Complaints Of Dyspepsia Research Articles

Analysis of Clinical Features and Treatment of Patients Presenting Dyspepsia Related to COVID-19: Retrospective Chart Review

Objectives: The main purpose of this study is to investigate the clinical characteristics of patients complaining of indigestion after COVID-19 infection (CI) or COVID-19 vaccination (CV) and to confirm the effectiveness and safety of Korean medical treatment.Methods: We retrospectively collected and investigated the medical records of 39 patients admitted to the Kyung Hee University Korean Medicine Hospital with a chief complaint of dyspepsia from January 1, 2020 to February 29, 2024 who reported the onset or significant exacerbation of dyspepsia after CV or CI. Patients were divided into vaccination and infection groups, and their demographic characteristics, Ryodoraku results, presenting symptoms, traditional Korean medicine treatments, and treatment outcomes were analyzed.Results: When comparing the groups with dyspepsia after CV and after CI, it was observed that the CI group had significantly lower average body weight, and the measurements of LH6, LF1, and LF6 in the Ryodoraku test were significantly lower. Additionally, compared to the CV group, the CI group showed significantly more abdominal distension, nausea, and abdominal pain. Significant relief of upper gastrointestinal symptoms was observed in both the CV and CI groups after treatment. No adverse reactions were observed during the course of treatment.Conclusion: The CI group tended to complain more severely of various dyspeptic symptoms and had a tendency to lower body weight than the CV group, as was also reflected in the results of the Ryodoraku test. Korean medical treatment can be effective and safe in treating these patients.

Esophageal Melanocytosis.

Esophageal melanocytosis is a rare entity defined by the proliferation of a melanocytic basal layer of the esophageal squamous lining and deposition of melanin in the esophageal mucosa. Esophageal melanocytosis is considered a benign entity of unknown etiology; however, it has been reported as a melanoma precursor. We report a case of esophageal melanocytosis in a diabetic and hypertensive 67-year-old male with recurrent dizziness and syncope for the past 6 months. Given his complaint of dyspepsia, he underwent an upper gastrointestinal endoscopy, in which an esophageal biopsy revealed the diagnosis of esophageal melanocytosis. The definitive diagnosis of esophageal melanocytosis can only be made by histological analysis. The histologic differential diagnoses include melanocytic nevi and malignant melanoma. Therefore, they need to be ruled out.

Evaluation of Dyspepsia with Optimal and Suboptimal Gastric Emptying Tests in Patients with Euthyroid Goiter.

The presence of gastroparesis in patients with dyspepsia can be evaluated by gastric emptying scintigraphy. We aimed to evaluate gastroparesis with optimal solid gastric emptying scintigraphy and suboptimal liquid gastric emptying scintigraphy in euthyroid goiter patients with dyspepsia. We included 67 patients diagnosed with euthyroid goiter with dyspepsia complaints. The patients did not use any medication and did not have any other chronic diseases. Solid and liquid gastric emptying scintigraphy was performed on all patients. In our retrospective study; the images were reevaluated. The region of interest was plotted on the area compatible with the stomach and timeactivity curves were obtained. The correlation of solid and liquid gastric emptying test results was evaluated. Twelve (18%) of the patients were male and the mean age of the patients was 64 (49-75). There is a correlation between solid and liquid gastric emptying scintigraphy (p< 0.0005, r: 0.0880). Solid gastric emptying time was prolonged in 27 patients (40%). Liquid gastric emptying was prolonged in 23 patients (34%). Solid gastric emptying was also prolonged in all patients with prolonged liquid gastric emptying. According to the results of the optimal gastric emptying test performed with radio-labeled solid food. The rate of gastroparesis was low in our patient group with dyspepsia complaints. However, there is a correlation between the optimal test and suboptimal gastric emptying test results in our patient group. Liquid gastric emptying scintigraphy may be preferred in specific patient groups in case of suspected gastroparesis because of its easy application and short duration.

