A Prospective Comparative Clinical Study on Repair of Paraumbilical Hernias with Mayo’s and Mesh Techniques and their Postoperative Complications

Background: “Paraumbilical hernia” occurs through Linea Alba either above or below umbilicus. The current trend is to use a mesh forthe repair irrespective of the size. The conventional suture method of Mayo’s is also being practiced in various centers. An attempt ismade in this study to compare both the methods especially in relation to their post-operative complications in the long-term follow-up.Aim of the Study: The aim of the study to study and compare Mayo’s method and use of mesh technique in the surgicalmanagement of repair of paraumbilical hernias in relation to their post-operative complications.Materials and Methods: A cross-sectional prospective clinical study was conducted in the Department of General Surgeryof Malabar Medical College Hospital, Modakkallur. Atholi, Kozhikode, Kerala, wherein 58 patients undergoing surgery forparaumbilical hernia were included in the study. The patients were assigned to these groups using random numbers from www.randomizer.org. The patients belonging to Group A were subjected to Mayo’s operation and Group B were subjected to Meshtechnique. All the patients were asked thorough history taking followed by investigations of surgical profile before undertakingthe surgery. All the patients were followed up from day 1 postoperatively for 2 years.Observations and Results: A total of 58 patients with paraumbilical hernia were divided into 2 equal groups comprising of29 each. The mean age in Group A was 43.65 ± 4.10 years and in Group B was 44.60 ± 3.20 years. There were 18 femalesand 11 males in Group A and 17 females and 12 males in Group B. The patients belonging to the age group of 33–62 yearswere 21/29 (72.41%) in group A and 23/29 (79.31%) in Group B. There was no statistical significance in the incidence amongthe two groups as P = 0.153 (P taken significantly at <0.05). The male to female ratio in Group A was 1:1.63 and 1:1.41 inGroup B. Pain was complained in the post-operative period in 19/29 (65.51%) patients in Group A and 16/29 (55.17%) patientsin Group B. Hematoma was observed in 5/29 (17.24%) patients in Group A and 7/29 (24.13%) patients in Group B. Seromawas observed in 4/29 (13.79%) patients in Group A and 3/29 (10.34%) patients in Group B.Conclusions: In a follow-up of 2 months to years, among the procedures used classical Mayo’s repair had 4/29 recurrencesand 1/29 were noted in patients underwent mesh repair. Even though Mayo’s repair for paraumbilical has been the procedureof choice in many centers, but the tension-free mesh repair has an advantage of having no recurrences and can be used in thepresence of bigger defect and weaker abdominal muscle tone, thus showing a superior and favorable procedure than Mayo’s repair.

A study on mosquito density in rural Kerala before and after floods

Background: Mosquito borne diseases are a major public health problem in Kerala. Mosquito density assessed by larval surveys is easier and quicker to perform. The larval indices are an important practical predictor of outbreaks of mosquito borne disease and are valuable in taking preventive measures. This study is done to calculate standardized larval indices namely house index, container index and Breteau index and to identify the major breeding sources of mosquitoes in the residential environment in a rural of Thrissur, Kerala.Methods: A cross-sectional study selecting 80 houses from 1 wards of Konnikara village under Thrikkur Panchayath under the field practice area of rural training centre, Amala Institute of Medical Sciences Thrissur. Every water holding container indoors and outdoors was counted and searched for larval presence and noted on a pretested format.Results: In this study, 80 houses were surveyed in 2 days initially in June and in September. All the entomological indices were found to be above the critical level in the initial survey in June. House index=36% container index=44%; Breteau index=143% showing high chances for outbreaks of mosquito borne diseases. In September though the indices were very low house index 1.25% container index 2.77% and Breteau index.Conclusions: The area is prone for mosquito borne disease outbreaks like dengue fever and after interventions the vector indices and potential risks came down

Phytochemical studies and anti-ulcerative colitis effect of Moringa oleifera seeds and Egyptian propolis methanol extracts in a rat model

