Andrographis paniculata as Promising Novel Protective Therapy of Oxidative Stress in Indomethacin-Induced Gastric Ulcer in Rats

This research investigated the effect of Andrographis paniculata (AP) on oxidative stress following indomethacin-induced gastric ulcer in rats. A total of 20 male albino Wistar rats (150-180g) used for this study were grouped into four (n=5): 1, Negative Control; 2, Positive Control and 3, test group treated with normal chow, 20mg/kg indomethacin, 20 mg/kg indomethacin plus omeprazole at 20mg/kg and 20mg/kg indomethacin plus AP at 16.7 mg/kg respectively. After treatment period, estimation of oxidative stress parameters was carried out on the animals. The LD50 of aqueous extract of AP was 50mg/kg bw. Body weight change was significantly reduced in omeprazole treated group compared to all other groups while extract treated group had significantly increased body weight change. There was a significant increase in malondialdehyde (MDA) level of ulcer untreated group compared to other groups. The two treated groups had significantly reduced MDA compared to ulcer untreated group. There was a significant decrease in the levels of GPx and SOD of ulcer untreated group compared to control. Meanwhile, these were significantly increased in extract and omeprazole treated groups compared to ulcer untreated group. Catalase was significantly increased in all three groups when compared to control but its level was significantly increased in extract treated group compared to ulcer untreated and omeprazole treated groups. From this study, AP has proved to protect against oxidative stress implicated in the pathogenesis of ulcer. If this result is applicable to humans, further research and use of AP in ameliorating debilitating consequences of peptic ulcer should be encouraged.

Change in prevalence and pattern of peptic ulcer disease in the Northern Savannah of Nigeria: An endoscopic study

Background: Peptic ulcer disease (PUD) is common worldwide. Its incidence and prevalence have been declining in recent years in developed countries, and a similar trend has been observed in many parts of Africa including Nigeria. Aim: This study aimed to provide an endoscopic update on PUD in the Northern Savannah of Nigeria and compare with past reports from the region and recent reports from Nigeria, Africa, and the rest of the world. Methods: Upper gastrointestinal endoscopy records of consecutive patients diagnosed with PUD between January 2014 and September 2022 at an endoscopy unit of a tertiary institution in North West Nigeria were retrieved and demographic data, types of peptic ulcer, and their characteristics were extracted and analyzed. Results: Over a 9 year period, 171/1958 (8.7%) patients were diagnosed with PUD: mean age 48.8 years (range 14­85), 68.4% male, and 70% >40 years. 59.6% were gastric ulcers (GU), 31.6% duodenal ulcers (DU), and 8.8% were both. The mean age of patients with GU was slightly higher than those with DU (49.9 years vs. 46.6 years, P = 0.29); patients aged 40 years significantly more GU than DU (74.6% vs. 54.7%, P = 0.016). There were no significant gender differences between GU and DU. Conclusion: The prevalence and pattern of PUD in Northern Savannah of Nigeria have changed ­ patients were predominantly male and older, and GU predominated.

Mechanism of Magnoliae Officinalis Cortex in treatment of peptic ulcer based on network pharmacology and molecular docking / 中国中药杂志

Magnoliae Officinalis Cortex(Houpo) can treat peptic ulcer disease(PUD), the mechanism of which remains unclear. In this study, network pharmacology and molecular docking were employed to predict the mechanism of Houpo in the treatment of PUD. Through literature review and TCMSP screening, 15 main active ingredients were obtained. The SwissTargetPrediction database was used to predict the potential targets of the ingredients, and Therapeutic Target Database(TTD), DrugBank, and Human Phenotype Ontology(HPO) to screen the disease-related targets. A total of 49 potential targets were obtained by the intersection of active ingre-dients-related targets and disease-related targets. Cytoscape 3.6.1 was employed to construct the protein-protein interaction network for the targets with high confidence(score>0.700) screened out by STRING. The DAVID database was used for GO and KEGG pathway enrichment of potential targets. GO enrichment analysis showed that the treatment mechanism was mostly related to nuclear receptor activity, ligand-activated transcription factor activity, and G protein-coupled acetylcholine receptor activity. KEGG enrichment analysis found that Houpo could regulate material metabolism, endocrine system, p53 signaling pathway, and PPAR signaling pathway. Molecu-lar docking verified that all 15 ingredients had good binding activities with key targets(CHRM1, CHRM2, FABP1, mTOR, and STAT3). The results mean that Houpo can treat PUD by participating in cell metabolism, inhibiting inflammatory cytokines, and regulating cell proliferation and apoptosis.

