Levofloxacin-Based First-Line Therapy versus Standard First-Line Therapy for Helicobacter pylori Eradication: Meta-Analysis of Randomized Controlled Trials

Background

First-line levofloxacin-based treatments eradicate Helicobacter pylori with varying success. We examined the efficacy and safety of first-line levofloxacin-based treatment in comparison to standard first-line therapy for H pylori eradication.

Materials and Methods

We searched literature databases from Medline, EMBASE, and the Cochrane Register of Randomized Controlled Trials through March 2013 for randomized controlled trials comparing first-line levofloxacin and standard therapy. We included randomized controlled trials conducted only on naïve H pylori infected patients in adults. A systematic review was conducted. Meta-analysis was performed with Review Manager 5.2. Treatment effect was determined by relative risk with a random or fixed model by the Mantel-Haenszel method.

Results

Seven trials were identified with 888 patients receiving 7 days of first-line levofloxacin and 894 treated with standard therapy (Amoxicillin, Clarithromycin and proton pump inhibitor) for 7 days. The overall crude eradication rate in the Levofloxacin group was 79.05% versus 81.4% in the standard group (risk ratio 0.97; 95% CI; 0.93, 1.02). The overall dropout was 46 (5.2%) in the levofloxacin group and 52 (5.8%) for standard therapy. The dizziness was more common among group who took Levofloxacin based treatment and taste disturbance was more common among group who took standard therapy. Meta-analysis of overall adverse events were similar between the two groups with a relative risk of 1.06 (95% CI 0.72, 1.57).

Conclusion

Helicobacter pylori eradication with 7 days of Levofloxacin-based first line therapy was safe and equal compared to 7 days of standard first-line therapy.     

Role of Single Nucleotide Polymorphisms of KIF1B Gene in HBV-Associated Viral Hepatitis

Background/Aim

Kinesin family member 1B (KIF1B) gene resides in the chromosomal region 1p36.22 and has been reported to have frequent deletions in a variety of human cancers. A recent genome wide association study (GWAS) study conducted on a Chinese population has reported the involvement of a KIF1B genetic variant in Hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). This study aims to investigate the significance of KIF1B genetic variations in HBV-associated hepatitis in patients of Saudi Arabian ethnicity.

Methods

TaqMan genotyping assay was used to investigate the association of three SNPs (rs17401966, rs12734551, and rs3748578) in 584 normal healthy controls and 660 HBV-infected patients. The patients were categorized into inactive carriers (Case I), active carriers (Case II), Cirrhosis (Case III) and Cirrhosis-HCC (Case IV) sub-groups.

Results

Since SNPs rs12734551 and rs3748578 are in strong linkage disequilibrium (LD) with rs17401966, only results for the latter SNP are reported. Therefore, the allele frequency of rs17401966 among HBV-infected patients and healthy controls were comparable and therefore, no significant association was observed (P = 0.2811, Odds Ratio (OR) 0.897). A similar analysis was performed among the different sub-groups in order to determine whether KIF1B SNPs were associated with the advancement of the disease. No significant differences were observed in any of the comparisons performed.

Conclusion

Polymorphisms at KIF1B gene locus investigated in this study showed no significant association with HBV infection or with HBV-associated diseases such as liver cirrhosis or HCC.     

<Emphasis Type="Italic">Dicroidium bandelii</Emphasis> sp. nov. (corystospermalean foliage) from the Permian of Jordan

Dicroidium bandelii sp. nov. (Corystospermales) is described from the Um Irna Formation (Permian) of the Dead Sea Region, Jordan. The type and only specimen is a compressed frond fragment with cuticle. The new species is unique in showing pinnate frond architecture with elongate, lanceolate pinnae with a dense, near-parallel venation. In situ epifluorescence-microscopic analysis of the cuticle revealed evenly distributed, superficial stomata with differentiated lateral subsidiary cells typical of the genus. Epidermal and cuticular features readily distinguish D. bandelii from some superficially similar species of Ptilozamites or Thinnfeldia. Our report demonstrates that the diversity of Corystospermales in the unusual ‘mixed flora’ of the Permian palaeotropics is still greater than previously thought, and that the Um Irna Formation in particular holds a great potential for future palaeontological research.     

