Helicobacter Pylori In Patients Research Articles

The Efficacy of Paraprobiotic, Probiotic, and Mineral Supplementation on the Eradication Rate of Helicobacter pylori in Patients with Dyspepsia: A Randomized Clinical Trial

Background. Helicobacter pylori (H. pylori) eradication regimens have been a concern, all along. Our study is aimed at assessing the effect of para- and probiotics plus minerals (Pyloshot) on H. pylori eradication rate. Methods. In this open-label randomized trial, 69 eligible adult patients with naïve H. pylori infection-related dyspepsia were randomly assigned into the group A, who received esomeprazole 40 mg BID, amoxicillin 1000 mg BID, and clarithromycin 500 mg BID, and group B with the same regimen plus one Pyloshot capsule BID for 10 days. Demographics and dyspepsia symptom severity scores (SSS), number needed to treat (NNT), dyspepsia SSS, and drug adverse effects were recorded at baseline and the end of treatment. H. pylori eradication was confirmed via 14C UBT eight weeks later. Results. Sixty-six patients completed the study. The intention-to-treat (ITT) and per-protocol (PP) eradication rates were slightly better in group B (85.2% vs. 80%, p=0.562, and 87.8% vs. 84.8%, p=0.720, respectively). Adverse effects were significantly lower in group B (20.6% vs. 54.3%; p=0.004). No significant differences in dyspepsia symptom improvement rates (p=0.255) and mean difference of SSS (p=0.231) were found between treatment groups. NNT for overall dyspepsia and epigastric pain syndrome (EPS) was 11 and 5 at the end of treatment, respectively. Conclusion. Adding Pyloshot to the H. pylori regimen could slightly improve the eradication rate and SSS of dyspepsia. NNT was considerably better among EPS patients. Adverse effects were significantly decreased by this regimen. Further trials with larger sample sizes should be thought out. This trial is registered with IRCT20141201020178N10.

Evaluation of the Inflammatory Response After Eradication of Helicobacter pylori in Patients With Familial Mediterranean Fever.

Evaluation of the inflammatory response after Helicobacter pylori (Hp) eradication in patients with Familial Mediterranean Fever (FMF) during the non-attack period and determining whether there is a change in the ongoing inflammation during the non-attack period. Sixty-four patients, who have not been eradicated for Hp in the last 2 years, diagnosed with FMF, and evaluated in the non-attack period, were included in the study. Hp eradication therapy was administered to patients who were found to be Hp-positive. C-reactive protein (CRP), high-sensitive C-reactive protein (hs-CRP), interleukin-6, interleukin-8, tumor necrosis factor-alpha, and serum amyloid A values were compared between the groups before and after eradication. CRP and hs-CRP levels were found to be statistically higher in the FMF group than in the control group. A statistically significant decrease was found in the values of CRP and hs-CRP, in the number of patients with attacks, and in attack frequency after eradication in the Infected Patients compared to the values before eradication. We determined a decrease in CRP and hs-CRP values, the number of patients with attacks, and attack frequency with the eradication of Infected Patients. In patients with FMF, in whom it has been proven by different studies that the inflammation continues during the non-attack period, it may be recommended to investigate the presence of Hp infection, which is thought to contribute to this inflammation and to give Hp eradication therapy to patients who are found positive to reduce the development of secondary complications caused by chronic inflammation.

The Effect of 131I Therapy on the Eradication of Helicobacter pylori in Patients with Thyroid Disorders: A Preliminary Study.

The leading cause of gastritis and its complications is Helicobacter pylori Radioactive iodine (131I) accumulates significantly in the stomach after consumption. On this basis, we decided to determine whether different doses of 131I in the stomach would be effective in eradicating the infection. Methods: All patients with hyperthyroidism or differentiated thyroid carcinoma who were referred for 131I treatment were invited to the study. A stool antigen test was conducted before consumption of 131I (0.15-5.5 GBq) and was repeated 2 mo later to detect H. pylori infection. Results: H. pylori positivity was found in 51.8% (14/27) of the patients. At 2 mo after treatment, 13 of the 14 patients with differentiated thyroid carcinoma or hyperthyroidism who had been identified as positive for H. pylori stool antigen before 131I administration were still positive, representing a nonsignificant eradication rate of 7.1%. Conclusion: Administration of 131I to patients with H. pylori did not show potential to eliminate the infection.

