Success rate of helicobacter pylori eradication using vonoprazan-based triple therapy as first-line treatment at a tertiary hospital in Baguio City

Background@#Helicobacter pylori is acknowledged to cause chronic gastritis and peptic ulcer disease and is also implicated in gastric carcinoma and B cell mucosa-associated lymphoid tissue (MALT) lymphoma development. It has infected at least half of the world’s population. Proton Pump Inhibitors (PPIs) have been the conventional antacid of choice for H. pylori eradication triple therapy, while vonoprazan is a novel drug of its class that was recently studied but is limited to an oral form which makes it less feasible in cases of acute gastrointestinal bleeding. According to several systematic reviews and meta-analyses, the vonoprazan-based triple therapy regimen for H. pylori eradication is a non-inferior treatment to traditional PPI-based treatment when given in 1 week for patients having no active gastrointestinal bleeding. Likewise, a safety profile has been established with its use, offering an alternative treatment option.@*Objectives@#The research aims to identify the H. pylori eradication rate among H. pylori-positive patients who received a vonoprazan-based triple therapy regimen as outpatients, describe their clinicodemographic profile, and identify potential side effects associated with the treatment.@*Methods@#This study utilized a cross-sectional study design in a single tertiary institution from January 2018 to December 2020. Descriptive and inferential statistics were used in data analysis. Frequency and percentage were utilized to determine the success and failure rates of H. pylori eradication, describe the clinicodemographic profile of patients who underwent vonoprazan-based triple therapy, and the potential side effects with treatment. The chi-square test of independence was applied to assess the significant difference in the successful and failed eradication rates across the clinicodemographic profile. A P-value of <0.05 was considered statistically significant, and statistical analyses were conducted using SPSS version 20.0.@*Results@#32 (91%) had successful H. pylori eradication, with the majority of them determined by a negative 13C-UBT result (62.8%) and the rest with a negative H. pylori stool antigen test (28.6%). The majority of patients undergoing H. pylori eradication using a vonoprazan-based regimen with documented successful eradication belonged to the 19 to 39 years old group (50%), clerical support workers (40.63%), with a chief complaint of abdominal pain (46.88%), with no known co- morbid illness (75%), and with endoscopic finding limited to antral gastritis alone (46.88%). This study described only two documented side effects of treatment: diarrhea and abdominal pain (2.9%).@*Conclusion@#Vonoprazan-based triple therapy, given at 20 mg twice daily for 7 days, has shown a high H. pylori eradication rate among hemodynamically stable patients, without active bleeding, and treated on an outpatient basis. There was a significant difference in eradication success and failure across co-morbidities, with a higher success rate in those without co-morbid illness. A high success rate was also seen in patients <40 years of age, with a single chief complaint, and with antral gastritis as the sole endoscopic finding.

Relationship between Helicobacter Pylori and Male Infertility / 中山大学学报(医学科学版)

Helicobacter pylori （H.pylori） is a gram-negative， spiral-shaped bacillus and it is the only bacteria known in medicine that can live in the stomach， with a high infection rate in the population. Besides its confirmed link to peptic ulcer and chronic gastritis， H.pylori has recently been found to be associated with many extragastric diseases， including male infertility. The incidence of male factor infertility keeps rising， but some reasons remain unclear. This paper summarized the research on H.pylori and infertility abroad in recent years in order to speculate and explore the possible relationship between them.

Helicobacter pylori and non-alcoholic fatty liver disease: Is there a relationship?

Non-alcoholic fatty liver disease (NAFLD) is distinguished by liver injury due to metabolic stress, identified by diffuse hepatocyte macrovascular fatty lesions [1]. The prevalence of NAFLD is rising yearly, with a worldwide incidence rate between 20% and 30% [2]. Complex hereditary variables, improper lipid metabolism, and insulin resistance are the key characteristics of the etiology of NAFLD [3]. The research has revealed that aberrant lipid metabolism in the liver can result in dysbacteriosis in the intestinal flora; abnormality of the flora eventually encourages lipid deposition in the liver. Additionally, there is mounting proof that NALFD is linked to abnormalities in the gut flora, particularly Helicobacter pylori (H, pylori) [4]. Gram-negative bacillus, termed H pylori, has colonized the deep layers of the gastric mucosa. [5]. The global infection rate for H pylori is about 50% or higher [6]. According to research, H pylori causes gastric cancer, gastrointestinal lymphoma, peptic ulcers, and chronic gastritis [7]. Additionally, some researchers indicate a connection between H pylori and liver cancers, diabetes, and improper lipid metabolism [8]. Some studies have discovered that infection by H pylori is one of the elements for NAFLD to progress and that getting rid of H pylori can partially stop the evolution of NAFLD [9].

