Acid Peptic Disease Research Articles

Industrial manufacturing method and characterization of Ayurvedic marine drugs: mother pearl, cowry, coral and pearl

Introduction: Ayurvedic marine drugs derived from mollusc shells and coral are regularly used by Ayurvedic physicians to treat several disease conditions like acid peptic disease, irritable bowel syndrome, osteoporosis, etc. However, standard operating procedures for manufacturing these drugs and their complete characterization have not been published in the Ayurvedic Formulary and Ayurvedic Pharmacopeia of India to date. Methods: Present study describes the traditional manufacturing process and thorough characterization using classical and advanced analytical tools. The raw materials characters, in-process parameters, and finished product specifications have been elaborated to develop monographs. Especially, the identity and purity of raw coral and pearl were checked by Raman Spectroscopy and Energy Dispersive X-ray Fluorescence analysis. Results: In the finished product analysis, the X-Ray Diffraction study revealed that incineration after trituration with Aloe barbadensis leaf pulp or rose water converted the aragonite phase of calcium carbonate into calcite phase in mother pearl, cowry, and pearl while the calcite form of raw coral was retained. The prominent bands around 1390, 870, and 712 cm−1 detected by Fourier Transform-Infrared Spectroscopy and mass loss between 39–44% (w/w) revealed by thermogravimetric analysis confirmed the carbonate form of these calcium-based drugs. The finished products were very fine grayish-white powders constituted by irregularly shaped nano-micro particulate calcium carbonate exhibiting particle size between 600 nm (D10 value) to 1.2 µm (D90 value). Conclusion: The quality control and assurance achieved in this study may be further utilized by the pharmaceutical industries to manufacture quality marine drugs and conduct efficacy studies.

The Effect of a Healthy Lifestyle Intervention on Shift Workers With Acid Peptic Disease: A Quasi-experimental Study in Karaikal, South India.

Acid peptic disease (APD) is the most common health issue among rotational shift workers, including night shifts. Alterations in diet patterns from the routines of life play a key role in the development of APD in this population. This study aims to determine food habits and evaluate the effect of a healthy lifestyle intervention on reducing the frequency of the occurrence of APD among rotational shift workers. A quasi-experimental study was carried out for six months in Karaikal, South India. About 37 employees involved in rotational shift work were recruited consecutively. A healthy lifestyle intervention was implemented, and preand postintervention data were collected using a pre-tested, semi-structured questionnaire. The McNemar test was employed to assess the preand postintervention data using SPSS Statistics version 24 (IBM Corp., Armonk, NY, USA). Among 37 shift workers, almost 21 (56.8%) were suffering from heartburn, and about 14 (38%) presented with two symptoms. Before the intervention, 24 (64.9%) workers experienced APD > 28 days after the previous episode. After intervention, a majority of 34 (91.9%) workers experienced APD > 28 days after the previous episode (p-value = 0.002). This highlights the importance of healthy lifestyle modifications in controlling APD among shift workers. This in turn improves the productivity of the workers.

Clinicopathological Study of Gastroduodenal Biopsies and Correlate with Endoscopic Findings in Northeast India- One- Year Cross-sectional Study in a Tertiary Care Centre

Background: The gastrointestinal tract (GIT) is a hollow muscular tube extending from the oral cavity to the anus. Acid peptic disease is among the most common disorders affecting this region globally, caused by an imbalance between acid secretion and gastric mucosal defenses. Endoscopy has enhanced the accuracy and early histologic diagnosis of mucosal lesions. This cross-sectional study examines 100 gastroduodenal biopsies over a one-year period. Methods: The study categorized histopathological findings from gastro-duodenal biopsies collected via endoscopy and analyzed their correlation with endoscopic results. Results: Gastroduodenal lesions were more prevalent in males, particularly in the fifth decade of life. Endoscopic findings included 12 normal cases, 31 ulcers, 15 erosions, 4 polyps, and 38 malignancies. Among the 38 malignancies, 10 were premalignant, 23 were diagnosed as gastric carcinoma, and 4 as duodenal carcinoma, demonstrating a strong correlation between endoscopic and histopathological findings. Conclusion: Endoscopic gastroduodenal biopsies are instrumental in diagnosing both benign and malignant lesions across various age groups and sites. The combination of endoscopy and histopathological analysis provides a powerful diagnostic tool for better patient management.