Association between MUC1 rs4072037 polymorphism and Helicobacter pylori in patients with gastric cancer.

The MUC1 gene encodes glycoproteins attached to cell membrane that play a protective role in gastric cancer and protect epithelial surfaces against external factors such as Helicobacter pylori. H. pylori infection can induce a cascade of innate and acquired immune responses in gastric mucosa. Relationship between rs4072037G>A polymorphism of MUC1 gene and increased susceptibility to H. pylori infection aimed to investigate in patients with gastric cancer in Mazandaran, northern Iran. A case-control study was conducted on 99 patients with gastric cancer (H. pylori positive and negative) and 98 controls (H. pylori positive and negative) without gastric cancer (confirmed by pathological biopsy samples obtained during endoscopy). H. pylori infection was diagnosed by histological examination using Giemsa staining. Genomic DNA extracted from peripheral blood was analyzed by PCR-RFLP technique. Analysis of all genetic models showed no significant relationship between rs4072037G>A polymorphism and risk of gastric cancer (GC). The relationship between H. pylori infection and rs4072037G>A polymorphism showed an increased susceptibility to gastric cancer in both positive and negative H. pylori groups (including case and control groups). The genetic model of GA/GG and H. pylori- positive versus GA/GG and H. pylori-negative showed a significantly increased susceptibility to gastric cancer (OR=0.251, CI: 0.128-0.493, P=0.000). These findings indicate that rs4072037G>A polymorphism may interact with H. pylori infection to increase the risk of GC.

Efficacy and Safety of Vonoprazan-Based Quadruple Therapy for the Eradication of Helicobacter pylori in Patients with Peptic Ulcers: A Pooled Analysis of Two Randomized, Double-Blind, Double-Dummy, Phase 3 Trials.

Helicobacter pylori eradication is crucial in the treatment of peptic ulcers caused by H. pylori infection, a disease highly prevalent in Asia. We present a pooled analysis of two randomized, double-blind, double-dummy, phase 3 studies evaluating the efficacy and safety of vonoprazan-based bismuth-containing quadruple therapy for H. pylori eradication. Patients aged ≥18 years with endoscopically confirmed duodenal or gastric ulcers were randomized 1 : 1 to receive vonoprazan 20 mg or lansoprazole 30 mg once daily for up to 6 (duodenal ulcers) or 8 weeks (gastric ulcers). H. pylori-positive patients received vonoprazan- or lansoprazole-based bismuth-containing quadruple therapy for the first 2 weeks. H. pylori eradication was determined using the carbon-13 urea breath test at a follow-up visit 4 weeks post-treatment. The H. pylori eradication rate was 90.6% with vonoprazan vs. 85.2% with lansoprazole (difference: 5.4%; 95% confidence interval (CI): -0.1, 10.8). H. pylori eradication rates were 7.1% (95% CI: 1.4, 12.8) and 12.6% (95% CI: 3.9, 22.0) higher in patients aged <65 years and current smokers, respectively, with vonoprazan vs. lansoprazole. In the Chinese subpopulation, the H. pylori eradication rate was 92.0% with vonoprazan vs. 86.0% with lansoprazole (difference: 6.1%; 95% CI: 0.5, 11.7). Treatment-emergent adverse events occurred in 72.7 vs. 62.6% of H. pylori-positive patients at baseline in the vonoprazan vs. lansoprazole arm. H. pylori eradication with vonoprazan-based quadruple therapy was noninferior to lansoprazole-based quadruple therapy and exceeded 90%, a clinically relevant threshold for determining the efficacy of H. pylori eradication regimens (ClinicalTrials.gov identifier: NCT03050359; NCT03050307).

