Helicobacter Pylori Associated Chronic Gastritis and Application of Visual Analogue Scale for the Grading of the Histological Parameters in Nepal

Sushna Maharjan*¹, Sabin Ranabhat¹, Mamata Tiwari¹, Anita Bhandari¹, Bidur Prasad Osti¹ and Puja Neopane²

DOI: 10.26717/BJSTR.2017.01.000108

Received: May 05, 2017   Published: May 25, 2017

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Abstract

Introduction: Sydney System Classification was designed to provide simple practical guidelines for reporting of the endoscopic appearances of gastric mucosa. The “Up-Dated Sydney System” provided a helpful “Visual Analogue Scale” for grading of histological parameters. Data on Helicobacter pylori gastritis is sparse from Nepal; hence this study is conducted to apply the Up-Dated Sydney Classification and grading of H. pylori gastritis for their diagnostic evaluation.

Materials and Methods: Gastric biopsies from 110 patients from February (2015) to July (2016) were analyzed for H. pylori, and Visual Analogue Scale presented by Up-Dated Sydney Classification system was applied. SPSS 16.0 was used for statistical analysis.

Results: Chronic gastritis was observed among age group of 20-82 years in 57 (52%) females and 53 (48%) males. The most common age group affected was 61-70 years. Abdominal pain was the frequent symptom. Antrum was the common site. Fifty nine (53.6%) cases had H. pylori colonization. Mild, moderate and marked density of H. pylori was demonstrated in 41(37.3%), 8(7.3%) and 10(9%) cases, respectively. Mononuclear cell infiltrate was detected in all the cases with H. pylori detection in 59 (53.6%) cases. Neutrophilic activity was observed in 37(33.6%) cases. Twenty four (40.7%) H. pylori positive cases had neutrophilc activity. Intestinal metaplasia and atrophy were observed in 19% and 5.5% of cases, respectively.

Conclusion: The significant correlation was found between the presence as well as concentration of H. pylori colonization with neutrophilic and mononuclear cell infiltrate activity.

Keywords: Atrophy; Gastritis; Helicobacter pylori; Intestinal Metaplasia

Abbreviations: CMC-TH: Chitwan Medical College Teaching Hospital; CMC-IRC: Chitwan Medical College Institutional Review Committee; H&E: Hematoxylin and eosin; H. pylori: Helicobacter pylori; IM: intestinal metaplasia; MNC: mononuclear cells; PAS: Periodic Acid Schiff; p value: probability value; SPSS: Statistical Package for Social Science

Introduction | Materials and Methods | Discussion | Limitation | Conclusion | Acknowledgement | Author Contributions | Figures | Tables | References |