Peptic Ulcer Research Articles

Opportunities for Helicobacter pylori Eradication beyond Conventional Antibiotics.

Helicobacter pylori (H. pylori) is a bacterium known to be associated with a significant risk of gastric cancer in addition to chronic gastritis, peptic ulcer, and MALT lymphoma. Although only a small percentage of patients infected with H. pylori develop gastric cancer, Gastric cancer causes more than 750,000 deaths worldwide, with 90% of cases being caused by H. pylori. The eradication of this bacterium rests on multiple drug regimens as guided by various consensus. However, the efficacy of empirical therapy is decreasing due to antimicrobial resistance. In addition, biofilm formation complicates eradication. As the search for new antibiotics lags behind the bacterium's ability to mutate, studies have been directed toward finding new anti-H. pylori agents while also optimizing current drug functions. Targeting biofilm, repurposing outer membrane vesicles that were initially a virulence factor of the bacteria, phage therapy, probiotics, and the construction of nanoparticles might be able to complement or even be alternatives for H. pylori treatment. This review aims to present reports on various compounds, either new or combined with current antibiotics, and their pathways to counteract H. pylori resistance.

Evaluation of Anti-Ulcerogenic Effects of the Crude Extract and Fractions of Dialium guineense Tree Bark in Ethanol-Induced Peptic Ulcer in Albino Rats

Evaluation of Anti-Ulcerogenic Effects of the Crude Extract and Fractions of Dialium guineense Tree Bark in Ethanol-Induced Peptic Ulcer in Albino Rats

Changes in the lipid balance in the gastric mucosa in rats under acute stress

BACKGROUND: Stress gastric ulcers are a type of peptic ulcer that develops in response to severe physiological or psychological stress. The causes of stress ulcers in the gaster have not yet been fully studied. AIM: To evaluate the composition of lipids in the gastric mucosa in rats under acute stress. MATERIALS AND METHODS: All rats included in the study (n=30) were divided into two groups. Group 1 (main group, n=20) included animals that had a model of stress gastric ulcer created by stimulation with electrical impulses for 12 hours. Group 2 (control group, n=10) included animals that had not been manipulated. At the end of the experiment, the effective and total concentration in blood serum of all animals was determined, followed by the calculation of the albumin binding reserve, and the plasma toxicity index. We also visually assessed the degree of damage to the gastric mucosa and determined the composition of lipids. RESULTS: Our study showed that a stressful situation led to the development of endogenous intoxication of group 1 animals. A decrease in the level of phosphatidylcholine by 16.3% and phosphatidylserine by 18.6% in stressed rats demonstrates the destruction of the cell membrane against the background of apoptosis, which macroscopically manifests itself in the form of spot hemorrhages, erosions and ulcers in the gastric mucosa. An increase in monoacylglycerol by 34.4% and diacylglycerol by 53.4% in group 1 animals indicates an increase in membrane permeability and induction of regenerative processes. CONCLUSIONS: In a stressful situation, against the background of a decrease in the total and effective concentration of albumin, endogenous intoxication develops, which contributes to a violation of the lipid balance and damage to cell membranes and the development of acute damage to the gastric mucosa.

Mild to Moderate Normalization of Lipid Profile, Blood Pressure and Body Weight of Obese and Hyperlipidemic Patients by Herbs and Allopathic Agents

