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Gastric juice for the diagnosis of H pylori infection in patients on proton pump inhibitors

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World Journal of Gastroenterology 2008年第10期14卷 1539-1543页

作者： javed yakoob Shahid Rasool Zaigham Abbas Wasim Jafri Shahab Abid Muhammad Islam Zubair Ahmad Department of Medicine Aga Khan University Hospital Karachi 74800 Pakistan Department of Pathology Aga Khan University Hospital Karachi 74800 Pakistan

AIM: To determine the efficacy of gastric juice polymerase chain reaction (PCR) for the detection of H pylori infection in comparison with histology and gastric antral biopsy PCR in patients on a proton pump inhibitor (PPI). METHODS: Eighty-five consecutive patients with dyspeptic symptoms were enrolled. Gastric biopsies for histology, PCR and gastric juice were collected at endoscopy for PCR of the H pylori urease C gene (ure C). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, positive and negative likelihood ratio for PCR of gastric juice for the H pylori ure C gene was compared to histology and gastric antral biopsy H pylori ure C PCR in patients with and without PPI. RESULTS: Gastric juice PCR was positive in 66 (78%) patients. Histology showed H pylori associated gastritis in 57 (67%). Gastric biopsy PCR was positive in 72 (85%). In patients not taking PPI, the sensitivity, specificity, PPV, NPV, accuracy and positive and negative likelihood ratio for gastric juice PCR were 89%, 72%, 91%, 67%, 90%, 85%, 3.1 and 0.1 respectively. In patients on PPI these values were 86%, 100%%, 100%, 29%, 86%, 9.5 and 1.4, respectively. CONCLUSION: Gastric juice PCR for the diagnosis of H pylori infection has increased sensitivity compared to histology with PPI. The use of gastric juice PCR is recommended to confirm H pylori status in patients taking PPIs.

关键词： H pylori Proton pump inhibitor Gastric juice Polymerase chain reaction Histology

Prevalence of non-Helicobacter pylori duodenal ulcer in Karachi,Pakistan

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World Journal of Gastroenterology 2005年第23期11卷 3562-3565页

作者： javed yakoob Wasim Jafri Nadim Jafri Muhammad Islam Shahab Abid Saeed Hamid Hasnain AliShah Hizbullah Shaikh Section of Gastroenterology

AIM:To determine the prevalence of non-Helicobacter pylori (H pylori)-related duodenal ulcer in patients with acid-peptic diseases. METHODS: Medical records of patients who attended the Gastroenterology Department at Aga Khan University Hospital from 1999 to 2001 and had endoscopic diagnosis of duodenal ulcers were reviewed. Duodenal ulcer associated with H pylori was diagnosed on the basis of endoscopy, rapid urease test and histopathology whereas histories of aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) related duodenal ulcers. Non-H pylori, non-NSAID duodenal ulcers were those without H pylori infection and history of NSAID intake. Co-morbid conditions associated were noted. RESULTS: Of 2 260 patients, 10% (217/2 260) had duodenal ulcer. Duodenal ulcer related to H pylori infection accounted for 53% (116/217), NSAID-related 10% (22/217), non-H pylori non-NSAID 29% (62/217), and 8% (17/217) had both H pylori infection and histories of NSAID intake. Fifteen percent (18/116)_patients had past histories of peptic ulcer disease in H pylori infection, while 8% (5/62) in non-H pylori non-NSAID ulcer. Co-morbid conditions in H pylori infection were seen in 23% (27/116) and 34% (21/62) in non-H pylori non-NSAID ulcer. CONCLUSION: Incidence of H pylori infection related with duodenai ulcer is common. In the presence of co-morbids, non-H pylori and non-NSAID duodenal ulcer is likely to be present.

