Objective: To find out association between peptic ulcer (PU) and high risk predictors like sex, smoking, use of non-streoidal anti-inflammatory drugs (NSAIDs) and H. pylori infection.
Methodology: This retrospective study was conducted at the medical unit of the Saidu Sharif Swat, months from October 2011 to January 2012 on 72 adult endoscopically proven patients of PU having previous history of smoking, ingestion of NSAIDs and presence of H. pylori infection on Urease test. Data was collected on structured proforma including patients demographics, clinical presentation and major risk predictors. Relevant statistics were carried out to see an association of these high risk predictors with PU.
Results: PU was more prevalent in age of 21-40 years with associated predictors like smoking, use of NSAIDs and H. pylori infection. Of the 72 patients, 68.05% patients were male and 31.94% were female. Smoking has a high incidence of 52.63%, and the use of NSAIDs shared 31.03% in patients of age 31-40 years. H. pylori infection was having 30% and 32% incidence in patients of groups 31-40 and 41-50 years, respectively. Smoking has a high Neg. R2 (26.82%) while for use of NSAIDs is 7.42%. Smoking + sex + NSAIDs + H. pylori have Neg. R2 score 48.09% (P > 0.05).
Conclusion: Smoking, sex, use of NSAIDs and H. pylori infection carries strong association in patients having peptic ulcer. As smoking alone is found to have stronger association with PU, public awareness program regarding hazards of smoking is recommended.
Key Words: Smoking, NSAIDs, Peptic ulcer, H. Pylori.
Nawaz M, Jehanzaib M, Khan K, Zari M: Role of barium meal examination in diagnosis of peptic ulcer. J Ayub Med Coll Abbotabad 2008; 20(4): 59-61.
Henderson RP, Lander RD: Peptic Ulcer Disease. In, Eric T Herfindal, Dick R Gourley (Ed). Textbook of Therapeutics, 17th edition. United States of America, Lippincott Williams and Wikins, 2000; pp 515-530.
Gregory MC, Tolman KG: Diseases: Manifestation
and Pathophysiology. In. Alfoso R Gennaro (Ed). The Science and Practice of Pharmacy, 20th edition. United States of America, Lippincott Williams and Wilkins, 2000; pp 1053-1097.
Palmer KR, Penman ID: Diseases of alimentary
tract and pancreas. In: Cristoper Haslett, Edwin R Chilvers, John AA Hunter, Nichlas A Boon (Ed). Principle and Practice
of Medicine, 18th edition. Edinburgh, Harcourt Publishers, 2000; pp 599-680.
Yeomans ND: Management of peptic ulcer disease not related to Helicobacter. J Gastroenterol Hepatol 2002; 17: 488-94.
Holman G. Hoyden C W: Management of peptic ulcer bleeding – the roles of proton pump inhibitors pylori eradication. Aliment Pharmacol Ther 2004; 19 (1): 66-70.
Newton EB, Versants MR, Sepe TE: Giant duodenal ulcer. World J Gastroenterol 2008; 14(32): 4995-99.
Sharma MP, Ahuja V: Current Management of Acid peptic Disorder. J Indian Acad Clin Med 2003; 4(3): 228-33.
Zia N, Farooq U, Alta H, Hanif M, Malik N, Khan MM: Perforated duodenal ulcer; Frequency during the holy month of Ramadan. Prof Med J 2004; 11(4): 474-9.
Danish M I: Textbook of Medical diagnosis and management. 6th Edition, Paramount Publisher Karachi 2005; (8): 170.
Kim YH, Lee JH, Lee SS, Cho EY, Oh YL, Son HJ, et al: Long term stress and helicobacter
pylori infection independently induce gastric mucosal lesions in C57BL/mice.scand. J Gastroenterol 2002; 37(11): 1259-64.
Hozawa A, Houston T, Steffes MW, Widome R, Williams OD, Iribarren C, et al. The association of cigarette smoking with self-reported disease before middle age: The Coronary Artery Risk Development in Young Adults (CARDIA) study. Prev Med 2006; 42(3): 193-9.
Tabachnick BG, Fidell LS: Using Multivariate
Statistics, 4th Edition Pearson Education; 2001; pp. 65-68.
Sakamoto Y, Ishiguro M: Kitigawa Akiake information criterion (AIC) statistics. KTK publishing House Tokyo, 1986.
Negelkerke: A note on a general definitions
of the coefficient of determination. Biometrika 1991; 78 (3): 691-2.
Arroyo MT, Forne M, de Argila CM, Feu F, Arenas J, de la Vega J, et al. The Prevalence of Peptic Ulcer not Related to Helicobacter pylori or Non-Steroidal Anti-Inflammatory Drug Use is Negligible in Southern Europe. Helicobacter 2004; 9(3): 249-354.
Vu C, Ng YY. Prevalence of Helicobacter pylori in Peptic Ulcer Disease in a Singapore
Hospital. Singapore Med J 2006; 4(10): 478-81.
Hamid S, Yakoob J, Jafri W, Islam S, Abid S, Islam M: Frequency of NSAIDs Induced Peptic Ulcer Disease. J Pak Med Assoc 2006; 56(5): 218-22.
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