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Article
Prevalence of autoimmune hemolytic anemia in ulcerative colitis

Author: Khalid A. Al-Khazraji
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 3 Pages: 273-281
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary
Background: Ulcerative colitis is a chronic idiopathic inflammatory disorder that affects the
rectum & extends proximally to affect variable extent of the colon. Autoimmune hemolytic
anemia had reported in few cases.
Objective: to determine the prevalence of autoimmune hemolytic anemia in Ulcerative
colitis.
Patient & Methods: Fifty Iraqi patients having Ulcerative colitis attending the GIT Center in
Baghdad during the period from March to August 2004 were interviewed, examined and
diagnosed according to pathological study done for colonic biopsies by the same centre.
Blood was drown for the assessment of complete picture with blood film, reticulocyte
percent, erythrocyte sedimentation rate, Coombs test (direct, indirect), antinuclear antibody,
immunoglobulin assay, serum iron and TIBC in the same laboratory unit.
Results: In our study, 18(36%) patients were anemic, fifteen of them had normal or low
reticulocyte percent with normochromic normocytic RBC in blood film, probable causes of
anemia was either iron deficiency proved by low serum iron and high total iron binding
capacity (TIBC), or anemia of chronic illness. The remaining three of eighteen patients with
reticulocytosis, two of them Coombs test were negative and normal film, but they were
having acute bloody diarrhea which probably was the cause of reticulocytosis.
The third patient was Coombs positive with features of hemolytic anemia in the blood film
(polychromic with spherocytosis), this patient had also a high titer of IGg, LDH, so that this
female had all the evidence of autoimmune hemolytic anemia which is a rare complication of
Ulcerative colitis.
Salfasalazine as a treatment of Ulcerative colitis can cause autoimmune haemolysis, but in
this case the drug had stopped for one month before the development of autoimmune
haemolysis.
In our sample we had five patients with reticuloytosis but normal haemoglobin level and
normal blood film with cooms negative (direct and indirect) those five patients might had
nonimmune causes of hemolytic like G6PD deficiency which need further investigations, or
might had bloody diarrhea which cause elevated reticulocyte as areaction to blood loss, or it
may be due to salazopyrine effect which may lead to increase level of reticulocyte.
Conclusion:Most studies giving range of autoimmune haemolytic anaemia with Ulcerative
colitis between 1%-2%, all these studies showed direct coomb's test positive, and our study
showed 2% incidence. So it is one of the rare manifestations of Ulcerative colitis. It does not
depend much on severity, duration and degree of colonic involvement.


Article
Descriptive study of Extragastrointestinal Manifestations of Ulcerative Colitis and their relation to disease activity in 100 Iraqi patients

Author: Khalid A. Al-Khazraji خالد الخزرجي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 1 Pages: 24-28
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Ulcerative colitis is a chronic inflammatory bowel disease (IBD); its extragastrointestinal manifestations vary from one country to another. This study identifies the prevalence of the extragastrointestinal manifestations in a sample of Iraqi patients with ulcerative colitis and their relation to disease activity.Patients and Methods: A descriptive study was conducted on 100 patients with established diagnosis of ulcerative colitis, who attended Baghdad Teaching hospital and Gastroenterology center in Baghdad during the period from May 2009 to January 2010. A direct interview and thorough clinical examination were done to determine the history of the disease, its severity and the presence or absence of the extraintestinal manifestations.Result: The Extragastrointestinal manifestations were observed in 17 patients (17%). The most common EGlMs were the peripheral arthritis and mouth ulcer. The EGlMs were more common in patients with severe disease.Conclusion: The EGlMs of ulcerative are less common in Iraqi patients than in patients from western countries, but their relation with disease activity was relatively similar.Keywords: ulcerative colitis. extragastrointestinal manifestatio


Article
Celiac disease: presentation with clinical and serological response
مرض الاضطرابات الهضمية: عرض مع الاستجابة السريرية والمصلية

Author: Khalid A. Al-Khazraji خالد احمد الخزرجي
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2009 Volume: 2 Issue: 152 Pages: 145-156
Publisher: Tikrit University جامعة تكريت