Objective: To analyze the phytochemical constituents, and to explore potential protective effect of the methanol extract of Moringa oleifera (M. oleifera) seeds and Egyptian propolis, each alone or concurrently administered on acetic acid-induced ulcerative colitis in rats. Methods: Eight groups of 5 rats each were used: normal control group with distilled water, model group, two groups with M. oleifera seeds (100 and 200 mg/kg), two groups with propolis (50 and 100 mg/kg), one group with concurrent administration of both, and one group with prednisolone (reference drug). Macro-and microscopic picture, ulcer index and lesion scores, oxidative markers, inflammatory mediators, in vitro activity of the inflammatory enzymes and 1, 1-diphenyl-2-picrylhydrazyl free radicals scavenging activity were evaluated. The phytochemical constituents of both extracts were explored by GC-MS analysis. Results: Both treatments modulated the macro-and microscopic picture, decreased the ulcerative index, lesion score, oxidative markers and inflammatory mediators, and inhibited the COX-1 and COX-2 enzymes. Propolis appeared to be powerful free radicals scavenger. A powerful synergistic effect of both treatments in modulating the course of the disease was reported. GC-MS analysis of methanol extract of M. oleifera seeds and propolis revealed the presence of 50 and 34 compounds, respectively. Conclusions: M. oleifera seeds and propolis methanol extracts have modulated the course of acetic acid-induced ulcerative colitis. Moreover, both treatments induce a good synergistic effect against the disease. Isolation of the active constituents is recommended.

Phytochemical, antioxidant and hepatoprotective effects of different fractions of Moringa oleifera leaves methanol extract against liver injury in animal model

Objective: To evaluate the potential antioxidant and hepatoprotective effects of n-hexane, dichloromethane(DCM), ethyl acetate(EtOAc), n-butanol and aqueous fractions of Moringa oleifera(M. oleifera) leaves methanol extract against carbon tetrachloride(CCl

Phytochemical, antioxidant and hepatoprotective effects of different fractions of Moringa oleifera leaves methanol extract against liver injury in animal model

Objective:To evaluate the potential antioxidant and hepatoprotective effects of n-hexane, dichloromethane(DCM), ethyl acetate(EtOAc), n-butanol and aqueous fractions of Moringa oleifera(M. oleifera) leaves methanol extract against carbon tetrachloride(CClMethods:These fractions were prepared from the M. oleifera leaves methanol extract by solubilization in water and partitioning in n-hexane, EtOAc, DCM and n-butanol. Their phyto-components were identified by GC-MS analysis. The in vitro antioxidant effect of these fractions was carried out by assessment of 1,1-diphenyl-2-picrylhydrazyl scavenging activity. A total of 40 Sprague Dawley rats were allocated into 8 equal groups: group 1 given olive oil (1 mL/kg b.wt.), group 2 injected with CClResults:The GC-MS analysis of different fractions of the M. oleifera leaves methanol extract revealed that n-hexane, DCM, EtOAc, n-butanol, and aqueous fractions contained 17, 22, 23, 19 and 32 compounds, respectively. The percent and the molecular structure of each component in each fraction were identified. The n-butanol and EtOAc fractions exhibited the strongest in vitro antioxidant activity against 1,1-diphenyl-2-picrylhydrazyl. CClConclusions:n-hexane, DCM, and aqueous fractions have the highest effectiveness against CCl

Cytogenetic and biochemical competency of chamomile essential oil against gamma-rays induced mutagenic effects in mice

Background: Chamomile essential oil [CEO] hauls out from Matricaria chamomilla L., is a well-known anti-oxidant. Oxidative stress induces clastogenic and biochemical disorders after gamma-irradiation of animals

Materials and Methods: Mice were divided into five groups. Control group received vehicle only.CEO-treated group received CEO. Irradiated group received vehicle and exposed to gamma-rays. Pre-treated group received CEO half h before gamma-rays exposure. Post-treated group received CEO half hour after gamma-rays exposure. Peripheral-blood micronucleus [PMN], bone-marrow micronucleus [BMN], frequency of chromosomal aberrations [CAs], reduced glutathione [GSH], malondialdehyde [MDA], superoxide dismutase [SOD], glutathione peroxidase [PGx] and myeloperoxidase [MPO], lactate dehydrogenase [LDH] and tumor necrosis factor-alpha [TNF-alpha] parameters were assessed

