Role of helicobacter pylori in perforated peptic ulcer disease and its persistence

The present study investigated H. pylori infection in patients with perforated peptic ulcer and attempted to determine whether continuing infection is related to persistence of peptic ulcer and leading to perforation. A prospective study of 35 patients was carried out, who presented to the emergency department with perforated peptic ulcer during 1995 and 1996. There were 34 male and one female patient. Ages ranged from 25-85 years. Eleven patients presented during the month of Ramdan. Twenty six patients had history of dyspepsia, eight had taken two to three doses of NSAIDs, 12 had history of medication from hakeems while 28 [80%] were smokers. Anti H. pylori antibody was positive in 12 out of 30 patients. Biopsies from ulcer was positive for urease test in nine patients. On histopathology, 10 patients had evidence of H. pylori infection and one had adenocarcinoma. Over all incidence of H. pylori infection was 40%. In patients with H. pylori infection, 10 out of 12 patients had persistent duodenal ucler on follow up endoscopy, which were treated subsequently by eradication therapy. The study suggests that H. pylori is responsible for persistence of chronic peptic ulcer, but has no role in acute peptic ulcer perforations, where NSAIDs and medications from hakeems appear to be responsible for its causation

Tuberculous mastitis

Tuberculosis of breast has become a rare disease since the advent of antituberculous chemotherapy. The present studies depict clinical presentation, management and follow up of 38 cases of tuberculous mastitis It concludes that tuberculosis of breast should be suspected in any women with recurrent breast abscess, discharging sinuses and lump breast particularly if she fives in an endemic area of the disease. The diagnosis is confirmed by histology and/or bacteriological culture of pus or mammary tissue