Validity and Reliability Test of Rome IV Functional Dyspepsia Diagnostic Questionnaire (R4-FDDQ) on Indonesian Population

Introduction: Currently there has not been a specific instrument to assess the presence of functional dyspepsia, which is specially designed for the Indonesian population. The main objective was to determine the validity and reliability of the Indonesian version of the Rome IV Functional Dyspepsia (FD) Questionnaire Criteria. Methods: A total of 80 participants (age ≥21 years) with a complaint of dyspepsia were recruited. The Kruskal-Wallis test is used to analyze the difference between demographic data and the type of FD. Pearson’s product-moment correlation and Cronbach’s alpha tests were used to assess the validity and reliability.

Description of Polypharmacy and Interactions that can Reduce the Effectiveness of Dyspepsia Drugs in patient BPJS with Dyspepsia at the Porsea Regional General Hospital based on Prescriptions Period November-January 2020

Dyspepsia is a collection of symptoms of pain, persistent or recurring discomfort in the upper abdomen, feeling full when eating, feeling full quickly, bloating, belching, decreased appetite, nausea, vomiting. Dyspepsia ranks 5th out of the top 10 diseases in hospitalized patients and 6th for outpatients. The prevalence of dyspepsia varies between 7-45%, depending on the definition used in geographic location. The prevalence in Asia is around 8-30%. It is estimated that 30% of patients who come to the gastroenterologist's practice are 60% with complaints of dyspepsia, around 20-40% of adults experience dyspepsia, whereas in general clinics it is only 2-5%. This study aims to Description of Polypharmacy and Interactions that can Reduce the Effectiveness of Dyspepsia Drugs in patient BPJS with Dyspepsia at the Porsea Regional General Hospital based on Prescriptions Period November-January 2020. The research design was descriptive with a retrospective time approach carried out at Porsea Hospital, Toba Regency, based on prescriptions for the period November-Januari 2020, data were collected in February 2020 with a sample of 118 cases using the Simple random sampling technique (November: 41 cases, December: 38 cases, January 39 cases). The instrument used to collect data in this study is the data collection format. The results showed polypharmacy in outpatient BPJS patients with dyspepsia at the Porsea Regional General Hospital for the period November-January 2020, namely 71 (60.17%) cases with major polypharmacy (5-11) and 47 (39.83%) cases with minor polypharmacy. For future researchers to examine the effects of the use of polypharmacy on reducing the effectiveness of dyspepsia drugs with guide books or other references.

A yellow sign indicating danger ahead.

A 59-year-old man presented with chronic complaints of dyspepsia and early satiety. Pantoprazole 20mg once daily did not relieve his symptoms. He did not report dysphagia nor any unintentional weight loss. A gastroscopy was performed and showed diffuse atrophic gastritis. In the gastric antrum a yellow lesion was seen, which felt hard upon palpation with the biopsy forceps (figure 1). Inspection of the duodenum and esophagus was normal. What is your diagnosis?

Microbial Association of Gastroduodenal Diseases with Special Reference to Epstein–Barr Virus and Helicobacter pylori and their Effect on Expression of miRNAs: A Review

Gastroduodenal diseases are very commonly encountered among patients who attend hospital with the complaints of dyspepsia. These diseases range from inflammatory ones like gastritis and peptic ulcer disease to neoplastic ones like gastric carcinoma and lymphoma. Gastroduodenal diseases may be caused by various factors of which microbial association with a bacterium called Helicobacter pylori and a virus called Epstein–Barr virus (EBV) is noteworthy. It has also been noted in various studies that the coinfection by these two organisms may also play a significant role in an exaggerated inflammatory response in cases of gastritis which may ultimately lead to carcinoma (Correa’s cascade of carcinogenesis). As a result, it appears critical to identify both H. pylori and EBV in samples taken for biopsy in various gastroduodenal illnesses. Recent research has also suggested that these two separate etiologies may work together to cause gastric cancer, with miRNAs playing a key part in this process. This review presents the status of the current research on the association of gastroduodenal diseases with EBV and H. pylori along with the emerging context of the connection with miRNA expression. This will help to understand these complex etiologies having significant bearing on human health as well as highlight the need for intensive research in the subject.

