Pylori Infection In Dyspeptic Patients Research Articles

Comparison of Stool Antigen and PCR-Based Diagnostics for Helicobacter pylori Infection and Associated Gut Dysbiosis in Wad-Medani City, Sudan

Background: The development of stomach illnesses has been linked, in part, to Helicobacter pylori (H. pylori) infection; in clinical practice, accurate identification of Helicobacter pylori infection is crucial, H. pylori infection was associated with a decrease in microbial diversity and an increase in pathogenic taxa, indicating its role in gut dysbiosis. Objectives: We tested a noninvasive method using immunochromatography to detect the presence of the H. pylori antigen in stool specimens. PCR was used to validate the presence of H. pylori by identifying the bacteria's ureC gene in the DNA extracted from stool specimens. Additionally, gut microbiome changes were assessed, understanding the link between H. pylori infection and gut dysbiosis is vital for public health interventions. Method: A total of 100 stool samples obtained from dyspeptic patients (46 men and 54 women, average age 46.1) were assessed using these methods. The results were then compared between the PCR-based technique and the SAT technique. Results: The results showed that 35 (35%) out of 100 samples were positive by the PCR-based technique, compared to 33 (33%) positive by the SAT technique and The PCR method demonstrated a sensitivity of 95% and specificity of 92% in detecting H. pylori. Beta diversity was assessed using Bray-Curtis dissimilarity, revealing significant variations in microbial composition among samples. Conclusion: These data suggest that the techniques used in this study are valuable for studying the molecular epidemiology of H. pylori infection in dyspeptic patients. Stool, as a non-invasive sample, has the potential to be a good replacement for the detection of H. pylori. Additionally, we found that infection with this bacterium contributes to gastric microbial dysbiosis, while no statistically significant differences were observed.

Prevalence of Helicobacter pylori infection in dyspeptic patients presenting to a tertiary care center of a developing country: a cross-sectional study

Background: Among the various causes for dyspepsia in patients presenting to the gastroenterology department, Helicobacter pylori is the most common etiological agents. Here, we explore the prevalence of Helicobacter pylori infection, particularly, in dyspeptic patients and different endoscopic findings in such patients. Methods: We conducted a simple observational study in the gastroenterology department of a tertiary care center of Nepal. The Helicobacter pylori was detected using rapid urease test and endoscopic findings were collected from gastroduodenoscopy unit. The obtained data was analyzed using Statistical Package for Social Sciences (IBM-SPSS), version 22. Results: The overall prevalence of Helicobacter pylori infection in dyspeptic patients in our center was found to be 0.329 (0.259 – 0.406) at 95% Confidence Interval (CI). There was significant association of Helicobacter pylori infection with alcohol history (12 [52.17] vs 44 [29.93], p = 0.035) and endoscopic findings of duodenal ulcer (3, 100%) followed by gastritis (29, 50.88%). Conclusions: Amidst various etiology for dyspepsia, Helicobacter pylori was still prevalent at our center. However, considering the variability of its prevalence due to factors like alcohol history, more comprehensive studies are needed to estimate actual proportion in patients presenting with dyspeptic symptoms.

The Diagnostic Usefulness of Stool Antigen Test with Serum Helicobacter pylori Antibody and CLO Test in the Diagnosis of Helicobacter pylori Infection in Dyspeptic Patients

