H. pylori infection among Buddhist monks in the selected regions of Myanmar.

Background: The prevalence of H. pylori infection is different in various regions of Myanmar, and the results of studies are contradictory regarding incidence of H. pylori infection. The infection rate of H. pylori among the monks could reflect the prevalence of the particular region studied. Objectives: The present study was aimed to determine the Helicobacter pylori status among asymptomatic Buddhist monks in Myanmar, and to observe the efficacy of clarithromycin based first line therapy by using C14 Urea Breath Test (PY test). Method: The Buddhist monks 17 years of age and above from the monasteries of both middle and lower Myanmar were selected by purposive sampling method. After filling out the questionnaire,H.pylori infection was detected by 14C-UBT (PY test, microCOUNTLite Liquid Scintillation Counter). H.pylori positive subjects were treated with 10 days' course of clarithromycin containing standard triple therapy as a first line.14C-UBT test was repeated at week 4 to check for H.pylori eradication status. Results: A total of 399 monks (from Bago and Mandalay city) were enrolled in this study. The mean age was 23.51+/ 8.907 years (range: 18 - 97). Urea breath test was positive in 65.4% of the monks. The prevalence of H. pylori infection was radically similar in different monasteries of different cities: Bago and Mandalay (67.52% ν 63.18%, p = 0.33). Among H. pylori infected monks, 67.7% achieved eradication with clarithromycin containing standard triple therapy. Conclusion: High H. pylori infection rates were found in asymptomatic Buddhist Myanmar monks and the standard triple therapy had moderate efficacy.

Chronic diarrhea and malabsorption due to hypogammaglobulinemia: a report on twelve patients.

Hypogammaglobulinemic sprue (HGS), which may predispose to infection, is uncommon. Twelve patients (all men; median age 29 years, 15–50) with HGS (4%) of 296 with chronic small bowel diarrhea and malabsorption syndrome (MAS) during a 10-year period were analyzed. Treatment of HGS was delayed due to misdiagnosis as intestinal tuberculosis (n=7) and diarrhea-predominant irritable bowel syndrome (n=1). All had diarrhea and weight loss (median loss 12 Kg). Associated conditions were clubbing, bronchiectasis, and seizure (2 patients each), and hypothyroidism (n=1). Laboratory parameters were urinary D-xylose median 0.46 g/5 g/5 h (range 0.2–1.6; normal ≥1), fecal fat 11.9 g/day (3.8–16.7; normal ≤7 g), serum IgA, IgG, and IgM: 23.5 mg/dL (17–114; normal 90–450), 584 mg/dL (145–1051; normal 800–1800), and 23 (0–40.3; normal 60–280). IgA, IgG, and IgM were low in 10, 10, and 11, respectively. Duodenal biopsy was normal in 6 patients and showed partial villous atrophy in 6 and nodular lymphoid hyperplasia in two. Associated infections were giardiasis (n=1), disseminated strongyloidiasis (1), small intestinal bacterial overgrowth (3), septicemia (2), and septic arthritis (1). Two patients died of sepsis, five are well on immunoglobulin and specific antiinfective treatment, and five are lost to follow up. Approximately 4% patients with MAS have hypogammaglobulinemia, which is often associated with infection and is diagnosed late.

Resistance patterns of microbes isolated from gastrointestinal tract.

Background: Digestive tract infection with clinical manifestation of diarrhea is an infectious disease that has the highest morbidity and mortality rate, especially in developing countries. Diarrhea causes mortality mostly in infants under one year old. Improvement in management is done continuously, but advances in diagnosis and therapy cannot be reached by developing countries. One of the etiological agents causing infection of digestive tract is bacteria. Therefore, knowledge of bacteria that cause gastrointestinal infection and their resistance patterns may support the management of this disease. The aim of this study was to examine microbes that were isolated from the digestive tract and their resistance patterns against antibiotics. Methods: Samples (stool, rectal/anal swab) were collected from the Clinical Microbiology Laboratory, FKUI during 2005-2008. Isolation, identifi cation and sensitivity test were conducted according to standard laboratory procedures. Interpretation of sensitivity test was done according to NCCLS/CLSI guidance. Data was analyzed using WHOnet version 5.3. Results: We found 28 isolates of pathogenic Escherichia coli, 1 isolate of S. paratyphi A and 4 isolates of yeasts. Pathogenic Escherichia coli were still sensitive against some antibiotics, but the sensitivity was reduced against amoxicillin, sulbenicillin, ticarcillin and trimethoprim/sulfamethoxazole. Conclusion: The most predominant gastrointestinal tract infection causing microbes was pathogenic Escherichia coli. These bacteria showed decrease sensitivity against some antibiotics commonly used to treat patients with gastrointestinal tract infection.