Investigating the Relationship between Type 2 Diabetes and Helicobacter Pylori

Introduction: Helicobacter pylori infection is known as one of the health problems in the world, and the concurrent infection of diabetics with Helicobacter pylori contributes to health and economic problems in the world. The present study was conducted to investigate the prevalence of Helicobacter pylori in patients with type 2 diabetes in Gonabad City, Iran.&#x0D; Methods: This case-control study was conducted in Gonabad City, Iran. The number of participants in the study was 168. The method was simple random sampling and the study population was typing 2 diabetic and non-diabetic people who were referred to Gonabad health centers. After obtaining informed consent from the patients, 4 milliliters of venous blood were collected from the patients with type 2 diabetes and the control group, and IgG antibodies against Helicobacter pylori and Fasting Blood Sugar and Glycosylated Hemoglobin (HbA1C) were measured by ELISA and Colorimetric method, respectively. After entering the data into SPSS version 16 software, they were analyzed using independent tests, chi-square tests, and logistic regression tests.&#x0D; Results: In the present study, 71.4% of type 2 diabetes patients had IgG antibodies against H. pylori bacteria. The odds ratio of diabetes in the patients with positive IgG was 1.37 times that of patients with negative IgG, and this relationship was statistically significant (P=0.003).&#x0D; Conclusion: The present study showed that H. pylori was more common in diabetic patients than non-diabetic ones, and in diabetic patients, there was no statistically significant relationship between the duration of diabetes, family history of diabetes, and smoking history with Helicobacter pylori infection.

S1868 Gut Microbiome-Metabolome Signature in Helicobacter pylori Patients, Potential Implications in Progression of Disease and Treatment

S1868 Gut Microbiome-Metabolome Signature in Helicobacter pylori Patients, Potential Implications in Progression of Disease and Treatment

Serum Evaluation of Helicobacter pylori in Patients with Multiple Sclerosis

Background: Multiple sclerosis (MS) is an autoimmune inflammatory disorder of the central nervous system of unknown etiology, which is believed to be caused by immune dysregulation triggered by genetic and environmental factors, leading to demyelination and axonal loss. Researchers consider infectious agents, like Helicobacter pylori, as these environmental factors. H. pylori can permanently infect someone’s stomach and cause an acute or chronic inflammatory response, in which inflammatory mediators affect the brain and cause a pathologic disease. Methods: In this cross-sectional study, 38 patients with multiple sclerosis who were referred to the Neurology Clinic of Ghaem Hospital were included, and their serum samples were analyzed for IgM, IgA, and IgG antibodies against H. pylori by using enzyme-linked immunosorbent assay (ELISA). Results were compared with the samples of 41 sex- and age-matched controls admitted to other wards of Ghaem Hospital &amp; had no symptoms of MS. In the end, we analyzed the data with SPSS v.20. Results: In this study, 79 patients, including 38 patients with MS disease in the case group and 41 healthy individuals in the control group, were studied. These two groups had no significant differences in demographic characteristics, including age, gender, and occupation. H. pylori seropositivity was significantly higher in patients with MS than in controls (68.4% vs 39%) (P = 0.009). In addition, comparing H. pylori seropositivity in 20 of 30 patients with relapsing-remitting MS versus 6 of 8 patients with progressive MS suggested a significant difference between these two groups (P = 0.030). Also, H. pylori seropositivity had no significant difference between males and females (39.1% vs 58.9%). Conclusions: The prevalence of H. pylori seropositivity was significantly higher in patients with MS than in control, besides this seems more frequent in a progressive type of MS than in a relapsing-remitting one, suggesting that H. pylori might be a causal factor for developing &amp; progressing MS and this may have an adverse impact on the prognosis and course of the disease.

Comparison of Risk and Severity of Helicobacter Pylori Infection in Non-Native Versus US Native Pediatric Patients.