Introduction: Helicobacter pylori colonization of the human gastric mucosa potentially leads to chronic gastritis that may progress to peptic ulcer disease. Additionally, this micro-organism has been identified as a risk factor for the development of gastric carcinoma and gastric lymphoma. Its relation with non-ulcer dyspepsia has not been clear. Objective: To assess the diagnostic usefulness of stool antigen test with serum Helicobacter pylori antibody and CLO test in the diagnosis of Helicobacter pylori infection in dyspeptic patients. Materials and Methods: This was a cross sectional study was conducted in the Department of Microbiology, Sylhet M.A.G. Osmani Medical College in collaboration with the Department of Gastroenterology Sylhet M.A.G. Osmani Medical College, Sylhet from July 2012 to June 2013. The calculated sample size was 196 but in this study we took 150 patients due to financial constrain and time limitation. Patients upper GI tract for dyspepsia and whoever fulfilled the inclusion and exclusion criteria were considered as study sample. All the findings, previous history and reports of investigations were recorded in a preformed data collection sheet prepared for this purpose. The patient with clinical features suggestive of dyspepsia was selected for upper GI endoscopy. Results: For this purpose, 150 dyspeptic patients fulfilling the inclusion and exclusion criteria were enrolled. The age of the patients ranged from 18 to 80 years with the mean age of 43.35 (SD ± 16.30) years. There were 32 (21.3%) patients in the age group of 21 to 30 years, 31 (20.7%) patients in the age group of 31 to 40 years, 30 (20.0%) patients in the age group of 41-50 years, 26 (17.3%) patients in the age group of 51-60 years, 21 (14.0%) patients in the age group of above 60 years and 10 (6.7%) patients in the age group up to 20 years. There were 93 (62.0%) male and 57 (38.0%) female with a ratio of male to female was 163:1. Showed the distribution of patients according to endoscopic findings. Endoscopic findings was normal in 85 (56.7%) patients, duodenal ulcer in 26 (17.3%) patients, gastritis in 23 (15.3%) patients, and gastric ulcer in 16 (10.7%) patients. The distribution of patients according to CLO test. CLO test was positive in 97 (64.7%) patients and negative in 53 (35.3%) patients. The patients according to serum Helicobacter pylori antibody by ELISA. Serum Helicobacter pylori antibody was positive in 101 (67.3%) patients and negative in 49 (32.7%) patients. Stool antigen test was positive in 73 (48.7%) patients and negative in 77 (51.3%) patients. Using CLO test as the gold standard the sensitivity and specificity of stool antigen test in the diagnosis of Helicobacter pylori infection was 72.7% and 94.3% respectively. Positive and negative predictive values were 95.9% and 64.9% respectively. The overall accuracy was 80.0%. There was moderate agreement between the two test (Kappa, k=0.603; p<0.001). Using CLO test as the gold standard in the diagnosis of Helicobacter pylori infection the sensitivity and specificity of serum Helicobacter pylori antibody was 89.7% and 82.2% respectively. Positive and negative predictive values were 86.1% and 79.6% respectively. The overall accuracy was 84.0%. There was a substantial agreement between the two test (Kappa, k=0.644; p<0.001). Conclusion: The overall accuracy was 80.0%. There was good agreement between the two test (Kappa, k=0.603). Using CLO test as the gold standard in the diagnosis of Helicobacter pylori infection this study showed that the sensitivity and specificity of serum Helicobacter pylori antibody was 89.7% and 82.2% respectively. Positive and negative predictive values were 88.7% and 100.0% respectively. The overall accuracy was 84.0%. In conclusion comparing CLO test (invasive) is still the superior to stool antigen and serology (non-invasive), both of which is going very close to each other in the diagnosis of Helicobacter pylori infection in dyspeptic patients.

Prevalence of Helicobacter pylori infection in dyspeptic patients undergoing upper gastrointestinal endoscopy in a tertiary-care teaching hospital

Background: Helicobacter pylori infection is widely prevalent in the world especially in the developing countries. The common clinical presentation of this disease includes peptic and duodenal ulcer. A major post-infection complication of this disease is gastric carcinoma. The scope of this study was to determine the prevalence of active H. pylori infection in the local population by retrospective review of patient records, which can give a better picture of the current situation and estimate the at-risk population of gastric carcinoma. Objective of the study was to determine the prevalence of H. pylori infection in biopsy specimens obtained from upper gastrointestinal endoscopy performed in dyspeptic patients in a tertiary-care hospital.Methods: The study was performed as a retrospective review of biopsy reports of 262 dyspeptic patients with previously unknown H. pylori status who underwent upper gastrointestinal endoscopy during the months of January 2018 to May 2018. Biopsy obtained from stomach was evaluated for the presence of H. pylori infection by Rapid Urease Test (RUT) or histopathological examination.Results: The prevalence of H. pylori infection in dyspeptic patients obtained from the above study was 44.7% and was found to be more common in males compared to females.Conclusions: H. pylori is a risk factor for gastric carcinoma. Determining the prevalence with early identification of active infections results in better treatment and post infection monitoring for malignancy.

