Gastric atrophy: use of OLGA staging system in practice

Aim: This study used the OLGA system to characterize the histology pattern of gastritis in dyspeptic outpatients with a mean age of 45 years from regions with different gastric cancer risks

Background: Several classification systems have been purposed for understanding the status of the gastric mucosa. Currently, the Sydney system is the most widely employed. Nevertheless, the applicability of the Sydney system in therapeutic and prognostic areas is a matter of debate. Given this shortcoming an international group of gastroenterologists and pathologists developed a new system named Operative Link on Gastritis Assessment [OLGA]

Patients and methods: In this cross-sectional comparative study the OLGA system was used to characterize the histology pattern of gastritis in 685 dyspeptic patients referring to the department of gastroenterology of a training hospital

Results: No significant correlation was found between active inflammation and total OLGA score [P > 0.05]. Also, no statistically significant correlation was found between activity and intestinal metaplasia, dysplasia, atrophy, and cancer [P > 0.05]. Even though, there is a positive correlation between mild chronic inflammation and total OLGA score, no correlation has been identified between chronicity and dysplasia or cancer [P > 0.05]. Nearly, In all cases with no dysplasia OLGA score was zero but all patients with gastric cancer OLGA score was more than two

Conclusion: Generally, the activity is not a useful factor in predicting prognosis and its loss of relation with total OLGA score does not make OLGA score any less predictable

Determination of the status of Helicobacter pylori saba gene in relation to clinical findings

Many Helicobacter pylori strains express adhesin proteins that bind to specific host-cell macromolecule receptors, like sialic acid binding adhesion [sabA]. SabA-expressing strains have been associated with gastric cancer and negatively associated with duodenal ulcers. The aim of this study was to determine the status of sabA gene of H. pylori and its association with the clinical diseases in Iranian dyspeptic pateints. Eighty six biopsy block samples that were positive for H. pylori according Geimsa staining were included in this study. Genomic DNA was extracted from paraffin-embedded gastric biopsies obtained from dyspeptic patients. The identity of Helicobacter genus was determined through amplification of 16S rRNA which followed by sabA PCR using the gene-specific primers. The prevalence of sabA gene in three clinical groups including gastritis, gastric ulcer, and gastric atrophy was determined. The association of sabA gene and clinical outcomes was assessed statistically using Chi-square test. A p-value less than <0.05 was considered statistically significant. Total of 86 patients was included in this study. Seventeen cases out of 86 [23.6%] were yielded a positive result for sabA gene. The prevalence of sabA gene was 28.6% in both dyspeptic and Gastric atrophy patients as compared with peptic ulcers [19.2%].For a first time the frequency of sabA gene using PCR methods was reported. The current study demonstrated that the sabA gene status was not associated with clinical diseases. In limited number of studied samples, higher frequency of sabA gene among dyspeptic and atrophic patients was found.

Comparison of mono and biphasic culture media in isolating bacteria from blood and evaluation Bu-Ali hospital lab quality

Blood Culture is an important diagnostic method in infectious diseases and has positive results in 30%- 50% and even to 80% of cases due to sample volume. In Bu-Ali Hospital, Tehran, it decreases to 2-3%. In this survey, quality of hospital lab and difference between Mono and Biphasic culture media in isolating bacteria from blood of patients suggestive of sepsis were evaluated.106 [48 F + 58 M] newly admitted patients with impression of sepsis as SIRS [Systemic Inflammatory Response Syndrome] [36[degree sign]C >OT>38.3[degree sign]C , tachycardia more than 100/min, leukocytosis with shift to left or leucopenia] with infectious source were sampled for culture [5ml blood 3 times in 1 Biphasic and 2 Monophasic media] in the infectious ward. One Monophasic Media in hospital lab and the two other [1 Monophasic + 1 Biphasic Media] in Reference Laboratory of Iran, Research Center were handled. Media were quality-controlled at beginning and in the middle of study by NCCLS [National Committee for Clinical Lab Standard] with ATCC [American Type Culture Collection] samples. Sampling, transfer, and handling were all in standard conditions usually used in hospital. Results were compared by Fisher Exact Test. Clinical diagnosis were bacterial in 84 [79%], and nonbacterial in 22 [21%] patients at admission. 57 [54%] patients had not used antibiotics in the past 72 hours. In Monophasic Media of hospital lab 2 [1.9%] positive cultures [S. epidermidis] one with history of Erythromycin use were reported. In both Monophasic and Biphasic Media in reference lab 3 [2.8%] positive cultures [2 S.epidermidis, 1 E. coli] were reported equally, one with history of Erythromycin use. Growth Index in both Monophasic and Biphasic Media were standard in quality control. Qualities of Mono and Biphasic Media in growing bacteria were alike and Biphasic Media had no superiority to Monophasic Media in routine bacterial isolation. Positive culture in both labs had no significant statistical difference. So, negative results are not due to media and laboratorial fields, and it is needed to educate and evaluate two other fields: Sampling and Transferring. Also, we may have more positive cultures by increasing blood samples from 5 to 20 ml which can be compared in next studies