Results: In irradiated mice group, PMN score, BMN occurrence and CAs were increased when compared with control mice group. In addition, significant increases in levels of liver lipid peroxidation [LP]; expressed as MDA and TNF-alpha. In addition, activities of liver MPO and LDH were found. Besides, significant decreases in content of GSH, activities of SOD and PGx in liver tissues were recognized. CEO treatment [1.0 g/kg body weight] before- and after-irradiation ameliorated all these biochemical indices, as well as cytogenetic alterations induced by gamma-rays when compared with irradiated group, indicating that pre- or post-treatment with CEO significantly attenuates the acute hazards caused by gamma-rays exposure

Conclusion: The data suggest that CEO possesses a radioprotective potential against gamma-radiation induced cytogenetic and biochemical damages in mice

Neonatal indirect hyperbilirubinemia and glucose-6-phosphate dehydrogenase deficiency / 소아과

PURPOSE: This study aimed to determine the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among infants with neonatal indirect hyperbilirubinemia (NIH); compare G6PD-deficient and G6PD-normal patients regarding hyperbilirubinemia and need for exchange transfusions (ET); and assess risk factors for ET and kernicterus. METHODS: This is a case-control retrospective study. Medical records of NIH patients admitted to the Pediatric Department, Salmaniya Medical Complex, Bahrain, between January 2007 and June 2010 were reviewed. Data on sex, age at presentation, hospitalization duration, need for ET, hemoglobin (Hb) level, reticulocyte count, direct Coombs test, serum total and indirect bilirubin levels, thyroid function, blood and urine cultures, G6PD status, and blood groups were collected and compared between the G6PD-deficent and G6PD-normal patients. RESULTS: Of 1,159 NIH patients admitted, 1,129 were included, of whom 646 (57%) were male. Among 1,046 patients tested, 442 (42%) were G6PD deficient, 49 (4%) needed ET, and 11 (1%) had suspected Kernicterus. The G6PD-deficient patients were mainly male (P<0.0001), and had lower Hb levels (P<0.0001) and higher maximum bilirubin levels (P=0.001). More G6PD-deficient patients needed ET (P<0.0001). G6PD deficiency (P=0.006), lower Hb level (P=0.002), lower hematocrit count (P=0.02), higher bilirubin level (P<0.0001), higher maximal bilirubin level (P<0.0001), and positive blood culture result (P<0.0001) were significant risk factors for ET. Maximal bilirubin level was a significant risk factor for kernicterus (P=0.021) and independently related to ET (P=0.03). CONCLUSION: G6PD deficiency is an important risk factor for severe NIH. In G6PD-deficent neonates, management of NIH should be hastened to avoid irreversible neurological complications.

Ameliorative effect of vitamin e on oxidative stress induced by bisphenol a in female albino rats

Objective: Oxidative stress is induced by bisphenol A [BPA] and affects many organs. Vitamin E is an effective antioxidant which prevents the activity of free radicals. This study was aimed to clarify the effect of vitamin E on the oxidative stress induced by chronic administration of BPA

Materials and methods: 30 female albino rats were divided into 3 groups [10/each]; group1: control rats, group 2: rats treated with bisphenol A [20 mg/ kg.B.wt] for three months, and group 3: rats treated with bisphenol A [20 mg/kg.B.wt] for three months, then treated with BPA and vitamin E [0.57/100 g B.wt] for other 15 days

Results: BPA induced hormonal disrupt in liver and kidney dysfunctions and hyperlipidemia. Vitamin E ameliorated all these parameters

Conclusion: since we exposed to many harmful disruptions and oxidative stress compounds, we must take vitamin E as a protective agent