Predictive Value of Neutrophil-to-Lymphocyte Ratio for Differentiating Organic Dyspepsia from Functional Dyspepsia

ABSTRACT Objective: Dyspepsia, one of the most commonly seen symptoms, can be due to organic dyspepsia (OD) or functional dyspepsia (FD). The aim of this study is to evaluate neutrophil-tolymphocyte ratio (NLR) for the predictability of OD due to peptic ulcer disease (PUD) and gastric cancer (GC). Methods: We investigated retrospectively the patients with dyspepsia who underwent endos-copy. The study included 119 patients with OD (41 patients with biopsy-proven GC and 78 patients with PUD) and 100 patients with FD diagnosed. Results: The NLR among the patients with GC and PUD was significantly higher than FD subject (p < 0.001 each). The NLR in patients with GC was also significantly higher than that in patients with PUD (p < 0.005). When OD was compared with FD, NLR and white blood cell were statistically significantly higher (p < 0.001 and p < 0.05 respectively). The best predictive cut-off value of NLR was 1.72 with a specificity of 63% and a sensitivity of 66% for OD, on receiver-operating characteristic curve analysis. Conclusion: Neutrophil-to-lymphocyte ratio was higher in patients with OD compared with those with FD, and even higher in patients with GC. Our findings suggest that NLR should be calculated in patients with dyspepsia and patients with high levels of NLR should undergo endoscopy.

Diagnosing Herpetic Genital Ulcers in a Resource-Limited Setting- What Works?

Aims: Globally, viral agents, especially herpes simplex virus (HSV), have overtaken the bacterial causes of genital ulcers. Very few laboratories in India, perform culture techniques and polymerase chain reaction (PCR) for diagnosis of genital ulcers. This study aimed to establish the utility of existing tests, which are cheaper and need less technical expertise, when compared to newer tests such as PCR.Study Design: This cross sectional study was carried out to determine the aetiology of genital ulcers, with emphasis on diagnosis of herpetic ulcers, using newer and more accurate methods of diagnosis and evaluating their performance by comparing against viral culture as gold standard test.Place and Duration of the Study: The study was carried out over a period of one year in the Apex Regional Sexually Transmitted Diseases (STD) Centre at Safdarjung Hospital, New Delhi and the Department of Microbiology, AIIMS, New Delhi.Methodology: Fifty three patients with genital ulcers were included in the study. Specimens from ulcers were taken for various tests, including Giemsa stain, ELISA for HSV-1 & 2, PCR and Viral culture for HSV.Results: HSV was identified in 31 of 53 cases (58.5%), including 03 cases of HSV-1, and 28 cases of HSV-2. Sensitivity and specificity of PCR was 90.0% and 84.85%, respectively. Viral culture positivity was 37.7%.Conclusion: Genital herpes is associated with an increased risk of Human Immunodeficiency Virus (HIV) acquisition, and clinical manifestations are diverse; hence a presumptive diagnosis should be confirmed by reliable laboratory tests. Nucleic acid amplification tests (NAAT) are the most sensitive methods for direct detection of HSV. The extensive validation of these tests allows for their application in routine laboratory settings with consistency and greater diagnostic accuracy. When standardised and used, PCR is a highly reproducible, rapid and labour efficient method for HSV detection.

A study on surgical complications of peptic ulcer disease: a prospective study at a tertiary care center

Background: Peptic ulcer was defined as a disruption of the mucosal integrity of the abdominal esophagus, stomach, duodenum leading to local defect or excavation due to active inflammation. Hospitalizations for peptic ulcer disease (PUD) have decreased since the advent of specific medical therapy & low tachyphylaxis associated with those drugs. This study aims to evaluate the surgical complications of peptic ulcer disease and tested the hypothesis that despite the decrease in hospitalization for PUD, the incidence of elective surgery for PUD during the recent three decades tends to decrease and in contrast, the frequency of emergency surgical interventions for complications of the PUD has remained consistent.Methods: A total of 60 patients operated for complications of PUD, admitted to PES Institute of Medical Sciences, Kuppam, from January 2018 to September 2019. All data that may be potential predictors concerning complications of PUD were prospectively analyzed.Results: In the present study, the most common complication was perforated peptic ulcer (78.3%) followed by Gastric outlet obstruction (15%) and rest bleeding peptic ulcer.Conclusions: Despite the efficacy of modern medical therapy, decreasing the overall PUD hospitalizations, the volume of procedures to treat complications of PUD has not declined.