A prospective study of proportion of Helicobacter pylori infection in patients presenting with dyspeptic symptoms in S. Nijalingappa Medical College and H.S.K. Hospital, Bagalkot

Background: More than half of the world’s population is infected with Helicobacter pylori, the primary cause of chronic gastritis. Chronic gastritis is associated with peptic ulcer and in advanced stages with an increased risk of developing gastric adenocarcinoma. The aim of the study was to determine the prevalence of Helicobacter pylori infection in dyspeptic patients and its relationship with gastroduodenal pathologies using gastric biopsy histology.Methods: A cross sectional prospective study was conducted from 1st January 2018 to 30th June 2019. It included out-patients and in-patients, presenting with dyspeptic symptoms and undergoing upper GI Endoscopy, at S. Nijalingappa Medical College and HSK hospital, Bagalkot, Karnataka, India. Endoscopic impressions were noted. In case of any abnormal findings on upper gastrointestinal endoscopy, endoscopic biopsy was obtained. Histopathological assessment of gastric mucosa was done after staining with H and E stain and Giemsa stain. The histopathological diagnosis of Helicobacter pylori infection in biopsy specimen will be mainly done using the Modified Giemsa stain.Results: 105 patients with dyspepsia were studied in total. Out of which, 44 patients (41.9%) were detected positive for Helicobacter pylori infection.Conclusions: The burden of Helicobacter pylori infection in patients with dyspepsia was high. Early diagnosis and eradication of Helicobacter pylori not only improves symptoms but also help to prevent complications associated with Helicobacter pylori infections.

CagA Effector Protein in Helicobacter pylori-Infected Human Gastric Epithelium in Vivo: From Bacterial Core and Adhesion/Injection Clusters to Host Cell Proteasome-Rich Cytosol.

A key role in the carcinogenic action of Helicobacter pylori is played by the effector protein CagA, the first identified oncoprotein of the bacterial world. However, the present knowledge in regard to the bacterial injection of CagA into epithelial cells (through a type IV secretion system) and its intracellular fate is based primarily on experimental studies in vitro. Our study was aimed to investigate, in H. pylori-infected human gastric epithelium, CagA delivery and intracellular distribution in order to identify any in vivo counterpart of the cell injection mechanism described in vitro and any intracellular cytoplasmic site of preferential CagA distribution, thus shedding light on the natural history of CagA in vivo. By transmission electron microscopy and ultrastructural immunocytochemistry (which combine precise molecule localization with detailed analysis of bacterial-host cell interaction and epithelial cell ultrastructure), we investigated endoscopic biopsies of gastric antrum from H. pylori-infected dyspeptic patients. Our findings provide support for CagA direct injection into gastric epithelial cells at bacterial adhesion sites located on the lateral plasma membrane and for its cytosolic intracellular distribution with selective concentration inside peculiar proteasome-rich areas, which might be site not only of CagA degradation but also of CagA-promoted crucial events in gastric carcinogenesis.

Are Histopathological Changes of H. pylori Infection in Young Dyspeptic Patients Necessitate Endoscopy?