Detection of helicobacter pylori infection by helicobacter pylori IgG serology test in pediatric patients at the Philippine General Hospital

Objective@#To determine the validity of serum H. pylori IgG in the detection of H. pylori-associated gastroduodenitis in patients with gastrointestinal symptoms. @*Methods@#Cross-sectional study which included consecutive patients 1-18 years old with upper gastrointestinal symptoms who underwent esophagogastroduodenoscopy. H. pylori infection was diagnosed by positive tests for both rapid urease test (RUT) and Giemsa stain of gastric biopsies. H. pylori IgG (ELISA) serology was also performed.@*Results@#Twenty-five patients [Mean (SD) age: 12 (4.5) years, 68% females] were included. Majority presented with epigastric pain (64%) and had endoscopic gastritis (84%). Four patients had ulcers (1 antral, 3 duodenal). Giemsa stain was positive in 16 (64%) patients and RUT in one. Prevalence of H. pylori infection was 4%. Serum H. pylori IgG test was positive in two; borderline in three with a 100% sensitivity, 80% specificity, and a positive and negative likelihood ratio of 10.9 and 0.6.@*Conclusion@#The present study showed a low prevalence of H. pylori infection, thus, the validity of the H. pylori serology could not be adequately evaluated. We presently could not recommend the serum IgG in the detection of H. pylori gastroduodenitis in our setting.

Intrafamilial infection of Helicobacter pylori in Zhengzhou area / 中华全科医师杂志

Objective:To investigate Helicobactor pylori (H. pylori) infection status and interfamilial transmission pattern in Zhengzhou area. Methods:A cross-sectional study was conducted from September 2020 to march 2021, among 731 individual from 266 families randomly selected from 9 communities of Zhengzhou area. H. pylori infection status was determined by serum antibody tests, and 13C-urea breath test was performed in the previously eradicated population to clarify the current infection status. The individual and familial infection rate, infection status for couples and children and adolescent were analyzed. Results:Among 731 individuals from 266 families, 397 of them were H. pylori positive. The individual infection rate was 54.31% (397/731); among infected individuals 77.83% (307/397) were infected with type Ⅰ strain, 22.67% (90/397) were infected by type Ⅱ strain. Annual household income ( χ2=0.419, 0.410, 0.213, all P>0.05), smoking history (χ 2=0.071, P>0.05), drinking history ( χ2=0.071, P>0.05), dining place ( χ2=0.009, P>0.05), gastrointestinal symptoms ( χ2=0.047, P>0.05), family history of gastric disease ( χ2=0.069, P>0.05), and history of gastric cancer ( χ2=0.004, P>0.05) had no significant differences between H. pylori-positive and -negative groups, but the infection rate in individuals with higher education level was lower ( χ2=4.449, P<0.05). The infection rate was significantly higher in≥18 age groups compared with<18 age groups ( χ2=6.531, 23.362, 20.671, 24.244, 37.948, 14.597 and 5.170, all P<0.05). The familial H. pylori infection rate was 87.59% (233/266), and in 61 families all member were infected (26.18%, 61/233). The positive rate was 23.08% (6/26) in 50 families with children under 18 years when both parents were infected. Among 231 coupled families, both couples were infected in 78 families (33.76%), one couple was infected in 113 families (48.92%), and both couples were not infected in 40 (17.32%). With the increase of marriage time, the infection rate of both spouses increased significantly ( χ2=7.775, 12.662, 15.487, all P<0.05). Conclusions:The distribution of H. pylori infection presents a family cluster pattern, and intrafamilial infection is an important transmission rout of H. pylori. The type I strain of H. pylori is the dominate strain in this area.