Effect of quercetin on histamine induced gastric ulcers in male guinea pigs

Background: Peptic ulcer disease is the most prevalent gastrointestinal diseases caused by an imbalance between gastric stimulant or aggressive factors and the mucosal defensive factors. The defence of flavonoids against the tissue oxidative stress is being proved in various animal models for wide pharmacological effects. The aim of the present study is to evaluate the anti-oxidant effect of quercetin in histamine induced gastric ulcers.Methods: Male guinea pigs were divided into 4 groups (n=6). Group I includes normal control. Group 2, 3 and 4 were induced gastric ulcers with histamine as intraperitoneal (IP) injection. Group 2 serves as the gastric ulcer control. Group 3 and Group 4 are pre-treated with quercetin 200 mg/kg per orally (PO) and ranitidine 100 mg/kg PO respectively 45mins before histamine injection. After 4 hours of histamine injection, the animals were sacrificed to collect blood samples and stomach tissue for estimation of plasma and tissue antioxidant levels.Results: On estimation of antioxidant levels both in plasma and stomach tissues the SOD and CAT levels increased in the Group 3 and 4 significantly and also a significant reduction in MDA levels were noted in the Group 3 and 4 compared to the gastric ulcer control group.Conclusions: Hence, with flavonoids quercetin utilization in histamine induced gastric ulcers, the antioxidants showed comparative levels with ranitidine treatment groups. So a permanent cure for the chronic gastric ulcers could be proved in further studies as this is the milestone, tough to achieve in general clinical practice.

A Study on the Healing of Peptic Ulcer Disease after Eradication of Helicobacter Pylori Infection in Rural People Bangladesh

Objective: In this study our main aim is to evaluate the healingof peptic ulcer disease after eradication of helicobacter pyloriinfection in rural people Bangladesh.Methodology: This Prospective observational study wasconducted at tertiary hospital Dhaka district from Tertiarymedical college and hospital among 100 patients diagnosedcoming to the gastroenterology outpatient departmentaccording to inclusion and exclusion criteria was included inthe study.Result: In our study among 100 patients, most of the patientsbelong to 31-40 years age group, which was 37.78% and 57%were male and 43% were female. 15.07% patients hadduodenal ulcer and 21.09% had gastric ulcer for H. pyloripositive.18% patients were still positive for H.pylori aftereradication therapy.Conclusion: In conclusion, we can say that, prolonged Followup with upper GI endoscopy for additional period for recurrenceof ulcer should have been done for patients whose peptic ulcerdisease had resolved but could not attain H. pylori eradication.

Frequency of Peptic Ulcer Disease Increases with Severity of Cirrhosis of Liver: Experience of Tertiary Level Hospital of Dhaka

Introduction: Cirrhosis of Liver is prevalent in Bangladesh.PUD can coexist with portal hypertension with cirrhosis.Objectives: To identify frequency of peptic ulcer diseaseincreases with severity of cirrhosis of liver.Materials & Methods: Consecutive 96 patients of cirrhosis ofliver had enrolled when found oesophageal varices at ourendoscopy unit during endoscopic evaluations in 4 monthsperiod (August 2017 to November 2017).Results: Total cirrhotic patients enrolled were 114 (M=75,F=39), mean age was 51.80 ± 14.20 yrs (18-86years). HBVwas the leading cause of cirrhosis in 54.18%, HCV 5.22 %,proven NASH were 12.24% and rest were from unknownaetiology. Their average CTP score were 8.6 (12-5), 37.6%associated with portal hypertensive gastropathy. Grade-IIIoesophageal varicose found in 52 patients, whereas grade-II in25 patients. Among this 114 patients 46 (40.62%) revealedpeptic ulcer disease more in the form of gastric ulcer (n=31)than duodenal ulcer (n=10) and both (n=5).Most of the ulcersbelonged to Forrest class III (76.92%).Conclusion: Variceal bleeding and portal hypertensivegastropathy in patients with liver cirrhosis are prevalent causesof bleeding and anaemia. One of the potential causes ofhaematemesis, melaena, and anaemia among these patientsin Bangladesh has been discovered to be peptic ulcer illness.To verify the findings, large, multicenter-controlled trials arerequired.