BACKGROUND:Helicobacter pylori is an important gastrointestinal infective bacteria with many serious complications including gastric erosions and ulceration, duodenal ulcer, gastric carcinoma and MALT gastric lymphoma. The gastric biopsy is commonly performed in H. pylori-positive dyspeptic individuals, and many previous researchers studied the histopathological features of infected gastric biopsies however little previous studies focused on the histopathological findings in young population in comparison to the older one.AIM:To make a focus on the histopathological effects of H. pylori infection in young patients compared with the older one and predicts the need for endoscopy in this population, also to estimates the prevalence of infection in Iraqi patients.MATERIAL AND METHODS:the sample for this study is 180 patients in total, they attended Marjan medical city in Iraq for dyspepsia of more than 3 months and prepared for OGD. Patients asked for their permission to do immunological tests for H. pylori. Both serology for H. pylori antibodies and stool for antigen tests are used, and the case is included in the study only if both tests were positive, after OGD, the gastric biopsies are processed and examined histopathologically.RESULTS:Normal gastric biopsy is the most common histopathological finding in young (< 25 years) patients (75%) while chronic atrophic gastritis is the most common one in patients > 25 years age (57%). The prevalence of Helicobacter pylori infection in dyspeptic patients was 73.3%, the correlation between infection and sex was insignificant (p-value 0.06), and no significant correlation between infection and age (p-value 0.07) was concluded.CONCLUSION:H. pylori-related histopathological changes of gastric mucosa in young (< 25 years) are commonly mild and does not necessitate endoscopy at this age unless there are alarming signs.

A Novel Three Drug Rigemen (Moxifloxacin –Omeprazole - Nitazoxanide) in Comparison to Traditional Triple Therapy for Treatment and Eradication of Naïve and Resistant H. Pylori Infection in Dyspeptic Patients

Background: Helicobacter pylori is one of the most common, medically prominent infection worldwide and one of the major causative factor of peptic ulcer disease. So, eradication of H. pylori is effective in healing ulcers, reducing the ulcer recurrence and eliminating the need for maintenance therapy. Objective: The aim of the work was to compare between the efficacy of traditional triple therapy and Moxifloxacin-based triple therapy in treatment of H. pylori infection and to evaluate the efficacy of moxifloxacin-based regimens as a rescue regimen for H. pylori eradication in resistant patients. Patients and methods: This study was carried out on 100 Helicobacter pylori (H. pylori)-infected patients (within the period between septemper, 2018 to May, 2019) who were enrolled from Hepatology, Gastroenterology & Tropical Medicine Department, Al Azhar University Hospitals (El-Hussein and BAB El-Shaarea). Results: Helicobacter pylori eradication results in group III as evaluated by monoclonal H. Pylori stool Ag, 6 weeks post therapeutic regimens reported that eradication rate was 76.9% (20 patients). Regarding post treatment clinical data in group III, 42.3% of patients remained having symptoms and 57.7% had acheived symptomatic improvement. Also, the best results were recorded for H.pylori eradication (90%) in group II who received moxifloxacin based triple therapy compared to group I (with eradication rate 62.9%) who received traditional triple therapy regimen. Thus the better results (76.9%) were achieved in group III (resistant patients from group I). Conclusion: The present results could state that moxifloxacin can overcome traditional triple therapy resistance.

A Novel Three Drug Rigemen (Moxifloxacin –Omeprazole - Nitazoxanide) in Comparison to Traditional Triple Therapy for Treatment and Eradication of Naïve and Resistant H. Pylori Infection in Dyspeptic Patients

Background: Helicobacter pylori is one of the most common, medically prominent infection worldwide and one of the major causative factor of peptic ulcer disease. So, eradication of H. pylori is effective in healing ulcers, reducing the ulcer recurrence and eliminating the need for maintenance therapy. Objective: The aim of the work was to compare between the efficacy of traditional triple therapy and Moxifloxacin-based triple therapy in treatment of H. pylori infection and to evaluate the efficacy of moxifloxacin-based regimens as a rescue regimen for H. pylori eradication in resistant patients. Patients and methods: This study was carried out on 100 Helicobacter pylori (H. pylori)-infected patients (within the period between septemper, 2018 to May, 2019) who were enrolled from Hepatology, Gastroenterology & Tropical Medicine Department, Al Azhar University Hospitals (El-Hussein and BAB El-Shaarea). Results: Helicobacter pylori eradication results in group III as evaluated by monoclonal H. Pylori stool Ag, 6 weeks post therapeutic regimens reported that eradication rate was 76.9% (20 patients). Regarding post treatment clinical data in group III, 42.3% of patients remained having symptoms and 57.7% had acheived symptomatic improvement. Also, the best results were recorded for H.pylori eradication (90%) in group II who received moxifloxacin based triple therapy compared to group I (with eradication rate 62.9%) who received traditional triple therapy regimen. Thus the better results (76.9%) were achieved in group III (resistant patients from group I). Conclusion: The present results could state that moxifloxacin can overcome traditional triple therapy resistance.

