Background: Non-alcoholic fatty liver disease (NAFLD) is a very common disease that affects 25-30% of the population in western countries. Many studies have observed the importance of H. pylori infection in the development of insulin resistance, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, and liver fibrosis and cirrhosis. However, the evidence from different studies was controversial. The present study aimed to investigate the relationship between H. pylori infection and NAFLD in a developing country. Patients and Methods: This cross-sectional study included all the attending outpatient clinics at four Major University hospitals and two research and clinical institutes in a developing country in the period between June and October 2019. Patients were assessed for the diagnosis of H. pylori infection as detected by H. pylori antigen in stool; they were also assessed for the diagnosis of NAFLD by ultrasound, fibroscan, and CAP. Results: The study was conducted on 646 patients; H. pylori infection was found to be present in 538 patients (83.3%). NAFLD (diagnosed by both U/S and Fibroscan with CAP), ALT, AST, hepatomegaly, hypertension, fasting blood sugar were significantly higher in H. pylori +ve group than H. pylori −ve group. After performing Linear regression of independent risk factors of NAFLD to prove or to refute the role of Helicobacter; H. pylori positivity, total cholesterol, degree of fatty liver by ultrasound, fasting blood sugar and diastolic blood pressure were independent risk factors for NAFLD. Conclusion: Helicobacter pylori infection was independent risk factors for NAFLD and correlated with increased degree of steatosis.

Evidences supporting the association between H. pylori infection and chronic cholecystitis could be found by using direct culture or staining of H. pylori in gallbladder tissues as well as indirect techniques. Stool antigen test has been widely used due to its non-invasive nature. Various stool antigen tests were developed to detect H. pylori using an enzyme immunoassay (EIA) based on monoclonal or polyclonal antibodies This study evaluated the frequency of H. pylori antigen in stool samples of patients with chronic calcular cholecystitis as regard gall bladder histopathological changes.-Fifty patients were included presented with symptomatic cholecystolithiasis recruited from the outpatient clinic of National Hepatology and Tropical Medicine Research Institute during 2014-2015. Full history and clinical examination and abdominal ultrasonography were performed. Stool samples were collected, prepared and examined for detection of H. pylori antigen. Cholecystectomy was done for all patients; 45 patients (90%) by laparoscopic Cholecystectomy and 5 patients (10%) by open surgery and removed gallbladders were submitted to pathology department for detection of H. pylori in tissue under microscope using Giemsa stain. The results showed that (82%) were females with mean age (42.6+1years). The mean BMI was (29+7.2) H. pylori-specific antigen in stool samples was detected in 40% of patients and38% were detected in patients; tissue, with significant correlation between H. pylori-specific antigen in stool and in tissue. Histopathological pictures infection in tissue were 68.4% mucosal erosions, 63.2% mucosal atrophy, 57.9% mucosal hyperplasia, 26.3% metaplasia, 42.1% musculosa hypertrophy, 26.3% fibrosis, but lymphoid aggregates were in 42.1% of cases.

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BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is now the factor behind the development of liver cirrhosis, liver cell failure, and liver transplantation in many cases. However, its relation to atrial fibrillation (AF) could not be cleared up. AIM: The purpose of the study was to evaluate prevalence of AF in the setting of NAFLD; the association between them, and to evaluate risk factors of AF in this category of patients. METHODS: This cross-sectional study was performed on 400 patients between January 2018 and June 2019. These patients were analyzed for the presence of NAFLD and presence of persistent or chronic AF. RESULTS: There were 138 patients with NAFLD, and 20 patients with persistent or permanent AF. Factors associated with AF were old age, male gender, and high values of aspartate aminotransferase, alanine-aminotransferase, γ-glutamyltranspeptidase, and serum uric acid. The participants with AF had a significantly greater prevalence of NAFLD than those without AF. CONCLUSION: Incidence and prevalence of atrial fibrillation in NAFLD patients were high. Severity of liver disease was an important predictor of new-onset atrial fibrillation.

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Background &Aims: The utility of ultrasound and color Doppler in diagnosis and assessment of the activity of inflammatory bowel diseases (IBD) is not studied enough. So, the aim of the current study was to evaluate the value of conventional abdominal ultrasound and color Doppler in the diagnosis of IBD and assessing disease activity. Methods: The study was conducted in National Hepatology and Tropical Medicine Research institute (NHTMRI) in the period between July, 2018 and January, 2019; where 150 patients suffering from diarrhea, dysentery, tenesmus or bleeding per rectum were evaluated by colonoscopy, high resolution ultrasonography and color Doppler scanning. Results: The present study was conducted on 150 patients, where 84 (56%) had Ulcerative colitis (UC) disease, 16 (10.7%) were Crohn's disease (CD) and 50 (33.3%) had normal colonosopic findings with their mean age was (37.2±9.059). The superior mesenteric artery (SMA) peak systolic velocity (PSV) and end diastolic velocity (EDV) was significantly higher in both UC and CD than the control group; however, pulsatility index (PI) was significantly higher in the control group than both UC and CD however there was no significant difference between UC and CD. The inferior mesenteric artery (IMA) PSV and EDV was significantly higher in both UC and CD than the control group. Conclusions: Doppler sonographic findings of SMA and IMA correlate with the incidence of IBD and their site of affection and their activity.

Background & Aims: Human genetic polymorphism has been reported in the susceptibility and clinical development of infection. In this regard, this study aimed to investigate the link between Vitamin D Receptor (VDR) gene polymorphism and H. pylori infection. Materials and Methods: This cross-sectional study was conducted on 224 adult patients with upper gastrointestinal symptoms who underwent an upper gastrointestinal endoscopy between July 2017 and May 2019 in two major university hospitals. All patients were evaluated for helicobacter pylori infection. Two gastric antral biopsy specimens were taken from each patient. One of those Biopsy specimens was evaluated for histopathology examination and the other one was immersed in a saline solution ready for genomic DNA extraction. Results: There were statistically significant differences between different genotypes of VDR rs7975232 polymorphism between H. pylori infected and non-infected groups (CC was higher in H. pylori negative and AC and AA were the most common in H. pylori positive group). There were statistical differences between different genotypes of VDR rs2228570 between H. pylori infected and non-infected groups (TT was higher in H. pylori negative and CT and CC were the most common in H. pylori positive group). Regarding VDR rs 7975232 gene polymorphisms; the (A) allele was significantly higher H. pylori infected, while (C) allele was significantly higher in uninfected patients. Regarding VDR rs 2228570 gene polymorphisms; the (C) allele was significantly higher H. pylori infected, while (T) allele was significantly higher in uninfected patients. Conclusion: There is a possible association between the FokI and Apal VDR polymorphism and H. pylori infection.

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