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Prevalence of Cytotoxin Associated Gene-A Positive Strains in Children With Symptomatic H. Pylori Infection

Thesis Info

Author

Muriithi, Patricia Mumbi

Department

Paediatrics and Child Health (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2017

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728060735

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Introduction: Helicobacter pylori is a common bacterial infection in humans with early acquisition in childhood. It is adapted to the gastric environment and has been associated with chronic active gastritis, peptic ulcers, atrophic gastritis, gastric adenocarcinoma and mucosa associated lymphoid tissue (MALT) lymphoma. H. pylori strains bearing the Cytotoxin Associated Gene-A (CagA) gene have enhanced pathogenicity and have been strongly linked with increased risk for gastric carcinoma in adulthood. Objectives: The primary objective was to determine the prevalence of CagA positive strains in children with H. pylori infection. The secondary objectives were to compare CagA status and endoscopy findings and to determine their correlation with Iron deficiency in children with H. pylori infection. Methodology: A cross sectional survey was carried out in 73 children under the age of 15 years who had undergone Upper Gastrointestinal (GI) endoscopy and had H. pylori identified on histology. Consent was obtained from the caregivers before administering a questionnaire on bio data and clinical history. Blood samples were drawn and evaluated for anti- CagA IgG antibodies using ELISA to determine prevalence of CagA positive H. pylori infection. Endoscopy findings, iron status as determined by serum ferritin level, haemoglobin level, mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) were compared with CagA status. Data Analysis: Data on age were summarized using median (IQR), categorical data were summarized using frequencies and percentages. Prevalence was determined as proportion with CagA positive H. pylori infection as numerator and all children with H. pylori infection as denominator. The association between CagA and demographic characteristics (gender and age-groups) were determined using Chi square test and logistic regression. Relationship between iron deficiency anaemia and endoscopy findings as exposure variables and CagA status as outcome was analysed. In view of the small sample size, exact logistic regression was used to calculate the odds ratio (OR) and the corresponding confidence interval. Precision was estimated using 95% confidence interval with p-values of ≤0.05 being considered statistically significant. All statistical analyses were done using STATA version 14. Results: Children below the age of 15years (median age of nine years (IQR six to 13) were recruited, 50.7% (n=37) were males. The overall prevalence of CagA was 60.3% (95% CI=48.1% - 71.5%). H. pylori infection was highest in the 5-11 year age group with a prevalence of 59.5% had CagA positive strain. The difference in proportion between the age groups was however not statistically significant (Exact p-value
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٢۔کرونا کارن

کرونا کارن

شاکر انور

اسکی  آنکھوں کے نیچے دھوپ کی  پتلی سی لکیر بچھی تھی ۔دوپہر کے سناٹے میں دروازے پر اسے دیکھ کر میں حیران ہوا،تھوڑی سی الجھن،کچھ کچھ خوف اور شاید مدھم سنہری امیدوں کو اپنے پیروں میں لپیٹے وہ   جھجھکتی ہوئ مسکرائی۔

اپ نے پہچانا نہیں  میں مسز مالتی ملہوترہ ،کناٹ پلیس میں ہم ملے تھے  کرونا سے پہلے   ۔اب تو پہچانا

اندر آجائیں،    کیسے آنا ہوا   ،صوفے پر بیٹھنے کا اشارہ  کرتے ہوئے مسکراکر میں نے پوچھا

۔میری مسکراہٹ کے آدھے حصے نے اسکی مسکراہٹ کو مکمل۔کردیا

یہ چٹھی ہے ،  ملہوترہ نے دی ہے۔صوفے پر تنگ لباس میں بپھرے بدن کو سمیٹتے ہوئےوہ بیٹھ گئ ۔مجھے لگا وہ مٹھی میں  ہوا کوبند کر رہی ہو، میں اس سے کچھ پرے بیٹھ کر چٹھی پڑھنے لگا  دل تو چاہا کہ  قریب ہی  بیٹھوں لیکن اندیشہ ہوا، قربت کی جلدی کہیں دوری میں نہ بدل۔جائے

پیارے سنیل جی !آشا ہے سب کشل ہوگا۔کرونا کارن مین آجکل بہت پریشان ہوں۔ورکشاپ  بند پڑا ہے ۔اپ کی گاڑی  کے ڈینٹ پینٹ کا کام بھی نہیں کرسکا  اب تک

مجھے ابھی 5 ہزار کی بہت اوشکتا ہے ۔آپ کی گاڑی کے کام کردوںگا تو اس  سے کاٹ لیجئے گا۔ یقین ہے نراش نہیں کرینگے

آپ کا سچا متر  ملہوترہ

وہ سر جھکائے قالین پر پاوں  کے انگوٹھے رگڑتی رہی  میں اسکی جانب نہیں دیکھ رہاتھالیکن اسےمحسوس ہورہا ہوگا کہ اسے ہی دیکھ رہا ہوں  وہ بھی مجھے نہیں دیکھ رہی تھی لیکن مجھے یقین تھا کہ وہ مجھے ہی دیکھ رہی ہوگی۔کچھ نظریں بغیر دیکھے ہی سب کچھ دیکھ لیتی ہیں 

۔کمرے میں جاکر میں...

