Helicobacter pylori-Associated Upper Gastrointestinal Disease in Saudi Arabia: A Pathologic Evaluation of 298 Endoscopic Biopsies from 201 Consecutive Patients

In a prospective study, histopathological examination 298 upper gastrointestinal (UGI) biopsies, obtained from 201 consecutive patients, was made. Patients were referred with mild to severe dyspeptic symptoms. The aim of the study was to compare the rate of identification of Helicobacter pylori (H. pylori) in the histologically normal gastric mucosa with that in histologically confirmed gastritis or peptic ulcer disease. The gastroduodenal mucosa was histologically normal in 35 patients (17.4%); among those patients, H. pylori was identified in only three (9%). Chronic gastritis was histologically confirmed in 162 patients (80.6%). H. pylori was identified in 123 (76%) of those patients. The difference was statistically significant (p less than 0.00001). Furthermore, when cases with a histological diagnosis of superficial chronic active gastritis (SCAG) are considered separately, the identification rate of H. pylori increases to 88% (121 of 137). When this rate is compared with that of 8% (two of 25), found in superficial chronic quiescent gastritis (SCQG), the difference is highly significant (p less than 0.00001). Of 38 endoscopically diagnosed peptic ulcers, H. pylori was identified in the gastric mucosa of 34 (89%). The organisms were always seen in the antral gastric mucosa, but never in duodenal mucosa. Identification of H. pylori correlates significantly with the histologic activity of chronic gastritis, in both peptic ulcer disease and non-ulcer dyspepsia.     

Efficacy of Spyglass-Guided Electrohydraulic Lithotripsy in Difficult Bile Duct Stones

Background/Aims:

We aimed to evaluate the efficacy and safety of Spyglass-guided electrohydraulic lithotripsy (EHL) for difficult common bile duct stones (CBD) not amenable to conventional endoscopic therapy.

Design:

A retrospective study evaluating the efficacy of Spyglass-guided EHL in treating difficult CBD stones, in a single tertiary care center.

Patients and Methods:

All patients who underwent Spyglass-guided EHL from 2012 to 2013 were compared with a historical cohort who had ECSWL.

Results:

A total number of 13 patients underwent Spyglass-guided EHL, 8 (61.5%) of them were males. The mean age was 46.5 ± 5.6 years. Bile duct clearance was achieved in 13 (100%) of them. Seventy-six percent required only one Endoscopic Retrograde Cholangiopancreatography (ERCP) to clear the CBD, 7.7% required two ERCPs, and 15.4% required three ERCPs. Adverse effects (cholangitis) occurred in one patient (10%), whereas only 30 patients (64.4%) of the ESWL group had complete CBD stone clearance. Thirty-seven percent required one ERCP to clear the CBD, 35.6% required two ERCPs, and 20% required three ERCPs. Adverse effects happened in seven (15.5%) patients, where five (11%) had cholangitis and two (4.4%) had pancreatitis.

Conclusion:

Although a retrospective design with a small sample size, we concluded that Spyglass-guided EHL is an effective procedure in treating difficult CBD stones.     

Corneal elevation indices and pachymetry values of Saudi myopes using scheimpflug imaging

Objectives:To report the corneal elevation and thickness values for Saudi myopes and to evaluate the differences between these parameters in subgroups of this target population.Methods:Pentacam corneal topographic maps of the right eyes of patients visiting Al-Hokama Eye Clinic, Riyadh, Saudi Arabia, a tertiary eye center between January 2009 and December 2015 were retrospectively analyzed in this cross-sectional study. The patients were grouped into 3 categories based on their spherical readings: mild (-0.25 to -2.75D), moderate (-3.00 to -5.75D), and severe (≥-6.00D). Furthermore, patients with cylindrical readings of ≥-1.00 diopter were categorized as having myopic astigmatism, whereas those with less than -1.00 cylindrical diopter were categorized as having simple myopia.Results:Our sample was comprised of 1,276 patients; 838 (65.7%) had simple myopia and 438 (34.3%) had myopic astigmatism. The values for the whole myopic group were as follows: anterior corneal elevation (AE) at the apex= 2.60±1.48 (standard deviation), thinnest AE= 2.56±1.68, posterior elevation (PE) at the apex= 3.67±3.58, thinnest PE= 4.92±3.81, central pachymetry= 550.09±34.29, apical pachymetry=550.73±34.64, and thinnest pachymetry= 546.30±34.61. All of the measurements, except the apical PE and thinnest PE, were statistically significant across the simple and myopic astigmatism groups (p<0.05). Comparing the mild to moderate myopia groups revealed a significant difference in the apical AE (p=0.037). Moreover, the comparison between the mild and severe myopia groups revealed that the apical PE and the thinnest PE, as well as the central, apical, and thinnest pachymetry values were statistically significantly different (p<0.05).Conclusion:The corneal elevation indices and thicknesses specific to the Saudi myopes were found to be comparable to the international databases in terms of the elevation and thickness in some of the parameters.     

Synthesis and anti‐inflammatory activity of diversified heterocyclic systems

In continuation with our research program on the development of novel bioactive molecules, we report herein the design and synthesis of a series of diversified heterocycles ( 4 – 22 ). The synthesized compounds were evaluated for their anti‐inflammatory activity. The chemical structures of the newly synthesized compounds have been confirmed by NMR, FTIR, and microanalysis.     

The influence of resin infiltration system on enamel microhardness and surface roughness: An in vitro study

Objective

To investigate the effect of a resin infiltrant on the surface microhardness and roughness of healthy enamel and, as a subsidiary aim, to compare it with a fissure sealant.

Materials and methods

Twenty freshly extracted premolars were used. Sound enamel surfaces were treated with a resin infiltrant (Icon) or fissure sealant (Seal-Rite). The average roughness (R_a, μm) of the specimens was measured with a profilometer (Surtronic 10 Tylor Hobson). Surface hardness was determined by utilizing Vicker’s surface hardness (VHN) with a Micromet II Microhardness tester. Each specimen acted as its own control. Data were analyzed with 2-way analysis of variance (ANOVA), and mean values were compared with independent t-test. All analyses were performed with the SPSS program version 16 (USA). Differences with a P-value of ⩽0.05 were considered statistically significant.

Results

Comparison of enamel surfaces before and after application of resin infiltrant revealed no significant differences in surface hardness; however, enamel surfaces treated by infiltrant showed significantly higher VHN (244.0 ± 79.8) values than those treated with fissure sealant (37.5 ± 14.2). Surface roughness did not differ before and after application of either material to sound enamel. Enamel surfaces treated with fissure sealant (5.3 ± 1.4) were significantly smoother than those treated with infiltrant (6.9 ± 2.0).

Conclusion

Within the limitations of the study, the results showed that enamels treated with the resin infiltrant showed approximately the same microhardness and surface roughness as sound enamel, indicating that this material might be suitable for the treatment of enamel subsurface lesions.