Helicobacter pylori, effect of its eradication on serum gastrin in gastritis and duodenal ulcer patients

It was observed that hypergastrinemia occurs with Helicobacter pylori [H. pylori] infection whether it may play a role in the pathogensis of duodenal ulcer disease or not, still controversial, Aim of the study is to observe the effect of H. pylori infection among duodenal ulcer [DU] and chronic gastritis patients before and after H. pylori eradication and observe the changes in serum gastrin levels and the reflection on the pathological course of gastritis and DU. disease. Out of 380 chronic dyspeptic patients 154 patients were H. pylori positive [40.5%]. DU was detected in 17.5% of H. pylori positive and in 8.8% with H. pylori negative dyspeptic patients. Serum fasting gastrin levels were measured by standard radioimmunoassay techniques, in 45 DU patients [25 patients of them were H. pylori infected] and 40 chronic gastritis patients [20 patients were H. pylori infected] before and one month after H. pylori eradication. In addition to a control group included 15 normal H. pylori negative individuals. H. pylori detection and monitoring was assessed by serologic test [ELISA], bacteriological culture, Clo test [unease test] and histopathological examination [Giemsa stain] before and after therapy. Colloidal bismuth, amoxicillin and metronidazole triple therapy was used for H. pylori eradication. Fasting hypergastrinemia was detected significantly among DU and chronic gastritis H. pylori infected patients [P<0.001], than H. pylori negative comparable groups and normal controls. Reversed hypergastninemia [mean values] were observed significantly [P<0.01], among chronic gastritis and DU, H. pylori infected groups after a month of triple therapy for H. pylori eradication. Successful eradication was achieved in 75% and 88% as detected by ELISA technique, 100% by bacterial culture, 90% and 88% by Clo test and 100% to 92% by histopathological examination among chronic gastritis and DU groups respectively. Although, significant decrease in the mean values of fasting serum gastrin after H. pylori eradication in chronic gastritis patients [P<0.01], the improvement in the grades of gastritis showed insignificant changes [P>0.05]. Also, a significant decrease in the fasting serum gastrin mean values in DU H. pylori infected patients after a month of H. pylori eradication [P<0.01], however, non significant differences were reported between the rates of complete DU healing, partial healing and non healing ulcers among H. pylori negative or positive DU groups [P>0.05]. In These findings suggest that hypergastrinemia is secondary to H. pylori infection and related to mucosal inflammation and play a minor role in inducing duodenal ulcer disease. Although, ELISA test is the most sensitive for H. pylori detection but its reliability in assessing eradication needs a further study. Also, serum gastrin measurement can be used to assess H. pylori eradication

Data from lipid screening in private practice in Jeddah, Saudi Arabia

We screened 475 subjects for fasting serum total cholesterol and triglyceride. They included 315 males and 160 females. The age range was 10-70 years. The mean serum total cholesterol [STC] was 5.5 mmol/L +/- 1.5 [5.5 +/- 1.6 in males and 5.6 +/- 1.4 in females]. The mean value for serum triglyceride was [2.5 +/- 1.3 in males and 2.1 +/- 1.4 in females], STC was slightly higher in females than in males in all age groups up to the 3rd decade of life. 39% of the population group had STC less than 5.2 - 7.5 mmol/L and in 23% the level was higher than 7.5 mmol/L. Serum triglyceride was above 2.28 mmol/L in 33% of cases, a higher incidence was found among the elderly and the diabetics. In comparison to the data reported from other countries, we have shown that the mean STC in our selected population is in the intermediate nations. Health care measure should be undertaken to counteract the problem of dyslipidemia including public education, routine necessary dietary modification and encouragement of physical exercise