Gastrointestinal Tract Disturbances Research Articles

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome with Multiple Drugs (Leflunomide and Cefuroxime): A Case Report

Background: Adverse Drug Reactions (ADRs) are unexpected reactions to a medicine administered in the correct manner and at the proper dosage. Drug Rash with Eosinophilia and Systemic Symptoms syndrome (DRESS syndrome) is a Severe Cutaneous Adverse Reaction (SCAR) type of ADR with complicated clinical features involving several organ systems of the body; frequently involved organs are the liver, kidney, lungs, and other organs. Prompt recognition and correct diagnosis, followed by withdrawal of the causative agent, can promote appropriate treatment, accelerate recovery, and reduce the related morbidity and mortality. Case presentation: We have, herein, presented a case of a 42-year-old female with a history of leflunomide intake for plantar fasciitis. The patient subsequently developed fever, gastrointestinal tract disturbance, facial edema, liver injury, skin rash, hematologic abnormalities (eosinophilia), hepatosplenomegaly, and lymph node enlargement. The probability of leflunomide-induced DRESS syndrome was rated as “definite”, with seven scores graded by RegiSCAR. The suspected causative agent was withdrawn, and the patient was managed symptomatically. Following her management and discharge, she again encountered similar complaints after administration of the cefuroxime tablet. The causality assessment of the reactions was done using the WHO-UMC scale and Naranjo’s assessment scale, and a “probable” reaction was found for both drugs. Conclusion: The presented case contributes to the existing global literature regarding exceptional clinical presentations. Leflunomide and cefuroxime drugs have the potential to cause DRESS syndrome. Thus, they should be handled cautiously, and if such a reaction occurs, it should be reported to the responsible authorities.

Effect of Mefenamic Acid on Premenstrual Syndrome in Reproductive age Group

Background: Premenstrual syndrome is a cyclic disorder with symptoms that are severe enough to interfere with some aspect of living. The debilitating symptoms reappear with each cycle, the most common being generalized headache, breast swelling and tenderness, bloating, fatigue, depression and irritability. Aim: To determine the efficacy of mefenamic acid in treatment of premenstrual syndrome women in reproductive age groups. Methods: A quasi experimental study was donein the Department of Obstetrics and Gynecology, Federal Government Services Hospital, Islamabad between November 2020 and April2021. The study was carried out over 75 patients. Mefenamic acid for at least 3 months and followed up for a minimum of 3 months were advised. After follow up the sequel of symptoms and efficacy was noted. Results: Average age of the patients was 26.03±6.27 years. The symptoms of premenstrual syndrome nausea 84%, gastrointestinal tract disturbance 85.3% and headache 80% noted to be the leading symptoms followed by breast tenderness 77.3% and vomiting 74.7%.The efficacy of mefenamic acid in term of relieving of symptoms was observed 70.7%.Statistically significant improvement in symptoms of headache, dysmenorrhea, breast tenderness and mood irritability were noted (p ≤ 0.05). While no clinically significant distinction found among marital status, occupation, education and duration of symptoms improvement (p ≥ 0.05). Practical implication of the study is that the effect of mefenamic acid relieving the symptoms of PMS. Conclusion: The study concluded that mefenamic acid is effective in term of relieving symptoms in patients with premenstrual syndrome. Keywords: Mefenamic acid; Efficacy; Premenstrual syndrome; vomiting.