Helicobacter pylori (HP) infection is associated with gastritis, peptic ulcer disease (PUD) in the stomach and duodenum, and an increased risk of gastric cancer. The risk of infection, secondary symptoms, and negative outcomes is known to be increased in low- and middle-income countries and vastly less substantial in the United States and Europe. Current North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines recommend endoscopic diagnosis and susceptibility-guided therapy, which is not reflected by current adult guidelines for therapy. In this study, we complete a single-center retrospective review of HP risk by nativity status, as well as the results of the use of standard empiric therapy in HP and PUD patients. We retrospectively reviewed all endoscopies with patients aged 1-21 years with a known nativity status and identified all HP diagnoses. We also completed the classification of Kyoto scores and classified patients as gastritis versus PUD. Treatment records were obtained, as well as downstream documentation of the impact of empiric therapy. HP prevalence and severity were compared between non-native and native US populations. In total 332 patients were identified, with 59 HP diagnoses. However, 64 patients were immigrants, and 268 were US natives. Totally 39.1% of all immigrant patients had an endoscopically identified HP infection, compared to only 12.7% of US native patients (P < 0.01, relative risk 3.07). HP severity was worse in immigrant patients (Kyoto score 1.5 versus 0.89; P = 0.008). Empiric high-dose amoxicillin triple therapy was equally effective in reducing symptoms in gastritis versus PUD patients. Immigrant patients have a substantially higher risk and severity of HP infection than US natives. Empiric therapy remains highly effective at relieving symptoms. These findings in aggregate suggest that North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines may not adequately serve non-native pediatric patients, with an additional prospective multicenter study needed to confirm. In addition, a prospective study of treatment based on stool antigen tests, as well as a larger prospective study of empiric therapy, may suggest alterations to our approach in line with recent changes to adult Gastroenterology practice.

Serological Qualitative Diagnoses of Helicobacter pylori in Patients Accessing Care at the Bingham University Teaching Hospital Jos, Nigeria

Serological Qualitative Diagnoses of Helicobacter pylori in Patients Accessing Care at the Bingham University Teaching Hospital Jos, Nigeria

Prevalence, Clinical and Demographic Characteristics of Helicobacter pylori in Patients Undergoing Esophagogastroduodenoscopy in Specialized Health Centers in Two Departments of the Colombian Coffee Growing Axis

Helicobacter pylori is a Gram-negative, microaerophilic bacterium with the ability to survive in extreme acid environments, with pH below 4.0. It is estimated that more than half of the world’s population is infected with this bacterium. Objective: To determine the prevalence, clinical and demographic characteristics of Helicobacter pylori infection in patients undergoing esophagogastroduodenoscopy in two specialized centers of the Coffee Growing Axis in Pereira and Manizales from February to October 2018. Method: Cross-sectional descriptive observational study in which the proportion of positivity to Helicobacter pylori in a period of time was determined. Results: The study included 94 patients; the prevalence of positivity to Helicobacter pylori was 86.1% (81/94), 56 (59.5%) of which were diagnosed by culture and 52 (55.3%) by histology. In the histological study, of the 24 (25.5%) subjects who presented precursor lesions of malignancy, 9 (9.5%) were positive for Helicobacter pylori, while in the 70 subjects (74.5%) without precursor lesions of malignancy, 43 (45.7%) were positive. The significant variables for Helicobacter pylori infection were: Histological response for precursor lesions of malignancy: OR of 0.3808 (95% CI: 0.1408-0.9907) p=0.04 and epigastric pain: OR 0.09489 (95% CI: 0.01928-0.3637) p=0.001. Conclusion: The frequency of Helicobacter pylori infection in the Departments of Risaralda and Caldas is high, and does not discriminate against gender, age, race or origin of the study subjects; Epigastric pain continues to be the most relevant symptom in the diagnosis of Helicobacter pylori infection and the combination of diagnostic tests improves the diagnosis of Helicobacter pylori infection.

