Objective: Ulcerative colitis (UC) is an idiopathic, chronic inflammatory disease of the large intestine, usually involving the rectum. During the last decade, clinical trials have shown adalimumab (ADA) and infliximab (IFX) to be efficacious in inducing and maintaining remission for moderate to severe UC refractory to the conventional therapies. The purpose of this study was to compare the efficacy and safety of ADA and IFX for induction remission in Iraqi patients with moderately to severely active UC.Methods: A total of 50 patients with moderate to severe UC, who were refractory to concurrent treatment with oral corticosteroids and/or immune suppressants, were randomly assigned in 1:1 ratio to receive either ADA (160/80 mg, subcutaneous) or IFX (5 mg/kg, intravenous) during the induction phase (8 weeks). Primary efficacy endpoint was clinical remission at week 8. Secondary efficacy endpoints were the clinical response, mucosal healing, subscores indicative of mild disease (rectal bleeding subscore [RBS], physician's global assessment [PGA] subscore, and stool frequency subscore [SFS]). Partial Mayo score was also evaluated in addition to the inflammatory bowel disease questionnaire (IBDQ). Additional subgroup analysis was based on the Mayo score, extensive colitis, concomitant medications, high sensitivity C-reactive protein (hs-CRP) level, and patient weight at baseline. The safety profile was assessed in all enrolled patients.Results: At week 8, 24% of patients receiving ADA were in clinical remission, compared with 28% on IFX (p>0.05). Clinical response was achieved in 48% of patients receiving ADA and 52% of patients on IFX (p>0.05). Mucosal healing was achieved in 40% of patients receiving either ADA or IFX (p>0.05). For the subscores indicative of mild disease (≤1), the patients % of RBS and PGA was significantly higher within IFX group (p<0.05) while the patients % of SFS was significantly higher within ADA group (p<0.05). The proportion of patients achieving clinical remission based on the partial Mayo score, in addition to IBDQ response index, was not differ significantly between the two groups from week 2 and throughout the study (p>0.05). The patients with higher Mayo score (≥10), higher hs-CRP (≥10 mg/L), and higher weight (≥70 kg) at baseline were associated with reduced remission rates. ADA and IFX treatment were generally well-tolerated and the overall safety profile matched. Conclusion:ADA and IFX were comparable in their effectiveness for inducing clinical remission and response in patients with moderate to severe UC. Both of the biologic agents were well tolerated with an approach safety profile.
Overuse of antibiotics has become the major factor for the emergence and dissemination of multi-drug resistant strains of several groups of microorganisms and this lead to search for agents that may have antibacterial effects. Vitamin E emerged as an essential, fat-soluble nutrient in the human body and it is essential, because the body cannot manufacture its own vitamin E, so foods and supplements must provide it. The aim of the present study was to evaluate the effect of vitamin E against pathogenic bacteria. Gram positive and gram negative bacteria were selected as the test microorganisms based on their importance in infections. In this study vitamin E used in four concentrations (50,100,200,400) IU/ml. The agar diffusion method was used to determine antibacterial activity. Results showed that gram negative bacteria were shown to be more resistant than gram positive bacteria. The resistance of gram negative bacteria towards antibacterial substances may be related to lipopolysaccharides in their outer membrane.
Background: a number of studies have shown that application of topical calcineurin inhibitors is effective for a broad spectrum of inflammatory skin disorders.Objective: to compare the efficacy and safety of 1% of pimecrolimus cream versus 0.05% of clobetasol cream and 0.005% of calcipotriol cream in psoriatic patients.Patients and methods: adults on stable plaque psoriasis were randomized to three treatment groups (pimecrolimus, clobetasol, and calcipotriol group). The criteria of inclusion involve affected BSA of ≤10%, with a local psoriasis severity index (LPSI) score of ≥5. The main assessment of clinical efficacy was the percent changes in LPSI. The quantitative determination of cytokine levels (IL -6, s IL-2R, TNF-α), skin biopsies, and creams safety were also evaluated.Results: the median percent changes in LPSI for pimecrolimus, clobetasol and calcipotriol groups were 51%, 56% and 59%, respectively (p>0.05). Pimecrolimus cream decreased cytokines levels and improved pathological features of psoriatic lesion. Mild skin burning was the most frequent adverse event reported by pimecrolimus (40%; p<0.05) versus 8% in clobetasol and 12% in the calcipotriol gr.Conclusion: pimecrolimus cream demonstrated efficacy comparable with that of clobetasol and calcipotriol for the treatment of mild to moderate plaque psoriasis.
Caraway seeds are widely used as spice for flavoring and seasoning foods, like bread and salads, because of their pungent and anise like flavor and aroma. Carum carvi was utilized in folk medicine for the management of many diseases. It is useful in hypothyroidism, liver and gall bladder problems, common cold, fever, bronchitis, diarrhea, and eczema. It also relives GIT spasms, fullness feelings and relieves baby's flatulent colic. The extracts of caraway have diverse compounds, including carvone and limonene, linalool, γ-terpinene and α-pinene. One or combination of these compounds may participate in the pharmacologic effects of caraway. Aim of this study was to assess toxicity of caraway extract on female rats. Carium carvi extract submitted to chemical analysis (Phytochemical screening and Gas chromatography-mass spectrometry (GC-MS) analysis). Acute toxicity study has been performed using 24 female rats divided randomly in 4 groups (n=6 for each group) that received different doses of hydroalcoholic seed extract of caraway 1000, 3000 and ,5000 mg/kg for 14 days. On day 15, the rats were euthanized and whole blood collected to examine complete blood picture. The liver, kidney and the heart have been harvested for histopathologic study and relative organ weight changes. Caraway extract considered relatively safe on blood profile and immune system within the studied doses, as it shown a non-significant change on complete blood counts (CBCs) in a dose-dependent manner (Hb and RBCs increased slightly, while WBCs and PLTs decreased slightly) and without any change in body weight and relative weight percentage of different organs. As conclusion, hydroalcoholic extract of caraway seeds was relatively safe in rats at a dose up to 5000 mg/kg
Background: a number of studies have shown that application of topical calcineurin inhibitors is effective for a broad spectrum of inflammatory skin disorders. Objective: to compare the efficacy and safety of 1% of pimecrolimus cream versus 0.05% of clobetasol cream and 0.005% of calcipotriol cream in psoriatic patients. Patients and methods: adults on stable plaque psoriasis were randomized to three treatment groups (pimecrolimus, clobetasol, and calcipotriol group). The criteria of inclusion involve affected BSA of ≤10%, with a local psoriasis severity index (LPSI) score of ≥5. The main assessment of clinical efficacy was the percent changes in LPSI. The quantitative determination of cytokine levels (IL-6, s IL-2R, TNF-α), skin biopsies, and creams safety were also evaluated. Results: the median percent changes in LPSI for pimecrolimus, clobetasol and calcipotriol groups were 51%, 56% and 59%, respectively (p>0.05). Pimecrolimus cream decreased cytokines levels and improved pathological features of psoriatic lesion. Mild skin burning was the most frequent adverse event reported by pimecrolimus (40%; p<0.05) versus 8% in clobetasol and 12% in the calcipotriol gr. Conclusion: pimecrolimus cream demonstrated efficacy comparable with that of clobetasol and calcipotriol for the treatment of mild to moderate plaque psoriasis.
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