EXAMINING AN ASSOCIATION BETWEEN FUT2 GENE AND HELICOBACTER PYLORI INFECTION RELATED TO CLINICAL MANIFESTATIONS

The aim of the study was to examine an association of the rs602662 FUT2 genetic locus with the status of H. pylori infection and development of related diseases (chronic gastritis, gastric ulcer and 12 duodenal ulcer).Methods: The study included 91 patients, divided into two groups - "case" and "control". Criteria for the “case” group enrollment: diagnosis of gastric or duodenal ulcer, chronic non-atrophic gastritis; positive test for H. pylori.The “control” group included patients with episodic complaints of dyspepsia while undergoing a comprehensive examination, with negative test for H. pylori, as well as having no history of former therapy on H. pylori elimination.The study for the presence of the polymorphic locus rs602662 of the FUT2 gene was carried out by the standard TaqMan PCR method on a Real-Time CFX96 Touch amplifier. The follow-up period was 6 months.Results: The main group included 50 patients aged 21 to 50 years, the control group – 41 patients. Patients infected with H. pylori more often noticed symptoms of dyspepsia - in 36%, compared with the control group - 9.7%. A family history of associated diseases in the main group was significantly differed, χ2 = 4.97, p 0.05.To assess the contribution of the rs602662 locus genotype in FUT2 gene to the risk of clinically manifested H. pylori infection, the main group was divided into subgroups. In the distribution of alleles in these groups, significant differences were revealed. Allele "A" has a protective effect regarding the onset of clinical symptoms of dyspepsia. The odds ratio (OR) with the carriage of allele "A" (genotypes A / A and G / A versus G / G) to have clinical symptoms with a positive H. pylori status was 0.175 (CI = [0.049-0.625] chi2 = 7.79 p = 0.0053 ).Conclusion:1. No association of alleles and genotypes of the rs602662 locus of the FUT2 gene with the status of H. pylori infection was revealed.2. Carriage of allele "A" have a significant association with the absence of clinical symptoms in patients with a positive status of H. pylori infection, OR 0.175 (CI = [0.049-0.625] chi2 = 7.79 p = 0.0053).

PENYULUHAN KESEHATAN MENGENAI DISPEPSIA PADA REMAJA DI SMAN 1 KAMPAR

Complaints of dyspepsia is a clinical condition that is often encountered in daily practice. The term dyspepsia started from being intensively promoted since the late 80s, which describes a complaint or a collection of symptoms (syndrome) consisting of pain or discomfort in the epigastrium, nausea, vomiting, bloating, early satiety, full stomach, belching, and a feeling of discomfort. radiating heat in the chest. Dyspepsia usually begins with bad habits breakfast, breakfast for teenagers, should be useful, because school time is an activity that requires energy and calories are quite large. The negative impact of not having breakfast can be an imbalance in the central nervous system followed by dizziness, shaking, or feeling tired. this can also trigger dyspepsia, because during 12 hours of sleep the body fasts all night, and in the morning it is in the first stage of feeling hungry so that the stomach which is still in the stage can increase stomach acid levels so that it can trigger dyspepsia. The purpose of this community service knowledge is to increase adolescents about dyspepsia and how to prevent dyspepsia. The method used is counseling with lectures, discussions, questions and answers and demos. The results of the 61 adolescents at SMAN 1 Kampar who participated in the counseling found that most of the adolescents were given better counseling after counseling than before counseling about dyspepsia.&#x0D; Keywords: dyspepsia, prevention, symptoms&#x0D;