Real-world data of Helicobacter pylori prevalence, eradication regimens, and antibiotic resistance in Thailand, 2013-2018.

Background and Aim Helicobacter pylori is a class I carcinogen. Nowadays, the problem of antibiotic resistance is increasing worldwide. The latest prevalence rates of infection and resistant status in Thailand vary or are out of date. Our aims are to identify the current prevalence and antibiotic resistance patterns in Thailand and to suggest regimens for treatment‐naive and ‐resistant patients.MethodsThis descriptive retrospective study was conducted, using a urea breath test, on patients in King Chulalongkorn Memorial Hospital between 2013 and 2017. They were categorized into the diagnostic group and posttreatment group. Specimens from some patients were cultured to identify the antibiotic‐resistant pattern.ResultsThere were 1894 patients included in our study. The prevalence of H. pylori infection in dyspeptic patients was 28.4%. Of 1258 patients, 1165 (92.61%) responded to initial treatment. The 95 patients who failed to respond could respond to second‐line treatment of longer period, at higher doses, or using other antibiotics (success rate 68.42%). There were 21.43, 14.29, and 10.71% of patients resistant to ciprofloxacin, metronidazole, and clarithromycin, respectively. However, no patients resistant to amoxicillin, tetracycline, and levofloxacin were found.ConclusionThe prevalence of H. pylori infection in Thailand has increased slightly. Initial regimens (triple therapy or sequential therapy or quadruple therapy) can be effective for the eradication of H. pylori infection, with a success rate of > 90%. For patients who failed to respond to initial triple therapy, using a longer duration of triple therapy or changing to quadruple therapy could be a good alternative. The resistance rates of amoxicillin, metronidazole, levofloxacin, and tetracycline are declining, but those of clarithromycin and ciprofloxacin are increasing.

ARTICLE PARTIAL RETRACTION] PREVALENCE OF HELICOBACTER PYLORI INFECTION IN DYSPEPTIC PATIENTS AND ITS ASSOCIATION WITH CLINICAL RISK FACTORS FOR DEVELOPING GASTRIC ADENOCARCINOMA.

In Brazil, particularly in the underdeveloped localities, the prevalence of Helicobacter pylori (H. pylori) infections can range up to 90%. These rates are higher in older individuals and vary by country region. H. pylori infections are linked to the development of gastric pathologies, namely mild to moderate gastritis, gastroenteritis, peptic ulcer, intestinal metaplasia, and gastric cancer. In 1994, this organism was classified by the International Agency for Research on Cancer (IARC) as pertaining to the Group 1 carcinogen for gastric adenocarcinoma etiology. Gastric cancer represents a significant public health problem, being the fourth most common malignant tumor and the second largest cause of cancer-related deaths. To investigate the prevalence of H. pylori infection in dyspeptic patients and determine the link between clinical risk factors and gastric adenocarcinoma diagnosis. Polymerase chain reaction (PCR) analysis was employed for molecular diagnosis of gastric tissue biopsies collected from 113 dyspeptic patients at the University Hospital of Federal University of Goiás. Molecular analyses allowed the identification of H. pylori infections. Furthermore, histopathological examinations were performed to determine the clinical risks of developing gastric malignancies. The test results identified 69 individuals older than 44 years, from 75 (66.4%) positive H. pylori infection samples. The prevalence of gastric adenocarcinoma in this study was 1.3%. Among the infected patients, six (8.2%) had high risk, and 67 (91.8%) had a low risk of developing gastric cancer (P<0.05). This study shows a high prevalence of H. pylori infection and identifies its contribution to gastric inflammations, which in the long term are manifested in high-risk clinical factors for the development of gastric adenocarcinoma.