Formulation and Evaluation of Flurbiprofen Topical Emulgels

Topical drug delivery has been used for centuries for the treatment of local skin disorders. Emulgel have emerged as one of the most interesting topical delivery system as it has dual control release system i.e. gel and emulsion. One side the topical applications of the drug offers the potential advantages of delivering the drug directly to the site of action and secondly delivering the drug for extended period of time at the effected site. Topical non-steroidal anti-inflammatory drug (NSIAD) formulations are designed to deliver therapeutic levels of the active ingredients to the inflamed tissue without elevating serum levels after application on the skin. This route is an attractive alternative to the oral administration of NSAIDS which is associated with high incidence of gastrointestinal tract (GIT) complications and other systemic toxic effects. Flurbiprofen is a potent non-steroidal anti-inflammatory agent usually well tolerated as compared to other NSAIDS product. It has analgesic and antipyretic properties. It is used in the treatment of rheumatic disorders such as ankylosing spondilities, oesteoarthritis and intraoperative miosis. It suffers from major GIT disturbances. The aim of the present study was to develop an emulgel formulation of flurbiprofen using water soluble polymer of hydroxy propyl methyl cellulose (HPMC K100M), carbopol 940, carbopol 941 and xanthan gum. Oleic acid and propylene glycol were used as permeation enhancers. The influence of the type of the gelling agent on the drug release from the prepared emulgel was investigated. The prepared emulgels were evaluated for their physical appearance, pH determination, viscosity, spreadability, extrudability, in-vitro drug release, ex-vivo drug release and stability. All the prepared emulgels showed acceptable physical properties, homogeneity, consistency, spreadability, viscosity and pH value. The emulgels were found to be stable with respect to physical appearance, pH, and rheological properties and drug content at all temperature and conditions for one month. Keywords: Emulgel, Topical drug delivery, Flurbiprofen, Carbopol, Hydroxy propyl methyl cellulose

Enhanced Transdermal Delivery of Acyclovir via Hydrogel Microneedle Arrays

Hydrogel microneedles represent a promising approach to deliver drug molecules across skin into systemic circulation in a sustained release manner and without any polymer residue within skin. Acyclovir is an antiviral drug used for the treatment of several viral infections. However, the oral administration of acyclovir may cause gastrointestinal tract (GIT) disturbances with low bioavailability and poor patient compliance due to its requirement of five daily administrations to produce the desired effect. Therefore, it is thought that the preparation of hydrogel microneedle arrays containing acyclovir would improve the bioavailability and patient compliance by reducing the frequency of administration to once daily as well as overcome the GIT side effects associated with oral administration. A mixture of PEG 10,000 Da and PMVE/MA co-polymer 1,980,000 Da at a ratio of 1:3 (7.5%:22.5% w/w) with Na2CO3 3% w/w was found to produce the optimum hydrogel microneedle array formulation (F8) which showed suitable needle formation with an appropriate mechanical strength and excellent insertion ability, high drug content, sufficient swelling property and a sustained drug release over a period of 24 hours. The Ex vivo permeation study across human skin has demonstrated that the permeation of acyclovir from F8 hydrogel microneedle array was significantly (P≤ 0.05) increased by 39 times in comparison with microneedle-free film (control). The microneedle array has delivered 75.56% ± 4.2 of its loading dose over 24 hours, while the control film was only able to deliver 1.94% ± 0.14 of the total loading dose during the same period. Accordingly, these findings propose the potential application of hydrogel microneedle arrays for the transdermal delivery of acyclovir in a sustained release manner over 24 hours.

Herbal therapies in gastrointestinal and hepatic disorders: An evidence-based clinical review.

The gastrointestinal tract (GIT) and the liver constitute the major organs of the human body. Indeed, the very survival of the human body depends on their proper functioning. Because the GIT is a huge and complex organ system, the maintenance of proper GIT and liver health is an arduous task. GIT disturbances such as diarrhea, stomach ache, flatulence, constipation, nausea, and vomiting are very common, and they contribute to a significant burden on the healthcare system. Pharmacies are full of over-the-counter pharmacological drugs to alleviate its common conditions. However, these drugs do not always prove to be fully effective and patients have to keep on living with these ailments without a proper and long-term solution. The aim of this review article is to present a practical reference guide to the role of herbal medicines in dealing with gastrointestinal and hepatic disorders, which is supported by systematic reviews and evidence-based trials. People have depended on herbal medications for centuries for the treatment of various ailments of the GIT, liver, and other organ system problems. Recently, this trend of incorporating herbal medication for the treatment of various diseases in both developing and developed countries have surged. Many people continue to use herbal medications, even though substantial data about their efficacy, uses, and toxicological effects do not exist. In addition, while herbal medicines have enormous benefits in both the prevention and the treatment of medical ailments, they can also have toxicological effects. It is, therefore, of the utmost importance that appropriate time, energy, and resources are spent on the development of ethnopharmacology. In addition, herbal products should be classified in a pattern similar to pharmacological medications, including their uses, side effects, mechanism of action, efficacy, and so on.

