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Background and Objective: After distinguishing the role of Helicobacter Pylori in gastritis and peptic ulcer, some hypothesis were brought up about the probable interference of this germ in dyspepsia. This study was done in order to determine the prevalence of Helicobacter Pylori infection in persons conflicted with dyspepsia, attended in 5th Azar Hospital in Gorgan during 8 months (From 2001/Mar/21 to 2001/Nov/22). Materials and Methods: In this research, 270 patients with diagnosis of dyspepsia were endoscopic based on clinical examinations and paraclinical studies and after ruling out of erosive gastrodeodenitis and peptic ulcer, two biopsy samples were taken from antrum. Then, the samples were put in urea rapid test environment media. The required time for positive response was 15 minutes but to be completely sure about it, urea environment media consisted of biopsy samples were maintained for 2 hours. Any color changes during this time were considered as positive response. Results: Among 270 patients conflicted with dyspepsia 136 patties were male and 134 were female with age average of 40.9% Y/O. The patients with Helicobacter Pylori infection were 139 (51.5%) and the ones without infection were 131 (48.5%), and age averages were 44.4 Y/O and 37.3 Y/O, respectively. The prevalence of dyspepsia subgroups were as follows: Ulcer like 53.7%, reflux like 31.1%, non specific 9.6%, and dismotility like 5.6%, and the prevalence of infection among dyspepsia subgroups were as follows: Ulcer like 62.02%, reflux like 40.47%, non specific 46.15%, and dismotility like 20%. Other risk factors in these patients were as follows: Cigarette smoking 25.6%, NSAID 16.3% and alcohol drinking 4.1%. Conclusion: This study suggests that Helicobacter Pylori infection can have a role in formation of dyspepsia.

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Background and Objective: Most of the diagnostic methods of Helicobacter Pylori infection are invasive and time consuming. This study compared salivary IgG with serum IgG in diagnosis of H.pylori infection in dyspeptic patients in order to search for a non-invasive, cheaper and more tolerable method. Materials and Methods: In a cross-sectional diagnostic study, during one year (Feb 2002-Feb 2003) 200 consecutive patients (Age range 11-83) referring to Imam Khomeini Hospital. For upper gastroduodenal endoscopy were recruited. Three biopsy specimens were obtained from antrum and body of the stomach and three from duodenum. Histological examination (Hematoxylin-Eosin and Gimsa), rapid urease test and culture were performed. Saliva and serum were obtained before endoscopy and IgG antibody level were determined by ELIZA using Randim Kit (Roma, Italy). Sensitivity, specificity, positive and negative predictive values were evaluated by SPSS soft ware. Results: Salivary IgG correctly identified 120 out of 146 H.pylori infected patients (82%). Salivary IgG assay showed high sensitivity in the detection of H.pylori infected patients (88.2%). Specificity and positive predictive value of Salivary IgG were higher than those of serum (84.4% versus 83.1% and 92.3% versus 91.9%). Conclusion: Salivary IgG assay can be used as an alternative to other non-invasive methods for screening of H.pylori infected patients.

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Background and Objective: There are some reports on the association between helicobacter pylori infection and typhoid fever in different parts of the world. The aim of this study was to estimate the co infection of helicobacter pylori and typhoid fever in Ahwaz city in South-West of Iran.

Materials and Methods: In this case – control study, fifty hospitalized patients with definite diagnosis of typhoid fever in Razi and Abuzar hospitals in Ahwaz were investigated. For each patient, one subject was matched with age, sex and socioeconomic characteristic as control. All of the case and control were tested for IgG –anti helicobacter pylori by ELISA method. Data were analyzed by chi squared test in SPSS software.

Results: Seroprevalence of helicobacter pylori in case (66%) was higher than control (44%) (p<0.05). There was a significant difference between patients and control in male (p<0.05), but not in female.

Conclusion: This study indicated that typhoid fever is associated with helicobacter pylori co-infection in this region.

