[Association between Helicobacter Pylori infection and first miscarriage]

Miscarriage is the most common problem in pregnancy. Major mechanisms responsible for abortion are not always clear. Some underlying factors have been proved. Hence, efforts are being done to determine the new factors; like chronic infection. In this study, we investigated relationship between helicobacter pylori [HP] infection and first miscarriage. In this study, 70 women with first miscarriage [case group] and 67 with normal [control group] delivery, aged 20-29 years old were studied. Interviews along with 5cc blood were taken from each case to test the specific IgG titer with ELISA method. A questionnaire was filled for each subject. Mean [ +/- SD] age of cases was 23.0 +/- 2.6 and control group was 23.8 +/- 2.7. This difference was not significant [P=0.076]. 45.7% of cases with the first miscarriage and 25.4% control group suffered from HP. Relationship between HP infection and miscarriage was significant [OR=2.48, 95% CI: 1.13-5.46, P=0.013. According to this study, it seems that there is an association between HP infection and first miscarriage. For determining the effect of HP infection on causing the first miscarriage, more studies are required

[ study on prevalence of helicobacter pylori in acute coronary syndrome]

Coronary artery disease is the main cause of mortality in developing countries like Iran. Due to failure of classic risk factors to completely explain epidemiologic variability of the disease, other risk factors, for example infection diseases are under investigation. One of these infectious agents is Helicobacter pylor which have been investigated in numerous studies. This study was designed to assess the controversies about Helicobacter pylor prevalence in acute coronary syndrome. All the patients with ACS including unstable angina and myocardial infarction who referred to Fatemie Hospital between 20 Feb 2003 to 9 Feb 2004 and were admitted in CCU ward were included in this cross-sectional study. A total of 411 patients with ACS were evaluated for prevalence of Helicobacter pylor antibody. Mean age of patients was 59.97and 56% of them were male. The serological test for Helicobacter pylor infection was positive in 45.6%of cases, negative in 43.8% and borderline in 10.6% of patients. 191 patients had unstable angina and 220 patients had myocardial infarction. This study showed that prevalence of Helicobacter pylorinfection in patients with acute coronary syndrome was not high. Thus acute or chronic infection with Helicobacter pylor could not be a risk factor for ACS

[ value of clinical presentation in diagnosis of reflux in noncardiac chest pain patients]

Non-cardiac chest pain [NCCP] presents as a frequent diagnostic challenge, with patients tending to use a disproportionate level of health care resources. Gastroesophageal reflux disease [GERD] is the most frequent cause of NCCP. Thus the typical symptoms of reflux like Heartburn and regurgitation, when present as predominant symptoms are quite specific for diagnosing GERD patients but in patients with NCCP the clinical diagnos of reflux is difficult and need to utilize invasive methods or omeprazol [PPI] test for its detection. The aim of the study was to evaluate the role of clinical presentation in diagnosing GERD in NCCP patients. NCCP patients underwent upper endoscoy, Bernstein test and short course of omeprazol test. the patients were divided in two groups based on the GER or non-GER related chest pain. In the end, clinical presentation of the patients was compared in two groups. GERD was considered positive as evidences of mucosal injury on upper endoscopy and or Bernstein and PPI tests had been positive together. From 78 NCCP patients [41 male; mean age 50.4 +/- 2.3], the chest pain in 35 patients [44.8%] were related to GERD. Two groups were the same based on sex and age. The chest pain; severity, site, radiation and relation to food, exercise, and sleep were the same in two groups, except two symptoms; the pain that was relived by anti-acid [p<0.031] and presence of classical reflux symptoms [p<0.009] were seen in GERD patients. It was interest that in the history of the patients, heart burn [p<0.036] and regurgitation [p<0.002] were seen in patients with GERD-related chest pain. Clinical examination is important in diagnosing GERD in NCCP. Although the chest pain is the same in reflux and non reflux related NCCP, but the symptoms of heartburn or regurgitation in present or recent past history of patients are diagnostic for GERD-related chest pain

Association of helicobacter pylori infection with cardiac syndrome X

Cardiac syndrome X includes chest pain and positive exercise and /or radionuclide test and normal coronary angiography. There is no obvious etiology for this syndrome. Some mechanisms such as endothelial dysfunction and estrogen deficiency have been explained. In this study, we studied correlation between helicobacter pylori infection and cardiac syndrome X 23 patients [17 female and 6 male] with cardiac syndrome X between 30-65 years old [mean 42 +/- 4] matched with control group [16 female and 7 male] between 31-64 years old [mean 41 +/- 4]. Helicobacter pylori infection detected by urease breathe test [UBT]. Patients with dyspepsia and coronary spasm were excluded. UBT showed that 91% of cases in patient group and 48% in control group were positive for helicobacter pylori infection, and this difference was significant [P<0.001]. Due to high prevalence of infection with helicobacter pylori in cardiac syndrome X patients [91%] in comparison with it's prevalence in control group [48%], possibility of relationship between infection with helicobacter pylori and cardiac syndrome X is suggested

[ value of clinical presentation in diagnosis of reflux in noncardiac chest pain patients]

Non-cardiac chest pain [NCCP] presents as a frequent diagnostic challenge, with patients tending to use a disproportionate level of health care resources. Gastroesophageal reflux disease [GERD] is the most frequent cause of NCCP. Thus the typical symptoms of reflux like Heartburn and regurgitation, when present as predominant symptoms are quite specific for diagnosing GERD patients but in patients with NCCP the clinical diagnos of reflux is difficult and need to utilize invasive methods or omeprazol [PPI] test for its detection. The aim of the study was to evaluate the role of clinical presentation in diagnosing GERD in NCCP patients. NCCP patients underwent upper endoscoy, Bernstein test and short course of omeprazol test. the patients were divided in two groups based on the GER or non-GER related chest pain. In the end, clinical presentation of the patients was compared in two groups. GERD was considered positive as evidences of mucosal injury on upper endoscopy and or Bernstein and PPI tests had been positive together. From 78 NCCP patients [41 male; mean age 50.4 +/- 2.3], the chest pain in 35 patients [44.8%] were related to GERD. Two groups were the same based on sex and age. The chest pain; severity, site, radiation and relation to food, exercise, and sleep were the same in two groups, except two symptoms; the pain that was relived by anti-acid [p<0.031] and presence of classical reflux symptoms [p<0.009] were seen in GERD patients. It was interest that in the history of the patients, heart burn [p<0.036] and regurgitation [p<0.002] were seen in patients with GERD-related chest pain. Clinical examination is important in diagnosing GERD in NCCP. Although the chest pain is the same in reflux and non refluxrelated NCCP, but the symptoms of heartburn or regurgitation in present or recent past history of patients are diagnostic for GERD-related chest pain