Frequency of Post-Cholecystectomy Syndrome Among Patients Undergoing Cholecystectomy: A Teaching Hospital Experience

Background and Objectives: Post-cholecystectomy syndrome is defined as upper abdominal pain or dyspepsia that persists after the cholecystectomy. Some studies show its incidence is about 40%. This study aims to find out the frequency of early post-cholecystectomy syndrome at our hospital and its possible cause.Methods: It was an observational study conducted at POF Hospital Wah Cantt from January 2018 to January 2022. 505 patients who underwent cholecystectomy were included in this study to find the incidence and cause of post-cholecystectomy syndrome. All the data were noted in a predesigned proforma and entered in SPSS version 24.0.Results: Out of 505, 59 patients were diagnosed as cases of post cholecystectomy syndrome with an incidence of 11.68%. 40(67.7%) were female, 19(32.2%) were male. The mean age of the patient was 38.43±8years. In 36(61%) patients, no cause of pain was found. In 12(20%) patients the cause was acid- peptic diseases. Three(5%) patients have CBD stones, 2(3.3%) patients have the remnant of the gallbladder, 2(3.3%) patients had a fluid collection, 2(3.3%) patient had pancreatitis, 1(1.6%) patient had scar pain (hypertrophic scar) and 1(1.6%) patient had periampullary growth.Conclusion: The incidence of post-cholecystectomy syndrome is significant. Any patient presenting with pain postoperatively should be examined and thoroughly investigated for possible treatable causes.Keywords: Post-cholecystectomy syndrome, Acid peptic diseases, jaundice, laparoscopic cholecystectomy.

Assessment of Morbidity Patterns and Occupational Hazards Among Food Handlers in Food Establishments in Tamilnadu, India

Background: Rapid urbanization has increased the intake of external (outside) foods, causing a surge in food-borne diseases. In the South-East Asian region of the World Health Organization, 150 million people fall ill with foodborne diseases every year, of which, 1.75 lakhs perish. Occupational hazards are of public health importance as they cause permanent disability, loss of livelihood, and morbidity. Methodology: This cross-sectional study was conducted among 235 food handlers working in food establishments of a private educational institution in Tamil Nadu using a semi-structured pre-tested questionnaire. Descriptive statistics, odds ratio and one-way ANOVA were used. Occupational risk score was calculated. Data were analyzed using SPSS 22.0. Results: The mean age of the food handlers was 30.7 (SD=10.3). Of the 235 participants, the majority were Males (86%). The commonest acute morbidity was Acid peptic disease (48.5%). Hypertension was reported in 26% of subjects. The most common occupational hazard was prickly heat (74.9% of the subjects). Work-related stress was reported by 72% of the food handlers. Physical hazards were high with a Mean value of 11.67 (SD=5.9) Conclusion: Half the subjects reported Acid Peptic Disease as the most common morbidity. Burns at work and psycho-social issues were found at higher rates. Periodic deworming, vaccination against enteric organisms, routine examinations and ergonomically designed workplaces can prevent outbreaks and preserve workers’ health.

Impact of large scale, multicomponent intervention to reduce proton pump inhibitor overuse in integrated healthcare system: difference-in-difference study

ObjectiveTo determine how a large scale, multicomponent, pharmacy based intervention to reduce proton pump inhibitor (PPI) overuse affected prescribing patterns, healthcare utilization, and clinical outcomes.DesignDifference-in-difference study.SettingUS Veterans Affairs Healthcare System,...

Study of Prevalence of Gastritis Caused by H. pylori and Correlation of Urease Test with Serology (ELISA) Test.

H. pylori are a pathogen of global importance. Gram-negative curved flagellate bacilli are implicated as one of the most trivial complaints of and are associated with peptic ulcer disease gastritis ulcer and gastric malignancy. This study was performed to find out the prevalence of Helicobacter pylori (H. pylori) infection in patients presenting the symptoms related with gastritis with or without chemically known peptic ulcer. The study was undertaken with the help of the Christensen and quotes urease test on endoscopic biopsy specimen and correlated with the detection of immunoglobulin IgG in the serum against H. pylori by an ELISA technique. A total of 67 cases were analyzed in which 29 (43%) cases were positive for H. pylori. The endoscopic findings of acid peptic diseases show 21 (31.4%) cases of stomach ulcer, and 3 (4.5%) have esophagitis, whereas 43 (64.1%) have nonulcer dyspepsia. There is strong positive association between the urease tesr and ELISA test. The urease test is a quick and inexpensive test with high specificity and sensitivity, but since it is an invasive test, it has reduced patient compliance.

