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Massarrat S, Fallahazad V, Kamalian N. Clinical, biochemical and imaging-verified regression of hepatitis B-induced cirrhosis. Liver International 2004: 24: 105–109. © Blackwell Munksgaard 2004 In a 65-year-old patient with ascites, jaundice and positive hepatitis B surface antigen (HBsAg), the histological diagnosis of cirrhosis with knodell total score 13 was made in 1995. The patient was followed up for 8 years. Spontaneous seroconversion of HBsAg appeared. Except for slight hyperbilirubinemia, all pathologic, clinical laboratory data remained normal from the second year of diagnosis till 8 years of follow-up. In the last follow up, the markers of liver fibrosis were all normal. The portal vein diameter was decreased and the esophageal varices disappeared. The imaging of liver by sonography and CT-scan did not reveal any abnormality. [ABSTRACT FROM AUTHOR]

Background: A definitive treatment for functional dyspepsia (FD), and the role of Helicobacter pylori eradication on the course of this disease are controversial. Aim: To investigate the effect of a combination of acid-suppressing and prokinetic drugs or eradication therapy on the course of H. pylori-positive FD. Method: A total of 157 patients with endoscopically-proven H. pylori-positive FD and no response to 4 weeks of antacid therapy were randomly divided into 2 groups. 84 were placed on bismuth subnitrate plus metronidazole and amoxicillin (group A) and 73 received ranitidine and metoclopramide for 4 weeks (group B). The severity of symptoms (7 items) were assessed on a 6-point categorical scale. Group B patients who failed to respond to their medication underwent eradication therapy after 3 months. All patients were followed and assessed for 9 months after the end of therapy by the same clinicians who initiated the therapy. Results: At the end of the medication period, symptom’s score decreased significantly, and to the same extent. At 3-month follow-up moderate or complete response was achieved in 27.4% (group A) and 19.2% (group B) by intention-to-treat analysis. 34 patients of group B, not responding to treatment, underwent eradication therapy and followed as group A. Eradication of H. pylori was successful in 60 of 110 controlled patients (54%). After 9-month follow-up, complete or moderate response was observed in only 30% of 60 patients in whom H. pylori had been eradicated (intention-to-treat analysis), compared to 38% in 50 noneradicated cases (p > 0.05, 95% CI: 19–43 vs. 24–52). Conclusion: Eradication therapy with bismuth compound is effective as ranitidine plus metoclopramide in a subgroup of patients with FD not responding to antacid therapy. There is no difference in improvement between patients cured or not cured from H. pylori infection. This suggests that bismuth compounds were effective in FD when used in the eradication regimen. Combination therapy with acid-suppressing drugs plus prokinetic and bismuth seems to hold promise for FD.Copyright © 2002 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

In order to identify the risk factors affecting the healing of duodenal ulcer, a clinical trial with effective dose of antacid was carried out in 53 patients. Duration of ulcer history, number of relapses, duration of the last and present relapse, number, duration and severity of pain attacks in the present ulcer relapse, pain radiation to back, vomiting, appetite, smoking habit, intake of analgesics and previous haemorrhage were registered. Number of ulcers, ulcer depth, bublar narrowing, erosions, duodenitis at initial endoscopy and healing of ulcer were assessed by one endoscopist. Basic and peak acid output were measured. The extent of duodenitis on the site opposite the ulcer was determined by histological examination. Sixty per cent of the duodenal ulcers were healed after three weeks. By univariate analysis, the following factors affect the healing; pain radiation to back and pain duration during treatment (p less than 0.001), multiple or deep ulcers, narrowing of duodenal bulb (p less than 0.01), number of pain attacks and poor appetite (p less than 0.05). By the stepwise logistic regression model, the following factors were selected as predictors for healing of duodenal ulcer with 76% correct classification: pain radiation to back (p = 0.002), deep ulcer (p = 0.013), multiple ulcers (p = 0.028). Number of cigarettes/day (p less than 0.007) and male sex (p = 0.036). By this model, the prediction of healing could be accurately assessed in 78% in a new sample. Individual treatment should be carried out on the basis of these factors. [ABSTRACT FROM PUBLISHER]

