Background and objectives: The prevalence of Helicobacter pylori infection differs in relation to the human population, age, living conditions, lifestyle, socioeconomic status and geographic location. The purpose of the present study was to evaluate the prevalence of H.pylori infection among students of Ibrahim Medical College, Dhaka, Bangladesh. Materials and methods: This cross-sectional study was conducted at the K.A. Monsur Research Laboratory, Department of Microbiology, Ibrahim Medical College. A structured questionnaire was used to collect socio-demographic information and clinical history. Blood and stool samples were collected from each participant. Serum H. pylori CagA IgG and H.pylori IgA antibodies were determined using enzyme-linked immunosorbent assay (ELISA), and H. pylori stool antigen (HPSAg) was detected by immunochromatographic test (ICT). Results: A total of 85 participants were enrolled in this study. The overall H. pylori infection rate was 69.4% by positive stool antigen test and /or the presence of H. pylori specific CagA IgG or IgA antibodies in serum. H. pylori stool antigen was detected in 9 (10.6%) individuals, of whom 8 (88.9%) were also positive for H. pylori specific CagA IgG and / or IgA antibodies. Among 85 participants, CagA IgG and IgA were positive in 43 (50.6%) and 46 (54.1%) students, respectively, while 31 (36.5%) were positive for both antibodies. IgA positivity rate was significantly higher (p≤0.005) in individuals who tested positive for CagA-IgG compared to those negative for CagA-IgG antibody. Gastrointestinal symptoms were reported by 17 (20.0%) participants, while 68 (80.0%) were asymptomatic. No significant difference in antibody positivity rates was observed between symptomatic and asymptomatic individuals in this study. Conclusion: The study revealed that H. pylori infection is common among the medical students in Bangladesh. This underscores the importance of improving awareness and early detection strategies among medical students to minimize transmission and associated health risks. July 2025; Vol. 19(2):009. DOI: https://doi.org/10.55010/imcjms.19.019 *Correspondence: Shahida Akter, Department of Microbiology. Ibrahim Medical College, 1/A Ibrahim Sarani, Shegunbagicha, Dhaka-1000, Bangladesh. Email: shahidamicro@gmail.com © 2025 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License(CC BY 4.0).

ObjectivesHelicobacter pylori (H. pylori) is a widespread Gram‐negative bacterium, affecting over half of the global population. This study investigated the prevalence of H. pylori among children in Ilam, western Iran, and assessed potential associations between infection, fecal occult blood tests (FOBT), hemoglobin concentration (HbC), and seasonality.MethodsOverall, we recruited 92 children less than 12 years of age who were investigated with an H. pylori stool antigen (HpSA) test from January 2021 to December 2022. The HpSA test was carried out based on a sandwich enzyme immunoassay using enzyme‐linked immunosorbent assay (ELISA) method. FOBT was performed on fresh samples using one‐step rapid diagnostic kit. HbC was determined with an automated blood analyzer.ResultsFrom 92 participants, 20 (21.7%) cases showed a positive result for H. pylori antigen. This result included 9 (45%) female and 11 (55%) males. There were no significant differences between H. pylori prevalence and gender (p‐value = 0.46), FOBT results (p‐value = 0.99), HbC (p‐value = 0.60), and seasonality (p‐value = 0.31).ConclusionsThe findings of this study demonstrated that the results of FOBT and HbC may not provide valuable data for predicting H. pylori infection in children.

