Effect of grinding on chemical and physical properties of rice husk ash

The effect of grinding on the chemical and physical properties of rice husk ash was studied. Four rice husk ashes with different finenesses, i.e. coarse original rice husk ash (RHA0), RHA1, RHA2, and RHA3 were used for the study.The effect of grinding on the chemical and physical properties of rice husk ash was studied. Four rice husk ashes with different finenesses, i.e. coarse original rice husk ash (RHA0), RHA1, RHA2, and RHA3 were used for the study. Ordinary Portland cement (OPC) was partially replaced with rice husk ash at 20% by weight of binder. The water to binder ratio (W/B) of the mortar was maintained at 110%±5% with flow table test. Specific gravity, fineness, chemical properties, compressive strength, and porosity test of mortars were determined. The differences in chemical composition of the rice husk ashes with different finenesses from the same batch are small. The use of RHA3 produces the mortars with good strength and low porosity. The strength of the mortar improves with partial replacement of RHA3 in comparison with normal coarse rice husk ash. The use of RHA3 results in a strong and dense mortar, which is due to the better dispersion and filling effect, as well as an increase in the pozzolanic reaction

Report from the multinational irritable bowel syndrome initiative 2012

Q1Q1In 2012, a group of 29 internationally recognized experts in the pathophysiology, diagnosis, and treatment of irritable bowel syndrome (IBS) convened to audit the current state of IBS research. The meeting was preceded by a comprehensive online survey that focused on research needs for IBS diagnosis (particularly the strengths and shortcomings of current criteria), definitions used in clinical trials for IBS patients and “healthy controls,” potential biomarkers for IBS, and outcome measures in drug trials. While the purpose of the meeting was not to make binding recommendations, participants developed a framework for future questions and research needs in IBS. First, participants indicated the need for revised criteria for the diagnosis of IBS; in particular, inclusion of bloating and de-emphasis of pain as criteria were considered critical needs. Second, participants noted that definitions of normal, healthy controls varied widely among clinical trials; these definitions need to be standardized not only to improve the reliability of results, but also to better facilitate inter-trial comparisons and data synthesis. Third, participants highlighted the need for accurate biomarkers of disease. Fourth and finally, participants noted that further defining outcome measures, so that they are functionally relevant and reflect normalization of bowel function, is a critical need. Together, the discussions held at this workshop form a framework to address future research in IBS.https://orcid.org/0000-0002-9219-4548Revista Internacional - Indexad

Helicobacter pylori virulence genes of minor ethnic groups in North Thailand

Background: There are few studies analyzed concurrently the prevalence and genotypes of Helicobacter pylori infection with the ancestor origins from different ethnics, especially with including minority groups. We recruited a total of 289 patients in MaeSot, Thailand (154 Thai, 14 Thai-Chinese, 29 Karen and 92 Hmong ethnics). The virulence genes and genealogy of the strains were determined by PCR-based sequencing. Results: Based on culture and histology/immunohistochemistry, the prevalence of H. pylori infection was 54.5 (158/289). Among 152 isolates cultured, the East-Asian-type cagA was predominant genotype among strains from Hmong, Thai-Chinese and Thai (96.0 48/50, 85.7% 6/7 and 62.7% 47/75, respectively), whilst majority of strains from Karen had Western-type cagA (73.3% 11/15). Patients infected with the East-Asian-type cagA strains had significantly higher activity and intestinal metaplasia in the antrum and activity in the corpus than those with Western-type cagA (P = 0.024, 0.006 and 0.005, respectively). The multilocus sequencing typing analysis discriminated that most strains from Hmong and Thai-Chinese belonged to hspEAsia (92.0 and 85.7%, respectively), whereas strains from Karen predominantly possessed hpAsia2 (86.7%) and strains from Thai were classified into hspEAsia (45.2%) and hpAsia2 (31.1%). Conclusions: Helicobacter pylori genotypes were relatively different among ethnic groups in Thailand and were associated with the source of ancestor even living in a small rural town. Caution and careful check-up are required especially on Hmong ethnic associated with high prevalence of virulence genotypes of H. pylori. © 2017 The Author(s)