Action Of Homoeopathy In Chronic Diseases – A Retrospective Analysis

Background: Homeopathy, as a holistic system of medicine, plays a pivotal role in the management of both acute and chronic diseases, offering a potential for permanent cure without causing harm to the patient. This retrospective analysis aims to underscore the advantages of homeopathy, focusing on common chronic ailments such as irritable bowel syndrome (IBS), polycystic ovarian syndrome (PCOD), bronchial asthma, allergic rhinitis, and low backache. Materials and Methods: The study was conducted retrospectively among patients attending the general Outpatient Department (OPD 2) at the National Homeopathy Research Institute in Mental Health, Kottayam, Kerala, every Tuesday from January 2023 to July 2023 (7 months). Analysis of data from 1677 patients revealed patterns of frequently indicated medicines. Results: A total of 1677 patients were included in the study, revealing distinct patterns in demographics and health conditions. The age distribution (Table 1, Figure1) indicated a higher prevalence among individuals aged 51-60 years (24%), while those in the 91-100 age group showed the least representation (1%). Notably, a predominant male presence was observed, constituting 51% of the patient population(Table2, Figure2). Among the patients, 197 were new attendees, while 1480 were returning patients, highlighting the sustained engagement of individuals with homeopathic care over time (Table 3, Figure3). The most prevalent disorders encountered during the study period (Table4, Figure4) were Bronchial Asthma (10%), Acid Peptic Disease (9%), and Diabetes Mellitus (9%). The most frequently used remedies were Sulphur, Pulsatilla, Nuxvomica, and RhusToxicodendron. Conclusion: In summary, this retrospective study involving 1677 patients at the National Homeopathy Research Institute in Mental Health revealed a predominant male demographic, with a concentration of cases in the 51-60 age group. Common disorders included Bronchial Asthma, Acid Peptic Disease, and Diabetes Mellitus, while Sulphur, Pulsatilla, Nuxvomica, and Rhustox emerged as frequently indicated remedies. Notably, the study showcased a remarkable improvement in all patients, affirming the efficacy and significance of homeopathy in achieving positive therapeutic outcomes.

Landscaping tuberculosis multimorbidity: findings from a cross-sectional study in India

BackgroundMultimorbidity, the concurrent presence of two or more chronic conditions is an emerging public health challenge. Till date, most of the research have focused on the presence and interaction of selected co-morbidities in tuberculosis (TB). There exist a critical knowledge gap on the magnitude of multimorbidity among TB patients and its impact on health outcomes.MethodsWe undertook a cross-sectional study to assess the prevalence and patterns of multimorbidity among newly diagnosed TB patients in two states of India. A total of 323 patients were interviewed using a structured multimorbidity assessment questionnaire for primary care (MAQ-PC). MAQ-PC is already validated for Indian population and elicits 22 chronic conditions. We defined TB multimorbidity as the co-existence of TB with one or more chronic conditions and identified commonly occurring dyads (TB + single condition) and triads (TB + two conditions).ResultsMore than half (52%) of TB patients reported multimorbidity. Among dyads, depression, diabetes mellitus (DM), acid peptic disease (APD), hypertension, chronic alcoholism, arthritis and chronic back ache (CBA) were the most common co-occurring conditions while ‘DM + arthritis’, ‘depression + APD’, ‘depression + DM’ were the most commonly occurring triads among TB patients. Factors such as increasing age, low levels of education, alcohol abusers, drug-resistant TB and having health insurance were significantly associated with multimorbidity among TB patients.ConclusionsOur findings suggest high prevalence of multimorbidity among newly diagnosed TB patients in India. The presence of concordant and discordant conditions with TB may increase the health complexity, thus necessitating appropriate care protocols. Given, the current situation, wherein TB and non-communicable diseases (NCD) services are delivered through collaborative framework between programmes, there is a need for addressing multimorbidity at the healthcare delivery level.

