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Article
Evaluation of the Gastrointestinal Clinical, Endoscopic, and Histological Findings in Patients with Bile Reflux Diseases: A Cross‑Sectional Study

Authors: Ahmed Sahir Alnajjar --- Sabeha Al‑Bayat
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2019 Volume: 18 Issue: 1 Pages: 10-15
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Bile reflux occurs when the bile flows upward from the duodenum to the stomach and esophagus. It occurs when the pyloricsphincter is damaged or fails to work correctly; bile can enter the stomach and then be transported into the esophagus as in gastric reflux.Objective: This study aims to evaluate clinical findings and the endoscopic and histological changes caused by bile reflux disease on gastric mucosa. Patients and Methods: This is a cross‑sectional study carried out at Gastrointestinal Endoscopy Unit in Al‑Yarmouk Teaching Hospitalin Baghdad during the period from January 2016 to October 2016, upper endoscopy done to 50 patients in the Gastrointestinal Tract Center of Al‑Yarmouk Teaching Hospital, in whom there is endoscopic evidence of bile reflux disease and biopsies from gastric mucosa were taken and send for histopathology and Helicobacter pylori examination. Results: Bile reflux was noted in 19 males (38%) and 31 females (62%).Bile reflux disease was more in age below 50 years (29 patients), more in the female, while after the age of 65 years, the male/female ratio was 1.5/1. The most common symptoms were epigastric pain. The most common endoscopic findings were gastric erythema. The major risk factors were cholecystectomy (8%). Pylori were present in about 24% of the patients. Conclusion: Bile reflux disease was more common in young female and cholecystectomy was common risk factor.


Article
β-Catenin Protein and Its Association with Helicobacter Pylori as A Possible Marker for Gastric Cancer

Authors: Mustafa K. Al-Bayaty --- Salma A. Abass --- Mohammed F. Al-Marjani
Journal: Al-Nahrain Journal of Science مجلة النهرين للعلوم ISSN: (print)26635453,(online)26635461 Year: 2019 Volume: 22 Issue: 3 Pages: 43-49
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Gastric cancer is still the main health threat being the third leading cause of deaths from cancers in the world, the major risk behind this disease is that it remains asymptomatic in the early stages and in (97 %) cases it metastasizes to other organs. Gastric cancer is a multifactorial disease with Helicobacter pylori (H. pylori) being the major risk factor, however, patients with gastritis, especially atrophic gastritis and gastric ulcer have been shown to be at an increased risk for developing gastric cancer. In this research, serum β-catenin, carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) were measured in patients diagnosed with gastric cancer, gastric ulcer and gastritis and also in healthy volunteers. Infection with Helicobacter pylori (H. pylori) was diagnosed by histological test, rapid urease test (RUT) and by serological tests which included IgG and IgA antibodies. The results showed that there was a large significant increase in the levels of serum β-catenin in patients with gastric cancer compared to the control group as well as to the gastritis and gastric ulcer patients. A significant increase was also seen in gastric ulcer and gastritis patients when compared to the control group. In addition, a significant increase was seen in β-catenin serum levels in patients with gastric cancer and gastric ulcer infected with H. pylori compared to the uninfected gastric cancer and gastric ulcer patients. A non-significant change was observed in the levels of CEA and CA 19-9 in all the patients compared to the control group. The results of this study suggest that β-catenin can serve as a potential biomarker for the diagnosis of gastric cancer and that H. pylori has a significant effect on the levels of this protein.


Article
Molecular Characteristics and Clinical Relevance of Cytotoxin‑Associated Genes A and E of Helicobacter pylori from Patients with Gastric Diseases

Author: Ahmed L. Hamad, Haidar A. Shamran1, Jasim Muhsin Al‑Maliki2, Ibrahim A. Mahmood3
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2019 Volume: 16 Issue: 2 Pages: 156-162
Publisher: Babylon University جامعة بابل

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Abstract

Background: Helicobacter pylori colonizes about a half of the world’s population. It possesses several genes that associated with virulence,among which are cytotoxin‑associated antigen (CagA) and cytotoxin‑associated gene E (CagE) genes within the cag pathogenicity island.These genes encode for proteins involved in the pathogenicity of the bacteria. Objective: This study aimed to investigate the prevalenceof CagA and CagE genes among H. pylori isolates from patients with different gastric pathologies and for phylogenetic analysis of theisolated bacteria according to gene sequence. Materials and Methods: A total of 104 gastric biopsies were collected for patients sufferingfrom different gastric pathologies. DNA was extracted from these biopsies, and a conventional polymerase chain reaction (PCR) wasperformed to amplify the gene fragments corresponding CagA and CagE genes using specific primers. PCR product of selected samples ofpositive for CagE was undergone direct sequencing. The result of sequences was aligned with reference sequences in National Center forBiotechnology Information (NCBI), and the phylogenetic tree was constructed. Results: Out of 104 isolates of H. pylori, 89/104 (85.58%)were found to have either CagA, CagE, or both genes. The frequencies of CagA, CagE, and coexistence of both genes were 71.15%,46.15%, and 31.73%, respectively. The phylogenetic tree revealed two main clades, one of which involved isolates 6 and 9 as separatedisolates and another clade involved all other isolates. The isolate 4 clustered with AY153111.1 and AP014523.1, the isolate 3 clusteredwith AY153124.1, the isolate 5 clustered with LC339073.1 and LC339017.1, the isolates 7 and 11 clustered with EU090726.1, the isolate2 clustered with AB191082.1, the isolate 10 clustered very close to LC339004.1 and less close to LS483488.1, while the isolate 1 clusteredwith AP017334.1. Conclusion: CagA and CagE genes are highly prevalence among H. pylori isolate from gastric pathologies from Iraqipatients.

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