RESUMEN
Carriage of Helicobacter Pylori in the human stomach is associated with increased risk of peptic ulcer disease, distal gastric adenocarcinoma and gastric B-cell mucosa associated lymphoid tissue lymphoma. To study the immunohistochemical expression of bcl-2, as apoptosis makers in the gastric mucosa of patients infected with cagA Helicobacter Pylori demonstrated by insitu hybridization method. Gastric antrum biopsies from 99 patients presented with dyspeptic symptoms [50 men, 49 women, median age 40] were analysed for the presence of H. pylori, and were classified according to updated Sydney system. Insitu hybridization technique was done to detect cagA H. pylori. Immunohistochemical expression of bcl-2 using [Avidin-Biotin method] was performed on paraffin embedded biopsy specimens. Forty four patients [44.44%] had H. pylori cagA positive starin. Atrophy of gastric mucosa was present in 14 [14.14%] patients. Intestinal metaplasia was present in 8 [8.08%] patients. The frequency of atrophy and intestinal metaplasia were significantly higher in cagA H. pylori gastritis than non-cagA H. pylori gastritis [p=0.023 and 0.041 respectively]. Bcl2 expression was not significantly higher in H. pylori gastritis than non-H. pylori gastritis [p=0.101]. Bcl2 expression was significantly higher in the presence of atrophy [p<0.001]. Bcl2 expression was significantly higher in the presence of intestinal metaplasia [p<0.001]. The rate of apoptosis decreases when lesions [gastric atrophy and intestinal metaplasia] are present
RESUMEN
Tuberculosis [TB] considered as the most communicable disease world wid. Among extra pulmonary TB the prevalence of abdominal TB shows rising tendency. Abdominal TB is defined as an infection of one or more common of two or more of the following sites; peritoneum, mesentery, gastrointestinal tract and or solid organs. Reported incidence of abdominal TB varies from country to country. The most common clinical features are abdominal pain, fever and weight loss. To evaluate the role of surgery in the management of abdominal TB especially with the advent of minimal access surgery [laparoscopy] in the diagnosis of this disease. Prospective study was conducted in Al-Kadhymia Teaching Hospital over three years [2007-2010], fifty six patients with abdominal TB were included, the patients were managed by full surgical and or medical teams, results was analyzed by appropriate statistical measures. Most patients were in the 2[nd], 3[rd] and 4[th] decades of life. Female to male ratio was 1.5:1. Most of the patients [82%] considered to have primary abdominal TB. Diagnostic laparoscopy was done for 21 patients and proved TB in 19 patients. Explorative laparotomy was done in 19 patients, the commonest operative finding was ascites and peritoneal tubercles. Abdominal TB should be considered in all patients who presented with unexplained abdominal symptoms and signs. Laparoscopy is an effective modality for diagnosis of abdominal TB