Correlation between parasitemia and different complications of malaria – The clinical outlook

Background: Malaria is one of the most severe public health problems worldwide. India contributes a substantial burden of malaria. It can cause several complications. Aims and Objectives: This study was conducted to determine the association of parasitemia of current malaria with age of patients, hemoglobin level, liver function test (LFT), platelet count, previous history of malaria, and relapse/recrudescence of malaria up to 1 year. Materials and Methods: An observational study conducted in hospital settings included thin and thick smear preparation with Leishman’s staining to determine the parasitemia as per the WHO guidelines from the blood samples of 280 malaria parasite dual antigen (MPDA) kit positive patients and their details were taken during study period of 2 years. Hemoglobin, LFT, and platelet count were tested and they were correlated with parasitemia. The previous history of malaria was taken and follow-up was done up to 1 year for relapse/recrudescence and their association with parasitemia in current disease was evaluated. Statistical tool R was used for data analysis. Results: Age group 20–40 years was most commonly affected with maximum mean percentage parasitemia. Higher parasitemia was associated with higher grade of anemia, LFT derangement, and thrombocytopenia. Disease severity was maximum for mixed infection followed by falciparum and vivax malaria. About 9.28% of patients with the previous history of malaria developed lower parasitemia in current infection. Relapse rate in vivax malaria –2.325% and recrudescence rate in falciparum malaria–12.5%. Conclusion: Malaria parasitemia should be reported routinely as it carries prognostic importance.

Clinical study on the treatment of gastrointestinal neurosis with insomnia by combination of "stomach ten acupuncture" and domperidone tablets / 国际中医中药杂志

Objective:To study on the effect of "stomach ten acupuncture" combined with domperidone tablets on clinical symptoms and sleep quality of gastrointestinal neurosis patients with insomnia based on the theory of "stomach harmonious leading to restless".Methods:Randomized controlled trial. From March 2020 to March 2021, 98 patients with gastrointestinal neurosis and insomnia in our hospital who met the inclusion criteria were randomly divided into two groups, with 49 patients in each group. The control group took domperidone tablets orally, and the observation group was treated with "stomach ten acupuncture" on the basis of the control group. Both groups were treated for 8 weeks. Before and after treatment, TCM syndromes were scored, the severity of gastrointestinal symptoms was assessed with Gastrointestinal Symptom Rating Scale (GSRS), anxiety and depression were assessed with Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD), and sleep quality was assessed with Pittsburgh Sleep Quality Index Scale (PSQI).Results:After treatment, the scores and total scores of epigastric pain, belching, abdominal distension, anorexia, noisy acid regurgitation, tiredness and asthenia, constipation and loose stools in the observation group were significantly lower than those in the control group ( t values were 19.61, 19.30, 23.10, 22.05, 20.43, 21.81, 20.51, 16.38, respectively, P<0.01); the scores and total scores of typical symptoms, abdominal pain symptoms, reflux symptoms, diarrhea symptoms, constipation symptoms were significantly lower than those in the control group ( t values were 10.10, 11.14, 11.04, 9.31, 11.24, 5.30, respectively, P<0.01); HAMA and HAMD scores were significantly lower than those in the control group ( t values were 6.96 and 6.85, respectively, P<0.01). The scores of time to fall asleep (1.15 ± 0.56 vs. 2.11 ± 0.75, t=7.18), time to sleep (0.92 ± 0.63 vs. 1.52 ± 1.12, t=3.27), sleep quality (1.02 ± 0.66 vs. 1.96 ± 0.80, t=6.35), sleep efficiency (0.86 ± 0.62 vs. 1.68 ± 0.85, t=5.46), sleep disorders (0.92 ± 0.36 vs. 1.48 ± 0.55, t=5.96), daytime dysfunction (0.96 ± 0.42 vs. 1.97 ± 0.87, t=7.32), hypnotics (0.98 ± 0.45 vs. 1.81 ± 0.62, t=7.58) and total scores (6.85 ± 1.47 vs. 12.73 ± 2.95, t=12.49) were significantly lower than those in the control group ( P<0.01). Conclusion:The "stomach ten acupuncture" combined with domperidone tablets can improve the clinical symptoms and sleep quality of gastrointestinal neurosis patients with insomnia.