Treatment of Qizhi Weitong Granule plus Wubei Powder in Army Men with Helicobacter Pylori Negative Duodenal Ulcer Disease / 医学研究杂志

Objective To evaluate the effect and safety of Qizhi Weitong Granule plus Wubei Powder in treatment of army men with helicobacter pylori negative duodenal ulcer disease.Methods A randomized,single-blind,controlled study was conducted in 84 army men with helicobacter pylori negative duodenal ulcer disease.They were randomly divided into trial group (n =40,Qizhi Weitong Granule plus Wubei Powder were administered daily for 4 weeks) and control group(n =44,they took imported esomeprazole daily for 4 weeks).Symptoms and adverse reactions were recorded.Gastroscopy was performed by the end of the fourth week.Results After treatment,the cure rate and total effective healing rate of ulcer were 87.5％ and 95.0％ in trial group,and those in control group were 86.4％ and 97.7 ％ respectively.The difference was not statistically significant(Z =0.074.P ＞ 0.05).The relief rates of symptoms were 95.0％ in trial group and 88.6％ in control group,the difference was not of statistical significance (Z =0.793,P ＞ 0.05).There was no statistically significant difference in the relief of gastric abscess,flatulence,belching and acid regurgitation between the two groups (P ＞ 0.05).But the symptoms of irritability and bad temper,chest distress and deep sighing,bitter taste in the mouth and poor appetite in trial group were improved more significantly than those in control group.The difference was statistically significant(P ＜ 0.05).The incidences of adverse reaction were 15％ in trial group and 13.6％ in control group,the difference was not statistically significant (x2 =0.01,P ＞ 0.05).Conclusion Qizhi Weitong Granule plus Wubei Powder is as effective,safe and well tolerated as imported esomeprazole in army men with helicobacter pylori negative duodenal ulcer disease.But Qizhi Weitong Granule plus Wubei Power can improve mental symptoms and appetite of patients with duodenal ulcer disease significantly.

Intervention experience of omeprazole in the treatment of peptic ulcer disease / 中国生化药物杂志

Objective To observe the effect of omeprazole combined with nursing intervention in the treatment of peptic ulcer disease and evaluate its clinical effect. Methods 83 cases from January 2014 to March 2017 were as the research object, using randomly divided into the control group of 41 patients treated with omeprazole alone, during perioperative treatment give nursing intervention, 42 patients in study group were given omeprazole treatment and nursing intervention, compared two groups of patients with clinical treatment. Results After treatment, the two groups of patients with various indicators of statistical data show that the total efficiency of the study group was 95.24% (40/42), control group was 80.49%(33/42), with statistical significance in two groups the difference (P< 0.05); in addition, compared with before treatment, two groups of patients after treatment, stomach burning sensation, epigastric pain, postprandial protection, belching symptoms and SDS scores, SAS scores were significantly improved, and the improvement in the study group The effect is obviously better than that of control group (P<0.05). Conclusion The treatment of omeprazole combined with nursing intervention in patients with peptic ulcer, can play a satisfactory effect, effectively improve the clinical symptoms of the disease and improve the negative emotions of patients, with clinical application value.

A Case Report of An End-Stage Renal Failure Patient with Peptic Ulcer Disease

@#A 64-year-old man with a background of chronic kidney disease (CKD) was admitted to hospital for symptoms of uraemia and was subsequently initiated on haemodialysis (HD). On day 13 of HD, he developed per rectal bleeding with a significant drop in his haemoglobin (Hb) level. Oesophagoduodenoscopy (OGD) was performed and showed several antral and duodenal ulcers. Colonoscopy was unremarkable. He was started on high-dose PPI and his Hb level remained stable with no recurrence of symptoms. This case report highlights the association between HD and the increased risk of developing peptic ulcer disease (PUD) in patients with end-stage renal failure. Abdominal symptoms are common in the primary care setting and it is crucial for family physicians to be able to recognise the red flags of PUD in this group of high-risk patients as timely referral and intervention reduces morbidity and mortality.