关键词： H pylori Acid-peptic diseases

Candida esophagitis:Risk factors in non-HIV population in Pakistan

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World Journal of Gastroenterology 2003年第10期9卷 2328-2331页

作者： javed yakoob Wasim Jafri Shahab Abid Nadeem Jafri Muhammad Islam Saeed Hamid Hasnain A Shah Akbar S Hussainy Section of Gastroenterology Department of Medicine and Pathology Agha Khan University Hospital Karachi Pakistan

AIM:Candida esophagitis is a frequent infection in immunocompromised patients. This study was designed to determine its characteristics in non- human immune deficiency virus (HIV) infected patients attending a teaching ***: Clinical records of all patients coded by international classification of diseases 9th revision with clinical modifications'(ICD-9-CM), with candida esophagitis diagnosed by esophagogastroduodenoscopy (EGD) and histopathology over a period of 5 years were ***: Fifty-one patients (27 males, 24 females, range 21-77 years old and mean age 52.9 years) fulfilled the criteria (0.34% of the EGD). The common predisposing factors were carcinoma (OR 3.87, CI 1.00-14.99) and diabetes mellitus (OR 4.39, CI 1.34-14.42). The frequent clinical symptoms were retrosternal discomfort, dysphagia and epigastric abdominal pain with endoscopic appearance of scattered mucosal plaques. Another endoscopic lesion was associated with candida esophagitis in 15% ***: Carcinomas, diabetes mellitus, corticosteroid and antibiotic therapy are major risk factors for candida esophagitis in Pakistan. It is an easily managed complication that responds to treatment with nystatin.

关键词： Adult Aged Candidiasis Endoscopy Esophagitis Female HIV Infections Hepatitis B Hepatitis C Humans Hyperplasia Incidence Lymphocyte Count Male Middle Aged Neutrophils Pakistan Risk Factors

Giardiasis in patients with dyspeptic symptoms

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World Journal of Gastroenterology 2005年第42期11卷 6667-6670页

作者： javed yakoob Wasim Jafri Shahab Abid Nadim Jafri Saeed Hamid Hasnain Ali Shah Lubna Rizvi Muhammad Islam Hizbullah Shaikh Section of Gastroenterology Department of Medicine Aga Khan University Hospital Karachi 74800 Sindh Pakistan Department of Pathology Aga Khan University Hospital Karachi 74800 Sindh Pakistan

AIM： To investigate the prevalence of giardiasis in patients with dyspeptic symptoms. METHODS＂ Clinical records of consecutive patients who attended Gastroenterology Department at Aga Khan University Hospital from January 2000 to June 2003 and had esophagogastroduodenoscopy （EGD） with duodenal biopsies and international classification of diseases 9th revision with clinical modifications （ICD-9-CM） coded with giardiasis were studied. RESULTS： Two hundred and twenty patients fulfilled the above criteria. There were 44% （96/220） patients who were giardiasis positive, 72% （69/96） of them were males and 28% （27196） of them were females. There were 65% （81/124） males and 35% （43/124） females who were giardiasis negative. The mean age of patients with giardiasis was 28±17 years, while that of giardiasis negative patients was 40±18 years （P〈0.001）. In patients with giardiasis, abdominal pain was present in 71% （68/96） of patients （P = 0.02） and diarrhea in 29% （28/96）（P = 0.005）; duodenitis in 25% （24/96） on EGD （P = 0.006） and in 68% （65/96） on histopathology （P = 0.002）. CONCLUSION： Giardiasis occurs significantly in young people with abdominal pain, while endoscopic duodenitis is seen in only 25% of giardiasis positive cases, which supports routine duodenal biopsy.

关键词： Abdominal pain Giardiasis Stool examination EGD Duodenal biopsy

Telomere,telomerase and digestive cancer

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World Journal of Gastroenterology 1999年第4期5卷 62-65页

作者： javed yakoob, HU Guo Ling, FAN Xue Gong and ZHANG Zheng

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Ｒｅｃｅｎｔａｄｖａｎｃｅｓｓｕｇｇｅｓｔｔｈａｔｔｅｌｏｍｅｒａｓｅｉｓａｓｏｃｉａｔｅｄｗｉｔｈｃｅｌｕｌａｒｉｍｍｏｒｔａｌｉｔｙｗｈｉｃｈｉｓａｈａｌｍａｒｋｏｆｃａｎｃｅｒ．ＴＥＬＯＭＥＲＥＳＨｕｍａｎｔｅｌｏｍｅｒｅｓｃｏｎｔａｉｎａｎａ...