Helicobacter pylori (H. pylori) is a globally prevalent pathogen, infecting nearly half of the world’s population. It is strongly associated with a spectrum of gastrointestinal disorders, including chronic gastritis, peptic ulcer disease, and gastric malignancies. Early detection of H. pylori infection, particularly among dyspeptic individuals, is essential for prompt treatment and prevention of complications. Objective: To determine the frequency of Helicobacter pylori infection among patients presenting with dyspepsia at tertiary care hospitals in Quetta and Turbat, Pakistan. Methods: This descriptive cross-sectional study was conducted at the Department of Internal Medicine, Sandeman Provincial Hospital, Quetta, and the Department of Medicine, Teaching Hospital, Turbat from January 2023 to December 2023. A total of 145 adult patients presenting with clinical features of dyspepsia and fulfilling the inclusion criteria were enrolled after obtaining informed written consent. Detailed history and clinical examination were performed. Stool samples were collected from all participants and tested for Helicobacter pylori stool antigen (HPSA) using enzyme immunoassay. Data were analyzed to determine the frequency of H. pylori infection. Results: Out of 145 patients with dyspepsia, 93 (64.1%) were males and 52 (35.9%) were females. The mean age of the study population was 29.95 ± 4.71 years. H. pylori infection was detected in 99 patients, representing a prevalence of 68.3%. Infection was more common among males and individuals residing in urban areas. Conclusion: The prevalence of Helicobacter pylori infection among dyspeptic patients in this study was notably high, especially in young males and those from urban settings. These findings highlight the need for routine screening and early eradication therapy in symptomatic individuals to reduce gastrointestinal morbidity.

Introduction: Proton pump inhibitors (PPIs) can lead to false-negative results in Helicobacter pylori stool antigen (HpSA) testing. A new bioluminescent enzyme immunoassay (BLEIA)-based HpSA test was introduced. This study aimed to evaluate the sensitivity of this test in patients on PPIs and compare its sensitivity with that of the enzyme immunoassay (EIA). Methods: We included patients without a history of H. pylori eradication who were diagnosed as H. pylori-positive via culture, microscopy, rapid urease tests, urea breath tests, serum H. pylori antibody tests, or HpSA tests. The sensitivity of HpSA detection was compared among patients based on their PPI intake using both BLEIA and conventional EIA. Results: Enrollment occurred from December 2020 to July 2022 across 10 facilities, with 109 patients enrolled in both the PPI and non-PPI groups. The sensitivity of BLEIA was 65.9% in the PPI group and 87.1% in the non-PPI group, showing a difference of −22.0% (95% CI: −11.0% to −32.9%) (p = 0.0003). For EIA, the sensitivity was 54.1% in the PPI group and 72.4% in the non-PPI group, with a difference of −18.3% (95% CI: −5.5% to −30.4%) (p = 0.0076). Significant differences in sensitivity were observed for both BLEIA and EIA between the PPI and non-PPI groups (p = 0.005 and p < 0.0001, respectively), with BLEIA demonstrating higher sensitivity. Conclusion: This study indicated that the sensitivity of HpSA detection using BLEIA decreased under PPI administration. Additionally, BLEIA may have higher sensitivity than EIA.

Increasing Antimicrobial Resistance (AMR) compromises the treatment of Helicobacter pylori infection globally. This study aimed to use probiotics together with an antibiotic regimen and a proton pump inhibitor to eradicate H. pylori. Stools from positive Helicobacter pylori Stool Antigen (HpSAg), totaling 114 (47.7%) were cultivated on Columbia-based Dent agar (Oxoid) at different times. D Berg’s commercially sourced brand of Lactobacillus rhamnosus/casei probiotic was used. Following biochemical and molecular identification. A per-clinical-factorial-experimental design was employed for the study. Animals, aged 40 weeks old and above were prepared and grouped into six subsets labeled T1 - T6, each defining a particular experimental variable with n = 20. The H. pylori isolates 1 × 108 CFU/ml in normal saline were intraperitoneally administered to the test animals (T2 - T6) over 21 days. Different preparations of probiotics and antibiotics-probiotic therapies were given to the relevant subsets and the outcomes were monitored daily. Fisher’s exact software was used to calculate the error value at 5% (p H. pylori treatment lies in a good Antimicrobial Sensitivity Testing (AST) platform and that only a probiotic-antibiotic regimen can guarantee total eradication (100%) of H. pylori.