The research study was planned to observe effects of Nicotinic acid (niacin) and psyllium husk on blood pressure, body weight, LDL-cholesterol and HDL-cholesterol. It was single blind placebo controlled research study, which was conducted at Lahore Journal Hospital, from April 2023 to December 2023. Forty male and female hyperlipidemic patients were included in the research study, among which 20 patients were on placebo as control group, and 20 were on tablet Niacin, 2.25 grams daily, in divided doses for the period of three months. Patients with diabetes mellitus, peptic ulcer, renal disease, hepatic disease, hypothyroidism and alcoholism were excluded from the study. Body weight and blood pressure of patients were recorded at fortnightly visit. LDL-Cholesterol was calculated by Friedwald formula (LDL= TC- (TG/5 + HDL-C). Serum HDL-cholesterol was determined by direct method. Serum cholesterol and triglycerides were estimated by the enzymatic calorimetric method. Data regarding results were expressed as the mean ± SD and “t” test was applied to determine statistical significance of results. A probability value of <0.05 was the limit of significance. Three patients were dropped from the study due to side effects of Niacin. In three months of treatment with 2.25 grams of niacin HDL-cholesterol increased from 36.41±1.96 to 43.70±1.81 mg/dl, which was highly significant change when analyzed statistically. Niacin has decreased LDL-Cholesterol from 182.58±8.74 mg/dl to 119.29±4.08 mg/dl, which was highly significant (P<0.001), when compared statistically by paired “t” test. Overall percentage (%) changes from day-0 to day-90 were 34.66. Triglycerides reduced from 169.64±7.60 to 137.35±6.31 mg/dl, which was highly significant (P value <0.001) reduction in three months. Niacin has also reduced Blood Pressure. Difference between mean values of systolic and diastolic blood pressure at day-0 and day-90 were found highly significant (P<0.001). Body weight was reduced from 66.29±194 kg to 64.79±1.82 kg in three months. This change was significant (P<0.01). We concluded from the research study that niacin decreases blood pressure, body weight and LDL-Cholesterol and increases HDL-cholesterol in primary hyperlipidemic patients. KEY WORDS: Blood pressure, diabetes, body weight, hyperlipidemia, herbs, allopathy.

Effect of psychological nursing intervention on anxiety level and quality of life in patients with gastrointestinal peptic ulcer.

Peptic ulcer is a common gastrointestinal disease, and psychological intervention has an important influence on its occurrence and development. To investigate the effect of psychological nursing intervention on the anxiety level and quality of life of patients with gastrointestinal peptic ulcers. Two groups of patients with peptic ulcer were selected from January to December 2012, with 60 cases in each group, and psychological nursing intervention and routine treatment were respectively performed. Psychological nursing interventions include cognitive behavioral therapy, psychological support and relaxation training. Self-rating anxiety scale (SAS) and quality of life questionnaire were used to evaluate the anxiety level and quality of life of patients before, during and after treatment. The SAS scores of the experimental group significantly decreased over the course of treatment, from 52.3 before treatment to 30.5 after treatment, while SAS scores of the control group did not change significantly. Meanwhile, the experimental group's quality of life score (SF-36) significantly improved over the course of treatment, from 65.2 to 85.2, while the control group remained stable. Further analysis showed that sex and age had no significant influence on the effect of psychotherapy. Both men and women, young and old, showed similar trends in anxiety relief and improved quality of life after treatment. Psychological nursing-based intervention program has a positive effect on the anxiety level and quality of life of patients with gastrointestinal peptic ulcer.

Dysbiosis of gut microbiota is associated with pathogenesis of peptic ulcer diseases through inflammatory proteins: A Mendelian randomization study.

The gut microbiota and inflammatory proteins may affect the development of peptic ulcer disease. However, this association remains unclear. We analyzed genome-wide association study data of gut microbiota, inflammatory proteins, and peptic ulcer disease using Mendelian randomization with instrumental variables to assess causal relationships. Various statistical methods, including inverse variance weighting, Mendelian randomization Egger regression, and sensitivity analysis were employed to evaluate the data and calculate mediation ratios. Our findings reveal that the genus Butyriciccus plays a role in mitigating the adverse effects of gastric ulcers by 7.9%, primarily through reducing beta-negative growth factor levels. Additionally, the genus Lachnospiraceae UCG004 can significantly alleviate the negative outcomes of gastric ulcers and reduces hepatocyte growth factor and beta-reserve growth factor levels by 6.39% and 7.45%, respectively. This study highlights the independent and mediating effects of the gut microbiota and inflammatory proteins on peptic ulcers, offering insights on potential pathways and targets for future preventive interventions.

PCR-based RFLP and ERIC-PCR patterns of Helicobacter pylori strains linked to multidrug resistance in Egypt.

