Cause Of Peptic Ulcer Research Articles

Greenness and practicability assessment of a new HPLC-DAD method for simultaneous determination of three drugs used for a triple-therapy regimen for helicobacter pylori and application to a pharmacokinetic study

Improving the environmental friendliness of laboratory procedures has become very strongly recommended. In this research, several metric tools evaluating the analytical methods, including eco-scale, analytical greenness calculator (AGREE), green analytical procedure index (GAPI), red–green–blue software (RGB) and blue applicability grade index (BAGI) have been used to assess the greenness, performance and practicality of a new useful HPLC-DAD method. The main cause of peptic ulcers and the problems that follow is Helicobacter pylori. Due to the bacteria’s high resistance, different medications are co-administered to overcome the resistance and manage the symptoms. Two antibiotics are mostly used to decrease bacterial resistance in addition to proton pump inhibitors. Pantoprazole, Levofloxacin, and Amoxicillin are co-administered in a triple therapy regimen for suppressing Helicobacter pylori. In this work, the first-time simultaneous estimation of the three medications in rat plasma has been designed and utilized to investigate pharmacokinetics using a new HPLC method with outstanding greenness and practicability. The method involved using a C18 analytical column with an eluent of acetonitrile: 0.03 M Na2HPO4 buffer (20:80, v/v) of 1.5 mL min−1 flow rate. Oxytetracycline was used as an internal standard and the drugs were determined at 230 nm. The validation protocol was adopted according to FDA instructions, and the results proved the ability of the new method to estimate the three medications in rat plasma.

Reassessing the Standard Chemotaxis Framework for Understanding Biased Migration in Helicobacter pylori.

Helicobacter pylori infections are a major cause of peptic ulcers and gastric cancers. The development of robust inflammation in response to these flagellated, motile bacteria is correlated with poor prognosis. Chemotaxis plays a crucial role in H. pylori colonization, enabling the bacteria to swim toward favorable chemical environments. Unlike the model species of bacterial chemotaxis, Escherichia coli, H. pylori cells possess polar flagella. They run forward by rotating their flagella counterclockwise, whereas backward runs are achieved by rotating their flagella clockwise. We delve into the implications of certain features of the canonical model of chemotaxis on our understanding of biased migration in polarly flagellated bacteria such as H. pylori. In particular, we predict how the translational displacement of H. pylori cells during a backward run could give rise to chemotaxis errors within the canonical framework. Also, H. pylori lack key chemotaxis enzymes found in E. coli, without which sensitive detection of ligands with a wide dynamic range seems unlikely. Despite these problems, H. pylori exhibit robust ability to migrate toward urea-rich sources. We emphasize various unresolved questions regarding the biophysical mechanisms of chemotaxis in H. pylori, shedding light on potential directions for future research. Understanding the intricacies of biased migration in H. pylori could offer valuable insights into how pathogens breach various protective barriers in the human host.

High incidence of antibiotic resistance amongst isolates of Helicobacter pylori collected in Nottingham, UK, between 2001 and 2018.