Endoscopic Evaluation of Dyspeptic Patient in Tertiary Care Hospital

Objectives: To observe the organic change occurs in dyspeptic patient by upper gastrointestinal endoscopy. Methods: The present prospective, observational, cross-sectional study was conducted at Medicine and Gastroenterology department of Sir Salimullah Medical College &amp; Mitford Hospital, over a period of 6 month from 2019 to 2020.The study population was 200with aged18 years and above, irrespective of sex and who were suffering from dyspeptic symptoms for at least 6 months duration. Data regarding the demographic profile of study population nand endoscopic findings were processed and analyzed using software SPSS (Statistical Package for social science) version 26. Results: It was observed that most of the dyspeptic patients 71%were showing normal endoscopic findings and 29% have abnormal endoscopy findingwhere majority of the patient were 51 – 70 years of age.Out of them 41% of male and 26% of female had organic changes. It was also found that 46% of the patients were smoker and among them 34(37%) had abnormal endoscopic finding where 24(22%) non-smokerpatient had abnormal finding, which were statistically significant (p,0.05) between two group. Among abnormal endoscopic finding, 11% gastric erosions, 08% gastric ulcer, 04% duodenal erosions, 03% duodenal ulcer, 02% reflux oesophagitis, and carcinoma stomach rare 01%. Conclusion: The study concludes that majority of patients with complaints of dyspepsia have no organic lesion and can be considered non ulcer dyspepsia. The common abnormal endoscopic findings included gastric erosion and gastric ulcers relating to dyspepsia. The study findings also suggest that smoking is a risk factor for developing organic changes in dyspeptic patients specially in middle age group. Bangladesh J Medicine July 2022; 33(1) : 3-7

Frequency of Seropositivity of Helicobacter Pylori Among Patients Presented with Dyspepsia

Objective: To determine the frequency of seropositive helicobacter pylori (H. pylori) among patients presented at outpatient department (OPD) with dyspepsia at tertiary care Hospital. Methodology: This descriptive case-control study was conducted at medicine department of Peoples University of Medical and Health Sciences for women Nawabshah (SBA). Study duration was six months from October 2018 to March 2019. All the patients of age 18-70 years, presented with complaint of dyspepsia, either of gender were included in the study. After taking informed consent all the patients underwent serological assessment for H. pylori. From each study participant a 5ml blood sample was taken and sent to the laboratory for the diagnosis of H. pylori. After collection of the laboratory reports, all the data was collected via self-made study proforma. Data analysis was done by using SPSS version 20. Results: Total 78 patients of dyspepsia were enrolled, their mean age was34.23+6.22 years and average duration of symptoms was 15.23+7.14 months. Males were 43(55.1%) and females were 35(44.9%). Feeling of abdominal distension after meal was among 21(26.9%) cases, epigastrium pain was in 14(17.9%) cases, heart burn was among 32(41.0%) patients, 07(09.0%) had belching and 19(24.4%) had multiple complaints. Seropositivity rate of H. pylori was 33.30% among patients of dyspepsia and it was statistically insignificant according to gender and socioeconomic status (p-&gt;0.05). Conclusion: As per study conclusion the seropositivity of H. pylori was observed to be higher among patients of dyspepsia and seropositivity of H. pylori was insignificantly linked to gender and socioeconomic status. Keywords: Dyspepsia, H. pylori, seropositive

Impact of alcohol on gastric mucosa in a population with high prevalence of Helicobacter pylori

Background: The purpose of the study was to see whether chronic alcohol abuse had any effect on the gastric mucosa in a population already affected by a high prevalence of Helicobacter pylori.Methods: 35 males with a history of chronic alcohol abuse were compared with 35 males who were abstinent or social drinkers. All subjects had complaints of dyspepsia. All subjects underwent endoscopy and targeted biopsies were taken from three specific sites in the stomach, namely body, antrum and incisura. Biopsies were studied to look for changes of atrophic gastritis and intestinal metaplasia. The presence or absences of H. pylori on the tissue biopsy were also recorded.Results: Atrophic gastritis were only assessable in 24 alcoholic patients and 21 non-alcoholic patients due to the inadequacy of the depth of the biopsy. AG were found to be equally distributed in both the groups. 23 (64.9%) patients in the alcoholic group and 19(54.5%) in the control group had AG (OR-1.54, p=0.47). Intestinal metaplasia was seen in 10 (28.5%) alcoholic group and 12 (34.2) in the control group (OR-0.65, p=0.45). Of the 42 subjects detected to have AG, 16 (38.1%) had IM. However, IM were always associated with AG. In addition, H. pylori were not seen to be different in the two groups. H. pylori were positive in 18 (51.4%) alcoholic and14 (40%) non-alcoholic patients (p=0.33).Conclusions: Chronic alcohol abuse doesn’t appear to have any major impact on the gastric mucosa in terms of producing premalignant lesions such as atrophic gastritis or intestinal metaplasia or enhancing the prevalence of H. pylori.

