Comparative Evaluation of the Diagnostic Tests for Helicobacter pylori and Dietary Influence for Its Acquisition in Dyspeptic Patients: A Rural Hospital Based Study in Central India 636-641
Dr. Navinchandra M. Kaore
HIG A-13, Peoples College of Medical Sciences & RC,
Bhanpur Road, Bhopal, India - 462037.
Madhya Pradesh, India.
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Introduction: Dyspepsia is a very common group of symptoms referring upper gastrointestinal tract for which patients consult the physician, accounting for about 4% to 14% of their consultations. Annual Incidence of Helicobacter pylori is 6%-14% in developing countries with faeco-oral route of transmission. In this context this study has been undertaken to look for the association of Helicobacter pylori in patients of dyspepsia with comparative evaluation of diagnostic test for detection of helicobacter pylori and also look for effects of smoking and alcohol consumption over symptomatic colonization in dyspeptic patients attending the NKP Salve Institute of Medical Sciences and Research Centre, Digdoh hills, Nagpur, a tertiary care hospital catering to rural population of central India.
Materials & Methods: It was a cross sectional prospective study involving 92 patients. After obtaining history of their dietary and personal habits, 3 mucosal biopsy specimens were collected from pyloric end of the stomach along with blood sample. Specimens were processed immediately for culture, direct gram staining, rapid urease test, histology and serology along with Urea breath test by HeliprobeTM.
All the data was managed in Microsoft Excel and statistical analysis was done using Epi-info. Pearsonâ€™s chi square test was used for comparative evaluation between two groups.
Results: 55% patients were considered as positive by the three test criteria and taken as Reference Standard as being infected by H. pylori. Diagnostic tests used as well as dietary habits were evaluated against the reference standard.
Conclusion: Culture and in absence of culture; RUT, Direct Gram Stain, and Serology in combination, followed by RUT, Direct Gram Staining with Histology are the best for increasing the specificity for diagnosis of Helicobacter pylori infection in patients of dyspepsia. Alcohol consumption is not significantly associated but smoking and tobacco chewing or smoking along with alcohol consumption is highly significant for symptomatic colonization of H. pylori in dyspeptic patients.Key-words: Helicobacter pylori, Dyspepsia, Reference Standard, Evaluation of diagnostic tests, Dietary influence, Smoking, Alcohol.