Background: The microorganism Helicobacter pylori has been closely linked to chronic gastritis, peptic ulcer, gastric cancer, and mucosa‐associated lymphoid tissue (MALT) lymphoma. Despite the current treatment regimens that lead to successful management of H. pylori‐positive chronic gastritis, the reinfection rate is high. It has been suggested that one of the possible mechanisms of reinfection is the recolonization from dental plaque. The purpose of this study was to determine whether dental plaque, poor oral hygiene, and periodontal disease were risk factors for H. pylori infection.
Methods: Among the 134 patients, 65 patients who had a positive H. pylori serology or positive rapid urease test or histologic evidence for the presence of H. pylori in antral biopsy specimens were categorized as cases. The remaining 69 patients who were negative for H. pylori serology, the rapid urease test, and histology were controls.
Results: It was found that the association of periodontal disease and poor oral hygiene with H. pylori infection was not significant. There was a higher prevalence of H. pylori in the dental plaque of patients with gastric H. pylori infection than in controls, but both groups had a surprisingly high positive urease test for H. pylori in plaque (89% and 71%, respectively).
Conclusions: H. pylori in dental plaque is seldom eliminated by H. pylori‐eradication therapy, and this may act as a source for future reinfection. Hence, eradication of H. pylori from the dental plaque should be made an important part of comprehensive management of H. pylori‐associated gastric diseases.
Introduction
These Asian Working Group guidelines on diet in inflammatory bowel disease (IBD) present a multidisciplinary focus on clinical nutrition in IBD in Asian countries.
Methodology
The guidelines are based on evidence from existing published literature; however, if objective data were lacking or inconclusive, expert opinion was considered. The conclusions and 38 recommendations have been subject to full peer review and a Delphi process in which uniformly positive responses (agree or strongly agree) were required.
Results
Diet has an important role in IBD pathogenesis, and an increase in the incidence of IBD in Asian countries has paralleled changes in the dietary patterns. The present consensus endeavors to address the following topics in relation to IBD: (i) role of diet in the pathogenesis; (ii) diet as a therapy; (iii) malnutrition and nutritional assessment of the patients; (iv) dietary recommendations; (v) nutritional rehabilitation; and (vi) nutrition in special situations like surgery, pregnancy, and lactation.
Conclusions
Available objective data to guide nutritional support and primary nutritional therapy in IBD are presented as 38 recommendations.
Peritoneal tuberculosis, carcinomatosis and pancreatic ascites are often considered as differential diagnosis of hemorrhagic ascites. Endometriosis can rarely present as hemorrhagic ascites and closely mimic these conditions. When this occurs without common clinical features of endometriosis, it can create a diagnostic challenge to the treating physician. We present three patients with endometriosis who presented with hemorrhagic ascites; two of them did not have gynecological symptoms or significant pelvic disease. These patients were evaluated several times in many centers and even received multiple courses of anti-tuberculous treatment. The diagnosis was made by histologic examination of parietal peritoneum obtained by laparoscopy or laparotomy. The diagnosis was missed possibly because of the atypical presentation, lack of clinical suspicion and incomplete assessment. In conclusion, this potentially treatable condition should be considered as a differential diagnosis for hemorrhagic ascites in a premenopausal woman.
CARDIOVIT is one of the first and largest studies in India to provide insight into the prevalence of hypertHcy, its association with AVD and conventional risk factors and the role of multivitamins in reducing it.
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