Background: Helicobacter pylori (H. pylori) remains one of the most common worldwide human infections and is associated with a number of important upper gastrointestinal (GI) conditions including chronic gastritis, peptic ulcer disease, gastric carcinoma and special type of lymphoma. Anaemia is a common disorder in developing countries and the commonest cause is iron deficiency. There are many causes for high prevalence of this disorder in our society, many are well-known and investigated while some are new and not well established. Although H. pylori associates peptic ulcers and gastric malignancy can cause bleeding, resulting in iron deficiency, but majority of patients infected with H. pylori does not have ulcer or malignancy. They usually have chronic gastritis that is not associated with GI bleeding. About 35% of iron deficiency anaemia cases remain unexplained after a gastrointestinal evaluation. Recently investigation focused on the role of H. pylori, in the development of extra-gastrointestinal diseases including Iron deficiency anaemia.
Methodology: This observational, cross sectional study was carried out at BSMMU, Dhaka from July 2010 to October 2011 to find out the association between H. pylori infection and iron deficiency anemia in Bangladeshi adults. Patients with dyspepsia and indication of upper GI endoscopy were initially enrolled in the study and finally a total of 168 subjects were included based on inclusion and exclusion criteria.Result : Among 168 patients, 105 (62.5%) were male and 63(37.5%) were female with the mean age of 33.25 years. On endoscopy, 147(87.5%) of the patients had normal findings and 21(12.5 %) had erosive gastritis. None of them had hemorrhagic erosive gastritis. Among 168 patients, 115(68.45%) were positive and 53(31.55%) were negative for H. pylori by rapid urease test.
In our study, we have found a significant low mean serum ferritin level (P<0.001) in H. pylori infected patients. This result is consistent with most of previous data concerning the effect of H. pylori infection on iron metabolism. This study has also revealed a significant (P<0.001) lower value of mean MCV and MCH in H. pylori positive patients.Regarding hemoglobin value, our study has showed no significant (P>0.05) different in hemoglobin level according to H. pylori status.
Microscopic Colitis (MC) and diarrhea predominant irritable bowel syndrome (IBS-D) has almost similar clinical feature but MC is diagnosed by histologic criteria and IBS is diagnosed by symptombased criteria. There is ongoing debate about the importance of biopsies from endoscopically normal colonic mucosa in the investigation of patients with IBS-D. Aim of this study was to assess the prevalence of MC in patient with IBS-D and to determine the distribution of MC in the colon. This observational study was conducted in department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
HEV RNA was found in sporadic AH and FH and sub-clinical CLD cases, but not in HP. HEV RNA-positivity was significantly related to values of ALT and AST and titers of IgG and IgM specific anti-HEV, with IgM specific anti-HEV showing the most significant relationship. All clones were genotype I, which is prevalent in South Asia.
In a recent investigation of hepatitis in Bangladesh, the sera from 74 adult patients (aged 15-67 years) who had been clinically diagnosed as cases of sporadic acute hepatitis were collected at various hospitals in and around Dhaka. Five cases were positive for IgM antibody against the hepatitis A virus and 30 were positive both for the surface antigen of the hepatitis B virus (HBV) and for IgM antibody against the HBV core (HBc). The six cases found positive for antibodies against the hepatitis D virus were all also positive for the HBV surface antigen but negative for anti-HBc IgM. Thirteen patients harboured hepatitis C virus RNA and 29 were positive for IgM antibody against the hepatitis E virus (HEV). There were 14 non-A-to-E subjects, whose illness was of unknown aetiology. Of the 83 infections with hepatitis viruses detected in the other 60 patients, 6%, 36%, 16%, 7% and 35% were of types A, B, C, D and E, respectively. Each of 28 of the patients (47% of those confirmed to have viral hepatitis) had concomitant infection with more than one type of hepatitis virus. The predominance of HBV and HEV infections and the high prevalence of multiple infection seen among these Bangladeshi cases have not been observed among hepatitis cases in developed countries.
Helicobacter pylori is a Gram negative bacteria which causes chronic gastritis, peptic ulcer disease, primary B-cell gastric lymphoma, and adenocarcinoma of the stomach. There are a set of laboratory tests to diagnose H. pylori infection with a variable accuracy, they are divided into non-invasive tests and invasive tests. Non-invasive tests include serology, urea breath test (UBT) and stool antigen test (SAT). Invasive tests include rapid urease test (RUT), histology and culture. This cross sectional study was carried out in the Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and H. pylori laboratory of International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) from July 2008 to September 2009 to evaluate the efficacy of RUT, SAT and Culture as a diagnostic tool for H. pylori. Dyspeptic patients were collected from outpatient department of BSMMU. Out of 224 dyspeptic patients 149 patients had ulcers or erosions in the stomach or duodenum. Stool sample could be collected from 139 patients. RUT has sensitivity of 100%, specificity 80.28%, positive predictive value 85% and negative predictive value 100%. Regarding culture, sensitivity is 100%, specificity 94.37%, positive predictive value 95% and negative predictive value 100%. Stool antigen test has sensitivity 95.94%, specificity 92.31%,positive predictive value 93% and negative predictive value 95%. DOI: http://dx.doi.org/10.3329/fmcj.v8i1.16890 Faridpur Med. Coll. J. 2013;8(1): 11-14
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