Antiulcerogenic effect of Capparis cartillaginea decne on indomethacin induced gastric ulcer in wistar rats

Background: Peptic ulcer disease is a non-malignant, mucosal lesion of the stomach or duodenum. The mucosal defect reaches the muscularis mucosa and sometimes, beyond causing life threatening complications, including haemorrhage, perforations, gastrointestinal obstruction and malignancy.Methods: The animals were pre-treated with omeprazole 20 mg/kg and 300 mg/kg of Capparis cartillaginea decne orally for 14 days. On the 15th day, ulcers were induced using indomethacin 30 mg/kg and 4 hours post ulcer induction, they were sacrificed. Ulcer index, pH, total acidity and volume were determined.Results: Extensive lesions were seen in indomethacin ulcerated rats with mean ulcer score of (1.260±0.18). In comparison, there were minimal areas of erosion on animals pre-treated with omeprazole (0.14±0.025) and plant extracts (0.280±0.097). Indomethacin-induced ulcer treated animals showed the highest volume of gastric juice output (3.14±0.21 ml), whereas the animals pre-treated with omeprazole had lower gastric juice output (2.20±0.2 9ml). This was comparable to animals pre-treated with the plant extract (1.80±0.13 ml). The pH was high in animals pre-treated with omeprazole (5.02±0.53). This was also seen in animals pre-treated with the extract (4.82±0.31). This was in comparison to the low pH seen in indomethacin ulcerated animals (2.20±0.16). Indomethacin-induced ulcer treated animals showed high levels of total acidity (88.64±1.71 mEq/L). Whereas the animals pre-treated with omeprazole had lower total acidity (55.26±3.77 mEq/L), which was also mirrored in animals pre-treated with the plant extracts (61.44±2.42 mEq/L).Conclusions: The extracts of Capparis cartillaginea decne showed anti-ulcer effect on indomethacin induced ulcers in Wistar rats.

The Incidence and Short-term Outcome of Perforated Peptic Ulcers

Objective:To determine the incidence of non-traumatic perforated gastro-duodenal ulcers in thesurgical population at GPHC.To identify/ discuss mortality associated with perforated hallow viscus at GPHC and itsrelated outcomes.Study Design and Methods:This study involves a retrospective analysis of all inpatients in the female and male adult surgical wards at GPHC.All charts coded for ‘acute abdomen’, ‘perforated hollow viscus’ and pneumoperitoneum were collected from 2016 to 2018 Data from this selective population were collected using the data collection tool. All data was coded for and entered into spreadsheet of which double data entry was done. Data was then analyzed using SPS.Results:Initially a total of 109 charts were collected but was reduced to sample size of 31 patients after review of charts. Majority of patients were males with an average age of presentation of 45.8years. Although many comorbidities are associated with perforations only 1 patient in this studyhad chronic hypertension. Time of presentation from onset of symptoms greatly influences theoutcomes for affected patients. However, 80% of patients presented after 24 hrs, none in a state of shock and no early mortality was found. Smoking affects the mucosal barrier of stomach and increases risk of peptic ulcer disease. In this study 67.7% of patients admitted to being frequent marijuana smokers and 74.2% cigarette smokers and although a small population size, a high association betweensmoking and resultant disease was shown with a P value of 0.0028. Graham’s patch was done by residents on all patients with an average operative time of 68.4 minutes. Intraoperatively the most common site of perforation was the antrum (60%) compared to the duodenum (6.7%), pylorus (6%) and body of stomach (3.3%). Post-op there was a 40% morbidity rate.Conclusions:Primary repair is a safe surgical approach with a low mortality.Conference Abstract

Dosis acumulada de analgésicos no esteroides relacionada con úlcera péptica hemorrágica y sus complicaciones en una población mexicana / Cumulative dose of non-steroidal analgesics related to hemorrhagic peptic ulcer and complications in a Mexican population

Resumen: OBJETIVO: Evaluar la dosis acumulada ingerida de antiinflamatorios no esteroides (AINEs) en pacientes con úlcera péptica hemorrágica y sus complicaciones durante la hospitalización. MATERIAL Y MÉTODO: Estudio retrospectivo en el que de julio de 2015 a diciembre de 2017 se evaluaron dos grupos: uno con antecedente hospitalario de perforación, resangrado, reintervención endoscópica y muerte y otro sin complicaciones. Se ajustó la dosis ingerida de diferentes AINEs equivalente a 10 mg de ketorolaco; se registró el índice de Charlson, infección por H. pylori y la clasificación endoscópica de Forrest. RESULTADOS: Hubo 156 admisiones de úlcera péptica hemorrágica (edad promedio de 70 años, 53% hombres), las complicaciones ocurrieron en 53 (33.9%), la dosis promedio mensual de AINEs fue de 2121 mg (pacientes con complicaciones) vs 1970 mg (sin complicaciones; p = 0.2). La tasa de AINEs/semana de 7.1 se relacionó con perforación. A todos se les aplicó dosis de omeprazol de 40 mg cada 12 horas vía intravenosa durante la hospitalización. Las complicaciones se correlacionaron con mayor índice de Charlson. Hubo relación entre muerte, factores de riesgo de úlcera péptica por estrés (sepsis, traumatismo, etc.) y la administración de anticoagulantes. El tabaquismo y el género masculino se relacionaron con mayor resangrado. CONCLUSIONES: Existe mayor probabilidad de perforación con necesidad de cirugía, estancia hospitalaria más larga y mayor número de transfusiones con mayor dosis ingerida de AINEs.