Clinical effect of radiofrequency introduction of tranexamic acid combined with Q-switched laser in the treatment of moderate to severe melasma / 中华医学美学美容杂志

Objective:To observe the clinical effect of tranexamic acid radiofrequency introduction combined with Q-switched laser comprehensive treatment of moderate to severe melasma.Methods:From December 2019 to September 2021, ninety-six female patients with melasma [age 24-59 years old, average age (37.8±6.0) years old] were admitted to the Plastic and Aesthetic Department of the First Affiliated Hospital of Henan University of Chinese Medicine. They were divided into the Q-switched laser group and the combined group by random number table method, with 48 cases respectively. The Q-switched laser group received Q-switched laser therapy, while the combined group received tranexamic acid radiofrequency introduction combined with Q-switched laser comprehensive therapy. The melasma area and severity index (MASI) scores were compared between the two groups before and after treatment. The clinical efficacy, adverse reactions and recurrence rates of the two groups were compared.Results:The MASI scores of the Q-switched laser group and the combined treatment group were (28.28±1.24) points and (28.52±4.25) points respectively before treatment, and (13.38±7.96) points and (9.11±5.48) points respectively after treatment. The MASI scores of the two groups were decreased after treatment, which of the combined group was lower than that of the Q-switched laser group ( t=3.06, P<0.05). The total clinical effective rate of the combination group (93.75%) was higher than that of the Q-switched laser group (79.17%) (χ 2=4.36, P<0.05). The incidence rate of hyperpigmentation (2.08%) and recurrence rate (2.08%) of the combination group were lower than those of the Q-switched laser group (14.58%, 16.67%) (χ 2=6.01, P<0.05). Conclusions:Tranexamic acid radiofrequency introduction combined with Q-switched laser comprehensive treatment can improve skin lesions and clinical efficacy in patients with moderate to severe melasma, and reduce pigmentation and recurrence.

Reoperation for cardiac myxoma: report of 23 cases / 中华胸心血管外科杂志

Objective:To summarize the experience of reoperation for 23 cases of cardiac myxoma recurrence.Methods:From January 2002 to December 2018, 1106 patients with cardiac myxoma underwent surgical treatment. Among them, 23 patients underwent reoperation after recurrence. 10 males and 13 females with an average age of (50.5±10.8) years old. There were 22 patients with secondary operation and 1 patient with four operations. 3 cases with mitral insufficiency and 1 case with tricuspid insufficiency. There were 20 patients with NYHA Ⅰ-Ⅱ and 3 patients with Ⅲ-Ⅳ. A total of 1 083 patients with cardiac myxoma undergoing primary operation were selected as the control group. The operation time, cardiopulmonary bypass time, aortic clamping time, ICU monitoring time, ventilator assisted breathing time, postoperative hospital stay, in-hospital mortality and cardiac ejection fraction at discharge were compared between the two groups.Results:8 cases (34.8%) had the first onset in the left atrial septum, and 15 cases (65.2%) in other parts. Recurrence site: left atrium in 17 cases(73.9%), left ventricle in 2 cases (8.7%), right atrium in 3 cases (13.0%), right ventricle in 1 case (4.3%). Reoperation accounted for 2.1% of cardiac myxoma surgery in the same period. The median recurrence time of 13 patients was 24 months. During the same period, mitral valve replacement was performed in 2 cases, mitral valvuloplasty in 1 case and tricuspid valve plasty in 1 case. The average operation time was (3.9±2.8) h, cardiopulmonary bypass time was (107.6±33.8) min, aortic clamping time was (64.9±23.8) min, ICU monitoring time was (20.1±16.0) h, ventilator assisted breathing time was (16.9±8.5) h, cardiac ejection fraction at discharge was 0.51±0.10, postoperative hospital stay was (8.3±1.5) days. The median follow-up time was 5 (1-18) years. One case (4.3%) died of all causes. There was no significant difference in ICU monitoring time, ventilator assisted breathing time, discharge cardiac ejection fraction, postoperative hospital stay and hospital mortality between reoperation patients and one operation ( P>0.05). Conclusion:Atypical cardiac myxoma has a high recurrence tendency after operation. Regular follow-up after the first operation of cardiac myxoma is a necessary means to early detect recurrence and avoid complications. Reoperation after recurrence can still achieve satisfactory results.

