Comparison of 4 laboratory methods for detection of Helicobacter pylori

To compare the usefulness of 4 commonly used tests in the diagnosis of Helicobacter pylori [H. pylori] infection in Saudi patients with dyspepsia. Patients presenting with dyspepsia at the gastroenterology clinic of Aseer Central Hospital, Abha, Kingdom of Saudi Arabia between October 2005 to May 2006, who consented to participate in the study were enrolled. Patients who received anti-Helicobacter treatment or proton pump inhibitors within 30 days, or in whom endoscopy revealed cancer or gastro-esophageal reflux, were excluded from the study. Stool sample for H. pylori stool antigen [HpSA] were tested using the enzyme immunoassay technique 2-7 days before endoscopy. At endoscopy, gastric antrum mucosal biopsies were taken for campylobactelike organism [CLO] test, histology and culture. There were 72 males and 43 females, age range from 18-75 years, mean age 40.09 +/- 15.68. Seventy-nine patients out of the 115 [68.7%] samples were positive for H. pylori, by culture. Culture and histology agreed in 112 cases [97.4%] and disagreed in 3 cases [2.6%]. The sensitivities and specificities [%] of histology were 97.5 and 97.2, of HpSAg were 91.9 and 98.6, and of CLO were 79.7 and 97.2 tests against culture. Culture, histology, and H. pylori stool antigen tests all have comparable results, and there is no need to use all 3 at the same time, for the diagnosis of H. pylori infection. The CLO test is less sensitive, and of low negative predictive value

Presentation diagnosis and management of deep neck space infections in children

the objective of this study is to review the pattern, the presenting symptoms and signs, bacteriology and management of deep neck spaces infection [DNSI] in children. Method: This is a retrospective review of the charts of all children seen in Ear Nose and Throat [ENT] department of Assir central Hospital of King Khalid University Abha. Saudi Arabia. The patients database was searched by using the diagnosis Peritonsillar Space Infection [PTSI], Parapharyngeal Space Infection [RTSI]. The search included inpatients and those on outpatients' visits of patients below the age of 12 years from 1999-2002. The charts were reviewed and data regarding presentation, management and outcome were recorded. Some comparisons with current trend in the literature were made, Twenty- four patients were identified, 16 with PTSI, 6 with PPSI and 2 with RTSI. The most common symptoms in the 3 groups were fever and dysphagia. Intravenous antimicrobial therapy was the main stay of treatment in 16 [66.6%] of the 24 patients. In patients with already formed abscess antimicrobial therapy with surgical drainage was the preferred treatment. Positive culture was obtained in 75% of patients with the predominance of streptococcus species. Descending mediastinitis complicated one case. All the patients survived without residual sequalae. Deep neck space infections in children are rapidly progressive and often cause obstruction. Patients are effectively treated with surgical drainage coupled with intravenous followed by oral antibiotics

Vancomycin-resistant enterococci colonization of patients in Asir Central Hospital

Vancomycin - resistant Enterococcus [VRE] has now been identified in the Assir region of Saudi Arabia seven years after it was first reported in Riyadh in the kingdom in 1993. The reasons for this delay may be due to good infection control practices in our hospital and rational antibiotic usage, particularly of vancomycin and cephalosporins, although routine screening for VRE was not carried out. These reasons are further corroborated by the sporadic occurrence of the VRE in 3 patients in 1999 when they first appeared and later in 3 patients in 2000, to only one patient in 2001. Five out of seven isolates were from the respiratory tract and the remaining two from wound swabs. All strains were regarded as colonization rather than infection. The spread of VRE in the kingdom has far-reaching clinical and economic consequences, which may be averted by careful surveillance and prudent antibiotic use, particulary vancomycin and cephalosporins. It is hoped that this communication will alert physicians and microbiologists and increase their awareness to the potential serious threat of VRE in our community

Otolaryngologic manifestations of HIV disease

Human Immunedeficiency Virus/ Acquired Immunedeficiency Symdrome [HIV/AIDS] has assumed epidemic proportions. The disease is spreading at an alarming rate globally and it does not discriminate between race, gender or organs. Some features of this multi-organ disease are often missed by clinicians especially those working in busy centers; hence the need to frequently highlighting them. This review draws the attention of the otolaryngologist to the various manifestations of this infection in the Neck and Head region, where HIV disease is associated with a variety of problems and as high as 70% of HIV infected patients eventually develop such conditions. The review is grouped according to anatomic sites in order to facilitate retention and proper management