Increased IL-17A Serum Levels and Gastric Th17 Cells in Helicobacter pylori-Infected Patients with Gastric Premalignant Lesions

Background:Helicobacter pylori infection is characterized by an inflammatory infiltrate that might be an important antecedent of gastric cancer. The purpose of this study was to evaluate whether interleukin (IL)-17 inflammation is elicited by gastric T cells in Helicobacter pylori patients with gastric intestinal metaplasia and dysplasia (IM/DYS). We also investigated the serum IL-17A levels in Helicobacter pylori patients with gastric intestinal metaplasia and dysplasia, and patients with Helicobacter pylori non-atrophic gastritis (NAG). Methods: the IL-17 cytokine profile of gastric T cells was investigated in six patients with IM/DYS and Helicobacter pylori infection. Serum IL-17A levels were measured in 45 Helicobacter pylori-infected IM/DYS patients, 45 Helicobacter pylori-infected patients without IM/DYS and in 45 healthy controls (HC). Results: gastric T cells from all IM/DYS patients with Helicobacter pylori were able to proliferate in response to Helicobacter pylori and to produce IL-17A. The Luminex analysis revealed that IL-17A levels were significantly increased in Helicobacter pylori IM/DYS patients compared to healthy controls and to Helicobacter pylori gastritis patients without IM/DYS (452.34 ± 369.13 pg/mL, 246.82 ± 156.06 pg/mL, 169.26 ± 73.82 pg/mL, respectively; p < 0.01, p < 0.05). Conclusions: the results obtained indicate that Helicobacter pylori is able to drive gastric IL-17 inflammation in IM/DYS Helicobacter pylori-infected patients, and that IL-17A serum levels are significantly increased in Helicobacter pylori-infected patients with IM/DYS.

Analysis of Genetic Relatedness between Gastric and Oral Helicobacter pylori in Patients with Early Gastric Cancer Using Multilocus Sequence Typing.

The oral cavity is the second most colonized site of Helicobacter pylori after the stomach. This study aimed to compare the genetic relatedness between gastric and oral H. pylori in Japanese patients with early gastric cancer through multilocus sequence typing (MLST) analysis using eight housekeeping genes. Gastric biopsy specimens and oral samples were collected from 21 patients with a fecal antigen test positive for H. pylori. The number of H. pylori allelic profiles ranged from zero to eight since the yield of DNA was small even when the nested PCR was performed. MLST analysis revealed that only one patient had a matching oral and gastric H. pylori genotype, suggesting that different genotypes of H. pylori inhabit the oral cavity and gastric mucosa. The phylogenetic analysis showed that oral H. pylori in six patients was similar to gastric H. pylori, implying that the two strains are related but not of the same origin, and those strains may be infected on separate occasions. It is necessary to establish a culture method for oral H. pylori to elucidate whether the oral cavity acts as the source of gastric infection, as our analysis was based on a limited number of allele sequences.

Роль бактеріального чинника у розвитку гострого панкреатиту та його гнійно-септичних ускладнень

Introduction. A feature of acute pancreatitis is the high risk of developing complications (occurring in 50% of patients), the total mortality of which reaches 15%, and in severe cases it varies within 40-70%. The aim of the study was to determine the role of Helicobacter pylori as an etiological factor of acute pancreatitis and a marker of the development of its purulent-septic complications. Materials and methods. The results of treatment of 280 patients with acute pancreatitis were analyzed, which were divided into two groups: the main group (n=187) – patients with severe acute pancreatitis and the comparison group (n=93) – patients with a mild and moderate course of the disease. In addition, in order to determine prognostic criteria for the development of purulent-septic complications, the patients of the main group were divided into two subgroups. The first subgroup included patients with a severe course and the development of purulentseptic complications (n=59), the second (n=128) – with a severe course without the development of purulent-septic complications of acute pancreatitis. Results. When screening patients for Helicobacter pylori, the results of the express test were positive in 232 patients (82.9%), while in the main group 165 (88.2%) patients, in the comparison group – 75 (80.6%) patients (χ2= 2.9, 95% CI -1.1-17.6, p=0.08). An increase in the content of immunoglobulin M to Helicobacter pylori was also determined in patients with a severe course of acute pancreatitis after 7 and 14 days from the moment of hospitalization, which indicates the acute phase of the disease. The correlation between immunoglobulin M and procalcitonin was strong (r=0.87; p=0.0001), but the relationship between these indicators was not linear, but closer to exponential (y=1.1543-2.7292*x +2.1604*x^2). Conclusions. The results of a screening study of Helicobacter pylori in patients with acute pancreatitis allow us to consider this microorganism as one of the factors in the pathogenesis of this disease (82.9% of cases). For patients with severe acute pancreatitis, the content of immunoglobulin M to Helicobacter pylori in blood serum ≥1.24 IU/ml can be considered as a likely predictor of the development of purulent-septic complications (sensitivity 86.4%, specificity 100.0%).

