Starting from scratch: The primary hyperacidity theory of the cause of pyloric stenosis of infancy

The early observations of those who first described babies with pyloric stenosis (PS) are used as a backdrop for the development of the Inherited Primary Hyperacidity theory of cause. Those early truths, uncomplicated by modern technology, have acted as a springboard for pathogenesis. Hyperacidity, male predominance, family history, self-cure, enhanced appetite, and time-sensitive presentation were all well known to the early pioneers. Any system of pathogenesis must explain all these clinical features. The Inherited Primary Hyperacidity theory does this and is a credible explanation for all the clinical features established by these early pioneers. The evidence which supports a delay in maturation of the negative feedback between gastrin and gastric acidity is presented. Such a phenomenon further supports the Primary Hyperacidity theory.

Self-Medication Practices in Pokhara: A Study of Knowledge and Purpose among Non-Medical Students

This study has tried to assess the self-medication practice among non-medical students. For this purpose, data were collected from 206 Bachelor’s and Master’s level students by using self-administered questionnaire at Prithvi Narayan Campus, Pokhara. Quick relief from pain is one of the reasons for self-medication, followed by previous experiences of illness, pharmacist’s advice, ease and convenience and time saving. The majority of students has been practiced self-medication to treat headache (62.9%), fever (32.7%), gastric acidity (23.9%), cough (27.3%), common cold (34%), dental pain (18.5%) and dandruff (24.4%). Almost two fifth of the respondents (37.37%) had knowledge regarding the composition of drugs and minority (8.74%) that had knowledge about dose, content, therapy duration and reaction of the drug. In addition, the majority of the respondents practiced Antipyretic (38.6%) followed by analgesics (33.4%), general antibiotics (17.7%) and anti-ulcerants (14.1%) without proper consultation with professionals. The findings of the study showed that non-medical students had self-medication practices, depending on their age, gender and academic level. Due to a high level of practice on self-medication, the study recommended that the concerned authority should formulate a set of rules and implement to prevent such practices in the university, providing adequate facilities for healthcare medical treatment.

Gastro-protective Effects of Honey in Male Wistar Rats

Honey is consumed as food and also used in the treatments of ailment. However, honey of various types exhibit varying properties. Their therapeutic effects are determined by whether the honey is multifloral or monofloral, and also on the variety of nectars the honey is derived from. Manuka and Tualang types of honey were observed to possess anti-ulcer effects. However, no such report is available for University of Ilorin honey. This study therefore aimed to determine the gastroprotective effects of University of Ilorin honey in Wistar rats using two laboratory models for inducing ulcer (HCl/Ethanol and Indomethacin). Twenty rats each were assigned to four groups for each model of ulcer. The rats were treated for 12 days with the administration of distilled water (control), cimetidine (100 mg/kg b.w.) and University of Ilorin honey (250 mg/kg b.w. in one group and 1000 mg/kg b.w in another group). The rats were fasted for 24 hours after the last treatment. Then, the ulcerogens were given orally. After four hours, the rats were sacrificed, gastric juice was collected and the stomachs were examined for ulceration. The results revealed that pre-treatment with University of Ilorin honey reduced gastric index from 6.80±0.20 (1000 mg/kg b.w. to 2.40±0.24 (control) P<0.05 and 7.20±0.37 (1000 mg/kg b.w.) to 3.20±0.37 (control) P<0.05 in HCl/Ethanol and indomethacin induced ulcer models respectively. There was no significant difference in ulcer index between the cimetidine administered rats and the honey administered group (1000 mg/kg bw.), but the honey group (250 mg/kg bw.) was less effective than the cimetidine group in the models used. Also, there were no changes in gastric acidity in all the groups compared with the control group. In conclusion, the results showed that University of Ilorin honey has protective effect on the gastrointestinal tract which is not due to alteration of gastric acidity.

