Relationship of serum gastrin and Helicobacter pylori in the gastric antral and body mucosa.

OBJECTIVE: To evaluate the relationship between serum gastrin and Helicobacter pylori status in the antrum and body of gastric mucosa. METHODS: Fasting and post-meal serum gastrin level were studied by radioimmunoassay in 41 patients with dyspepsia. These patients were divided into three groups depending on H pylori status ie H pylori present in both antrum and body; (A+B+; n = 13), present in antrum but not in the body; (A+B-; n = 7) and absent in both antrum and body A-B-; n = 21. RESULTS: There was no difference in fasting or post meal serum gastrin levels between the groups A+B+ and A+B-. Serum gastrin values 20 and 40 minutes post meal were significantly higher (p < 0.05) in the group A+B+ as compared to A+B-. CONCLUSION: Post meal serum gastrin levels are higher in patients with dyspepsia in whom Helicobacter pylori is present in the antral and body mucosa as compared to those in whom it is present in the antrum only.

Relationship of serum gastrin and Helicobacter pylori in the gastric antral and body mucosa.

OBJECTIVE: To evaluate the relationship between serum gastrin and Helicobacter pylori status in the antrum and body of gastric mucosa. METHODS: Fasting and post-meal serum gastrin levels were studied by radioimmunoassay in 41 patients with dyspepsia. These patients were divided into three groups depending on H pylori status ie H pylori present in both antrum and body; (A + B+; n = 13), present in antrum but not in the body; (A + B-; n = 7) and absent in both antrum and body; (A - B-; n = 21). RESULTS: There was no difference in fasting or post meal serum gastrin levels between the groups A + B+ and A - B-. Serum gastrin values 20 and 40 minutes post meal were significantly higher (p < 0.05) in the group A + B+ as compared to A + B-. CONCLUSION: Post meal serum gastrin levels are higher in patients with dyspepsia in whom Helicobacter pylori is present in the antral and body mucosa as compared to those in whom it is present in the antrum only.

Prevalence of hepatitis B e antigen in pregnant women and patients with liver disease.

Knowledge of HBeAg status is important in pregnant women to decide immunoprophylaxis to the infant and to decide therapy in patients with HBsAg positive chronic active hepatitis. Two thousand pregnant women were tested for HBsAg by the Hoechst IHA Cellognost Kit. Those who were HBsAg positive were tested for HBeAg by ELISA (Hoechst). One hundred consecutive HBsAg positive patients admitted in hospital were tested for HBeAg by Elisa (Abott). The prevalence of HBsAg and HBeAg in pregnant women was 5% (100/2000) and 12% (12/100) respectively. The prevalence of HBeAg in the 100 consecutive HBsAg positive patients with liver diseas was 30% (14/46) in acute viral hepatitis and 52% (28/54) in chronic liver disease. Routine screening of all pregnant women in the third trimester for HBsAg and immunoprophylaxis to infants of BHeAg positive mothers atleast is immediately recommended.

A randomised multicentre study to compare the safety and efficacy of albendazole and metronidazole in the treatment of giardiasis in children.

A randomised control multicentre study to compare the safety and efficacy of albendazole and metronidazole in the treatment of giardiasis in children is reported. One hundred and fifty children of either sex (age range: 2-10 years) were randomised to receive either a single dose of 400 mg of albendazole suspension, or 22.5 mg/kg/day of metronidazole in 3 divided doses for 5 consecutive days. At the end of therapy, majority of children in both treatment groups were symptom free. Two days after completion of therapy, 97% of children in both treatment groups were giardia free in the stools. Side effects were noted in 3 children in the albendazole group, and in 20 children in the metronidazole group. We conclude that albendazole suspension is as effective as metronidazole in the treatment of giardial infection in children. It is safe and has fewer side effects as compared to metronidazole.

Helicobacter pylori in dental plaque of children and their family members.

A prospective study was undertaken to determine the presence of Helicobacter pylori in the dental plaque of children and their family members. 22 children (age range: 2-12 years; males: 16) admitted to the paediatric ward for various disorders and 17 healthy family members (age range: 7-40 years; males: 9) of 13 of these children were screened for presence of Helicobacter pylori in the dental plaque by the rapid urease test. H. pylori was detected in dental plaque of 82% (18/22) children and 88% (15/17) of family members. In 85% (28/33) of the positive cases the rapid urease test was positive within 1 hour. Our observations indicate that Helicobacter pylori is present in the dental plaque of majority of children and their family members.

Age-related prevalence of Helicobacter pylori antibodies in Indian subjects.

OBJECTIVE: To determine the age-related prevalence of Helicobacter pylori antibodies in Indian subjects without upper gastrointestinal symptoms. MATERIAL AND METHODS: Sera of 340 subjects without any upper gastrointestinal complaints were screened for IgG and IgA Helicobacter pylori antibodies by the ELISA technique. RESULTS: The prevalence of IgG and IgA antibodies was 22%, 56% and 87% and 48%, 58% and 83% in 0-4, 5-9 and 10-19 year age groups respectively; thereafter it remained almost constant upto fifth decade. A significant fall in IgG and IgA prevalence was observed from fifth to seventh decades. CONCLUSION: Our data indicate that in India exposure to Helicobacter pylori occurs early in life and is widespread; about 83% of the population is exposed to Helicobacter pylori during the first two decades of life. The comparable prevalence rates of IgG antibodies to Helicobacter pylori and hepatitis A virus, in different age groups, in India and in the West, suggest a feco-oral mode of transmission for Helicobacter pylori.