Antibiotic Resistance of Helicobacter pylori in Patients with Peptic Ulcer.

Background and Objectives: To determine the antibiotic resistance rate of H. pylori among patients with peptic ulcer. Materials and Methods: A cross-sectional monocentric study was conducted from January to December 2021 among patients aged from 16 years with gastrointestinal symptoms and esophagogastroduodenoscopy. Gastric mucosa biopsies were collected at the edges of the ulcer or at lesion sites for H. pylori culture. Five antibiotics (amoxicillin (AMX), clarithromycin (CLR), metronidazole (MTZ), levofloxacin (LEV), and tetracycline (TET)) were selected for antibiotic susceptibility testing. Results: One hundred and twenty-five patients were included, and the sex ratio was 0.6. Their mean age was 47.3 ± 14.2 years. All of the participants had gastritis, and 24.0% had duodenitis. A total of 21.6% of patients had a duodenal ulcer, and 12.8% had an antral ulcer. A total of 40 specimens have grown in H. pylori culture. The proportion of resistance to AMX, CLR, MTZ, LEV, and TET was 27.5%, 50%, 67.5%, 35%, and 5%, respectively. The proportion of multidrug resistance was 22.5%. The proportion of double resistance to AMX + CLR was 20.0%, AMX + MTZ was 15.0%, AMX + LEV was 2.5%, CLR + MTZ was 32.5%, and TET + MTZ was 5.0%. Conclusions: Our research results show that the treatment with MTX-TET or LVX-AMOX has the highest sensitivity rate. Therefore, practitioners should refer to these regimes to eradicate H. pylori in patients with gastric and duodenal ulcers. The reports on H. pylori eradication from different geographic areas show heterogeneous results. Therefore, continuous monitoring of antibiotic resistance of H. pylori in each population is very important. Having evidence helps clinicians to treat patients most effectively, reduce treatment costs, and limit the rate of antibiotic resistance.

Epstein-barr virus/Helicobacter pylori coinfection and gastric cancer: the possible role of viral gene expression and shp1 methylation.

Among the various factors involved in the development of gastric cancer (GC), infectious agents are one of the most important causative inducers. This study aimed to investigate the possible role of EBV gene expression on SHP1 methylation in co-infection with Helicobacter pylori in patients with GC. Formalin-fixed paraffin-embedded samples were obtained from 150 patients with gastrointestinal disorders. The presence of the H. pylori and EBV genome were examined by PCR. The expression level of viral gene transcripts and methylation status of the SHP1 cellular gene was assessed by quantitative real-time PCR and methyl-specific PCR. EBV and H. pylori coinfection were reported in 5.6% of patients. The mean DNA viral load was significant in patients coinfected with cagA-positive H. pylori (P= 0.02). The expression of BZLF1 and EBER was associated with GC. Also, the expression level of BZLF1in GC tissues was significantly higher in coinfection (P = 0.01). SHP1 methylation frequency was higher in the GC group than in the control group (P = 0.04). The correlation between the methylation rate and the H. pylori infection was highly significant (P<0.0001). The strongest positive correlation was observed in GC specimens between SHP1 methylation and H. pylori cagA-positive strains (p= 0.003). Our results suggested that cagA might involve in the elevation of EBV lytic gene expression and SHP1 methylation, and the development of gastric cancer. Understanding the mechanism of EBV H. pylori - cagA + coinfection, as well as host epigenetic changes, can play an important role in diagnosing and preventing gastric cancer.