Solubility and dissolution enhancement of ketotifen by solid dispersion technique

Ketotifen [KT] solid dispersions and physical mixtures were prepared with the objective of solubility and dissolution improvement using Hydroxypropyl-Beta-Cyclodextrin [HP-beta-CD], Pluronic 127 [PF-127], Pluronic 68 [PF-68], Polyethylene glycol 6000 [PEG 6000], and Polyethylene glycol 4000 [PEG 4000]. The saturation solubility and in-vitro dissolution studies showed remarkable improvement in solubility and drug dissolution of these new solid dispersions and physical mixtures over pure ketotifen. The XRD, DSC, IR and SEM studies indicated the transformation of crystalline ketotifen [in pure drug] to amorphous ketotifen [in solid dispersions]. This study concluded that the improved solubility as well as drug dissolution of these new ketotifen solid dispersions may be attributed to improved wettability and reduction in drug crystallinity, which can be modulated by appropriate level of hydrophilic carriers

Human cystic echinococcosis in the Nalut District of Western Libya: A clinico-epidemiological study

Human cystic echinococcosis (CE) is an endemic disease in the Mediterranean area that has not yet been fully documented in western Libya. The present study describes the clinico-epidemiologic profile of CE in western Libya’s Nalut district. From April 2008 to July 2011, 36 cases of CE were confirmed following surgical removal of cysts. The cysts were most frequently found in the liver (61.1%), followed by the lungs (19.4%), kidneys (11.1%), peritoneal cavity (11.1%), and spleen (5.6%). Among the 36 patients, 6 possessed plural cysts and 3 had cysts in 2 organs. Blood samples from this group were examined for the presence of serum anti-hydatid IgG antibodies, which revealed positivity in 25 patients (69.4 %). An additional 300 blood samples were collected randomly from the inpatient and outpatient clinics at Nalut Hospital. Twenty-seven samples (9%) were found to be positive for the anti-hydatid IgG antibody among which the prevalence of infection tended to be higher in men (12%) than in women (6%). This study demonstrates that CE is a major parasitic infectious disease of public health significance in Libya, notably in the western part of the country and that disease awareness needs to be raised nationwide.

Human Cystic Echinococcosis in the Nalut District of Western Libya: A Clinico-epidemiological Study

Human cystic echinococcosis (CE) is an endemic disease in the Mediterranean area that has not yet been fully documented in western Libya. The present study describes the clinico-epidemiologic profile of CE in western Libya’s Nalut district. From April 2008 to July 2011, 36 cases of CE were confirmed following surgical removal of cysts. The cysts were most frequently found in the liver (61.1%), followed by the lungs (19.4%), kidneys (11.1%), peritoneal cavity (11.1%), and spleen (5.6%). Among the 36 patients, 6 possessed plural cysts and 3 had cysts in 2 organs. Blood samples from this group were examined for the presence of serum anti-hydatid IgG antibodies, which revealed positivity in 25 patients (69.4%). An additional 300 blood samples were collected randomly from the inpatient and outpatient clinics at Nalut Hospital. Twenty-seven samples (9%) were found to be positive for the anti-hydatid IgG antibody among which the prevalence of infection tended to be higher in men (12%) than in women (6%). This study demonstrates that CE is a major parasitic infectious disease of public health significance in Libya, notably in the western part of the country, and that disease awareness needs to be raised nationwide.

Inappropriate use of antibiotics in the treatment of pharyngo-tonsilitis in children in Khartoum, Sudan

