[Efficacy of stool antigen test for the non-invasive diagnosis of helicobacter pylori infection in dyspeptic patients referred to GI clinic of Kashan Shahid Beheshti hospital during 2007-8]

Dyspepsia is one of the most common ailments today and Helicobacter pylori infection is known as one of the common causes of dyspepsia in adults and children. Histopathologic diagnosis of Helicobacter pylori is a standard method and biopsy samples can be obtained by invasive endoscopy method. The current study was designed to evaluate the diagnostic value of stool antigen test of Helicobacter pylori as a non-invasive method. In this study all dyspeptic patients referred to GI clinic of Kashan Shahid Beheshti Hospital from 2007 to 2008 were involved in this study. In upper gastrointestinal endoscopy, mucosal biopsy was taken from antrum and corpus; simultaneous examination of the stool antigen sample for diagnosing of Helicobacter pylori was evaluated using ELISA method [positive titer>1/1]. Data were collected and analyzed for sensitivity, specificity, positive predictive value and negative predictive value. Among the 100 dyspeptic patients 50 were men and the remaining 50 women with a mean age of 43.3 +/- 17.13. The sensitivity, specificity, positive predictive value and negative predictive value in stool antigen test were%83.3,%79.4, 88.7% and 71.7%, respectively. There was a direct correlation between the severity of Helicobacter pylori infection and stool antigen titer in biopsy samples. The stool antigen test as a noninvasive method of diagnosing Helicobacter pylori can be regarded as an affordable alternative to the invasive biopsy procedure

[Relevance of serum vitamin D level and the disease activity in rheumatoid arthritis]

Rheumatoid arthritis [RA] is one of the most prevalent autoimmune diseases in the world. Some of the researches have suggested that the serum vitamin D level may relate to disease activity. The current study was designed to identify the correlation between serum vitamin D level and the disease activity index [DAI]. In this sectional study, 108 patients [diagnosed based on the American Committee of Rheumatology criteria] were enrolled. In all cases after determining the serum vitamin D level and ESR, complete joint examination were done. The normal range of vitamin D was 47.7-144 nm/lit. Then, the specified disease activity form [DAS-28] and visual analog scales [VAS] were filled out. The correlation between disease activity index, [based on VAS, tendered or swelled joints and ESR] and serum vitamin D was analyzed using Chi square, Mann Whitney and t-tests. Seventy nine [73.14%] out of 108 patients had normal serum vitamin D and 29 [26.86%] had low serum vitamin D level. The mean age of patients with normal and low serum vitamin D level were 52.22 +/- 11.6 and 48.48 +/- 12.51, respectively [P=0.075]. The mean DAI in normal and low vitamin D patients were 3.75 +/- 1.37 and 5.19 +/- 1.56, respectively [P=0.00]. The mean number of swollen joints in normal and low vitamin D patients was 1.24 +/- 1.39 and 3.65 +/- 3.3, respectively [P=0.001]. The mean number of tender joints in normal and low vitamin D patients were 6.84 +/- 4.41 and 9.44 +/- 3.62, respectively [P=0.042]. The mean ESR in normal and low vitamin D patients were 19.40 +/- 12.40 and 37.91 +/- 21.72, respectively [P=0.002]. Moreover, the mean VAS in normal and low vitamin D patients was 23.29 +/- 19.42 and 50.68 +/- 30.78, respectively [P=0.003]. The more active the RA, the less serum vitamin D level

[Therapeutic endoscopy outcomes in upper GI peptic ulcer bleeding]

Background: upper gastrointestinal [UGI] bleeding is the leading cause for many hospital admissions which imposes a heavy expense on health care systems in most countries. The aim of this study was to compare the outcomes of therapeutic and diagnostic endoscopy in patients with upper GI bleeding

Materials and Methods: this retrospective study was carried out in a 2-year period [2002- 4] on 145 patients undergone UGI endoscopy with a history of upper GI peptic ulcers in their diagnostic or therapeutic endoscopy reports hospitalized in Beheshti hospital. Participants were divided into two groups: endoscopically treated group [receiving managements such as diluted epinephrine injection or sclerosant material], and diagnostic endoscopy group

Results: therapeutic endoscopy was done on 46 [31.7%] cases. Mean days of hospital stay was 7.23 +/- 2.64 and 8.97 +/- 3.73 in therapeutic and diagnostic endoscopy groups, respectively [P=0.005]. Mean enquired unit of transfusion solution for therapeutic and endoscopic diagnostic groups was 6.54 +/- 3.30 and 9.05 +/- 3.9 respectively [P<0.001]. Mortality rate due to upper GI bleeding in therapeutic and diagnostic endoscopy group was 2.3% and 8.3% , respectively [P=0.17]. The need to surgical intervention in therapeutic and diagnostic endoscopy group was 6.5% and 19.1% , respectively [OR=4/3, P=0.048]

Conclusion: therapeutic endoscopy compared to medical treatment is an effective attempt to stop hemorrhage, establish homodynamic stability and prevent complications [e.g., early recurrent bleeding]. In addition, using this approach has some advantages such as reduced transfusion rate and hospital stay and no need to surgical intervention. Hence it is recommended that therapeutic endoscopy be done for all patients with upper GI bleeding