Is There a Relationship Between Helicobacter Pylori and GERD Before Laparoscopic Sleeve Gastrectomy?

The aim of this study is to determine the prevalence of Helicobacter pylori (HP) in patients before laparoscopic sleeve gastrectomy (LSG) and to reveal whether HP is associated with gastroesophageal reflux disease (GERD) before LSG. The study included 435 patients who underwent primary LSG between April 2018 and September 2021. All patients underwent preoperative endoscopy. All patients were investigated for the presence of HP. No treatment for HP eradication was given to any of the patients. Patients were divided into 2 groups HP (+) and HP(-), and compared for GERD, complications, and weight loss before and after LSG. The mean age of the patients was 38.3±11 years (56.1% female), and the mean BMI was 44.2±7.1kg/m 2 . Symptomatic GERD was found in 102 (23.4%) patients. Endoscopy showed hiatal hernia in 42 (9.7%) patients, and these patients also underwent hiatal hernia repair in the same session. HP was (+) in 125 (28.7%) patients. HP (+) patients were assigned to Group A, while HP (-) patients were assigned to Group B. In the preoperative period, the rate of symptomatic GERD was 22.4% (n=28/125) in Group A and 23.9% (n=74/310) in Group B ( P =0.74). The mean follow-up period was 17±5.7 (range, 12 to 28) months. The mean BMI decreased to 28.3±4.9kg/m 2 at 12 months after LSG. Given the association between HP and GERD after LSG, it was 25.6% (n=32/125) in Group A and 20% (n=62/310) in Group B ( P =0.2). In addition, there was no difference between the 2 groups in terms of weight loss. This study showed no difference between patients with or without HP infection in terms of GERD before LSG.

Analysis of Helicobacter pylori in Saliva of Patients with Laryngopharyngeal Reflux and Non-Laryngopharyngeal Reflux

BACKGROUND : Helicobacter pylori is a gram-negative bacteria known as the causative agent of chronic gastritis, peptic ulcer, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue lymphoma. Several studies have correlated H. pylori in the pathogenesis of upper airway diseases. H. pylori can be detected in saliva, oropharyngeal aphthae, nasal and sinus mucosa, secretions from the tympanic cavities, larynx, and pharyngeal lymphoid tissue. The diagnosis of LPR can be made simply by examining saliva.&#x0D; AIM : The aim of the study is to analyze the presence of H.pylori in the saliva of LPR and non LPR patients.&#x0D; METHODS : This study is an analytic observational study with a case control design. The research was conducted in the ENT-KL Department of Dr. M. Djamil Hospital, Padang, Indonesia. PCR examination was carried out at the Biomedical Laboratory of the Faculty of Medicine, Andalas University on saliva samples to detect the presence of H.Pylori. The study was conducted on 22 LPR patients and 22 control subjects.&#x0D; RESULT : LPR patients are more common in women than men, which were 12 women and 10 men. The average age of LPR patients is 43.7 years. The presence of H.pylori in LPR patients was 86.4%, while in the non-LPR group was 50%. After being tested using the Chi-square test, a significant difference was found between the presence of H. Pylori and the incidence of LPR (P = 0.010).&#x0D; CONCLUSION : There was an increase in the frequency of the presence of Helicobacter Pylori in patients with LPR compared to Non LPR patients after statistical analysis.&#x0D;

The frequency of Helicobacter pylori infection in patients with rheumatoid arthritis and adult residents of the city of Tula

