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Background and purpose : Helicobacter pylori is the most prevalent infection in the world, particularly in the developing countries, which usually leads to gastritis, gastric ulcer, deoudenal ulcer, even gastric cancer and lymphoma. Çonsidering the importance of this infection and its different prevalence rate in various provinces of the country, this study was conducted to determine the prevalence of helicobacter pylori among the persons of 7-18 years of age in Sari township during 1999.
Materials and Methods : Some 400 students were selected randomly from the primary, secondary and high school. Primarily, personal characteristics like the age, sex, civil region, Socio-economic status i.e. father’s-occupation, parent’s education, dwelling situation, foundation area, the number of family members, address, the amount of used water and the type of management in school were recorded in the forms. Serum samples were examined for the existence of Âb ÏgG by ËLÏSÂ method and kit of HPG screen made by Genesis diagnostic company of Ëngland. Statistical analysis of the results was done by SPSS and X2 test.
Results : Âccording to the results, the prevalence rate of H.P. was 19.2% (accuracy 95%, 17.2-21.2)therefore, there is a statistically significant relationship between the prevalence of H.P. infection and the age or educational status (P<0.002), Socio-economic status (P<0.04), father’s education (P<0.02), mother’s education (P<0.006), foundation area (P<0.0005), number of family members (P<0.002) and the type of management in school (P<0.05). But the other variables like Sex, father’s occupation, residential place, history of digestive problems in the subject, his parents, dwelling situation and the type of water used, had statistically no significant relationship.
Çonclusion : The prevalence rate of H.P. infection in children of 7-18 years of age is high in Sari township and an extensive study on its clinical importance is recommended.

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Background and purpose : Helicobacter pylori (H.pylori) is responsible for causing many diseases in children. Ïn the recent years different methods have been used to identify this infection. The aim of this study is to compare the results of above mentioned methods in identification of H.pylori in children.
Materials and methods : This prospective study was done on 50 infants aged 3 to 14 years having various complaints under went upper gastrointestinal endoscopy in Âmir kolah pediatrics hospital in the year 2000. Biopsy specimen was obtained for microbiological examination (Giemsa staining) and urease test in BÏRD medium. Blood was collected from the patients for serologic test (using RÂDÏM kit). The standard ratio for identification of H.pylori infection in this study was indicated as at least two positive tests out of three tests.
Results : Ôut of 50 infants under investigation, 19 (38%) were infected with H.pylori. Frequency distribution of this infection in boys was 45% and in girls 96.3% (P>0.05). Ïn this study the presence of ÏgG against H.pylori was determined by ËLÏSÂ with cut off=23 ur/ml. The sensitivity and specificity for ËLÏSÂ, histology and urease test was as follow: 89.4% and 96.7%, 89.4% and 96.7, 89.4% and 100% respectively.
Çonclusion : Ït is concluded from this study that, through standardization of ËLÏSÂ, the above mentioned three methods of the tests have the same sensitivity property. Though rapid urease test with higher specificity is more reliable method, but without standardization of ËLÏSÂ in infants the sensitivity and specificity would be lower.