Analysis of the relation between elevated neutrophil lymphocyte ratio, and erythrocyte sedimentation ratein Helicobacter pyloripositive chronic gastritis patients

Background:Aim of the study was to analyse the relation between elevated neutrophil lymphocyte ratio (NLR), and erythrocyte sedimentation rate (ESR) in Helicobacter pylori(H. pylori)positive chronic gastritis patients, as compared to the control group containing H. pylorinegative chronic gastritis patients.Methods:Chronic gastritis patients were segregated in equal numbers based on H. pyloristatus. NLR was calculated, and ESR noted from the observations, comparison was done between the control and the study groups.Results:A total of 100 patients were included in the study. The 50 each from the control and study group. An observation of elevation in NLR and ESR in H. pyloripositive chronic gastritis patients, as compared to the control group was seen. With an average NLR of 2.43 and 1.43, in the control and study group, respectively.Conclusions:Raise in NLR in H. pyloripositive chronic gastritis patients with an associated raise in ESR suggests, the severity of the infection and the need for eradication and prevent complications

Prevalence of Helicobacter pylori infection among asymptomatic children in southeastern Brazil: a cross-sectional study

ABSTRACT BACKGROUND: The prevalence of Helico bacter pylori (H. pylori) infection is decreasing worldwide, but is still high in developing countries. We previously observed an H. pylori infection rate of 52% among children and adolescents with chronic non-ulcer dyspepsia. OBJECTIVE: To investigate the prevalence of H. pylori infection among asymptomatic children living in a single region and to evaluate the risk factors for this infection. DESIGN AND SETTING: Cross-sectional study in which 161 children aged 5-13 years (mean age 7.8 years), at a public school in Botucatu, state of São Paulo, southeastern Brazil, were assessed. METHOD: The children's H. pylori infection status was determined through the urea breath test and the risk factors for acquisition of the infection were determined based on a sociodemographic questionnaire. RESULTS: The overall prevalence of H. pylori infection was 20.5%: 18.7% among females and 22.2% among males. The results from the sociodemographic survey did not differ between children with and without H. pylori infection. 30.9% of the children had previous records of upper gastrointestinal symptoms, which consisted of H. pylori infection in only 26.5% of these cases. Family histories of gastritis and peptic ulcer disease were found in relation to 50% and 32.3% of the children with H. pylori infection respectively. CONCLUSION: The prevalence of H. pylori infection among asymptomatic children in southeastern Brazil is lower than that recorded among symptomatic children in the same region and similar to the prevalence of H. pylori infection observed in developed countries.

Effect of H. Pylori on Fibrinogen Level among Sudanese Patients at Khsartoum State

Background: Helicobacter pylori (H. pylori) is a gram-negative, spiral shaped pathogenic bacterium that specifically colonizes the gastric epithelium causing chronic gastritis, peptic ulcer disease, and/or gastric malignancy.Aim: To assess the effect of H. pylorion fibrinogen level of Sudanese patients with diabetes millets (D.M) living in Khartoum state.Subjects and Methods: This was case control study conducted among Sudanese diabetic patients during the period from May 2018 to July 2021. A total of 181 diabetics patients are involved in this study. Citrated blood and stool samples were collected from each participant. All stool samples were tested for the presence of H. pylori antigen by using commercially available H. pylori antigen detection card. Based on the result examination for H. pylorithe study population are sub grouped in two groups one group 124 of cases with Positive H. pylori antigen and another group 57 of controls with negativeH. pylori infection. Both groups were assessed for the fibrinogen level. Data was gathered and analyzed by using SPSS version 20.Results: Our results revealed that cases have slightly higher values of fibrinogen levels 326.29± 89.99 mg/dl compared to 309.47± 90.82 mg/dl for control group. However, the statistical analysis indicate that the difference was remain insignificant with P-value of 0.246. Among cases group gender concerned the fibrinogen concentration mean in the plasma of male 336.2±98.5 mg/dl was higher than female 311.1±73.4 mg/dl.Conclusion:they were insignificant association between fibrinogen level and presence of H. pyloriinfection among Sudanese diabetic patients. gender concerned the fibrinogen concentration in the plasma in H. pylori among males showed higher levels than females.