Low concentrations of Ambrosia maritima L. phenolic extract protect endothelial cells from oxidative cell death induced by H2O2 and sera from Crohn's disease patients

Ethnopharmacological relevanceA rising resort to herbal therapies in Crohn's disease (CD) alternative treatments has been recently observed due to their remarkable natural efficiency. In this context, the weed plant Ambrosia maritima L., traditionally known as Hachich el Aouinet in Algeria and as Damsissa in Egypt and Sudan, is widely used in North African folk medicine to treat infections, inflammatory diseases, gastrointestinal and urinary tract disturbances, rheumatic pain, respiratory problems, diabetes, hypertension and cancer. Aim of the studyTo assess an Ambrosia maritima L. phenolic extract for its phenolic profile composition, its potential antioxidant activity in vitro, and its cytoprotective effect on cultured primary human endothelial cells (ECs) stressed with H2O2 and sera from CD patients. Materials and MethodsPhenolic compound extraction was performed with a low-temperature method. Extract chemical profile was attained by HPLC-DAD/ESI-MS. The extract in vitro antioxidant activity was assessed using several methods including cupric ion reducing power, DPPH radical scavenging assay, O-Phenanthroline free radical reducing activity, ABTS cation radical decolourisation assay, Galvinoxyl free radicals scavenging assay. Intracellular reactive oxygen species levels were evaluated in human endothelial cells by H2DCFDA, while cell viability was assessed by MTT. ResultsThe phenolic compounds extraction showed a yield of 17.66% with three di-caffeoylquinic acid isomers detected for the first time in Ambrosia maritima L. Using different analytical methods, a significant in vitro antioxidant activity was reported for the Ambrosia maritima L. extract, with an IC50 value of 14.33 ± 3.86 μg/mL for the Galvinoxyl antioxidant activity method. Challenged with ECs the Ambrosia maritima L. extract showed a biphasic dose-dependent effect on H2O2-treated cells, cytoprotective and antioxidant at low doses, and cytotoxic and prooxidant at high doses, respectively. Viability and ROS levels data also demonstrated a prooxidant and cytotoxic effect of CD sera on cultured ECs. Interestingly, 10 μg/mL of Ambrosia maritima L. extract was able to counteract both CD sera-induced oxidative stress and ECs death. ConclusionOur data indicated Ambrosia maritima L. as a source of bioactive phenolics potentially employable as a natural alternative for CD treatment.

Streptozotocin-Induced Diabetes Causes Changes in Serotonin-Positive Neurons in the Small Intestine in Pig Model.

Serotonin (5-hydroxytryptamine or 5-HT) is an important neurotransmitter of the central and peripheral nervous systems, predominantly secreted in the gastrointestinal tract, especially in the gut. 5-HT is a crucial enteric signaling molecule and is well known for playing a key role in sensory-motor and secretory functions in the gut. Gastroenteropathy is one of the most clinical problems in diabetic patients with frequent episodes of hyperglycemia. Changes in 5-HT expression may mediate gastrointestinal tract disturbances seen in diabetes, such as nausea and diarrhea. Based on the double immunohistochemical staining, this study determined the variability in the population of 5-HT-positive neurons in the porcine small intestinal enteric neurons in the course of streptozotocin-induced diabetes. The results show changes in the number of 5-HT-positive neurons in the examined intestinal sections. The greatest changes were observed in the jejunum, particularly within the myenteric plexus. In the ileum, both de novo 5-HT synthesis in the inner submucosal plexus neurons and an increase in the number of neurons in the outer submucosal plexus were noted. The changes observed in the duodenum were also increasing in nature. The results of the current study confirm the previous observations concerning the involvement of 5-HT in inflammatory processes, and an increase in the number of 5-HT -positive neurons may also be a result of increased concentration of the 5-HT in the gastrointestinal tract wall and affects the motor and secretory processes, which are particularly intense in the small intestines.

Impact of environmental toxicants exposure on gut-brain axis in Parkinson disease.