关键词： Digestive system neoplasms telomere telomerase antitelomerase therapy

Helicobacter pylori outer membrane protein Q genotypes and their susceptibility to antiadhesive phytotherapeutic agents

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Journal of Integrative Medicine 2017年第5期15卷 398-406页

作者： javed yakoob Zaigham Abbas Malik Hassan Mehmood Kanwal Tariq Saima Azhar Saleem Safia Awan Abdul Malik Saeed Hamid Rustam Khan Wasim Jafri Department of Medicine Aga Khan UniversityKarachi 74800Pakistan Department of Biological Biomedical Sciences Aga Khan UniversityKarachi 74800Pakistan

OBJECTIVE： Helicobacter pylori is a Gram-negative organism. Its outer membrane protein Q（Hop Q） mediates host-pathogen interactions; Hop Q genotypes 1 and 2 are found associating with gastroduodenal pathologies. The authors measured the anti-adhesion effects of the extracts of Abelmoschus esculentus, Zingiber officinale, Trachyspermum ammi, Glycyrrhiza glabra, Curcuma longa and Capsicum annum against Hop Q genotypes and H. pylori cytotoxin-associated gene A（Cag A）.METHODS： DNA was extracted by polymerase chain reaction of the Hop Q genotypes（i.e., type 1, type 2 and Cag A） from 115 H. pylori strains. The effect of the extracts from selected dietary ingredients was determined using a gastric adenocarcinoma cell line and a quantitative DNA fragmentation assay. The anti-adhesive effect of these extracts on H. pylori was tested using an anti-adhesion ***： C. annum, C. longa and A. esculentus showed prominent anti-adhesion effects with resultant values of 17.3% ± 2.9%, 14.6% ± 3.7%, 13.8% ± 3.6%, respectively, against Hop Q type 1 and 13.1% ± 1.7%, 12.1% ± 2%, 11.1% ± 1.6%, respectively, against Hop Q type 2. C. longa（93%）, C. annum（89%） and A. esculentus（75%） had better anti-adhesive activity against H. pylori with Hop Q type 1 compared to Hop Q type 2 with respective values of 70%, 64% and 51%. Extracts of C. annum（14.7% ± 4.1%）, A. esculentus（12.3% ± 4.1%） and Z. officinale（8.4% ± 2.8%） had an anti-adhesion effect against Cag A-positive H. pylori strains compared to Cag A-negative strains.

关键词： outer membrane protein Q Helicobacter pylori anti-adhesion Abelmoschus esculentus Capsicum annum Curcuma Ionga

Optimized health care for subjects with type 1 diabetes in a resource constraint society: A three-year follow-up study from Pakistan

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World Journal of Diabetes 2019年第3期10卷 224-233页

作者： Muhammad yakoob Ahmedani Asher Fawwad Fariha Shaheen Bilal Tahir Nazish Waris Abdul Basit Department of Medicine Baqai Institute of Diabetology and Endocrinology Baqai Medical University Karachi 74600 Pakistan Department of Biochemistry Baqai Medical University Research Department Baqai Institute of Diabetology and Endocrinology Baqai Medical University Karachi 74600 Pakistan Research Department Baqai Institute of Diabetology and Endocrinology Baqai Medical University Karachi 74600 Pakistan

BACKGROUND Inadequate health infrastructure and poverty especially in rural areas are the main hindrance in the optimal management of subjects with type 1 diabetes (T1D) in Pakistan. AIM To observe effectiveness of diabetes care through development of model clinics for subjects with T1D in the province of Sindh Pakistan. METHODS A welfare project with name of “Insulin My Life”, was started in province of Sindh, Pakistan. This was collaborative work of Baqai Institute of Diabetology and Endocrinology, World Diabetes Foundation and Baqai Medical University between February 2010 to February 2013. Under this project thirty-four T1D clinics were established. Electronic database was designed for demographic, biochemical, anthropometric and medical examination. Monthly consultation was part of the standardized diabetes care. All the recruited subjects with T1D were provided free insulins and related materials. RESULTS Out of 1428 subjects, 795 (55.7%) were males and 633 (44.3%) were females. Subjects were categorized into ≤ 5 years of age 103 (7.2%), between 6-12 years 323 (22.6%), between 13–18 years 428 (29.7%) and ≥ 19 years of age 574 (40.2%) groups. Glycemic control as assessed by HbA1c was significantly improved (P 0.05). CONCLUSION This study gives us long-term longitudinal data of people with T1D in a resource constraint society. With provision of standardized and comprehensive care significant improvement in glycemic control without any change in the frequency of microvascular complications was observed over 3 years.