Prevalence, risk factors, and virulence genes of Helicobacter pylori among dyspeptic patients in two different gastric cancer risk regions of Thailand

Gastric cancer risk is varied among different regions of Thailand. We examined the characteristics of Helicobacter pylori infection in two regions of Thailand. The H. pylori status of 273 dyspeptic patients (136 from the South and 137 from the North; a low and high incidence of gastric cancer region, respectively) was evaluated, and virulence genotypes (cagA, vacA, hrgA and jhp0562-positive/β-(1,3)galT) were determined. The overall H. pylori infection rate was 34.1% (93/273). The prevalence was higher in the North than in the South (50.4% vs. 17.6%, P <0.001) and was significantly higher among individuals with the following characteristics: low income, birthplace in the Northeast or North regions, agricultural employment, or consumption of alcohol or unboiling water. Among these socio-demographic determinants, region was an independent risk factor for H. pylori infection (odds ratio = 6.37). Patients including both H. pylori infected and uninfected cases who lived in the North had significantly more severe histological scores than those in the South. In contrast, among H. pylori-positive cases, patients in the South had significantly more severe histological scores than those in the North. Of the 74 strains cultured, 56.8% carried Western-type cagA, with a higher proportion in the South than in the North (76.2% vs. 49.1%, P = 0.05). In disagreement with the current consensus, patients infected with the Western-type cagA strains had more severe inflammation scores in the antrum than those infected with the East Asian-type cagA strains (P = 0.027). Moreover, Western-type cagA strains induced more severe histological scores in patients from the South than those of either genotype from the North. Other virulence genes had no influence on histological scores. The incidence of gastric cancer in Thailand was different among regions and corresponded to differences in the prevalence of H. pylori infection. More careful follow-up for patients in the South will be required, even if they are infected with H. pylori carrying Western-type cagA

Characterizing Helicobacter pylori cagA in Myanmar

Background/Aims Differences in the Helicobacter pylori infection rate are not sufficient to clarify the dissimilarity of gastric cancer incidence between Myanmar and its neighboring countries. To better understand this trend, the H. pylori virulence gene cagA was characterized in Myanmar. Methods Glutamate-proline-isoleucine-tyrosine-alanine (EPIYA) patterns and CagA multimerization (CM) motifs of cagA genotypes were examined by performing polymerase chain reactions and DNA sequencing. Results Of 69 tested H. pylori strains, cagA-positive patients had significantly more severe histological scores in their antrum than cagA-negative patients. Sequence analysis revealed that 94.1% of strains had Western-type cagA containing an EPIYA motif (92.6%) or EPIYT motif (6.4%). The intestinal metaplasia scores in the antral of patients infected with the ABC and ABCC types of cagA were significantly higher than those of patients with AB-type cagA. Interestingly, in patients infected with H. pylori, 46.3% of strains with three EPIYA motifs contained two identical Western-typical CM motifs, and these patients showed significantly higher antrum inflammation scores than patients infected with two identical nontypical-CM motif strains (p=0.02). Conclusions In Myanmarese strains, Western-type cagA was predominant. The presence of CM motifs and the proportion of multiple EPIYA-C segments might partially explain the intermediate gastric cancer risk found in Myanmar

Ten‐day high‐dose proton pump inhibitor triple therapy versus sequential therapy for Helicobacter pylori eradication