The relationship between smoking and gastric secretory capacity was studied in 201 25-40 year old healthy subjects with normal laboratory data and no gastrointestinal lesions. Basal acid output (BAO) and peak acid output (PAO) were determined in all, and basal and stimulated pepsin outputs were measured in 85 participants. The accuracy of the patients' statements was checked by urinary nicotine assay. Basal acid output and PAO were significantly higher in male smokers (n = 55) than in male non-smokers (n = 49). In women PAO in smokers (n = 38) was higher than in non-smokers (n = 59). Female smokers (n = 38) had a higher pepsin output than female non-smokers (n = 23). Eight variables were considered in relation to BAO and PAO: age, height, weight, alcohol abuse, smoking habits, duration of smoking habit, number of cigarettes per day, and the product of years of smoking multiplied by daily number of cigarettes. The daily number of cigarettes X years of smoking was most closely correlated with BAO and PAO by stepwise multiple linear regression analysis. It was concluded that smoking is related to increased gastric acid capacity. [ABSTRACT FROM PUBLISHER]

In 80 patients with duodenal ulcer, the effects of various factors--symptoms, endoscopic findings, and peak acid output (PAO)--on the healing rate were studied during eight weeks of outpatient therapy with low-dose antacid (neutralising capacity less than 50 mmol HCl/d). Fifty-six per cent of the ulcers healed. The following unfavourable factors were found to cause a significant delay in ulcer healing: a long duration of pain in the last ulcer relapse and the present period of ulcer pain, smoking, stenosis of the duodenal bulb, and a high PAO. Multiple regression analysis showed that three factors (duration of the present ulcer pain, smoking, and stenosis of the duodenum) had a significant influence on healing rate. According to the results obtained with this method, the patients with no or only one unfavourable factor (n = 35) had the best healing rate: 80%, compared with patients who had two (n = 31) or three (n = 14) unfavourable factors. The healing rate of the latter two groups was 41% and 28%, respectively (p less than 0.001). A prognostic score based on these three factors represents the severity of duodenal-ulcer disease with regard to the healing process under placebo-like doses of antacid. [ABSTRACT FROM PUBLISHER]

Objectives: Triple therapy and amoxycillin plus omeprazole are the two most widely recommended regimens for the eradication of Helicobacter pylori. However, no controlled studies with a large number of cases are available for the reliable comparison of these two regimens. The aim of this controlled, randomized, prospective study was to compare the effect of these two regimens and a further regimen for metronidazole-resistant patients on duodenal ulcer healing, H. pylori eradication, and prevention of ulcer relapse. Methods: Patients (n = 144) with proven duodenal ulcer (DU) were randomized to one of the three following regimens: group A, omeprazole (2 X 40 mg) plus amoxycillin (4 X 500 mg) for 2 wk; group B, triple therapy: bismuth nitrate (4 x 375 mg) plus metronidazole (4 X 250 mg) and tetracycline (4 X 500 mg) daily for 2 wk and ranitidine (150 mg) for the first week and bismuth nitrate (4 x 375 mg) alone for a further 2 wk; group C, omeprazole (20 mg) plus amoxycillin (4 X 500 mg) and tinidazole (2 x 500 mg) for 2 wk. Results: A total of 46 patients in group A, 39 in group B, and 43 in group C completed the study. One patient in group A and three in group B did not tolerate the regimens and dropped out of the study. Control endoscopy was performed 8 wk after the start of treatment and when symptoms appeared (up to 1 yr after the start of treatment). In subjects who completed the study, both the healing rate of DU in group B (97 % compared with 74 and 73% in A and C, respectively, > 0.02) and the H. pylori eradication rate in group B (85 compared with 35%, p > 0.0001 in A and 58%, p > 0.02, in C) were significantly higher than in groups A and C. The symptomatic ulcer relapse during the 1-yr follow-up in patients with initially healed ulcers was similar in all groups (18, 16, and 19% in A, B, and C, respectively). The predictor of healing using logistic regression analysis was night pain (p > 0.05). The predictor of H. pylori eradication... [ABSTRACT FROM AUTHOR]

