Hazarders of Smoking and <i>Helicobacter pylori</i>Infection on Gastric Mucosa among Egyptian Patients with Dyspepsia

Background: Smoking is hazardous to almost any organ in the body and has a harmful effect on the gastric mucosa. Objective: The main goal of this study was to evaluate the synergistic effect of smoking and H. pylori infection on gastric mucosal among dyspeptic Egyptian patients. Patients and Methods: A cross-sectional study was conducted among 240 consecutive patients with dyspepsia who underwent upper endoscopy and histopathological examination of gastric biopsies at Zagazig and Tanta University Hospital with H. pylori-positivity assessment by stool antigen and rapid urease test. Results: There were 60 smoker patients and 180 non-smoker patients. Erosive gastritis was more prevalent in smoker patients than non-smoker patients (46.7% versus 15.6%, p = 0.00). In H. pylori-positive patients (36.7% of all patients), smokers were more prevalent than non-smokers in the development of intestinal metaplasia (20% versus 0%, p = 0.003), erosive gastritis (80% versus 30%, p = 0.00), glandular atrophy (20% versus 0%, p = 0.003) and reactive gastropathy (20% versus 0%, p = 0.003). Conclusions: This study revealed that smoking may increase the prevalence of having gastric intestinal metaplasia, erosive gastritis, glandular atrophy and reactive gastropathy in H. pylori-positive Egyptian patients.

Which Gastric Microbiota Associated with <i>H. pylori</i>in Dyspeptic Patients with Gastritis

Introduction: H. pylori is the comment infection worldwide. Its relation to dyspepsia has long been investigated. However, the association between H. pylori and other microbiota in the context of dyspepsia is less understood. The aim of this study was to determine different bacterial species isolated from the stomachs of patients with H. pylori infection and dyspepsia. Methods: A total of 81 patients were included and divided into: group I (N = 50) patients complaining of chronic dyspepsia and group II (N = 31) are patients with non-dyspeptic symptoms endoscoped for reasons other than dyspepsia. All patients were endoscoped and 4 gastric biopsies were obtained from each patient. All patients were examined initially by rapid urease test then histopathology to confirm H. pylori infection and determine the degree of gastric inflammation and finally tissue cultures for H. pylori and other bacterial species using matrix-assisted laser desorption ionization-time-of-flight mass spectroscopy (MALDI-TOF MS). Results: Regarding the demographics;patients of dyspepsia in group I were more consumers of spicy food and smoking than non-dyspeptic patients. Almost, all dyspeptic patients (98%) who had underlying gastric pathology with active gastritis and erosions were the most frequent reported pathological findings. Culture results showed significant association of Staphyloccus and Lactobacillus with dyspepsia while Streptoccous and Klebsilla were more frequent among non-dyspeptic patients. Conclusion: Dyspeptic patients in this study had different grades of gastric pathology and different species of microbiota were isolated, which seems to have concomitant interaction with H. pylori in pathogenicity of gastric mucosa and cause symptoms of chronic dyspepsia.

A Comparative Study of the Typhidot (Dot-EIA) versus Widal Test in Diagnosis of Typhoid Fever among Egyptian Patients

Background and Study Aim: Typhoid (Enteric) fever is a systemic infection caused by Salmonella Typhi and Salmonella Paratyphi. It is endemic in the developing countries including Egypt. Different diagnostic tools can achieve diagnosis and include cultures from the blood, stool, bone marrow, rarely urine for isolation of the organism. Antibody detection by Widal test and relatively recent typhoid are also used. The current study aimed at comparing the most commonly used antibody detection Widal test with the rapid antibody detection typhidot for diagnosis of typhoid fever among Egyptian adults. Patients and Methods: The study included 140 patients who are presented with picture suggestive of typhoid fever. Confirmed cases after the blood culture were included in the final analysis. Widal and typhidot tests were performed in all patients and were compared for sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. Results: 45 patients out of 140 were diagnosed as typhoid fever by blood culture. Out of them, Widal test was positive in 39 patients with sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of 86.7%, 89.5%, 79.5%, 93.4% and 88.5% respectively. Typhidot test was positive in 42 patients with sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of 93.3%, 90.6%, 82.3%, 96.6%, and 91.4% respectively (P = 0.00). Conclusions: Typhidot test is reliable, simple highly sensitive and specific test in diagnosing typhoid fever when compared with Widal test.