The Relationship between Primary Duodenogastric Reflux and Helicobacter pylori Gastritis in Children

Background: Most studies of the relationship between duodenogastric reflux (DGR) and Helicobacter pylori have reported that the presence of DGR decreases H. pylori colonization, while H. pylori infection increases the frequency of DGR by impairing antroduodenal motility. The present study aimed to investigate the relationship between primary DGR and the prevalence of H. pylori in children, as well as the degree of colonization and the presence and severity of gastritis. Methods: Included in the study were 410 patients between the ages of 2 and 18 years, referred to the pediatric gastroenterology clinic with complaints of dyspepsia, abdominal pain, and nausea/vomiting, who underwent upper gastrointestinal system endoscopic examination and stomach biopsy. The study group included 60 patients with DGR, while 350 non-DGR patients formed the control group. Results: The mean age of patients with DGR was 15.7 ± 2.1 years, while the mean age of the control group was 14.2 ± 3.8 years (p = 0.02). Of those with DGR, 50 (83.3%) were girls, while in the control group, 215 (61.4%) were girls (p = 0.001). Of patients with DGR, 16 were H. pylori (+) (26.7%), while in the control group, 168 were H. pylori (+) (48%) (p = 0.002). There was no significant difference between the 2 groups with respect to H. pylori degree of colonization (p = 0.08). Gastritis was present in 56 (93.3%) patients in the DGR group and 322 (92%) patients in the control group (p = 0.72). A significant difference was found between the 2 groups in terms of gastritis severity (p = 0.01). Conclusions: The mean age of patients with DGR was significantly higher than that of patients without DGR, and DGR was found to be more common in girls. In patients with DGR, H. pylori prevalence was significantly lower than in those without DGR; however, no significant difference was found between the 2 groups with respect to the colonization degree.

Comparison of intestinal metaplasia and Helicobacter pylori positivity in patients from different age groups with antral gastritis

Background/Aim: Gastric carcinoma (GC) is the fourth most common cancer worldwide and the second most common cause of cancer death. Primary prevention for GC includes healthy diet, eradication of Helicobacter pylori (HP), chemoprevention and early diagnosis. For this reason, finding out the HP incidence in patients with suspected antral gastritis in various age groups can lead to forming a treatment strategy to prevent development of GC. The aim of this study is to find out the HP incidence in patients with a proven antral gastritis diagnosis in various age groups and form different treatment strategies. Methods: This study included 1589 patients aged between 15-91 years who underwent diagnostic upper gastrointestinal endoscopy due to complaints of dyspepsia. The demographic characteristics, such as age and sex, and histopathological HP score (HPS) and IM score (IMS) were recorded. The patients were divided into three groups according to age: 15-29 years, 30-64 years, and 65 years and above. Results: In the 15–29-year age group, IM positivity was significantly lower and HP positivity was significantly higher compared to other age groups (P<0.01). In the age group of 65 years and above, HP positivity was significantly lower than in the other groups (P<0.01). The incidence of IM was significantly higher and that of HP was significantly lower in male patients aged 65 years and older (P<0.01 for both). IM positivity was significantly higher in HP negative patients than in HP positive patients (P=0.02). Conclusion: The most important risk factors for the development of IM are male gender and being aged 65 years and older. HP positivity is higher among the young population and IM prevalence is higher in advanced ages. There is no correlation between HP positivity and the presence of IM.