H. pylori infects approximately 50% of the world's population that causes chronic gastritis, and may lead to peptic ulcer disease (PUD). H. pylori-induced chronic infections are associated with gastric adenocarcinoma and low-grade gastric lymphoma. In Egypt, H. pylori strains are widespread and became resistant to antimicrobial agents, thus advanced typing methods are needed to differentiate infectious strains that are resistant to antibiotics, and therefore earlier prognosis and infection control. The main objectives were (i) to determine susceptibility of infectious H. pylori strains to some antimicrobial agents that are currently used in eradication therapy in Egypt; (ii) to identify diverse strains commonly detected in the gastrointestinal (GIT) endoscopy units in Egypt through phenotypic and genotypic analyses. In this observational study we isolated 167 isolates from 232 gastric biopsies (antrum and corpus) of patients who were admitted to the upper GIT endoscopy units in five governmental Egyptian hospitals. Antimicrobial susceptibility patterns were investigated using Kirby Bauer disc diffusion and agar dilution Minimum Inhibitory Concentrations (MICs) methods. Phenotypic characterization was based on biotyping and antibiogram typing techniques. Genotypic characterization was carried out using PCR-based Restriction Fragment Length Polymorphism (RFLP) and Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR analyses. H. pylori isolates were highly resistant to diverse antimicrobial agents including Metronidazole, Fluoroquinolones, Macrolides, Amoxycillin, Tetracycline and Gentamicin. Two factors contributed to the increased resistance of H. pylori to the conventional therapy seen in Egypt: (i) Metronidazole and Amoxycillin are inexpensive and available drugs being abused by patients; (ii) the regional prescribing practice of Macrolids commonly used to treat upper respiratory and urinary tract infections. Five different biotypes were identified depending on the ability of the isolates to synthesize different enzymes. Nine antibiogram types were identified. PCR-RFLP analysis revealed fifteen different fingerprints while ERIC-PCR revealed 22 fingerprints. Biotyping alone or in combination with antibiogram typing are highly useful molecular tools in the prognosis of strain relatedness. PCR-RFLP and ERIC-PCR acquired good discriminatory power for identifying H. pylori infectious sub-types.

Risk factors associated with Helicobacter pylori infection among patients attending private clinics in Borama district, Somaliland

ABSTRACT Risk factors associated with Helicobacter pylori infection among patients attending private clinics in Borama district, Somaliland, are studied. We specifically investigated the association among the use of non-steroidal anti-inflammatory drugs, the users’ socioeconomic status, and the household hygiene practice of people with H. pylori infection attending the Borama private clinic. Helicobacter pylorus (H. pylori) is a Gram-negative spiral-shaped bacterium that infects gastric-type epithelium, and it is probably the most common bacterial agent in humans after Streptococcus mutans, which causes dental caries. H. pylori infection is now recognized as a worldwide problem and it is the most common cause of chronic gastritis and is strongly linked to peptic ulcer disease and gastric cancer. The prevalence of H. pylori infection is high in less-developed Asian countries like India, Bangladesh, Pakistan, and Thailand, and is acquired at an earlier age than in the more developed Asian countries like Japan and China. H. pylori infection is a global public health problem, affecting over 50% of the population worldwide.

Unravelling Peptic Ulcers: Comprehensive Insights into Etiology, Diagnosis, Screening Techniques, and Treatment.

The risk of illnesses is increasing in the modern era due to unhealthy and modern lifestyles. Research has shown that the most frequent acid-induced abrasion, which often occurs in the stomach and proximal duodenum, is gastric and Peptic Ulcer Disease (PUD), which is a primary worldwide health concern. The deformity is characterized by denuded mucosa and spreads into the submucosa. Non-steroidal antiinflammatory drugs (NSAIDs) and H. pylori infections are two common offenders. In the past, it has been thought that dietary variables, stress, and an acidic hypersecretory state encourage mucosal disruption in peptic acid disease patients. Peptic ulcers continue to be a significant health issue because of their potential for substantial consequences, including bleeding, blockage, and perforation, even with advancements in detection and treatment. This review discusses current screening methods for peptic ulcers and the challenges in diagnosis and treatment, emphasizing the need for precise diagnosis and more effective therapies.

Real-Time Gastric Juice Analysis in Cirrhotic Patients: Can We Avoid Unrewarding Gastric Biopsies?