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Background and purpose: Ëradication of Helicobacter pylori (H.pylori) is essential for the effective treatment of peptic ulcer (p.ulcer). Triple therapy as the first line of treatment in eradication of H.pylori is recommended. Ïn this study, we aimed at comparing the efficacy of quadruple and triple therapies containing low dose furazolidone versus a triple therapy containing metronidazole and bismute.
Materials and methods: Ïn this study, 150 patients under endoscopy who had deodenal ulcer and confirmed for H.pylori were randomly enrolled with one of the following three methods of ÔÂF omeprasol 20 mg BÏD, amoxycillin 1000 mg BÏD and furazolidone 100 mg BÏD or metronidazole 500 mg BÏD (ÔÂM) and/or (ÔÂBF), omeprazol 20 mg BÏD, amoxycillin 1000 mg BÏD, furazolidone 100 mg BÏD and bismuth subcitrate 240 mg BÏD for 2 weeks. Ëradication of H.pylori 12 weeks after treatment was assessed confirmed with 14-c urea breath test.
Results : 150 patients,included 88 males and 62 females with mean age group of 40.3 ± 11.5 were under study. Ïn these three groups, there was no significant difference for ratio of male to female, mean age, smoking, gastrointestinal bleeding history, using of non steroid drugs, duration of observing symptoms and size of ulcer. Drug compliance for ÔÂF, ÔÂM and ÔÂBF were 94% , 96% and 98% respectively. Severe side effects (malaise, anorexia and diarrhea) of ÔÂF were observed in 8%, in ÔÂM 4% (headache and dry mouth), in ÔÂBF group 6% (malaise, nausea and dizziness). 140 patients could complete the treatment courses. Rate of eradication based on intention to treat for ÔÂBF, ÔÂM and ÔÂF were 72%, 40% and 54% respectively, and based on completion of the study were 73.4%, 40.8% and 57.4% respectively.
Çonclusion: Çonsidering the obtained result, and in spite of priority of Furazolidone, none of the three mentioned triple theray regimens had required efficacy and are not recommended for eradication of H.pylori. Ïn quaruple regimens containing low dose of furazolidone, eradication rate of H.pylori had significant increase, but was less than gold standard. Therefore in order to obtain ideal regimen, more study with low doses of furazolidone such as, moderate dose of furazolidone daily 300 mg in quadruple regimen for 2 weeks or even high dose of furazolidone 400 mg daily. Ïn quadruple regimen furazolidone only in the first week and rest of drugs, are recommended. for 2 weeks

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Background and purpose : Ïnfection with Helicobacter pylori (H.p) has been recognised as a major cause of gastric and duodenal ulcer and gastric cancer. Some case reports revealed the involvement of H.p in unexplained iron deficiency anemia. The aim of this study was to investigate the relationship between serum iron, ferritin and total iron binding capacity (TÏBÇ) and H.p infection in children.
Materials and methods : 7-18 years old children were randomly selected and their sera were assayed for the presence of H.p infection using ËLÏSÂ test. Ôf these, 74 had H.p infection and were considered as the case group. Then 74 children without H.p infection were matched for age, sex and socio-economical status and considered as the control group. Serum iron, ferritin and TÏBÇ levels were compared between the two groups.
Results : The mean age was 14.3±2.5 years in both groups. Regardless of sex, serum iron ferritin and TÏBÇ were 120±33 mg/dl, 45±26 ng/ml and 298±48% in non-infected group and 102±37 μg/dl, 34±19ng/ml and 320±51% in the infected group respectively. There were statistically significant differences between the two groups. Taking the gender into account, serum ferritin level was the only factor showing statistically significant difference between males in the case and control groups, whereas all other factors showed significant differences between females of the two groups.
Çonclusion : Deficits of iron stores in those children infected with H.p may be due to ferritin uptake in stomach by the microorganism. Possible health implications of H.p induced low ferritin levels justifies further investigation.

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Background and purpose : The objective of this study was to evaluate the role of several risk factors in upper gastrointestinal bleeding (ÜGÏB) from peptic ulcers.
Materials and methods : Patients with acute ÜGÏB due to peptic ulcers and control patients with peptic ulcer disease without bleeding were enrolled. Üpper GÏ endoscopy and rapid urease test for evaluation of Helicobacter pylori infection were performed in both groups. The relation of the following variables with the risk of ÜGÏB were assessed: sex, age, smoking, previous history of bleeding, non-steroidal anti-inflammatory drugs (NSÂÏD) use, ulcer size, ulcer location, duration of acid-peptic disease and Helicobacter pylori status. Multivariate logistic regression analysis was performed to identify independent risk factors.
Results : Â total of 161 cases of ÜGÏB and 287 patients with non-bleeding peptic ulcer were enrolled in the study. Ünivariate analysis showed that smoking and duration of acid-peptic disease were not different in the case and control groups. The odds for the following factors were resulted in the logistic regression analysis: gastric ulcer / duodenal ulcer 11.90 (95% ÇÏ: 4.04-35.03), previous GÏ bleeding 7.72 (95% ÇÏ: 4.39-13.58), ulcer size 2.63 (95% ÇÏ: 1.20-5.77), NSÂÏD-use 2.21 (95% ÇÏ: 1.17-4.20), male sex 1.71 (95% ÇÏ: 1.01-2.89) and age by increasing the risk as 1.03 for every year increase in age (95% ÇÏ: 1.01-1.04). H. pylori was not an independent factor in the multivariate analysis (ÔR=0.49, 95% ÇÏ: 0.23-1.04).
Çonclusion : The risk of ÜGÏB is strongly related to gastric ulcer, previous history of bleeding, ulcer size, and NSÂÏD use. Ïn an area with high prevalence of H. pylori infection, this infection may not be a risk factor for bleeding from peptic ulcers.