Long-Term Use of Proton-Pump Inhibitors: Unravelling the Safety Puzzle.

Globally, over 25% of the population suffers from acid-related disorders such as dyspepsia or gastroesophageal reflux disease (GERD), and around 7.6% of Indians report having GERD symptoms on a frequent enough basis to warrant a diagnosis. Over the past three decades, proton-pump inhibitors (PPIs) have been the mainstay of medical therapy for acid-peptic diseases like GERD, etc. Additionally, they are frequently prescribed for prophylactic purposes and in conjunction with non-steroidal anti-inflammatory drugs. PPIs are generally prescribed for four to eight weeks. However, it may be prescribed for patients with comorbidities and multiple medications for a longer period of time. While this remains true in terms of effectiveness, concerns have been raised about the safety of long-term PPI use and the serious adverse effects that may result. Some of the observational and population-based cohort studies have shown an association between long-term use of PPIs and an increased risk of pneumonia, major cardiovascular events, dementia, vitamin B12 deficiency, bone fractures, gastric cancer, and kidney injury, among others. This review analyzes the clinical data supporting the long-term use of PPIs and takes a deep dive into whether these several emerging long-term concerns apply to the currently available PPIs in India. We have summarized a vast array of studies, including randomized trials, cohort studies, and meta-analyses, that report low or high incidences of major health risks linked with PPIs and have assessed their appropriateness over a given period.

A study on phenotypic characterization and genotypic determination of drug resistance of Helicobacter pylori from cases of acid peptic disease in a tertiary care center

Background: Helicobacter pylori infection is one of the major risk factors for gastroduodenal disease, and invasive or non-invasive tests are available to detect it. Aims and Objectives: The study aims to identify H. pylori phenotypically and genotypically to identify drug-resistant H. pylori in suspected cases of peptic acid disorders at a tertiary care center. Materials and Methods: This 6-month prospective and observational study was performed at Saveetha Medical College and Hospitals. Patients’ gastric biopsy samples were obtained from 105 individuals with gastroduodenal disorders who had upper gastrointestinal endoscopies at the Hospital. A fiber optic endoscope and biopsy forceps were used for the endoscopy. Biopsy samples were collected from the antrum and placed in Eppendorf tubes for fast urease, culture, gram stain, polymerase chain reaction (PCR), and histological analysis. Results: A total of 78 (74%) males and 27 (26%) females were among the 105 patients. Endoscopic findings imply gastritis, gastric ulcer, and duodenal ulcer in 74 patients (70.48%). Rapid urease test (RUT), gram stain, and histology revealed positive results in 20 cases. RUT showed that 30.47% of patients tested positive. Gram stain detected 25.1% of H. pylori infections, and 12 cases were histopathologically positive. By PCR, 21.62% of gastritis patients were positive for H. pylori infection. RUT and PCR give comparable results for detecting H. pylori infection, with a strong association between H. pylori infection and peptic ulcer disease. Conclusion: A combination of RUT and PCR is an effective diagnostic approach for H. pylori infection, allowing doctors to select the most appropriate medications for specific patients.

Etiology, risk factors, and endoscopic profile in patients presenting with upper gastrointestinal bleeding – An observational study

Objectives: Upper gastrointestinal bleeding (UGIB) poses a strong diagnostic and therapeutic challenge to emergency physicians and gastroenterologists. There are wide variations in the etiological profile of UGIB, and it often varies with the demography of the patient clientele. A thorough understanding of these changing patterns of the etiological profile, characteristics of the affected patients, and treatment outcomes in the wake of constantly evolving diagnostic and therapeutic protocols are vital for healthcare providers. The aim is to study the clinical profile and assess possible risk factors and endoscopic findings among the patients presenting with UGIB at two different centers: Armed Forces Tertiary Care Teaching Hospital and Civil Tertiary Care Hospital. Materials and Methods: This is a cross-sectional observational study conducted at two centers: A tertiary care hospital of the armed forces (n = 113) from September 2015 to January 2018 and a civil tertiary care center in a tier 3 city (n = 178) from January 2019 to November 2021. The study population comprised patients presenting with UGIB. All patients diagnosed with UGIB and confirmed by endoscopy were enrolled in the study. Results: The study included patients presenting with UGIB visiting either of the two tertiary care centers. The majority of the study population (75%) was male. Between the two clinical settings, alcohol consumption was higher in proportion in the army tertiary care than those visiting the civil tertiary care. Relatively, a history of UGIB (35%), acid peptic disease (23%), and cirrhosis of the liver (35%) was high among the armed forces tertiary care patients. Among the patients visiting a tier 3 civil hospital, more than two-thirds were diagnosed with gastritis (66.67%) and carcinoma of the esophagus (17%). Conclusion: The etiology of UGIB varies with different clinical care settings. The risk factors are majorly driven by sociocultural factors, respectively.

