 6 weeks. Patients were assessed at the baseline, 3 rd, 6th, and 12th weeks of treatment. Quadriceps strength was evaluated by isokinetic dynamometer. The range of motion at testing was set between 0 for extension to 90 for flexion. The test was performed at 60 degrees/sn and concentric maximum peak torque value was recorded. Kujala and Lysholm scores were used for functional assessments. The data were analyzed using the SPSS 20.0. Shapiro-Wilk test was used to assess the distribution of data. The changes in dependent variables before treatment, 3 rd, 6th, and 12th weeks were analyzed using a 2 by 4 mixed-model analysis of variance (ANOVA). Pairwise comparisons with paired t test were used to determine whether the Group I or Group II, has changed over time. An intention- to- treat analysis was performed to impute values for missing data. An alpha level of 0.05 was established.Results:The study was completed with 20 patients. Group I (n=10; mean age=39.4±8.5 years; 7 females) and group II (n=10; mean age=43.2±11.7 years; 5 females) had no differences in pre-operative measures (p>.05). There was significant improvements in within groups statistics of all parameters for both groups (p<.05). No differences in quadriceps strength, Kujala and Lysholm scores between groups were found at the different time points (F= 0.86; p = 0.12, F=0,001; p =0.97, F=0.12; p=0.73, respectively)Conclusion:NMES combined with quadriceps strengthening exercises has no additional effect on PFPS patients’ on muscle strength and function. When considering these results, we believe that there is no need to continue the study in progress.A Comparison of Repeated Measures of Strength And Fuction Between Groups.AssessmentGroupBaseline3rd week6 th week12 th weekF2x4 ANOVAMuscle StrengthGroup I130,6±19,2123,0±15,3128,0±19,2159,2±23,00,860,37Group II98,0±0,0112,2±13,0123,2±14,1123,5±19,4Kujala ScoreGroup I60,4±14,869,2±13,573,0±14,371,4±16,70,0010,97Group II60,9±15,269,4±15,575,0±8,168,4±13,0Lysholm ScoreGroup I56,1±16,458,9±16,874,2±16,676,6±19,20,120,73Group II55,3±15,765,0±19,880,1±14,269,6±11,5

Effects of alendronate on osteoporosis treatment and levels of related cytokines.

Alendronate regulates the activity of osteoclasts and healing of osteoporosis. This study investigated the effect of alendronate on bone healing and changes in the levels of cytokines. Bilateral ovaries of 10 adult female rabbits were removed surgically in aseptic condition to establish the animal model of osteoporosis. Five rabbits in group A were treated with alendronate (1.15 mg·kg-1·week-1) once a week by a stomach tube, whereas the remaining 5 in group B were treated with physiological saline. The success of the animal model establishment and the efficacy of alendronate treatment were evaluated by the sports ability score and the Basso, Beattie, and Bresnahan (BBB) score; the healing degree of osteoporosis was determined by X-ray analysis and measurement of biomechanical properties; the changes in the levels of related cytokines were measured by enzyme-linked immunosorbent assay (ELISA) and immunohistochemical staining. Treatment improved dyskinesia of the animals in group A than that in group B, with significant improvement occurring in the 4th week of treatment. The BBB score of the group A animals revealed movements similar to normal, but that of the group B animals exhibited significant motor disturbance (P < 0.01). X-ray examination showed that with time, the X-ray ratings increased. Measurement of the biomechanical properties further showed that alendronate had a positive effect on osteoporosis healing. The results of ELISA and immunohistochemistry showed that the levels of ALP, BMP-2, bFGF, and IGF-1 were upregulated in group A. In conclusion, alendronate accelerated osteoporosis healing probably via certain cytokine-related mechanism.