Endoscopic Evaluation of Dyspeptic Patients

Background: Dyspepsia is a common gastrointestinal problems affecting all age groups &amp; social classes.&#x0D; Objectives: The purpose of the study was to determine the endoscopic findings of dyspeptic patients &amp; to observe the demographic characteristics (age, sex, residence, education, socioeconomic condition) of the patients presented with dyspepsia.&#x0D; Methodology: This was a cross-sectional study conducted at Department of Medicine, Rangpur Medical College Hospital, Rangpur over a period of 1 year from 1st June 2010 to 31st May 2011. 150 dyspeptic patients of 18 or &gt; 18 years old irrespective of sexes and suffering from one or more of the five symptoms (flatulence, food intolerance, epigastric pain, heartburn and aerophagia) for at least 6 months duration were recruited for the study from outpatient and inpatient department who were met the inclusion &amp; exclusion criteria. Data were collected by using a structured questionnaire after taking written consent &amp; upper GI Endocopy were done following meticulous history &amp; through physical examination.&#x0D; Result: Over one-third (36%) of the patients were below 30 years, 17% between 30 – 40 years old, predominantly were rural residents, having primary to secondary level of education with monthly income below Taka 10000. Males to females ratio were 2:1. More than half (50.6%) of the patients was smoker, 32.7% had habit of taking tea, 10% were tobacco chewing and rest 6.7% used to take spicy meal.. Epigastric discomfort, flatulence and heartburn were the common complaints in both male and females but vomiting were proportionately higher in male dyspeptics compared to the female dyspeptics. Common associated symptoms like constipation and weight loss were equally in both sexes. Upper GI endoscopy revealed 17.3% of male and 11.5% of female with abnormal findings.Others abnormal findings included gastric ulcer, gastritis and duodenal ulcers (17.6 vs. 33.3%; 23.6 vs. 50% and 17.6 vs. 16.7% in male and female respectively). Majority (nearly 90% in either sex) of patients does not show any lesions on endoscopic examination and hence can be considered as non-ulcer dyspepsia.&#x0D; Conclusion: The study concludes that majority of patients with complaints of dyspepsia have no lesion on the gastric or duodenal mucosa and can be considered non-ulcer dyspepsia. The study findings also suggest that dyspepsia is a disease of young and early middle aged people with males being more likely to develop the disease than the females. However, large-scale community survey is recommended for further evaluation of dyspepsia.&#x0D; J Shaheed Suhrawardy Med Coll, December 2020, Vol.12(1); 9-14

S2920 Oxyntic Gland Adenoma of the Stomach; A Case Study of an Under-Reported Entity

INTRODUCTION: Oxyntic gland adenoma (OGA), also known as gastric adenocarcinoma with chief cell predominance is a rare entity, with incidence and prevalence data unknown. Given its rarity, we present a case of OGA incidentally found on EGD in a patient with complaints of dyspepsia. CASE DESCRIPTION/METHODS: A 58-year-old female with a history of smoking presented to the GI clinic for colorectal cancer screening. On presentation, ROS was only notable for dyspepsia not related to food intake or exercise. Her physical exam was unremarkable. She was scheduled for both colonoscopy for cancer screening and EGD for evaluation of dyspepsia. Colonoscopy was negative for cancer. EGD showed a solitary papule in the gastric fundus (Figure 1). The papule was raised, pale/white in color, 4 mm in diameter, and had a highly vascularized base. The papule was completely excised with cold biopsy forceps. Pathological analysis was notable for a completely resected papule without evidence of intestinal metaplasia. Further analysis revealed that the papule was composed of fundic gland mucosa, with chief cells predominating and low-grade cytologic features consistent with an oxyntic gland adenoma (Figures 2 and 3). DISCUSSION: OGA is characterized as a benign, solitary, polypoid growth, usually located in the fundus and less often in the cardia of the stomach. Prior studies have explored the histological patterns of these polyps and have defined them as either chief cell predominant, or a mixture of chief and parietal cells. The nomenclature is disputed as multiple names have been proposed for a similar histological description including: chief cell hyperplasia, chief cell hamartoma, and oxyntic gland adenocarcinoma with chief cell predominance. The last is a misnomer as these polyps lack atypical features such as mucous gland cells or foveolar epithelium. Additionally, they do not invade through the submucosa, as seen in other carcinomas. As some pathologists and gastroenterologists are still unfamiliar with the clinical and histological presentation of OGA, we highlight this rare finding for further discussion of its proper nomenclature and a better understanding of etiology, incidence, and prevalence in the United States.Figure 1.: Endoscopic View of Polyp (Encompassed in Black Circle).Figure 2.: Full Slice of Polyp revealing Fundic Type Mucosa Containing Oxyntic Gland Adenoma.Figure 3.: 200x Zoomed view of Fundic Mucosa with Oxyntic Gland Adenoma (Black Arrow points to normal Oxyntic gland and White arrows point to Oxyntic gland with Chief cell predominance).