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Abstract

Celiac disease occurs in nearly 1% of the population in many countries. The diagnosis depends on the mucosal duodenal biopsy, serological testing and observation of the response to gluten free diet. Prospective study was conducted in GIT center teaching hospital in Baghdad; between February 2007 and February 2008 for 30 celiac patients based on clinical, serological and histopathological background, The age of these patient range from 1 year to 40 years . Venous blood sample were taken for CBP, Coomb’s test, serology AGA IgG and IgA; OGD was done and three biopsies from the duodenum were sent for histopathological study. The study has shown female to male ratio of 1.5:1 in children, while it was the reverse in adult. Associated disorder in celiac patients were recurrent chest infection in 17/30 (56%) and autoimmune disease in 6/30(20%). The result also shows that breast feeding delays the onset of presentation in 10/30(33.3%), anemia presents in 20/30(66.7) of celiac patient. The histopathological finding of examined duodenal biopsies of celiac disease (marshIII in relation to AGA IgA) was marshIIIa10/30(33.4%)-AGAIgA8/30(26.6%),marshIIIb12/30(40%)-AGAIgA11/30(36.3),marshIII c8/30(26.6%)-AGAIgA7/30(23.3%). The present study conclude that histopathological study is still the golden standard way for the diagnosis of celiac disease while presence of AGA IgA and IgG is an indicator for the presence of celiac disease. it also shows that there is a positive relationship between celiac disease and recurrent chest infection, between celiac disease and autoimmune disease ,and positive relationship between celiac disease and positive family history as well as a positive relationship between delay onset of celiac disease and prolonged breast feeding

الزلاقي يحدث المرض في حوالي 1٪ من السكان في العديد من البلدان. التشخيص يعتمد على أخذ عينة من الغشاء المخاطي الاثني عشر، واختبار الأمصال ومراقبة الاستجابة للحمية خالية من الغلوتين. وقد أجريت دراسة استطلاعية في مركز الجهاز الهضمي المستشفى التعليمي في بغداد، وبين فبراير 2007 وفبراير 2008 لمدة 30 مرضى الاضطرابات الهضمية استنادا إلى خلفية السريرية، والمصلية والأنسجة، وعمر المريض وتتراوح هذه الفترة من 1 سنة إلى 40 سنة. وقد أخذت عينات من الدم الوريدي لCBP، اختبار كومس، الأمصال مفتش AGA و IgA، وقد تم OGD وشهدت طرد ثلاثة خزعات من العفج للدراسة النسيجية المرضية. وقد أظهرت الدراسة أن نسبة الإناث إلى الذكور من 1.5:1 في الأطفال، في حين كان العكس في الكبار. وكان المرضى الذين يعانون اضطراب في الجهاز الهضمي المتكررة عدوى مرض الصدر في 17/30 (56٪) والمناعة الذاتية في 6/30 (20٪). النتيجة تبين أيضا أن التأخير الرضاعة الطبيعية في بداية العرض في 30/10 (33.3٪)، وفقر الدم ويعرض في 20/30 (66.7) من المريض الجهاز الهضمي. وتمثلت النتيجة المرضية في الخزعات الاثنى عشر فحص للمرض (marshIII فيما يتعلق ايغا AGA) marshIIIa10/30 (33.4٪) -AGAIgA8/30 (26.6٪)، marshIIIb12/30 (40٪) -AGAIgA11/30 (36.3)، marshIII c8/30 (26.6٪) -AGAIgA7/30 (23.3٪). هذه الدراسة تخلص إلى أن الدراسة التشريحية المرضية لا يزال الطريق الذهبي معيار لتشخيص الداء الزلاقي في حين وجود ايغا AGA ومفتش الحكومة هو مؤشر لوجود مرض الاضطرابات الهضمية. لكنه يظهر أيضا أن هناك علاقة إيجابية بين مرض الاضطرابات الهضمية والمتكررة عدوى في الصدر، وبين مرض الاضطرابات الهضمية وأمراض المناعة الذاتية، والعلاقة الإيجابية بين مرض الاضطرابات الهضمية وإيجابية التاريخ العائلي، فضلا عن وجود علاقة إيجابية بين بداية تأخير من مرض الاضطرابات الهضمية، والرضاعة الطبيعية لفترة طويلة


Article
Descriptive study of incidence of side effects of Pegylated interferon alpha therapy and their relation to age, gender, duration of treatment and type of hepatitis in 50 Iraqi patients.
دراسة وصفية من حدوث الآثار الجانبية للعلاج مضاد للفيروسات ألفا انترفيرون وعلاقتها العمر والجنس ومدة العلاج ونوع التهاب الكبد في 50 مريضا العراقي.

