Tehran University Medical Journal

Background: Many recent studies have examined potential risk factors of H. pylori gastritis to improve our understanding of the early events in gastric carcinogenesis. We evaluated the extent and topography of chronic gastritis in a high risk area for gastric cardia cancer and investigated the critical role of H.pylori, risk index and age in its pathogenesis.

Materials and Methods: During a national population-based endoscopic survey, we enrolled 508 participants aged ≥40 from urban and rural areas of Meshkin-Shahr, Ardebil province of Iran. After informed consent, all underwent complete upper GI endoscopy. At least one mucosal biopsy was obtained from 6 standard sites: three of antrum (sites 1, 2, 3), two of corpus (sites 4, 5) and one of cardia (site 6). Severity, activity and combined inflammatory scores (CIS) of chronic gastritis and H.pylori infection status were assessed according to modified Sydney Classification of Gastritis. Statistical effects of H.pylori, age, gender, and residency place on mean gastritis severity, activity and CIS were separately calculated in each site.

Results: Total of 508 participants with mean age (±SD) of 54.6(±SD) were enrolled. 234(46.1%) were male and 274(53.9%) were female. Histologically 80.5% of cases were H.pylori positive. Mean activity scores of all sites except for site 5 are significantly (P<0.01) higher in H.pylori + cases. Mean CIS of all sites was significantly (P<0.01) higher in H.pylori + patients. In 44% of infected subjects, CIS of the corpus was at least equally as severe as that in antrum. Also in 54% of H.pylori + cases, cardia’s CIS was ≥ than antral CIS. Age had a significant (P<0.01) negative relationship with CIS of antral site, but this relationship in cardia was positive and more potent.

Conclusion: H.pylori is the main cause of gastritis activity in all sites of stomach this causality is more potent in antrum and cardia. Continuous cardia inflammation in advanced age may contribute to high incidence of gastric cardia cancer in this region.

Background: Prolonged antiacid and antibiotic usage in gasterointestinal diseases may predispose candidial colonization in GI tract. In order to isolate and diagnose of candida infections in patients with gastritis, duodenitis, gastric ulcer and duodenal ulcer, this study have been planned.

Methods: We studied 300 biopsy specimens of patients referred to hospital, 51.7% of the patients were male and the others were female. The isolated fungi were identified by direct examination and culture of specimens.

Results: Forthy four cases of yeasts were isolated in this investigation. Isolated yeasts have been identified as follows: 26 cases of C.albicance , I case C.tropicalis, 2 cases of C.krusei, and finally 1 case of unknown yeast.

Conclusion: All the patients had a positive history of long lasting antacid taking for gastric ulser or gastritis. Candidiasis must be investigated in patients with gastritis, duodenitis and gastric ulcer, who are refractory to classic therapies and also in patients who have the chronic disease .

Background: Helicobacter pylori (Hp) infection often occurs in childhood and adolescence, with the frequency increasing with age. Hp infection is associated with insufficient hygiene, overcrowding and low socioeconomic status. Although declining in developed countries, children in the developing countries continue to have a high prevalence of Hp infection. As the association of Hp infection with chronic abdominal pain is not ubiquitously accepted, in this study we investigate the significance of endoscopic finding associated with Hp infection in children with abdominal tenderness.

Methods: This cross-sectional study included 1,665 healthy children, aged 6 to 12 years, in whom Hp infection was evaluated using the IgG anti-H. pylori test. Hp-positive children with epigastric tenderness underwent upper gastrointestinal (GI) endoscopy. Urease activity of gastric mucosal biopsies was measured. The presence and density of Hp organisms, the presence of follicular gastritis, and the nature of inflammation and gastritis activity were assessed by histologic examination.

Results: Of 1665 children, 429 (26%) subjects (51% girls, 49% boys) were seropositive for H. pylori. There was a significant association between Hp infection and older age (p<0.001) and male/female ratio (p<0.05). Epigastric tenderness was detected in 39 children (1%), 29 of whom underwent upper GI endoscopy. Nodular gastritis with antral erythema was the most common endoscopic finding (26/29 89.7%). Histological findings revealed that, in all cases with endoscopic nodularity, lymphoid follicles were present. Bacterial density was low in 13 (44.8%), moderate in 14 (48.2%) and high in 2 (7%) subjects.

Conclusion: The findings of the present study demonstrated that antral nodularity is the most common feature in children with Hp infection and epigastric tenderness was significantly associated with histological findings of lymphoid follicles.