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Background and purpose : -Helicobacter pylori is a gram negative spiral bacilus which infects gastric mucosa and causes a wide range of gastro intestinal diseases.Unfortunately the prevalence of the infection by this organism in developing countries is high and despite numerous existing drug regimens, treatment fails to eradicate the organism in many occasions. To reach an effective and curative regimen, invitro determination of suscepibility and resistance of the organism, to various antimicrobials, is pradent. The goal of this study was to determine the prevalence of antimicrobial resistance in Helicobacter pylori,s isolated from cultures. Biopsies from 67 patients admitted to the Sari Imam Hospital were used to cultur Helicobacter pylori and determine their susceptibility and resistance to metronidazole, claritromycin and amoxycillin.
Materials and methods : Disc diffusion tecniqu was used to determine the minimum inhibitory concentration , (MIC) and resistance pattern of the isolated Helicobacter pylori.In this method we used the cutoff point of MIC 90 ie , a concentration at which 90% or more of culture plates show inhibition zone around the antimicrobial test disc.
Results : MIC 90 for amoxycillin and claritramycin in our study was 0.25 g/ml and all isolates were susceptible to amoxycillin. Only one isolate was resistant to claritramycin. MIC 90 for metronidzole was 16 and 4 resistant cases were isolated.
Conclusion : This stndy showed low level of resistance to metronidazole and claritramycin which were comparable to the reported results from other studies. No resistance was observed to amoxycillin which was also the same as other reported results. According to the pattern of antimicrobial resistance, we can recommend the studied drugs, against Helicobacter pylori.

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Background and purpose: Helicobacter pylori(HP) has an important role in the pathogenesis of gastritis, peptic ulcer and gastric cancer. The eradication of HP results in the prevention of the recurrence of peptic ulcer and its complications. In developed countries, the recurrence of infection is unusual and rare after the successful eradication of HP infection, however it is likely in developing countries and the rate is variable in different parts of the world. The aim of this study was to evaluate the recurrence rate of HP infection, at least 2 years after the successful eradication of HP infection.
Materials and Methods: Those patients with documented duodenal ulcer (according to endoscopy) and HP infection (according to rapid urease test) were included in this study. The patients were treated with different HP eradication regimens and the eradication was proved, using the 14C Urea Breathing Test (UBT). The patients were re-evaluated with 14C UBT at least 2 years after the first negative UBT result (mean duration: 36 months, ranging from 24 to 30 months).
Results: Eighty patients (51 males and 29 females) were included in the study. Mean age was 40.53 + 10.99 years (ranging from 20 to 79 years). HP infection recurrence was documented in 11 patients (13.75%).
Conclusion: Although HP eradication was performed successfully, the recurrence rate was significant. This can influence the therapeutic and the following up strategies of the patients.

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Background and Purpose: Helicobacter pylori are a bacterial pathogen evolved to chronically colonize the gastric epithelium and causes gastritis, peptic ulcers, and even gastric malignancies in few infected humans. More recently, a pathogenicity island has been identified within the H. pylori genome that contains a cluster of genes, including cagE. The aim of the current study was to investigate the prevalence of cagE genotypes of H. pylori isolates from patients with NUD(Non Ulcer Dyspepsia), peptic ulcer and cancer.
Materials and Methods: 150 Gastric biopsy specimens obtained from patients were inoculated onto a Brucella Columbia Agar containing 5% sheep for 3 to 5 days at 37°C under micro aerobic conditions (5% O2, 5% CO2, and 90% N2). After DNA extraction, genotyping of the cagE gene was performed by PCR amplification using the primers. PCR products were separated by 1% agarose gel electrophoresis and examined under UV illumination.
Results: Of 92 positive cultures, 34, 28, 20, and 10 isolations were obtained from patients with NUD, duodenal ulcers (DU), gastric ulcers (GU) and gastric cancer (GC), respectively. The frequency of cagE gene was 88/24%, 100% , 85% , 100% and within isolates of patients with NUD, DU, GU and GC, respectively.
Conclusion: The presence of cagE in patients with Helicobacter pylori infection is not a marker for predicting or diagnosing the resultant diseases.