Background: To search for H. pylori infection and gastric precancerous lesions in cirrhotic patients is worthwhile when considering the high incidence of peptic ulcers and gastric cancer in these patients. We tested if gastric juice analysis allows to avoid unrewarding gastric biopsies. Methods: This prospective study enrolled consecutive patients with liver cirrhosis who underwent upper endoscopy with standard gastric biopsies. Real-time gastric juice analysis was performed with a specific device (EndoFaster®) that test ammonium concentration for H. pylori diagnosis, and pH values to suspect extensive atrophy/metaplasia involving gastric body mucosa. Sensitivity, specificity, positive predictive value, negative predictive value (NPV), the overall accuracy, and the likelihood ratio were calculated for both H. pylori infection and extensive precancerous lesions on gastric mucosa. Results: A total of 78 cirrhotic patients (males: 55; mean age: 66 ± 12 years) were enrolled. When considering as positive EndoFaster® results when at least one of two (ammonium and pH levels) tests were positive, the NPVs were as high as 89% and 86%, respectively, to rule out H. pylori and extensive precancerous lesions on gastric mucosa, with an overall accuracy of 83% and 74%. Conclusions: This study supports the evidence that real-time gastric juice analysis allows to avoid clinically unrewarding and potentially unsafe gastric biopsies in a definite portion of cirrhotic patients, but more data are needed.

DIAGNOSTIC ACCURACY OF BOEY SCORE TO PREDICT 30 DAYS MORTALITY IN PERFORATED PEPTIC ULCER PATIENTS

Perforated peptic ulcers remain a life-threatening condition despite advancements in surgical and medical treatments. Accurate risk stratification of patients can improve outcomes by guiding clinical decision-making. The Boey scoring system is widely used for predicting mortality in patients with perforated peptic ulcers, yet its diagnostic accuracy warrants further evaluation. Objective: This study aimed to evaluate the diagnostic accuracy of the Boey score in predicting 30-day mortality among patients with perforated peptic ulcers. Methods: This cross-sectional study was conducted at the Department of Surgical Unit VI, Civil Hospital Karachi, over a six-month period from December 7, 2020, to June 7, 2021. A total of 149 patients diagnosed with perforated peptic ulcers were included using non-probability consecutive sampling. The Boey score was calculated for each patient based on preoperative shock, comorbid illness, and duration of perforation >24 hours. The primary outcome measure was 30-day mortality. Descriptive statistics were used to assess the frequency distribution of mortality, and the association between Boey score and mortality was analysed using appropriate statistical methods, with significance set at p < 0.05. Results: The study included 149 patients, with a minimum age of 21 and a maximum age of 50. Of the total, 32 patients (21.5%) experienced 30-day mortality. Among patients with a Boey score of 1, 2.68% had 30-day mortality, and 0.67% of patients with a Boey score of 2 died. Patients with a Boey score of 3 had the highest mortality rate, with 18.1% of this group experiencing 30-day mortality. In contrast, 81.9% of patients with a Boey score of 1 to 3 survived beyond 30 days. Conclusion: The Boey scoring system demonstrated vital predictive accuracy for 30-day mortality in patients with perforated peptic ulcers. This scoring tool effectively identifies high-risk patients, allowing for timely and appropriate management. Despite modern treatment advances, perforated peptic ulcer remains associated with significant mortality, particularly in high-risk patients, as identified by the Boey score.

