Comparison of stool antigen test with gastric biopsy for the detection of helicobacter pylori infection

Helicobacter Pylori [H.pylori] is one of the most important causes of dyspepsia and diagnosis can be made by invasive or non-invasive methods. One of the non-invasive methods, H.pylori stool antigen test [HpSA] is simple, fast and relatively inexpensive. According to this view with regard to gastric biopsy as a gold standard the sensitivity, specificity, positive and negative predictive values of this method were calculated. Stool samples of 61 patients who underwent upper endoscopy and gastric biopsy due to dyspepsia were evaluated for H. Pylori stool antigen using sandwich ELISA method. From the 61 patients who participated in this study, H.pylori was diagnosed in 38 [62.3%] gastric biopsies, 25[66%] of these had positive HpSA test. Also, of 27 [37.7%] positive HpSA cases, H.pylori was seen in 25 gastric biopsies. For this method, sensitivity of 66% with 93% positive predictive value was calculated. Also, 91% specificity with 62% negative predictive value was estimated. High positive HpSA indicates high risk of H.pylori infection and high specificity shows that the likelihood of false positive is low. Therefore, physicians can trust on this method and start patient`s treatment

Enhanced ovarian folliclular development by metformin does not correlate with pregnancy rate: a randomized trial

Polycystic ovary syndrome [PCOS] is a common, complex endocrine disorder for women of productive age. A high incidence of ovulation failure in women with PCOS is related to insulin resistance. Some studies have assessed the effects of hyperinsulinemia and insulin resistance in relationship with insulin sensitizing agents such as Metformin [Met]. These medicines have been suggested new scope for ovulation stimulation enhancement with Clomiphene Citrate [CC] in PCOs women. The aim of this study is to compare the effectiveness of adding Met to CC in women with PCOS. This multicenter, single-blind, randomized controlled trial study was performed on 334 PCOS patients from 2007 to 2009. Patients were randomly divided into two groups and ovulation induction was performed with either CC alone or CC + Met. The treatment was continued for three cycles, then the mature follicle and pregnancy rates were evaluated. In the CC + Met group, 68% had at least one dominant follicle in the first cycle that was significant [p<0.001], and 31.7% had one in the second cycle. In the CC group 54.5% in the first cycle, 31.7% second cycle, and 6.9% ovulated in the third cycle. The pregnancy rate was 28.7% in CC + Met group and 24.6% in the CC group, with no significant differences between the two groups. Adding Met to CC is significant for ovulation, but it does not enhance the pregnancy rate

[Efficacy of domperidone and pyridostigmine in the treatment of patients with functional dyspepsia: a randomized clinical trial]

The majority of dyspeptic patients do not have identifiable disease, which is also known as functional dyspepsia. The therapeutic approach to patients with functional dyspepsia is still a matter of debate; prokinetic agents are commonly used for symptom relief. This study aims to evaluate the efficacy of domperidone and pyridostigmine [an inhibitor of cholinesterase] in patients with functional dyspepsia. This was a single-blind, randomized clinical trial performed on 117 patients [December 2007 to November 2009] diagnosed with functional dyspepsia according to ROME II criteria. The effects of 4 weeks of treatment with domperidone [10 mg tid], yridostigmine [60 mg tid], and placebo were compared. We scored each patient according to VAS to rank the severity of 8 different upper GI symptoms [epigastric fullness, early satiety, gnawing, nausea, vomiting, belching, bloating, and epigastric pain] both before and at the end of treatment. Data were entered into SPSS software version 16 and analyzed. P<0.05 was considered significant. At the end of treatment, the total dyspeptic symptom score decreased from 24 to 13. According to ANOVA, there were significant differences between the 3 groups in 3 out of 8 symptom scores of bloating [p=0.039], early satiety [p=0.006], and nausea [p=0.016]. The post hoc test determined that domperidone was more effective than pyridostigmine and placebo in improvement of early satiety [p=0.038 and p=0.014, respectively]. Domperidone was more effective than pyridostigmine in the control of nausea [p=0.024]. Domperidone [p=0.023] and pyridostigmine [p=0.042] were superior in relieving bloating symptoms compared to placebo. Overall, in the control of GI symptoms domperidone was more effective than placebo [p=0.045]. domperidone and pyridostigmine are useful in improving bloating, early satiety, and nausea. However they are similar to placebo in controlling epigastric pain, fullness, belching and gnawing

[Correlation between abnormal glucose challenge test and pregnancy outcomes]

Gestational diabetes is the most common metabolic disorder in pregnancy. Glucose Challenge Test [GCT] is done for all pregnant women during the 24th to 28th weeks of gestation. If the GCT value is more than 130 mg/dl a Glucose Tolerance Test [GTT] is asked and if GTT is impaired, gestational diabetes mellitus [GDM] is diagnosed and she will receive treatment accordingly. Some studies have illustrated that impaired GCT can cause unfavorable pregnancy outcomes. Therefore, the goal of this study was to determine the pregnancy outcome in pregnant women with abnormal GCTs. This study was done on all pregnant women attending Babol Shahid Yahyanezhad Hospital for prenatal care during 1999 to 2009. GCT was done for all the participants during the 24th to 28th weeks of gestation. Pregnancy outcomes of 225 pregnant women with abnormal GCTs and normal GTTs were compared with those of 225 pregnant women with normal GCTs as the controls. The individuals were compared for pregnancy outcomes such as macrosomia, premature rupture of membranes [PROM] and the need for a cesarean section [C/S]. The average birth weight of the neonates were 3.5 +/- 0.5 kg and 3.3 +/- 0.4 kg [p<0.001] in the cases and controls, respectively. Twenty-five neonates in the case group [12.1%] and eight neonates in the control group [3.6%] had macrosomia [p=0.003]. Frequency of PROM was 17.85% [40] in the cases and 8.9% [20] in the controls [p=0.008]. The cases had a higher frequency for preeclampsia 4.4% [10] than the controls 1.8% [4], [p=0.17]. and pregnancy in the cases lead to a greater number of Cesarean sections, 42.2% [95] in comparison to the controls, 28% [63], [p<0.001]. Prevalence of macrosomia, PROM and C/S were higher in pregnant women with abnormal GCTs. Due to the aforementioned unfavorable conditions that bear the risk of a poor perinatal outcome, early diagnosis and proper follow up of women with GDM is suggested during the prenatal period