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Background and purpose: Helicobacter pylori, which infect approximately one half of the world’s population, are an important risk factor in chronic gastritis, peptic ulcer disease, and gastric cancer. H. pylori eradication is now widely recommended as the most effective treatment of peptic ulcer disease. One of the most important reasons for treatment failure is H. pylori resistance to the antimicrobials usage in therapy. The aim of this study was to determine susceptibility patterns of H. pylori isolates in 6 routine anti-microbial agents in Northern Iran.
Materials and methods: 125 patients from Tooba Medical Center in Sari with endoscopic evidence of dyspepsia complaints were used for obtaining gastric biopsies specimens. Biopsies were sent to the laboratory in thioglycolate broth (transport medium). Bacteria were primarily cultured on Columbia agar supplemented with 7% horse blood, 7% fetal calf serum. Urease, Catalase and Oxidase activities were used for H. pylori identification. Bacterial suspensions equivalent to 3 Mc. Farlands were spread on plates, along with antibiotic disks and placed in the diameter zone. Inhibition was measured after 3 days of incubation in micro-aerophilic condition.
Results: H. pylori were isolated from 116(92.8%) subjects, a total of 125 biopsy specimens. Resistance to metronidazole, amoxicillin, clarithromycin, tetracycline, furazolidone and ciprofloxacin were 71%, 35%, 25%, 9%, 24% and 25%, respectively. Multiple resistance (amoxicillin-clarithromycin-metronidazole) were found in (6)5% of the isolates.
Conclusion: Comparison of our data with previous results showed that prevalence of H. pylori resistance to clarithromycin, furazolidone and metronidazole has increased in Iran considerably. Resistance to amoxicillin in our study was too high in comparison with foreign studies. The present study demonstrates the need for continuous monitoring of the antimicrobial susceptibility in H. pylori in order to determine the optimal drug regimens.

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Background and purpose:Chronic idiopathic urticaria (CIU) is a recurrent disorder that is characterized by itching wheels lasting more than 6 weeks. Etiology of CIU is unknown. The aim of this study is to assess the efficacy of Helicobacter pylori (Hp) infection eradication in improvement of CIU.
Materials and methods:In this double blind placebo-controlled clinical trial, 60 CIU patients were enrolled in the study. Urea breath test (UBT) was performed for indicating the Hp infection. Hp positive patients were divided in 2 groups: cases that were treated with quadruple therapy for eradication of Hp(Amoxicillin, Omeprazole, Bismuth and Metronidazole) and controls (placebo). The gastrointestinal (GI) and dermatologic symptoms and signs were recorded and compared in the beginning of the study, and 1 and 3 months after the treatment.
Results:From 60 CIU patients, 32 (53%) were UBT positive. 15 cases and 13 controls completed the study. There were no significant statistical differences between the two groups for their GI and dermatologic complaints before intervention, and 1 and 3 months after eradication, except for pyrosis that was improved in cases after 3 months (P= 0.029)
Conclusion:Eradication of Hp does not have any effect on improving CIU symptoms or signs.

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Background and purpose: Breast cancer is one of the leading causes of death in women around the world with a very high degree of mortality and morbidity. Conventional treatments use cytotoxic drugs which have high levels of side effects, affecting the patient’s quality of life. Therefore today’s pharmacology is looking into treatments with low side effects and maximum efficiency. The helicobacter pylori neutrophil-activating protein (HP-NAP) is a virulence factor that attracts and activates neutrophils, and promotes their endothelial adhesion and the production of oxygen radicals and chemokines. HP-NAP is an immune modulator able to induce the expression of IL-12 and IL-23. Chitosan is biodegradable and biocompatible component. It is low toxicity effect, so apply in drug delivery targets. In this study, we evaluated the preparation of chitosan nanoparticles carrying recombinant HP-NAP helicobacter pylori. Materials and methods: Chitosan nanoparticles were produce. The size and morphology of the nanoparticles were investigated. Recombinant HP-NAP helicobacter pylori were produce. Results: SDS-PAGE analysis showed the expression of an approximately 20,000 Dalton protein. DLS confirm size and zeta potential of the nanoparticle. Conclusion: The complex has the potential to shift antigen-specific T-cell responses from a predominant Th2 to a polarized Th1 cytotoxic phenotype, characterized by high levels of interferon-γ and tumor necrosis factor-a production. HP-NAP may be a new tool for future therapeutic strategies aimed in cancer immunotherapy. Nanomaterials have been used to enable drug delivery with lower toxicity to healthy cells and enhanced drug delivery to tumor cells.

