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Introduction: Peptic ulcer is a mucosal lesion of stomach or deodenum in which acid and pepsin play major pathogenic roles. In general population, Helicobacter pylori (HP) plays an important role in peptic ulcer. Peptic ulcer is more common in chronic renal failure (CRF) but its etiology is unknown. Materials and methods: In a descriptive cross-sectional study, the prevalence of peptic ulcer in CRF patients was studied and its relationship with HP was evaluated. All patients were visited in Tajrish shohada hospital, Tehran. CRF was defined as a serum ceratinin concentration equal or more than 2 mg/dl at least for 3 months. Patients who stressful conditions, or were recieved immunosuppressive or NASID drugs, or drugs for eradication of HP were excluded. Upper GI endoscopy was performed for all patients by gastroentrologists to find out peptic ulcer. Biopsy was taken for HP identification by rapid ureas test. Results: The mean age of participants was 56 year and 51% of them had GI symptoms. Nineteen of 98 patients with CRF (19%) had peptic ulcer. That 5 of them were positive HP. HP was identified in 45 (46%) of patients. Conclusion: This study showed that HP is not more prevalent in CRF patients compared to general population. Additionally, peptic ulcer was more common in male patients with CRF than non-CRF subjects.

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Introduction: Peptic ulcer is a condition in which there is an ulcer in the stomach or duodenum. The incidence of peptic ulcer is 5 to 10% and is more prevalent in men. Infection with helicobacter pylori, NSAIDS, smoking and alcoholism are of the most important risk factors. Another risk factor is the O blood group. Since most research in this field are done abroad this study is done with the aim of determining the relation between ABO blood group and Rh with peptic ulcer. Materials and Methods: In this case-control study, 325 persons with dyspepsia were investigated. These individuals were referred for endoscopy. The case group consisted of 110 persons in whom endoscopy had revealed a peptic ulcer and control group 215 persons in whom endoscopy had showed no sign of ulcer. Blood grouping was performed by slide and tube methods .Chi square test was used for data analysis. Results: Based on the results, patients’ age was between 18-75 years. 68.6% of samples were women because they had more referrals. There was a significant relation between age and sex with peptic ulcer. 25.5% of patients were single and 72.5% married. Among all samples 32.9% had A blood group, 18.5% B, 11.1% AB and 37.5% O and 88% were Rh positive and 12% Rh negative. There was no significant relation between ABO blood group and Rh with peptic ulcer. The gathered data was analyzed using odds ratio, relative risk and Chi square test. Conclusion: Although some investigations have showed correlations between ABO blood group and peptic ulcer, our data showed no correlation. This may be due to the prevalence of helicobacter pylori infection among patients with peptic ulcer which needs more investigations. Other effective factors may be life style and nutrition.

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Background: Helicobacter pylori iceA gene has been reported to be a genetic marker for the development of peptic ulcer in western populations. The aim of this study was to investigate the prevalence of iceA genotypes and their relationship with peptic ulcer in Iran. Materials and Methods: This observational study was carried out on 75 patients. Biopsy specimens were evaluated for the presence of Helicobacter pylori through rapid urease test. GlmM gene and iceA1 and iceA2 genotypes allelic verification and variation culture were determined via PCR. Results: In this study, iceA1 and iceA2 alleles were identified in peptic ulcer disease (PUD) patients. IceA1 genotype (64%) was more prevalent than iceA2 (21.3%). IceA1 strains were more observable in patients with PUD. No significant relationships were seen between iceA genotypes and the clinical outcomes following infection (p= 0.71). Conclusion: This study revealed a significant two-tailed correlation between iceA genotypes and PUD occurrence. The results indicate that iceA1 gene can be used as a reliable marker in predicting the clinical outcomes of Helicobacter pylori infection. Therefore, further in-vitro and in-vivo investigations are needed for reaching general consensus in this regard.