Pharyngo-tonsillitis represents a major public health problem all over the world. Recent studies in Sudan have revealed alarming results reporting antibiotics over prescription in the management of acute tonsillitis. The aim of this study was to estimate the prevalence of Group A Beta hemolytic streptococci and document the appropriateness of using antibiotics in the treatment of acute tonsillo-pharyngitis in Jaafar Ibn Auf Pediatrics Hospital. A cross sectional hospital based study was conducted in the period January to August 2012 in Jaafar Ibn Auf Hospital, the largest tertiary pediatrics hospital in Sudan. The sample size was 100 including children aged 2-17 years and got antibiotics treatment for their current sore throat. A pharyngeal swab was collected at presentation from tonsils and posterior pharynx. Gram staining was done first, and then Group A Beta hemolytic streptococci were isolated and identified in the laboratory by their growth characteristics. All children included in the study were assessed clinically and subjected to a structural questionnaire. Data were analyzed by SPSS version 19. The estimated prevalence of Group A Beta hemolytic streptococci tonsillitis and/or pharyngitis was 22%, nevertheless the proportion of antibiotic prescription was 100%. Most children were treated inappropriately regarding the need for using antibiotics, the type of antibiotics used and the duration of management. As many studies suggested that increased using of antibiotics may be due to uncertainty of diagnosis, requesting scoring system or rapid diagnostic test can contribute to the reduction of the rate of antibiotics prescription

Classical abdominoplasty with flank liposuction versus extended abdominoplasty

AbdominopIasly is one of the most commonly performed aesthetic surgery procedures. We have chosen comparison between two groups, group 1-25 patients who underwent classical abdominoplasty with flank liposuction which will stop the incision at the anterior/superior iliac spine.and groupII-25 patients who underwent extended abdominoplasty with lateral extension of the lower abdominal incision in the flanks as regards to patient satisfaction, scar length, lateral upper thigh sensation, dog ears, and skin redundancy.Fifty patients underwent cihdominoplasty between July 2009 and July 2012 The mean age of the studied groups of patients in this work was 35.36 in group I and 36.20 in group II and we had female to male incidence of 9:1.With inclusion criteria presented with abdominal deformities [Matarasso type HI]. In both groups there were no skin redundancy and dog ears, no step-off borders, the scar was narrow, the edges were coapted, there was no inflammation, the overall cosmetic result was excellent and the scar was optimum.Hypothesia in upper lateral thigh was [20%] group 7, [40%] group II and total [30%]. Unilateral loss of sensation in upper lateral thigh in group II was [4%] in group II,but there was no significant difference between the two groups as regards to hypothesia bilateral and unilateral, age groups and hypothesia, age groups and loss of sensation, and sex and hypothesisa and loss of sensation bilateral and unilateral. Patients usually seek abdominoplasty for abdominal wall laxity, excess skin, striae, or diastasis of the rectus muscles. Liposuction is a very affective treatment for recontouring localized fat and decreases the length of abdominoplasty scar and decreases complications such as hypothesia and loss of sensation in upper lateral thigh

Screening for PPD using HPLC- dad in fatal cases with hair dye in upper Egypt

Para-phenylenediamine [PPD] is used alone or in combination with Henna as hair dye or skin decoration. The present study was conducted on 84 fatal cases[27 males and 57 females] who used hair dye using biological samples [urine and blood] referred to Assiut Forensic Chemistry Laboratory of Medico-legal Department, Assiut, from January 2007 to December 2012 to confirm PPD intoxication and to understand the magnitude and pattern of accidental suicidal and homicidal poisoning by PPD among males and females in Upper Egypt. During this period, the cases were reported. The suicidal homicidal and accidental cases were 77[91.7%], 6[7.1%] and I [1.2%], respectively. The suicidal poisoning of females was higher 55 cases [71.4%] than of males 22 [28.6%]. Most of the PPD deaths were between the third and fourth decades of life. PPD was detected by High Performance Liquid Chromatography - Photo Diode Array detector Agilent technologies 1200 Series [USA] [HPLC-DAD] in blood and urine samples. The present study concluded an the advice of "public education and strict control over the sale and distribution of PPD should be done to reduce poisoning by this agent

Screening of diseases associated with abnormal metabolites for evaluation of HPLC in organic aciduria profiling