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Background and Objective: Helicobacter pylori (H.pylori) with positive Cytotoxin associated Gene A (CagA) have higher potential for pathogenesis. Cytotoxin associated Gene A (CagA) accelerate the pathogenecity of bacteria due to cytotoxin production stimulation. The aim of this study was to determine the prevalence of the anti-CagA antibody among H. pylori infected persons in Golestan province-North of Iran. Materials and Methods: This descriptive study was carried out on 676 H. pylori positive subjects in Golestan province, northern Iran during 2008. Anti CagA antibody were determined in H.pylori positive subjects. Data analyzed by SPSS-16 software and chi-square test. Results: Prevalence of anti CagA in Helicobacter pylori infected cases was 57.7% (390 cases: 179 males and 211 females) (95% CI: 53.9-61.4). According to age the highest and lowest cases of anti CagA antibody were seen in, 15-24 (63.4%) and under 5 years old (26.3%). The level of anti CagA antibody in Sistanian ethnicity group (67.2%) was more than other ethnic group. Anti CagA antibody in Rural area was more than urban regions. Sero prevalence of anti CagA antibody was highest in Minudasht twon (78%), located in East of province in comparison with Bandar Gaz (44%) in west of province. Conclusion: This study showed the prevalence of CagA positive Helicobacter pylori strains in this region is similar to other regions of Iran, Asia and Europe and higher than African population.

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Background and Objective: Antibiotical resistance to Helicobacter pylori reduced the eradication rates. This study was done to compare the sequential comparison of sequential and routine four drugs therapeutic regiments in Helicobacter pylori eradication. Materials and Methods: In this double blind clinical trial study 160 chronic dyspepsia patients randomly divided into 2 groups of sequential and routine four drugs therapeutic regiments. We performed invasive tests for H. pylori in patients who underwent gastroduodenoscopy. 160 patients who were diagnosed as H.pylori-positive by histological evaluation were selected for the trial. A 14-day sequential regimen (Omeprazole, Amoxicillin, each administered twice daily for the first 5 days, followed by Omprazole, Clarithromycin and Urazolidon, each administered twice daily for the remaining 9 days. 14-day 4 drug therapy, Omprazole, Clarithromycin, Amoxicillin and Bismoot each administered twice daily. 5 weeks after treatment urease breath test (UBT) was preformed. Results: The recovery was seen in 50.9% and 49.1% in sequential and routine four drugs theraputical treatment, respectively. The recovery of patient with severe H. pylori infection was non-significantly higher in sequential regiment (64.7%) than four drugs regiment (41.2%). In comparison to four drugs, sequential therapy was significantly more effective in patients with sever gastritis (87.5% vs. 25%, p<0.05). Conclusion: The eradication of H. pylori infection particularly in severe gastritis is preferred by sequential theraputical regiment.

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Background and Objective: Helicobacter pylori is the main gastric pathogen in human. BabA2 and Hsp genotypes are essential for enormous clinical outcomes in gastreodeoneal and dyspepsia. This study was done to determine the assessment of babA2 and hsp genotype frequency in Helicobacter pylori specimens isolated from digestive disorders patients. Method: This descriptive-analytic study was carried out on 80 digestive disorders patients in 5th hospital, Gorgan, northern Iran. Stomach specimen biopsy was taken by a gastroenterologist. Urease test, histopathologic assessment and DNA extraction were performed. The frequency of babA2 and hsp geno-types was determined using poly merase chain reaction. Results: In 80 affected patients with H.pylori, 36, 18 and 26 patients were found to suffer from gastritis, stomach cancer and stomach ulcer, respectively. 51 specimens (63%) were positive babA2 genotype. 49 specimens (61%) were positive hsp genotype. No significant relationship was found between babA2 and hsp geno types with stomach diseases. Conclusion: In spite of positive babA2 and hsp genotype in isolated Helicobacter pylori speicments from digestive disorders patients, this finding was not correlated with type of digestive disorders.

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Background and Objective: Helicobacter pylori are one of the most common gastrointestinal bacterium infections. This study was done to compare the urease test with Giemsa staining to detection of Helicobacter pylori infection in patients with gastric ulcer and gastritis.

Methods: This descriptive – analytic study was conducted on 601 patients' diagnosed with gastric ulcer and gastritis, whom under went endoscopy in 5th Azar hospital, Gorgan, Iran during 2008-12. Rapid urease test was immediately taken during endoscopy. Pathological examination, Giemsa staining on paraffin blocks and haematoxylin and eosin stain were done to assess either presence or absence of Helicobacter pylori.

