Validation of diagnostic tests and epidemiology of Helicobacter pylori infection in Bangladesh

Introduction: Helicobacter pylori infection is associated with gastritis, peptic ulcer, and gastric cancer. We conducted a cross-sectional study to compare five diagnostic tests for H. pylori infection and studied the epidemiology of the infection in Bangladesh. Methodology: Bangladeshi patients with dyspeptic symptoms referred for endoscopic examination were enrolled in this study. Each patient underwent upper endoscopic examination and four gastric biopsy specimens were taken. We used 5 tests for the diagnosis of H. pylori; culture, histology confirmed by immunohistochemistry, rapid urease test (RUT), urinary and serological test. Demographic and environmental variables were collected. Results: A total of 133 patients participated in the study, 61 males and mean age 37.3 ± 12.3 years. We used the culture and/or histology results as the gold standard to estimate the sensitivity, specificity, positive and negative predictive values for the studied diagnostic tests. RUT, culture and histology had high sensitivity and specificity with moderate positive and negative likelihood ratio, whereas urine test and serology showed a good sensitivity and specificity but poor likelihood ratio. The overall prevalence of H. pylori among study subjects was 47% with no difference between gender and age groups. Conclusions: The invasive tests showed better performance than noninvasive tests among Bangladeshi population. The overall prevalence of H. pylori was less than the previously reported in the region with no difference among all age groups

Total cholesterol and anthropometric measurements distributions in a cross-sectional study of school children

Cross-sectional age and sex specific distributions of serum total cholesterol were described for 1091 children age 6-18 years, in The Woodlands, Texas. Associations of serum total cholesterol with five anthropometric measurements (weight, height, body mass index, arm circumference, and triceps skinfold thickness) were examined by correlation and regression analyses. Examination of serum total cholesterol distributions showed lower levels in boys than in girls for most of the age groups studied. Mean levels of total cholesterol peaked at age 9 for boys and 8 for girls. Serum total cholesterol leveled off until age 14 for boys and 11 for girls, and then dropped through age 18 for both boys and girls. These results support the hypothesis that serum total cholesterol concentration drops at pre-adolescence. Age adjusted correlations were observed between serum total cholesterol and triceps skinfold thickness for both boys and girls. This association was stronger in boys. Triceps skinfold thickness and arm circumference were consistently the strongest correlates for serum total cholesterol in boys. Weight and arm circumference were consistently the strongest correlates for serum total cholesterol in girls