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Background and purpose: Helicobacter pylorus is a well-recognized cause of chronic active gastritis, peptic ulcer disease (PUD) and linked to the development of gastric adenocarcinoma. Heat shock protein (HSP) acts as molecular chaperons in the folding of newly synthesized proteins in cells and assist in the refolding of damaged proteins.The HSP70-2 gene has a pst1 site due to an A to G transition at the 1267 position and different genotypes of the HSP70-2 gene have been shown to be associated with a different level of HSP70 mRNA expression. The aim of this study was to investigate the association between polymorphism of the HSP70-2 gene and susceptibility to helicobacter pylori infection. Materials and methods: The studied population comprised of 100 subjects, attending the Endoscopy Center of Hafez Hospital in Shiraz, Iran. All the subjects underwent upper gastroscopy. RFLP (restriction fragment length polymorphism) analysis was performed for 1267G/A polymorphism of HSP70-2 gene in all the subjects. Results: After gastroscopy, 50 cases with H. pylori infection and 50 cases with normal gastric tissues were considered as the controls. In the normal subjects, the HSP70-2 genotype distribution was 20 AA (40%), 26 AG (52%), and 4 GG (8%). Meanwhile, the HSP70-2 genotype distribution in patients were 5 AA (10%), 43 AG (86%) and 2 GG (4%). Conclusion: The analysis showed that the AG genotype increased the risk of peptic ulcer (OR = 6.61, 95% CI = 2.21-19.76, P = 0.0007). The results of this study suggested that HSP70-2 polymorphism may be involved in susceptibility to helicobacter pylori infection.

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Background and purpose: The aim of this study was to compare the proportion of natural killer (NK) and natural killer T (NKT)-like cells in dyspeptic disorders caused by Helicobacter pylori (H. pylori). Materials and methods: In a case-control study, 27 patients with gastric cancer (GC), 25 patients with peptic ulcer (PUD), and 22 patients with non-ulcer dyspepsia (NUD) were enrolled. After endoscopic diagnosis, the proportions of NK cells subsets (CD3-CD56+ and CD3-CD16+), as well as NKT-like cells (CD3+CD56+) in peripheral blood were determined by flow cytometry. The frequency of CD8+ and CD8– NK cell subsets were also determined. H. pylori infection was confirmed in all study subjects using the rapid urease test and histopathology. Results: The frequencies of CD3-CD16+ NK, CD3-CD56+ NK, and CD3+CD56+ NKT-like cells in patients with gastric cancer infected by H. pylori were significantly lower than those in patients with non-ulcer dyspepsia (P < 0.001, P = 0.050, and P = 0.020, respectively). However, these cell populations showed no significant difference between the PUD and NUD groups. Further analysis showed that high numbers of CD8– NK cells in the blood were CD56+ and CD16+ phenotypes. Conclusion: This study showed decreased numbers of NK and NKT-like cell populations in patients with gastric cancer compared to those with non-ulcer dyspepsia. It is thus suggested that these cells may limit the prolonged inflammation by H. pylori, which, in turn, reduce the risk of gastric cancer.