Introduction. Helicobacter pylori is the leading cause of peptic ulcers and gastric cancer. The most common treatment regimens use combinations of two or three antibiotics and a proton pump inhibitor (PPI) to suppress stomach acid. The World Health Organization designated clarithromycin-resistant H. pylori as a high priority pathogen for drug development, due to increasing antibiotic resistance globally.Hypothesis/Gap Statement. There is no routine surveillance of H. pylori primary antimicrobial sensitivities in the UK, and published data are lacking.Aim. This study aimed to characterize antimicrobial sensitivities of isolates collected in Nottingham, UK, between 2001 and 2018.Methodology. Gastric biopsy samples were collected, with informed written consent and ethics approval, from 162 patients attending the Queen's Medical Centre in Nottingham for an upper GI tract endoscopy. Antibiotic sensitivity was assessed using E-Tests and a more cost-effective disc diffusion test.Results. The clarithromycin, amoxicillin and levofloxacin disc diffusion tests provided identical results to E-Tests on a subset of 30 isolates. Disparities were observed in the metronidazole test results, however. In total, 241 isolates from 162 patients were tested using at least one method. Of all isolates, 28 % were resistant to clarithromycin, 62 % to metronidazole and 3 % to amoxicillin, which are used in first-line therapies. For those antibiotics used in second- and third-line therapies, 4 % were resistant to levofloxacin and none of the isolates were resistant to tetracycline. Resistance to more than one antibiotic was found in 27 % of isolates. The frequency of patients with a clarithromycin-resistant strain increased dramatically over time: from 16 % between 2001 and 2005 to 40 % between 2011 and 2018 (P=0.011). For the same time periods, there was also an increase in those with a metronidazole-resistant strain (from 58 to 78 %; P=0.05). The frequencies of clarithromycin and metronidazole resistance were higher in isolates from patients who had previously received eradication therapy, compared to those who had not (40 % versus 77 %, and 80 % versus 92 %, respectively). Of 79 pairs of isolates from the antrum and corpus regions of the same patient's stomach, only six had differences in their antimicrobial susceptibility profiles.Conclusion. Although there was high and increasing resistance to clarithromycin and metronidazole, there was no resistance to tetracycline and the frequencies of amoxicillin and levofloxacin resistance were very low.

Prevalence of Helicobacter pylori infection in adult immune thrombocytopenia patients

Background: Helicobacter pylori is a Gram-negative, microaerophilic bacteria colonizing more than half of the world’s human stomachs. It is the causal agent of active chronic gastritis and the most common cause of peptic ulceration, including gastric and duodenal ulcers. Aims and Objectives: This study aims to the prevalence of H. pylori infection in adult immune thrombocytopenia (ITP) patients. Materials and Methods: An interventional and prospective study was conducted over 6 months with over 50 ITP patients, including those admitted to the general medicine ward and those in regular follow-up in medicine outpatient department. In addition, in all primary ITP patients, a stool antigen test for H. pylori Ag and baseline complete blood count, including platelet count, were done. In addition, all patients’ platelet count was monitored twice weekly for 6 months. Results: Of the 50 patients, 40 are female and 10 are male. The bleeding manifestation was present in 34 patients (68%) and absent in 16 (32%). Among 34 patients, purpura was more frequent (35.3%), followed by gum bleeding 17.6%. Fourteen people tested positive for the H. pylori antigen. Thirty-six patients were found to be H. pylori antigen negative. H. pylori positive frequency was 28%. Patients who receive both steroids and an H. pylori regimen are 9 (18%). Patients who received the H. pylori regimen were only 5 (10%). Patients only receiving steroid doses are 27 (54%). Conclusion: We conclude that 28% of our study patients are infected with H. pylori, and eradicating this organism significantly improves the platelet count. However, a more extended follow-up period is needed to detect the true prevalence of H. pylori infection and the duration of remission.

The evaluation of the MMP-2/TIMP-1 ratio in peptic ulcer and its association with refractory helicobacter pylori infection

BackgroundHelicobacter pylori (H. pylori) is one of the leading causes of peptic ulcers, and its treatment is a worldwide challenge. Matrix metalloproteinases and their inhibitors influence the development and healing of peptic ulcers. This study aimed to evaluate the ratios of matrix metalloproteinase-2 (MMP-2) to tissue inhibitor of metalloproteinase-1 (TIMP-1) in patients with peptic ulcers that are sensitive or resistant to H. pylori treatment and compare them with healthy individuals.MethodsIn this study, 95 patients were included and divided into two groups sensitive (41 patients) and resistant to treatment (54 patients). The results were compared with a control group of 20 participants with normal endoscopy and H. pylori-negative. After obtaining written informed consent, five ml of venous blood was taken to determine their serum MMP-2 and TIMP-1 levels using an enzyme-linked immunosorbent assay.ResultsIn patients with H. pylori-induced peptic ulcers, the MMP-2/TIMP-1 ratio was significantly higher than the healthy controls (P < 0.05). MMP-2 level was associated with patients’ response to treatment (P < 0.05). The MMP-2/TIMP-1 ratio was higher in patients with simultaneous gastric and duodenal ulcers (P < 0.05).ConclusionIt seems that peptic ulcer disease caused by infection with H. pylori increases the MMP-2/TIMP-1 ratio in patients with peptic ulcers. However, it might not be a good predictor of refractory H. pylori-induced peptic ulcer disease.