Wilson's disease: varied hepatic presentations.

BACKGROUND: Wilson's disease is an inherited disorder of copper metabolism. Previous Indian studies have high-lighted the neurological manifestations of this disorder. Eleven patients with Wilson's disease with different hepatic manifestations are reported. METHODS: Patients referred to the gastroenterology department of a tertiary referral center were investigated for Wilson's disease, based on clinical suspicion, with slit-lamp examination for Kayser-Fleischer rings, serum ceruloplasmin and 24-hour urinary copper estimation. Liver biopsy was done whenever possible. RESULTS: Patients with Wilson's disease presented as acute viral hepatitis (n = 5), fulminant hepatic failure (n = 2), subacute hepatic failure (n = 2) and cryptogenic cirrhosis (n = 2). Therapy with penicillamine/trientene and zinc sulphate was started in 9 patients; 5 showed good response to therapy, one had to be switched to trientene due to penicillamine toxicity, two died, and one was lost to follow-up. CONCLUSION: Wilson's disease has varied hepatic presentations and should be suspected in all patients with unexplained liver disease. Any young adult presenting with acute hepatitis or fulminant hepatic failure who has evidence of underlying chronic liver disease or associated hemolytic anemia should be investigated for Wilson's disease. Therapy with penicillamine or trientene combined with zinc sulphate shows improvement in a majority of patients.

Genetic hemochromatosis presenting as asymptomatic hepatomegaly.

A case of genetic hemochromatosis presented with asymptomatic hepatomegaly. The diagnosis was based on elevated serum iron, serum ferritin and transferrin saturation, a characteristic picture on magnetic resonance imaging, and liver biopsy showing cirrhosis with excessive iron deposits in the liver parenchyma. The extreme rarity of this disease in our country is perhaps determined by hereditary factors.

Helicobacter pylori and acid secretion.

BACKGROUND. Helicobacter pylori has been implicated in the aetiopathogenesis of peptic ulcer but data on the effect of infection by this organism on gastric acid secretion are equivocal. We, therefore, examined the effect of the presence of Helicobacter pylori in the antrum and body of the stomach on acid secretion. METHODS. We used the augmented histamine test and intragastric titration in three groups of patients. In one group Helicobacter pylori was present in both the antrum and body of the stomach, in the second it was present in the antrum but not the body, and in the third the organism was absent. RESULTS. There were no significant differences in acid secretion between these three groups. CONCLUSION. The presence of Helicobacter pylori in the mucosa of the gastric antrum and body has no effect on acid secretion.

Epidemiology of Helicobacter pylori: the Indian scenario.

OBJECTIVE: To compare the age-related prevalence of Helicobacter pylori in populations from developing and developed nations to determine the possible mode of transmission. METHODS: Endoscopic gastric biopsies (for biopsy urease test and histology) were obtained in 526 patients with dyspepsia and in 82 control subjects to determine H pylori prevalence. RESULTS: H pylori prevalence in patients with dyspepsia and in control subjects was 65% and 46% respectively. Age-related prevalence in these two groups in the age groups 10-19 years, 20-29 years, 30-39 years, 40-49 years and > or = 50 years was 52%, 70%, 69%, 60% and 59%, and 44%, 55% 58%, 36% and 33% respectively. CONCLUSION: Exposure to H pylori occurs early in India and is widespread, even in control subjects. The high prevalence of the organism in young Indian control subjects and the comparable prevalence of antibodies to H pylori and hepatitis A virus infection in different age groups both in developed and developing nations may suggest a feco-oral mode of transmission.

Mono and dual therapy for Helicobacter pylori associated gastritis.

Sixty patients with Helicobacter Pylori positive non ulcer dyspepsia were randomly allocated to one of the following treatment groups: Group I--norfloxacin 400 mg bid for 10 days, Group II--amoxycillin 500 mg bid plus tinidazole 500 mg bid for 15 days, Group III--colloidal bismuth subcitrate (CBS) 240 mg bid for 4 weeks. H pylori elimination was achieved in 14%, 81%, and 62% in Groups I, II and III respectively. Eradication of H pylori was not observed in Groups I and II, but was achieved in 25% of patients in Group III. Antral gastritis improved in 69% in Group II and 50% in Group III. We conclude that norfloxacin is not effective in H pylori infection. A combination of amoxycillin and tinidazole is highly effective in H pylori elimination with improvement in associated gastritis, but H pylori eradication is not observed with this therapy. CBS is also effective in H pylori elimination though H pylori eradication is achieved in only 25%.

Recombinant hepatitis B vaccine for prevention of hepatitis B infection.

Twenty-five resident doctors were given 1 ml (20 micrograms) of recombinant hepatitis B vaccine intramuscularly in the deltoid region at 0, 1 and 6 months. Seroconversion rates at 1, 2, 3, 7 and 8 months were 8%, 48%, 64%, 96% and 100% respectively. Acceptability of the vaccine was 100%. The recombinant hepatitis B vaccine is safe and efficacious, with seroconversion rates comparable to the plasma derived vaccine, and has negligible side effects.