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Background and purpose: cagA, vacAs1 and babA2 in Helicobacter pylori are important virulence factors associated with gastrointestinal diseases. The prevalence of these genes and their association with gastrointestinal disease is different around the world. Materials and methods: In a cross-sectional study, 1500 patients with gastroduodenal disorders were enrolled. They attended Imam Khomeini Hospital in Kermanshah 2013. Biopsy specimens were obtained from the antrum and corpus of stomach. The specimens were inoculated onto selective medium for 3-5 days. The suspected colonies of Helicobacter pylori were identified by morphology, biochemical tests and presence of ureC gene. The frequencies of cagA ،vacAs1 and babA2 genes were surveyed using PCR. Results: The frequencies of cagA, vacAs1 and babA2 genes were 89%, 58.3%, and 68%, respectively. There was no significant correlation between cagA, vacAs1 and babA2 with gastric and peptic ulcers. The frequency of triple-positive strains of cagA, vacAs1 and babA2 was 40.3%. Also, babA2 with cagA and vacAs1a were found in 66% and 43%, respectively. Conclusion: Triple-positive strains in H. pylori isolates were more frequent in patients with peptic ulcer compared to those of the gastritis but this difference was not significant. However, further investigations are required to clarify these results.

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Background and purpose: The expression of growth factors, proteolytic enzymes, fibrogenic factors, and cytokines are altered in Helicobacter pylori (H. pylori) infected gastric mucosa. Matrix metalloproteinases (MMP) are a family of zinc-dependent homologous enzymes digesting most of the components of the extracellular matrix and basement membrane and are involved in remodeling and functioning of the biological processes. The purpose of this study was to compare gene expression of matrix metalloproteinase-7 (MMP-7) in patients with H. pylori-infected and uninfected individuals with gastrointestinal diseases.

Materials and methods: This study was conducted in 50 H. pylori-negative patients and 50 H. pylori-positive patients being admitted to Shahrekord Hajar Hospital due to gastrointestinal diseases in 2014. The participants’ demographic information was collected and sampling was done. First DNA was extracted, and then PCR was performed to check for the presence of 16sRNA and UreC. The RNA from each sample was also extracted and cDNA was prepared. Afterwards, the expression of MMP-7 was measured by real time-PCR using specific primers and probes.

Results: MMP-7 mRNA expression was significantly higher in biopsies of H. pylori-infected patients compared to that in H. pylori-uninfected patients (P<0.0001).

Conclusion: Increased expression of MMP-7 can be effective in inflammatory response and development of the disease. It could be used as a key marker for early diagnosis of gastrointestinal diseases and gastric cancer.

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Background and purpose: Iron anemia deficiency and helicobacter pylori infection are common diseases throughout the world. The aim of this study was to evaluate the association between iron deficiency anemia (IDA) and H. pylori CagA+ infection among children under 5 years of age.

Materials and methods: An analytical-descriptive study was performed in Hajar and Kashani hospitals in Shahrekord, Iran, 2014. We investigated the seropositive prevalence of H. pylori CagA+ infection in 59 children with IDA and compared the results with that of 69 sex- and age-matched non-anemic children using SPSS V.20.

Results: The mean age of participants in case and control groups was 42±3 and 40±2 months, respectively. The controls and cases included 30 boys and 29 girls and 30 boys and 39 girls, respectively. In anemic children 50% were found to be positive for IgG anti-CagA while in non-anemic group 8% were detected. The results showed significant relationship between the two groups (P< 0.01).

Conclusion: Helicobacter pylori infection may induce iron deficiency anemia and CagA virulence factor may play a role in the severity of anemia.

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The repeated exposure of a normal cell to carcinogenic agents may lead to its mutation, which changes into a cancer cell. In this case, the structure and function of the cells would alter, and they do not act normally. Chemicals, sun exposure, shortwaves, viruses, and bacteria play a significant role in cancer. Among the infectious and bacterial agents causing cancer, Helicobacter pylori (H. pylori) is the most important bacterium involved in carcinogenesis. H. pylori causes chronic gastritis, peptic ulceration, and gastric cancer. Recently, this bacterium has been classified as class I carcinogen (i.e., a definite cause of cancer in humans). Despite the pathogenic effect of this bacterium, it has been recently affirmed to induce apoptosis in cancer cell line and affect the reduction of tumor size in animal models. This result suggests that some factors of H. pylori can be used as a new tool in future therapeutic strategies implemented in cancer immunotherapy.