Author: Khalid A. AL-Khazraji خالد الخزرجي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 4 Pages: 386-392
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Hepatitis C and B is common disease all over the world and their chronicity is a social and medical problem so medical treatment by alpha interferon can change the mortality and morbidity.Object: Identify the incidence of the side effects of pegylated interferon alpha in a sample of Iraqi patients with chronic hepatitis B&C and their relation to age, gender, duration of treatment and type of hepatitis comparing them with the literatures from other countries.Patients and methods:A descriptive case series study was conducted on 50 patients, 24 male and 26 female, with established diagnosis of hepatitis B(20 patients)and C(30 patients) who attend Baghdad Teaching hospital and Gastroenterology and Hepatology centre in Baghdad between the period of January 2009 and October 2010 with follow up over at least 3 months.A direct interview with detailed history and thorough clinical examination with some simple laboratory investigation were done to determine any of the documented side effects of alpha interferon therapy or discover new side effects not elicited in the studies done on other populations.Results: Flu-like illness is the most common side effect (84%), followed by fatigue, anorexia, local reaction and neuropsychiatric side effects while Neutropenia, lymphopenia and thyroiditis are rare.There is no significant difference in the incidence of side effects between age groups with the exception of constipation which occurs more in younger age group. Arthralgia, palpitation, eczema, itching and rash increase in incidence with prolonged duration of treatment.There is no significant difference in incidence of side effects between both genders apart from hypertension (more in female) and dizziness (more in male).There is no significant difference in incidence of side effects between patients with hepatitis B&C but anemia occurs more in patients with hepatitis C and tremor reported more in patients with hepatitis B.Conclusion: Almost all patients on treatment with interferon-based regimen will experience adverse events that can threaten good adherence. Flu-like illness is the most common side effect (84%), followed by fatigue, anorexia, local reaction and neuropsychiatric side effects (depression, nervousness, insomnia).The higher incidence of anemia in patients with hepatitis C is mostly due to concomitant ribavirin therapy.Age, gender, type of hepatitis and duration of treatment can affect the incidence of interferon therapy.

الغاية:تعيين وقوعات الاثار الجانبية لعقار PG Interferon في نموذج من مرضى عراقيين مصابين بالتهاب الكبد الفايروسي المزمن نوع (ب) و (س) وعلاقة ذلك بالعمر ،الجنس ، فترة العلاج ، و نوع التهاب الكبد الفايروسي مقارنة مع بحوث من دول اخرى .الطريقة:عدد من المرضى العراقيين اجمالي كانوا (50) مريضا ( 26 امراه و 24 رجل) عشرون منهم مصابون بالتهاب الكبد الفايروسي نوع (ب) وثلاثون نوع (س) في مستشى بغداد التعليمي ومستشفى الجهاز الهضمي للفترة من كانون الثاني 2009 ولغاية ايلول 2010 مع فترة متابعة لمدة 3 – 6 اشهر مع مراجعة لتاريخ المرض وفحص سريري دقيق واجراء فحوصات مختبرية اللازمة لهم حسب مايقتضيه الحال.النتائج:اعراض مشابه لانفلونزا كانت بنسبة 84% مع نحول وعدم شهية الطعام مع تفاعل موضعي في منطقة زرق الابرة واعراض عصبية ونفسية وكذلك هبوط في عدد خلايا الدم البيض واخيرا التهاب الغدة الدرقية.لم يكن هناك فرق كبير في نسبة الاثار الجانبية للعقار ماعدا نسبة الاصابة بالامساك حيث كانت اكثر في الشباب من الشيوخ كما لوحظ ان الالم المفاصل والخفقان والحساسية كانت اكثر مع اطالة مدة العلاج.ولم يكن هناك فرق في الجنس للاصابة بالاثار الجانبية عدا ان ارتفاع ضغط الدم كان اكثر في النساء والدوار كان اكثر في الرجال كما ان فقر الدم كان اكثر حدوثا في مرضى التهاب الكبد الفايروسي نوع (س) وارتعاش اليدين كان اكثر في مرضى التهاب الكبد الفايروسي نوع (ب).الخلاصة: معظم المرضى الذين عولجوا بعقار انترفيون قد اصيبوا ببعض الاعراض الجانبية وكان الاكثر شيوعا هي الاعراض المشابهة للانفلونزا وفقر الدم عند مرضى التهاب الكبد الفايروسي (س) وربما كان له علاقة في استخدام العقار Rebarin ، العمر والجنس ونوع الفايروس وفترة العلاج يمكن ان يكون لها تاثير على ظهور بعض الاثار الجانبية.


