Immune thrombocytopenia (ITP) is a bleeding disorder. Helicobacter pylori is a Gram-negative bacterium that is presumed to be associated with ITP and therapeutic response of patients. To evaluate the effect of H. pylori eradication on the platelet count of patients with ITP. To this end, we analyzed studies conducted on the association between H. pylori infection and response to therapy in patients with ITP in Western Asia, with a particular focus on the Middle East region. A systematic search of databases (PubMed/Medline, ISI Web of Science, Cochrane Central) and Google Scholar search engine results was conducted up until January 2020. The keywords included in the search were Helicobacter pylori and/or H. pylori, ITP and/or immune thrombocytopenia. Seven studies comprising a total of 228 H. pyloriinfected patients (193 with successful eradication) were included in this study. The association between H. pylori eradication and ITP was expressed as odds ratios (ORs) and 95% confidence intervals (CI). The findings showed that patients who received eradication treatment for H. pylori infection had significantly higher ORs (OR, 8.83; 95% CI, 2.03-38.35; P=0.004) than those in the non-eradicated group. Our results indicate a significant therapeutic effect of H. pylori eradication on the platelet count of patients with chronic ITP. Given the inherent limitations of this study, including the small number of patients, further studies with more patients are recommended.

Background: Acute respiratory infection (ARI) is caused by human metapneumovirus (HMPV), respiratory syncytial virus type A and B (RSV-A, RSV-B), human parainfluenza viruses 1, 2, and 3 (HPIV-1, HPIV-2, and HPIV-3), influenza viruses A and B (IfV-A, IfV-B), and human coronaviruses (OC43/HKU1, NL63, 229E) worldwide. Objectives: This study was conducted to assess the causative agents of viral ARI among hospitalized adults by real-time PCR. Methods: Clinical nasopharyngeal swabs of 112 patients including 55 (49.1%) males and 57 (50.89%) females with ARI were analyzed using multiplex real-time RT-PCR. Results: Out of 112 specimens, 61 (54.46%) were positive including 10 (8.9%) for influenza H3N2, one (0.89%) for influenza B, 28 (25%) for RSV-A, 18 (16.07%) for HMPV-A, two (1.78%) for HPIV-1, and three (2.67%) for HPIV-3. Two (1.78%) specimens were positive for two agents, RSV-A/HMPV-A and RSV-A/HPIV-3. The distribution of viral infections was 30 among males (26.78%) and 31 (27.67%) among females (P = 0.862). High frequency of RSV-A infection (25%) and the low frequency of influenza B virus infection (0.89%) were detected among patients. The remaining 51 (45.53%) samples were negative for RSV-B, HMPV-B, IfV-A, HPIV2-4A-4B, and HCoVs (OC43/HKU1, NL63, 229E). Conclusions: The role of other viruses such as human adenoviruses rhinovirus/enterovirus (RV/EV), human bocavirus (HBoV), and human parechovirus (HpeV) was not investigated. Multiplex PCR can be used as a rapid test for the diagnosis of viruses causing acute respiratory infection, which results in decreased length of hospitalization.

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