Prevalence of oral Helicobacter pylori infection in dyspeptic patients with gastric Helicobacter pylori infection

Prevalence of oral Helicobacter pylori infection in dyspeptic patients with gastric Helicobacter pylori infection

Gastric precancerous conditions and Helicobacter pylori infection in dyspeptic patients with or without endoscopic lesions

Objective: In dyspeptic patients, esophagogastroduodenoscopy is often negative for visible lesions. Biopsies of the normal-appearing mucosa for Helicobacter pylori detection are not routinely obtained. Diagnostic gain of routine biopsies is still debated. This study aimed to assess the occurrence of H. pylori infection and related gastric premalignant conditions in dyspeptic patients without visible lesions at esophagogastroduodenoscopy and whether the presence/absence of endoscopically visible lesions may address the endoscopist to obtain gastric biopsies.Materials and methods: Post hoc study on endoscopic–histological data from 589 patients with dyspepsia (median age 57 years) obtained during a prospective nationwide study. Patients with dyspepsia as indication for esophagogastroduodenoscopy, never treated for H. pylori, were included. All the patients underwent esophagogastroduodenoscopy with biopsies according to Sydney system. Clinical data were collected using a structured questionnaire.Results: In 66.4% patients, the gastricduodenal mucosa appeared normal at esophagogastroduodenoscopy. In patients with or without visible lesions at esophagogastroduodenoscopy, H. pylori infection (51.5% vs. 50.1%, p = 0.82) and atrophic-metaplastic gastritis (33.3% vs. 27.6%, p = 0.18) were similar. Endoscopically visible lesions were poor predictors for H. pylori infection or gastric precancerous conditions showing positive and negative predictive values of 51.5% and 49.8% for H. pylori and 33.3% and 72.3% for atrophic-metaplastic gastritis. At logistic regression, the presence of H. pylori infection showed a negative association with ongoing antisecretory treatment (OR: 0.67), the presence of visible gastroduodenal lesions was not associated.Conclusions: Dyspeptic patients with or without visible endoscopic lesions had the same occurrence of H. pylori infection and related premalignant conditions, which might be missed without biopsies, in particular, in patients on anti-secretory treatment.

Helicobacter pylori infection in patients with selective immunoglobulin a deficiency.

Selective immunoglobulin A (IgA) deficiency (IgAD) is the most common primary immunodeficiency in the western world. The aim of the study was to investigate the prevalence and clinical characteristics of Helicobacter pylori-infected dyspeptic patients with IgAD. Case samples were drawn from all subjects ≥12 years of age (n=104729) who had undergone serum total IgA measurements during 2004-14 for any reason at Leumit Healthcare Services (Israel) and had serum total IgA <0·07 g/l. The control group was comprised of a random sample of remaining patients with a case-control ratio of 10 controls for each case. The dyspeptic diseases were identified and retrieved from Leumit Health Care Services electronic database using specific ICD-9-CM diagnostic codes. The case group included 347 subjects and the control group 3470 subjects. There were no significant differences in the prevalence of patients with dyspepsia [84 (24·2%) versus 821 (23·6%) for cases and controls, respectively]. Additionally, there was no difference in a proportion of dyspeptic H. pylori-positive subjects [59 (17·1%) versus 524 (15·1%)] between the case and control groups. Only 59 (17%) among the 347 IgAD patients underwent gastroscopy. A significantly larger proportion of case subjects experienced several forms of gastritis [13 (61·9%) versus 38 (21·6%), P < 0·001), duodenal ulcers [seven (33·3%) versus 19 (10·8%); P=0·01] and nodular lymphoid hyperplasia (NLH) [two (9·5%) versus none; P=0·011]. IgAD is not associated with increased prevalence of H. pylori-associated dyspepsia; nevertheless, H. pylori-infected dyspeptic IgAD subjects experience more EGD-proved gastritis, duodenal ulcers and NLH.

Molecular Epidemiology of Helicobacter pylori Infection in Nepal: Specific Ancestor Root.