Long-Term Recurrence Rates of Peptic Ulcers without Helicobacter pylori

BACKGROUND/AIMS: The purpose of this study is to investigate the recurrence rate of peptic ulcer disease (PUD) over a long follow-up period with PUD patients without Helicobacter pylori. METHODS: We retrospectively reviewed patients diagnosed with PUD on endoscopy and divided them into two groups: a H. pylori-negative group (HP-negative group), and a group of patients with untreated H. pylori (HP noneradicated group). We compared the recurrence rates of PUD in these two groups and analyzed the factors that affected ulcer recurrence. RESULTS: Total of nine hospitals in Korea participated, and a total of 1,761 patients were retrospectively reviewed. The HP-negative group included 553 patients, and the HP noneradicated group included 372 patients. The 5-year cumulative probabilities of PUD recurrence were 36.4% in the HP-negative group and 43.8% in the HP noneradicated group (p=0.113). The factors that were found to affect recurrence in the HP-negative group were elder, male, and comorbid chronic kidney disease. CONCLUSIONS: The 5-year cumulative probability of PUD recurrence without H. pylori infection after a long-term follow-up was 36.4% and the factors that affected recurrence were elder, male, and comorbid chronic kidney disease.

Diagnosis and Treatment of Peptic Ulcer Disease: Present and Future Perspective / 대한소화기학회지

Peptic ulcer disease is one of the most commonly encountered diseases in gastroenterology clinics. After the discovery of Helicobacter pylori by Warren and Marshall, it has been identified as the most important cause of peptic ulcer. Eradication of H. pylori markedly reduces the post-treatment recurrence rate of peptic ulcer. However, as human populations age, the incidence of cardiovascular and musculoskeletal diseases increases and consequent use of aspirin and non-steroidal anti-inflammatory drugs increases. Thus causes and presenting patterns of peptic ulcer have changed. In this review, I describe new diagnostic and therapeutic strategies for peptic ulcer disease and explore future perspectives.

Estomatitis aftosa recurrente: reporte de un caso / Recurrent aphthous stomatitis: a case reporti

La estomatitis aftosa recurrente es una alteración de la mucosa oral asociada en algunos casos a la depresión del sistema inmunológico, el cual condiciona la respuesta tisular a nivel del epitelio, desencadenando el cuadro clínico repetitivo de ulceras pequeñas y medianas (3-5 mm), las cuales presentan fondo necrótico y bordes eritematosos de una duración no mayor a 15 días. El cuadro se vuelve recidivante, sintomático, comprometiendo la salud del paciente, quien consulta nuevamente con iguales características en cavidad oral. La literatura asocia el proceso con cambios hormonales, traumatismo, ingesta prolongada de medicamentos, y estrés. Se presenta un caso clínico en Santa Marta, en el Centro de Implantología y Rehabilitación Oral: paciente femenina de 53 años,quien acude al servicio de estomatología por presentar múltiples aftas orales que dificultan la deglución, marcada sialorrea y estado febril. De acuerdo al interrogatorio y al examen clínico se asocia con un proceso reactivo inflamatorio producido por la ingesta de medicamentos para tratar un proceso infeccioso o viral, al cual se le da el diagnóstico presuntivo de eritema medicamentoso. Se suspende toda ingesta de medicamentos y se ordenan exámenes complementarios de anticuerpos antinucleares.

Recurrent aphthosus stomatitis is an alteration of the oral mucosa in some cases associated with depression of the immune system that affects the tissue response at the level of the epithelium, triggering repetitive clinical picture of small and medium ulcers (3-5 mm) which necrotic presented erythematous background and lasting no more than 15 days. The picture becomes recurrent, symptomatic, compromising the health of the patient who consults again with the same characteristics in oral cavity. The literature associates the process with hormonal changes, trauma, prolonged intake of medications, and stress. A case of female patient 53, who attends the service of dentistry to present multiple oral thrush that hard to swallow, drooling and feverish marked presents in Santa Marta, at the Center for Implantology and Oral Rehabilitation. According to the interrogation and clinical examination it is associated with a reactive inflammatory process caused by the intake of drugs to treat infectious or viral process, which is given the presumptive diagnosis of erythema drug. Any medication intake was suspended and additional tests are ordered antinuclear antibodies.