Attributes of Pathological Fractures in a Nigerian myeloma cohort

Multiple Myeloma (MM) is a plasma cell tumor usually characterized by lytic bone lesions. Pathological Fracture (PF) is a debilitating condition that usually affects a patient’s psychomotor functions, treatment modality, morbidity, and outcome. We evaluated the associations, characteristics, and impact of PF on survival in a group of Nigerian myeloma cohort. A 10-year (2011-2021) retrospective review of MM data from Nigerian tertiary hospital haemato-oncology unit to evaluate attributes of PFs in myeloma cohort. Sixty-six patients had MM of which 23 had PF while forty-three had no fractures. Of the number with PF, 18 had lytic bone lesions, while 20 had bone pains. Monoclonal Immunoglobulin G was predominant followed by Immunoglobulin A. Significant correlations existed between hemoglobin level (r=0.446, p=0.002); platelet count (r=-0.347, p=0.041), serum calcium (r=0.471, p=0.006) and bone pains; as well as between urea level (r=-0.787, p=001), creatinine level (r=-0.853, p=0.001) and renal impairment respectively. PFs are associated with diabetes, peptic ulcer disease, hypertension, nephropathy, and arthritis. Bortezomib-based regimen was the choice treatment. Overall survival was 16 (69.6%) with 7 (30.4%) mortality. PF is common amongst the myeloma cohort with the spine being the most common site. It is associated with significant comorbidities like hypertension, diabetes, peptic ulcer disease, and paraplegia and is characterized by severe debilitating bone pains, anemia, hypercalcemia, raised plasma monoclonal immunoglobulin, renal impairment, loss of man-hour at work, and psychosocial imbalance. The impact of the fracture has increased morbidity and mortality and has reduced the median survival duration to as low as 4 years.

A population-based study of familial coaggregation and shared genetic etiology of psychiatric and gastrointestinal disorders

BackgroundIt has been proposed that having a psychiatric disorder could increase the risk of developing a gastrointestinal disorder, and vice versa. The role of familial coaggregation and shared genetic loading between psychiatric and gastrointestinal disorders remains unclear.MethodsThis study used the Taiwan National Health Insurance Research Database; 4,504,612 individuals born 1970–1999 with parental information, 51,664 same-sex twins, and 3,322,959 persons with full-sibling(s) were enrolled. Genotyping was available for 106,796 unrelated participants from the Taiwan Biobank. A logistic regression model was used to examine the associations of individual history, affected relatives, and polygenic risk scores (PRS) for schizophrenia (SCZ), bipolar disorder (BPD), major depressive disorder (MDD), and obsessive-compulsive disorder (OCD), with the risk of peptic ulcer disease (PUD), gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD), and vice versa.ResultsHere we show that parental psychiatric disorders are associated with gastrointestinal disorders. Full-siblings of psychiatric cases have an increased risk of gastrointestinal disorders except for SCZ/BPD and IBD; the magnitude of coaggregation is higher in same-sex twins than in full-siblings. The results of bidirectional analyses mostly remain unchanged. PRS for SCZ, MDD, and OCD are associated with IBS, PUD/GERD/IBS/IBD, and PUD/GERD/IBS, respectively. PRS for PUD, GERD, IBS, and IBD are associated with MDD, BPD/MDD, SCZ/BPD/MDD, and BPD, respectively.ConclusionsThere is familial coaggregation and shared genetic etiology between psychiatric and gastrointestinal comorbidity. Individuals with psychiatric disorder-affected relatives or with higher genetic risk for psychiatric disorders should be monitored for gastrointestinal disorders, and vice versa.

Self-Reported Gastrointestinal Symptoms Associated with NSAIDs and Caffeine Consumption in a Jordanian Subpopulation.

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) and caffeine-containing beverages are widely consumed but their impact on gastrointestinal (GI) health requires further investigation. This cross-sectional study investigated the relationship between NSAIDs use, caffeinated drink consumption, and the prevalence of self-reported GI symptoms in a Jordanian subpopulation. Methods: An online survey was administered to 400 Jordanian individuals aged 18-65 years. Data on sociodemographics, NSAIDs use, caffeine consumption, peptic ulcer disease (PUD) history, and GI symptoms were collected. Contingency tables were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between exposures and outcomes. Results: The prevalence of self-reported PUD-related GI symptoms was 6.0%. NSAID users had higher odds of PUD (OR = 2.431) and related GI symptoms, including abdominal pain (OR = 4.688, p < 0.001) and discomfort (OR = 8.068, p < 0.001). Caffeine consumption was associated with self-reported burning stomach pain (OR = 14.104, p < 0.001), fullness (OR = 8.304, p = 0.010), and bloating (OR = 8.304, p = 0.010). Coffee, tea, soft drinks, and energy drinks were associated with increased odds of various GI symptoms (ORs 2.018-12.715, p < 0.05). Conclusions: NSAIDs use and caffeine consumption were independently associated with the increased prevalence of self-reported PUD and related GI symptoms. Despite the lack of adjustment for necessary confounders, our findings highlight the importance of considering the potential GI effects of NSAIDs and caffeine. Public health strategies promoting their safe use may help reduce the burden of GI disorders.