Determine the Effectiveness of Low Dose Tamsulosin as a Medical Expulsive Therapy in Patients with Lower Ureteric Stones

Introduction: The human ureter contains a high number of α-adrenergic receptors, especially α1d -receptors at the lower part of the ureter. Tamsulosin is a combined α1a- and α1d- selective adrenergic antagonist that is an alternative to other medications, such as calcium channel blockers, corticosteroids, and analgesic and anti-inflammatory drugs, for the treatment of distal ureteric stones. Objective: To determine the effectiveness of low dose tamsulosin as a medical expulsive therapy in patients with lower ureteric stones. Setting: Department of Urology, Liaquat University of Medical and Health Sciences Jamshoro. Study design: Randomized controlled trial.Duration of study: 6 months Subjects and methods: All patients with either gender, age range 30-60 years and stone size 4-10 mm in the lower 1/3rd of the ureter determined on ultrasound were enrolled. Group A patients was offered low dose tamsulosin (0.2 mg) one tablet daily in the morning for a maximum of 4 weeks and group B served as control. The final outcome was measured at the end of 4th week of treatment. Patients were instructed to note the time and the date of expulsion of stone. Absence of echoic shadows on lower 1/3rd of ureteric line on ultrasound was taken as effectiveness (expulsion of stone). Results: In control group mean age was 45.52 ± 6.70 years whereas in low dose Tamsulin mean age was 46.72 ± 6.73 years. Frequency of male was higher in both control and low dose Tamsulin group, i.e. 39 (78%) and 21 (42%) respectively. In control group effectiveness was found 3 (6%) patients whereas in low dose Tamsulin group effectiveness was found in 47 (94%). Conclusion: In our study the effectiveness of low dose tamsulosin as a medical expulsive therapy in patients with lower ureteric stones was higher as compared to control.

Evaluation of Cisplatin Induced Toxicity in Head and Neck Cancer and Cervical Cancer During Concurrent Chemoradiotherapy. Experience of National Institute of Oncology in Morocco

Background: Cisplatin is widely used as radio sensitizer in head and neck cancer (HNC) and cervical cancer. We conducted this prospective study to evaluate cisplatin induced toxicity as once-weekly regimen in HNC and cervical cancer during concurrent chemoradiotherapy (CCRT) to optimize its administration. Patients and methods: From 01 January 2015 to 11 May 2015, a data of all eligible patients treated by chemoradiation regimens containing a low dose of cisplatin were collected at the Department of radiotherapy in National Institute of Oncology in Morocco. Cisplatin was used weekly at 40 mg/m2 with adequate hydration and premedication in all patients. A complete blood count and renal function tests were done prior to each cycle of chemotherapy to evaluate toxicity according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE, version 4.0). Results: A total of 96 patients were eligible for the analysis. Mean age, PS, initial weight, enteral nutrition, cisplatin mean dose, use of oral Ondansetron and baseline serum tests did not differ significantly among the types of malignancy. However, weight loss was significantly noted among HNC group compared to cervical cancer patients with 6.06 ± 2.92 kg and 0.02 ± 0.13 kg respectively. Toxicity was observed only in 16 (20%) patients after the 4th week of treatment especially among HNC group. The neutropenia and thrombocytopenia were significantly greater for patients of HNC. However, we did not observe any renal toxicity, thrombocytopenia and ≥ grade 3 neutropenia toxicity in cervical cancer group. In multivariated analysis, only a subtype of HNC (OR, 1233; 95% CI, 16-95 103; P=0.001) and grade 2 emetogenicity (OR, 34.8; 95% CI, 2.1-583; P=0.014) were significantly associated with an increased risk for cisplatin toxicity. Whereas, less than 4 weekly cisplatin treatment (OR, 0.4; 95% CI, 0.1-0.9; P=0.046) was associated with a significantly reduced risk. Conclusion: Our data have revealed that individuals with HNC were at a significantly higher risk for cisplatininduced toxicity during CCRT and suggest that the once-weekly smaller dose of cisplatin regimen and conventional prophylactic procedures of administration might be effective for protection against the renal toxicity of cisplatin.