Article
Comparison study between the treatment of Hepatitis C virus with (peg-interferon, ribavirin, silymarin) and (peg-interferon, ribavirin) in Baghdad teaching hospital.

Author: Khalid A. Al-Khazraji خالد الخزرجي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2017 Volume: 59 Issue: 1 Pages: 14-18
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Infection with Hepatitis C virus (HCV) is a major cause of chronic liver disease, WHO estimated that about 170 million people are infected with Hepatitic C virus, Silymarin (Legalon) have been recently shown to be effective in treatment of Hepatitic C virus infection.Objectives: The effectiveness of Legalon (Silymarin) on viral load in patients with Hepatitic C virus infection.Patients and methods: A prospective case – control study included 400 patients with Hepatitis C virus infection. 200 patients (group A) were treated with (peg-interferon, ribavirin, silymarin) the other 200 patients (group B) were treated with (peg-interferon, ribavirin) . only G1 & G4 genotypes were included , viral load were assessed initially and after 3 months in patients with positive viral load.Results: Viral load follow in group A, Hepatitis C Viral load was reported in 150 cases giving a response rate of 75% while in the 200 cases of group B the response was reported in 110 giving an overall response rate 55% , this indicate that cases in group A had a significant higher response rate than those in group B.Conclusion: Patients taking Silymarin (420 mg/day) for 3 months showed a decrease in viral load, effectiveness of silymarin was more in Genotype 1 than in the Genotype 4, the response was better in low viral load patients ( less than 600000 IU/ml).Keywords: Hepatitis C, Treatment, Silymarin effects on treatment.


Article
Evaluation of T- Helper (Th-1) Cytokines during the Treatment Responses of chronic Hepatitis C Virus

Authors: Eman Sh. AL- Obeidy --- Khalid A. Al-Khazraji
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 4 Pages: 464-466
Publisher: Baghdad University جامعة بغداد

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Abstract

Background:It is widely assumed that cellular immune response and cytokine (especially proinflammatory cytokines) production play an important role in the course and treatment effectiveness of chronic hepatitis C infection.
Aim of the study: evaluate the level of Th-1 cytokines during treatment of chronic HCV infection and their dynamic changes in response to treatment.
Patients and methods: The study was performed on sixty patients with chronic HCV infection, the patients were recruited from medical city gastroenterology and hepatology teaching hospital for the period from February 2007 till February 2008 and 50 healthy control group. Diagnosis was made using third generation ELISA-based screening test, RIBA-based test and PCR-based test. On the other hand, Cytokines (serum level) were determined by ELISA method before, during (6, 12, 24 weeks) and after the treatment.
Results: This study showed that after 6 weeks from the initiation of the treatment by pegilated interferon-α in the combination with ribavirin, concentration of serum cytokines IL-1β, TNF- α and INF- γ have significantly changed and at the end of the treatment concentration of all cytokines have decreased and this change was statistically significant for all cytokines.Conclusion: dynamic changes of some cytokines during INF- α and ribavirin treatment may be used as a predictor factor for evaluation of the therapy effectiveness.