Effects of screening for Helicobacter pylori on gastric cancer incidence and mortality are unknown. To evaluate the effects of an invitation to screen for H pylori on gastric cancer incidence and mortality. A pragmatic randomized clinical trial of residents aged 50 to 69 years in Changhua County, Taiwan, eligible for biennial fecal immunochemical tests (FIT) for colon cancer screening. Participants were randomized to either an invitation for H pylori stool antigen (HPSA) + FIT assessment or FIT alone. The study was conducted between January 1, 2014, and September 27, 2018. Final follow-up occurred December 31, 2020. Invitation for testing for H pylori stool antigen. The primary outcomes were gastric cancer incidence and gastric cancer mortality. All invited individuals were analyzed according to the groups to which they were randomized. Of 240 000 randomized adults (mean age, 58.1 years [SD, 5.6]; 46.8% female), 63 508 were invited for HPSA + FIT, and 88 995 were invited for FIT alone. Of the 240 000 randomized, 38 792 who were unreachable and 48 705 who did not receive an invitation were excluded. Of those invited, screening participation rates were 49.6% (31 497/63 508) for HPSA + FIT and 35.7% (31 777/88 995) for FIT alone. Among 12 142 participants (38.5%) with positive HPSA results, 8664 (71.4%) received antibiotic treatment, and eradication occurred in 91.9%. Gastric cancer incidence rates were 0.032% in the HPSA + FIT group and 0.037% in the FIT-alone group (mean difference, -0.005% [95% CI, -0.013% to 0.003%]; P = .23). Gastric cancer mortality rates were 0.015% in the HPSA + FIT group and 0.013% in the FIT-alone group (mean difference, 0.002% [95% CI, -0.004% to 0.007%]; P = .57). After adjusting for differences in screening participation, length of follow-up, and patient characteristics in post hoc analyses, an invitation for HPSA + FIT was associated with lower rates of gastric cancer (0.79 [95% CI, 0.63-0.98]) but not with gastric cancer mortality (1.02 [95% CI, 0.73-1.40]), compared with FIT alone. Among participants who received antibiotics, the most common adverse effects were abdominal pain or diarrhea (2.1%) and dyspepsia or poor appetite (0.8%). Among residents of Taiwan, an invitation to test for HPSA combined with FIT did not reduce rates of gastric cancer or gastric cancer mortality, compared with an invitation for FIT alone. However, when differences in screening participation and length of follow-up were accounted for, gastric cancer incidence, but not gastric cancer mortality, was lower in the HSPA + FIT group, compared with FIT alone. ClinicalTrials.gov Identifier: NCT01741363.

Background and aim Helicobacter pylori (H. pylori) is the leading cause of human stomach infections. Accurate diagnosis is ucial for the effective management of H. pylori, leading to the eation of numerous diagnostic techniques, including both invasive and noninvasive methods. Methods This study thoroughly examines the diagnostic accuracy of the H. pylori Stool Antigen (HpSA) test in comparison to the rapid urease test (RUT). Background and aim HpSA test, known for being non-invasive, cost-effective, and quick, is contrasted with the fast but invasive RUT. Conducted on 100 adult patients from June to December 2022, the study utilized a comprehensive diagnostic approach, including medical history evaluations, physical exams, abdominal ultrasounds, laboratory tests, and careful stool sample collection. Additionally, all participants underwent RUT, stool antigen tests, and histopathology examinations. Results The findings revealed that the HpSA test identified more positive H. pylori cases (73) than the RUT (59) (P&lt;0.01). Although RUT results closely matched histopathology outcomes, both RUT and histopathology showed greater accuracy than HpSA. Furthermore, RUT demonstrated higher sensitivity (98.2%) and accuracy (98.3%) compared with HpSA, while specificity was similar for both tests. Conclusion The HpSA test is a straightforward and noninvasive diagnostic method that is easy to use in laboratory settings. On the other hand, the RUT is known for its high accuracy and sensitivity. Together, these characteristics make the HpSA test a valuable alternative for diagnostic purposes.

Background: Helicobacter pylori (H. pylori) is a gramnegative, spiral-shaped microorganism and is responsible for colonization in the gastric microniche of more than 50% of the world population. This work aimed to compare H. pylori stool antigen titer in different H. pylori morphological forms in gastric biopsy. Patients and Methods: This study was carried out on 120 patients with dyspepsia. All patients were subjected to full history taking, upper GI endoscopy, and gastric biopsies according to Sydney protocol for histopathology and stool antigen test by using the H. pylori Antigen (ELISA) quantitative test kit. Results: Of the 120 patients there were 37 males and 83 females with a mean age of (29.57 ± 9.17), H. pylori morphological form was divided into two forms: Coccoid form (n = 27) and Bacillary form (n = 91). H. pylori gastritis was more common in females (69.17%) than males (30.83%), and common above the age of 30 years (56.7%), and more patients were nonsmokers (89.2%). H Pylori stool antigen was significantly higher in the case of the bacillary form of H. pylori than in the coccoid form. Conclusion: H. pylori stool antigen is higher in bacillary forms of H. pylori than in coccoid forms.