Background and AimEradication rates of Helicobacter pylori following standard triple therapy are declining worldwide, but high‐dose proton pump inhibitor‐based triple therapy (HD‐PPI‐TT) and sequential therapy (ST) have demonstrated higher cure rates. We aimed to compare the efficacy and tolerability of HD‐PPI‐TT and ST in H. pylori‐associated functional dyspepsia (FD).MethodsOne hundred and twenty H. pylori‐associated functional dyspepsia patients were randomized to receive 10‐day HD‐PPI‐TT (60 mg lansoprazole/500 mg clarithromycin/1 g amoxicillin, each administered twice daily for 10 days) or 10‐day ST (30 mg lansoprazole/1 g amoxicillin, each administered twice daily for 5 days followed by 30 mg lansoprazole/500 mg clarithromycin/400 mg metronidazole, each administered twice daily for 5 days). H. pylori status was determined in post‐treatment week 4 by 14C‐urea breath test. Eradication and antibiotic resistance rates, dyspeptic symptoms, drug compliance, and adverse effects were compared.ResultsIntention‐to‐treat eradication rates were similar in the ST and HD‐PPI‐TT groups (85% vs. 80%; P = 0.47). However, the eradication rate was significantly higher following ST compared with HD‐PPI‐TT in per protocol analysis (94.4% vs. 81.4%; P = 0.035). ST achieved higher cure rates than HD‐PPI‐TT in clarithromycin‐resistant H. pylori strains (100% vs. 33.3%; P = 0.02). Treatment compliance was similar in the HD‐PPI‐TT and ST groups, although nausea and dizziness were more common in the ST group.ConclusionsSequential therapy achieved better H. pylori eradication than HD‐PPI‐TT in patients with FD. However, the eradication rate for ST fell from 94.4% in per protocol to 85% in intention‐to‐treat analysis. Adverse effects might result in poorer compliance and compromise actual ST efficacy (ClinicalTrials.gov: NCT01888237).Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146477/1/jgh14292_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146477/2/jgh14292.pd

Characterization of a novel Helicobacter pylori East Asian-type CagA ELISA for detecting patients infected with various cagA genotypes

Currently, Western-type CagA is used in most commercial Helicobacter pylori CagA ELISA kits for CagA detection rather than East Asian-type CagA. We evaluated the ability of the East Asian-type CagA ELISA developed by our group to detect anti-CagA antibody in patients infected with different cagA genotypes of H. pylori from four different countries in South Asia and Southeast Asia. The recombinant CagA protein was expressed and later purified using GST-tag affinity chromatography. The East Asian-type CagA-immobilized ELISA was used to measure the levels of anti-CagA antibody in 750 serum samples from Bhutan, Indonesia, Myanmar, and Bangladesh. The cutoff value of the serum antibody in each country was determined via Receiver-Operating Characteristic (ROC) analysis. The cutoff values were different among the four countries studied (Bhutan, 18.16 U/mL; Indonesia, 6.01 U/mL; Myanmar, 10.57 U/mL; and Bangladesh, 6.19 U/mL). Our ELISA had better sensitivity, specificity, and accuracy of anti-CagA antibody detection in subjects predominantly infected with East Asian-type CagA H. pylori (Bhutan and Indonesia) than in those infected with Western-type CagA H. pylori predominant (Myanmar and Bangladesh). We found positive correlations between the anti-CagA antibody and antral monocyte infiltration in subjects from all four countries. There was no significant association between bacterial density and the anti-CagA antibody in the antrum or the corpus. The East Asian-type CagA ELISA had improved detection of the anti-CagA antibody in subjects infected with East Asian-type CagA H. pylori. The East Asian-type CagA ELISA should, therefore, be used in populations predominantly infected with East Asian-type CagA. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature

Self-Care in the Twenty First Century: A Vital Role for the Pharmacist

© 2016, The Author(s). In order for the global healthcare system to remain sustainable, healthcare spending needs to be reduced, and self-treating certain conditions under the guidance of a pharmacist provides a means of accomplishing this goal. This article was developed to describe global healthcare trends affecting self-care with a specific focus on the role of the pharmacist in facilitating over-the-counter (OTC) medication management. Potential healthcare-related economic benefits associated with the self-care model are outlined. The importance of the collaboration between healthcare providers (HCPs), including specialists, primary care providers, and pharmacists, is also discussed. The evolving role of the pharmacist is examined and recommendations are provided for ways to successfully engage with other HCPs and consumers to optimize the pharmacist’s unique qualifications and accessibility in the community. Using the management of frequent heartburn with an OTC proton-pump inhibitor as a model, the critical role of the pharmacist in patient self-treatment of certain symptoms will be discussed based on the World Gastroenterology Organization’s recently published guidelines for the community-based management of common gastrointestinal symptoms. As the global healthcare system continues to evolve, self-care is expected to have an increasing role in treating certain minor ailments, and pharmacists are at the forefront of these changes. Pharmacists can guide individuals in making healthy lifestyle choices, recommend appropriate OTC medications, and educate consumers about when they should consult a physician. Funding: Pfizer Inc