[Diagnostic accuracy of polyclonal stool antigen for detection of helicobacter pylori infection in children]

Helicobacter pylori infection has various clinical features. One of the most common presentations of this infection is upper abdominal pain. Complications such as gastritis, gastric ulcer, gastric carcinoma and MALT lymphoma mandate early diagnosis of H.P infection by a low cost and non invasive manner. The aim of this study was to evaluate the diagnostic role of H.P stool antigen detection as a simple and non invasive method for diagnosis of this infection. Upper endoscopy with gastric biopsy was done on all patients between 6 months to 18 years old with upper abdominal pain. Stool test was done by polyclonal anti-h.p antibody. Results of stool Test were compared with results of RUT and histologic examination Overall 110 patients [57 boys, 53 girls] were studied, 32 patients were Helicobacter pylori positive and 78 patients were Helicobacter pylori negative based on RUT and histologic examination. Stool antigen testing was positive for 39 patients. Sensitivity and specificity of stool Ag were 100% and 91% respectively Stool Ag test has high sensitivity and negatity predictive value for diagnosis of Helicobacter pylori infection

[Children sedation during gastrointestinal endoscopy comparison of two methods]

Endoscopy is an invasive and painful procedure in children. Since children can not tolerate pain and stress, sedation is necessary in pediatric endoscopy. The aim of this study was comparison of propofol versus intravenous midazolam for reducing anxiety in children. In this study, 103 patients [2-14 years old] in whom endoscopy was indicated were divided into three groups. In the first group, patients received propofol, in the second group, intravenous midazolam was given and patients in the third group received no sedation. Procedures were performed in the endoscopy room. Heart rate, respiratory rate and oxygen saturation were recorded before and during endoscopy in 1 minute intervals. Tremor, sweating and pain scores were recorded by using Visual Analogue Scale [VAS]. A significant increase in heart rate was documented in all groups [p=0.038]. Respiratory rate also increased in all groups. Too Oxygen saturation decreased in the propofol group, but it was not statistically significant [p=0.17]. Pain score in propofol group was significantly lower than those receiving midazolam [20 +/- 22 vs 50 +/- 27, p<0.001]. No noticeable side effect was seen in the propofol group. It seems that propofol is a very useful and effective drug for reducing pain and stress in children and its administration leads to a safe sedation in pediatric endoscopy