AB: H. pylori colonization is associated with chronic gastritis,peptic ulcer, and adenocarcinoma of the distal stomach. H. pylori may colonize columnar-lined esophagus, although its etiologic role in esophageal adenocarcinoma is unproven. This study was designed to examine the prevalence of H. pylori infection in stomach and esophagus of patients suffering from gastritis, peptic ulcer or cancer. 138 biopsies were taken, 69 from the esophagus and 69 from the stomach of dyspeptic patients. Rapid urease test was performed in endoscopy room for the primary diagnosis of H. pylori infection. Biopsies were cultured and the identity of isolated bacteria was confirmed by microscopy and biochemical tests. The results of this study show that H. pylori colonizes the esophagus of patients with gastritis or deuodenal ulcer but not the esophagus of individuals with gastric ulcer or cancer. H. pylori was isolated from esophageal biopsies of 10/69 (14.5%) patients, including 8/47(17.02%) with gastritis, and 2/16 (12.5%) suffering from ulcer. Gastric-type metaplasia of Barrett's esophagus which appears suitable for colonization of H. pylori was not found in 8/10 (80%) of patients with H. pylori infected esophagus. Histological analysis of esophagus of these patients revealed no tissue injury. However Barrett's esophagus was found in 13/47 (27.6%) patients with gastritis. Positive cultures of H. pylori were obtained from 12/13 (92.3%) gastric biopsies. Esophageal biopsies of only 2/13 (15.4%) patients were also positive for H. pylori. One of the latter had severe inflammation and the other suffered from ulcer. Such symptoms were not observed in patients with Barrett's esophagus who were not infected with H. pylori. The results of this study suggest that H. pylori colonization in Barrett's esophagus leads to esophageal inflammation or ulcer (P < 0.001). This is confirmed by the finding that such tissue injuries were not found in patients who were colonized with H. pylori in their... [ABSTRACT FROM AUTHOR]

Backgrounds/Aims: Omeprazole is a gastric parietal cells proton pump inhibitor that is also active against H. pylori in vitro. This study was designed to examine the neutralization of H. pylori cytotoxicity on Vero cells by omeprazole micronized in strains isolated from gastritis, ulcer, cancer and Barrett's ulcer. This study could determine whether omeprazole could inhibit vacuolation of the Vero cells induced by cytotoxin of H. pylori or by urease. The effect of omeprazole on motility of H. pylori was assessed using concentrations lower than MIC. Materials and Methods: The antimicrobial activity of omeprazole micronized was studied by determining the MICs for 15 cytotoxic and four non-cytotoxic H. priori strains. Water extract of the cytotoxic bacteria (concentrated culture supernatant) and different concentrations of omeprazole were added to Vero cells in culture. Also extracted urease from H. pylori strains with urea (10 Mm) and omeprazole were added to Vero cells in culture. The inhibitory effect of omeprazole on motility of H. pylori was tested in semi-solid medium. Results: MIC90 of omeprazole micronized was 20 µg/ml. MICs for cytotoxic and non-cytotoxic strains were similar. Omeprazole could inhibit induced vacuolation by the water extract of cytotoxic H. pylori strains in Vero cells. It could also inhibit vacuolation induced by urease. Inhibition of vacuolation strains was assessed microscopically and by the neutral red method, it was also found that omeprazole inhibits the motility of H. pylori strains at concentrations lower than MIC. Conclusions: The results of this study suggest that omeprazole micronized could neutralize the vacuolation effect of H. pylori cytotoxin on Vero cells propably by targeting v-type ATPase. The bacterial motility was also inhibited by low concentrations of omeprazole. The results of this study conciders omeprazole micronized as an effective drug which targets important virulence factors of H. pylori including,... [ABSTRACT FROM AUTHOR]

