DIAGNOSTIC CONCORDANCE BETWEEN RAPID UREASE TEST, HISTOPATHOLOGY, AND ENDOSCOPY IN DETECTING HELICOBACTER PYLORI INFECTION IN TYPE 2 DIABETICS WITH DYSPEPSIA

Background: Helicobacter pylori infection is a signicant public health concern worldwide. It contributes to various upper gastrointestinal (GI) pathologies and is notably prevalent among patients with Type 2 Diabetes Mellitus (T2DM). This metabolic condition predisposes individuals to various infections due to impaired immune responses and altered gastrointestinal motility. Dyspepsia in diabetics often masks or mimics other GI conditions, complicating diagnosis. This study evaluates the diagnostic concordance between the rapid urease test (RUT), histopathology, and endoscopic ndings in detecting H. pylori infection among dyspeptic T2DM patients, emphasizing the implications for metabolic control and disease management. Methods: A cross-sectional observational study was conducted over one year at S.R.N. Hospital, Prayagraj, involving 114 patients aged 35–60 years diagnosed with T2DM and presenting with dyspeptic symptoms. Each participant underwent upper GI endoscopy, during which gastric biopsies were obtained for RUT and histopathological analysis. Demographic, clinical, and biochemical data were recorded. Statistical analyses, including sensitivity, specicity, positive predictive value (PPV), negative predictive value (NPV), and correlation with glycemic control, were performed using SPSS v23. Results: Of the 114 patients, 75 (65.8%) tested positive for H. pylori via RUT, and 70 (61.4%) were conrmed positive through histopathology. Endoscopic abnormalities were identied in 68 (59.6%) patients. The RUT demonstrated strong concordance with histopathological ndings, with a sensitivity of 93.33%, specicity of 100%, PPV of 100%, and NPV of 83.87%. Endoscopy showed fair agreement with both RUT and histopathology. Notably, 56.1% of patients showed concordant positive results across all three diagnostic modalities. A statistically signicant correlation was observed between H. pylori positivity and poor glycemic control, as indicated by higher HbA1c levels (p = 0.005). Conclusion: RUT is a highly reliable and accessible diagnostic tool for detecting H. pylori in T2DM patients presenting with dyspepsia. Its strong concordance with histopathology and endoscopy supports its routine use in clinical settings, especially in resourceconstrained environments. Given the observed association with glycemic control, early diagnosis and treatment of H. pylori may contribute to improved metabolic outcomes.