Mobile health service demand, key morbidity magnitude, and trend at mountainous outreaches of Uttarakhand: A descriptive study

Background: Deploying mobile health vans (MHVs) to service disadvantaged, underserved mountainous hamlets across six districts of Uttarakhand on a “fixed day-fixed location” strategy was an effective initiative in the state in collaboration with Technology Information Forecasting and Assessment Council (TIFAC) and NRHM. Aims and Objectives: The aim of the study was to provide quality diagnostic and curative care through mobile health clinics at select mountainous outreaches of Uttarakhand state. Materials and Methods: A bimonthly mobile health services with fully equipped MHV sponsored by the directorate of science and TIFAC and assessment council and Government of Uttarakhand on a “fixed day, fixed time and fixed place” schedule were provided along pre-designated service locations. Results: A total of 77,688 beneficiaries received services through 902 camps spanning 13 quarters with an estimated 5976 and 89 beneficiaries per quarter per camp; 573 clients received ultrasound, 639 X-ray, 34 ECG, and 3543 other lab procedures. Quarterly demand for services was highest, 19.5% for gastrointestinal disorders, followed by 18.4% for musculoskeletal disorders, 13.8% for genitourinary system disorders, 11.8% for respiratory system disorders, and 8.5% for ENT and ocular disorders. The prevalent morbidity was predominantly acid peptic disease (15.5%), followed by osteoarthritis (13.3%) and low backache and renal stones (7.2% each). Conclusion: Integrating mobile health service delivery component with existing strategies adopted by public health system in primary health care is an operationally feasible and viable option to address ‘inaccessibility at disadvantaged mountainous outreach.

Comparative Characterization of Marketed Antacid Granules

Before inhibitors of the proton pump and antagonists of the H2 receptor, the mainstay of therapy was antacids for acid-peptic diseases. In this work different tests for characterization of different brands of antacid granules were carried out. This study set out to compare the quality of five antacid brands. Angle of repose, Bulk density, Tapped density, Carr's index, Hausner's ratio, Effervescent duration, Preliminary Antacid Test, Acid Neutralizing Capacity, Reheis Test, and Rosette Rice Test were used to compare the antacid granules. In the examination of several antacid granules available in the market, the values of bulk density, tapped density, angle of repose, carr's index, and hausner's ratio reveal that Brands A, B, and D have good flow property, Brand C has fair property, and Brand E has passable flow property. Brand A has a shorter effervescent time than other brands, while Brand D has a longer one. Because the antacid-acid (HCl) solution's pH for each brand is found to be greater than pH 3.5, all of the brands are considered to be antacids. The acid neutralizing capacity (ANC) test reveals that none of the antacid products meet the US FDA's requirement that they have an acid neutralizing capacity of at least 5 mEq. The Reheis test revealed that Brand B needed more time than other brands to neutralize, but Brand D needed less time. Brand A required less time than other brands to maintain the pH level between 3 and 5, while Brand D required more time, according to the Rosette rice test.

Acid Peptic Disease among Patients with Acute Abdomen Visiting the Department of Emergency Medicine in a Tertiary Care Centre.

Acid peptic disease is caused by excessive acid secretion or weakened mucosal defense. Symptoms include epigastric pain, bloating, and nausea. Factors like gastric acid, Helicobacter pylori infection, alcohol consumption, smoking, and stress contribute to peptic ulcers. Imbalances between offensive and defensive factors can lead to ulcers. Acid-related disorders impact the quality of life and mortality. Accurate diagnosis and prompt treatment are vital. This study aimed to find out the prevalence of acid peptic disease among patients with acute abdomen in the Department of Emergency Medicine in a tertiary care centre. A descriptive cross-sectional study was conducted from 2 April 2022 and 2 April 2023 among the patients presented in the Department of Emergency Medicine in a tertiary care centre. Ethical approval was obtained from the Institutional Review Committee. All patients presenting with acute abdominal pain in the Emergency Department were included in the study. Patients not giving consent were excluded from the study. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Out of the 400 patients with acute abdomen, the prevalence of acid peptic disease was found to be 87 (21.75%) (17.71-25.79, 95% Confidence Interval). The prevalence of acid peptic disease among patients with acute abdomen was found to be lower than in other studies performed in similar settings. acute abdomen; gastroenteritis; Helicobacter pylori; peptic ulcer.