BACKGROUND: Antimicrobials have been useful in the treatment of H. pylori-related dyspeptic diseases. However, emergence of resistant strains often decreases the eradication rates of H. pylori infections. Large-scale use of antimicrobials will lead to the diminishment of susceptible strains while allowing resistant survivors to outgrow and spread resistance genes. The aim of this study was to assess the change in antimicrobial resistance rate of H. pylori isolates from 2005 to 2008 and indicate the consequences of indiscriminate and widespread use of antimicrobials against H. pylori- and non-H. pylori-related infections.METHODS: A total of 110 H. pylori strains were isolated from dyspeptic patients during 2005 to 2008 and tested for their susceptibility to antimicrobials using the disk diffusion method. MICs were determined for metronidazole (8 microg/mL), tetracycline (0.5 microg/mL), clarithromycin (2 microg/mL), amoxicillin (1 microg/mL) and furazolidone (0.5 microg/mL). Since the rates of resistance to metronidazole and tetracycline were remarkably high, another 50 isolates were tested for their susceptibility to metronidazole at the same MIC (8 microg/mL) and tetracycline at MICs of 0.5,1 and 2 microg/mL. Resistance rates were compared to those obtained in our two previous studies between 1997-2000 and 2001-2004. RESULTS: The resistance rates of 110 H. pylori isolates to clarithromycin, amoxicillin and furazolidone were 7.3%, 7.3%, and 4.5%, respectively. Among 160 H. pylori isolates, 55.6% exhibited resistance to metronidazole and 38.1% to tetracycline. DISCUSSION: Compared to our two previous studies, the resistance rates of H. pylori isolates to current antimicrobials has changed over time. The change in resistance rates of clarithromycin, amoxicillin and furazolidone was not statistically significant. However, resistance to metronidazole and tetracycline showed a considerable increase from 33-36.3% to 55.6% and 0-0.7% to 38.1%, respectively. Emergence of resistance due to the intensive use of antibiotics has become a global public health problem. It appears that plasmid-carried genes are involved in the spread of resistance traits among bacteria. Results obtained in this study indicate that the increase in resistance rates of H. pylori isolates to metronidazole and tetracycline could be the indication of indiscriminate and frequent use of antibiotics in Iran. [ABSTRACT FROM AUTHOR]

Background : Despite all improvements in sanitation and exposure to antibiotics over time, Helicobacter pylori (HP) prevalence remains high, affecting the lives of about half of the world population, which can gradually lead to serious upper gastrointestinal disorders. Understanding HP's epidemiologic patterns help us to better manage the burden of this infection and to plan more effectively regarding potential screening or eradication strategies. We, therefore, aimed to report the crude and age- and sex-standardized prevalence rate of HP infection, its trend, and possible associated factors among asymptomatic healthy individuals in Rafsanjan city, a low-incidence area of gastric cancer (GC) in the southeast of Iran, from July 2018 to December 2021. Methods : This population-based cross-sectional descriptive study included 2,046 male and female subjects between 3 to 72 years who were in good health condition. Study participants were randomly selected from the Health Houses and each underwent a questionnaire-based interview and provided blood and feces samples. The presence of HP infection was detected by serum IgG antibodies and stool antigen test. Results : The overall and age- and sex-standardized prevalence rates of HP infection were 50.9% and 43%, respectively. The prevalence rate has notably decreased in all age groups compared with 2007. Also, it was significantly higher among men ( P =0.033) and increased with advancing age ( P <0.001). A higher population density living in a specific room area ( P =0.012) increased the likelihood of HP infection. Conclusion : To conclude, the prevalence of HP infection is decreasing over time in Rafsanjan city, which may be due to improvements in living standards in this area. A healthy lifestyle and adherence to hygienic principles, especially during childhood, may be required for a reduction in the prevalence of HP infection., Competing Interests: Conflict of Interest The authors declare no conflict of interest related to this work., (© 2022 Middle East Journal of Digestive Diseases.)

Background: In the last two decades, the simple low-cost abdominal ultrasound (US) examination for the diagnosis of advanced fibrosis and cirrhosis was displaced by very expensive and not readily available modern imaging systems like magnetic resonance imaging (MRI), computed tomography (CT) scan and transient elastography. The aim of this study is to evaluate and emphasize the potential of US for diagnosis of advanced liver fibrosis and cirrhosis., Methods: US, laboratory tests (blood counts, transaminases, aspartate platelet ratio index [APRI], international normalized ratio [INR], serum albumin and bilirubin) and liver biopsy were performed on 197 patients with chronic liver diseases. Development of liver fibrosis was categorized in six stages, with stages 1-3 considered as mild to moderate and stages 4-6 as advanced fibrosis. Sonographic parameters (interrupted liver surface line, nodularity of liver surface, biconvexity of liver edges, grade of liver angle, caudate lobe diameter, parenchyma echotexture and spleen size) were obtained. All variables were dichotomized into zero and one and compared with respect to the different stages of liver fibrosis. The sensitivity, specificity, and positive and negative predictive values of all variables as well as their summations scores through receiver operating characteristic (ROC) curve analysis were calculated for the correct histologic diagnosis., Results: Totally, 39 cases had severe fibrosis and cirrhosis and 158 had mild to moderate fibrosis. The area under the curve by ROC curve analysis of sonographic variables (surface nodularity, angle of left lobe, echotexture of liver and spleen size) was 85%, that of laboratory data (APRI, serum albumin and INR combined) was 83.8%, that of APRI alone was 81.8% and all combined (sonography and lab data together) was 92.4% for the correct diagnosis., Conclusion: The simple US examination, alone or combined with lab data, is able to diagnose advanced fibrosis and cirrhosis with excellent accuracy, making the use of other modern imaging modalities unnecessary., (2022 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons. org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