Parkinson disease (PD) is a major public health challenge as many of the current drugs used in its management provide symptomatic relieve without preventing the underlying cause of the neurodegeneration. Similarly, the non-motor complications of PD, especially the gastrointestinal tract (GIT) disturbance increases the disease burden on both the PD patient and caregivers. Different theories have been postulated regarding the mechanisms or pathways involved in PD pathology but gut-brain axis involvement has gained much more momentum. This pathway was first suggested by Braak and colleagues in 2003, where they suggested that PD starts from the GIT before spreading to the brain. However, human exposure to environmental toxicants known to inhibit mitochondrial complex I activity such as rotenone, paraquat and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) are well associated with PD. Several reports have shown that oral exposure of laboratory animals to rotenone causes mitochondria dysfunction, GIT disturbance, overexpression of alpha synuclein and microbiota imbalance. This review focuses on the mechanism(s) through which rotenone induces PD pathogenesis and potential for therapeutic small molecules targeting these processes at the earliest stages of the disease. We also focused on the interaction between the GI microbiota and PD pathology.

Alteration of Gut Microbiota: New Strategy for Treating Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is defined as a complex heterogeneous disorder and characterized by stereotyped behavior and deficits in communication and social interactions. The emerging microbial knowledge has pointed to a potential link between gut microbiota dysbiosis and ASD. Evidence from animal and human studies showed that shifts in composition and activity of the gut microbiota may causally contribute to the etiopathogenesis of core symptoms in the ASD individuals with gastrointestinal tract disturbances and act on microbiota-gut-brain. In this review, we summarized the characterized gut bacterial composition of ASD and the involvement of gut microbiota and their metabolites in the onset and progression of ASD; the possible underlying mechanisms are also highlighted. Given this correlation, we also provide an overview of the microbial-based therapeutic interventions such as probiotics, antibiotics, fecal microbiota transplantation therapy, and dietary interventions and address their potential benefits on behavioral symptoms of ASD. The precise contribution of altering gut microbiome to treating core symptoms in the ASD needs to be further clarified. It seemed to open up promising avenues to develop microbial-based therapies in ASD.

Study on Physiological and Biochemical Evalutions of Horses Affected by Gastrointestinal Tract Disturbances

Study on Physiological and Biochemical Evalutions of Horses Affected by Gastrointestinal Tract Disturbances

The Role of the Microbiome in Autism: All That We Know about All That We Don't Know.

ABSTRACTAutism spectrum disorder (ASD) is a remarkably complex disorder influenced by both genetic and environmental factors. Numerous microbial diversity surveys conducted over the past decade have attempted to link specific ASD biomarkers to gastrointestinal tract disturbances, but results generated across cohorts and studies remain inconsistent. This commentary discusses multidirectional interactions between the host, the microbiome, and external factors germane to autism. Recent studies posit the heritability of the gut microbiome itself, confounding attempts to discern heritable from nonheritable effectors in neurodevelopmental disorders. Elucidating the ever-evolving gut microbiome’s role in modulating the ASD phenotype will most certainly require new experimental methodologies and designs. In a recent paper published in mSystems (J. Fouquier, N. Moreno Huizar, J. Donnelly, C. Glickman, et al., mSystems e00848-20, 2021, https://doi.org/10.1128/mSystems.00848-20), the authors describe a web of interactions by collecting samples longitudinally, analyzing cross-sectional cohorts, and recording nonbinary phenotypic measurements.

Retrospective Study of Bone-TB in Oman: 2002–2019

ObjectiveLittle information is available about the etiology, pathophysiology, risk factors, and epidemiologic features of Bone Tuberculosis (Bone-TB). In this work, we present the epidemiological data about the Bone-TB in the Sultanate of Oman.MethodsRetrospectively, we identified and assessed those patients who were diagnosed with Bone-TB between January 2002 and December 2019 at Khoula Hospital. The following data were collected: demographics, clinical presentation, anatomical location, diagnosis, and treatment of the Bone-TB.ResultsDuring the study period, 115 cases of Bone-TB were diagnosed. Males were affected more than females (57.4% and 42.6%, respectively). About 30% of Bone-TB cases were primary diagnosed in other organs particularly the lungs and then after disseminated to the bone. However, the Bone-TB was detected in hip, leg, hand, shoulder, and skull bones, the most detected Bone-TB was in spine (66% of cases). After vaccination the Bacillus Calmette–Guérin (BCG) strains were identified in the bones of eight babies. Tubercle bacilli were detected by Acid-Fast Stain (AFS) in 59% of cases, and the rest of cases were confirmed using polymerase chain reaction (PCR) tests. There are two used treatment regimens, with 12.4% relapse. The gastrointestinal tract (GIT) disturbances were the most related side effects. The resistance has been detected to pyrazinamide in six cases, rifampicin in three cases, and isoniazid, streptomycin and kanamycin were detected in one case.ConclusionThe most predominant Bone-TB cases were spine-TB that were mainly disseminated from the lungs. AFS failed to detect tubercle bacilli in 40% of cases. There is no statistical significance in relapse between the used two regimens. The death was predominant among skull-TB cases.

