American Journal of Clinical Medicine Research

Background: Non-alcoholic fatty liver disease (NAFLD) is a very serious medical and social problem that can lead to the progression of liver cirrhosis and eventually hepatic failure. There is a paucity of data regarding the prevalence and risk factors for NAFLD in the Russian Federation. Methods: The open multicenter prospective screening study, DIREG 1, involved patients aged 18–80 years who were admitted to various polyclinics for ambulatory therapeutic care (with or without apparent signs of hepatic diseases) at 208 centers in the Russian Federation from March 25th to November 26th, 2007. NAFLD was diagnosed by ultrasonography; a range of clinical and laboratory findings were also recorded for each participant. Results: A total of 30,754 outpatients were included in the screening study analysis. The prevalence of NAFLD was 27.0% (8,315/30,754), of which 80.3% had steatosis, 16.8% had steatohepatitis and 2.9% had disease at the cirrhotic stage. Most cases of NAFLD were observed in those aged 50-59 years (31.1%), 40-49 years (23.6%), and 60-69 years (18.1%). The most common risk factors associated with the NAFLD cohort vs the general screening population were dyslipidemia (75.9% vs 37.6%), arterial hypertension (69.9% vs 41.8%), and hypercholesterolemia (68.8% vs 33.5%) (all P<0.001). Conclusion: There is an urgent need to address the high prevalence of NAFLD in the Russian Federation (27%) and the large proportion of individuals with associated risk factors.

American Journal of Clinical Medicine Research. 2015, 3(2), 31-36. DOI: 10.12691/ajcmr-3-2-3
Pub. Date: June 05, 2015

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Prognostic Significance of Serum Uric Acid at the Time of Admission in Patients with Acute Stroke

by Dhrubajyoti Bandyopadhyay, Adrija Hajra, Sabyasachi Mukhopadhyay, Manas Layek, Diptak Bhowmick, Vijayan Ganeshan, Sibnarayan Sasmal, Debarati Bhar, Cankatikachoudhury and Partha Sarathi Karmakar

Original Research

Background & objectives: Stroke is the one of the important causes of death.Uric acid is described as a strong endogenous antioxidant that is consumed early in acute stroke. Uric acid being an aqueous antioxidant can become a pro-oxidant under certain circumstances, particularly, if other antioxidants such as ascorbate are low. This work was conducted to find an association between serum uric acid levels at the time of admission with functional outcome in patients with acute stroke. Method: This study was carried out on 96 patients of stroke including both ischemic and hemorrhagic stroke. Sampling scheduled one day of the week by rotation to avoid selection bias and the study design was descriptive, observational, cross-sectional study. Result: we found statistically significant positive correlation between serum uric acid level and change in Mathew score in ischemic stroke patients and poor positive correlation between uric acid level and change of Mathew score in hemorrhagic stroke patients. Conclusion: High serum uric acid level is associated with good neurological outcome in patients with acute ischemic stroke. A high serum uric acid level is associated with insignificant poor neurological outcome in patients with hemorrhagic stroke.

American Journal of Clinical Medicine Research. 2015, 3(2), 24-30. DOI: 10.12691/ajcmr-3-2-2
Pub. Date: June 02, 2015

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The Effect of a Multi-strain Probiotic on the Symptoms and Small Intestinal Bacterial Overgrowth in Constipation-predominant Irritable Bowel Syndrome: A Randomized, Simple-blind, Placebo-controlled Trial

by Ivashkin V., Drapkina O., Poluektova Ye., Kuchumova S., Sheptulin A. and Shifrin O.

A Clinical Study

Background and aim: the qualitative and quantitative difference in the intestinal microbiota between irritable bowel syndrome (IBS) patients and healthy volunteers doesn't raise doubts. Small intestinal bacterial overgrowth(SIBO), reported in 9-35% patients with constipation-predominant of irritable bowel syndrome (IBS-C), is involved in the pathogenesis IBS. Elimination of SIBO can lead to improvement of clinical symptoms. The aim of this study was to assess the efficacy of a bifido- and lactobacillis-containing probiotic Florasan-D on the eradicating SIBO and on the severity of clinical symptoms in patients with IBS-C. Methods: this randomized (1 : 1), simple-blinded, placebo-controlled investigation conducted at one centre in Russia.33 patients with IBS-C (clinical type was determined according to ROME III criteria) were randomized to receive a multi-strainprobiotic Florasan-D containing Bifidobacteriumbifidum, Bifidobacteriumlongum, Bifidobacteriuminfantis, Lactobacillus rhamnosus or placebo for 4 weeks: 16 and 17 persons respectively. The intensity of abdominal pain and bloating was estimated by a visual analogue scale (VAS), stool consistency – by a Bristol stool form scale before and after the intervention. Quality of life was assessed by the Short Form-36 questionnaire (SF-36). All subjects were analysed by lactulose hydrogen breath test with using Gastro+ Gastrolyzer (Bedfont, UK) to determine SIBO. Results: patients treated with multi-strainprobiotic Florasan-D reported a reduction in the severity of clinical symptoms: abdominal pain decreased from 4 to 2 point (р=0,003), stool frequency – from 3 to 7 per week (р=0,001) and stoolconsistency – from type 2 to type 3 by a Bristol stool form scale (р=0,001); SIBO was found in 56,3% patients before treatment and no patients had this syndrome after therapy. Patients treated with placebo reported a reduction the severity of abdominal pain only (р=0,028). SIBO in these patients before treatment was revealed in 52,9% and remained in all patients after it. Conclusions: multi-strainprobiotic Florasan-D is significantly more effective than placebo for reduction of clinical symptoms and SIBO elimination in IBS-C patients.

American Journal of Clinical Medicine Research. 2015, 3(2), 18-23. DOI: 10.12691/ajcmr-3-2-1
Pub. Date: April 14, 2015

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