A Review of the Phytochemicals Found in Medicinal Plants that may have Antiulcer Properties

The risk of peptic ulcer is also increased by non-steroidal anti-inflammatory medications and Helicobacter pylori infection. Adverse effects and concurrent usage of antibiotics result from the careless use of synthetic medicines. Compounds drug-drug interactions; thus, it is vital to look for medications made from natural sources, particularly plants. Numerous ulcer-inducing models in lab animals have been used to assess the antiulcer effectiveness of numerous herbal remedies. The current study is to examine putative medicinal plants with gastro-protective and ulcer-healing properties and compile relevant data. The antiulcer effectiveness of medicinal plants is the exclusive focus of this essay. This study provides details on the anti-ulcer properties of medicinal plants as well as the many anti-ulcer models that are used to evaluate them.

Advances in Diagnostic Modalities for Helicobacter pylori Infection.

Helicobacter pylori (H. pylori) infection is a widespread global health issue with a varying prevalence influenced by geography, socioeconomic status, and demographics. In the U.S., the prevalence is lower, though certain groups, such as older adults and immigrants from high-prevalence regions, show higher rates. The decrease in infection rates in developed countries is due to improved sanitation, antibiotics, and healthcare, whereas developing countries continue to experience high rates due to poor living conditions. H. pylori infection can be asymptomatic or cause symptoms like dyspepsia, abdominal pain, bloating, nausea, and loss of appetite. Pathophysiologically, H. pylori contribute to conditions such as gastritis, peptic ulcers, and gastric cancer through mechanisms including urease production and the release of virulence factors, leading to chronic inflammation and an increased cancer risk. Diagnostic methods for H. pylori have progressed significantly. Non-invasive techniques, such as serological assays, stool antigen tests, and urea breath tests, are practical and sensitive. Invasive methods, including endoscopic biopsy and molecular diagnostics, are more definitive but resource intensive. Recent advancements in diagnostic technology, including matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), biosensor technology, and next-generation sequencing (NGS), promise improved speed, accuracy, and accessibility. These innovations are expected to enhance the detection and management of H. pylori, potentially reducing the global disease burden. This review aims to discuss these diagnostic modalities with a focus on further advances under investigation.

Increasing our knowledge about the epidemiology of Helicobacter pylori in Nunavik’s Inuit population (Québec, Canada) using Qanuilirpitaa? 2017 cross-sectional survey

ABSTRACT Helicobacter pylori is a bacterium that may colonise and proliferate in human stomachs, leading invariably to chronic inflammation and, to a lesser extent, to peptic ulcers and cancer. The main objective of this study is to describe the epidemiology surrounding H. pylori in Nunavik’s Inuit population using the 2004 and 2017 Health Surveys. Estimated prevalences were 70.9% for bacterial colonisation using a stool antigens test (SAT), 72.5% for anti-H. pylori antibodies, 12.7% for faecal occult blood in participants aged ≥ 50 and respectively of 28.4%, 11.2% and 2.4% for a prior diagnosis of colonisation, gastritis and peptic ulcer in the medical charts, with under five cases of gastric cancer reported. Variables associated with higher SAT+ prevalence were the number of household members (prevalence ratio [PR] = 1.03) and age (quadratic relationship), whereas mainly drinking municipal (PR = 0.84) and natural water (PR = 0.72) compared to bottled water, and increasing alcohol consumption (PR = 0.96) were associated with reduced prevalence. Despite current regional guidelines targeting high risk individuals in the context of high prevalence, Nunavik’s health authorities must remain vigilant by following gastric cancer incidence and the rapid evolution of guidelines, while considering local realities.

