Abstract
Objectives: Many patients presented to the causality with upper gastrointestinal bleeding, which is a serious condition associated with significant morbidity and mortality especially in elderly patients and those with coexisting medical diseases. The purpose of the study was to assess the general use of NSAIDs and their relation to upper gastrointestinal bleeding. Methods: Cross sectional study on patients who were referred for endoscopy for upper gastrointestinal bleeding in Sulaimany Teaching Hospital during the period from January to December 2016. All of them had been exposed to full history taking regarding age, gender, smoking, alcohol and medication used in addition to thorough physical examination and upper gastrointestinal endoscopic examination with biopsy when indicated. Results: This study enrolled 100 patients with upper GIT bleeding and showed that 48% of those with upper GIT bleeding were using NSAIDs, with male to female ratio of approximately 2:1, and 37 patients (77.1%) of those who were taken NSAIDs, did not use PPI concomitantly. Conclusion: The study also revealed that elderly patients taking NSAIDs were at higher risk of developing upper GIT bleeding. Peer Review History: Article received on- 2 October; Revised on- 2 November; Accepted on- 4 November, Available online 15 November 2016 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Dr. Sally A. El-Zahaby, Pharos University in Alexandria, Egypt, sally.elzahaby@yahoo.com Kian Navaee, Shahre Daru Pharmaceutical Co., Iran, kian.navaee@chemist.com Similar Articles: DEVELOPMENT AND ESTIMATION OF ANTI-INFLAMMATORY ACTIVITY OF TOPICAL ETORICOXIB EMULGEL BY CARRAGEENAN INDUCED PAW OEDEMA METHOD
Highlights
50 non-steroidal anti-inflammatory drugs (NSAIDs) are in use throughout the world, the oldest and best known is aspirin
This study showed that elderly patients taking NSAIDs were at higher risk of developing upper GIT bleeding, as 24 out of 29 patients with an age of 60 years or older (82.8%) were taking NSAIDs, In contrast, only 9 out of 29 patients (31%) whose age was 20-39 year-old were taking NSAIDs indicating that the effect of other risk factors for upper GIT bleeding had stronger effect in comparison to the effect of NSAIDs on the frequency of upper GIT bleeding among young patients
Regarding the history of NSAIDs use including the use of aspirin in all of its recommended doses, many studies with different designs reached the conclusion of considering the use of NSAIDs as a major risk factor in the development of upper GIT bleeding which is the main cause of morbidity and mortality related to NSAIDs use[31,32]
Summary
50 non-steroidal anti-inflammatory drugs (NSAIDs) are in use throughout the world, the oldest and best known is aspirin. NSAIDs are popular because of their versatile effectiveness as analgesics, antipyretics, and (by definition) as anti-inflammatory agents[1]. Aspirin and most other NSAIDs can injure the gastric and duodenal mucosa, with considerable morbidity and mortality[2]. UGI bleeding commonly presents with hematemesis (vomiting of blood or coffee-ground like material) and/or melena (black, tarry stools). A nasogastric tube lavage which yields blood or coffee-ground like material confirms this clinical diagnosis. Gastroduodenal ulcer disease remains a common cause of UGI bleeding. There are four major risk factors for bleeding peptic ulcers[3]. NSAIDs are a common cause of gastrointestinal ulceration[8,9,10,11]
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