Detection of Helicobacter Pylori in Gastric Biopsy Sample from Patients with Upper Gastrointestinal Disorders using Conventional and Molecular Methods.

Chitra, - (2010) Detection of Helicobacter Pylori in Gastric Biopsy Sample from Patients with Upper Gastrointestinal Disorders using Conventional and Molecular Methods. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : The discovery of Helicobacter pylori in 1982 by Marshall & Warren was the starting point of a revolution concerning the concepts and management of gastroduodenal diseases. H.pylori is a gram negative curved motile rod found in the deeper portion of the mucous gel coating the gastric mucosa. It is extraordinary among bacteria in its ability to colonize and persist among this niche for decades despite host defenses and gastric acidity. It is now established that H.pylori infection induces several gastro intestinal complications, ranging from mild gastritis to peptic ulcers and even Gastric malignancies, such that the International Agency for Research on Cancer has declared this pathogen as an independent carcinogen. In addition the etiologic association of this infection with an increasing number of Disorders including cardiovascular diseases, and metabolic syndrome are being investigated. Therefore it is of utmost essence to detect the infection and Pursue with eradication therapy and follow up. In the present study, four parameters, namely rapid urease test, culture method, histopathology, and serology were used to detect presence of H.pylori in the gastric biopsy samples, supplemented with PCR for selected 50 samples. AIMS OF THE STUDY : 1. Detection of Helicobacter pylori in outpatients and inpatients presenting with upper Gastrointestinal symptoms. 2. To compare the various tests like Gram stain, Geimsa stain, Rapid urease, Culture and Histopathology for the identification of H.pylori. 3. To find out the PCR positivity in gastric biopsy samples. 4. To evaluvate the antibody response to H.pylori by Immunochromatography test and ELISA method. 5. To correlate the H.pylori infection with Endoscopic clinical diagnosis. MATERIAL AND METHODS : Outpatients and inpatients, of both sexes in the age group 20-69 years, based on the following criteria were included in the study. Inclusion criteria: Patients with complaints suggestive of upper gastro intestinal diseases. Patients with gastric ulcer, duodenal ulcer, antral gastritis and gastric carcinoma. Patients who were not on antibiotics, proton pump inhibitor or Helicobacter eradication therapy within 1 month prior to inclusion in this study. Exclusion criteria: Patients with previous gastric surgery. Patients with active bleeding. CONCLUSION : A preponderance of H.pylori infection was noted in patients with duodenal ulcer. The simple and inexpensive Rapid urea test detected the maximum number of positive cases among the conventional tests. Hence it is a valuable adjunct to endoscopy. ELISA detected a significant number of H.pylori cases as compared to conventional methods however; the levels of H.pylori specific antibodies must be evaluated in the normal population to establish ELISA as a definitive diagnostic tool. ELISA is preferred to rapid test for the detection of H.pylori when facilities for Elisa are available. Isolation of organisms is feasible only in reference laboratories. PCR amplification of H.pylori DNA sequences has the potential to be a highly sensitive method for the laboratory diagnosis of H.pylori infection.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Detection ; Helicobacter Pylori ; Gastric Biopsy Sample ; Patients ; Upper Gastrointestinal Disorders ; Conventional Molecular Methods.
Subjects: MEDICAL > Microbiology
Depositing User: Subramani R
Date Deposited: 03 Aug 2017 02:36
Last Modified: 03 Aug 2017 02:36

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