Results: Based on biopsy results, Gastritis and gastric ulcer were diagnosed in 80.69% and 19.3%, respectively. In gastritis and gastric ulcer patients, there was a significant differences between urease test (91.5% and 90%, respectively) in comparison with Giemsa staining (91.5% and 90%, respectively) (P<0.05).

Conclusion: The study revealed that in primary diagnosis and screening of role of Helicobacter pylori in patients with gastric ulcer and gastritis, urease test is suitable than giemsa staining.

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Background and Objective: Helicobacter pylori infection is one of the most common chronic bacterial infections all over the world, particularly in the developing countries. LeoA gene plays an important role in pathogenesis, and the main role of this gene is to increase the bacterial toxin secretion. This study was conducted to isolate and clone the leoA gene in a pEGFP-C2 expression vector and evaluate its expression in eukaryotic system.
Methods: In this laboratory study, the leoA gene was amplified from the standard strain of Helicobacter pylori genome (ATCC 43504) by PCR method. It was then inserted into the pTZ vector by cloning T/A. Sub cloning of this gene was performed in a pEGFP-C2 expression vector with a ligase enzyme. The final structure of pEGFP-C2-leoA was transformed by electroporation in CHO (Chinese hamster ovary) cells and the expression of the leoA gene was evaluated by SDS-PAGE and RT-PCR.
Results: The results of PCR indicated that the 1758 bp fragment was amplified from the leoA gene. Cloning of this gene was performed successfully in pTZ and pEGFP-C2 vectors, respectively. The enzyme digestion with two KpnI and SacII enzymes, as well as sequencing, confirmed the accuracy of gene cloning. The observation of the protein product of the leoA gene in CHO cells indicated the successful expression of the LeoA gene in the eukaryotic system of Helicobacter pylori.
Conclusion: The final construct of pEGFP-C2-leoA had a successful expression of the leoA gene in animal cells.

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Background and Objective: Helicobacter pylori infection is a pathogenic agent of many stomach disorders, including peptic ulcer disease, stomach cancer and stomach lymphoma. The reasons for the variety of the outcomes of the infection resulting from Helicobacter pylori may be related to difference in genotype or expression of pathogenic bacterial-related factors, as well as environmental and host factors. This study was conducted to determine the frequency of s1, s2, m1 and m2 alleles of the vacA Helicobacter pylori gene isolated from clinical samples.
Methods: This descriptive-analytic study was conducted on 183 patients whom suffering from digestive disorders which referring to the endoscopic department of Kordkuy’s Amiralmomenin hospital in Golestan province, north of Iran during 2016. Two samples of biopsy from antrum region were taken from each patient. The first sample was evaluated by urease test and the second one was done with saline buffer phosphate solution. Urease test of 50 positive samples and DNA extraction was performed. The polymerase chain reaction was performed for vacA alleles and then the relationship between toxin secretion with the symptoms such as abdominal pain, stomachache, reflux, nausea, gastritis, bleeding, stomach ulcers, burning, anemia, and weight loss were evaluated.
Results: Frequency of s1, s2, m1, m2 vacA alleles of isolated strains was 88%, 6%, 38% and 70%, respectively. Also, the s1 / m1, s1 / m2, s2 / m1 and s2 / m2 genotypes of vacA Helicobacter pylori gene were determined 36%, 58%, 0% and 6%, respectively. Toxin secretion did not have significant relationship with digestive symptoms.
Conclusion: The dominant genotype of the patients with digestive disorders (58%) in this study was s1 / m2 and s2 / m1 genotype did not observe in clinical samples.

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Background and Objective: Chronic and recurrent abdominal pain affect about 7-20% of children in school age, and it is responsible for 2-4% of children's medical referrals. Helicobacter pylori infection in children can cause gastrointestinal problems in childhood, and the lack of treatment and eradication can lead to serious complications. This study was done to evaluate the prevalence of Helicobacter pylori ELISA stool antigen in children with chronic abdominal pain.

Methods: In this case control study, 33 children with chronic abdominal pain and 30 normal children were evaluated. The stool was tested by ELISA method to evaluate Helicobacter pylori antigen.