Peptic ulcer of gastrojejunal anastomosis: an undeservedly neglected problem

Aim. To evaluate the incidence and causes of peptic ulcers of the gastrojejunal anastomosis to develop the corresponding preventive measures.Materials and Methods. We retrospectively analysed the case histories of the patients with peptic ulcer who have been admitted to our surgical unit during 1981-1996 and 2007-2021. A total of 62 patients with peptic ulcers of the anastomosis who underwent Billroth II resection were examined radiographically, endoscopically, and intraoperatively, including proteolysis and acidity measurements.Results. While the number of gastric operations has been reduced by 86%, the number of treated peptic anastomotic ulcers decreased by only 20%. The main cause of peptic ulcers was the high acidity and proteolytic activity of the gastric stump. In 22 out of 28 fully examined patients, duodenal ulcer was treated by hemiresection. The incidence of peptic ulcers of gastrojejunal anastomosis in Kemerovo in 2021 was 0.9 per 100,000 population, with 3.7 Billroth II surgeries per 100,000 population. A resection without vagotomy and insufficient acid reduction are the main causes of peptic ulcers of the gastrointestinal anastomosis, especially duodenal ulcers.Conclusion. A significant decrease in the number of distal resections of the stomach according to Billroth II over the past 25 years is not accompanied by a similar decline in the number of hospitalized patients with peptic ulcers of the gastrojejunal anastomosis.

Vitamin E ameliorates oxidative stress in the stomach of l-arginine induced acute pancreatitis rat model

Gut dysfunction is a major outcome during acute pancreatitis (AP). Some studies have reported a positive association between acute pancreatitis and peptic ulcer. The major cause of peptic ulcer is due to ischaemia reperfusion leading to oxidative stress. This study assessed the oxidative status of the stomach during AP and the role of vitamin (Vit.) E administration. Twenty male Wistar rats were divided randomly into 4 groups; Control, Vit. E (500 mg/kg) only, AP and Vit. E + AP. Acute pancreatitis was induced by administering four doses of l-arginine (100 mg/100 g) intraperitoneally at 1-hour interval. The rats were sacrificed 72 hours later and stomach obtained for mucin content and biochemical assays (MDA, MPO, NO, CAT, GST, and GSH). Mucin content was depleted following AP induction while, vit. E significantly increase mucin content. AP resulted in significant reduction of antioxidant enzymes (GSH and GST) and increase in oxidative stress markers (MDA, MPO and NO). Vitamin E reverse these changes. In conclusion, the oxidative status of the stomach was greatly altered following AP induction with an increase in oxidative stress markers and decrease in antioxidants. Vitamin E was able to protect the stomach from the damaging effect of acute pancreatitis.

