Comparison of immunohistochemical and modified Giemsa stains for demonstration of Helicobacter pylori infection in an African population

Modified Giemsa staining has been favoured by many researchers because it is easy to perform but; like many other stains; demonstration of the bacteria depends on its morphology. It has been arged in some research circles that some of the organisms in the gastric mucosa may not be true H.pylori. Immunohisochemical techniques have been developed and make use of anti H.pylori antibody; which reacts; with somatic antigens of the whole bacteria and have been found to correlate well with the presence of the bacteria. Objective: to ascertain the efficacy of modified Giemsa stain in an African setting where H.pylori seems quite prevalent. Study design: A laboratory - based study of two diagnostic tests in which modified Giemsa stain was compared with immunohistochemistry. Methods: A total of 48 consecutive autopsy cases with no upper gastro intestinal diseases had their gastric mucosa stained for demonstration of H.pylori using both modified Giemsa and immunohistochemical staining techniques. Results: Twenty-seven cases of H.pylori were demonstrated by both techniques and 14 cases were not identified by the two staining methods. In 2 cases immunostain could not demonstrate the bacteria but they were identified with modified Giemsa stain while in 5 cases the bacteria were identified by immunostain but not with modified Giemsa stain. The sensitivity of modified Giemsa stain was 85(CI 66.5-98.8) while the specificity was 89(CI 60.4-97.8). The positive predictive value of modified Giemsa stain was 93CI 75 - 98.8) while the negative predictive value was 74(CI 48.6-89.9). The kappa statistic comparing the 2 stains was 0.69 (p-value 0.00001) giving a good agreement between the two tests. Conclusion: With the above results the modified Giemsa stain; which is readily available in most African laboratories; is recommended for diagnosis of H.pylori; a prevalent infection in Africa

Trends in Cancer Incidence in Kyadondo County; Uganda; 1960-1997

Incidence rates of different cancers have been calculated for the population of Kyadondo county (Kampala; Uganda) for four time periods (1960-1966; 1967-1971; 1991-1994; 1995-1997); spanning 38 years in total. The period coincides with marked social and lifestyle changes and with the emergence of the AIDS epidemic. Most cancers have increased in incidence over time; the only exceptions being cancers of the bladder and penis. Apart from these; the most common cancers in the early years were cervix; oesophagus and liver; all three have remained common; with the first two showing quite marked increases in incidence; as have cancers of the breast and prostate. These changes have been overshadowed by the dramatic effects of the AIDS epidemic; with Kaposi's sarcoma emerging as the most common cancer in both sexes in the 1990s; and a large increase in incidence of squamous cell cancers of the conjunctiva. In the most recent period; there also seems to have been an increase in the incidence of non-Hodgkin lymphomas. So far; lung cancer remains rare. Cancer control challenge. With little improvement in the incidence of cancers associated with infection and poverty (liver; cervix; oesophagus); it must face the burden of AIDS-associated cancers; while coping with the emergence of cancers associated with Weternization of lifestyles (large bowel; breast and prostate)

Mucin secretion by gastric carcinoma cells: PAS alcain blue stain study

Thirty cases of gastric cancer were studied. Slides were stained with PAS Alcian Blue. The staining characteristics of the mucin were correlated with gross characteristics of the tumours and histological types. Due to the few cases studied; there was no observed statistical significance between the various mucin staining characteristics with the histological type; sex site of tumour and ethnicity. In 84of cases the tumour cells secreted either neutral or mixed mucins. Acid mucins were demonstrated in 5 cases only. neutral mucin is normally secreted by gastric epithelium and neck cells of gastric glands. The observation in this study suggests that those tumours which secrete neutral and mixed mucin probably arise from gastric epithelium; neck cells of gastric glands or colonic metaplasia. In those cases where the tumour produces acid mucin it is possible the tumour arose from areas of intestinal metaplasia

Frequency of helicobacter pylori in gastroscopic biopsy of Ugandan Africans

A total of 56 patients who presented for gastroscopy from 1993 to 1995 in Mulago Hospital had their gastroscopic biopsy specimens examined for Helicobacter pylori (H.pylori). H. pylori was demonstrated in 14(25) of the patients. There was no sex difference in those with H.pylori infections and the bacteria were only found in those above 22 years of age. Fifty six percent of those with the infection in which ethnicity was mentioned were Nyankole although they formed only 21of the study group. In all positive cases; H. pylori was found in the antrum with accompanying chronic atrophic gastritis

Frequency of helicobacter pylori in gastroscopic biopsy of Ugandan Africans

A total of 56 patients who presented for gastroscopy from 1993 to 1995 in Mulago Hospital had their gastroscopic biopsy specimens examined for Helicobacter pylori (H.pylori). H. pylori infections and the bacteria were only found in those above 22 years of age. Fifty six percent of those with the infection in which ethnicity was mentioned were Nyankole although they formed only 21of the study group. In all positive cases; H.pylori was found in the antrum with accompanying chronic atrophic gastritis

Chemodectoma arising from the heart. [case report]

A case of chemodectoma from the heart in 39 year old hypertensive female African is reported. Tumour; measuring 8 x 4 x4 cms; was found autopsy firmly attached to the interventricular muscle and completely surrounding a segment of right coronary artery. The histology of the tumour was consistent with that of chemodectoma; an observation not; to the authors knowledge; hitherto reported in man though it has been reported in dogs