Therapeutic Effects of Probiotic Minas Frescal Cheese on the Attenuation of Ulcerative Colitis in a Murine Model.

Inflammatory bowel diseases (IBDs) constitute disturbances of gastrointestinal tract that cause irreversible changes in the structure and function of tissues. Ulcerative colitis (UC), the most frequent IBD in the population, is characterized by prominent inflammation of the human colon. Functional foods containing probiotic bacteria have been studied as adjuvants to the treatment or prevention of IBDs. The selected probiotic strain Lactococcus lactis NCDO 2118 (L. lactis NCDO 2118) exhibits immunomodulatory effects, with promising results in UC mouse model induced by dextran sodium sulfate (DSS). Additionally, cheese is a dairy food that presents high nutritional value, besides being a good delivery system that can be used to improve survival and enhance the therapeutic effects of probiotic bacteria in the host. Therefore, this work investigated the probiotic therapeutic effects of an experimental Minas Frescal cheese containing L. lactis NCDO 2118 in DSS-induced colitis in mice. During colitis induction, mice that consumed the probiotic cheese exhibited reduced in the severity of colitis, with attenuated weight loss, lower disease activity index, limited shortening of the colon length, and reduced histopathological score. Moreover, probiotic cheese administration increased gene expression of tight junctions’ proteins zo-1, zo-2, ocln, and cln-1 in the colon and increase IL-10 release in the spleen and lymph nodes. In this way, this work demonstrates that consumption of probiotic Minas Frescal cheese, containing L. lactis NCDO 2118, prevents the inflammatory process during DSS-induced colitis in mice, opening perspectives for the development of new probiotic functional foods for personalized nutrition in the context of IBD.

Comparative study between the efficacy of using sofosbuvir/daclatasvir and sofosbuvir/ledipasvir in treatment of hepatitis C virus in Egypt

Background Hepatitis C virus (HCV) infection is a global health care problem, with more than 170 million people infected worldwide. With the discovery of new direct-acting antiviral drugs, a new hope to get HCV cure has arisen. This work was designed to compare the efficacy between the use of sofosbuvir (SOF)/daclatasvir (DCV) and SOF/ledipasvir (LDV) in treatment of HCV. Patients and methods A total of 430 patients were enrolled into two groups: SOF/DCV group included 340 patients and SOF/LDV group included 90 patients. Each patient received treatment for 12–24 weeks. All patients were checked at each visit (at weeks 4, 8, 12, and 24) for the potential adverse events by a check-list questions, examinations, and laboratory tests. Check-list questions include headache, gastric upset, skin rash, and sleep disturbance. Results A total of 419 (97.4%) patients achieved sustained virologic response (SVR), and only 11 (2.5%) patients failed to achieve SVR. In SOF–DCV, 97.4%, and in SOF–LDV, 97.8% achieved SVR. Minor adverse events were mainly headache, sleep distribution, gastrointestinal tract disturbance, and skin rash, which were observed in 13.8% of patients in SOF–DCV group 20% in SOF–LDV group. Conclusion The use of the two regimens SOF/DCV and SOF/LDV yielded high success ratio for viral eradication with minimal tolerable adverse effects. These regimens of therapy have a great margin of safety with high efficacy.

Research on Nonsteroidal Anti-inflammatory Drugs in Malaysia: A Bibliometric Analysis.