Bocavirus humano: Estudios en la literatura médica y en Chile / Human bocavirus: Studies in the literature and in Chile

The human bocavirus (HBoV), virus of the Parvoviridae family, discovered by molecular methods in 2005,has been reported in respiratory samples, stool, urine and blood, both in children and adults. Prevalence ratesrange from 0.8% in fecal samples of individuals with acute diarrhea, up to 19% in respiratory samples and blood.HBoV has been detected in up to 43% of nasopharyngeal samples in asymptomatic children. In Chile, HBoV wasdetected in 24.2% of nasopharyngeal swabs in children under 5 years of age with respiratory symptoms of which74% had coinfection with other viruses. In asymptomatic children under 5 years of age, 37.5% of NP sampleswere positive for HBoV. We discuss the role of HBoV as a causal agent of respiratory and/or enteric disease inlight of the high rates of coinfection and asymptomatic infections.

A preliminary study of acute gastrointestinal infection-associated functional dyspepsia / 中华内科杂志

To investigate the clinical characters and the possible pathogenesis of post infectious functional dyspepsia(PI-FD).Methods 550 patients suffered with acute gastrointestinal infection were followed-up for half year to evaluate the prevalence and symptoms of PI-FD.Meanwhile,thirty patients with non-special functional despepsra(NS-FD)and twenty healthy volunteers were enrolled.The number of mast cells,the total amount of tryptase and histamine released were determined.Furthermore,the ultra-structure of mast cells was observed by electron microscope,and the number of mast cells located within 5μm of nerve fibers was also countered.Results The prevalence of PI-FD is about 6.7%(35/522)after acute gastrointestinal infection in half year.The scores of epigastric pain,epigastric burning sensation and early satiety in patients with PI-FD were significantly higher than those in patients with NS-FD(P<0.05 for all),so did the scores of histological chronic inflammation in gastric mucusa(P<0.05).There is no significant difference in the number of mast cells between patients with PI-FD and NS-FD(P>0.05).However,the number of activated mast cells in patients with PI-FD is significantly higher than that in patients with NS-FD.The total amount of tryptase in gastric mucoss and the histamine released in patients with PI-FD is higher than that in patients with NS-FD and healthy volunteers(P<0.05 for all).Under the electron microscope,the number of mast cells located within 5μm of nerve fibers in PI-FD patients was significant higher than that in other two groups(P<0.05 forall).Conclusions PI-FD is probably a specific type of functional dyspepsia.Epigastric pain,epigastric burning sensation,and early satiety are the major symptoms in these patients.Mast cells maybe involved in the pathogenesis of PI-FD.

Pediatrician Perspectives on the Evaluation and Treatment of Acute Gastrointestinal Infections, Jeonbuk, South Korea, 2002

PURPOSE: This study was conducted to assess clinical practices related to the evaluation and treatment of patients with acute gastrointestinal infection(AGI) in infants and children. This survey also evaluated the current opinion regarding the use of rotavirus vaccine. METHODS: This survey was conducted using a self-administered questionnaire provided to 82 pediatricians in private clinics of Jeonbuk province. From April to June, 2002, 63 of 82 pediatricians(76.8 %) responded to the survey. RESULTS: The annual proportion of patients with AGI was 13%. The highest proportion of patients with diarrhea were reported for the months of October through December. For the treatment of diarrhea, pediatricians preferred to prescribe lactobacillus products, oral rehydration solution, enzyme products, anti-emetics, anti-diarrheal formula, nothing by mouth(NPO) and bowel movement inhibitors in descending order of frequency. Most pediatricians(79.4%) prescribed antibiotics in less than 20% of patients with AGI. Amoxicillin was the most commonly prescribed antibiotics followed by trimethoprim/sulfamethoxazole(TMP/SMX) and amoxicillin/clavulanate. Clinical manifestations that pediatricians considered as important factors in prescribing antibiotics were bloody diarrhea, mucoid diarrhea, high fever, persisting disease and abdominal pain. Diagnostic procedures that pediatricians preferred for AGI patients were stool examination(rotavirus antigen, RBC, WBC), abdominal X-ray, and serum electrolytes. Pediatricians had a strong interest in rotavirus vaccine(71.4%). CONCLUSIONS: Acute gastrointestinal illness remains a common problem, especially during the winter months in Korea. AGI manifesting as watery diarrhea is appropriately treated with commonly available agents but pediatricians appear ready to consider additional approaches to decrease the sizable disease burden of AGI among children in Korea.