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Background and purpose: Helicobacter pylori is one of the most prevalent agents causing gastric infection.  Most of the type I strains genome containing cag pathogenicity island (i.e. cagA) result in peptic ulcer and gastric cancer. Antibiotics are amongst the main treatments but drug resistance may cause treatment failure. The aim of current research was to investigate the presence of cagA in H. pylori samples and their antibiotic resistance patterns.
Materials and methods: A descriptive study was performed in 86 patients. The endoscopy specimen was used fosr rapid urease test and culture and preparation of paraffin blocks to observe lam of tissue and performing PCR method. Samples were grown in standard media and grown colonies in culture medium were identified using catalase and oxidase tests. Antibiotic susceptibility tests were performed by antibiogram.
Results: In this study, the rapid urease test, tissue lam observation, culture results and PCR analysis were positive in 45.3%, 53.4%, and 55.9%, and 80.2%, respectively. CagA gene was detected in 69.56% of the samples. Among patients with positive culture, highest rates of resistance were found to metronidazole, amoxicillin, ciprofloxacin, clarithromycin, and furazolidone, while the lowest rate of resistance was to tetracycline.
Conclusion: Compared with other methods, PCR analysis was found to be more appropriate. Current study showed that H. pylori strains in Iran are increasingly resistant to clarithromycin, and furazolidone, and metronidazole.

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Background and purpose: Identifying precancerous lesions for early detection of gastric cancer is greatly important in high risk areas for stomach cancer. In this study, we evaluated stomach biomarkers as a non-invasive method for recognition of gastric precancerous lesions.
Materials and methods: In a cross-sectional study, patients with chronic dyspeptic symptoms who were candidate for endoscopy were selected from Sari gastroenterology clinic. After endoscopic and pathological evaluations, patients were divided into three groups: those with normal endoscopic findings and pathology, patients with chronic active gastritis, and those with intestinal metaplasia. Their serum samples were evaluated for PG1, PG2, PG1/PG2 ratio, Gastrin-G17, and Helicobacter pylori serology. Data analysis was done in SPSS V21.
Results: A total of 63 patients were investigated of whom 19 were found with normal endoscopic results and pathology, 25 had chronic active gastritis, and there were 19 with intestinal metaplasia. Serum levels of PG1 and PG2 in patients with chronic active gastritis and intestinal metaplasia were higher than normal patients (p<0.05). These patients also had higher incidence of Helicobacter pylori infection compared with normal patients. (75% vs. 21%).
Conclusion: Measurement of PG1, PG2, and anti-H pylori antibody in dyspeptic patients can be helpful in identifying gastric precancerous lesions.
 

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Background and purpose: About half of the world’s population is infected with Helicobacter pylori (H. pylori). But, the efficacy of therapeutic regimens decreases over time due to increasing resistance of H. pylori to antibiotics. This research aimed at evaluating the efficacy of two triple therapy regimens.
Materials and methods: This tudy was performed in Sari Imam Khomeini Hospital, 2016-2017. One hundred forty patients with peptic ulcer disease and naïve H. pylori infection were randomly divided into two groups to receive either 10-day standard triple therapy (Pantoprazole 40 mg, Amoxicillin 1 gr, and Clarithromycin 500mg, all twice daily) or 10-day Levofloxacin-containing triple therapy (Pantoprazole 40 mg BD, Amoxicillin 1000mg BD, and Levofloxacin 500 mg/daily). Eight weeks after the treatment, H. pylori eradication was assessed by ¹⁴C- urea breath test.
Results: A total of 133 patients completed the study. According to intention to treat analysis (ITT), H. pylori eradication rates were 75.7% (95% CI: 65.7%-85.7%) and 58.8% (95% CI= 47.1%-70%) in standard and Levofloxacin-containing therapies, respectively. Also, per-protocol eradication rates were 83% (95% CI: 74%-92%) and 61% (95% CI= 49%-73%), respectively. The rates of severe adverse effects of therapy were 7.1% and 2.9% in the aforementioned groups, respectively.
Conclusion: Both Clarithromycin- and Levofloxacin-containing triple therapies do not seem to be suitable options for first-line H. pylori eradication in Iran. We suggest using Clarithromycin in quadruple regimens and reserve Levofloxacin to be used in second-line eradication regimens, as recommended by Maastricht V Consensus Report.
 
(Clinical Trials Registry Number: IRCT2015110224825NI)