Analysis of Images of Neutrophil Lymphocyte Ratio and Bacteria Density Level of Helicobacter Pylori in Tissue in Gastritis Patients

Gastritis is an inflammatory disease that can last for a long time. Helicobacter pylori infection is known as the main cause of peptic ulcer and the most common cause of gastritis. Helicobacter Pylori infection will cause mononuclear (MN) and polymorphonuclear (PMN) cell infiltration and will increase the production of proinflammatory cytokines in the gastric mucosa compared to non-Helicobacter Pylori gastritis. Helicobacter Pylori with histopathological examination diagnosis. This type of research is descriptive observational with purposive sampling data collection technique at the Anatomical Pathology Laboratory Installation, RSPAL dr. Ramelan Surabaya. The data used are the results of a biopsy of 60 samples that were determined as gastritis with histopathological examination of the identification of Helicobacter Pylori bacteria in gastric tissue classified by the level of bacterial density using The Updated Sydney System, as well as haemogram data for complete blood examination to further calculate the neutrophil lymphocyte ratio (NLR). The data were processed using descriptive statistical tests to determine the average neutrophil lymphocyte ratio (NLR). Based on the statistics of the r-Spearman test, the density of Helicobacter Pylori, (Pν = 0.000) below &lt; 0.005 indicates that there is a strong relationship between the neutrophil lymphocyte ratio (NLR) and the density of Helicobacter Pylori bacteria.

Evaluation of the Antibiotic Resistance Rate of Helicobacter pylori in Peptic Ulcer Patients in Tien Giang Central General Hospital, Tien Giang Province, Vietnam

BACKGROUND: Peptic ulcer (PU), trauma on the lining of the stomach and/or small intestine, is among the top five reasons for hospitalization in Tien Giang, a province in the South of Vietnam. Since Helicobacter pylori (HP) is one of the main causes of PU, its features, especially the antibiotic-resistant status, have critical significance in PU treatment. AIM: This study evaluates the HP infection prevalence, HP antibiotic resistance rate, and its associations with the patients’ sociodemographic characteristics. MATERIALS AND METHODS: A cross-sectional study was conducted on PU patients in Tien Giang province, Vietnam, from June 2020 to June 2021. The volunteers were tested for HP infection and antibiotic resistance using three methods, where appropriate, including Gram staining, CLO (urease) test, and bacterial culture method. RESULTS: Among 368 samples, 31.5% had infected with antibiotic-resistant HP. The resistance rates to five antibiotics commonly used in HP treatment, including metronidazole, clarithromycin, tetracycline, levofloxacin, and amoxicillin, were 96.6%, 94.8%, 70.7%, 61.2%, and 53.4%, respectively. The rates of tetracycline and clarithromycin resistance were related to alcohol consumption (t-test, p &lt; 0.05). The HP treatment history was significantly associated with the levofloxacin resistance (t-test, p &lt; 0.05). CONCLUSIONS: The emergence of antibiotic-resistant HP is a major public health concern in Tien Giang, Vietnam. This issue should be tackled at the national level to avoid the further spread of these multi-drug resistant HP strains.

Sex-Specific Risk Factors Associated with Helicobacter pylori Infection Among Individuals Undergoing Health Examinations in China.

PurposeHelicobacter pylori is one of the most common causes of peptic ulcers, gastritis, and gastric cancers. This study investigated sex-specific differences in the prevalence of H. pylori infection and its associated factors among individuals undergoing hospital-based health examinations in southern China.MethodsThis study enrolled consecutive healthy individuals who underwent regular health examinations at a hospital physical examination center between September 2020 and September 2021. Anthropometric characteristics and biochemical profiles were measured. All individuals underwent carbon-13 urea breath tests. Univariate and multivariate analyses were used to evaluate the factors associated with H. pylori infection.ResultsA total of 5035 individuals (men, 59.1%; women, 40.9%) were included in the analyses. The total rate of H. pylori infection was 35.0% (men, 35.5%; women, 34.3%). In the multivariate analysis, the risk factors identified for H. pylori infections were high fasting blood glucose levels and blood pressure ≥160 mmHg in men and older age, high body mass index, and low albumin levels in women.ConclusionThese findings suggest that physicians must be aware of the metabolic factors associated with H. pylori infections in the Chinese population. Early detection of these factors and timely intervention are expected to reduce H. pylori infections and provide a theoretical basis for the primary prevention of several gastrointestinal diseases.