Despite the numerous articles discussing the relationship between diabetes mellitus type 2 (DMT2) and chronic Helicobacter pylori (H. pylori) infection the results have been inconsistent, necessitating further research. This study investigated the coexistence of Helicobacter pylori infection and DMT2. We conducted a study in selected laboratories in Tehran, measuring the H.Pylori stool antigen (HpSA) in individuals referred by physicians for a glycosylated hemoglobin A1c (HbA1c) test. Out of the 2500 patients who were referred to randomly selected laboratories, a total of 2025 (81%) patients had serum HbA1c levels above 6.5%. of 2025 patients with HbA1c levels above 6.5%, 1321 (52.84%) had HpSA in their stool. No significant gender difference was observed, with a mean age ± SD, 48.65 ± 7.55. HpSA was positive in 52.84% of the DM group, while in the non-DM group, HpSA was positive in 37.36% of cases. Fecal antigen titers are not related to gender (P = 0.274) but are related to age (r = 0.213, P=0.034). Long-term infection with Helicobacter pylori may be significantly associated with elevated HgA1c.Testing for H. pylori infection, regular monitoring of blood sugar and HbA1c levels in high-risk people can prevent DMT2.

Objective: To identify Helicobacter Pylori (HP) gastritis-associated histopathological changes in Gall Bladder (GB) mucosa in patients undergoing cholecystectomy. Methodology This prospective comparative cross-sectional study was conducted in the Gastroenterology department of Liaquat National Hospital, Karachi, Pakistan, from December 2021 to December 2022. The study included all patients admitted with a diagnosis of any Gall Bladder pathology and those who were electively scheduled for cholecystectomy. Participants were categorized into two groups based on the presence of HP: group A (HP positive) and group B (HP negative) in gastric mucosa before cholecystectomy. HP detection was performed using various methods, including HP stool antigen (HPSA), Urea breath test (UBT), HP antibodies, and biopsy confirmation through gastroscopy. Results: The mean age of patients in group A was 42.88 ± 8.28 years, and in group B, it was 43.35 ± 8.74 years (p=0.458). According to the GB histological findings, Chronic cholecystitis with focal Cholesterolosis was significantly more common in group A (75.4%), while Chronic cholecystitis alone was significantly higher in group B (66.2%) (p=0.001). Dysplasia was observed more frequently in group B compared to group A. Erosion was more prevalent in group A, patients than in group B (p=0.001). Although symptom improvement in the HP positive group with persistent symptoms post-eradication was not statistically significant, it did show some improvement (p=0.527). Conclusion: The histological findings of chronic cholecystitis with focal Cholesterolosis were significantly higher in the HP positive group compared to the HP negative group, while chronic cholecystitis alone was significantly more common in the HP gastritis negative group. Some HP gastritis group patients experienced symptom improvement after HP eradication.