Organic acid disorders are a heterogeneous group of inborn errors of metabolism, in which organic acids accumulate in the body. They have high prevalence in Egypt because of a high rate of consanguineous marriages. Here we report our experience with the diagnostic evaluation of patients with organic acidemias as well as several other inborn errors of metabolism [lEMs] by liquid chromatography-tandem mass spectrometry [LC/MS-MS], gas-chro-matography mass spectrometry [GC/MS] and by isocratic cation exchange [high-performance liquid-chromatography] [HPLC] to evaluate the use of HPLC method for disease-associated metabolite screening. In this study, we screened 86 suspected Egyptians patients with organic acid disorders by LC/MS-MS, GC/MS and by HPLC aged from 3 days to 12 years old. Data obtained from the three methods were statistically analyzed to evaluate the specificity and sensitivity of the HPLC method over the other two methods and to pursue its precision in the diagnosis of organic acid disorders. Moreover, 17 urine samples were collected from patients with several other lEMs to evaluate the efficiency of HPLC in detecting abnormal metabolites in urine samples. The screening results showed that diagnostic efficiencies were varied among the three methods, HPLC showing a higher sensitivity of detecting normal urine as well as a highly satisfactory extent for the detection of different metabolic disorders. In addition, some typical urinary HPLC chromatograms of different metabolic disorders were presented to help the investigator who is going to start an organic aciduria screening program by HPLC to be familiar with various patterns. This study has indicated that HPLC is an easy applicable and useful technique for the initial screening of organic acid disorders and many other disease associated metabolites

Is vesicolithotomy with bladder wash the answer for rectovesical fistula secondary to neglected vesical stone? Complicated presentation but simple management

It is extremely rare that the urinary bladder stones cause vesicorectal fistulas. Urinary tract infection and poor fluid intake are the main etiologies that precipitate vesical stone formation, and subsequent rectovesical fistula. We present a complicated case of neglected vesical stone, which recurred 3 times. The patient presented with passage of urine per rectum leading to fecal incontinence. He was managed only with vesicolithotomy and bladder wash with eventual spontaneous closure of the rectovesical fistula

Effect of cyclosporine-A on the structure of adult albino rat testis and the role of lycopene supplementation: a histological and immunohistochemical study

Cyclosporine A [CsA] has improved the quality of life and survival rate of transplant patients. However, the oxidative stress induced by CsA limits its use as it causes side effects in different organs. Lycopene is an antioxidant found in tomatoes, water melon, and pink guava. This study aimed to investigate the histological and immunohistochemical changes occurring in rat testes following CsA intake and evaluate the role of lycopene supplementation. Thirty adult male albino rats were divided into three groups: group I, group II, and group III. Group I was divided into subgroup IA, which received distilled water, and subgroup IB, which received lycopene [10 mg/kg/day] dissolved in corn oil. Group II received CsA [15 mg/kg/day] dissolved in distilled water and group III received CsA+lycopene at the same doses as above. All treatments were given by oral gavage for 21 successive days. Testis samples were prepared for light microscopic [histological and immunohistochemical] and electron microscopic examination. The area percentage of bcl-2 reaction and height of the germinal epithelium were morphometrically measured and statistically analyzed. The germinal epithelial cells of the CsA-treated group were separated and were seen to contain dark nuclei. Sloughed germ cells in the lumen were seen. Ultrastructurally, primary spermatocytes showed vacuoles. Spermatids had shrunken nuclei and irregular distribution of mitochondria. Leydig cells contained lipid droplets of different densities with projecting multiple processes. The basement membrane was thick and contained multiple collagen fibers. The axonemes of the mid-pieces of sperms were disorganized with swollen mitochondrial sheathes. Statistically, the area percentage of bcl-2 reaction and germinal epithelial height showed a significant decrease in group II versus other groups. Lycopene improved the adverse effects of CsA in group III. CsA induced profound damage in the testicular structure in rats. It was ameliorated by concomitant lycopene administration. Thus, these results could be considered for further clinical investigations to recommend lycopene with CsA in transplant patients

Hepatitis C, hepatitis B and HIV infection among Egyptian prisoners: seroprevalence, risk factors and related chronic liver diseases

