Background and study aim: Worldwide some endoscopy units routinely continue to use manual reprocessing techniques for disinfection of side-view endoscopes. The aim of this study was to evaluate the outcome quality of manual reprocessing techniques for removal and inactivation of the bioburden from side-view endoscopes used for endoscopic retrograde cholangiopancreatography (ERCP) in a tertiary referral endotherapy unit in Sri Lanka. Methods: 102 samples obtained from two different flexible side-view endoscopes (Olympus TJF Q 180V and Olympus TJF 160 R) were tested for microbial growth. Three samples were collected each time; one swab from the tip before and another after manual reprocessing. The third sample was collected by flushing the working channel with sterile normal saline after manual reprocessing. Microorganisms were identified by culturing the samples. Result:: After reprocessing, culture-positive rates were 20 % and 9 % for the samples obtained from the tip and the working channel of the side-view endoscopes, respectively. Klebsiella spp. and Candida spp. were found to be the commonest microorganisms in the samples from the tips and from the working channels, respectively, of the reprocessed side-view endoscopes. Conclusion: There is a high culture-positive rate after reprocessing of the side-view endoscopes using the manual reprocessing procedure, despite strict adherence to the protocol for reprocessing.

Background: Infection with Helicobacter pylori is considered as a major cause of chronic gastritis, peptic ulcer disease and gastric cancer. More than half of the world's population is infected with H. pylori. In Sri Lanka various groups have reported a prevalence ranging from 3% to 70% over the last decade. Objectives: The aim of this study was to determine the current proportion of H. pylori and risk factors for H. pylori infections. Patients and Methods:The study was a cross sectional, descriptive study in which 100 dyspeptic patients who were required to undergo endoscopy examination were included. The study was carried out at a Teaching Hospital in Sri Lanka. In-house urease test and PCR amplification of the glmM gene of H. pylori was performed to diagnose H. pylori infection. A questionnaire was filled to collect sociodemographic data from the dyspeptic patients. Results: Eighteen dyspeptic patients were positive for H. pylori by both in-house CLO (Campylobacter-like organism test) test and polymerase chain reaction (PCR). Ten of cases were male (18%) while eight were female (17%). There was no association between the demographic factors and risk of H. pylori infection. Conclusions: The proportion of H. pylori infections was found to be 18% in the study population. There was no significant association with H. pylori and the studied demographic factors.

The gut microbiota is a complex ecological community, consisting of trillions of microbes which include bacteria, viruses, fungi and protozoa. The stomach was previously considered as a sterile site uninhabited by microbes due to its hostile environmental conditions. Breaking this concept, Helicobacter pylori was the first pathogen reported to inhabit the stomach. Recent studies have suggested that the stomach harbours transient as well as certain commensal bacterial and fungal species. The five major microbial phyla in the stomach have been identified as Firmicutes, Bacteroidetes, Actinobacteria, Fusobacteria and Proteobacteria.The composition of gastric microbiota is dynamic and is affected by several factors. These include age group, dietary habits, medication use, inflammation of gastric mucosa and H. pylori colonization. Further, the role of host genetics has recently been studied in maintaining the stomach microbiota. Mutations in host genes may affect the host's immune response towards commensal bacteria and reduce their number and diversity.The essential multiple roles of gut microorganisms include maintaining homeostasis in the gut, contributing to immune function and extraction of nutrients and energy from our diets. Loss of the normal balance between the gut microbiota and host has been associated with several abnormal conditions and disorders such as obesity, malnutrition, inflammatory bowel diseases (IBD), neurological disorders, and cancer. In the stomach, the interaction between H. pylori and the gastric microbiota can also influence gastric disease progression. Further studies should focus on addressing the role of gastric dysbiosis in health and disease. Identifying gastric microbiota is essential to understand how the gut microbiota and H. pylori affect health and disease.