Among 35 species of genus Helicobacter, H. pylori is the most common causative agent of human gastritis, peptic ulcer, and gastric cancer. The infection can spread through direct human-to-human contact, fecal–oral route, and contaminated water. The study was designed to investigate the rate of prevalence of H. pylori in the population of Dhamar, Yemen. In this one-year study, 460 including 250 male and 210 female stool specimens were collected between January to December 2020 in Dhamar Governorate, Yemen. Of the total 460, 215 rural (male: n = 120 and female: n = 95) and 245 urban (male: n = 130 and female: n = 115) specimens were investigated for identification of H. pylori by serological test using Helicobacter pylori stool antigen (HpSA) test. In addition, for comparing an improved recovery of H. pylori, conventional culture-based isolation was also carried out using three selective media. Modified Campy-blood Agar (MCA), Belo Horizonte Agar (BHA), and Egg yolk Emulsion (EYE) medium supplemented with antimicrobial agents including vancomycin (10 mg/L), cefsulodin (5 mg/L), trimethoprim (5 mg/L), and amphotericin B (5 mg/L) and isolates were phenotypically characterized. The HpSA test results revealed that of the total 460 specimens, 89 (19.3%) were positive for H. pylori with relatively low in male (n = 43; 17.2%) as compared to the female (n = 46; 21.9%) specimens. After 3–10 days of incubation, H. pylori was recovered at a variable rate on each selective (MCA: 16.5%; BHA: 15.0%; EYE: 13.0%) media. However, culture-based assay results showed less recovery (n = 81; 17.6%) with no significant difference among all selective media tested and between genders (male: n = 39; 15.6%; female: n = 42; 20.0%). The infection rate was comparatively higher in rural (n = 45; 20.9%) as compared to urban (n = 36; 14.7%) population. Overall, the study data showed the prevalence of infection in both genders of all age groups. The present study showed a relatively high rate of infection of H. pylori in the Dhamar population. The serological identification and culture-based methods are important for rapid detection, aid in treatment, and developing policies for the control and eradication of H. pylori infection and to prevent the disease in different age groups in Yemen.

Helicobacter pylori is one of the most pathogenic organisms that cause gastritis, peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue (MALT) lymphoma in humans. The main aim of this study was to determine the H. pylori infection among patients undergoing upper GI endoscopy and to compare the efficacy of the diagnostic method of H. pylori infection including invasive tests (biopsy-based tests like the rapid urease test (RUT), direct smear, and culture) and the noninvasive test (HpSA). A total of 100 stool samples and 200 gastric biopsy specimens were collected (2 samples from each patient) from June to November 2019. Stool samples were processed for the detection of an H. pylori stool antigen (HpSA) by a kit method. One biopsy specimen was processed for the RUT, and another was transported to the laboratory in an Eppendorf tube containing normal saline for preparation of the smear and culture. Out of 100 participants, 26% were found to be H. pylori positive by the RUT, 11% by the direct smear, 6% by the culture, and 17% by the stool antigen test. The prevalence of H. pylori infection was found to be 14%, considering at least two of the three biopsy-based tests that gave positive results. H. pylori infection was found to be higher in the age group of 46–55 years. The overall prevalence of H. pylori infection was higher in gastric ulcer cases, followed by erosive pangastritis and gastroduodenitis. Tea drinking habits and the frequency of meal consumption more than twice a day were found to be significantly associated with H. pylori infection (P < 0.05). Hence, the RUT was found to be more efficient than the direct smear and the culture method for finding H. pylori in the biopsy sample. However, none of these methods can be considered to be the gold standard alone. Thus, the RUT combined with other tests is preferable for the detection of H. pylori.

Oral lichen planus (OLP) is a multifactorial chronic inflammatory condition with unknown etiology. This condition has been associated with Helicobacter pylori. This study aimed to investigate the relationship between the treatment of H. pylori infection and improvements in OLP lesions. In this cohort study, 42 patients with erosive or ulcerative OLP lesions were evaluated in terms of H. pylori infection using the H. pylori stool antigen (HpSA) test. The patients were divided into three groups. The first group consisted of 12 H. pylori-negative patients. The second group consisted of 21 H. pylori-positive patients receiving antibacterial treatment. The third group included nine H. pylori-positive patients not willing to receive treatment. All the three groups underwent the usual OLP treatment. Patients in the second and third groups were re-evaluated by the HpSA test after two months. The efficacy indexes and visual analog scale were used to evaluate clinical improvements. The efficiency index and pain scores were affected by the intervention (P<0.001). The logistic regression analysis showed that the severity index before treatment was significantly effective (OR=0.745 (95% CI: 0.602‒0.923; P=0.007). No statistical significance for factors affecting other variables (P>0.05) was obtained. Pain intensity was higher in patients with H. pylori than in those without H. pylori before treatment. Also, in patients with H. pylori, the treatment affects the complete recovery rate.

