ABSTRACT
Background H. pylori infection causes diverse clinical outcomes, including dyspepsia, peptic ulceration, gastric carcinoma and mucosa associated lymphoid tissue [MALT] lymphoma. Up-remulation of COX-2 has been observed in H. pylori gastritis in response to inflammatory cytokines. IL-8 is a major activator for neutrophils which contribute to mucosal damage in H. pylori infected patients. A wide-spread use of non-invasive simple diagnostic method is indicated for diagnosis and follow-up of H. pylori infection
Aims: Assessment of COX-2 and IL-8 immuno-express.ion in gastric mucosa in correlations to H. pylori infection in patients suffering from dyspepsia and evaluation of different available diagnostic modalities for detection of H. pylori infection in Sohag city, Egypt
Methods: The study included 62 patients complaining of dyspepsia. Stool samples were examined for detection of H. pylori stool antigen [HpSA] using enzyme immunoassay [ElA]. Antral endoscopical biopsies were taken for culture, and histopathological evaluation using Giemsa stain. Immunohistochemical expressions of IL-8 and COX-2 in tissue sections were evaluated
Results: H. pylori infection was detected in 42/62 [67.7%] of patients with dyspepsia by using the gold standard method [culture and Giemsa stain]. The diagnostic accuracy of HpSA was 83.8% which made it a good non-invasive alternative for detection ofH. pylori infection in our community. COX-2 was expressed in 90.5% ofH. pylori positive and in 55% of H. pylori negative cases [P < 0.003]. IL-8 was expressed in 83.3% ofH. pylori positive and in 50% ofH. pylori negative cases [P < 0.003]
Conclusions: Wherever endoscopy is not indicated, HpSA EIA is a non invasive, rapid, easily performed, reliable method for diagnosis ofH. pylori infection. H. pylori infection causes enhancement of COX-2 and IL-8, and this may have a role in the progression of gastritis to more advanced lesions?
ABSTRACT
Tuberculosis [TB] is responsible for about one third of preventable deaths worldwide. Accurate and rapid diagnosis of tuberculosis is essential for controlling the spread of the disease caused by Mycobacterium tuberculosis. The aim of this study was to evaluate the Mycobacteria Growth Indicator Tube [[MGIT 960] [M960]] which is a fully automated, non-invasive, system for growth and detection of mycobacteria and Lowenstein-Jensen [LJ] media for the recovery of Mycobacterium tuberculosis from sputum samples. Out of 67 specimens processed, 60 isolates [89.5%] were recovered by M960 media while, 50 isolates [74.6%] were obtained by LJ. M960 as a single system detected 11 [16.4%] isolates more than L.J media while; L.J media detected 2 [2.9%] isolates [revealed no growth in MGIT 960]. In total, Out of these 67 specimens, 48 [71.6%] were positive by all methods [Z-N smear, culture on both LJ and MGIT broth] and 48 [71.6%] isolates also were obtained by the combined use of both culture methods. Average detection time of M960 and LJ media was 14.6 days [2-38] and 30.6 days [7-58] respectively. The contamination rates in our study were [2.9%] for M960 and [1.49%] for L.J media. In conclusion, comparable to LJ media, M960 system is a rapid and efficient method for diagnosis of pulmonary tuberculosis. But for maximum recovery of mycobacteria, a combination of both M960 and LJ media should be used
ABSTRACT
Introduction: infection with Helicobacter pylori is accepted as a main cause of gastritis and gastritis associated diseases. Giardia lamblia parasite is considered the most common protozoal infection in human. Concomitant H. pylori and Giardia infection is common for their similar mode of transmission and strong correlation to socioeconomic levels, but only few reports had described gastric giardiasis. In this work, H. pylori and Giardia lamblia were detected by PCR in gastric antral mucosal biopsies from a random sample of patients complaining from dyspepsia, in Sohag University Hospital, Egypt. Results were compared with a control group of patients undergoing EGD for other reasons rather than dyspepsia. The impact of H. pylori and Giardia lamblia infection whether singularly or concert, on clinical, endoscopic or histopathogical changes was studied
Patients and methods: 48 patients [26 males and 22 females] with dyspepsia and 28 control [26 males and 2 females], were subjected to esophagogastroduodenoscopy [EGD]. Endoscopic data were reported and gastric biopsy specimens were obtained for subsequent PCR assay for H. pylori and Giardia lamblia, histopathological and electron microscopic examination
Results: endoscopic antral gastritis and duodenal lesions were found in both patients and controls. Both lesions occurred significantly more frequently in patients group [p= 0.002 and 0.0005 respectively]. Esophageal lesions, nodular antral gastritis, gastric ulcers and superficial carpal gastritis were found only in patients group. PCR detected H. pylori infection in 28 out of the 48 patients [about 58%] and in 18 out of 28 [64%] control subjects while Giardia lamblia infection was present in 32 out of 48 patients [67%] compared to 12 out of 28 controls [64%]. In the latter, the results were statistically significant [P=0.0003, Odd ratio=2.6]. Co-infection with H. pylori and Giardia was present in 33% of patients compared to 36% of controls. Abnormal histologic findings were found in both patients and control groups, however, gastric atrophy occurred significantly more frequently in symptomatizing patients [P=0.027] with an odd ratio = 2.6. Intestinal metaplasia was found only in the patients group. Electron microscopic study; cellular abnormalities in the form of cytoplasmic vacuoles, mitochondrial destruction or nuclear abnormalities were found in infected subjects [H.pylori, Giardia or both]
Conclusion: H. pylori is not the only gastric pathogen in our community, gastric giardiasis is quite common. Its contribution to symptoms or pathological changes couldn't be confirmed in our study but it might be a factor in persistent epigastric pain after H. pylori eradication