Effect of H. pyloriamong Diabetic Patients Living in Khartoum State, Sudan

Background:Studies suggest an association between Helicobacter pylori (H. pylori)infection and extra gastrointestinal disease. Limited studies provided conflicting results on the association between H. pyloriinfection and diabetes. The present study was aimed at examining the association between H. pyloriinfection and diabetes among Sudanese patients.Methods:This was case control study conducted among Sudanese diabetic patients during the period fromMay 2018 to July 2021. A total of 181 diabetics patients are involved in this study. Blood, stool samples were collected from each participant. All stool samples were tested for the presence of H. pylori antigen by using commercially available H. pyloriantigen detection card. Based on the result examination for H. pylori the study population are sub grouped in two groups one group 124 of cases with Positive H. pyloriantigen and another group 57 of controls with negative H. pylori infection. Both groupswere assessed for the level of fasting blood glucose. Data was gathered and analyzed by using SPSS version 20.Results: among cases group the mean of fasting blood glucose was 201.94± 90.45 mg/dl compared to 199.40± 97.83 mg/dl among control group. The statistical analysis was showed insignificant difference between cases and controls in the level of fasting blood glucose with P-value of 0.864 . In addition, among cases group the mean of male’s blood glucose 213.0±91.52 mg/dl was higher than females blood glucose level 185.0 ±87.0 mg/dl.Conclusion: They were insignificant association between blood glucose level and H. pylori infection among diabetes patents, However, the subgroup analysis suggested that H. pylori infection was possibly associated with increased risk of diabetes among males. Future cohort studies are needed to verify this association in females and to address possible implication in the prevention of diabetes

The Assessment of Gastric Antral Wall Thickness in Helicobacter pylori Gastritis by Abdominal Ultrasonography, Case-Control Study (2016-2018)

Abdominal ultrasonography is effective in the visualization of gastric wall layers and measuring its thickness. The study aimed to assess gastric antral wall thickness in patients with H. pylori gastritis by abdominal ultrasonography and to study its predictive value in detecting H. pylori gastritis.

NOD1 rs2075820 (p.E266K) polymorphism is associated with gastric cancer among individuals infected with cagPAI-positive H. pylori

BACKGROUND: Helicobacter pylori is detected by pathogen recognition receptors including toll-like receptors (TLR) and nucleotide-binding oligomerization domain (NOD)-like receptors, eliciting an innate immune response against this bacteria. The aim of this study was to assess if polymorphisms of TLR2, TLR4, TLR5, NOD1 and NOD2 genes are associated with gastric cancer, in particular in individuals infected with H. pylori. RESULTS: A case-control study of 297 gastric cancer patients and 300 controls was performed to assess the association of 17 polymorphisms. Analyses performed under the allele model did not find association with gastric cancer. However, NOD1 rs2075820 (p.E266K) showed association with intestinal-type gastric cancer among H. pylori infected subjects (OR = 2.69, 95% CI 1.41-5.13, p = 0.0026). The association was not statistically significant in diffuse-type gastric cancer cases (OR = 1.26, 95% CI 0.63-2.52, p = 0.51). When the analyses were performed in patients carrying H. pylori strains harboring the cag pathogenicity island (cagPAI), we noticed significant association with NOD1 rs2075820 (OR = 4.90, 95% CI 1.80-3.36, p = 0.0019), in particular for intestinal-type gastric cancer cases (OR = 7.16, 95% CI 2.40-21.33, p = 4.1 × 10- 4) but not among diffuse-type gastric cancer cases (OR = 3.39, 95% CI 1.13-0.10, p = 0.03). CONCLUSIONS: NOD1 rs2075820 increases the risk of intestinal-type gastric cancer among individuals infected with H. pylori, particularly in those harboring the cagPAI.

Adaptación a la realidad de Latinoamérica de la Guía Clínica NASPGHAN/ESPGHAN 2016 sobre Diagnóstico, Prevención y Tratamiento de Infección por Helicobacter pylori en Pediatría / Adaptation to the reality of Latin America of the NASPGHAN/ESPGHAN 2016 Guidelines on the Diagnosis, Prevention and Treatment of Helicobacter pylori Infection in Pediatrics

