Objective: This study was designed to explore the benefit of curcumin as adjuvant therapy to the standard Helicobacter pylori eradication triple therapy in both duodenal and gastric ulcers patients.Methods: The present study enrolled 40 patients newly diagnosed endoscopically with peptic ulcer disease to be allocated into group 1 treated with standard H. pylori eradication triple therapy, and group 2 patients treated with curcumin (500 mg) capsules three times daily for 14 days as an adjuvant to standard triple therapy. Stool antigen test, immunoglobulin M serology test, tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL-1β), and total antioxidant capacity (T-AOC) are measured at the baseline and after 6 weeks of treatment. Results:The result showed that the use of curcumin as adjuvant therapy produced highly significant improvement in healing efficacy which was significantly distinguished in duodenal ulcer patients compared to gastric ulcer groups 2 patients (p<0.05), along with a highly significant reduction in pro-inflammatory IL-1β level in group 2 patients (p<0.01). After 6 weeks of treatment, there was a highly significant elevation in the level of TNF-α in groups 1 (p<0.01), though group 2 patients presented with non-significant elevation in TNF-α level. Moreover, the T-AOC was improved with curcumin adjuvant therapy, though non-significant, compared to group 1 patients who showed a reduction in T-AOC. Conclusion:This study revealed that addition of curcumin as adjuvant therapy produced improvement in ulcer healing efficacy, and controlled the inflammatory and oxidative stress process induced by H. pylori infection.

Background Previous studies have found an association between myocardial infarction (MI) and abnormal haemoglobin (Hb) but it is unknown whether Hb-levels are associated with type 1 and type 2 MI in unselected patients with chest pain visiting the emergency department (ED). Purpose To investigate the association between abnormal Hb-levels and type 1 and type 2 MI in patientens visiting the ED with chest pain. Methods The study population comprised all consecutive patients visiting four urban ED:s for chest pain between 2013–2016 with available data on Hb. Clinical data from the ED visit were cross-referenced to compulsory national registries retrieving information on previous diagnoses and treatments to identify history of cardiovascular disease (defined as previous MI, stroke or peripheral vascular disease), hypertension, hyperlipidaemia and diabetes mellitus. Patients were categorized depending on the exposure (Hb-level) to anaemia, normal and polycythaemia. The primary outcome (type 1 and type 2 MI) was identified in the Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART). Relative risk ratio (RRR) was calculated using multinomial logistic regression, with 95% confidence interval (CI) using no infarction as reference. The robust sandwich estimator was used to estimate standard errors. Adjustments were made for risk factors according to HEART-score. Results A total of 64 606 patient with chest pain were included with a mean (SD) age of 56 (19) years and 48% were women. Anaemia was present in 10 204 (15.8%) and polycythaemia in 1598 (2.5%). Overall, type 1 MI occurred in 2 296 patients and type 2 MI in 145. The risk for type 1 MI was higher in both anaemia (RRR 1.8, 95% CI 1.6–2.0) and polycythaemia (RRR 1.6, 95% CI 1.3–2.0) compared to normal Hb. For type 2 MI the risk was markedly higher for both low and high Hb compared to normal (RRR 4.0, 95% CI 2.8–5.6) and (RRR 3.0, 95% CI 1.4–6.9). Taking age, gender and risk factors into account, patients with anaemia had a lower risk (RRR 0.8, 95% CI 0.7–0.9) for type 1 MI compared to patients with normal Hb whereas patients with polycythaemia still had a higher risk (RRR 1.6, CI 1.2–2.0). For type 2 MI, the risk remained higher for both low (RRR 1.9, 95% CI 1.3–2.8) and high Hb (RRR 2.8, 95% CI 1.3–6.2) compared to normal. Conclusion Abnormal Hb-levels in chest pain patients in the ED were significantly associated with an increased risk of type 1 or type 2 MI, however when accounting for risk factors, in a differential pattern. These novel findings indicate that Hb-level may be important when assessing patients for MI symptoms in the ED, however, further investigations are needed to establish the definite predictive value. FUNDunding Acknowledgement Type of funding sources: None. Adjusted results type 1 and type 2 MI

Inflammatory bowel disease (IBD) is considered as a general term for groups of idiopathic, chronic, relapsing inflammatory disorders of the GIT.  Inflammatory bowel disease (IBD) can be divided into two main diseases: Ulcerative colitis (UC) and Crohn’s disease (CD).  Melatonin (N-acetyl-5-methoxytryptamine) is a hormone that is secreted from a pineal gland and other tissues such as gastrointestinal tract (GIT). This study was intended to evaluate the potential effectiveness of melatonin as an adjuvant to the standard treatment. This interventional prospective randomized-controlled, open-label, single center study was carried out on 30 patients visiting the Biological Unit/Baghdad Teaching Hospital/Medical City Directorate, for their scheduled standard treatment for moderate to severe CD during the period from August 2016 to March 2017. Ethical committee approval and patients written consent were obtained. Hemoglobin (Hb) level in CD patients was significantly increased after both regimen (standard treatment and melatonin adjuvant therapy), but no significant difference in hemoglobin between the two groups. The erythrocyte sedimentation rate (ESR) level was significantly decreased after both regimens (P<0.05) with no significant difference was found between patients groups. The tumor necrosis factor (TNF-α) level was not affected after both regimens in CD patients. From the present study, a promising therapeutic strategy emerged in respect to melatonin as adjuvant therapy in patients with CD which may suggest a role in ameliorating disease process both subjectively and objectively thus optimize therapeutic outcome