Article
Production of Different Cytokines in Acute and Chronic Hepatitis C Virus.
انتاج مختلف السايتوكينات في التهاب الكبد الفايروسي ج الحاد والمزمن

Authors: Khalid A. Al-Khazraji د.خالد الخزرجي --- Eman Sh. Al- Obeidy د.ايمان العبيدي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2010 Volume: 23 Issue: 2 Pages: 134-140
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Summary:Background: the role of pro-inflammatory cytokines has been documented in acute phase reactions in the liver, in normal proliferation of hepatocytes, in autoactivation of Kupffer cells and proliferation of immunocyte, in cirrhotic processes in the liver and in regeneration of the organ in chronic hepatitis C.Objective: assess whether there is a differential production of Th1 or Th2 associated cytokines in the course of acute and chronic HCV infection.Patients & methods: Serum level of IL2, INF gamma (Th1 associated cytokines) and IL10 (Th2 associated cytokines) were measured in 12 patients with acute HCV, 50 patients with chronic HCV infection and 50 healthy volunteers. Results: mean serum level of IL-2 was significantly higher in chronic hepatitis C (30.5 ± 16.02) than in acute cases (26.9 ± 13.01) and controls (11.3 ± 2.03). Acute HCV cases had a higher mean IL-10 level (99.3 ± 17.0) than controls (5.0 ± 2.0) and chronic HCV cases had a higher mean IL-10 level (100.9 ± 53.7) than acute HCV cases. Mean serum level of INF gamma where nearly equal in all three groups. Conclusion: this study suggests weak response of Th1 cells in acute HCV infection and a possible suppressive Th2 cell response in chronic HCV, which might explain the failure of viral clearance and a weak cellular immune response.Key wards: Chronic hepatitis-C; Pro-inflammatory cytokines; IL-2; IL-10 NF-gamma.

الملخص:الخلفية:تم اثبات دور السايتوكينات المؤيدة للالتهاب في تفاعلات المرحلة الحادة في الكبد, في التكاثر الطبيعي لخلايا الكبد,في التنشيط الذاتي لخلايا كفر,في تكاثر الخلايا المناعية,في عمليات التشمع في الكبد,وفي تجدد العضو في التهاب الكبد الفايروسي ج المزمن. الاهداف:تقييم فيما اذا كان هناك انتاج نوع مختلف من السايتوكينات المرتبطة بخلاياTالمساعدة نوع1و2(Th1andTh2)خلال مرحلة العدوى بالتهاب الكبد الفايروسي ج الحاد والمزمن.المرضى وطرق العمل:تم قياس مستوى المصل من انترلوكين2 و انترفيرون كاما(سايتوكينات مرتبطة بخلاياTالمساعدة نوع1Th2)في 12 مريضا مصابا بالتهاب الكبد الفايروسي ج الحاد و50 مريضا مصابا بالتهاب الكبد الفايروسي ج المزمن و50شخصا اصحاء متطوعين.٭٭ معدل مستوى المصل من انترلوكين2كان اعلى بصورة ملفتة للنظر في التهاب الكبد الفايروسي ج المزمن(16,02±30,5)من التهاب الكبد الفايروسي ج الحاد(26,9±13,01)والكونترول(11,3±2,03) وسجلت حالات التهاب الكبد الفايروسي ج الحاد مستويات اعلى من انترلوكين10(99و3±17)من الكونترول(5±2).اما حالات التهاب الكبد الفايروسي ج المزمن فسجلت مستويات اعلى من انترلوكين10(100,9±53,7)من التهاب الكبد الفايروسي ج الحاد.٭٭معدل مستوى المصل من انترفيرون كاما كان تقريبا متساويا في الحالات الثلاث.الاستنتاجات:هذه الدراسة تبين استجابة ضعيفة للخلايا المساعدة1Th1في الحالات الحادة واستجابة مثبطة محتملة للخلايا المساعدة2Th2في الحالات المزمنة والذي من الممكن ان يفسر فشل تنقية الفايروس وضعف الاستجابة المناعية الخلويةالكلمات المفاتيح: التهاب الكبد الفايروسي ج المزمن,السايتوكينات المؤيدة لللالتهاب,انترلوكين1,انترلوكين10,انترفيرون كاما


Article
Study of H.Pylori in a Group of Iraqi Patients with Inflammatory Bowel Disease (Histological and Molecular Study)

