RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
Ms. GRACE MARENE THOMAS
I Year M. Sc Nursing
Medical Surgical Nursing
Year 2012-2014
RR COLLEGE OF NURSING
CHIKBANAVARA
BANGALORE-560090
1
RAJIVGANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
PERFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
1. NAME
OF
THE MS.GRACE MARENE THOMAS
CANDIDATE
AND
1ST YEAR M.Sc NURSING
ADDRESS
R.R. COLLEGE OF NURSING,
BANGALORE
KARNATAKA.
2. NAME OFINSTITUTION
R.R.COLLEGENURSING,BANGALORE
KARNATAKA.
3. COURSE
OF
STUDY M.Sc. (NURSING)
AND THE SUBJECT
MEDICAL SURGICAL NURSING.
4. DATE OF ADMISSION 01.06.2012
TO COURSE
5. TITLE OF THE TOPIC:
A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTUREDTEACHING
PROGRAMME ON HEALTHY LIFESTYLE PRACTICES IN PREVENTION OF
PEPTIC ULCER DISEASES AMONG
P.U.COLLEGES IN BANGALORE
2
ADOLESCENTS IN
SELECTED
BRIEF RESUME OF THE INTENDEDWORK
6.0. INTRODUCTION
“The doctor of the future will give no medication, but will interest his
patients in the care of the human frame, diet and in the cause and
prevention of disease.”
-THOMAS ALVA EDISON
“The trouble with always trying to preserve the health of the body is that
it is so difficult to do without destroying the health of the mind.”
-G.K.CHESTRON
“Everything in excess is opposed to nature”. The stomach is an enlarged segment
of the digestive tract in the left superior part of the abdomen. Its shape and size vary from
person to person even within the same individual. Its size and shape change from time to
time depending on its food content and the posture of the body.
Disease of the stomach and small bowel are common and cause significant
morbidity, economic hardships and health consequences. Acid peptic ulcer diseases alone
accounted for an estimated $12.4 billion in direct costs in 1998.
Peptic ulcer is quite a common condition that affects a number of people
worldwide. It is prevalent among different societies be it rich or poor. Peptic ulcer can be
defined as a discontinuity in the mucosal lining of the stomach or duodenum which results
from continuous action of gastric acid and digestive enzymes on the mucosal surface. It is
important to note that H.pylori ,use of Non steroidal anti inflammatory drugs and lifestyle
conditions play a major role in the development of peptic ulcers. Stress, alcohol
consumption and poor diet can contribute to gastritis and which in turn lead to formation
of peptic ulcer.1
Peptic ulcers occur when the balance between the acid pepsin digestion and defense
3
mechanism of the mucosa is disturbed.10% of the population is affected by peptic ulcer
sometime or the other, the rate of incidence of peptic ulcer is decreasing in the developed
countries but is on the rise in developing countries. Peptic ulcer in adolescents is attributed
to stress, improper eating and infection. Many people think hat spicy foods cause peptic
ulcer diseases but the real causative agent is H.pylori infection. Peptic ulcer is generally of
two types they are; firstly gastric ulcer and secondly duodenal ulcer.2
Helicobacteria pylori is a type of bacteria responsible for widespread
infections with more than 5o% of the world’s population being infected . The bacteria
has evolved to survive in the acidic environment of stomach where enzymes digest food
h.pylori.. The bacteria burrow
in the cells of stomach lining causing low grade
inflammation. Hence due to these factors h.pylori is the most common cause for
occurrence of peptic ulcer.3
H.pylori infection maybe contagious, infection may spread when an infected
person spreads the bacteria through feces; while cleaning a persons laundry, unhygienic
bathrooms . Research has also found that h.pylori can also spread through saliva.3
Nowadays youngsters are attracted towards ready to eat food and fried foods, this
attitude among youngsters render their nutritional status to be imbalanced. Hence due to
these causes the rate of peptic ulcer diseases is on the rising stride. Sometimes these
ulcerative diseases tend to take another route i.e they might tend to become malignant. So
youngsters need to eat some natural foods which have got more nutrients
and which is
more healthy and nutritious and yields more energy.
6.1 NEED FOR STUDY
Peptic ulcer is the primarily reported cause of death in approximately 6500
persons in the United States each year. The estimated direct costs of patient care and
indirect costs caused by work and productivity loss for peptic ulcer disease are $6 billion
annually. Before 1983 the major causes of Peptic ulcer disease were considered to be
excess acid, diet, smoking and stress.