Birinci Basamakta Dispepsi Şikayeti Olan Erişkin Hastaya Klinik Yaklaşım

Dyspepsia is defined as pain and discomfort in the upper abdominal or retrosternal region and combination of symptoms with comprehensive differential diagnoses and multicomponent pathophysiological mechanisms.Dyspepsia is one of the most common reasons for patients applying to primary health care center. In the majority, an underlying organic cause cannot be found. While 40% of dyspepsia cases have functional dyspepsia, 60% have organic cause dyspepsia. Some diseases can only occur with the complaint of dyspepsia, and in case of suspected by primary care physicians, they should be directed to the upper health care provider for endoscopic evaluation and further examination.

Primary gastric melanoma: a case report of a rare malignancy

ABSTRACT Noncutaneous melanoma is a rare clinical entity, and their primary or secondary nature is often difficult to establish. Few cases of primary gastric melanoma have been described in the literature. We report a case of a 55-year-old male patient with dyspepsia complaints. Esophagogastroduodenoscopy revealed a polypoid mass with blackened areas at the greater curvature of the gastric body, which was histologically compatible with melanoma; positive immunohistochemistry for S100, melan-A, and vimentin. The extensive dermatological exam did not identify a primary lesion.

Health literacy and helicobacter pylori in patients who underwent endoscopic examination for dyspepsia

Aim: The main factors most frequently associated with Helicobacter pylori (HP) in studies include patient age, poor socio-economic status, and antibiotic use. Limited/inadequate Health Literacy (HL) is also associated with poor health conditions. A possible relationship between HP and HL has not been shown in the literature yet. This study aimed to explore the relationship between HL and HP infection both of which have comparable patient profile.Material and Methods: The study evaluated the data regarding 188 patients who underwent gastroscopy due to the complaint of dyspepsia in cross-sectional analytic design. Health Literacy was evaluated using European Health Literacy Survey Questionnaire (HLS-EU-Q47) scale. The presence of HP was confirmed by histopathological examination.Results: Median age was smaller in the HP-positive group (p=0.001). In Helicobacter pylori-positive patients, mean scores were only high for household and taking part in community activities questions in the HLS-EU-Q47 scale. While 47.20% of the patients in the HP (+) group were smokers, 31.30% of the patients in the HP (-) group were smokers, with a difference between HP groups in terms of smoking status (p=0.026). Conclusion: There was no relationship between HP and HL in this sample. HL probably does not play a role in HP positivity but its prognostic role can be discussed further in prospective studies.

Radical resection for duodenal carcinoma with isolated bilateral ovarian metastasis: a case report

Natural history of duodenal adenocarcinoma is not well known. Although extremely rare, the incidence of primary small bowel adenocarcinoma has been increasing. Primary duodenal cancer is a very rare, which has accounted for only 0.3% of all gastrointestinal cancers. Isolated ovarian metastasis from duodenal carcinoma is extremely rare entity. We report a case of duodenal carcinoma with isolated bilateral ovarian metastasis in a 39-year-old female patient managed surgically with Whipple’s procedure with bilateral oophorectomy. She presented with complaints of dyspepsia and intermittent vomiting since 1½ years. History of anorexia and weight loss present. Upper gastrointestinal endoscopy was suggestive of circumferential ulcerated friable lesion at duodenum (D1-2) region and histopathology suggestive of moderately differentiated adenocarcinoma. Subsequent imaging studies revealed 6×5 cm duodenal mass in D1 and D2 without IHBRD with right ovarian mass. She underwent staging laparoscopy with open classic Whipple’s procedure with bilateral oophorectomy was done. Intraoperatively 6×6 cm mass involving first and second part of duodenum involving head of pancreas was found with 3×3 cm right ovarian mass. Post-operative period was uneventful and she discharged on POD6. Final biopsy was suggestive of moderately differentiated adenocarcinoma of duodenum with bilateral ovarian metastasis and she received adjuvant chemotherapy. Now at 1 year, on regular follow up she is completely asymptomatic and imaging showed no recurrent disease. Isolated ovarian metastasis may not be a contraindication for radical surgery in selected group of patients with duodenal carcinoma.