Helicobacter pylori and Its Virulence Factors' Effect on Serum Oxidative DNA Damages in Adults With Dyspepsia.

Helicobacter Pylori infection is a common gastrointestinal infection that can cause pathological effects, increase oxidative stress and induce an inflammatory response in gastric mucosa. Inflammatory aspects may prompt the production of radical oxygen substance (ROS) which may damage cells and release 8-hydroxydyoxyguanosine (8-OHdG) to serum. In this study, we evaluate the prevalence of H. pylori virulence factors and the association between serum level of 8-OHdG, H. pylori infection, and its various virulence factors. The presence of H. pylori and prevalence of cagA, babA and oipA genes in samples were determined by rapid urease test (RUT), histopathological exam (HE) and polymerase chain reaction (PCR) and oxidative DNA damage situation were assessed by using serum level of 8-OHdG. There was not any direct relation between H. pylori negative and H. pylori oipA+specimens by 8-OHdG serum level (P>0.05). In all clinical observations, the presence of cagA and oipA genes was common. There was a statistical relationship between the presence of cagA, babA factors, and high serum level of 8-OHdG (P<0.05). The presence of cagA and babA virulence factors may be associated with increased serum 8-OHdG in dyspeptic patients and may induce the damage to gastric cells.

The efficacy and safety of adding the probiotic Saccharomyces boulardiito standard triple therapy for eradication of H.pylori: a randomized controlled trial.

AIM: Evaluating the efficacy and safety of adding the probiotic Saccharomyces boulardiito standard triple therapy for eradication of Helicobacter pylori. BACKGROUND: Several probiotics such as Saccharomyces boulardii have been investigated for their clinical efficacy. This probiotic, inhibit H. pylori urease by lowering the gastric pH, adhesion of H. pylori to gastric epithelial cells, stabilize the gastric barrier function and reduce the side effects of antibiotics. PATIENTS AND METHODS: In this randomized controlled trial we evaluated 160 adult patients with biopsy confirmed H. Pylori infection referred to gastroenterology ward of Taleghani hospital. The patients were randomized into two treatment regimens: patients in group A (n = 80) were given amoxicillin (1000 mg, b.i.d), clarithromycin (500 mg, b.i.d), omeprazole (20 mg, b.i.d) and probiotic of saccaromyces boularidi (Yomogi) (250 mg, b.i.d) for 14 days, moreover patients in group B (n = 80) were given amoxicillin (1000 mg, b.i.d), clarithromycin (500 mg b.i.d) and omeprazole (20 mg,b.i.d) for 14 days. RESULTS: 160 patients (66 male 41.25%, 94female 58.75%) with the mean age of 47.1±11.4 years were evaluated. The success rate for H. pylori eradication in group A was higher 75(87.5%) than group B 65 (81.2%), but the difference between two groups was not significant (p = 0.350). Moreover, in case group side effects as nausea, diarrhea, abdominal discomfort and bloating were significantly lower than control group in first and second weeks. CONCLUSION: This study showed that saccaromyces boularidi decreased the adverse effects associated with H.pylori therapy but did not significantly decrease the eradication rate of H.pylori.

Duodenal adenocarcinoma might be the cause of intractable nausea and vomiting in patient with coeliac disease.

Coeliac disease (CD) is an autoimmune disorder which leads to chronic inflammation of the gut. Untreated CD is associated with upper gastrointestinal malignancies, Small-bowel lymphoma and adenocarcinoma are recognized complications of untreated coeliac disease (CD). We report the case of a 43-year-old male suffering from CD who was treated with a gluten-free diet one year, presenting with complaints of intractable nausea and vomiting. After several studies, He underwent push enteroscopy, which identified one large mass lesion in the third part of duodenum. However, histopathological examination showed adenocarcinoma. Subsequently, a duodenal segment resection was performed. After surgery, the patient recovered well and left our hospital in good condition. Clinicians should take into small bowel adenocarcinoma is rare but associated with CD particularly in CD patients with worrying symptoms such as nausea and vomiting unresponsiveness to treatment and these patients should be screened for long term complications like malignancy.