1. This study aims to evaluate the use of Narrow Band Imaging endoscopy for the detection of Helicobacter pylori infection in patients presenting with dyspepsia. 2. 110 patients presenting with dyspepsia will undergo upper GI endoscopy with Narrow Band Imaging and have urease kit testing. Results will be analyzed to determine the sensitivity, specificity, and accuracy of NBI compared to the urease kit test. 3. The study hopes to identify the incidence of H. pylori infection in dyspepsia patients and analyze factors that influence detection using NBI endoscopy.

1. Efficacy and feasibility of Narrow
Band Imaging Endoscopy in the real
time detection of active Helicobacter
Pylori Infection-A Prospective
Observational Analytical Study.

2. Dr. Sidney Palha
Junior Resident in General Surgery,
Goa Medical College.
Guide: Dr.C.G.Radhika Raj,
Associate Professor in General Surgery,
Goa Medical College.

3. 1. Up to 50% of the world’s population, 85%-95% in developing countries may be
infected with the Gram negative bacterium Helicobacter Pylori.1
2. H. Pylori infection is present in 58% patients with functional dyspepsia2
3. Helicobacter pylori infections are associated with significant morbidity. It is a
common cause of gastritis and a major risk factor for the development of
diseases like peptic ulcers, gastric adenocarcinomas and mucosa-associated
lymphoid tissue lymphomas 3
4. The diagnosis of H. pylori can be obtained by using non-invasive methods (urea
breath test and stool antigen tests) and Invasive methods (tissue culture, rapid
urease test, polymerase chain reaction, and histology).
5. Narrow Band Imaging is a novel endoscopy technique whose diagnostic
accuracy in detecting H Pylori needs evaluation.

4. AIMS & OBJECTIVES
Primary Objective:
To evaluate the use of Narrow Band Imaging Endoscopy for detection of H pylori
Secondary Objective:
To identify the incidence of H Pylori in patients presenting with dyspepsia.
To study the factors influencing H. Pylori detection.

5. MATERIALS & METHODS:
STUDY DESIGN: Prospective Observational Analytical Study
DURATION OF STUDY: 18 months from August 2022 to January 2024
SOURCE OF DATA: All Adult Patients presenting to General Surgery Department
with features of dyspepsia who undergo upper GI endoscopy
SAMPLE SIZE: 110 patients.

6. Inclusion and Exclusion Criteria
INCLUSION:
All patients, Male and Female presenting to General Surgery Department with features of
dyspepsia.
EXCLUSION:
● Patients below 18 years of Age
● Patients not giving valid consent.
● Patients having upper GI Bleed
● Patients on Proton Pump Inhibitors in the last 2 weeks.
● Patients who have undergone H. Pylori eradication recently
● Patients who underwent gastric surgery in the past.
● Patients on NSAIDs

7. 1. ENDOSCOPE
● FUJIFILM ELUXEO® 7000
System
● Ikegami Monitor
● BLI (Blue Light Imaging) Imaging
Technology

9. 2.UREASE KIT TEST
Principle: Detects change in pH due to NH3
Duration of results: 24 hours
The sensitivity and specificity of Urease test
when compared with histology were 89% and 88%
respectively.5

10. Methods:
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NBI
ENDOSCOPY
UREASE KIT
TEST
● H PYLORI POSITIVE
1
● H PYLORI POSITIVE
3
● FURTHER ANALYSIS
WITH
HISTOPATHOLOGY
2

11. STATISTICALANALYSIS
Data of all cases satisfying inclusion and exclusion criteria will be entered in a proforma taking into
account detailed clinical history, general & systemic examination and Test Results.
The data gathered on Excel Sheet, Microsoft. For assessing the accuracy of NBI we will be comparing
the test with Urease Kit Test taken as reference standard.
Sensitivity, Specificity, PPV and NPV will then be calculated using a 2x2 table.
The data gathered will be analyzed using the Statistical Package for Social Science (SPSS,
IBM version 25) and Chi Square Test.
Urease Kit Test
POSITIVE
Urease Kit Test
NEGATIVE
Narrow Band
Imaging POSITIVE
A B
Narrow Band
Imaging NEGATIVE
C D

12. PROFORMA
Name:
Age:
Sex:
H No:
Date of Endoscopy:
PRESENTING FEATURES
Abdominal pain
Abdomen fullness
Vomiting
Bloating
Indigestion
GENERAL EXAMINATION
SYSTEMIC EXAMINATION
Urease Kit Test Result:- POSITIVE/NEGATIVE
Endoscopy Test Result:- POSITIVE/NEGATIVE
If urease Kit Test negative and Endoscopy test is positive then Biopsy Test Result:- POSITIVE/NEGATIVE
ENDOSCOPY
Findings
Procedure

13. INFORMED CONSENT
Study Title : Efficacy and feasibility of Narrow Band Imaging Endoscopy for detection of Helicobacter Pylori Infection
I, ______________________________________________, Voluntarily agree to participate in this study.
I understand that the study will involve :
Collection of Personal and Clinical Details.
Collection of investigations and intraoperative findings.
I understand that the data generated out of my participation in the study will be used for research/ thesis purposes and will be kept
confidential. I confirm that I have not been offered any financial incentive to participate in this study .
I am also aware that I can withdraw from the study at any point of time without stating any reasons for it , without my right being
affected.

14. Bibliography
1. Bailey and Love’s Short Practice of Surgery, 27th Edition, Part 11, Chapter 63, page 1114
2. J L Rodriguez -Garcia, Functional dyspepsia and dyspepsia associated with Helicobacter
pylori infection: REVISTA DE GASTROENTEROLOGIA MEXICO Volume 81, Issue 3,2016,Pages
126-133
3. Malfertheiner P, Venerito M, Schulz C. Helicobacter pylori Infection: New Facts in Clinical
Management. Curr Treat Options Gastroenterol. 2018;16:605–615.
4. T.Chen, et al “Linked color imaging can help gastric Helicobacter pylori infection diagnosis
during endoscopy” Journal of the Chinese Medical Association 81 (2018) 1033e1037
5. Chou CH, Sheu BS, Yang HB, Cheng PN, Shin JS, Chen CY, Lin XZ. Et all “Clinical
assessment of the bacterial load of Helicobacter pylori on gastric mucosa by a new
multi-scaled rapid urease test” J Gastroenterol Hepatol. 1997;12:1–6
6. de Brito BB, da Silva FAF, Soares AS, Pereira VA, Santos MLC, Sampaio MM, Neves PHM,
de Melo FF. Pathogenesis and clinical management of Helicobacter pylori gastric infection.
World J Gastroenterol. 2019 Oct 7;25(37):5578-5589.

15. Conclusion
NBI seems to be a promising method for H. Pylori infection identification.
New diagnostic methods should be better explored in order to provide
diagnostic alternatives to doctors

16. THANK YOU.

19. Bibliography
1. Bailey and Love’s Short Practice of Surgery, 27th Edition, Part 11, Chapter 63,
page 1114
2. “Functional dyspepsia and dyspepsia associated with Helicobacter pylori
infection: Do they have different clinical characteristics?”Volume 81, Issue
3,2016,Pages 126-133
3. Malfertheiner P, Venerito M, Schulz C. Helicobacter pylori Infection: New Facts
in Clinical Management. Curr Treat Options Gastroenterol. 2018;16:605–615.
4. “Linked color imaging can help gastric Helicobacter pylori infection diagnosis
during endoscopy” Journal of the Chinese Medical Association 81 (2018)
1033e1037
5. Chou CH, Sheu BS, Yang HB, Cheng PN, Shin JS, Chen CY, Lin XZ. Clinical