Resumen: Introducción: Las últimas guías clínicas conjuntas de NASPGHAN y ESPGHAN en relación a la infección por H. pylori publicadas el año 2016, contienen 20 afirmaciones que han sido cuestionadas en la práctica respecto a su aplicabilidad en Latinoamérica (LA); en particular en relación a la preven ción del cáncer gástrico. Métodos: Se realizó un análisis crítico de la literatura, con especial énfasis en datos de LA y se estableció el nivel de evidencia y nivel de recomendación de las afirmaciones mas controversiales de las Guías Conjuntas. Se realizaron 2 rondas de votación de acuerdo a la técnica Delfi de consenso y se utilizó escala de Likert (de 0 a 4) para establecer el "grado de acuerdo" entre un grupo de expertos de SLAGHNP. Resultados: Existen pocos estudios en relación a diagnóstico, efectividad de tratamiento y susceptibilidad a antibióticos de H. pylori en pacientes pediátricos de LA. En base a estos estudios, extrapolaciones de estudios de adultos y la experiencia clínica del panel de expertos participantes, se realizan las siguientes recomendaciones. Recomendamos la toma de biopsias para test rápido de ureasa e histología (y muestras para cultivo o técnicas moleculares, cuando estén disponibles) durante la endoscopia digestiva alta sólo si en caso de confirmar la infección por H. pylori, se indicará tratamiento de erradicación. Recomendamos que centros regionales seleccio nados realicen estudios de sensibilidad/resistencia antimicrobiana para H. pylori y así actúen como centros de referencia para toda LA. En caso de falla de erradicación de H. pylori con tratamiento de primera línea, recomendamos tratamiento empírico con terapia cuádruple con inhibidor de bomba de protones, amoxicilina, metronidazol y bismuto por 14 días. En caso de falla de erradicación con el esquema de segunda línea, se recomienda indicar un tratamiento individualizado considerando la edad del paciente, el esquema indicado previamente y la sensibilidad antibiótica de la cepa, lo que implica realizar una nueva endoscopía con extracción de muestra para cultivo y antibiograma o es tudio molecular de resistencia. En niños sintomáticos referidos a endoscopía que tengan antecedente de familiar de primer o segundo grado con cáncer gástrico, se recomienda considerar la búsqueda de H. pylori mediante técnica directa durante la endoscopia (y erradicarlo cuando es detectado). Con clusiones: La evidencia apoya mayoritariamente los conceptos generales de las Guías NASPGHAN/ ESPGHAN 2016, pero es necesario adaptarlas a la realidad de LA, con énfasis en el desarrollo de centros regionales para el estudio de sensibilidad a antibióticos y mejorar la correcta selección del tratamiento de erradicación. En niños sintomáticos con antecedente familiar de primer o segundo grado de cáncer gástrico, se debe considerar la búsqueda y erradicación de H. pylori.

Abstract: Introduction: The latest joint H. pylori NASPGHAN and ESPGHAN clinical guidelines published in 2016, contain 20 statements that have been questioned in practice regarding their applicability in Latin America (LA); in particular in relation to gastric cancer prevention. Methods: We conduc ted a critical analysis of the literature, with special emphasis on LA data and established the level of evidence and level of recommendation of the most controversial claims in the Joint Guidelines. Two rounds of voting were conducted according to the Delphi consensus technique and a Likert scale (from 0 to 4) was used to establish the "degree of agreement" among a panel of SLAGHNP ex perts. Results: There are few studies regarding diagnosis, treatment effectiveness and susceptibility to antibiotics of H. pylori in pediatric patients of LA. Based on these studies, extrapolations from adult studies, and the clinical experience of the participating expert panel, the following recom mendations are made. We recommend taking biopsies for rapid urease and histology testing (and samples for culture or molecular techniques, when available) during upper endoscopy only if in case of confirmed H. pylori infection, eradication treatment will be indicated. We recommend that selected regional centers conduct antimicrobial sensitivity/resistance studies for H. pylori and thus act as reference centers for all LA. In case of failure to eradicate H. pylori with first-line treatment, we recommend empirical treatment with quadruple therapy with proton pump inhibitor, amoxi cillin, metronidazole, and bismuth for 14 days. In case of eradication failure with the second line scheme, it is recommended to indicate an individualized treatment considering the age of the pa tient, the previously indicated scheme and the antibiotic sensitivity of the strain, which implies performing a new endoscopy with sample extraction for culture and antibiogram or molecular resistance study. In symptomatic children referred to endoscopy who have a history of first or se cond degree family members with gastric cancer, it is recommended to consider the search for H. pylori by direct technique during endoscopy (and eradicate it when detected). Conclusions: The evidence supports most of the general concepts of the NASPGHAN/ESPGHAN 2016 Guidelines, but it is necessary to adapt them to the reality of LA, with emphasis on the development of regional centers for the study of antibiotic sensitivity and to improve the correct selection of the eradication treatment. In symptomatic children with a family history of first or second degree gastric cancer, the search for and eradication of H. pylori should be considered.

