ABSTRACT
Helicobacter pylori has been strongly associated with peptic ulcer diseases, chronic gastritis, ulcers, and reported as a risk factor for gastric cancer, too. The vaculating cytotoxin [vacA], the cytotoxin associated genes [cagA], the induced by contact with epithelium factor antigen [iceA gene], blood adhesion binding antigen [babA2], and outer membrane protein oipA have been described as different virulence factors of H. pylori. The aim of this study was to investigate the prevalence of the vacA, cagA, cagE, iceA, babA2 and oipA genotypes of H. pylori isolates from patients with upper gasterointestinal problem or dyspepsia. H. pylori isolated from endoscopic biopsies obtained from 222 studied patients. PCR was done only on cultured positive samples. The vacA alleles, cagA, cagE, iceA, babA2 and oipA genotypes were determined by PCR. The isolation rate of H. pylori strains from culture of gastric biopsies was 16.7%. The vacA alleles s1, s2, m1 andm2 were detected in 20 [54.1%], 14 [37.8%], 9 [24.3%] and 23 [62.2%] isolates, respectively. VacA s1c genotype was detected in 70.3% of isolates. s1m2 was the most frequent vacA allelic combination in the examined H. pylori strains. ThecagA gene was detected in 62.2%, cagE in 40.5%, iceA1 in 48.6%, iceA2 in 16.2%, oipA in 81.1% [95% CI: 0.0902-0.1798] and babA2 in 94.6% [95% CI: 0.113- 0.207]. A significant correlation was observed between vacAs1 and cagA genotypes [P < 0.008], vacAs1/cagE [P = 0.001], vacAs2/cagA [P < 0.047], and vacAs2/cagE [P = 0.016] with Non-ulcer dyspepsia; but there were not observed any correlation between other virulence markers. No significant correlation was found between the existence of vacA, cagA, cagE, iceA, babA2, and oipA genes with peptic ulcer diseases and non-ulcer dyspepsia groups of studied patients
ABSTRACT
Non-alcoholic steatohepatitis [NASH] is a common liver disease that, in the absence of treatment may progress to cirrhosis. There is a strong association of NASH with insulin resistance; thus insulin sensitizer drugs have been used for this disease. The aim of this study was to compare the effect of pioglitazone with metformin on liver transaminases, the HOMA Index, and adiponectin in patients with NASH. This double-blind clinical trial was performed on 80 patients diagnosed with NASH according to imaging and abnormal liver function tests. Patients were divided into two groups [n=40] based on block randomization. In one group patients received metformin [500 mg, bid] and the other group received pioglitazone [30 mg, qd] for 4 months. AST, ALT, alkaline phosphatase, FBS, and lipid profiles were evaluated before the study and at two and four months after. HOMA Index and adiponectin levels were evaluated before the study and at four months later. Data analysis was carried out with SPSS using repeat measurement and ANCOVA tests. p<0.05 was considered significant. We included a total of 40 patients [37 males] in the pioglitazone group and 40 patients [31 males] in the metformin group in this study. There was no significant difference in both groupsin terms of age, sex, and weight. ALT and alkaline phosphatase levels decreased significantly in the pioglitazone group compared with the metformin group. There was no significant difference in both groups in AST, FBS, TG, LDL, HDL, and HOMA Index levels. After treatment, the adiponectin level in the metformin group was less than the pioglitazone group. The results showed that pioglitazone was more effective than metformin and led to a greater reduction in the level of liver transaminases. Pioglitazone and metformin had the same effect on FBS and HOMA Index. Both drugs reduced adiponectin levels, but this effect in pioglitazone group was less than the metform in group.