Clinical Observation of Modified Wufu Maxin Guijiang Decoction Treatment to Chronic Nonspecific Low Back Pain (NLBP) with Syndrome of Cold Dampness and Stasis / 中国实验方剂学杂志

Objective: To observe the short-term and long-term clinical effect of modified Wufu Maxin Guijiang decoction treatment to chronic nonspecific low back pain (NLBP) with syndrome of cold dampness and stasis, and to investigate the mechanism of anti-inflammatory and analgesia. Method: One hundred and nineteen eligible patients were randomly divided into control group (59 cases) and observation group (60 cases) by random number table. Patients in control group got acupuncture treatment and pilates. Based on the treatment in control group, patients in observation received additional modified Wufu Maxin Guijiang decoction, 1 dose/day. The course of treatment was 6 weeks in both groups. Before and after treatment, scores of short-form McGill pain questionnaire (SF-MPQ), Oswestry disability index (ODI), Japanese orthopaedic association (JOA) and syndrome of cold dampness were graded. After treatment, the patients made self efficacy assessment. Levels of thromboxane 2 (TXB2), 6-Keto-PGFla, tumor necrosis factor-α(TNF-α) and interleukins-1β(IL-1β) were detected both before and after treatment. Result: After treatment, the rank sum test showed that the clinical efficacy in observation group was better than that in control group (Z=2.226, PZ=2.104, PPP2, TNF-α and IL-1β and TXB2/6-Keto-PGFla were lower than those in control group (Pla was higher than that in control group (PConclusion: Based on the acupuncture treatment and pilates, modified Wufu Maxin Guijiang decoction in the treatment of chronic NLBP can ameliorate symptoms of pain, promote the recovery of function, and enhance activity of daily living in a short term, reduce the recurrence and stabilize the disease condition in a long term, with certain effects of anti-inflammatory and analgesia.

Recrudescence of Helicobacter pylori infection and its affecting factors / 中华临床感染病杂志

Helicobacter pylori ( Hp) is one of the most common infectious pathogens with a high infection rate and recurrence rate in humans worldwide.In developing countries , the prevalence of Hp infection can be up to 90%and its recurrence rate is also much higher than that in developed countries.The recurrence of Hp infection is either due to recrudescence or reinfection.Compared with reinfection , the time window for recrudescence is generally shorter.Recrudescence is generally considered as the recurrence of Hp infection within one year after eradication , followed by the recurrence of Hp-associated diseases shortly.This article reviews the factors related to Hp recrudescence.

Efficacy of distraction osteogenesis of mandible in adult patients with hemifacial deformity / 中华医学美学美容杂志

Objective To evaluate recurrence after mandibular distraction osteogenesis in adult patients with hemifacial microsomia using the digital three dimensional measurement.Methods Nine adult hemifacial microsomia patients were evaluated using the method of digital measurements with three dimensional computed tomography.Three observation points were studied:pre-operation (T0),post-operation (T1) and follow-up (T2).The length of ramus (H for normal side and h for affected side),the length of body (L for normal side and l for affected side) and distance between pogonion and facial midline (D) were measured and the recurrence rate (R) was calculated.Results Percentages of h/H at T0,T1,T2 were (58.19±12.06)％,(87.09±17.92)％and (81.13±30.57)％,which had statistical significance respectively.2.Percentage of l/L at T0,T1,T2 were (87.70±7.86)％,(90.69± 5.77) ％ and (90.11±5.62)％,respectively,which had statistical significance between T0 and T1.3.Lengths of D at T0,T1,T2 were (13.66±3.28) mm,(4.926±1.75) mm and (6.616±1.82) mm,respectively,which had statistical significance between T0,T1 and T0,T1.4.Average R was (22.80± 9.73) ％.Conclusions Varying degrees of recurrence do happen in both ramus and body of mandibular after distraction osteogenesis.While it is demonstrated that the mandible grows obviously after operation compared to that pre-operation,Meanwhile,the facial symmetry is also improved significiantly.