Evaluation of the probiotic potential of Pediococcus strains from fermented dairy product kefir

Fermented dairy products mostly harbour some microbiota, also known as probiotics. Over the last years, there has been a significant increase in interest in probiotics. Among them, Pediococcus strains also exist in fermented dairy products, including kefir. However, the probiotic potential of Pediococcus strains has not been explored extensively. This study was performed to evaluate the probiotic potential of Pediococcus strains from traditionally produced kefir samples. To do this, a total of 32 kefir samples from Marmara and Central Anatolia regions in Turkey was collected. The samples were exposed to conventional microbiological analysis to culture lactic acid bacteria (LAB), followed by identification using VITEK^® mass spectrometer (MS), and molecular characterisation of Pediococcus strains by polymerase chain reaction (PCR). After that, the probiotic potential of each Pediococcus strain was tested for resistance to gastric acidity and bile salt and property of hydrophobicity. Overall, 22 strains (34.9%) were identified as Pediococcus spp. out of 63 LAB isolates. Among them, only one isolate, Pediococcus pentosaceus K6, was found to be resistant to gastric acidity, bile salt and to have hydrophobic properties. In conclusion, our study suggests that a limited number of strains could reveal their potential probiotic action on the host organism. Thus, Pediococcus strains of diverse natural origins can provide more insights into further probiotic supplement designs in human nutrition without genomic intervention.

Gastroprotection and mucus stimulation by vitamin D3 in pyloric ligation and Indomethacin-induced gastric ulcers rats models

The effect of vitamin D3 (VD3) on gastric ulcers was investigated by evaluating ulcer index, biochemical aggressive, and protective factors. Rats were divided into 4 groups; untreated indomethacin ulcer, VD3 pre-treated + indomethacin ulcer, untreated pyloric-ligation ulcer and VD3 pre-treated + pyloric-ligation ulcer. Treatment with VD3 (400 IU/kg intramuscular) was done daily for 6 days and an hour before ulcers induction. Four hours post-induction, the blood sample was obtained for the determinations of 1,25-dihydroxy vitamin D (1,25-DHCC), Parathyroid Hormone (PTH), and Calcium (Ca). Laparotomy was performed and the stomach was harvested for gastric acidity, ulcer index, and biochemical evaluations. The data were analyzed using statistical tools and the “student t-test” was performed at p<0.05. VD3 pre-treatmment caused an increase in serum levels of 1,25-DHCC, has no significant effect on PTH and Ca levels but decreased gastric acidity and ulcer index (p<0.05) with protective ratios of 42.11% and 60.00% against indomethacin and pyloric-ligation ulcers respectively. Pretreatment resulted in decreased gastric MDA, increased gastric protein, mucin, and nitric oxide levels. Gastric protection by VD3 was through oxidative stress inhibition and stimulation of mucus and blood flow against indomethacin and pyloric ligation gastric damage.

Comparison of effect of Various Combinations of four drugs i.e IV Ondansetron, Ranitidine, Metoclopramide and Omeprazole, to reduce Gastric Fluid Residual Volume and Gastric Acidity in Elective Laparoscopic-Cholecystectomy patients

Background: Inhaling of gastric contents in lower respiratory tract and larynx results in developing of pulmonary aspiration. The acidity of aspirate contents and its volume determines severity of aspiration and is major cause of post-anesthetic mortality. Objective: To compare the effect of four drugs (ranitidine, IV ondansetron, metoclopramide, omeprazole and metoclopramide) in all possible four combinations, to decrease gastric fluid residual volume and gastric acidity in undergoing laparoscopic-cholecystectomy. Design: It was a clinical randomized trial. Study Settings: Trial was conducted at Department of Anesthesiology and ICU, Sheikh Zayed Hospital, Lahore, for a period of 6 months from 01-07-2019 to 31-12-2019. Patients and Methods: A total of 308 patients from both the genders undergoing laparoscopic cholecystectomy were included in this study. Four equal groups were made by random division of patients. Group A: ranitidine & ondansetron, group B: ranitidine & metoclopramide, group C: omeprazole & ondansetron and group D: omeprazole & metoclopramide. Pre-anesthetic medicine was given to all the patients two hours before surgery. For assessing volume of gastric fluid and its pH, an oro-gastric tube was passed. An informed written informed consent was taken from all the patients. Results: Mean age in this study was 36.40±9.15, 33.23±9.13, 36.82±9.37 and 36.57±9.49 years respectively for Group A,B,C and D. Aspirate had mean quantity of 12.56±5.60 ml/kg, 12.65±5.39 ml / kg, 13.68±5.76 ml/kg and 14.34±6.85 ml/kg and he aspirate mean pH was 2.56±0.55, 2.47±0.58, 2.51±0.57 and 2.45±0.58 respectively for group A,B,C and D. Among both the trial groups, this different was insignificant (p-value > 0.05) for both outcomes. Conclusion: All the drug combinations had no significant difference. However, comparatively less pH and volume of gastric fluid was shown by combination of ranitidine plus ondansetron. Therefore, this combination is recommended before general anesthesia for reducing gastric fluid aspirate in patients undergoing surgery. Keywords: Laparoscopic cholecystectomy, Omeprazole, Ranitidine, Metoclopramide, Ondansetron, gastric fluid acidity, pH, gastric fluid volume