Evaluation of Rockall and Blatchford Scores and Forrest Staging in Upper Gastrointestinal Bleeding

Objective: The study aimed to investigate the predictive value of Rockall and Blatchford scores and endoscopic Forrest staging in the need for transfusion and intensive care in upper gastrointestinal bleeding. Materials and Methods: This retrospective study was conducted on 294 patients with gastrointestinal bleeding who presented to the emergency department between January 1 and June 1, 2013. Results: The mean age of 294 patients was 58.73±21.30 years. The endoscopic diagnoses of the patients included peptic ulcer (43.5%, n=128), erosive gastritis (17.3%, n=51), and erosive bulbitis (12.6%, n=37). There was no statistically significant relationship between Forrest staging and Rockall and Blatchford scores (p=0.944, p=0.757). The need for blood transfusion was significantly more frequent in patients with a Rockall score of 5 and above and those with a high Blatchford score (p=0.004, p=0.001). Patients with a Rockall score of 5 and above were significantly more common among those referred to the intensive care unit (p=0.003). Conclusion: Pre-endoscopic Rockall and Blatchford scores and endoscopic Forrest staging can be used safely in predicting transfusion requirement, intensive care requirement, mortality risk, treatment and follow-up of patients with gastrointestinal bleeding, and thus may help to reduce health expenditures.

Investigating the prevalence burden of peptic ulcer disease in older adults aged 70+ from 1990 to 2019: an analysis of Global Disease Burden Studies

Background Peptic ulcer disease (PUD) affects individuals aged ≥70 years globally, exerting a significant impact on their health and well-being. Understanding its epidemiological evolution and associated factors is crucial for guiding interventions and improving management. Methods This study utilized Global Burden of Disease Study data to examine the prevalence and temporal changes of PUD in individuals aged 70 years and older between 1990 and 2019. The analysis included assessing estimated annual percentage changes (EAPCs) to investigate temporal trends and regional variations. Results Over the past 30 years, the number of individuals aged 70 years and above suffering from PUD globally has increased from 1 065 730 cases in 1990 to 1 608 463 cases in 2019. Despite an increasing number of cases, the prevalence of PUD among the elderly has exhibited a steady decline, with an EAPC of −1.47 (95% confidence interval: −1.57 to −1.37) over this timeframe. In 2019, the prevalence rates of PUD among individuals aged 70–74, 75–79, 80–84, and 85 years and older were 313.36, 365.77, 388.45, and 352.51 per 100 000 population, respectively. South Asia, high-income North America, and Central Sub-Saharan Africa were the regions with the highest prevalence rates of PUD in 2019, with rates of 624.90, 575.48, and 474.80 per 100 000 population, respectively. At the national level, Ireland, Australia, Brazil, Brunei Darussalam, and Bangladesh have effectively managed the burden of PUD among the elderly, achieving the greatest reduction. Additionally, regions with higher levels of socioeconomic development tended to have relatively lower burdens of PUD among the elderly, and prevalence rates varied across different regions and age groups. Conclusion Our study highlights the enduring burden of PUD among the global elderly population, emphasizing the significance of tailored interventions to address this pressing issue. This research underscores the critical need for targeted public health strategies aimed at improving outcomes specifically for older adults affected by PUD.

Anti-ulcerative effect and antioxidant effects of Garcinia kola Heckel (Clusiaceae) seed infusate

Abstract Objectives Peptic ulcer (PU) is a condition in which the gastric lining breaks down, causing bleeding. This study investigates the anti-ulcer effects of Garcinia kola seed infusate in a rat model. Material and methods Garcinia kola seeds were harvested, freeze-dried, ground, and stored in the freezer. Ulcers were induced using 96% ethanol. After 2 h of ulcer formation, they received; 20 mg/kg omeprazole for group 2 and 200, 400, and 800 mg/kg body weight Garcinia kola infusate by oral gavage for 3 days. On day 4 the stomachs were removed and analysed. Levels of oxidative stress markers were assessed. Results There was no evidence of acute or subacute toxicity of the infusate. Histological analysis of the stomach showed a healing effect of the infusate in both male and female rats. With regard to nitrite malonyl dialdehyde and reduced glutathione levels, there was no statistical difference between the rats of both sexes receiving Garcinia kola compared to the normal rats. The catalase level tended to be similar between treated and untreated females. The treated male with both Garcinia kola and omeprazole tended to normalize the level of catalase when compared to the normal animal. Conclusion The Garcinia kola seed infusate was found to possess anti-ulcer and antioxidant properties.