Risk factors and outcomes of multiple episodes of peritoneal dialysis related bacterial peritonitis / 中华肾脏病杂志

Objective To investigate the risk factors and prognosis of peritoneal dialysis (PD)related bacterial peritonitis.Methods The clinical data of patients with PD related bacterial peritonitis from January 2006 to September 2016 in our hospital were retrospectively analyzed and followed up until December 2016.Patients were divided into two groups according to the frequency of peritonitis,single episode group and multiple episodes group (no less than two episodes of peritonitis).According to efficacy of therapy,the episodes of peritonitis were divided into two groups,cured group (no relapse,recurrence or repeat episodes) and failure group (relapse,recurrent or repeat infection after the therapy of initial episode).Logistic regression and Cox regression were used to analyze the risk factors for outcomes.Results Five hundred and fifty-nine patients had PD related bacterial peritonitis,including 339 patients in the single episode group and 220 patients in the multiple episodes group.Logistic analysis showed low serum albumin level (OR=787,P ＜ 0.001) and malnutrition (OR=0.422,P ＜ 0.001) at baseline were independent risk factors for multiple episodes (P ＜ 0.001).The technical survival was better in the single episode group than that in the multiple episodes group (75.2％ vs 36.2％,P=0.001) while the difference of survival rate was not significant between the two groups (48.2％ vs 24.1％,P=0.592).Five hundred and thirteen episodes of peritonitis were analyzed,including 147 episodes in failure group (88 relapse episodes,16 recurrent episodes and 43 repeat episodes) and 366 episodes in cured group.There were 78 patients in failure group and 253 patients in cured group.Logistic analysis showed prolonged response time (OR=1.200,P ＜ 0.001),Gram-positive bacteria infection (OR=1.736,P=0.022),higher hs-CRP level (OR=1.004,P=0.013),lower serum albumin level (OR=0.936,P=0.008) were independent risk factors for failure of therapy.Multivariate Cox regression showed prolonged response time (HR=1.120,P=0.032),Gram-positive bacteria infection (HR=2.462,P=0.002),higher hs-CRP level (HR=1.007,P=0.009) were independent risk factors for failure of therapy and higher serum albumin level (HR=0.942,P=0.048) was an independent protection factor.Conclusions Low serum albumin level and malnutrition at baseline are independent risk factors for patients with multiple peritonitis episodes.Prolonged response time,Gram-positive bacteria infection,the high hs-CRP level are independent risk factors for relapse or recurrent or repeat episodes while high serum albumin level was an independent protection factor.

Tasa de reinfección por Helicobacter pylori en una cohorte de pacientes colombianos tratados exitosamente con seguimiento superior a 2 años / Helicobacter Pylori Reinfection Rate after More Than Two Years of Follow-up in a Cohort of Successfully Treated Colombian Patients

El Helicobacter pylori (H. pylori) infecta por lo menos a la mitad de la población mundial, aunque la prevalencia es más alta en países subdesarrollados. La tasa de reinfección es variable en las diferentes regiones y puede incluir recrudescencia de la infección o verdadera recurrencia. Hasta el momento hay pocos estudios en Colombia que hayan investigado la recurrencia de la infección y ninguno se ha realizado en Bogotá, Colombia. Objetivo: determinar la tasa de recurrencia de H. pylori en pacientes tratados eficazmente con 3 terapias triples diferentes. Materiales y métodos: estudio observacional analítico anidado en una cohorte de 180 pacientes a la que se le erradicó exitosamente H. pylori durante 2008-2009. La erradicación se verificó con test respiratorio con urea marcada y el tiempo promedio de seguimiento fue 43,7 meses (rango 31-56 meses). La recurrencia se investigó con la prueba de antígenos fecales monoclonales ImmunoCard STAT® HpSA (Meridian Bioscience Inc.). Resultados: se siguieron 86 pacientes y el porcentaje total de reinfección por H. pylori fue de 5,8% (5/86) y la tasa anual de reinfección fue de 1,59% (5/313,4 pacientes año x 100). El primer caso de reinfección se presentó a los 32 meses y los demás ocurrieron a los 37, 42, 44 y 56 meses de seguimiento. La tasa de reinfección calculada fue 1,8%/año después de 2 años de seguimiento. Conclusiones: la tasa de reinfección de H. pylori en Bogotá es baja e inferior a la previamente informada para otras regiones de Colombia.