A Culture-Based Strategy Is More Cost Effective Than an Empiric Therapy Strategy in Managing Pediatric Helicobacter pylori Infection.

BackgroundHelicobacter pylori infection is a major cause of peptic ulcers and gastric cancer. This study aimed to compare the eradication rate and essential costs of culture-based and empiric therapy strategies in treating pediatric H. pylori infection.MethodsWe retrospectively enrolled patients aged <18 years with a diagnosis of H. pylori infection who received esophagogastroduodenoscopy at two medical centers in southern Taiwan from 1998 to 2018. Patients with positive cultures and minimum inhibitory concentration test results were allocated to a culture-based strategy, and those with negative cultures or without culture as an empiric therapy strategy. We collected demographic data and eradication rates, and calculated the total essential costs of treating a hypothetical cohort of 1,000 pediatric patients based on the two strategies.ResultsNinety-six patients were enrolled, of whom 55 received a culture-based strategy and 41 received an empiric therapy strategy. The eradication rates with the first treatment were 89.1 and 75.6% in the culture-based and empiric therapy strategy, respectively. There were no significant differences in age, sex, and endoscopic diagnosis between the two strategies. For every 10% increase in those receiving a culture-based strategy, the total cost would have been reduced by US$466 in a hypothetical cohort of 1,000 patients. For every 10% increase in successful eradication rate, the total cost was reduced by US$24,058 with a culture-based strategy and by US$20,241 with an empiric therapy strategy.ConclusionsA culture-based strategy was more cost effective than an empiric therapy strategy in treating pediatric H. pylori-infected patients.

Atrophic gastritis in Helicobacter pylori-infected children.

Helicobacter pylori infection is the leading cause of peptic ulcer and chronic gastritis and may initiate gastric carcinogenesis following the Correa cascade. Another lineage of metaplasia, spasmolytic peptide-expressing metaplasia (SPEM) has recently been found to be an alternative precursor to gastric cancer. To date, few reports have investigated gastric precancerous lesions among children with H.pylori infection. This study aimed to evaluate the histopathological pattern of H.pylori atrophic gastritis in children and the extent of precancerous lesions. This study enrolled pediatric patients with H.pylori infection from 1998 to 2019. During esophagogastroduodenoscopy examinations, biopsy fragments were collected from the gastric antrum and corpus for rapid urease test, culture, and histology evaluation. The presence and degree of chronic inflammation, activity of gastritis, H.pylori density, atrophy, and intestinal metaplasia (IM) were assessed according to the modified Updated Sydney System. Trefoil factor 2 (TFF2) immunohistochemistry was also performed to assess SPEM in the gastric tissues collected from each case using rabbit anti-human TFF2 antibodies. A total of 92 children with H.pylori infection and adequate gastric mucosa biopsies were enrolled. Esophagogastroduodenoscopy showed that 39 (42.4%) had duodenal ulcers, 11 (12.0%) had gastric ulcers, 41 (44.6%) had gastritis, and 1 (1.1%) had negative findings. Mild-to-moderate IM was identified in 4 patients (4.3%). SPEM was found in 8 patients (8.7%) with a significantly higher incidence among female patients (15.8% vs. 8.7%, p=.031). Gastric glandular atrophy presented in 28 patients (30.4%), and high-grade atrophy was more common in female patients (3.2% vs. 1.9%, p=.031). The prevalence rates of atrophic gastritis in the children with H.pylori infection were 30.4% for gastric glandular atrophy, 4.3% for IM and 8.7% for SPEM. SPEM and high-grade atrophy were more common in female patients.