关键词： Insulin My Life Type 1 diabetes Insulin Care Pakistan

DNA methylation and carcinogenesis in digestive neoplasms

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World Journal of Gastroenterology 1998年第2期4卷 82-85页

作者： yakoob J Fan XG Hu GL Zhang Z

ＤＮＡｍｅｔｈｙｌａｔｉｏｎａｎｄｃａｒｃｉｎｏｇｅｎｅｓｉｓｉｎｄｉｇｅｓｔｉｖｅｎｅｏｐｌａｓｍｓＪａｖｅｄＹａｋｏｏｂ，ＦＡＮＸｕｅＧｏｎｇ，ＨＵＧｕｏＬｉｎｇａｎｄＺＨＡＮＧＺｈｅｎｇＳｕｂｊｅｃｔｈｅａ... 详细信息

ＤＮＡｍｅｔｈｙｌａｔｉｏｎａｎｄｃａｒｃｉｎｏｇｅｎｅｓｉｓｉｎｄｉｇｅｓｔｉｖｅｎｅｏｐｌａｓｍｓＪａｖｅｄＹａｋｏｏｂ，ＦＡＮＸｕｅＧｏｎｇ，ＨＵＧｕｏＬｉｎｇａｎｄＺＨＡＮＧＺｈｅｎｇＳｕｂｊｅｃｔｈｅａｄｉｎｇｓＤＮＡｍｅｔｈｙｌａｔｉ...

关键词： DNA methylation mutation DNA methyltransferase genes, suppressor tumor digestive system neoplasms p53 gene gene expression

Treatment of hepatitis C virus genotype 4 with peginterferon alfa-2a: Impact of bilharziasis and fibrosis stage

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World Journal of Gastroenterology 2006年第35期12卷 5692-5698页

作者： MF Derbala SR Al Kaabi NZ El Dweik F Pasic MT Butt R yakoob A Al-Marri AM Amer N Morad A Bener Department of Gastroenterology and Hepatology Hamad Medical Corporation Doha Qatar Department of Immunology Hamad Medical Corporation Doha Qatar Department of Haematology Hamad Medical Corporation Doha Qatar Department of Histopathology Hamad Medical Corporation Doha Qatar Department of Medical Statistics and Epidemiology Hamad Medical Corporation Doha Qatar

AIM： To evaluate pegylated interferon alpha2a （PegIFN-α2a） in Egyptian patients with HCV genotype 4, and the impact of pretreatment viral load, co-existent bilharziasis and histological liver changes on response rate. METHODS： A total of 73 nafve patients （61 with history of bilharziasis） with compensated chronic HCV genotype 4 were enrolled into： group A （38 patients） who received 180 mg PegIFN-alpha2a subcutaneously once weekly for a year and group B （35 patients） received IFN alpha-2a 3 MU 3 times weekly. Ribavirin was added to each regimen at a dose of 1200 mg. Patients were followed for 72 wk and sustained response was assessed. RESULTS： Significant improvement in both end of treatment response （ETR）（P 〈 0.002） and sustained response （SR）（P 〈 0.05） was noted with pegylated interferon, where ETR was achieved in 29 （76.3%） and 14 patients （40%） in both groups respectively, and 25 patients in group A （65.8%） and 9 （25.7%） in group B could retain negative viraemia by the end of follow up period. Sustained virological response （SVR） showed a significant negative correlation with age and positive correlation with pretreatment inflammation in patients receiving PegIFN. Viral clearance after 3 mo of therapy was associated with high incidence of ETR and SR （P 〈 0.001）, but without significant difference between both forms of interferon. Significant improvement in response was achieved in patients with high grade fibrosis （grade 3 and 4） with PegIFN-α2a, where SR was seen in 5 out of 13 patients in group A, but none in group B. There was no significant difference in response between bilharzial and non-bilharzial patients in both groups. In terms of safety and tolerability, neutropenia was the predominant side effect, both drugs were comparable. CONCLUSION： PegIFN-~2a combined with ribavirin results in improvement in sustained response in HCV genotype 4, irrespective of history of bilharzial infestation.

关键词： Hepatitis C virus Genotype 4 Pegasys Bilharziasis