Effectiveness of Omeprazole in Acid Peptic Disease: A Real-World, Patient-Reported Outcome Measures Study.

Objectives This prospective study assessed the effectiveness and patient satisfaction of four-week omeprazole therapy in acid peptic disease (APD). Methods This was an observational, post-marketing, real-world evidence, patient-reported outcome(PRO) measures study. Patients visiting the five study sites across India with symptoms ofAPD, andwho were prescribed oral omeprazole (20/40 mg per day) for at least four weeks were enrolled after obtaining informed consent. Study assessments includedfrequency and severity of symptoms and overall satisfaction reported by the patients using the Patient Assessment of Gastrointestinal Disorder Symptom Severity Index (PAGI-SYM) questionnaire. The satisfaction with therapy was reported by the patients using the Treatment Satisfaction Questionnaire for Medication (TSQM) questionnaire. Both PAGI-SYM and TSQM were reported by patients on days 14 and 28. Omeprazole safety was assessed based on the adverse events reported by the patients. Results A total of 96 (62 males and34 females) patients were included in the study, of which 38.54% had significant findings related to APD at baseline.The proportion of patients with symptoms reduced to 16.67% on day 14and 8.33% on day 28 with omeprazole therapy. The PAGI-SYM total scores at baseline were 41.32 (15.487), which reduced to 20.86 (11.620) on day 14 (p < 0.0001), and to 8.93 (8.361) on day 28 (p < 0.0001). Significant reductions were also seen in individual symptom scores. The TSQM total scores increased to 36.67 (range: 13 to 63) on day 28 from 34.69 (range: 12 to 58) on day 14. Improvement in scores for all domains of TSQM (effectiveness, convenience, and global satisfaction) was seen on day 28. Improvement in reflux symptoms was reported by 46.74% and 68.48% of patients on day 14 and day 28, respectively. Four (4.17%) patients reported adverse events, which were of mild severity and were unrelated to omeprazole. Conclusions Omeprazole provides significant improvement in PAGI-SYM and TSQM questionnaires on day 14 and day 28.Patients reported the omeprazole-based therapy as effective, convenient, and satisfactory. Omeprazole therapy is safe and effective for the treatment of APD and shows good improvement in APD in patients suffering from duodenal ulcers, gastric ulcers, and reflux oesophagitis.

Multimorbidity clusters and associated health care cost among patients attending psychiatric clinics in Odisha, India.

There is a dearth of data on common multimorbidity clusters and the healthcare costs for individuals with mental health disorders. This study aimed to identify clinically meaningful physical-mental multimorbidity clusters, frequently occurring clusters of conditions, and healthcare utilization patterns and expenditure among patients attending a psychiatric outpatient clinic. Data were collected in the psychiatric outpatient department among patients aged 18 years and above in February-July 2019 (n = 500); follow-up data on non-communicable disease incidence were collected after 18 months. For analysis, morbidity clusters were defined using two approaches: 1) agglomerative hierarchical clustering method to identify clusters of diseases; and 2) non-hierarchical cluster k mean analysis to identify clusters of patients. Self-reported healthcare costs in these clusters were also calculated. Two disease clusters were identified: using the 1st approach were; 1) hypertension, diabetes, and mood disorder; 2) Neurotic, stress-related, and somatoform disorders, and acid peptic disease. Three clusters of patients identified using the 2nd approach were identified: 1) those with mood disorders and cardiometabolic, musculoskeletal, and thyroid diseases; 2) those with neurotic, substance use, and organic mental disorders, cancer, and epilepsy; and 3) those with Schizophrenia. Patients in Cluster 1 were taking more than six medicines and had more hospital visits. Within 18 months, 41 participants developed either one or two chronic conditions, most commonly diabetes, hypertension, or thyroid disease. Cardiometabolic diseases are most commonly clustered with mood disorders. There is a need for blood pressure and sugar measurement in psychiatric clinics and mood disorder screening in cardiac, endocrinology, and primary care clinics.

EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING ACID PEPTIC DISEASE AND ITS PREVENTION AMONG THE INDUSTRIAL WORKERS

Aim- To assess the impact of STP on knowledge regarding Acid Peptic Disease and its prevention among inductrial workers. Subject &amp;Method: An quasi-experimental study was conducted on 66 industrial workers by using convienient sampling. A self structured questionnaire was used for data collection over a period of 4 weeks that included questions related to demographic informations and knowledge related to Acid Peptic Disease. Results: The studys findings indicate that the majority of workers (98%) had poor knowledge about acid peptic disease prevention. But after the teaching programmes on Acid Peptic Disease, most of them (88%) had good knowledge. The mean knowledge difference between pretest -post test intervention is 0.18±0.694 (P &lt; 0.05). The Z test value indicated a significant change between the pretest and posttest knowledge levels (p = 0.021).This indicated that the STP was effective in raising industrial workers awareness of the prevention of acid peptic illness. Conclusion : Structured teaching programme on knowledge regarding Acid Peptic Disease and its prevention has resulted in an increment of knowledgeamong industrial workers. Nursing personnel can help the community people to prevent themselves from Acid peptic disease by creating awareness among the community people.

Perforation Peritonitis: Clinical Insights from a Three-Year Experience

Background: Peritonitis caused by gastrointestinal perforation is a frequent surgical emergency globally. Early detection and treatment are vital in reducing complications and death. Surgical intervention and good perioperative care improve outcomes. A clinical trial assessed the outcome of perforation peritonitis at a tertiary healthcare institute to identify factors contributing to morbidity and mortality. Materials and Methods: The study conducted at IMS, BHU, was a Prospective Observational Study for 3 years. Patients of all ages presenting with acute abdominal pain and gas under the diaphragm were enrolled. After examination through different methods, after resuscitation, Laparotomy was performed in all patients, followed by thorough peritoneal lavage. The site, size, type, and number of perforations were documented, and biopsy was taken from the edge of the perforation when necessary. Results: The study showed that duodenal ulcer perforation was the leading cause of gastrointestinal perforation, followed by appendicitis, typhoid perforation, and malignancy. Primary closure was the most common surgical procedure, followed by appendectomy, gut resection, and exteriorization. Mortality rate was , and observed morbidity included wound infection, fever, respiratory complications, residual abscess, electrolyte imbalances, burst abdomen, sepsis, cardiac complications, and anastomotic disruption. Conclusion: Gastrointestinal perforation is a common complication of acid peptic disease and typhoid. To control acid peptic disease, NSAIDs and triple therapy for H. pylori eradication can be used. Early and primary treatment for typhoid should be prioritized on a larger scale, and common practitioners should be educated to increase awareness about the disease.

PREVALANCE OF HELICOBACTER PYLORI INFECTION IN DYSPEPTIC PATIENTS UNDERGOING UPPER GI ENDOSCOPY IN TERTIARY HOSPITAL

Background And Objectives:-Acid peptic disease comprises of a wide spectrum of diseases, which cause considerable morbidity. Helicobacter pylori, a curved rod-shaped bacterium, has been consistently associated with patients suffering from acid peptic diseases, more in ulcer disease than in non-ulcer disease. Due to this high association, it is now believed that helicobacter pylori plays an important role in the aetiopathogenesis of acid peptic disease. Methods:We Have Attempted To Study The Prevalence Of H.Pylori In Patients Undergoing Upper GI Endoscopy In Patients With Dyspepsia At Our Pes Hopital(Pesimsr) ,Kuppam,AndhraPradesh. Results:-Total Of 100 Upper Gastro Intestinal Endoscopies Were Performed And Biopsies Were Taken During The Study Period In Which Males Were More Infected With H.Pylori Infection In The Age Group Of 31-50 Years . Conclusion:-The Burden Of H.Pylori Infection Among Dyspeptic Patients Was High.There Is Limited Access To Endoscopic Services And Widespread Prior Antibiotics as Empirical Treatment.