Introduction: The significance of chronic gastritis is underrated. Even though Helicobacter pylori (HP) has been the main contributing factor to this condition, if testing for it comes back negative, we should always rule out other underlying diseases, especially if the biopsy reveals Russell body (RB) gastritis. Case Description/Methods: A 67-year-old male with a past medical history of immune thrombocytopenic purpura (ITP) on prednisone and eltrombopag, hypertension, and choledocholithiasis status post cholecystectomy complicated by abscess formation and drain placement, presented with worsening nausea, vomiting, and abdominal pain for three days associated with early satiety and weight loss. His symptoms were not related to food or activity. Vital signs and physical exam were unremarkable except for right upper quadrant abdominal tenderness. Labs were remarkable for WBC 55 k/ul, HGB 11 g/dl, and PLT 90 k/ul. Full infectious workup was negative. CT scan showed massive splenomegaly with widespread lymphadenopathy and circumferential wall thickening of the gastric fundus and body. An upper endoscopy was performed and revealed diffuse gastric erythema in a mosaic pattern, most pronounced in the body of the stomach (Fig. 1a). Biopsies were obtained from the gastric antrum and body. Gastric body biopsies revealed gastric oxyntic mucosa with RB gastritis (Fig. 1b), and it was negative for HP, intestinal metaplasia, dysplasia, or malignancy. Kappa and lambda immunohistochemistry stain showed a polyclonal mixed population of plasma cells (Fig. 1c), indicating no underlying malignancy. HP stool antigen was checked twice, and it was negative. His WBC continued to rise, and bone marrow (BM) biopsy was performed. Findings were suspicious for myelodysplastic/myeloproliferative disorder; however, a reactive process could not be ruled out. Since the patient's condition significantly deteriorated, a repeat BM biopsy revealed morphological changes consistent with chronic myelomonocytic leukemia (CMML). After discussing goals of care with the patient, he opted for hospice care and expired after three days.Figure 1.: (a) An upper endoscopy showing diffuse punctuate gastric erythema with mucosal mosaic pattern. (b) A high power stomach biopsy with Hematoxylin and Eosin stain showing atypical plasma cells with Russell bodies (yellow arrow) which are eosinophilic homogeneous immunoglobulin-containing inclusions. (c) A high power stomach biopsy with kappa and lambda immunohistochemistry stain showing polyclonal mixed population of plasma cells (positive for both kappa and lambda). Discussion: RB gastritis is a reactive mucosal infiltration of plasma cells filled with cytoplasmic RB. There is a strong association with HP infection, but there is also an association with hematopoietic malignancies and gastric adenocarcinoma. Our case represents the vital importance of looking for underlying malignancies in HP negative RB gastritis patients.

Objective: The objective of this study is to evaluate the diagnostic accuracy of H. pylori Stool Antigen (HpSA) test keeping histopathology as gold standard.&#x0D; Study Design: This is a cross sectional observational study.&#x0D; Place and Duration: This study was performed from Jan 2015 to Mar 2020 at Najran Armed Forces Hospital, kingdom of Saudi Arabia.&#x0D; Methodology: Total 151 patients in whom HpSA was done were included in the study. They were followed for their results of histopathology on gastric biopsies.&#x0D; Results: Among 151 patients 85(56.3%) were females and 66 (43.7%) were males. Mean age was 40 years. Forty three (28.5%) patients were positive for both HpSA and on histology, Fifteen (9.9%) patients were positive on HpSA test but negative on histology. Twenty two (14.6%) patients were negative on HpSA but they were positive on histology. Seventy one (47%) patients were negative both on HpSA and histology. The sensitivity and specificity were 66.1% and 82.5% respectively. Positive predictive value (PPV) was 74.1% and negative predictive value (NPV) was 76.3% for HpSA. Diagnostic accuracy for this test was 75.5%.&#x0D; Conclusion: Keeping in view the low sensitivity and diagnostic accuracy HpSA test cannot be used as screening tool in all patients, however it can be used for clinical correlation in setups where other diagnostic tests are not available due to the simplicity of its use, low cost and easy repeatability

