Salivary PCR detection of Helicobacter pylori DNA in Egyptian patients with dyspepsia

Several methods are available for detecting Helicobacter pylori infection: [1] invasive methods based on gastric biopsies, [2] non invasive methods like Urea Breath Test [UBT], serology and stool antigen tests. Importance of salivary PCR in detection of H. pylori is still questionable. To evaluate the role of salivary PCR technique in detecting H. pylori gastric affection in Egyptian patients with dyspepsia and in differentiating between functional dyspepsia and acid-ulcer syndrome. This study included 60 patients with dyspepsia classified into three groups: [Group 1] patients with gastric H. pylori and ulcers or erosions [n = 20], [Group 2] patients with gastric H. pylori and no ulcers or erosions and had functional dyspepsia [n = 20], [Group 3] patients without H. pylori and had functional dyspepsia [n = 20]. All underwent upper gastrointestinal endoscopy with biopsies, rapid urease test and salivary samples for H. pylori PCR. Significant difference between the three groups regarding salivary PCR values. No significant difference between Group 1 and Group 2 but both had significant difference with Group 3, significant difference between gastric H. pylori positive patients [n = 40] and negative ones [n = 20]. Salivary PCR test had sensitivity of 85%, specificity of 70% in diagnosing H. pylori. PCR value of 534000 Iu/ml had best sensitivity [75%] and specificity [100%] for diagnosing H. pylori, highly significant positive correlation between H. pylori gastric affection and salivary PCR values. No significant difference between patients with acid ulcer syndrome [n = 20] and those with functional dyspepsia [n = 40] as regard salivary PCR mean values. Salivary PCR test showed sensitivity of 100%, specificity of 50% in differentiating between patients with acid ulcer syndrome and those with functional dyspepsia. PCR value of 440000 Iu/ml had best sensitivity [100%] and specificity [55%] in differentiating acid ulcer syndrome from functional dyspepsia with non significant. H. pylori salivary PCR may be of value in diagnosing H. pylori gastric affection and is strongly correlated with it but it is of limited value in differentiating between acid ulcer syndrome and functional dyspepsia

Prevalence of asymptomatic bacteriuria in Egyptian children and adolescents with type 1 diabetes mellitus

The prevalence of asymptomatic bacteriuria [ASB] and associated risk factors were investigated in 100 Egyptian children and adolescents with type 1 diabetes mellitus and 100 age and sex matched healthy controls. All were subjected to clinical evaluation and assessment of mean random blood glucose, mean glycosylated hemoglobin [HbAlc]; microalbuminuria and midstream urinary samples were collected for complete urine analysis and two consecutive urine cultures and sensitivity tests. The prevalence of ASB was higher among diabetics than controls [30% versus 14%, p<0.01] and was more among older age [p=0.033] and female patients [p<0.001]; especially postpubertal. Microalbuminuria [36.7%] and microvascular complications [50%] were significant risk factors for ASB in patients while metabolic control and disease duration were not relevant to ASB [p>0.05]. Pyuria was a strong predictor of bacteriuria in patients [80%] and controls [100%]. The most common isolates were E. coli in patients [30%] and Pseudomonas in controls [57.1%]. Gram positive isolates were detected in 46.7% of diabetic patients but not in controls. ASB is more prevalent among type 1 diabetic patients in the pediatric age group. Screening for ASB is warranted in diabetic patients with risk factors especially if pyuria is detected in their urine analysis