Helicobacter pylori (H. pylori) infects at least half the world’s population although its prevalence is higher in developing countries. The reinfection rate varies from region to region and may include recrudescence of infection or true recurrence. So far there are few studies that have investigated recurrence of infections in Colombia, and none had been done in Bogota, Colombia. Objective: The objective of this study was to determine the rate of recurrence of H. pylori in patients who had been treated effectively with three different triple therapies. Materials and Methods: This was an observational study nested in a cohort of 180 patients in whom H. pylori had been successfully eradicated during 2008 and 2009. Eradication was verified with the labeled urea breath test. The average follow-up time was 43.7 months (range: 31-56 months). Recurrence was investigated with monoclonal stool antigen tests (ImmunoCard STAT®, HpSA (Meridian Bioscience Inc.)). Results: A total of 86 patients were monitored during the follow-up period. Out of this group the reinfection rate was 5.8% (5/86). The annual reinfection rate was 1.59% (5/313.4 patient-years x 100). The first case of reinfection was presented at 32 months, and the other cases occurred at 37, 42, 44 and 56 month of follow-up. The reinfection rate was 1.8%/year calculated after two years of monitoring. Conclusions: The H. pylori reinfection rate in Bogotá is low and is less than that previously reported for other regions of Colombia.

Outstanding insecurities concerning the use of an Ov16-based ELISA in the Amazonia onchocerciasis focus

In a recent issue of Memórias do Instituto Oswaldo Cruz, published in Rio de Janeiro in February 2014 (109: 87-92), Adami et al. have published a survey reporting Mansonella parasite prevalence in the Amazon Region. This report makes a useful contribution to the existing knowledge of filarial parasite distribution within the Amazon area, parasite prevalence rates in relation to age and occupation and provides observations on the possible clinical impact of Mansonella ozzardi. Their publication also provides an account of what appears to be a novel ELISA that has recently been used in the Simuliidae and Onchocerciasis Laboratory of the Oswaldo Cruz Institute, Rio de Janeiro, Brazil. We are concerned that the publication of this ELISA may have created an excessively positive impression of the effectiveness of the onchocerciasis recrudescence serological surveillance tools that are presently available for use in the Amazonia onchocerciasis focus. In this letter we have, thus, sought to highlight some of the limitations of this ELISA and suggest how continuing insecurities concerning the detection of antibodies to Onchocerca volvulus within the Amazonia onchocerciasis focus might be minimised.

Genetic diversity and complexity of Plasmodium falciparum infections in Lagos, Nigeria

<p><b>OBJECTIVE</b>To analyse the genetic diversity of Plasmodium falciparum (P. falciparum) using msp-1 and msp-2 as antigenic markers.</p><p><b>METHODS</b>Parasite DNA was extracted from 100 blood samples collected from P. falciparum-positive patients confirmed by microscopy, and followed by PCR-genotyping targeting the msp-1 (block2) and msp-2 (block 3) allelic families.</p><p><b>RESULTS</b>All the families of msp-1 (K1, MAD20 and R033) and msp-2 (FC27 and 3D7) locus were observed. Results revealed that K1 (60/100) was the most predominant genotype of msp-1 allelic family followed by the genotypes of MAD20 (50/100) and R033 (45/100). In the msp-2 locus, FC27 genotype (62/100) showed higher frequency than 3D7 genotype (55/100). The allelic families were detected either alone or in combination with other families. However, no R033/MAD20 combination was observed. Multiplicity of infection (MOI) with msp-1 was higher in the locality of Ikorodu (1.50) than in Lekki (1.39). However, MOI with msp-2 was lower in the locality of Ikorodu (1.14) than in Lekki (1.76). There was no significant difference in the mean MOI between the two study areas (P=0.427).</p><p><b>CONCLUSIONS</b>The observation of limited diversity of malaria parasites may imply that the use of antigenic markers as genotyping tools for distinguishing recrudescence and re-infections with P. falciparum during drug trials is subjective.</p>

A Case of Imported Plasmodium malariae Malaria

Malaria, the most common vector-borne parasite infection worldwide, results from infection by Plasmodium species. Approximately 80% of malaria cases are caused by P. vivax, which is broadly distributed from tropical to temperate regions; P. falciparum is the second most common infectious species. P. malariae and P. ovale are responsible for a relatively small proportion of malaria cases. Here, we report the case of a 23-yr-old Korean woman who acquired a P. malariae infection while visiting the Republic of Ghana in West Africa for business. She was diagnosed with P. malariae malaria on the basis of peripheral blood smear (PBS) and species-specific conventional and real-time PCR assays for 18S rRNA. She was treated with hydroxychloroquine, and the resulting PBS examination on day 2 suggested that negative conversion occurred. At her 1-month follow-up, however, both the PBS examination and molecular test for malaria demonstrated recurrent parasitemia. We started rescue therapy with mefloquine, and the patient recovered successfully. This is an important finding suggesting possible late recrudescence of a chloroquine-resistant P. malariae strain identified not only by its morphological features, but also by molecular tests.

