Comparison of enzyme immunoassays detecting Helicobacter pylori specific IgG in serum and saliva with endoscopic and biopsy findings in patients with dyspepsia.

Purpose: To compare the performance of two indirect enzyme-linked immunosorbent assays (ELISA) detecting Helicobacter pylori (HP)-specific IgG antibodies in serum and saliva with endoscopic observations and histologic findings of biopsies from dyspeptic patients, in an area of high HP prevalence. Materials and Methods : Sera, saliva and antral biopsies were obtained from 55 dyspeptic patients. IgG antibodies against HP were assayed in sera and saliva utilizing two indirect ELISAs. Biopsies were processed according to standard procedures in order to detect histological changes and the presence or absence of Helicobacter pylori. Laboratory data thus obtained were compared and statistically analyzed. Results: Forty-two (76.36%) biopsies were positive for HP. The organisms were detected in 4 of 16 (25%) cases with normal endoscopic findings, in all 16 cases of gastritis and in 22 of the 23 (95.6%) cases of duodenal ulcers (DU). Serum and saliva HP-specific IgG antibodies were detected in 4 normal cases with positive biopsies, in 12 and 14 cases of gastritis, respectively, and in all 22 (100%) biopsy positive cases of DU. The sensitivities of the serum and saliva tests were 90.5% and 95%, respectively, while the specificities were 84.5% and 70%, respectively. Conclusion: Due to their high sensitivity and specificity in diagnosing HP-associated DU and gastritis, serum and saliva antibody testing seems to offer a valuable alternative to invasive procedures especially in areas of high HP prevalence such as ours; saliva antibody testing is simple and practical especially in children and in difficult patients who resent venipuncture.

Dietary and Fluid Adherence among Haemodialysis Patients Attending Public Sector Hospitals in the Western Cape

Objective There has been considerable debate about the extent to which social cognitive models of health behaviour apply in developing countries. The purpose of this paper was to determine the applicability of the Theory of Planned Behaviour (TPB) in predicting dietary and fluid adherence among a sample of haemodialysis patients attending public sector hospitals in the Western Cape.Design and methods A sample of 62 historically disadvantaged patients undergoing haemodialysis completed a battery of psychometric instruments measuring attitudes; subjective norms; perceived behavioural control regarding dietary and fluid adherence; health literacy; perceived social support; and self-reported dietary and fluid adherence. Interdialytic weight gain (IDWG); predialytic serum potassium levels; and predialytic serum phosphate levels served as biochemical indicators of dietary and fluid adherence.Results Regression analyses indicated that the linear combination of attitudes and perceived behavioural control significantly accounted for 15.5of the variance in self-reported adherence (a medium-effect size) and 11.4of the variance in IDWG (a modest-effect size). No significant predictors were identified for predialytic serum potassium and predialytic serum phosphate levels. Interpretation and conclusions The results indicate that; while the TPB may not function in the same manner as it does in Western samples; it may have some nuanced applicability among haemodialysis patients attending public sector hospitals in the Western Cape