ABSTRACTBackground:Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common analgesics used for pain relief. Adverse effects of NSAIDs range from gastrointestinal tract disturbances to increased risk of bleeding, renal injury, and myocardial infarction. In Malaysia, the research productivity of NSAIDs is not well explored.Objective:This study examined research productivity of NSAIDs in Malaysia.Materials and Methods:This bibliometric study included all published research articles on NSAIDs from 1979 to 2018, which were conducted in Malaysia. The search databases such as Google Scholar, PubMed, ScienceDirect, and Scopus were used. Search terms included NSAIDs and specific drug names such as ibuprofen, celecoxib, and naproxen. Growth of publication, authorship pattern, citation analysis, journal index, type of studies, and geographical distribution of institutions publishing articles on NSAIDs were measured.Results:Overall, 111 articles were retrieved from 1979 to 2018. The annual productivity of articles throughout the study fluctuated in which the highest productivity was in 2018, 12.61% (n = 14). Majority of articles were multiple authored, 99.10% (n = 109), and University of Science Malaysia (USM) produced the highest number of articles (30 articles). Most of the articles were International Scientific Indexing-indexed, 52.25% (n = 58), and the main issue studied in most of the articles was the drug formulation of NSAIDs.Conclusion:The growth of NSAID research in Malaysia was slow, and the majority of research involved laboratory studies. Clinical studies evaluating the clinical outcomes of NSAIDs in patients, particularly using large healthcare databases are still lacking.

Synthesis, Characterization and Acute Anti-inflammatory Evaluation of New Mefenamic Acid Derivatives Having 4-Thiazolidinone Nucleus

Mefenamic acid (MA) is one of the non-steroidal anti-inflammatory drugs, it is widely used probably due to having both anti-inflammatory and analgesic activity, the main side effects of mefenamic acid include gastrointestinal tract (GIT) disturbance mainly diarrhea, peptic ulceration, and gastric bleeding. The analgesic effects of NSAIDs are probably linked to COX-2 inhibition, while COX-1 inhibition is the major cause of this classic adverse effects. Introduction of thiazolidinone may lead to the increase in the bulkiness leads to the preferential inhibition of COX-2 rather than COX-1 enzyme. The study aimed to synthesize derivatives of mefenamic acid with more potency and to decrease the drug's potential side effects, new series of 4-thiazolidinone derivatives of mefenamic acid were synthesized IVa-g. The synthetic procedures for target compounds and their intermediates are designed to be as follows: acylation of secondary amine of mefenamic acid by chloroacetylchloride to produce compound (I), then reaction between compound (I) and hydrazine hydrate to form hydrazine derivative of mefenamic acid (compound II). After that, Schiff base formation by addition of seven benzaldehyde derivatives and finally, cyclization in presence of thioglycolic acid to form 4-thiazolidinone heterocyclic ring. The characterization of the titled compounds has been established on the basis of their spectral FTIR, 1HNMR data, and by measurements of their physical properties. In vivo acute anti-inflammatory effect of the synthesized compounds was evaluated in rats using egg-white induced edema model of inflammation. The tested compounds and the reference drug produced significant reduction of paw edema with respect to the effect of dimethyl sulfoxide 10%v/v (control group). Compound IVe showed more potent effect than mefenamic acid at 240-300 min, while at time 300 min, compounds IVa and IVd exhibit more potent anti-inflammatory effect than mefenamic acid (50mg/kg, i.p.) as they reduced paw edema significantly more than mefenamic acid at mentioned intervals (p<0.05) . On the other hand compound IVc exhibited lower anti-inflammatory effect.

Synthesis, Characterization and Acute Anti-inflammatory Evaluation of New Mefenamic Acid Derivatives Having 4-Thiazolidinone Nucleus

Mefenamic acid (MA) widely used probably due to having both anti-inflammatory and analgesic activity, the main side effects of mefenamic acid include gastrointestinal tract (GIT) disturbance mainly diarrhea, peptic ulceration, and gastric bleeding. The study aimed to synthesize derivatives of mefenamic acid with more potency and to decrease the drug's potential side effects, new series of 4-thiazolidinone derivatives of mefenamic acid were synthesized IVa-g. The synthetic procedures for target compounds and their intermediates are designed to be as follows: acylation of secondary amine of mefenamic acid by chloroacetylchloride to produce compound (I), then reaction between compound (I) and hydrazine hydrate to produce compound (II). After that, Schiff base formation by addition of seven benzaldehyde derivatives and finally, cyclization in presence of thioglycolic acid to form 4-thiazolidinone heterocyclic ring. The characterization of the titled compounds has been established on the basis of their spectral FTIR, 1HNMR data, and by measurements of their physical properties. In vivo acute anti-inflammatory effect of the synthesized compounds was evaluated in rats using egg-white (i.p) induced edema model of inflammation. The tested compounds and the reference drug produced significant reduction of paw edema with respect to the effect of dimethyl sulfoxide 10%v/v (control group). Compound IVe showed more potent effect than mefenamic acid at 240-300 min, while at time 300 min, compounds IVa and IVd exhibit more potent anti-inflammatory effect than mefenamic acid (50mg/kg, i.p.). On the other hand compound IVc exhibited lower anti-inflammatory effect.

