Introduction: Helicobacter pylori (H. pylori) infection is reported to be the most frequent cause of morbidity and mortality in cases of upper gastrointestinal (GI) diseases. There is paucity of research between the possible association of H. pylori and iron stores and iron deficiency anemia (IDA). In this study, we will determine if there is an association between serum total iron-binding capacity (TIBC), serum iron and ferritin levels, and H. pylori infection.Methods: This case-control study was conducted in the gastroenterology ward of a major hospital in Pakistan from December 2020 to April 2021. Three hundred patients diagnosed with H. pylori were enrolled along with 300 participants in the control group. H. pylori was confirmed or excluded with the help of Giemsa stained gastric biopsy specimens. Blood was sent to the laboratory to test for ferritin, serum iron, and TIBC. Each sample was drawn in the morning to avoid any fluctuations.Results: The mean serum iron level was significantly lower in participants with H. pylori infection compared to those who did not have H. pylori infection (110.72 ± 28.38 ug/dL vs. 162.5 ± 21.18 ug/dL; p-value: <0.0001). Serum ferritin level was significantly higher in participants with H. pylori infection (536.82 ± 117.0 ng/dL vs. 391.31 ± 101.54 ng/dL; p-value: <0.0001). Conclusion:In comparison with the control group, TIBC and serum iron levels were found to be lower in the case group.

Introduction: Neuropathic pain is a painful condition that arises after a lesion or an insult to the somatosensory nervous system, either in a central or peripheral location. The most common cause of neuropathic pain is diabetes. Controlled trials have been conducted on recent advancements in medicine to investigate the effect of vitamin C in the treatment of neuropathic pain. In this study, we aim to investigate the role of vitamin C in reducing pain associated with diabetic neuropathy.Methods: This open-label, parallel-arm, interventional study was conducted in a public tertiary care hospital in Pakistan from April 2019 to March 2021. A total of 300 type II diabetic patients with newly diagnosed painful peripheral diabetic neuropathy, of either gender, were enrolled in the study. The intervention group received 60 mg duloxetine along with 200 mg oral vitamin C. The control group received 60 mg duloxetine without any additional intervention. Patients were asked to return for follow-up after 12 weeks.Results: The mean visual analog score (VAS) was significantly lower in both, the intervention (5.54 ± 0.81 vs. 6.72 ± 0.90; p-value: <0.0001) and the control group (5.91 ± 0.80 vs. 6.79 ± 0.94; p-value: <0.0001), at week 12 compared to day 0. However, in comparison, VAS score in intervention at week 12 was significantly lower as compared to the control group (5.54 ± 0.81 vs. 5.91 ± 0.80; p-value: 0.0002). Conclusion:The use of vitamin C could be cost-effective and would be a safe and useful adjunctive therapy for pain associated with diabetic peripheral neuropathy.

Background: Helicobacter pylori (H. pylori) infection has increased worldwide and it is found to be positive in more than 50% of the specimens taken during endoscopy. The goal of the study is to compare the efficacy of two triple-therapy regimens in eradication of H. pylori and to evaluate the cost factor involved. Aims:• To compare and study between two triple-therapy regimens in treating (H. pylori)-related peptic ulcer disease.• To find the cost efficacy between two triple-therapy regimens. Materials and methods: A randomized single-blinded study was conducted at a tertiary care hospital from 2016 to 2018. Upper gastrointestinal endoscopy was performed on all the patients after spraying them with a topical local anesthetic agent (10% lignocaine spray). Two biopsy specimens were taken from the antrum of the stomach. The rapid urease test (RUT) was considered positive, if a color change from yellow to pink was noted in the RUT kit within 10 minutes. The sample size was calculated and fixed at 60. The RUT-positive patients were divided into two groups by computer-generated random allotment. Group I patients were started on regimen I comprising omeprazole 20 mg twice daily, clarithromycin 500 mg twice daily, and amoxicillin 1,000 mg twice daily for 2 weeks. Group II patients were started on regimen II: OCM: omeprazole 20 mg twice daily, clarithromycin 500 mg twice daily, and metronidazole 400 mg twice daily for 2 weeks. The endoscopic RUT was performed in the beginning and after 6 weeks to check for eradication of H. pylori. The ethical committee approval was obtained (IEC no. 2017/308) and data were collected using a proforma and were entered in the Excel sheet. The statistical analysis was done by SPSS (version 23). Descriptive statistics regarding age, sex, and inference with regimens were calculated and recorded. Results: Among the patients administered regimen I, H. pylori was eradicated in 27 (90%). And among the patients administered regimen II, H. pylori was eradicated in 28 (93.3%). This difference was not statistically significant with p value of 0.323. However, it was observed that regimen II was cheaper than regimen I.