Results: 15.2% of chidern in the chronic abdominal pain group were positive for Helicobacter pylori. No positive case was found among control group. This difference between case and control groups was significant (P<0.05).

Conclusion: Considering the high prevalence of Helicobacter pylori antigen in children with chronic abdominal pain, it is suggested that children with chronic abdominal pain without a definite cause screened for Helicobacter pylori infection.

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Background and Objective: The infection of Helicobacter pylori (H. pylori) is one of the most complex items addressed in the clinical microbiology. Although H. pylori positive subjects are bound to develop into atrophic gastritis, current body of evidences is rare. Due to the high prevalence of this bacterium worldwide, finding the true virulence factors as biomarkers for severe gastroduodenal diseases was the priority in recent researches. This study was carried out to determine the prevalancy of cagA and babA of Helicobacter pylori isolated from gastric atrophic patients.
Methods: This descriptive – analytical study was conducted on 100 patients with gastroduodenal disorders in Labafinejad hospital in Tehran, Iran during 2018. Identification of each patient and also bacterial isolation were undertaken according to the standard protocols.
Results: H. pylori were isolated in 23% of patients. 10 patients affected by atrophic gastritis followd by gastric ulcer (7 patients) and acute gastritis (6 patients). In totally, the rate of cagA gene and babA in H. pylori isolated with positive results was 52% and 34%, respectively. There was a significant association between the presence of cagA positive strains and patients with gastric atrophic (P<0.05). The babA gene did not correlate with the presence of gastric atrophic patients.
Conclusion: This study showed that various carrying cagA positive H. pylori can be recovered from patients with gastric atrophy.

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Background and Objective: Multiple sclerosis (MS) is an autoimmune disease that targets the central nervous system. Various studies have shown that several factors influence this disease’s occurrence and prevent its progress. Multiple studies have shown that several factors affect this disease’s occurrence and prevent its progress. Helicobacter pylori can be mentioned among these factors. This study was conducted to determine Helicobacter pylori infection in MS patients and healthy individuals.
Methods: This case-control study was conducted on 100 patients with MS (mean age: 36.99±9.87 years) and 100 healthy subjects (mean age: 38.05±11.38 years) in Golestan province, north of Iran during 2021. The case group included eighty relapsing-remitting cases and twenty secondary progressive cases. Blood samples were taken from both groups, and after separating the serum using the ELISA test, anti-Helicobacter pylori antibody (IgG) was detected by determining the antibody titer.
Results: Helicobacter pylori IgG in the MS and control groups was 21% and 44%, respectively (P<0.05). The mean concentration of IgG in the case group was significantly lower than the control group (13.48±10.83 versus 19.78±16.14 AU/ml). The percentage of positive cases of IgG antibody against Helicobacter pylori in the relapsing-remitting and secondary progressive group of patients with MS was determined as 21.2% and 20%, respectively, and the difference between these two groups was not statistically significant.
Conclusion: The history of Helicobacter pylori infection is less than two times in patients with MS compared to healthy people probably indicate the protective role of this bacterium against this disease.

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Background and Objective: Helicobacter pylori infection is a chronic bacterial infection in humans, and its link to epilepsy has been reported in some studies. This study was conducted to compare the frequency of Helicobacter pylori infection in patients with and without epilepsy.
Methods: This case-control study was conducted on 234 patients with focal and generalized epilepsy (the case group consisted of 88 males and 146 females) referring to Alavi Hospital in Ardabil, Iran and 234 individuals without epilepsy (the control group consisted of 88 males and 146 females) during 2019. Stool samples were taken from the subjects to assess the Helicobacter pylori stool antigen. Demographic information, including age, gender, place of residence, a history of alcohol, cigarette, hookah, and opium use, and the test result of the Helicobacter pylori stool antigen, were collected in a checklist.
Results: The frequency of Helicobacter pylori infection was determined to be 67.2% in the case group and 71.1% in the control group, and no statistically significant difference was found between the case and control groups. Cigarette and opium use had statistically significant relationships with epilepsy (P<0.05). Moreover, opium users had a 6.92 times higher odds rate (OR) of contracting Helicobacter pylori infection than other individuals (CI 95%=1.05-45, OR=6.92, P<0.04).
Conclusion: No difference was observed in Helicobacter pylori infection between individuals with and without epilepsy.