Varicella complications in children one-site Polish population – a 19- year long survey

The aim of this study was to describe the epidemiology of chickenpox complications in children, based on a 19-year long survey. This publication constitutes a review of medical records of 761 patients under the age of 18 who were hospitalized at the T. Browicz Provincial Hospital for Infectious Diseases in Bydgoszcz, Poland from the 1st of January 1999 to the 31st of December 2017. Over the study period, 761 children diagnosed with varicella complications were hospitalized. The mean number of hospitalizations in each year amounted to 40. The median age of admitted patients was 4 years. The median length of hospitalization was 5 days (ranged from 1 to 30 days). The most frequent varicella complications included respiratory tract infections – 229/761 (30.1%), bacterial skin infections – 189/761 (24.8%) and gastrointestinal tract disorders – 142/761 (18.6%). Pneumonia, bronchitis and gastrointestinal tract disturbances, were reported most often in children under 2 years of age, while neurological complications occurred most frequently in children at 3-6 years of age. No significant differences in the number of varicella complications between immunocompromised and immunocompetent children were reported. Varicella complications mainly affect the youngest immunocompetent children. Population-wide vaccination and herd immunity appears to be the best way to reduce the incidence of chickenpox and the rate of varicella complications. This study gives support for inclusion of universal varicella vaccine in the National Immunization Program in Poland.

Morfologiya slizistoy obolochki dvenadtsatiperstnoy kishki u patsientov s sindromom razdrazhennogo kishechnika pri kontaminatsii kampilobakterom, kriptosporidiyami i gribami roda Candida

Irritable bowel syndrome is a certain spectrum of functional gastrointestinal tract disturbances. However recent data indicate, that patients with the mentioned syndrome present with noticeable morphological changes in the gastrointestinal tract mucosa. The aim of the study was evaluation of morphological changes in the duodenal mucosa in the course of its contamination with Campylobacter, Candida and Cryptosporidium in patients with irritable bowel syndrome. Patients under 50 years old (14 women and 10 men) with irritable bowel syndrome underwent complex clinical, laboratory and instrumental examination including esophagogastroduodenoscopy and colonoscopy with biopsy. Histological examination of bioptates, obtained from the patients' duodenal mucosa, revealed various grades of chronic duodenitis accompanied by high density of inflammatory cellular infiltrate (which consisted of plasmocytes, lymphocytes, macrophages, fibroblasts and fibrocytes), by duodenal villous atrophy, by low count of Paneth cells or their absence, by Brunner's glands' hyperplasia, by presence of Campylobacter, Candida and Cryptosporidium in the duodenal mucosa. The revealed duodenal mucosa morphological changes indicated on chronic inflammation accompanied with gut biocenosis abnormalities.

Probiotics as an Adjuvant Therapy in Major Depressive Disorder.

BackgroundMajor depressive disorder is a common, debilitating psychiatric disorder, which originates from the interaction of susceptibility genes and noxious environmental events, in particular stressful events. It has been shown that dysregulation of hypothalamus-pituitary-adrenal (HPA) axis, imbalance between anti- and pro-inflammatory cytokines, depletion of neurotransmitters (serotonin, norepinephrine and/or dopamine) in the central nervous system, altered glutamatergic and GABAergic transmission have an important role in the pathogenesis of depression. Due to numerous diverse biological events included in the pathophysiology of depression a large number of antidepressant drugs exerting distinct pharmacological effects have been developed. Nevertheless, clinical needs are still not solved.ResultsRelatively new research strategies advanced the understanding of psychiatric illness and their connections with disturbances in gastrointestinal tract. The existence of bidirectional communication between the brain and the gut has been proven, and an increasing body of evidence supports the hypothesis that cognitive and emotional processes are influenced through the brain-gut axis. On the other hand, microbiome may influence brain function and even behavior giving to the specific microorganisms a psychobiotic potential.ConclusionsIn this review we discuss the possibilities of classical antidepressant drug treatment being supported with the psychobiotics/probiotic bacteria in patients suffering from major depressive disorder.