“…Numerous studies have investigated diurnal, weekly, or seasonal variations in the onset of different diseases, such as cardiovascular diseases [7,[22][23][24] , cerebrovascular diseases [25,26] , and psychiatric disorders [27][28][29] , as well as complicated (including hemorrhage and perforation) and uncomplicated PUs [8][9][10][11] , for which the highest incidences are in winter. This seasonal fluctuation of PU may be affected by several factors, including climatic factors [30] , increased intake of NSAIDs in winter [31] , significantly increased number of H. pylori infections in winter [32] , and variations in alcohol consumption [33] .…”