Approximately 60%respondents believed that ulcers were caused by too
much stress 17% believed that eating spicy foods caused ulcers and 27% believed that a
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bacterial infection caused ulcers. The belief that stress was the highest among cause
persons aged 18-24 years 78% and among persons with annual household incomes of less
than $15,000.15
In the United States there are approximately 100,000 new cases and 4
million recurrences of peptic ulcer diseases yearly. The one-year point prevalence of
Peptic ulcer diseases in the U.S is about 1.8% of a life time prevalence of 8-14%.
Estimated annual direct costs for Peptic ulcer diseases are $3.3 billion with additional
costs of 6.2 billion .Peptic ulcer disease due to H. pylori is unlikely to have its initial
presentation at age ≥50 years. In Western countries H. pylori infects about 20% persons
below the age of 40 years and 50% of persons above the age of 60 years. The incidence of
H. pylori infection in developing countries is much higher.4
According to study conducted in India the statistical ratio of peptic ulcer
disease as done in the year 2011 is 14,488,092 is the prevalence of peptic ulcer among
the adolescent age group of 15-25yrs. In the general population in the state of Kashmir in
INDIA the incidence of peptic ulcer was determined by using the endoscopy procedure in
randomly selected population of2763 adults aged about 15 yrs to 25yrs the point
prevalence of peptic ulcer disease is 6% and lifetime prevalence is 25%. duodenal to
gastric ulcer ratio was17: 11. Duodenal ulcer and gastric ulcer was found more common
among men. The prevalence of peptic ulcer increased with age , and the peak prevalence
of 28.8% was found to be in the 5th decade of life.5
According to WHO study published in the year 2011 , people who die due
to peptic ulcer in india is 108,392 per annum. India is ranked number 5 in the world in
terms of occurrence of peptic ulcer disease. According to this study adolescents of the age
group16-20yrs are affected by peptic ulcer6
So as a researcher, I have decided to take up this study in view that those
belonging to the adolescent group derive necessary knowledge regarding prevention of
peptic ulcer diseases and they lead a healthy life.
6.3 REVIEW OF LITERATURE
Review of literature is a key step in research process. The typical purpose of
review of literature is to generate research questions to identify what is known about the
5
topic. The major goal of review of literature is to develop a strong knowledge based to
carry out research and other non research scholarly activities.
Review of literature is processed according to the following headings;
Studies related to peptic ulcer diseases among adolescents
Studies related to lifestyle factors contributing to peptic ulcer
Studies related to hazards of peptic ulcer
Studies related to prevention of peptic ulcer
STUDIES RELATED TO PEPTIC ULCER DISEASES AMONG ADOLESCENTS:
El Mouzan, Abdullah.A.M [2004] conducted a study in the province of Saudi
Arabia to find out the prevalence of peptic ulcer among adolescents. The study was
conducted among 500 adolescents and children among the age group 10-18yrs.the study
found that the average age of occurrence was 15yrs and male to female ratio was 7:1.there
was 20 cases of duodenal ulcers and 4 cases of gastric ulcer among a group of 30 .the
study also concluded that lifestyle factors and stress contributed to rise of peptic ulcer
among adolescents.7
Deckelbaum Richard,J Roy,Et Al (2000) conducted a retrospective study of
finding the causative factors for upper gastrointestinal bleeding among adolescents. The
study was conducted among a group of 68 children who were aged between 15-19yrs.the
study found that the most commonest cause for upper gastrointestinal bleeding were due to
bacterial infections and changes n food habits which lead to formation of perforated ulcers
. Most commonest of ulcers were duodenal and gastric ulcers which accounted for 50%.8
Hua M.C,Kong.Ms, (2000) conducted a clinical study on increasing incidence of
perforated peptic ulcers among adolescents in taiwan. The results showed that clients with
peptic ulcer had abdominal pain and peitoneal pain. The clients with cases of perforated
peptic ulcers were of the adolescent age group comprising about 94.2%.9
6
STUDIES RELATED TO LIFESTYLE FACTORS CONTIBUTING TO PEPTIC
ULCER
Scand J Gastroenterol.( 2003). conducted a study to assess the etiological
factors for causation of peptic ulcer diseases mainly the factors assessed include
