ETIOLOGYAre response to a treatment compare tosingle Duodenal

ETIOLOGYAre Genetic Influences on Peptic Ulcer Dependant or Independent ofGenetic Influences for H.Pylori Infection?Helicobacter Pylori is considered to be common etiology for peptic ulcer. This study wasdone with two objectives. First one being the association of genetic factors as etiology ofpeptic Ulcer, Secondly whether the genetic factors associated with the Peptic Ulcer aredependant on genetic factors which are associated with Helicobacter Pylori infection.A sample size of 691 pairs of twins having positive history of peptic ulcer is selected. Ofwhich 95 are Monzygotic rared apart, 159 Monozygotic rared together and 226 Dizygoticrared apart, 211 Dizygotic rared together. The genetic analysis for peptic ulcer is donethrough mail-questionnaire. Among these 270 pairs serum samples are taken for theassessment of H-Pylori. The presence of H-Pylori is assessed using H-Pyloriimmunoassay kit. Optical density of greater than 2 was scored positive.By using above methods number of concordant pairs is calculated. It was found that theconcordant monozygotic was seven and dizygotic was four. Then ProbandwiseConcordant Rate(PBR) is calculated using the formula “number of affected twins inconcordant pairs / total number of cases”. The PBR of monzygotic rared apart is found tobe 40%, monozygotic rared together 38% and the mean is 39%. In case of dizygotic raredapart PBR is 13%, rared together 17% and the mean is 15% for Dizygotic twins.The next objective of the study is to assess whether genetic factors associated with PepticUlcer are dependent on genetic factors associated with H.Pylori infection. This is done byselecting the 299 individuals randomly and using Chi-square test the cross correlation ofGenetic Variation of peptic ulcer and H-pylori infection calculated.By the above measures it was found that very low PBR(39%,15%) giving a conclusionthat the association between peptic ulcer and Genetic factors is mild. Also thosemonozygous twins rared apart have higher PBR than rared together showing lowinfluence of environmental factors on genetic factors. The mean cross correlation beinglow(0.27) indicates genetic factors of peptic Ulcer are not dependent on genetic factors ofH-Pylori infection.Dr.Yathish.SPATHOPHYSIOLOGYMultiple Duodenal Ulcers: Natural history and PathophysiologyAim of the study is to establish whether Multiple Duodenal ulcers share a differentnatural history; differ in their pathophysiology and response to a treatment compare tosingle Duodenal Ulcers.During the period of 1980-85 new cases of duodenal ulcer seen were 998. All thesepatients were randomized in to five therapeutic groups. Therapeutic groups consist of 120patients treated with oxmetidine compared with placebo, 246 patients withCimetidine(200 mg tds, 600 mg nocte, and 1 g/day), 229 patients with misoprostol (300micrograms qid compared with 200 micrograms qid compared with placebo) 283 patientsof cimetidine(1 g/day ) compared with sucralfate( 1 g qid) and 120 patients of cimetidine(400 mg tds, 200 tds, 600 nocte,1.2 gm nocte). Among them 200 patients with singleulcers are selected randomly to compare retrospectively with 96 patients suffering frommultiple duodenal ulcers.The clinical, physiological, personal, endoscopic features are obtained within 72 hours ofthe start of intended treatment. Clinical characteristics calculated were age, sex, workstress, neurosis, alcoholic consumption, pain score, duration of pain, dyspepsia,gastrointestinal bleeding were scored. Physiologic characteristics like Basal acid out put,maximum acid output were measured. Endoscopic characters like diameter and depth ofthe ulcer is measured. Degree of deformity inflammation, edema, were scored.Statistical analysis is done using student t test; ?2test and Mann-Whitney test areperformed to get nonparametric data. The results include more significance of multipleulcers compared single ulcers in relation to male patients(84.4%), pain(2.2±0.8h),cigarette smoking(52.1%), ulcers in anterior wall(51.4%), serum gastrin level(5.1±0.4).The multiple ulcers had similar significance in relation to single ulcers in environmentalstress, neurosis, symptoms (7.3±0.01), basic acid output(3.26±0.32), sensitivity togastrin(2.8±0.3).Dr.Yathish.SThe conclusion is that multiple ulcers are more commonly seen with male, smokers. Thegastrin level, duration of pain, susceptibility of anterior wall, sensitivity to gastrin levelare higher in multiple ulcers compared to single ulcers. The effect of alcoholism,environmental stress, analgesic consumption, neurosis, basic acid out put, basic acid output and symptoms of Multiple ulcers are similar when compared to single ulcers.