Prevalence of Hepatitis B and C in the normal population and high risk groups in north Kerala.

BACKGROUND: Our aim is to assess the prevalence of Hepatitis B and Hepatitis C infections among normal healthy persons and high risk groups in the northern part of Kerala state in South India as there is insufficient published literature related to this subject. METHODS: HBsAg and AntiHCV screening were done in normal persons and in high risk groups. Normal persons screened included voluntary blood donors, those attending mandatory medical check up for jobs in middle east Asia and pregnant women. High risk groups were health care workers, intravenous drug abusers, commercial sex workers and male homosexuals. RESULTS: HBsAg and anti HCV antibody test results in the various groups were as follows. Voluntary blood donors--HBsAg was positive in 0.71 % and anti HCV was positive in 0.33%; job seekers to middle east Asia had 0.89% and 0.12% prevalence of HBV and HCV respectively. Among the pregnant women, 0.21% were HBsAg positive. Among the high risk groups, none of the health care workers were HbsAg positive and 0.79% were antiHCV positive. Among the IV drug abusers 2.7% were HBsAg positive and 51.89% were positive for antiHCV. In commercial sex workers, 3.47 % were HBsAg positive and 2.6 % were antiHCV positive. In male homosexuals, 4.49% were HBsAg positive and 3.37% were antiHCV positive. CONCLUSIONS: The prevalence of Hepatitis B and C in the normal population of Calicut in the northern part of Kerela is 0.52% and 0.24%. Compared to other areas of India, the seroprevalence of Hepatitis B and C are low in the normal population of Calicut. Among the high-risk groups, IV drug users have a high prevalence of AntiHCV.

Histopathological and histogenetic study of carcinoma stomach in a high risk area.

Seventy gastrectomy specimens of carcinoma-stomach received at the Department of Pathology, Medical College, Calicut were prospectively studied. The carcinomas were classified according to Lauren (1965) and adjacent mucosa was studied for evidence of atrophic gastritis and intestinal metaplasia (IM). The scoring system of Lauren was applied in all cases to analyses histogenesis. In cases with histological evidence of intestinal carcinoma, the adjacent mucosa showed IM, suggesting that "intestinal carcinomas" arise from areas of intestinal metaplasia. However, nine of the histollogically "diffuse mucous cell" carcinomas also showed intestinal metaplasia, and four of them were "intestinal" and others "gastric" when Lauren's scoring was applied. In this study type I and type II metaplasia were seen with a total absence of type III colonic metaplasia, raising the question, whether complete small intestinal type metaplasia also has to be viewed as a pre-malignant condition, in high risk areas.

A clinico-pathological study of carcinoma stomach.

North Kerala is a high risk area for carcinoma stomach. Therefore, 'intestinal type' carcinoma of Lauren is more prevalent here and the disease occur even in people below the age of 40. An attempt is made to analyse various risk factors in 70 patients who had undergone gastrectomy for carcinoma stomach in Medical College Hospital, Calicut. The population study revealed no relationship between the disease and the various religious communities. Diet is found to be the most important potential environmental influence. Even though both males and females share the same type of diet, males are found to be more affected by the disease. The high frequency of female population in North Kerala with a low frequency of carcinoma stomach in them, suggests the possible role of smoking and alcohol abuse in males. The blood group profile of healthy population in North Kerala and that of the patients show that people with blood group A have a differential susceptability to gastric carcinoma. Age and chewing of tobacco were the other factors involved.