Antibiotic resistance and poor patient compliance with treatment cause Helicobacter pylori to show increased resistance to typical first-line therapeutic regimens. This study aimed to evaluate the efficacy of the new nitazoxanide-based treatment regimens for Helicobacter pylori infection vs. the current metronidazole-based regimens to address the problem of increasing metronidazole resistance. This randomized clinical trial enrolled 100 patients with Helicobacter pylori infection. The patients were randomly assigned to one of two groups: group I received nitazoxanide-based triple therapy (nitazoxanide, proton pump inhibitor, and clarithromycin) for 14 days, whereas group II received standard treatment (metronidazole, omeprazole, and clarithromycin) for 14 days. On enrollment and after six weeks of treatment, all patients underwent careful history taking, full clinical examination, laboratory investigations (complete blood count, liver and renal function tests), and Helicobacter pylori stool antigen testing. Of the patients, 92% in the nitazoxanide group and 84% in the metronidazole group recovered from infection, with no statistically significant difference between the two groups. Patients in the nitazoxanide group showed a 54% lower risk of resistant infection (odds ratio, 0.5; 95% confidence interval, 0.161-1.555) than those in the metronidazole group. The nitazoxanide-based therapeutic regimen produced higher eradication rates than the standard treatment. However, the difference was not substantial in this particular group of patients.

Objective: To determine the diagnostic accuracy of serologic (IgG) in the diagnosis of Helicobacter Pylori among patients of dyspepsia by taking Helicobacter pylori Stool Antigen (HpSA) as the gold standard. Material and methods: The study was conducted in Microbiology Department, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi with the collaboration of gastroenterology OPD. All the patients with a history of dyspepsia, above 25 years of age and of either gender were included. After taking informed consent the clinical samples of blood and stool from patients were taken. A 6 ml venous blood was taken from the antecubital vein for detecting IgG antibody to H. pylori. Stool samples were collected for detecting H. pylori antigen in a wide mouth, sterile, leak proof container properly labeled by serial number and stool samples were stored in a refrigerator at 4°C up to 72h. On the specimens containing H. pylori antibodies, a colored line appeared in the test line region consider a positive result. H. pylori antigen was detected in stool (HpSA) by rapid chromatographic immunoassay. During analysis, the specimen responds with an anti-H. pylori antibody-coated particle. By capillary action, the mixture migrates upward on the membrane, reacting with anti-H. pylori antibodies on the membrane to produce a colorful line. A positive result is indicated by the presence of this colored line in the test zone, whereas a negative result is indicated by its absence. All the data were obtained using a study proforma, and the data was analyzed using SPSS version 26. Results: A total of 210 patients presented with dyspepsia were studied, their mean age was 49.07±10.97 and females were in majority (71.9%). H. Pylori was positive among 137 cases, those who underwent serological test (IgG) and 127 were positive for stool antigen (HpSA). The diagnostic accuracy of serological test (IgG) was found 95.23% by taking Stool Antigen (HpSA) test gold standard followed by sensitivity 92.7%, specificity 100%, PPV 100% and NPV 87.95%. Conclusion: The diagnostic accuracy of serological test (IgG) was found 95.23% by taking Stool Antigen (HpSA) test gold standard followed by sensitivity 92.7%, specificity 100%, PPV 100% and NPV 87.95%. Key words: H. pylori, diagnosis, IgG, Stool antigen