"Helicobacter pylori, hoy": una historia de 30 años / "Helicobacter pylori, today": a 30 year history

En 1983, hace 30 años, Warren JR y Marshall BJ publican el artículo en Lancet1, que revolucionó el entendimiento de varias patologías gástricas, al encontrar un bacilo curvo no identificado en el epitelio gástrico, en gastritis crónica activa, de forma casi fortuita, al bacilo llamado subsecuentemente, Campylobacter pylori y con la nomenclatura de hoy, Helicobacter pylori. Fue considerado por la OMS carcinogenético gástrico el año 2001 (Figura 1). En el 2005, fueron galardonados con el Premio Nobel de Medicina, por su contribución (Figura 2). Es el tópico que más publicaciones científicas ha generado en la literatura. En la presente revisión, nos ocuparemos de un enfoque eminentemente práctico, sobre hechos de relevancia clínica de su presencia, de su diagnóstico, de la terapéutica y sus variables actuales y de los diferentes escenarios, en los cuales nos desenvolvemos. Se hace mención de un excelente documento generado en un Consenso actualizado en Latinoamérica2.

In 1983, 30 years ago, Warren JR & Marshall BJ, published in Lancet, their leading revolutionary article1, modifying the understanding of several gastric pathologies, thanks to the discovery of an unidentified curved bacilli in the gastric epithelium, in chronic active gastritis, almost unvoluntariously, nominated sequentially Campylobacter pylori and according to the today's nomenclature Helicobacter pylori. It has been considered gastric carcinogen by WHO in 2001 (Figure 1). In 2005, they were awarded with the Nobel Prize of Medicine for their contribution (Figure 2). It is the topic generating the highest number of scientific publications, in the literature. In this publication, we deal with a practical focus on clinical relevant aspects, related with its presence, its diagnosis, the therapeutic approach and its variables, and tackling the different clinical scenarios. A recently published practical Latin American consensus, has been preferently considered2.

Triple and Quadruple Eradication Therapy for H. pylori in Iraqi Patients with Peptic Ulcer Disease a Comparative Study.

The eradication of H. pylori has become an important issue; since Helicobacter pylori infection can cause chronic gastritis, peptic ulcer, gastric cancer and (MALT) lymphoma. Standard triple therapy efficacy has decreased gradually worldwide during the last decade and quadruple therapy is recommended as an alternate treatment option for the management of H. pylori. The aim of this study was to compare between triple and quadruple therapy for eradication of H. pylori in Iraqi patients with peptic ulcer disease, and to treat the patients who relapsed after triple therapy. In addition to that; response to therapy (triple and quadruple) have been evaluated according to the Body Mass Index (BMI). A prospective case controlled study was carried on 60 patients who had peptic ulcer disease and positive H. pylori infection confirmed by (histology; stool antigen test and anti-H. pylori IgG antibody test) patients were divided into 3 groups first group involved 38 patients treated with triple therapy (500 mg clarithromycin capsules; 1 g amoxicillin capsules; and 20 mg esomeprazole capsules) for 14 days. The second group involved 22 patients treated with quadruple therapy (pylera)®; (140 mg bismuth sub citrate potassium, 125 mg metronidazole, and 125 mg tetracycline hydrochloride) for 10 days, while third group involved patients un responding to triple therapy treated with secondline quadruple therapy for 10 days. The results showed that the eradication rate of the per-protocol and intention-to-treat for quadruple therapy was 88.57%, 83.78% respectively which was more than 57.89% per-protocol and 50% intention-to-treat for standard triple therapy with high significant difference (p<0.01). Patients compliance with quadruple and triple therapy was good for the two regimens in spite of the more adverse effect of quadruple regimen compared to triple regimen. On conclusion; the 10 days treatment with quadruple therapy was more effective than 14 days triple therapy that could be attributed to more eradication rate for H. pylori.

Association between Helicobacter pylori Infection, ABO Blood Groups and Rhesus Factor in Peptic Ulcer Disease Patients, in Gezira, Central Sudan.