The aim of this study was to assess the current applicability of articles that show important advances in medicine. The recruited papers include those published fifty years ago in the most respected journals in the USA, England and Germany. Using PubMed Central citations since 2010, original articles closely related to papers published in 1966 in the New England Journal of Medicine (NEJM), the Lancet and the Deutsche Medizinische Wochenschrift (DMW) were identified. In the NEJM, there were 163 observational articles, 18 clinical, and 117 case reports. In the Lancet, there were 390 observational articles, 29 diagnostic, 82 therapeutic, 38 animal, 28 in vitro studies and 61 case reports. In the DMW, there were 77 observational articles, 39 therapeutic, 28 diagnostic, 7 animal, 4 in vitro, 9 other studies and 57 case reports. The number of highly relevant articles still currently cited were determined as 12/298 (4%) in the NEJM, 11/ 628 (1.7%) in the Lancet and 1/221 (0.45%) in the DMW (0.45%). It was concluded that "halfhundred years impact index" should be regarded as a measure of 'relevance and quality over time'. Combined with impact factor, it could be a better indicator for importance of scientific journals., (© 2019 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

The indexed Iranian journals in ISI and PubMed at the end of 2012 with known impact factor (IF) were evaluated with regard to the number of articles published in 2010-2012, the number of citations by authors from inside and outside Iran, their IF as well as their ranking order among all other journals in their specialized categories. There were among 130 English journals, 21 indexed with known IF. The mean IF of these journals increased from 0.4 in 2010 to 0.68 in 2012. The number of citations per article by authors from outside Iran increased from 0.19 to 0.49 during the same time period. The rank of the majority of the indexed journals was in the lowest 20% of their category. Although some improvement has been observed in the quality and the number of citations of Iranian journals indexed in ISI during these two years, the quality of the manuscripts remains low. A reduction in the number of journals, a change of their structure as well as more financial resources for research is necessary for the improvement of the quality and better rank and status of Iranian science among an international audience.

Background: The importance of coinfection of Helicobacter pylori (H.pylori) and Candida albicans (C. albicans) in the development of gastric diseases is not known. In this study, the frequency of concurrent infection of H. pylori and C. albicans in dyspeptic patients was assessed while considering age, gender, and PPI consumption of patients., Methods: Gastric biopsies were taken from 74 yeast-positive dyspeptic patients and gastric disease, age, gender, and proton pump inhibitor (PPI) consumption of subjects were recorded. One antral biopsy was used for rapid urease test (RUT) and one for H. pylori and yeast cultivation and smear preparation. Bacterial isolates were identified according to spiral morphology and the biochemical characteristics. Yeast isolates were identified on Chromagar and by the Nested-PCR amplification of C. albicans-specific topoisomerase II gene. Twenty-seven biopsy smears were Gram-stained and examined by the light microscope for observing H. pylori and yeast cells., Results: Fifty-four (73%) of patients were >40 year. Of 68 patients with PPI consumption record, 46 (67.6%) consumed PPI (p = 0). Comparison of patients in peptic ulcer group (12, 16.2%) with (6, 8.1%) or without (6, 8.1%) H. pylori or in gastritis group (62, 83.8%) with (25, 33.8%) or without (37, 50%) H. pylori showed no significant difference (p > 0.05). Of the 46 patients who consumed PPI, 13 (17.5%) were H. pylori-positive and 33 (44.6%) H. pylori-negative (p = 0). Ten out of twenty-seven smears showed the occurrence of H. pylori cells, including three with yeast cells. Of the 17 H. pylori-negative smears, three showed the occurrence of yeast cells only. Yeasts stained Gram-positive or Gram-negative and appeared as single or budding cells., Conclusion: The older age and PPI consumption could favor fungal colonization in the human stomach. The occurrence of a considerable number of H. pylori-positive or H. pylori-negative patients with gastritis or peptic ulcer shows that co-infection of Candida and H. pylori or infection of yeast alone could be associated with dyspeptic diseases. The occurrence of yeast cells in gastric biopsies with different Gram's reactions indicates that fungi might change their cell wall components for establishing a persistent colonization in the stomach.