Seropositividad de H. pylori y Fiebre Tifoidea en Pacientes iraquíes con dispesia / Seropositivity of H. pylori and Typhoid Fever in Dyspesia Iraqi Patients

Background: There are many studies highlight the association between Helicobacter pylori seropositivity with typhoid fever in human populations and there is no study in Iraq. Aim: Our study designed to estimate the correlation between seroprevelace of H. pylori and Typhoid fever in clinically examined patients as dyspeptic and typhoid fever infected. Methods: From May (2016) to February (2018), a total of 213 patients (134 females and 79 male) attending an enterology outpatient clinic in AL-Najaf province, Iraq. The patients with age range from 10 to 90 years and with symptoms of dyspepsia and typhoid fever (as fever, diarrhea, headache), were referred to serologic diagnosis of antibodies against H. pylori (IgG) and Typhoid (IgG and/or IgM), using the Rapid Tests Cassette. Results: Of a total of 213 clinically examined as dyspeptic and typhoid fever infected patients,134 (63.0%) were females and 79 (37.0%) were males.In this study, 82 (38.5 %) of 213 patients were seropositive for typhoid fever and 131 patients were seronegative. Moreover, 128 (60.1 %) of 213 patients were seropositive for H.pylori IgG (51 case,39.8%, typhoid seropositive, and 77 case,60.2%, typhoid seronegative) and 82 were seronegative. The serologic co-infection diagnosed in 51 (24.0%) patients. The seropositivity of typhoid fever was higher in H. pylori seropositive patients, co-infections (62.2 %), than H. pylori seronegative patients (37.8%). The co-infection was more in female (64.7%) than male (35.3%). In respect of age H. pylori seropositivity was more prevelance (25.8%) in 30s age group where as co-infection was more prevalence in 40s age group (29.4%). But the statistical analysis showed insignificant association of H. pylori with typhoid fever (P value = 0.6203), gender (P value = 0.4770) and age groups (P value = 0.0745). Conclusion: Our study indicates that H. pylori seropositive dyspepsia more susceptiple to typhoid fever particularly in female and 40s ages and suggest there was insignificant relationship amongst seropositivity of H. pylori and typhoid fever within dyspepsia patient

The role of Helicobacter pylori in preeclampsia and in gastric diseases in pregnant women

Background: Helicobacter pylori is a gastric organism was first observed more than 100 years ago. It may cause chronic gastritis, peptic ulcers and gastric adenocarcinoma and lymphoma. It can produce some extragastric disorders including preeclampsia. This study aimed to focus on the importance of H. pylori and its relationship with preeclampsia and gastric illnesses in pregnant patients.Methods: This study includeed 100 pregnant women, half of them were healthy and the other half with preeclampsia. Patients with chronic medical illnesses were excluded. Data was collected and laboratory investigations were done including that for H. pylori. Oesophagogastroduodenoscopy then was done 6 weeks post-delivery or termination of pregnancy for symptomatic H. pylori positive women.Results: 50% of the total number were healthy, 17% had mild preeclampsia, 33% suffering from severe preeclampsia. Seropositivity for H. pylori is significantly higher in preeclampsia and significantly related to severity of preeclampsia and complications of pregnancy. Positive H. pylori test in stool was seen in (45%) of total number of patients. Epigastric pain persist in 41 (91%) of patients with positive H. pylori test in stool. Gastritis, duodenal ulcer, and gastric ulcer were found in 85.3%, 12.1% and 2.4% of symptomatic patients respectively.Conclusions: Significant correlation between Helicobacter pylori seropositivity and preeclampsia may indicate the benefit of using this parameter in the prediction and management of preeclampsia and its severity. H. pylori infection plays an important role in gastric pathologies in pregnant women that can be dealt with or may be prevented more efficiently in future.

Helicobacter pylori infection and its correlates among the patients of peptic perforation and gastric carcinoma

Background: Presence of H. pylori infection was found associated with peptic perforation and gastric carcinoma. Present study tried to estimate the prevalence of H. pylori infection in those patients and to find out the correlates of H. pylori infection.Methods: After matching the inclusion and exclusion criteria, all cases of diagnosed peptic perforation and gastric carcinoma were taken for this prospective, single center, observational study.Results: Among the study population, gastric carcinoma was found in higher age group; whereas peptic perforation was found in lower age group; male and female ratio was 2:1 in both groups of patient. Laborer and housewives were mostly affected in both cases. Gastric carcinoma was more prevalent in urban residents, opposite was seen in peptic perforation. Most patients in two groups had no previous co-morbid condition. Use of NSAIDs was found in high frequency in both groups. Most of the patients were chronic alcoholic and chronic smoker, and most of them had history of taking spicy foods more than twice in a week.Conclusions: H. pylori infection was found in high frequency in both group of patients, and it was higher in peptic perforation. The study establishes the association of H. pylori with the gastric carcinoma and peptic perforation.

