Moses, K Daniel (2011) To assess the Prevalence of Helicobacter Pylori in Patients with Chronic Renal Failure and to study the Gastric Mucosa in these Patients. Masters thesis, Madurai Medical College, Madurai.
|
Text
200100311moses_k_Daniel_G.pdf Download (344kB) | Preview |
Abstract
Majority of the patients were from in and around Madurai. Age of patients ranged from 26-70 years. Out of 50 patients with CRF 38 were males and 12 were females. Out of them 30% were positive for H.pylori which goes well with the world statistics of H.pylori prevalence in general asymptomatic population. In a study conducted by Kerari EM et al at Nairobi, Kenya they have analysed the endoscopic findings and H.pylori prevalence in CRF patients with dyspepsia. They found that there is no statistical difference between the prevalence of H.pylori in CRF patients and controls. Symptomatology : In our patients mild to moderate dyspepsia is encountered. 60% had mild dyspeptic symptoms with symptom score 0-10 and 40% had moderate dyspeptic symptoms with symptom score 10-20 63.3% of the mild dyspeptic category are negative for H.pylori and 36.7% of the mild dyspeptic category are positive for H.pylori. 80% of the moderate dyspeptic category are negative for H.pylori and 20% of the same category are positive for H.pylori. Again we find that severity of dyspeptic symptoms have no correlation with the H.pylori positivity. In a study conducted by V. Misra et al in Allahabad – the conclusion was that the patients with CRF have significant UGI symptoms which mainly occur due to metabolic changes in response to high urea concentrations in gastric juice and are not related to H.pylori infection. Another study in Italy done by Nardone G et al showed clearly that Uremic patients with H.pylori positivity show low symptoms score and high frequency of peptic lesions. Ammonia generated by the action of urease producing organism(s) or urea is generally held responsible for gastro intestinal symptoms in Uremia. However little information is available on the exact organism(s) available. It is concluded that H.pylori present in the gastroduodenal mucosa of patients with renal failure does not appear to play significant role in severity of dyspeptic symptoms in uremic patients. UGI scopy and H.pylori : UGI scopy was normal in 96% of patients and only in 4% it was abnormal 2% antral gastritis and 2% duodenal ulcer in 2nd part of duodenum. Among those with normal endoscopy 29.2% have H.pylori positive and 70.8% have H.pylori negative. Among those with abnormal endoscopy 50% positive for H.pylori and 50% negative for H.pylori. Similar study was conducted in Kuwait in 77 patients with CRF a prospective study. In this the result was that there is no direct correlation between UGI scopy, H.pylori positivity and dyspeptic symptoms. Biopsy & Histopathology : Lymphocytic infiltration in the Lamina propria and inflammatory cells in the submucosa was found in 6 patients. 3 of them were H.pylori positive and 3 were negative. However no lymphoid follicles are found in any of the specimens which is pathognomonic of H.pylori infections. GFR and H.pylori positivity Patients with GFR < 15 ml / min are 12 in no out of them 33.33% are positive for HP. Patients with GFR 15 to 29 ml - 34 in no. and out of them 4% are positive. Patients with GFR 30 - 59 ml - 4 in no. out of them 0% positive. CONCLUSION: 1. Prevalence of H.pylori in CRF patients is very much similar to non CRF patients. 2. Severity of dyspeptic symptoms do not correlate with H.pylori postivity in CRF patients. 3. Endoscopic findings do not have any relation to H.pylori positivity in CRF patients.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Prevalence ; Helicobacter Pylori ; Patients ; Chronic Renal Failure ; Gastric Mucosa. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 16 Mar 2018 04:03 |
| Last Modified: | 16 Mar 2018 04:03 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6299 |
Actions (login required)
 |
View Item |