Atomic level and structural understanding of natural ligands inhibiting Helicobacter pylori peptide deformylase through ligand and receptor based screening, SIFT, molecular dynamics and DFT – a structural computational approach

Helicobacter pylori is a Gram-negative microaerophilic gastric pathogen, responsible for the cause of peptic ulcer around half of the global population. Although several antibiotics and combination therapies have been employed for H. pylori-related gastric ulcer and cancer regiments, identifying potent inhibitors for specific targets of this bacterium will help assessing better treatment periodicity and methods to eradicate H. pylori. Herein, 1,000,000 natural compounds were virtually screened against Helicobacter pylori Peptide deformylase (HpPDF). Pharmacophore hypotheses were created using ligand and receptor-based pharmacophore modeling of GLIDE. Stringent HTVS and IFD docking protocol of GLIDE predicted leads with stable intermolecular bonds and scores. Molecular dynamics simulation of HpPDF was carried out for 100 ns using GROMACS. Hits ZINC00225109 and ZINC44896875 came up with a glide score of −9.967 kcal/mol and −12.114 kcal/mol whereas; reference compound actinonin produced a glide score of −9.730 kcal/mol. Binding energy values of these hits revealed the involvement of significant Van der Waals and Coulomb forces and the deduction of lipophilic forces that portray the deep hydrophobic residues in the S1pocket of H. pylori. The DFT analysis established the electron density-based features of the molecules and observed that the results correlate with intermolecular docking interactions. Analysis of the MD trajectories revealed the crucial residues involved in HpPDF – ligand binding and the conformational changes in the receptor. We have identified and deciphered the crucial features necessary for the potent ligand binding at catalytic site of HpPDF. The resulting ZINC natural compound hits from the study could be further employed for potent drug development. Communicated by Ramaswamy H. Sarma

Rational Drug Therapy of Peptic Ulcer Disease In Patients Admitted To Gastroenterology Ward of LRH Peshawar, Khyber Pakhtunkhwa, Pakistan

The present study was conducted from 12 Sep.2019 to 10 Nov. 2019 at the Gastroenterology ward, Lady Reading Hospital Peshawar Pakistan, aiming to accurately investigate the Peptic Ulcer Disease state, signs and symptoms, to ensure complete information about drug therapy and patients response. Peptic ulcer disease is defined as an upper gastric mucosal rupture due to acid hat results in the formation of ulcers that extend beyond the muscular mucosa to the submucosa. Peptic ulcer is characterized by abdominal pain, change in appetite, unexplained weight loss, nausea, vomiting, heart burn and dark, tarry stools. Spicy and acidic foods, Stress and restless lifestyle were considered to be the leading causes of peptic ulcer. However the Helicobacter pyloribacterium is responsible for up to 60% stomach ulcers. Frequent use of painkillers, old age, obesity Smoking, excessive alcohol use, too little sleep, type O blood and chronic stress, are the risk factors of peptic ulcers. Acute peptic ulcers results from taking aspirin or anti-inflammatory drugs. Chronic peptic ulcer represents a profound loss of substance. Data from a total of10 patients (6 female and 4 male)of all age, having various peptic ulcer diseases were involved in this study. It was concluded that most of the female patients (60%) were having peptic ulcers as compared to male patient (40%). It was found that 30-40 years old peptic ulcer patient percentage was 20%.Moreover it was observed that frequent use of Nonsteroidal Anti-inflammatory Drugs has been found to be the main causes of peptic ulcers

Emblica officinalis Fruit Pulp Extract Protects against Naproxen-Induced Gastric Ulcer in Rats: Anti-inflammatory and Antioxidant Machinery