Blood group antigens were associated with peptic ulcer disease, which is potentially caused by Helicobacter pylori. It was recently demonstrated that the receptor for H. pylori is the blood group antigen lewisb, which is exposed only in blood group O. Objectives: To report the possible correlation among H. Pylori Infection, ABO and Rhesus (Rh) blood groups in patients with peptic ulcer disease. Methods: This cross-sectional, prospective study was carried out between Jan 2010 and Dec 2010 among patients suffering from dyspeptic symptoms attending to Wad Medani Teaching Hospital-Endoscopy Unit. All patients had their blood group phenotype and Rhesus determined by the slide hemagglutination test. All patients underwent oesophagogastrodudenoscopy to diagnose peptic ulcer disease. Gastric biopsies were obtained and examined for H. pylori by urease test. Results: 40 patients were enrolled in this study, 29 were males and 11 were females with a mean age of 50.75 ± 18.18 years. 28 patients were both H. pylori biopsy-urease and Rhesus factor positive (93.3%), while 2 patients were H. pylori positive and Rhesus negative (6.7%). Among patients who were H. Pylori urease positive; 3 were blood group A (10%), 9 were B (30%) and 18 were O (60%).Most patients 31(77.5%) had duodenal ulcers, while 9(22.5%) had gastric ulcers at oesophagogastrodudenoscopy. Out of those who had D.U at oesophagogastrodudenoscopy; 3 were Blood group A (9.7%), 10 were B (32.3%) and 18 were O (58.1%).while among those with G.U; 3 were Blood group B (33.3%) and 6 were O (66.7%). Rhesus factor was positive in 28 patients (93.3%) and negative in 2 patients (6.7%) among those who were urease positive. Patients with DU; 29(93.5%) were Rhesus positive and 2(6.5%) were negative. All patients with GU (9 patients) were Rhesus positive (100%). This implies that there was statistically significant correlation between the O blood group, positive Rhesus factor and H. Pylori infection in peptic ulcer disease patients. γ=0.023 and 0.024 respectively. Conclusion: This study suggests that can be a significant association between Rhesus positive group O and H. pylori infection.

Why do we still have Helicobacter Pylori in our Stomachs?

The existence of any infectious agent in a highly acidic human stomach is contentious, but the chance finding of Helicobacter pylori is by no means an accident. Once H. pylori colonises the gastric mucosa, it can persist for a lifetime, and it is intriguing why our immune system is able to tolerate its existence. Some conditions favour the persistence of H. pylori in the stomach, but other conditions oppose the colonisation of this bacterium. Populations with high and extremely low prevalence of H. pylori provide useful insights on the clinical outcomes that are associated with this type of infection. Adverse clinical outcomes including peptic ulcer disease and gastric cancer depend on a delicate balance between a harmless inflammation and a more severe kind of inflammation. Is the only good H. pylori really a dead H. pylori? The jury is still out.

Therapeutic Effect of Wenwei Zhitong Granules Combined with Acupoint Moxibustion for Spleen-stomach Deficiency-cold Ulcer Disease / 广州中医药大学学报

Objective To observe the therapeutic effect of Wenwei Zhitong Granules ( WZG) combined with acupoint moxibustion for spleen-stomach deficiency-cold ulcer disease. Methods A total of 120 cases of spleen-stomach deficiency-cold ulcer disease were evenly randomized into treatment group and control group. Both groups were given conventional treatment with western medicine plus oral use of WZG, and the treatment group was given acupoint moxibustion additionally. The treatment lasted for 8 weeks. The therapeutic effect on gastroscopy and on relieving stomachache, and the adverse reaction were observed. Results ( 1) The total effective rate showed by gastroscopy was 95.00% in the treatment group and was 85.00% in the control group, the difference being significant (P<0.05). (2) Total effective rate for relieving stomachache was 98.33% in the treatment group and was 88.33% in the control group, the difference being significant ( P<0.05). ( 3) During the treatment, both groups had 2 cases of adverse reaction of nausea, poor appetite and loose stool after oral use of Clarithromycin and Amoxicillin, and then the adverse reaction disappeared after two weeks. No other reverse action was found. Conclusion WZG combined with acupoint moxibustion is effective, convenient and safe for the treatment of spleen-stomach deficiency-cold ulcer disease by promoting the healing of ulcer and relieving stomachache.