Abstract: OBJECTIVE: To evaluate the cumulative dose of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with hemorrhagic peptic ulcer and their complications along hospitalization. MATERIAL AND METHOD: A retrospective study done from July 2015 to December 2017 including two groups: one with a hospitalization history of perforation, rebleeding, endoscopic reintervention and death, another group without complications. We registered doses of different NSAIDs according to 10 mg of ketorolac, Charlson index, H. pylori infection and endoscopic Forrest classification. RESULTS: There were 156 admissions of hemorrhagic peptic ulcer with the administration of NSAIDs (average age 70 years, 53% men), complications occurred in 53 (33.9%). The average monthly dose of NSAID in the cases was 2121 mg vs 1970 mg in controls. The NSAID/week rate of 7.1 was associated with perforation. Charlson index correlated with complications. Death and physiological stress related with the administration of anticoagulants. Smoking and the male gender related to higher rebleeding. CONCLUSIONS: The higher the NSAID/weekly rate, the higher the probability of perforation with the need for surgery, longer hospital stay and increased number of transfusions.

Gastric Helicobacter Pylori Infection / Peptic Ulcers And Periodontal Disease: A Literary Overview.

H.Pylori is an important factor in pathogenesis of numerous diseases including metabolic, gastrointestinal and vascular disorders.The oral cavity has been proposed as a reservoir for Helicobacter pylori that could be responsible for refractoriness of gastric infection to triple therapy (antibiotics, antimicrobials, proton pump inhibitors). Analysis of data suggests that periodontal treatment in combination with systemic therapy could be a promising approach to increasing the therapy’s efficacy and decreasing the risk of infection recurrence. Some authors have given conflicting evidences, to date there has been no clear cut evidence / study which directly correlates H. Pylori infection of periodontal pockets / plaque leading to peptic ulcer, duodenal ulcers and stomach cancers.

The Influence of Diabetes Mellitus on Short-Term Outcomes of Patients with Bleeding Peptic Ulcers

PURPOSE: Little information is available on the influence of diabetes mellitus on the short-term clinical outcomes of patients with bleeding peptic ulcers. The aim of this study is to investigate whether diabetes mellitus influences the short-term clinical outcomes of patients with bleeding peptic ulcers using a Japanese national administrative database. MATERIALS AND METHODS: A total of 4863 patients treated by endoscopic hemostasis on admission for bleeding peptic ulcers were referred to 586 participating hospitals in Japan. We collected their data to compare the risk-adjusted length of stay (LOS) and in-hospital mortality of patients with and without diabetes mellitus within 30 days. Patients were divided into two groups: patients with diabetes mellitus (n=434) and patients without diabetes mellitus (n=4429). RESULTS: Mean LOS in patients with diabetes mellitus was significantly longer than those without diabetes mellitus (15.8 days vs. 12.5 days, p<0.001). Also, higher in-hospital mortality within 30 days was observed in patients with diabetes mellitus compared with those without diabetes mellitus (2.7% vs. 1.1%, p=0.004). Multiple linear regression analysis revealed that diabetes mellitus was significantly associated with an increase in risk-adjusted LOS. The standardized coefficient was 0.036 days (p=0.01). Furthermore, the analysis revealed that diabetes mellitus significantly increased the risk of in-hospital mortality within 30 days (odds ratio=2.285, 95% CI=1.161-4.497, p=0.017). CONCLUSION: This study demonstrated that presence of diabetes mellitus significantly influences the short-term clinical outcomes of patients with bleeding peptic ulcers.

ABO blood groups and Helicobacter pylori cagA infection: evidence of an association

Diseases resulting from Helicobacter pylori infection appear to be dependent on a host of genetic traits and virulence factors possessed by this microorganism. This paper aimed to investigate the association between the ABO histo-blood groups and H. pylori cagA infections. Genomic DNA samples (n = 110) of gastric biopsies obtained from patients with endoscopic diagnosis of peptic ulcers (n = 25) and chronic active gastritis (n = 85) were analyzed by PCR using specific primers for the cagA gene. Of the samples, 66.4 percent (n = 73) tested positive and 33.6 percent (n = 37) negative for the gene. The cagA strain was predominant in peptic ulcers (n = 21; 84.0 percent) compared with chronic active gastritis (n = 52; 61.2 percent) (p = 0.05; OR 3.332; 95 percent CI: 1.050-10.576). Additionally, the cagA strain was prevalent in the type O blood (48/63; 76.2 percent) compared with other ABO phenotypes (25/47; 53.2 percent) (p = 0.01; OR 2.816; 95 percent CI: 1.246-6.364). These results suggest that H. pylori cagA infection is associated with the O blood group in Brazilian patients suffering from chronic active gastritis and peptic ulcers.

Analysis of the Charactristics of the Cognition and Personality of Patients with Peptic Ulcer / 中国临床心理学杂志

Objective:To explore the cognitive styles and personality characteristics of patients with peptic ulcer.Methods:The personality characteristics,defense styles, and cognitive styles of 30 patients and 30 controls were evaluated.Results:(1)The patients group got higher scores on defense mechanism of sublimation,intercourse trend,consumptive trend and self-making than the control group.(2)Logistic analysis showed that some factors of DSQ were significantly different between the patient group and control group.(3)The interaction between personality and cognitive styles was also found in the analysis.Conclusion:Personality and cognitive styles together contributed to the onset and the course of peptic ulcers.