Malaria y embarazo: un caso importado de África / Malaria and pregnancy: an imported case from Africa

La malaria es un importante problema de saluden el mundo y es la principal causa de enfermedad ymuerte en muchas zonas tropicales y subtropicales, principalmente en África subsahariana donde las infecciones por Plasmodium falciparum son las másfrecuentes, situación particularmente importante, porque esta especie puede provocar malariagrave e incluso la muerte. Según la OrganizaciónMundial de la Salud se presentan entre 350 a 500millones de casos por año, la gran mayoría enÁfrica subsahariana, donde se registran el 60...

Some features of primary and recrudescent amodiaquine-resistant Plasmodium falciparum infections in Nigerian children

Characteristics of primary and recrudescent Plasmodium falciparum infections were evaluated in 25 children who did not recover after amodiaquine (AQ) treatment. Recrudescence was detected by a thick blood smear and confirmed by polymerase chain reaction. Over half of recrudescent events occurred after 14 days of initiation of treatment and were associated with relatively low asexual parasitaemia. We examined the gametocyte sex ratio (GSR) in these children and in age and gender-matched controls that had AQ-sensitive (AQ-S) infections (n = 50). In both AQ-S and AQ-resistant (AQ-R) infections, the GSR was female-biased pre-treatment and became male-biased by the third day after treatment initiation. However, gametocyte males persisted after this period in children with AQ-R infections. AQ-recrudescent infections are relatively low (25 of 612.4 percent) in children from this endemic area.

Social and Family Support in Recrudescent Schizophrenia / 中国康复理论与实践

@#ObjectiveTo investigate the social and family support in the recrudescent schizophrenia. MethodsThe Social Support Scale and The Family Environment Scale were adopted in the 71 patients with recrudescent schizophrenia. Other 49 non-recrudescent patients were adopted as control. ResultsAs compared with controls, the scores of recrudescent schizophrenia in external support, social support, familiarity and expressiveness were obviously lower, while the scores of the conflict and the control were higher. Logistic regression showed the familiarity was the protective factor, while conflict and control were risk factors of recrudescence. ConclusionThe patients with recrudescent schizophrenia get lower social and family support which might play an important role in the recrudesce of the schizophrenia.

Establishment of an Helicobacter pylori-Eradication Regimen in Consideration of Drug Resistance , Recrudescence and Reinfection Rate of H . pylori / 대한내과학회지

OBJECTIVE: This study was conducted to establish an ideal treatment regimen for H. pylori eradication in three aspects: clinical, microbiological, and reinfection. METHODS: Four hundred thirty two patients with H. pylori positive peptic ulcer were randomized to receive two types of triple therapy: one includes colloidal bismuth subcitrate, metronidazole and tetracycline (BMT), and the other includes omeprazole, amoxicillin and clarithromycin (OAC). RESULTS: More than 50% of symptom reduction within 1 week was 94.4% both in OAC and in BMT group. The percentages of side effects were 21.6% and 27.1% in OAC and BMT regimen, respectively. Good compliance with at least 85% intake was 99.0% and 95.2% in OAC and BMT regimen. The eradication rates of H. pylori were 85.9% and 89.1% in OAC and BMT regimen. Resistance rates to metronidazole and clarithromycin were 40.6% and 10.2% by E test, 74.3% and 27.0% by broth microdilution, and 45.3% and 10.9% by disk diffusion method. The eradication rates for H. pylori was 100% and 77.8% by BMT in patients with metronidazole-sensitive and -resistant strains, and 100% and 80.0% by OAC with clarithromycin- sensitive and -resistant strains, without significance by their resistances. The recrudescence rate within 1 year after eradication was 21.2% and 14.2% for OAC and BMT regimen without significant difference. The reinfection rate after 1 year was 4.0% and 5.0% for OAC and BMT regimen. CONCLUSION: Because the eradication rate of BMT regimen is 89.1% in spite of high metronidazole resistance rate, and there was no statistical difference in the aspects of symptom reduction, side effect, compliance, recrudescence and reinfection rate, BMT regimen is as favorable as OAC to eradicate H. pylori.