Currently, the list of microorganisms that have a possible connection with the development of rheumatoid arthritis continues to be updated. The role of not only traditional pathogens, but also representatives of conditionally pathogenic microflora is being actively studied. A number of domestic and foreign works demonstrate a high degree of Helicobacter pylori infection in patients with rheumatic diseases, including rheumatoid arthritis.The aim of the present study is to identify the frequency of detection of Helicobacter pylori infection in patients with rheumatoid arthritis and in adult residents of the city of Tula.Material and methods. The study included 3288 residents of Tula who do not have rheumatic diseases, and 119 patients with rheumatoid arthritis. To detect the infection, FEGDS was performed according to the generally accepted method with the taking of biopsies of the mucous membrane of the antrum and the stomach body, followed by verification of Helicobacter pylori using the Helpil-test test system.Results. According to the results of the data on the infection rate of residents of Tula without rheumatic diseases (n=3288), the largest percentage of infected (78.8%) was detected by an invasive method – express diagnosis of urease activity of the biopsy. The detection rate using a respiratory ammonia test and serological method was lower and amounted to 51.1 and 49.3%, respectively. In total, H. pylori was detected in 1692 people, which was 51.46%. Among patients with rheumatoid arthritis, Helicobacter pylori infection was 81.5%. Signs of damage to the mucous membrane of the upper gastrointestinal tract were often detected: superficial and subatrophic gastritis, single erosions.Conclusions. 1. Based on the study, it was found that the infection rate of Helicobacter pylori in patients with rheumatoid arthritis is at a fairly high level, not significantly different from that in residents without rheumatic diseases, when examined by an invasive method – express diagnosis of urease activity of the biopsy (81.5% and 78.8%, respectively). 2. Among patients with rheumatoid arthritis, there was a tendency to increase the frequency of infection with age and peak values in older age groups (r=0.37; p&lt;0.05). 3. The frequency of detection of erosive and ulcerative lesions of the gastrointestinal tract in infected and uninfected Helicobacter pylori patients with rheumatoid arthritis significantly differed (42.2 and 13.6%) (p=0.03). Key words: Tula population, rheumatoid arthritis, Helicobacter pylori infection&gt;˂ 0.05). 3. The frequency of detection of erosive and ulcerative lesions of the gastrointestinal tract in infected and uninfected Helicobacter pylori patients with rheumatoid arthritis significantly differed (42.2 and 13.6%) (p=0.03).

Therapeutic Guidelines and Antimicrobial Resistance of Helicobacter Pylori in Patients with Peptic Ulcer at Tertiary Care Hospitals of Rawalpindi and Islamabad

Objective: The purpose of this study was to investigate the prevalence of antibiotic resistance among Helicobacter pylori isolates obtained from patients suffering from peptic ulcer disease in Rawalpindi and Islamabad, Pakistan, and to propose a novel anti-H. pylori therapy strategy for use in these locations. Methodology: A total of 132 H. pylori from the patients suffering with peptic ulcer disease were reported for clinical treatment in institutions in the twin Cities that provide tertiary care. Antibiotics such as ciprofloxacin, clarithromycin, amoxycillin, metronidazole, and tetracycline were tested on the isolates to determine their levels of susceptibility to these drugs. The Epsilometer test, often known as the E-test, is a quantitative disc diffusion method that is used to determine antibiotic sensitivity. This test was utilised for the purpose of verifying isolates. Results: The overall rate of resistance among H. pylori was found to be 27.9% for amoxycillin, 38.9% for clarithromycin, and 73.6% for metronidazole. 47 out of 132 isolates exhibited multiple drug resistance, with metronidazole, clarithromycin, and amoxycillin showing the highest frequency of two, three, and four drug resistance patterns. Ciprofloxacin had a low level of tetracycline resistance, ranging from 1.2 to 4%, whereas metronidazole resistance was substantial. In the population of Pakistan, the frequency of H. pylori resistance to metronidazole is quite high, whereas it is moderate in response to clarithromycin and amoxycillin, and low in response to ciprofloxacin and tetracycline. The rates of resistance to clarithromycin and amoxycilin were higher in Rawalpindi than they were in Islamabad. It is imperative, for the sake of the public's health, that Pakistan make an adjustment to its policy regarding antibiotics, one that will permit the use of antibiotic rotation in the treatment of H. pylori. Keywords: Peptic ulcer, Helicobacter pylori, antibiotic susceptibility.