Evaluation of serological test in the diagnosis of Helicobacter pylori and risk factors associated with the infection

Background: Serological testing has been widely used for the diagnosis of H. pylori. This study aimed to evaluate the serological test and to determine the sensitivity and specificity of the test in the diagnosis of H. pylori. The study also aimed to address if there are risk factors like blood grouping, Smoking, Age, gender, and residence of the patients associated with H. pylori infection.Methods: A prospective cross‑sectional study was performed among 100 symptomatic patients attending Dr. Suliman dispensary, Elnehoud city in west Kordofan state-Sudan, from March to September 2016. H. pylori were detected on plasma by using Healgen immunochromatography test cards from Xiamen Boson Biotech Co., Ltd (China), and identified from a stool by using monoclonal antigen detection from the same trademarked company. Data for the risk factors associated with the infection were assessed in a participant interview.Results: The serological test showed significant differences when compared to the stool antigen test p-value = 0.000. The statistical analysis showed moderate sensitivity and high specificity of the serological test compared to the stool antigen detection test. The study also showed that smoking [odds ratio (OR): 1.20, 95% confidence interval (CI): (1.24-4.02) and blood grouping (OR: 1.10, 95% CI: (1.08-1.60) were risk factors for H. pylori infection.Conclusions: The serological test showed high specificity and moderate sensitivity in comparison to the stool antigen test. The increased risk of H. pylori infection associated with smoking and blood grouping.

Is Helicobacter pylori Infection Associated with Perforated Gastro-Duodenal Ulcer

About 95% of the patients suffering from duodenal ulcer and 70-80% of the gastric ulcer patients are found to be Helicobacter pylori (H. pylori) positive. Although the role of H. pylori is well known in peptic ulcer disease aetiology, its role in perforated peptic ulcer is not well established. There are conflicting results in the literature regarding its association, with some studies showing high prevalence of H. pylori infection in gastro-duodenal perforation patients and also its eradication prevented the relapse of ulcer while others showing low or lack of association, suggesting a different pathogenesis for perforated peptic ulcer.METHODSGroup-I patients were operated for gastro-duodenal perforation and group-II patients were with the upper gastrointestinal endoscopic diagnosis of peptic ulcer disease. The mucosal biopsy samples taken from antrum from both the groups were tested with rapid urease test and histopathological examination to detect H. pylori.RESULTSThe prevalence of H. pylori infection was significantly less in patients with perforated gastro-duodenal ulcer than with peptic ulcer disease (p-value-0.026; OR – 0.31).CONCLUSIONSThrough this study it was found that alcohol intake and smoking were significant risk factors associated with perforation of gastro-duodenal ulcer whereas NSAIDs use was not significantly associated. H. pylori infection was not significantly associated with perforated gastro-duodenal ulcer suggesting that some other factors were involved in perforation.

Does H. pylori therapy augments the effect of iron therapy among children with iron deficiency anemia?

Background: To assess beneficial effects of H. pylori therapy on children with pre-existing Iron Deficiency Anemia (IDA).Methods: A total of 218 consecutive patients with iron deficiency anemia (Hb 6-11 gm/dl) were invited to participate in the study. Patients underwent endoscopic biopsy and rapid urease test for H. pylori detection. A total of three groups were formed- Group I (n=13) - positive for H. pylori, underwent treatment for H. pylori therapy and IDA, Group II (n=16) - positive for H. pylori, underwent treatment for IDA only, Group III (n=101) - negative for H. pylori, underwent treatment for IDA only. All the patients were followed up after every 4 weeks till week 12. Change in haematological parameters and anaemic and iron status was assessed. Chi-square paired 't'-test and ANOVA were used using SPSS 21.0.Results: All the 3 groups showed a significant increase in S. Hb, Ferritin and iron levels and a decrease in S. TIBC levels. At 12 weeks, mean S. ferritin and S. iron levels were significantly higher in Groups I and III as compared to Group II while Mean S. TIBC levels were significantly higher in Group II as compared to that in Groups I and II. A total of 73.3% of Group III, 53.8% of Group I and 56.3% of Group II patients had hemoglobin levels >11 g/dl, but difference was not significant (p=0.175).Conclusions: The findings of study showed that H. pylori therapy augments the effect of iron therapy among H. pylori positive children with iron deficiency anemia.

