Evidence map›Paper›PMID 41458784›Full record

ArticleCureus2025

Utilization of Hematological Markers to Distinguish Bile Reflux Gastritis From Helicobacter pylori-Associated Gastritis in Pediatric Patients.

Shehanshah Muhammad Arqam, Maliha Mahmood, Labiqa Khowaja, Naveed Ul Haq, Farhan Ullah, Akshy Kumar, Muhammad Tayyab Rehman, Raheel Ahmad Sohail, Muhammad Hamza Khan, Ali Khan

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Shehanshah Muhammad ArqamMedicine, Dow University of Health Sciences, Karachi, PAK.
Maliha MahmoodMedicine, Balouchistan Institute of Child Health Services, Quetta, PAK.
Labiqa KhowajaMedicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK.
Naveed Ul HaqMedicine, Khyber Teaching Hospital, Peshawar, PAK.
Farhan UllahMedicine, Khyber Teaching Hospital, Peshawar, PAK.
Akshy KumarMedicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK.
Muhammad Tayyab RehmanMedicine, Pakistan Navy Ship (PNS) Shifa Hospital, Karachi, PAK.
Raheel Ahmad SohailMedicine, Shaikh Zayed Hospital, Lahore, PAK.
Muhammad Hamza KhanMedicine, Dow University of Health Sciences, Dow International Medical College, Karachi, PAK.
Ali KhanMedicine, Jinnah Postgraduate Medical Centre, Karachi, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Gastritis is a frequent pediatric disease and is associated with significant morbidity, nutritional compromise and reduction in the quality of life. Among the etiologies, Helicobacter pylori (H. pylori) gastritis and bile reflux gastritis (BRG) are most frequent though clinically indistinguishable without invasive examinations like biopsy. This prospective observational cross-sectional study was carried out at the Department of Pediatric Gastroenterology, Jinnah Postgraduate Medical Centre (JPMC), Karachi, aiming to elaborate the diagnostic utility of these hematological markers in differentiating BRG from H. pylori gastritis. One hundred twenty children aged five to 15 years with endoscopically and histologically confirmed gastritis were recruited from January to December 2024, of which the BRG (n = 60) and H. pylori gastritis (n = 60) groups had equal number of participants. Research data was gathered with the help of a structured proforma, endoscopic examination and confirmed by biopsy from pretreatment blood samples. The determined hematologic parameters were as follows: hemoglobin (Hb), total leukocyte count (TLC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean corpuscular volume (MCV), red cell distribution width (RDW) and platelet counts. t-tests, Chi-square tests, Mann-Whitney U tests and receiver operating characteristic (ROC) curve analyses were used for statistical analysis. The children with H. pylori gastritis demonstrated lower levels of hemoglobin (10.9±1.2 g/dL vs 11.8±1.3 g/dL, p=0.001), MCV (80.1±5.7 fL vs 82.6±6.2 fL, p=0·04) and higher RDW (15.6±2.0% vs 14.5±1.9%, p=0.003), indicating iron-deficiency with microcytic anemia in the former group than the latter groups respectively with no such differences seen among patients who were Helicobacter free. On the other hand, NLR was significantly higher in BRG patients (2.6±0.8 vs 2.1±0.7, p=0.001), reflecting an increased neutrophil-mediated inflammation. PLR was higher in H. pylori gastritis (148.7±34.2 vs 131.5±29.1, p=0.02), whereas platelet counts were similar between the two groups (p=0.21). By ROC analysis, NLR (area under the curve (AUC)=0.72) and RDW (AUC=0.70) were the best discriminative factors, as well as hemoglobin level (AUC=0.68). These results indicated that the simple and inexpensive hematological parameters NLR, RDW, and Hb could have clinical application value as adjuncts for distinguishing between BRG children and H. pylori gastritis patients. An approach like this might reduce the use of invasive procedures, increase diagnostic accuracy, and help in clinical decision making, particularly in low-resource health care settings.

Indexed as

bile reflux gastritishelicobacter pylorihematological indicesneutrophil-to-lymphocyte ratiopediatric gastritis

Identifiers

PMID41458784
PMCPMC12741569

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.