Aims: Helicobacter pylori (H. pylori) is the primary causative agent of peptic ulcers in multiple developing countries, including Bangladesh. This study was designed to investigate the diagnostic value of a rapid immunochromatography-based H. pylori stool antigen (HpSAg) test to screen for H. pylori infection in a Bangladeshi population. Methodology and results: A total of 140 suspected peptic ulcer patients who underwent an upper gastrointestinal endoscopy at Chittagong Medical College and Hospital, Chattogram, Bangladesh were included in the study. A histopathology, rapid urease test (RUT), and microscopic examination of the stained smears were conducted to define the H. pylori-positive cases. Later, a stool antigen detection test was performed for the H. pylori-positive status group, the H. pylori-negative status group, the indeterminate status group, and the healthy controls. Out of the 140 suspected peptic ulcer patients, 75 (53.6%) patients were confirmed to have peptic ulcers or erosions. Although the proportion of antral erosion was 57.4% in patients who were under 40 years old, it decreased to 23.4% in patients over 40 years old. Patients over 40 years of age mostly suffered from pyloric erosion (42.9%). All peptic ulcer patients were also positive according to the histopathological analysis. However, microscopic grading of the curved bacilli and RUT were found among 93.3% (70/75) and 89.3% (67/75) patients who were positive, respectively. In our study, high sensitivity (95%), specificity (80%), and diagnostic accuracy (91%) scores for the HpSAg assay were obtained. Conclusions, significance, and impact of the studies: The HpSAg test, as a comparatively less sophisticated assay, can be efficient at detecting the presence of H. pylori pre- and post-therapy, and it provides more valid test results than other invasive test methods.

Background: Helicobacter pylori are gram-negative bacillus that colonizes the gastrointestinal mucosa. Dyspepsia is a clinical syndrome including manifestations related to the upper gastrointestinal tract, which may include acute, chronic, or recurrent pain or discomfort. Understanding the prevalence and the factors associated with H. pylori seropositivity in dyspeptic persons can provide a guide for health policies. Aim of the research was to study the prevalence and factors associated with H. pylori infection among dyspeptic patients in Chitwan, Nepal. Methods: A descriptive cross-sectional study was conducted in the Department of Microbiology at CMC-TH from July 2019 to June 2021. A non-probability consecutive sampling technique was employed to collect 510 Stool samples from the suspected patients for the detection of H. pylori stool antigen (HpSAg) following the procedures recommended by the manufacturer. A standard questionnaire on the potential risk factors was also designated and completed. Chi-square test was used to study the association of H. pylori colonization with symptoms, life-style findings and socio-economic status. p&lt;0.05 were considered statistically significant. Results: HpSAg was detected in 20.0%. Prevalence was higher (25.0%) among males compared to females (15.56%). Prevalence was higher among middle-aged (21-60 years) people with smoking, alcohol, and tobacco consumption habits. Socioeconomic conditions and family size play an important role in the prevalence. Nausea, sour eructation, bloating, heartburn, and bleaching were the common symptoms among dyspeptic patients. Conclusions: The burden of H. pylori infection in patients with dyspepsia was high. Factors associated with an elevated level of colonization by H. pylori leading to dyspepsia are low income, education up to the primary, habits like smoking, alcohol, and tobacco consumption.

Background: Helicobacter pylori is the most common chronic bacterial infection globally and is the underlying cause of many disorders, including dyspepsia. Also, the prevalence of gastric cancer in Zanjan city is high. Therefore, this study investigates the prevalence of H. pylori infection in patients with dyspepsia by the H. pylori stool antigen (HpSA) test. Materials and Methods: This cross-sectional study was performed on patients over 18 years of age who were referred to Shafieieh Special Clinic in Zanjan with dyspepsia during 2019-2020. First, the HpSA test was examined for H. pylori infection. Since the results of two separate tests are needed to prove that H. pylori infection is negative, the serological test was used in the patients with HpSA negative results. Results: Based on the demographic information of the present study, most patients (70.1%) were under 40 years old, and most (55.1%) were women. Smoking, alcohol, drug, and non-steroidal anti-inflammatory drugs (NSAIDs) use in patients were 16.5%, 6.3%, 7.9%, and 39.4%, respectively. The highest and lowest symptoms were abdominal pain (44.9%) and burp (22%), respectively. Except for the relationship between positive serological results and age (P˂0.001), no significant relationship was found between other variables (P≥0.05). Based on the HpSA test, H. pylori infection was seen in 56.7% of patients. By the serological test, another 29 patients had H. pylori infection. Therefore, the total number of patients was 101, and the overall prevalence of H. pylori increased to 79.5%. Conclusion: The results of the present study showed that the overall prevalence of H. pylori infection was high compared to previous studies. Also, above the age of 40 years, female gender in HpSA test and male gender in serology test, higher education level, and the presence of risk factors (smoking, alcohol, and NSAIDs) have a higher positive test for H. pylori.