Obesity and helicobacter pylori infection in adults with non specific colitis / Obesidade e infecção por Helicobacter pylori em adultos com colite inespecífica

ABSTRACT Background Non specific colitis is defined as inflammatory condition of the colon that when examined microscopically lacks any characteristic features of any specific form of colitis and is commonly seen in reports of colonoscopy biopsies. There are many factors that cause it like obesity and H pylori. Aim of the study To determine the association of obesity and H pylori as contributory factors to this disease. Patients and methods This is a case-controlled study was carried out in Al-Kindy College of Medicine from January 2017 to June 2018. Sixty individuals were included; forty of them had non specific colitis. The rest were healthy control group. Demographic information's were taken like age and sex. Anthropometric measurement like weight in kilograms (kg), height in meters (m), waist circumference in centimeters (cm), and body mass index was done. H pylori IgG was done to both groups. Results Study results indicated that this disease was more common with increasing age, there is a significant difference (p = 0.002) between patients (48.12 ± 1.50) and control group (41.00 ± 1.10) regarding age. BMI of the patients is significantly higher in patients group (29.21 ± 0.41; p = 0.000) than the control (22.23 ± 0.41). Patients with non specific colitis showed significant (p = 0.000) increased in H pylori infection 33 (82.5%) compared with control group 2 (10%). Conclusions Obesity and infection withH pylori may predispose to non specific colitis.

RESUMO Introdução Colite inespecífica é uma condição inflamatória do cólon que microscopicamente não apresenta características de qualquer forma específica de colite; é comumente observada em relatórios patológicos de biópsias de colonoscopia. Vários fatores podem causar colite inespecífica, dentre os quais obesidade e infecção por H. pylori. Objetivo do estudo Determinar o possível papel da obesidade e H. pylori como fatores contribuintes para esta doença. Pacientes e Métodos Este foi um estudo caso-controle, realizado na Al-Kindy College of Medicine entre janeiro de 2017 e junho de 2018. Um total de 60 indivíduos foram incluídos, 40 dos quais apresentavam colite inespecífica. Os demais foram incluídos no grupo de controles saudáveis. Foram coletadas informações demográficas, como idade e sexo. Medidas antropométricas, como peso (kg), altura (m), circunferência da cintura (cm) e índice de massa corporal, também foram coletadas. Nos dois grupos, foi feita serologia para H. pylori (IgG) Resultados Os presentes resultados indicaram que esta doença era mais comum entre pacientes de idade mais avançada; observou-se uma diferença significativa p = 0,002 entre os pacientes 48,12 ± 1,50 e o grupo controle 41,00 ± 1,10 quanto à idade. O IMC foi significativamente maior no grupo de pacientes 29,21 ± 0,41; p = 0,000 do que no grupo controle 22,23 ± 0,41. A infecção por H. pylori foi significamente mais frequentemente observada no grupo de pacientes (33; 82,5%) em comparação ao grupo controle (2; 10%; p = 0,000. Conclusões A obesidade e a infecção por H. pylori podem predispor à colite inespecífica.

Evaluation of persistent upper abdominal pain by upper gastrointestinal endoscopy

Background: The upper gastrointestinal tract is affected by a spectrum of conditions which span from infectious, idiopathic, inflammatory diseases, polyps, motility disorders and malignancy. Upper gastrointestinal scopy is believed to be the most effective screening modality as it not only allows direct visualization of oesophagus, gastric and duodenal mucosa but to perform biopsies in suspected malignancies. Aim: To evaluate persistent upper abdominal pain by upper gastrointestinal scopy.Methods: A total of 100 patients presented with complains of persistent upper abdominal pain were subjected to upper gastrointestinal scopy. Biopsies in indicated cases were taken from abnormal areas and sent for histopathology.Results: Most common finding in patients according to upper gastrointestinal scopy was gastritis (27%), followed by duodentitis (9%), and gastroduodenitis (7%). Rapid urease test in cases of gastritis and duodenitis to determine H. pylori infection were positive in 53.8% cases.Conclusions: Because of its precision and relatively safe technique upper GI endoscopy can be considered in patients above age of 50 years presenting to surgical OPD with complaints of persistent pain in upper abdomen. Investigating helicobacter pylori should be considered in all patients found to have gastric or duodenal lesions on upper GI endoscopy as its association with these lesions ranges from 50 to 80%.