A comparison of oral omeprazole and intravenous cimetidine in reducing complications of duodenal peptic ulcer

BACKGROUND: Gastrointestinal bleeding is a common problem and its most common etiology is peptic ulcer disease. Ulcer rebleeding is considered a perilous complication for patients. To reduce the rate of rebleeding and to fasten the improvement of patients' general conditions, most emergency departments in Iran use H2-blockers before endoscopic procedures (i.e. intravenous omeprazole is not available in Iran). The aim of this study was to compare therapeutic effects of oral omeprazole and intravenous cimetidine on reducing rebleeding rates, duration of hospitalization, and the need for blood transfusion in duodenal ulcer patients. METHODS: In this clinical trial, 80 patients with upper gastrointestinal bleeding due to duodenal peptic ulcer and endoscopic evidence of rebleeding referring to emergency departments of Imam and Sina hospitals in Tabriz, Iran were randomly assigned to two equal groups; one was treated with intravenous cimetidine 800 mg per day and the other, with 40 mg oral omeprazole per day. RESULTS: No statistically significant difference was found between cimetidine and omeprazole groups in regards to sex, age, alcohol consumption, cigarette smoking, NSAID consumption, endoscopic evidence of rebleeding, mean hemoglobin and mean BUN levels on admission, duration of hospitalization and the mean time of rebleeding. However, the need for blood transfusion was much lower in omeprazole than in cimetidine group (mean: 1.68 versus 3.58 units, respectively; p < 0.003). Moreover, rebleeding rate was significantly lower in omeprazole group (15%) than in cimetidine group (50%) (p < 0.001). CONCLUSION: This study demonstrated that oral omeprazole significantly excels intravenous cimetidine in reducing the need for blood transfusion and lowering rebleeding rates in patients with upper gastrointestinal bleeding. Though not statistically significant (p = 0.074), shorter periods of hospitalization were found for omeprazole group which merits consideration for cost minimization

Reactive lesions of the oral cavity: A retrospective study on 2068 cases

Background: Reactive lesions of the oral cavity are non-neoplastic proliferations with very similar clinical appearance to benign neoplastic proliferation. This similarity is troublesome in the differential diagnosis. The aim of this study was to determine the frequency and distribution of oral cavity reactive lesions. Materials and Methods: The study was a retrospective archive review. The medical records of 2068 patients with histopathologic diagnosis of oral cavity reactive lesions were studied. The patients′ clinical data were registered and evaluated retrospectively. The obtained frequency of patients′ age, gender, and anatomic location were analyzed. Descriptive statistics were used for evaluating the registered data. Results: Peripheral giant cell granuloma was the most prevalent lesion (n=623, 30.12%). This was followed by pyogenic granuloma (n=365, 17.65%), epulis fissuratum (n=327, 15.81%), irritation fibroma (n=288, 13.93%), cemento-ossifying fibroma (n=277, 13.40%), inflammatory fibrous hyperplasia (n=177, 8.56%), and inflammatory papillary hyperplasia (n=11, 0.53%). The age ranged from 2 to 85 years, with a mean of 39.56 years. The lesions were more common in males (n=1219, 58.95%) than in females (n=849, 41.05%). Attached gingiva with 1331 (64.36%) cases was the most frequent place of reactive lesions. Conclusion: Peripheral giant cell granuloma was the most prevalent reactive lesion of the oral cavity. The reactive lesions were more common in males, gingival, and the third decade. Some differences have been found between the findings of the present study and previous reports

A Patient with Chronic Hepatitis C and a Pancreatic Mass in Endoscopic Ultrasound

We report a rare case of pancreas tumor (lymphoma) in a patient with a history of chronic hepatitis C virus (HCV) infection without treatment, with a high viral load (20,199,805 IU/ml). He presented with abdominal pain, jaundice, weight loss and sweating. Computed tomography showed a hypodense mass located in the head of the pancreas, and immunohistochemistry of a specimen obtained by endoscopic ultrasound-guided fine needle aspiration revealed non-Hodgkin’s lymphoma of the pancreas, B cell type. An association of HCV infection with pancreatic lymphoma has only been reported rarely in the literature and its clinical significance is uncertain

CONSORT flow chart of the clinical trial comparing oral omeprazole and intravenous cimetidine in reducing complications of duodenal peptic ulcer in 80 Iranian patients

<p><b>Copyright information:</b></p><p>Taken from "A comparison of oral omeprazole and intravenous cimetidine in reducing complications of duodenal peptic ulcer"</p><p>BMC Gastroenterology 2006;6():2-2.</p><p>Published online 11 Jan 2006</p><p>PMCID:PMC1360671.</p><p>Copyright © 2006 Khoshbaten et al; licensee BioMed Central Ltd.</p

Pathological and Clinical Correlation between Celiac Disease and Helicobacter Pylori Infection; a Review of Controversial Reports

There are overwhelming reports and descriptions about celiac associated disorders. Although there is a clear genetic association between celiac disease (CD) and some gastrointestinal disorders, there are controversial reports claiming an association between CD and Helicobacter pylori (H. pylori) infection. Different studies indicated the possible association between lymphocytic gastritis and both CD and H. pylori infection, although this evidence is not consistently accepted. Also it was shown that an increase in intraepithelial lymphocytes count is associated with both H. pylori infection and celiac disease. Therefore the following questions may raise: how far is this infection actually related to CD?, which are the underlying patho-mechanisms for these associations? what are the clinical implications? what is the management? and what would be the role of gluten free diet in treating these conditions? PubMed (PubMed Central), Ovid, ISI of web knowledge, and Google scholar were searched for full text articles published between 1985 and 2015. The associated keywords were used, and papers described particularly the impact of pathological and clinical correlation between CD and H. pylori infection were identified. In this review we tried to answer the above questions and discussed some of the recent developments in the pathological and clinical aspects of CD and H. pylori infection