Prevalence of Helicobacter pylori infection in Nepal, a low-risk country for gastric cancer, is debatable. To our knowledge, no studies have examined H. pylori virulence factors in Nepal. We determined the prevalence of H. pylori infection by using three different tests, and the genotypes of virulence factors were determined by PCR followed by sequencing. Multilocus sequence typing was used to analyze the population structure of the Nepalese strains. The prevalence of H. pylori infection in dyspeptic patients was 38.4% (56/146), and was significantly related with source of drinking water. In total, 51 strains were isolated and all were cagA-positive. Western-type-cagA (94.1%), cagA pre-EPIYA type with no deletion (92.2%), vacA s1a (74.5%), and m1c (54.9%) were the predominant genotypes. Antral mucosal atrophy levels were significantly higher in patients infected with vacA s1 than in those infected with s2 genotypes (P = 0.03). Several Nepalese strains were H. pylori recombinants with genetic features of South Asian and East Asian genotypes. These included all East-Asian-type-cagA strains, with significantly lesser activity and inflammation in the corpus than the strains of the specific South Asian genotype (P = 0.03 and P = 0.005, respectively). Although the population structure confirmed that most Nepalese strains belonged to the hpAsia2 population, some strains shared hpEurope- and Nepalese-specific components. Nepalese patients infected with strains belonging to hpEurope showed higher inflammation in the antrum than strains from the Nepalese specific population (P = 0.05). These results support that ancestor roots of Kathmandu`s people not only connected with India alone.

Frequency of Helicobacter Pylori Infection on Histopathology in Patients with Dyspepsia

Objective: To determine the frequency of Helicobacter Pylori infection on histopathology in patients presenting with dyspepsia. Background: Helicobacter Pylori is associated with dyspepsia in patients who have gastric mucosal abnormalities and this infection can be diagnosed by invasive and non invasive test. Histology of endoscopically taken biopsy, for exploration of this organism is used in this study. Study Design: Cross-sectional, observational study. Place and Duration of Study: Department of Emergency Medicine, Ziauddin University Hospital, Karachi for Six months from March 2013 to August 2013. Methodology: A total of 362 cases with dyspeptic symptoms were underwent an upper gastrointestinal endoscopy after fulfilling the selection criteria. H. Pylori infection would be defined by the presence of dyspeptic symptoms with detection of the bacterium on histopathology. All the data was collected by using a proforma and different parameters were assessed for a minimum follow-up period of one month. Data was analyzed by descriptive statistics using SPSS software version 19. Result: Out of 362 cases of dyspepsia 218 (60.2%) males and 144 (39.8%) females (Male: Female was 1.5: 1). Two fifty one (69.3%) patients with dyspepsia were H. Pylori positive on histopathology. Out of 251 cases having H. Pylori infection 165 (75.7%) were male and 86 (59.7%) female. High percentage was found in the age between 31 – 50 years, 160 (77.3%). Conclusion: In this study 69.3% of the patients examined were H. Pylori positive on histopathology. Male sex and older age (> 30 years) are independent risk factor of H. Pylori infection in dyspeptic patients.

Expression of Cyclooxygenase-2 ( COX-2 ) and Interleukin-8 ( IL-8 ) in H. Pylori Gastritis : A Study on Diagnostic Methods and Pathological Effects of H. Pylori Infection in Dyspeptic Patients

Expression of Cyclooxygenase-2 ( COX-2 ) and Interleukin-8 ( IL-8 ) in H. Pylori Gastritis : A Study on Diagnostic Methods and Pathological Effects of H. Pylori Infection in Dyspeptic Patients