Background: The use of non-steroidal anti-inflammatory drugs (NSAIDs) is one of the leading causes of peptic ulcers. There is a rising interest and demand for nontoxic, antiulcer remedies derived from medicinal plants to treat NSAID-induced gastric ulcers (GU). Aim: This study is a comparative assessment of the possible gastro-protective role of Emblica officinalis fruit pulp extract (EOFPE) and Omeprazole (Omepra) against Naproxin (Naprox)-induced GU. Methodology: Five groups of rats (8 rats each) represent control, Naprox, Omepra (20 mg/kg), EOFPE (700 mg/kg), and EOFPE + Omepra. Omepra and EOFPE were ingested orally for 17 days. Naprox was ingested orally on day 15 for three consecutive days. Results: Pretreatment with EOFPE and/or Omepra caused significant increases in gastric pH and gastric mucin content. Besides, significant decline in the total gastric acidity and gastric mucosal lesion relative to the Naprox group. Pretreatment with EOFPE and/or Omepra markedly improved the examined gastric pathologic features in Naprox-pretreated groups. Besides, EOFPE and/or Omepra overcome the gastric inflammation and oxidative stress markers induced by Naprox ingestion. Pretreatment with both EOFPE + Omepra leads to the best antiulcer impact and lesion inhibition percent relative to the Naprox groups pretreated with either EOFPE or Omepra alone. Conclusion: EOFPE protected against Naprox-induced GU across anti-inflammatory and antioxidant mechanisms. Keywords: Antioxidant, Anti-inflammatory, Emblica officinalis, Gastric ulcer.

RATIONAL DRUG THERAPY OF PEPTIC ULCER DISEASE IN PATIENTS ADMITTED TO GASTROENTEROLOGY WARD OF LRH PESHAWAR KHYBER PAKHTUNKHWA, PAKISTAN

The present study was conducted from 12 Sep.2019 to 10 Nov. 2019 at the Gastroenterology ward, Lady Reading Hospital Peshawar Pakistan, aiming to accurately investigate the Peptic Ulcer Disease state, signs and symptoms, to ensure complete information about drug therapy and patients response. Peptic ulcer disease is defined as an upper gastric mucosal rupture due to acid hat results in the formation of ulcers that extend beyond the muscular mucosa to the submucosa. Peptic ulcer is characterized by abdominal pain, change in appetite, unexplained weight loss, nausea, vomiting, heart burn and dark, tarry stools. Spicy and acidic foods, Stress and restless lifestyle were considered to be the leading causes of peptic ulcer. However the Helicobacter pyloribacterium is responsible for up to 60% stomach ulcers. Frequent use of painkillers, old age, obesity Smoking, excessive alcohol use, too little sleep, type O blood and chronic stress, are the risk factors of peptic ulcers. Acute peptic ulcers results from taking aspirin or anti-inflammatory drugs. Chronic peptic ulcer represents a profound loss of substance. Data from a total of10 patients (6 female and 4 male)of all age, having various peptic ulcer diseases were involved in this study. It was concluded that most of the female patients (60%) were having peptic ulcers as compared to male patient (40%). It was found that 30-40 years old peptic ulcer patient percentage was 20%.Moreover it was observed that frequent use of Nonsteroidal Anti-inflammatory Drugs has been found to be the main causes of peptic ulcers

HELICOBACTER PYLORI WORSENING FACTOR OF THE PATIENT'S CONDITION IN PATIENTS WITH LIVER ENCEPHALOPATHY

Hepatic encephalopathy is one of the neuropsychiatric reversible syndromes that manifests itself as impairment of brain function. H. pylori plays a vital role in providing a factor in the pathogenesis of peptic ulcer disease, and there is currently debate about its role in hepatic encephalopathy. Statistics from previous studies have shown that in the gastric secretions and at the same time in the blood serum, some association was found associated with high ammonia content. H. pylori is a gramnegative bacterium that mainly live and infect the acid-resistant mucous membrane of the human stomach. environment, and are the main cause of peptic ulcer and gastritis. They are rich in the enzyme urease, which increases the production of ammonia from the lumen of the stomach, passes into the systemic circulation and enters the brain, which is the main cause of hepatic encephalopathy. High blood ammonia levels are also found in patients with hepatic encephalopathy, which may play a role in its pathogenesis

High-dose dual therapy versus bismuth-containing quadruple therapy for the treatment of Helicobacter pylori infection - A review of the strengths, weaknesses, and proposed solutions.