Synthesis,anticancer and apoptosis-inducing activities of quinazoline–isatin conjugates: epidermal growth factor receptor-tyrosine kinase assay and molecular docking studies

A new series of quinazolinone compounds 16–34 incorporating isatin moieties was synthesized. The antitumor efficacy of the compounds against MDA-MB-231, a breast cancer cell line, and LOVO, a colon cancer cell line, was assessed. Compounds 20, 21, 22, 23, 25, 27, 28, 29, 30, 31, 32, 33, and 34 displayed potent antitumor activity against MDA-MB-231 and LOVO cells (IC₅₀: 10.38–38.67?μM and 9.91–15.77?μM, respectively); the comparative IC₅₀ values for 5-fluorouracil and erlotinib in these cells lines were 70.28?μM, 22.24?μM and 15.23?μM, 25.31?μM respectively. The EGFR-TK assay and induction of apoptosis for compound 31 were investigated to assess its potential cytotoxic activity as a representative example of the novel synthesized compounds. At a concentration of 10?μM, compound 31 exhibited efficient inhibitory effect against EGFR-TK and induced apoptosis in MDA-MB-231 cells. Furthermore, a molecular docking study for compound 31 and erlotinib was performed to verify the binding mode toward the EGFR kinase enzyme, and showed a similar interaction as that with erlotinib alone.

Graphical Abstract: Compound 31 showed potent antitumor activity and efficient inhibitory effect against EGFR-TK and induced apoptosis of MDA-MB-231 cells at a concentration of 10?μM.     

Inbreeding effects on reproductive outcome in a Sudanese population

926 women attending the Obstetrics and Gynaecology Department of the Faculty of Medicine, Khartoum, were investigated to study the inbreeding effects on reproductive profiles and morbidity of the offspring. 49.5% of the women had married their first cousins and 13.8% had married more distant relatives. Altogether, 4,471 pregnancy outcomes were analysed including abortions, still births, neonatal and childhood deaths, physical deformity, mental retardation and other congenital abnormalities. No significant difference in the reproductive loss or net fertility was observed between the inbred and outbred groups. Only the proportions of childhood deaths were found to be significantly higher in the inbred marriages (p less than 0.005). The morbidity was also not affected by the practice of inbreeding.     

Comparative SEM Studies of Lattice Organs: Putative Sensory Structures on the Carapace of Larvae from Ascothoracida and Cirripedia (Crustacea Maxillopoda Thecostraca)

Putative sensory structures, called lattice organs, were studied with scanning electron microscopy from ascothoracid or cypris larvae representing a wide range of families of the Ascothoracida and Cirripedia. These organs, situated dorsally on the carapace were, with few exceptions, always found in two anterior and three posterior pairs. The lattice organ morphology displayed by the Ascothoracida, a seta–like structure with a terminal pore, is believed to be the most plesiomorphic condition. Within the Cirripedia lattice organ morphology varied from types resembling the Ascothoracida in the Acrothoracica and the lepadomorph Capitulum mitella, to an elongate pore field with a larger terminal pore in most Thoracica and Rhizocephala. Akentrogonid Rhizocephala seem to display the most apomorphic condition. While lattice organ morphology was generally constant at the family level, cases were seen where closely related species such as Chthamalus stellatusand Chthamalus montaguishowed minor, but clear cut differences. Lattice organs in 2 + 3 pairs are argued to represent a synapomorphy for the Ascothoracida and the Cirripedia. The results confirm that the cyprid morphology at the ultrastructural level will prove to be of high value in estimating phylogeny within the Cirripedia.     

Microbiological and chemical analysis of fermented sorghum dough for Kisra production

Summary Sorghum flour was fermented in the traditional way for Kisra production. Wet or dry preparations of fermented sorghum dough from Sudanese households were employed as inocula. Microbiological and chemical analysis was performed throughout the fermentation process. Cell counts reached values of up to 9 × 10⁸ cfu/g and contained >99% lactobacilli. Strains of Lactobacillus fermentum, L. reuteri and L. amylovorus or L. fermentum and L. amylovorus were found as dominant organisms in doughs inoculated with wet or dry sorghum dough preparations, respectively. The ratios of the lactobacilli remained constant after up to four consecutive fermentations. After inoculation with the dry dough preparation the yeast Candida krusei was detected at 10⁶ cfu/g. During the fermentation the pH declined from 5.5 to values of approximately 3.4. The maltose content of the dough decreased continuously, wheraas glucose was accumulated as an intermediate. The relative content of most amino acids in the doughs did not significantly change during the fermentation. However, the concentrations of cysteine and methionine decreased, whereas threonine was enriched in the dough. Correspondence to: R. F. Vogel