This study examined a possible aetiological agent, namely, Helicobacter pylori, in perforated peptic ulcer disease and its relationship to persisting ulcer. Twenty-nine patients with perforated peptic ulcer underwent simple closure of the perforation at laparotomy. A 13C urea breath test carried out on the eighth day after operation was positive in 24 patients. Fourteen of 17 patients who underwent upper gastrointestinal endoscopy 6 weeks after discharge from hospital had a positive 13C urea breath test. The biopsy urease test performed on mucosal samples taken at endoscopy was positive in 12 of these 14 patients, indicating continuing active infection with H. pylori. Seven patients with positive 13C urea breath and biopsy urease tests had persisting duodenal ulceration. None of the three patients with a negative 13C urea breath test had evidence of duodenal ulceration at endoscopy. The association between a high rate of duodenal ulcer persistence and a high incidence of H. pylori infection suggests that antibiotic therapy to eradicate this microorganism should be given to all patients with perforated peptic ulcer disease.

BackgroundWe established a trauma registry in 2003 to collect data on trauma patients, which is a major cause of death in the United Arab Emirates (UAE). The aim of this paper is to report on the long term effects of our early analysis of this registry.MethodsData in the early stages of this trauma registry were collected for 503 patients during a period of 6 months in 2003. Data was collected on a paper form and then entered into the trauma registry using a self-developed Access database. Descriptive analysis was performed.ResultsMost were males (87%), the mean age (SD) was 30.5 (14.9). UAE citizens formed 18.5%. Road traffic collisions caused an overwhelming 34.2% of injuries with 29.7% of those involving UAE citizens while work-related injuries were 26.2%. The early analysis of this registry had two major impacts. Firstly, the alarmingly high rate of UAE nationals in road traffic collisions standardized to the population led to major concerns and to the development of a specialized road traffic collision registry three years later. Second, the equally alarming high rate of work-related injuries led to collaboration with a Preventive Medicine team who helped with refining data elements of the trauma registry to include data important for research in trauma prevention.ConclusionAnalysis of a trauma registry as early as six months can lead to useful information which has long term effects on the progress of trauma research and prevention.

Purpose: to study the mechanism, management and outcome of patients who had sustained pancreatic trauma.Methodology: Patients who were treated for pancreatic trauma in al-ain hospital between October 2002 and august 2007 were retrospectively studied.Results: all eleven patients were males having amedian age of 30 years (range 24-52 years). nine had blunt trauma while two had suffered penetrating injury.t hree presented with shock. associated injuries were present in nine patients (head, chest, and extremities) while seven had other intra-abdominal injuries. Only one patient had isolated pancreatic injury.early serum amylase was elevated in six patients. ct abdomen was diagnostic for pancreatic injury in seven patients. twocases were missed by early ct scan (sensitivity of 78%) while the remaining two patients were taken immediately to the operating theater.all patients underwent laparotomy.Five patients were treated by drainage alone, four had distal pancreatectomy,a bdominal packing was performed in one patient and in another gastrocystostomy was carried out. Pancreatic fistula occurred in three patients. median hospital stay was 25 days (range 12-152 days). two patients (18%) died.Conclusions: blunt trauma is the main cause of pancreatic injury in our country.early ct scan may miss pancreatic injury in almost aq uarter of the patients. thin sliced ct scan, with special views in adedicated abdominal pancreatic study,isrecommended. a high index of clinical suspicion, depending on the mechanism of injury,isimportant for diagnosis of pancreatic injury.mortality is mainly attributable to other associated injuries so simple procedures should initially be adopted for pancreatic injury,especially in haemodynamically unstable patients.

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