ABSTRACTHelicobacter pylori is the principal cause of peptic ulcers, gastric cancer, and mucosa-associated lymphoid tissue lymphoma. The first treatment to H. pylori infection is dual therapy (a bismuth compound plus metronidazole). On the launch of omeprazole in 1988, dual therapy became omeprazole and amoxicillin (low dose). The poor H. pylori eradication rates by either bismuth-based or low-dose dual therapy drove more combinations of antibiotics were needed. Antibiotic resistance, especially clarithromycin and metronidazole, has made bismuth-containing quadruple therapy (BCQT) a savior for first-line and second-line treatments. However, its complicated dosing regimen commonly causes more adverse events and poor drug compliance. Thus, high-dose dual therapy (HDDT) has been re-arising. This article reviews the strengths and weaknesses of HDDT versus BCQT with proposed solutions.

Study on the Interaction of Algal Peptides on Virulence Factors of Helicobacter pylori: In Silico Approach.

In the Asian region, Helicobacter pylori infects about 80% populations, which is most leading cause of peptic ulcers, and it is an asymptomatic infection. Studies reported that the particular bacteria carry specific virulence factors that leads to severe complications. These virulence factors can be used as a drug targets to inhibit their growth and pathogenicity. Chronic infection with H. pylori virulence factors are CagA, VacA and HtrA positive strains the risk factor of gastric cancer. In this study, we aimed to study the antagonistic interaction pattern between the potential eight algal peptides against the virulence factors of H. pylori through in silico analysis intended to treat peptic ulcer and prevent the further complications such as cancer. The proteins of virulent factors are docked using C-Docker algorithm and calculated the bind energy of the complexes. The results showed that the peptide derived from a green alga, Tetradesmus sp. are active against the three virulent factors such as cag-A, vac-A, and Htr-A with multiple hydrogen, vdW, electrostatic interactions, and mild π-hydrophobic bindings with the libdock energy score for CagA, VacA and HtrA are 175.625, 158.603 and 89.397 kcal/mol. These primes and the peptide lead to develop a better and potential inhibitors against H. pylori infection.

Prevalence of Idiopathic Peptic Ulcer in Southeastern Iran

Background: The idiopathic peptic ulcers (IPU), or non-Helicobacter pylori nonsteroidal anti-inflammatory drugs (NSAIDs)-associated peptic ulcers, are a serious therapeutic challenge. The prevalence of IPU is increasing in some parts of the world. Objectives: This study aimed to determine the prevalence of IPU in southeastern Iran. Methods: In this cross-sectional study, a total of 367 patients with active peptic ulcer were diagnosed by endoscopy between Jan 2018 and Feb 2019. The patients were assessed for history of medication use (including NSAIDs) in the past month, smoking, alcohol, as well as a complete history of health problems related to underlying disease such as cardiopulmonary, hepatic, renal problems, and chronic pancreatitis. Biopsy samples from antrum were performed for rapid urease test (RUT), and if RUT was negative, then biopsies were sent for histopathology. If both RUT and pathologic findings were negative for H. pylori, in patients who had treatment for H. pylori eradication, anti-H. pylori IgG antibody of blood samples was assessed. Patients were considered infected with H. pylori if any of the diagnostic tests had a positive result. Results: According to the results, 336 (91.3%) cases had at least one of the two main etiologic factors (H. pylori and NSAIDs) for peptic ulcer. While 323 (87.7%) patients were H. pylori-positive, 45 (12.3%) patients were H. pylori-negative. However, out of 45 H. pylori-negative cases, 13 patients had a positive history of using NSAIDs, and 32 (8.69%) patients were IPU. Conclusions: Our study showed that both H. pylori infection and NSAIDs use remain the main cause of peptic ulcers, and the prevalence of IPU is relatively high in Zahedan.