Helicobacter Pylori Associated Chronic Gastritis and Application of Visual Analogue Scale for the Grading of the Histological Parameters in Nepal
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 1
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. A working party presented the Sydney System: A New Classification of Gastritis in Sydney at the World Congress of Gastroenterology in 1990 [1-6]. The discovery of Helicobater pylori by Robin Warren and Barry Marshall (1982) was the revolution in understanding of gastritis and upper gastrointestinal disease [7]. H. pylori infection became evident as the key factor and initiator of the majority of the pathology related to gastritis and its sequelae. Since then interest in gastritis and the morphological appearances of endoscopic biopsies increased. However, H. pylori may not be the sole etiological agent in some cases where H. pylori are detected in biopsies [8,9]. Sydney System Working Party was designed to provide simple practical guidelines for the documentation of histological features of gastritis and also to provide guidelines for the reporting and classification of the endoscopic appearances of the gastric mucosa [3]. The core of the classification was the topography of the gastritis which was restricted to the antrum, the corpus, or a pangastritis. A prefix was to be added if the etiology of gastritis was known (e.g. H. pyloriantral gastritis; autoimmune corpus gastritis etc). Later on Dixon et al. published the “Up-Dated Sydney System” (1997) [10].
Authors and Affiliations
Sushna Maharjan, Sabin Ranabhat, Mamata Tiwari, Anita Bhandari, Bidur Prasad Osti, Puja Neopane
Keywords
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- EP ID EP566626
- DOI 10.26717/BJSTR.2017.01.000108
- Views 187
- Downloads 0
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