International Journal of Medical Science and Clinical Invention 6(4): 4417-4422, 2019 DOI:10.18535/ijmsci/v6i4.05 ICV 2016: 77.2 e-ISSN :2348-991X, p-ISSN: 2454-9576 © 2019,IJMSCI 4417 International Journal of Medical Science and Clinical Invention, vol. 6, Issue 4, April, 2019 Research Article Utility of Rapid urease test in diagnosis of Helicobacter pylori infection Shaan Khetrapal, 1 Samarth Shukla 2 , Safia Rana 3 , Zeeba S Jairajpuri 4 , Sourya Acharya 5 1,3,4 Asst. Prof Department of Pathology. Hamdard Institute of Medical Sciences and Research, New Delhi 2 Professor Department of Pathology DMIMS University Wardha Maharashtra 5 Professor Department of Internal Medicine DMIMS University Wardha Maharashtra Abstract: Aim: To evaluate the role of rapid urease test in diagnosis of Helicobacter pylori infection in various gastro intestinal lesions vis a vis conventional and special staining methods. Materials & Methods: This hospital based cross sectional study was conducted on 50 cases with gastro intestinal lesions. The obtained biopsies were then subjected to rapid urease test for detection of H. pylori by using the Pronto Dry Kit immediately. Further histopathology examination using conventional H & E (haematoxylin and eosin) stain and special Gimenez stain for H. pylori was done. Results: In this study gender wise distribution of patients showed 58% males and 42% females. Chronic gastritis was found to be the most common diagnosis (28%), followed by squamous cell carcinoma (20%) chronic inflammation (16%), H. pylori gastritis and adenocarcinoma stomach (6%), adenocarcinoma esophagus, dysplasia, erosion, esophagitis and perforation in 4%. Least common diagnosis was atrophic gastritis and carcinoid in 2%. We found that 26 cases were positive for H. pylori with Rapid urease test and 24 with special stain (Gimenez). Conclusion: This study amalgamates and incorporates the valuable clinical assessment along with the endoscopic findings, the surgical pathological (histopathology) evaluation of the biopsies along with the proto dry kit (rapid urease test), as a kind of “Gastric Triple Test” for declaring the patients as positive or negative for pathogenic infection with Helicobacter pylori. Keywords: H. pylori, Rapid urease test, Giemnez, Special stain , Haematoxylin , Eosin Introduction: It has been known for more than a century that bacteria are present in the human stomach. [1] About 20 years ago, Barry Marshall and Robin Warren described the successful isolation and culture of a spiral bacterial species, later known as Helicobacter pylori [2] , from the human stomach which can colonize and induces inflammation of the gastric mucosa. It is a gram-negative bacterium, belongs to the family Helicobacteraceae. [3] H. pylori colonize the stomach of more than half of the world's population, and the infection continues to play a key role in the pathogenesis of a number of gastro duodenal diseases. The prevalence of H. pylori infection varies widely by geographic area, age, race, and socioeconomic status (SES). The acquisition rate of H. pylori appears to be more rapid in developing than developed countries. [4, 5] The primary disorder, which occurs after colonization with H. pylori, is chronic active gastritis. H. pylori-positive patients have a 10 to 20% lifetime risk of developing ulcer disease and a 1 to 2% risk of developing distal gastric cancer. [6,7] The available tests to detect H. pylori infection are generally divided into invasive and non invasive tests. Invasive diagnostic methods such as histological stains, culture and urease test require an endoscopic biopsy of gastric mucosa. While serology, urea breath test, stools, urine, or saliva for detection of antibodies, bacterial antigens, or urease activity are currently available non invasive tests. Various researches undertaken in present day point towards H. pylori as the prime culprit of the gastro intestinal lesions. There is however a paucity in the studies in central India regarding the same, this study of 50 patients was taken up at Acharya Vinobha Bhave Rural Hospital, Wardha. The crux of the study was to evaluate and establish the role H. pylori in Gastro intestinal lesions and to compare the utility of rapid urease test in detecting H. pylori infection with conventional and special staining methods. Material & Methods: Type of study: Cross sectional study Duration: September 2016 to September 2018 (2 years) Inclusion criteria: 1. Patients with symptoms of gastrointestinal disease. 2. Willing to go for endoscopic biopsies Exclusion criteria: 1. Subjects with any major medical or surgical illnesses. 2. Patients already on drugs for gastro intestinal complaints. 3. Not willing to give informed consent. Endoscopic biopsies were then taken from all patients. The