Authors: Sinan S. Farhan --- Khalid A. Al-Khazraji --- ,Fadhil A. Al-Khafaji --- Huda M. Al-Khateeb --- et al.
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: supplement Pages: 734-741
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Helicobacter pylori is one of the commonest bacterial pathogens in human. The organism is associated with development of peptic ulcer diseases, lymphoproliferative disorders and gastric cancer.Helicobacter pylori could be isolated from patients with inflammatory bowel disease (IBD) but still the possibility of etiological link need further study thereforeOBJECTIVE:Is to assess the possible causal factor of H.pylori in development of inflammatory bowel disease, in addition to assess Cytotoxic associated gene A(CagA) gene status in H.pylori positive samples.PATIENTS AND METHODS:Study involved 120 patients of colonoscopically determined normal colon (n=90) & patients with IBD (n=30) including both Ulcerative colitis(n=16) and Crohn’s disease(n=14). Those patients is further divided into three age groups including <20 years group, 20-40 years group and >40 years group of Iraqi patients. Endoscopic specimens after histopathological confirmation of diagnosis will be tested for Biopsy Urease Test (BUT) and Hematoxylin & Eosin (H&E) methods (for detection of H. pylori) also detection of CagA mRNA using In Situ Hybridization technique with a biotin labeled probe (to specify pathogenic H. pylori)RESULTS:H.pylori detected in 36.7% (using BUT) and 30% (using H&E) in the colon of IBD patients and 33.3% (using BUT) and 26.7% (using H&E) in patients with normal colon (NC patients) as a control. Among our H.pylori positive patients, there was significant difference (P=0.036) regarding CagA status in which 25% were CagA positive of NC patients and 66.7% CagA positive H.pylori in IBD patients using In Situ Hybridization technique.CONCLUSION:H.pylori was isolated from nearby or the site of lesion of patients with inflammatory bowel disease although there was no statistical relationship between H.pylori and IBD. In addition CagA genes were more prominent in H.pylori that isolated from IBD patients than H.pylori of normal colon. Also there was no possible relationship between age and infection rate of H.pylori in both IBD & NC patient


Article
Detection of H.pylori in a Group of Iraqi Patients with Colonic Cancer (Histological and Molecular Study)

Authors: Sinan S. Farhan ,Khalid A. Al-Khazraji --- Fadhil A. Al-Khafaji --- Huda M. Al-Khateeb ,Zahraa Q. Al-Kassam, Haider A. Al-Zubaidi
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 1 Pages: 153-159
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: H. pylori is a one of the gastrointestinal organism which infects more than half the population of the world. H.pylori had been recognized as a class I human carcinogen by the International Agency for Research on Cancer. Recently H. pylori were detected in the mucosa of normal colon. Certain studies suggested a possible relationship between CagA (Cytotoxin Associated Gene A) positive H.pylori and Colonic Cancer while other studies did not find causal relationship between CagA positive H.pylori and Colonic Cancer. OBJECTIVE: We studied and isolated H.pylori from at or near by the site of lesion of Colonic Cancer and it is found to assess a possible relationship between CagA positive H.pylori and Colonic Cancer.PATIENTS AND METHODS: Study involved 30 patients of colonoscopically and Histopathologicaly determined Colonic Cancer (CC group) compared with patients with normal colon (n=90) as a control group (NC group). Patients divided into <20 years age group, 20-40 years age group and >40 years age group. Endoscopic specimens were tested for Biopsy Urease Test (BUT) and Hematoxylin & Eosin (H&E) method for detection of H. pylori also the detection of CagA mRNA using In Situ Hybridization technique with a biotin labeled probe.RESULTS: There was 66.7% H.pylori positive in patients with Colonic Cancer (by BUT) and 60% by (H&E) compared to 33.3% (by BUT) and 26.7% (H&E) in patients with normal colon (Control). A comparison between NC&CC groups regarding H.pylori infection using H&E method revealed significant difference (P=0.001).Using In Situ Hybridization technique, there was 66.7% CagA positive H.pylori in CC group in correspondence to 25% in NC group. CagA positive H.pylori infection between CC and NC groups revealed significant difference (P=0.008)CONCLUSION: H.pylori detected at or near by the site of lesion of Colonic Cancer. In addition it was found that there is a statistical relationship between CagA positive H.pylori infection and Colonic Cancer which suggested a possible role of CagA positive H.pylori in Colonic Cancer.

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