Prevalence of Helicobacter pylori infection in dyspeptic patients in Iran

Although Helicobacter pylori ( H. pylori ) infection has been known to be associated with several upper gastrointestinal disorders such as peptic ulcer and gastric cancer, the relationship between H. pylori infection and dyspeptic symptoms remains controversial. Furthermore, it is still not clear which factors are associated with H. pylori infection in the Iranian population. We investigated the prevalence of H. pylori infection in dyspeptic patients and factors associated with H. pylori infection in the Iranian population. In this cross-sectional study, 303 patients with dyspeptic symptoms underwent endoscopy. Clinical data and a questionnaire about gastrointestinal symptoms were collected from each patient. H. pylori status was evaluated by histological examination. Among the 303 patients, 263 (86.8%) were found to be positive for H. pylori. The prevalence of H. pylori infection decreased significantly with age. There was no difference in the prevalence of H. pylori infection between the patients with and those without a family history of gastroduodenal diseases. Among 250 patients with abdominal pain, 219 (87.6%) were infected with H. pylori. Among 211 patients with epigastric abdominal pain, 185 (87.7%) were infected with H. pylori . It was observed that belching was significantly associated with H. pylori infection (P = 0.03). Dyspepsia triggered by the consumption of tea was higher in H. pylori- positive patients than in H. pylori- negative patients (P = 0.03). The prevalence of H. pylori infection in dyspeptic patients was quite high in Iran. Belching and dyspepsia triggered by tea consumption was related with H. pylori infection.

HELICOBACTER PYLORI INFECTION;

Objective: To determine the frequency of H. pylori infection in dyspeptic patients undergoing endoscopy at a tertiary care centerin Karachi. Data source: Patients undergoing endoscopy at Liaquat National Hospital, Karachi. Design of study: Cross sectional descriptivestudy. Setting: Department of Gastroenterology, Liaquat National Hospital, Karachi. Period: May 2008–October 2008. Material andmethods: All adult patients with symptoms of dyspepsia for more than 1 month duration were included. Patients with upper gastrointestinalbleed, anemia or weight loss were excluded. Upper gastrointestinal endoscopy was performed in all patients and biopsy specimens two eachfrom antrum and body and one from fundus were taken for histology. Results: A total of 123 dyspeptic patients were included in the study. 76(61.8%) patients were males and 47 (38.2%) were females. H pylori was detected in mucosa of 49 (39.8%) patients. The mean age of thepatients was 41.41 ± 13.15 Years (95%CI; 39.06 to 43.75). Rate of H.pylori infection was not found statistical significant with age, gender,duration of symptoms and BMI. Conclusions: The prevalence of H pylori infection in dyspeptic patients was lower than reported in previousstudies from other centers in Pakistan. Other environmental factors should be evaluated in every patient especially who is negative for H. pyloriin our setup.

The Modified Sequential Treatment Regimen Containing Levofloxacin for Helicobacter pylori Eradication in Turkey

Eradication rates of Helicobacter pylori have declined to unacceptable levels in recent years. New and effective treatment options are warranted both as a first and second line treatment. To test an effectiveness of modified sequential therapy with levofloxacin for H. pylori eradication in Turkey. Helicobacter pylori infected dyspeptic patients were included to the study. Subjects were treated with modified sequential therapy consisting of rabeprazole 20 mg b.i.d. and amoxicillin 1 g b.i.d., for 7 days followed by rabeprazole 20 mg b.i.d, levofloxacin 500 mg q.d. and metronidazole 500 mg b.i.d for the remaining 7 days. Sixty-three treatment naive patients and 37 previous treatment failures were enrolled to the study (59 F, 41 M, age: 21-80 years). There was five drop out. Helicobacter pylori eradication was achieved in 80 patients, intention-to-treat (ITT): 80% (95% CI: 71-87%) and per-protocol (PP): 84.2% (95% CI: 75-91%), totally. In treatment naive patients ITT and PP eradication rates were 82.5% (95% CI: 71-91%), and 86.7% (95% CI: 75-94%), respectively. As a second line treatment eradication was successful in ITT 75.7%.(95% CI: 59-88%), and PP 80% (95% CI: 63-92%).Mild side effects were reported by 8 patients (8.4%). Sequential therapy using "rabeprazole and amoxicillin 7 days followed by rabeprazole, metronidazole and levofloxacin for 7 days" is a new regimen with acceptable eradication rates in naïve patients in Turkey. Further modifications in the dose or duration of this new sequential therapy might increase its effectiveness as both first and second line treatment.