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Background: H. pylori infection is common worldwide involving 50% of the general population. The aim of this study was to compare the effect of two sequential regimen therapies on the eradication of H. pylori. Materials and Methods: In this clinical trial, 150 patients were allocated to two groups of 75 each: group A and group B. The eradication of H. pylori in groups A and B was based on azithromycin and ofloxacin sequential regimens, respectively, and the results were compared between the groups. The data were analyzed by t-test, Chi-square test, and Fisher’s exact test using SPSS software version 16. Results: Mean of the patients’ age was 39.3± 1.2 within the age range of 18 to 85 years. There were not significant differences between the two groups considering the type of peptic ulcer. In group A, Urea Breath Test (UBT) was negative in 67 (89.3%) patients while in group B, it was only positive in 8 (10.7%) patients. In group B, there were 64 (85.3%) negative and 11 (14.7%) positive UBT test results. There were no significant differences in H. pylori eradication rates between the two groups (P=0.31). Conclusion: Noticing the absence of a significant difference between the two groups in terms of H. pylori eradication, it can be concluded that ofloxacin-based drug regimens have no superiority over azithromycine-based regimens and each regimen can be prescribed considering drug complication rates in different patients.

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Background: There have been reports showing the protective role of inducible Heat-shock protein (HSP) 70 in gastric epithelial cells. HSP70-2 gene is located in the class-III region of the MHC on the short arm of chromosome 6. The HSP70-2 gene has a pst1 site due to an A to G transition at the 1267 position and different genotypes of the HSP70-2 gene have been shown to be associated with a different level of HSP70 mRNA expression. This study was performed to investigate relations between polymorphism of the HSP70-2 gene and risk of peptic ulcer diseases.

Materials and Methods: In this descriptive analytical study, the studied population comprised 100 subjects, attending the Endoscopy Center of Hafez Hospital in Shiraz on 2012. All subjects underwent upper gastroscopy. Genomic DNA was extracted from bioptic tissues. Genotypes were determined in patients and controls using PCR-RFLP.

Results: In the non-ulcer subjects, the HSP70-2 genotype distribution was 20 AA (40%), 26 AG (52%), and 4 GG (8%). Meanwhile, the HSP70-2 genotype distribution in peptic ulcer patients were 5 AA (10%), 44 AG (88%) and 1 GG (2%). The results showed that 1267G/A HSP70-2 Gene polymorphism is associated with peptic ulcer.

Conclusion: It appears that polymorphism of HSP70-2 gene is associated with the susceptibility to peptic ulcer diseases. The analysis showed that the AG genotype increased the risk of peptic ulcer (OR=6.76, 95%CI=2.26-20.20, p=0.0006).

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Background: Upper gastrointestinal bleeding is a common medical emergency condition which can be very costly with potential risks. Prompt evaluation of the patients’ status and determination of the risks involved are of utmost significance. Rockall score is one of the Methods determining the risk of bleeding. The aim of the present study was to determine sensitivity, specificity and negative and positive predictive values of Rockall scoring system during a 3-month follow-up period in patients with upper gestronintestinal bleeding.

Materials and Methods: 340 hospitalized patients with acute upper gastrointestinal bleeding in Imam Reza hospital were studied from December 2013 to September 2014. The full and clinical Rockall scores, sensitivity, specificity and negative and positive predictive values were specified for all the subjects who were followed for 3 months in relation to complications and mortality.

Results: Of all patients, 204 were males and 136 were females who 15.6% of the subjects had a clinical Rockall score under 3, with 84.4% having a score over 3. In relation to endoscopic Rockall score, 15.6%, 66.8% and 17.6% of the subjects had a score under 3, between 3-8 and over 8, respectively. During the 3-month follow-up period, in the low-risk group, 92.5% did not exhibit hemorrhage again, 3.8% had one recurrent episode of hemorrhage, 1.9% exhibited 2 hemorrhage episodes, with 1.9% having 3 hemorrhage episodes. In the moderate-risk group, 90.9% experienced no recurrence and 9.1% exhibited 1 case of recurrent hemorrhage (p=0.4). There was no mortality in the low-risk group. In the moderate-risk and high-risk groups, the mortality rates were 8.07% and 22.7%, respectively (p<0.001). The sensitivity and specificity of the test were calculated at 11.1% and 81.1%, respectively. The positive and negative predictive values were 5% and 91.4%, respectively.

Conclusion: With due attention to the specificity of 81.8% and negative predictive value of 91.4% for the Rockall score, it might be guaranteed the patient will not suffer from the complications resulting from recurrence of hemorrhage. Given the low sensitivity of the test, the test is not appropriate to rule out disease.