جج پر ضمان: فقہی قواعد اور پاکستانی قانون میں تطبیق

A judge should be honest,  transparent, free and fair. He should always respect law. The question arises that if a judge who disrespects law and makes unbalanced decisions: as a result of which people get affected then will he or she be penalized? The Ḥanafi Scholars opine that if a judge passes a wrong decision intentionally, he should be penalized from his own property. Because in Islamic jurisprudence, judiciary owns a supremacy over the masses and everyone irrespective of the position is equal and has to obey law. Whether he is a judge or a commoner, he has to follow the rules and regulations as prescribed by law. In practice, Pakistani judges are not held responsible for making a wrong verdict. Our judges make judgments on the basis of already manipulated evidence. A judge bars himself from the responsibility of collecting evidence. Similarly, if a judge has developed personal grudges with the criminal then the criminal reserves right of appealing the higher court where the decision is reviewed and rectified. In such situation, there is a compulsion between the legal maxim "وَالْأَصْلُ عَدَمُ الضَّمَان" and the Pakistani laws. However, Ḥanafi jurisprudence and Pakistani Laws are not in accordance with each other. This study concentrates upon the nature of punishment and tort to be applied on judges in case of making a decision based on falsehood. It is suggested that Pakistan’s Judiciary should be reread as that the already in-practice system does not comply with the standards of Islamic teachings.

Synthesis, Electrochemical and Flourescent Studies of Metal Complexes and Nanomaterials

The research work has been divided into three parts, Part I, Part II, and Part III. Part I A Series of di-and tri-organotin(IV) complexes (23) have been synthesized by the reaction of tri- and diorganotin(IV) chlorides/oxides with 3(3-Indolyl)-propionic acid and 4,5-diphenyl 2-imidazole thiol ligand in dry toluene under reflux condition for 6-8 hrs. The coordination behaviour of ligands and geometry of synthesized complexes were studied by employing different analytical techniques such as FTIR, multinuclear NMR (1H, 13C, 119Sn). Based on these results, the ligand appeared to coordinate the Sn atom via COO- & -SH moiety. The triorganotin(IV) derivatives reveal a monomeric tetrahedral structure in solution. While diorganotin(IV) dicarboxylates have shown an octahedral geometry, however, the coordination around Sn change from six to five in solution, in most cases. The appearance of new peaks for Sn-O and Sn-S in the IR spectra indicated the formation of organotin(IV) carboxylates and values point to the bidentate nature of ligands in solid state. Multinuclear NMR (1H, 13C and 119Sn) data revealed that the coordination number of Sn changed from five to four in triorganotin (IV) derivatives and from six to five in diorganotin(IV) compounds. Part II For the first time, we have studied Electrogenerated chemiluminescence of Ru(phen)32+ /Dibutylamino)ethanol system. ECL of Ru(phen)32+ /DBAE was compared with ECL of Ru(bpy)32+ /DBAE at both Au and GC electrodes. ECL intensities of Ru(phen)32+ /DBAE were found several times of ECL of Ru(bpy)32+ /DBAE. In addition, Ru(phen)32+ is sensitively detected using very low concentration of DBAE. ECL behavior of Ru(bpy)32+ /DBAE and Ru(phen)32+ /DBAE was vigilantly studied under cyclic voltametry and amperometry conditions at Au and GC electrode.Therefore, Ru(phen)32+ / DBAE system is promising for the sensitive detection of biologically important compounds. Part III We have presented a new, easy and environment friendly method for the facile aqueous preparation of silver nanoparticles well defined in size and shape by exploiting EG as mild reductant. No additives, such as surfactant is needed in the procedure. The size and shape of the silver nanoparticles are sensitive to the reactant temperatures and the concentration of the precursor. A denser concentration of precursor facilitates the formation of large and highly crystalline nano-Ag particles. The other metal nanoparticles, such as gold, can be successfully fabricated as well by this technique. It is important to note that the reducing reactivity of EG was rapidly increased with the increase in reaction time, concentration of the precursor and temperature, which offers the possibility of preparation of metal nanoparticles with a shift of particle size range from ca. 10 to 30 nm. In addition, Quantum dots (QDs) are reported as promising fluorescent probes for biomedical imaging. We have tried to fabricate CdTe QDs using SFSD as reducing agent under isothermal method.