Serum pepsinogen I and II are considered as indicators of changes in gastric morphology. Important publications from the last decades are reviewed with regard to the serum level of these biomarkers for the diagnosis of normal gastric mucosa, diffuse gastritis and its change to atrophic gastritis and intestinal metaplasia as well as gastric cancer. Due to the low sensitivity of serum biomarkers for diagnosis of gastric cancer, especially at its early stage and the poor prognosis of the tumor at the time of diagnosis, its prevention by eradication of H. pylori remains the mandatory strategy. On the other hand, the severity of regression and non-reversibility of precancerous lesions and intestinal metaplasia in gastric mucosa through eradication of H. pylori make it necessary to diagnose diffuse gastritis at its early stage. Increased serum pepsinogen II compared to normal serum pepsinogen I seems to indicate the presence of diffuse gastritis without precancerous lesions suitable for eradication of H. pylori infection, when it is serologically positive. A diagram illustrates the strategy of this therapeutic measure depending on the age of people and the level of serum biomarkers in areas with high gastric cancer prevalence.

Gastric cancer is a heterogeneous disorder; genetic factors, H. pylori infection and various environmental factors contribute to its development. Advanced atrophic corpus-predominant gastritis provides the histological base for its genesis. Low socio-economic status and poor hygienic conditions, smoking habits, heavy alcohol consumption, high salt and low intake of vegetables and fruits are important external factors for the occurrence of gastric cancer. For its prevention, the eradication of H. pylori infection at an early age is mandatory for subjects at high risk or those living in areas with high prevalence of gastric cancer. Given that an increased serum level of Pepsinogen II is a good biomarker for the presence of gastritis, it seems reasonable to screen all infected subjects at risk of gastric cancer with increased serum pepsinogen II at an early age (at around 30 years) to eradicate H. pylori. An endoscopy should be performed for subjects at an older age (40 years and older), when increased serum pepsinogen II level is associated with decreased serum pepsinogen I and pepsinogen I to II ratio.

Background: Current diagnosis of Helicobacter pylori infection by biopsy-based tests requires invasive sampling. Non-invasive methods such as the H. pylori stool-antigen (HpSA) test may be the best alternative for diagnosis of active infection. However, due to the presence of antigenic-diversity among the strains, various commercial tests have shown some discrepancies in different geographical-areas., Objectives: This study evaluates a homemade HpSA kit developed by using the H. pylori antigens from Iranian-isolates for detection of H. pylori in the stool of infected patients., Patients and Methods: Based on the endoscopic features and/or a rapid-urease test (RUT), 30 child and 50 adult patients, were recruited. From these candidates, three biopsies for RUT, culture and histology, and a stool-sample, were obtained. Patients were considered as H. pylori-positive if culture alone or RUT plus histology were found to be positive. Presence of H. pylori antigens in their stools was detected by the homemade HpSA test and an imported HpSA kit (Immundiagnostik, Germany)., Results: Using the biopsy-based tests with RUT, histology and culture, 53% (16/30) of children were diagnosed as H. pylori-positive while using the imported kit 57% and the homemade kit 50% of the candidates showed positive results. Also by the biopsy-based tests, 54% of the adults were diagnosed as H. pylori-positive while by the homemade kit 56% showed positive results. Considering the biopsy-based tests as the gold standard, sensitivity and specificity for the imported kit was 94% and 86%, respectively, while the mean sensitivity and specificity for the homemade kit was 96% and 98%, respectively., Conclusions: The homemade kit, compared with the imported kit and biopsy-proven tests may be a valid and reliable method for determining the presence of H. pylori infection in Iran.