Prevalence of helicobacter pylori vacA, cagA, cagE, iceA, babA2, and oipA genotypes in patients with upper gastrointestinal diseases

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

Serotyping, antibiotic susceptibility and related risk factors aspects of nasopharyngeal carriage of streptococcus pneumoniae in healthy school students

Streptococcus pneumoniae is an important problem worldwide and nasopharyngeal colonization plays significant role in pneumococcal infections. The aims of this study were to determine the nasopharyngeal colonization rate, serotyping, antibiotics susceptibility and study the risk factors for nasopharyngeal colonization with S. pneumoniae in students in Kashan, Iran. A cross-sectional study was conducted on children aged 7 to 19 years from December 2011 to November 2012. Nasopharyngeal swabs were plated onto brain heart infusion agar plates with 5% sheep blood and 4 micro g/ml of gentamycin. Antimicrobial susceptibility profiles were determined on Mueller-Hinton agar in accordance with CLSI. S. pneumoniae strains were investigated for the presence of the most common pneumococcal serotypes using a multiplex polymerase chain reaction. 13.9% were found to be carriers. The most prevalent serogroups were 19F [30%], 6A/B [18.9%], 15A [16.5%], 11 [11.3%], 23F [8.2%], 1 [6.2%], 19A [3.4%], and 35B [2.4%]. Nine strains [3.1%] were non-typeable. The carrier rate was significantly higher in 12 to15 year old age group. Upper respiratory tract infections within the last month [OR=1.5, P<0.011], previous hospitalization [OR=1.6, P<0.001], previous antibiotic usage last two weeks [OR=1.89, P<0.001], rhinorea [OR=1.9P<0.001], male sex [OR=3.5 P< 0.001] and passive smoking [OR=1.56, P< 0.001] have been determined to be risk factors for S. pneumoniae carriage. The highest pneumococcal resistance was to tetracycline [25.4%]. All strains were susceptible to linezolid and levofloxacin. Our information leads to an important source to screen the future impact of pneumococcal vaccination on bacterial colonization

Influence of body mass indexes on response to treatment in acute asthma

Increases in body mass index [BMI] are reported to influence asthma response to treatment. The aim of this study was to investigate the relationship between BMI and response to treatment in a group of patients that were referred for asthma control. Effectiveness measurements in this analysis included percentage of changes in forced volume in 1 second [FEV1], forced volume capacity [FVC], FEV1/FVC, and forced expiratory flow between 25% and 75% of FVC [FEF25-75%]. A total of 293 subjects with asthma of both genders and above 18 years of age were divided into the following BMI categories: 107 [36.5%] non-obese [BMI <25], 186 [63.5%] overweight and obese [BMI >/= 25]. Percentage of change was defined as change in variable between baseline and end-of-treatment. Analyses of non-obese vs. overweight/obese asthmatics demonstrated non-significant differences in baseline FEV1 [1.62 +/- 0.56 Lit vs. 1.63 +/- 0.56 Lit L, P=0.89]; FVC [2.58 +/- 0.73 Lit vs. 2.47 +/- 0.82 Lit, P=0.25]; and FEF25-75% [1.04 +/- 0.55 ml/sec vs. 1.05 +/- 0.50 ml/sec, P=0.47] respectively. Compared with non-obese subjects, in overweight/obese subjects with asthma were less responded to treatment. Percentage changes of FEV1, FVC, FEF25-75%, and FEV1/FVC in non-obese versus obese/overweight patients were: 79.57 +/- 55.14% vs. 62.13 +/- 41.72%, P=0.005; 47.71 +/- 33.76% vs. 39.93 +/- 28.30%, P=0.036; 151.98 +/- 127.82% vs. 123 +/- 91.12%, P=0.041; 20.54 +/- 15.63% vs. 15.63 +/- 11.32%, P=0.005; respectively. Percentage changes of spirometric values to treatment in over weight/obese asthmatic patient were lesser in compared with non-obese subjects

Comparison of newborn outcomes in women with gestational diabetes mellitus treated with metformin or insulin; a randomised blinded trial

Few studies have been done on the use of metformin in pregnancy and their results were not similar, therefore this research is performed to compare neonatal outcomes of metformin and insulin in the treatment of gestational diabetes. In this prospective randomized trial, 200 pregnant women within their 24[th] to 34[th] weeks of gestation with gestational diabetes, single fetus pregnancy, and in need of hyperglycemia treatment were entered and grouped as either metformin or insulin. Data related to maternal and neonatal outcomes were recorded and analyzed. Considering data recorded of HbA[1c] at the beginning of pregnancy, pregnancy induced hypertension, preeclampsia, birth weight, dystocia, first and 5[th] min APGAR, neonatal sepsis, rout of delivery, liver function tests of neonate, hypoglycemia, anomaly, and still birth, there were no significant statistical differences between groups. The end pregnancy HbA[1c], maternal weight gain during pregnancy, preterm labor, neonatal jaundice, respiratory distress and hospitalization of infants were higher in insulin group. Considering data from this study, metformin is efficient to control hyperglycemia in pregnancy. It is suggested performing more studies to evaluate long term side effects of metformin in pregnancy with higher sample size and longer follow-up of newborns

Relationship of pleural and serum cholesterol and lipoprotein levels in exudative and transudative effusions

This study aimed to assess whether total cholesterol [CHOL], low-density lipoprotein cholesterol [LDL], and high-density lipoprotein [HDL] are sensitive markers for discriminating between transudative and exudative pleural effusions [PE]. In this study CHOL, LDL, HDL, TG, protein and LDH were analyzed in PE and serums of 119 patients with pleural effusion out of which 49 had transudative and 70 had exudative pleural effusion. Sensitivity, specificity, and area under the curve [AUC] of CHOL, LDL and HDL were measured by receiver operating characteristic curve [ROC]. Pleural fluid CHOL, LDL and HDL levels were significantly lower in the transudate group compared to the exudate [29.6 +/- 16.3 mg/dl versus 65.24 +/- 25.9 mg/dl, p < 0.001; 17 +/- 14.8 mg/dl versus 43.94 +/- 21.6 mg/dl, p < 0.001; and 9.2 +/- 4.8 mg/dl versus14.9 +/- 6.3 mg/dl, p<0.001, respectively]. Sixty-seven percent of cases with pleural transudates were secondary to heart failure, while 41% and 39% of those with pleural exudates were of parapneumonic effusion and neoplastic origin, respectively. Pleural fluid CHOL, LDL and HDL levels were significantly higher in malignant pleural effusion [71.5 +/- 18.6, 48.1 +/- 17.4 and 16.1 +/- 6.6mg/dl, respectively], and in parapneumonic effusion [70.7 +/- 28.5, 49.4 +/- 22.4 and 14.7 +/- 6.4 mg/dl, respectively] than in heart failure [30.6 +/- 11.9, 17.5 +/- 10.4 and 9.6 +/- 5.4 mg/dl, respectively]. The optimum cut-off value for pleural fluid CHOL level of >/= 38 mg/dL had a sensitivity of 87% and 80% specificity, for LDL pleural fluid level a cut-off value of >/= 22.5 mg/dl had a sensitivity of 87% and 78% specificity, and for HDL pleural fluid a cut-off value of >/= 10.5 mg/dl had a sensitivity of 70% and 69% specificity. AUC values were 0.906, 0.883, and 0.783, for CHOL, LDL, and HDL of pleural fluid, respectively. We conclude that pleural fluid CHOL, LDL and HDL are significantly increased in exudative effusions compared to the transudative ones. Measurement of CHOL, LDL and HDL concentrations in pleural effusions is useful in distinguishing exudates from transudates