Prisons in Egypt do not currently screen for blood-borne viruses, and there are no statistics concerning the prevalence of hepatitis C virus, hepatitis B virus or human immunodeficiency virus among prisoners. This study was performed to detect the prevalence of antibodies against hepatitis C, hepatitis B core and human immunodeficiency virus among Egyptian prisoners. The study was conducted in an Egyptian prison. The prisoners voluntarily completed a risk factor questionnaire and provided blood specimens for testing for antibodies against hepatitis C virus, hepatitis B virus core antigen and human immunodeficiency virus. Positive results were confirmed by the detecting HCV RNA via polymerase chain reaction. Multivariate regression analysis was performed to determine the factors that were independently associated with positive HCV serology. Five hundred resident prisoners were screened. The prevalence of hepatitis C virus antibodies was 15.8% [79/500], and viremia was confirmed by PCR in 77.2% [61/79] of the antibody-positive prisoners. The prevalence of antibodies to hepatitis B core antigen was 9.8% [49/500], and 1.2% [6/500] of prisoners were dually infected with HBV and HCV. Antibodies to human immunodeficiency virus were not detected in any of the prisoners. The best predictor for hepatitis C and hepatitis B infection was a history of intravenous drug use [P < 0.011 for HBV and P < 0.001 for HCV], a period of >10 years spent in prison [P < 0.052 for HBV and P < 0.021 for HCV] and shared toiletries [P < 0.059 for HBV and P < 0.002 for HCV]. Hepatitis C and hepatitis B virus infections constitute an important public health problem in prisons. Public health strategies to prevent morbidity and mortality from these infections should include hepatitis B vaccination, HCV testing, counseling and medical management of infected prisoners

Helicobacter pylori infection: seroprevalence and predictors among healthy individuals in Al Madinah, Saudi Arabia

Background: Helicobacter pylori infection is one of the most common chronic bacterial infections among humans worldwide. However, there is no information on the epidemiology of H. pylori infection in Al Madinah, Saudi Arabia

Objective: This study was conducted to determine the seroprevalence of H. pylori in asymptomatic healthy individuals and the possible relationship between H. pylori infection and sociodemographic, lifestyle, and environmental factors in this region

Methods: A hospital-based cross-sectional study was conducted on a consecutive sample of asymptomatic healthy individuals. A pilot-tested interview format was used as the research tool. Venous blood was collected from individuals and sera were separated. The enzyme-linked immunosorbent assay was used to determine H. pylori IgG antibody levels in all serum samples

Results: A total of 456 samples were collected. H. pylori antibodies were found in 129 [28.3%] individuals. Seroprevalence of 16.9% was found in individuals younger than 20 years of age, which gradually increased with age and reached 36.8% by the age of 50. After controlling for the confounding factors, significant independent predictors of seropositive state were: rural residence [odds ratio [OR]=2.5, 95% confidence interval [CI]=1.3, 4.7], crowded housing [OR=1.6, 95% CI=1.1, 2.6], low socioeconomic status [OR=3.3, 95% CI=1.6, 8.8], using tanks for drinking water supply [OR=2.2, 95% CI=1.2, 7.4], active smoking [OR=5.6, 95% CI=3.2, 9.8], alcohol drinking [OR=2.3, 95% CI=1.5, 6.2], eating raw vegetables [OR=3.2, 95% CI=1.4, 7.1], eating spicy food [OR=2.1, 95% CI=1.3, 3.5], and presence of asthmatic/atopic symptoms [OR=2.5, 95% CI=1.3, 5.9]. No associations were found between infection and age, gender, source of sewage disposal, eating fruits, or family history of upper gastrointestinal symptoms

Conclusion and recommendations: Infection with H. pylori is declining among healthy individuals of Al Madinah, Saudi Arabia. Infection is acquired at an early age and reaches up to 36.9% as age advances. The risk of H. pylori seropositivity was related to socioeconomic, lifestyle, and environmental factors. A nationwide epidemiological study is warranted to determine the seroprevalence of H. pylori in Saudi Arabia