Neonatal bacterial attack-unraveling the mysteries of acid defense

This review article examines how gastric acidity develops and is maintained during the first 4 weeks of life. An initial maternal transfer of gastrin is followed by progressively increasing baby gastrin, not yet restrained by the rising acidity. When the negative feedback matures, baby acid secretion becomes controlled and independent.

In-vitro Antacid Properties of Cameroonian Clay (MY41g) and its Potential Use in Anti-ulcer Triple Therapy Regimen Formulated with Eremomastax speciosa Extract

Aims: The antisecretory, antibacterial on Helicobacter, and antacid properties of Eremomastax speciosa (E. speciosa) and MY41g clay respectively, led us to evaluate the potential use of this clay in the anti-ulcer tri-therapy formulated with Eremomastax speciosa. Place and Duration of Study: Department of Animal Biology & Physiology (Animal Physiology Laboratory), Faculty of Science, University of Yaoundé I, between August 2020 and February 2021. Materials and Methods: In vitro antacid were evaluated by studying: Fordtran's method, and the influence of temperature on the pH values. In vivo activity was studied on chronic gastric ulcers induced by injection of 0.05 ml of acetic acid (30%) into the stomach wall. Rats were treated daily for 10 days after ulcer induction with a combination of E. speciosa and MY41g (ESMY) ; (ESMY 100+250 and 200+250 mg/kg). The model of "unhealed" gastric ulcers was also used: from day 5 to day 18 of experimentation, rats were given ESMY orally concomitantly with indomethacin (1 mg/kg/day) subcutaneously. Ulcer index, percentage of healing, mucus secretion, gastric acidity, histological, hematological, and oxidative stress parameters were evaluated. Results: ESMY showed good neutralizing capacity in vitro in Fordtran’s method. Treatment with ESMY accelerated the spontaneous healing of chronic gastric ulcers (93.82-96.14%). However, administration of indomethacin did not induce significant variations in the percentage of healing (90.73-94.60%). For both ulcer models performed, ulcer healing was accompanied by a significant (P = 0.001) increase in mucus mass at 200/250 mg/kg. ESMY increased antioxidant activity, decreased gastric acidity, lipid peroxidation, and maintained hematological balance. Conclusion: In addition to its buffering properties, the healing mechanism of ESMY includes reduced gastric acidity, enhanced mucus production, re-epithelialization of gastric mucosa, improvement of hematological and antioxidant status. ESMY can be used in traditional medicine, as a therapeutic regimen against gastric ulcers.

Effect of Food and Dosing Regimen on Safety and Efficacy of Proton Pump Inhibitors Therapy—A Literature Review

Proton pump inhibitors (PPIs) are the first-choice drugs used to prevent and treat acid-related diseases. However, a lack of satisfactory response to the standard PPI dose (“PPI failure”) is often reported, especially in patients with gastroesophageal reflux disease. Poor compliance seems to be one of the main causes of PPI failure; hence, it is crucial to gain knowledge on how to properly administer PPIs. In this review, we aimed to evaluate the effect of food, beverages, and dosing regimen on pharmacokinetics and pharmacodynamics of PPIs and to frame recommendations for healthcare professionals to improve both patient’s counseling and compliance to treatment with PPIs. A total of 201 papers were identified following a literature search. After full-text evaluation, 64 studies were included in the review. Co-administration of PPIs with a meal may affect both their bioavailability and effectiveness; however, the influence of food depends on the type of drug and its formulation. Except for pantoprazole, PPIs can be administered in the morning or evening; however, morning intake generally provides better daytime control of gastric acidity. In most cases, the choice of the proper schedule of administration should be based on the patient’s symptoms and individual dosing preferences.