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Article
H. Pylori Infection Among Adults Undergoing Gastrointestinal Endoscopy

Author: Leen K.Mustafa Kamil
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2007 Volume: 6 Issue: 1 Pages: 37-40
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACK GROUND:INTRODUCTION: Helicobacter Pylori was brought to the worlds attention 1983by Warren and Morshall, it is now acknowledged that H.Pylori gastritis is the one of the most common human bacterial infectious disease and is causally linked with gastritis , peptic ulcer disease, gastric adeno- carcinoma ,and gastric B.cell lymphoma.(1)H.Pylori is a slow growing , microaerophilic, highly motile, Gram negative spiral organism whose most striking biochemical characteristic is the abundant production of urease enzyme which is an important indirect marker of the organisms presence because it is the bases of biopsy rapid unease test, the urea broth test and as an antigen for serologic detection . The prevalence of H.Pylori among healthy individuals varies depending on age , socioeconomic class, country of origin. In developing countries children are typically infected by age 10 years, whereas in developed countries there is an age related increase in prevalence (1,2 ).The major risk factor for infection is the socioeconomic status of the family during childhood as reflected by number of persons in a house hold, sharing a bed ,and absence of a fixed hot water supply all of which probably are markers for the level of sanitation and house hold hygiene(3,4,5 ).* Immunology Unit, Teaching Laboratories-Medical CityIt is not known how often an acute infection with H.Pylori sponteneously clears , studies in children suggest that sponteneous loss of infection may be common (6 ).Infection in adults appears to be typically long lived and is probably life long.(7 ) . Most infected individuals have chronic active, non atrophic superficial gastritis .This histological form is usually asymptomatic but may be associated with duodenal ulcer; chronic atrophic gastritis , gastric adeno carcinoma or gastric lymphoma. (6,7 ) Diagnostic tests for H.Pylori can be divided into those that do and do not require samples of gastric mucosa, mucosal biopsy of histological examination of the specimen for the presence of H.Pylori and or gastritis has been the diagnostic method of choice until recently :to increase diagnostic yield ,use of large cup biopsy and 3 samples biopsy (lesser curve Angularis ,greater curve pre pyloric and greater curve body ) examined by both Giemsa stain as a standard stain and hematoxylin & eosin stain which is excellent to determine histologic chronic or chronic active gastritis and demonstrates H.Pylori if large number of organisms are present ( 1,6) . Biopsies may also be tested for the presence of unrease enzyme production by agar gel slide test such as rapid urease test which is excellent for screening for the presence of H.Pylori in patients with peptic ulcer.Tests that do not require a mucosal biopsy include serologic tests as urea broth test, detection ofinfection in adults To determine the prevalence of H.Pylori undergoing oesphagogastrodudenoscopy by two methods serology (ELISA technique) comparing it with histopathology.METHODS:Forty patients referred to the GIT clinic of AL-Yarmok teaching hospital for GI endoscopy were involved in this study; their biopsies and sera send to histopathology and immunology department respectively for detection of H.Pylori. RESULTS:H.Pylori Abs(IgG) were detected in the sera of 25(63%) patients by ELISA,15 (37.50%) of them H.Pylori was also seen in their biopsies by Giemsa s stain. Most patients with detectable antibodies are those with chronic gastritis ;however patients complaining from reflux oesophagitis showed a significant absentees of these Abs.CONCLUSION:Most patients with gastritis had detectable H,Pylori Abs in their sera; However the study reveled a significant decrease in H.Pylori Ab detection in patients sera with reflex esophagitis (R.O).

Keywords

Endoscopy --- H.Pylori --- ELISA


Article
Anti Cathepsin Antibody In Systemic Lupus Erythematosus

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Abstract

Abstract:Antineutrophil cytoplasmic autoantibodies (ANCA) were found in patients withsystemic lupus erythematosus (SLE). Cathepsin G was the major target antigen. However,some ANCA-positive sera did not recognize either of them.The present study was toinvestigate the unknown target antigens of ANCA (Cathepsin G) in patients with SLE and itsrelation to the activity of the disease (ds DNA ),C1q ,C3and C4.Seventy four SLE patients referred to immunological department in teachinglaboratory medical city during period of (1st of march–31st of May) 2011 and 30 apparentlyhealthy individual as a control group were subjected to Antinuclear antibody (ANA),Cathepsin G and C1q were detected by enzyme-linked immunosorbent assay (ELISA)technique.While dsDNA was detected by indirect immunofluorescent (IIF) technique and C3,C4 by single radial immunodiffusion (SRID).The age of SLE patients ranged between (4-71) years with mean age of 32.4. Themean C1q and Cathepsin G levels were 30.14 and 9.7 respectively with significant differenceif compare it with the healthy control group. A significant result found between mean age ofSLE patients and Cathepsin Ab of a P value 0.007.The Cathepsin G antibody was found in 26 (35%) of SLE patients with a significant Pvalue (0.0001).The Cathepsin Ab were detected in 18 (43.9%) of a patients with positive ds DNAwith no significant P value 0.078. while C1q Ab were detected in 38 (51.4%) of SLE patientsand only 18 (47.4%) from them with Cathepsin Ab with statistically significant P value 0.024.Cathepsin Ab found in 19 (42.2%) of SLE patients with low level of C3 and only 6 (21.4%)of normal level of C3 with no significant P value0.076.This study showed 54(73.0%) of SLE patients had low level of C4 with no significantP value (0.15) and the Cathepsin Ab detected in 22 (40.7%) of them with no statisticallysignificant P value 0.097.A statistically significant result were found for ANA, C1q,C3,C4 and Cathepsin Abif we compare the result of SLE patients with control group, while The Cathepsin G antibodywas found statistically significant in SLE patients ,with significant relation to C1q,on otherhand no relation found with the activity of the disease (ds DNA ),C3 and C4 levels.Key Word: SLE, Cathepsin G, ds DNA, C1q, C3, C4

الخلاصة:لدى المرضى (pANCA) P وجدت الاجسام المضادة الضادة لسایتوبلازم كریات الدم البیض العدلة نوعمع ANCA المصابین بداء الذئب ألاحمراري وكان الكثبسین ج ھو المستضد المستھدف، وان نسبة علاقة مضادمستضاداتھا تحت الدراسة.الغرض من ھذه الدراسة ھو لمعرفة العلاقة بین مضاد الكثبسین ج وفعالیة المرض المتمثلة بالشریط المضاعف.(C3,C ومستوى المتمم الثالث والرابع ( 4 (dsDNA) للحامضالنووي الدیوكسي الرایبوزيخلال الفترة من الأول من آذار إلى 31 أیارعام 2011 تم تحویل 74 مریض مصابین بداء الذئب ألاحمراري إلىقسم المناعة في المختبرات التعلیمیة في دائرة مدینة الطب وتم اخذ عینات منھم مع 25 عینة من أشخاص أصحاءباستعمال تقنیة c1q ومضاد الكثبسین ج و ANA كمجموعة سیطرة، وتم أجراء فحوصات الاجسام المضادة الضادة للنواة.SRID بواسطة C و 4 C و 3 IIF بواسطة dsDNA الامتزاز المناعي المرتبط بالإنزیم (الالیزا)، وتم فحصال

Keywords

Key Word: SLE --- Cathepsin G --- ds DNA --- C1q --- C3 --- C4.

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