Helicobacter pylori, non-steroidal anti-inflammatory drugs and smoking which were the
risk factors contributing to peptic ulcer diseases. 5967 dyspeptic patients underwent 13Curea breath test (UBT) and upper endoscopy, Out of 5967 patients, 31.8% were ulcerated;
9.2% had gastric, 17.2% duodenal and 5.4% both gastric and duodenal ulcers. H. pylori
was found in 72.5% of gastric ulcer patients, in 83.6% of duodenal ulcer patients, in
76.9% of gastro duodenal ulcer Based on multivariable logistic regression analysis they
concluded that: H. pylori infection, Non steroidal anti inflammatory drugs use, smoking
and age play major roles in the pathogenesis of peptic ulcerations.10
Rosenstock S, Jørgensen T. ET AL [2003 ]; conducted a study to find the
etiological factors for peptic ulcer . A sample of 2416 Danish adults with no history of
peptic ulcer were interviewed The main risk factors for Peptic ulcer diseases were H
pylori infection [95%]tobacco smoking (3.8%), and use of minor tranquillizers. Tobacco
smoking and H pylori infection are the main risk factors for Peptic ulcer diseases in
Danish adults10
Moshowitz.M.[ 2000] conducted a study on Additive deleterious effect
of smoking on causing pepti ulcer The study group comprised 596 consecutive H.pyloripositive dyspeptic patients. The incidence of gastrointestinal bleeding was significantly
lower in non-smokers than in current or past smokers(7.1%, 8.1% and 20.7%,
respectively) (P < 0.05). Bacterial density, as assessed by the UBT value in 244 patients,
was higher in non-smokers (mean 352.3 +/- 273units) than in past smokers (mean 320.8
+/- 199) or current-smokers (mean 229.9+/- 162) (P < 0.05). Logistic regression analysis
revealed that male gender, current smoking, and immigration from developing countries
were all significant independent risks for developing duodenal ulcer, while only past
smoking was associated with a superior rate of upper gastrointestinal bleeding in the
past.11
Ostenson. M Gudmudson .T.L.[ 1999] ; conducted a study on Genetic and
life-style determinants of peptic ulcer. A study of 3387 men years investigated the
importance of the association of these genetic markers, life-style factors, and social class
with lifetime risk of peptic ulcer, testing specifically the hypothesis that the strength of the
7
association of risk factors with peptic ulcer depends on genetic susceptibility. Potential
non-genetic risk factors examined were smoking history, alcohol consumption, physical
activity level, consumption of tea and coffee, and use of sugar in tea or coffee.. This
findings showed there is strong interactions between genetic and life-style factors and
between genetic factors and social class for the risk of peptic ulcer have both public-health
and clinical implications.12
STUDIES RELATED TO HAZARDS OF PEPTIC ULCER DISEASES
Frank.Lanza. Francis K.L. [2010] ;the researchers found that due to peptic
ulcer there is stong inclination of developing pancreatic cancer is one of the major risk
factors,.The study
investigated the association between pancreatic cancer and the
occurrence of gastric or duodenal ulcer in a large US cohort. The analyzed data was
collected from 51,529 male health professionals in a prospective cohort study. Men
with gastric ulcer had an increased risk of pancreatic cancer (95% ), the risk remained
significantly increased 10-19 years after the gastric ulcer diagnosis.14
STUDIES RELATED TO MANAGEMENT AND PREVENTIVE MEASURES OF
PEPTIC ULCER
Harvard school of public health(2010) conducted a cohort study to
determine the preventive measures for occurrence of peptic ulcer. The study found that
clients consuming high fiber diet reduced the risk for developing duodenal ulcer. Food
sources of soluble fibres such as oats, legumes, barley and certain fruits and vegetables
were found to be protective and reduced the risk by 60%.also adolescents consuming vit.A
rich diet had chances of decreased rate for occurrence of peptic ulcers by 54%. Other
factors concluded in the study were avoidance of alcohol, coffee reduces the occurrence of
peptic ulcer.13
Frank L. Lanza [2010]
The researcher found that patients at high risk for
haemorrhage and perforation from aspirin and other non steroidal anti inflammatoryinduced ulcers should be considered for prophylaxis with misoprostol. Proton pump
inhibitors are an acceptable alternative for prevention of Non steroidal anti inflammatory
drugs-related complications. H2 receptor antagonists have been shown to prevent only
duodenal ulcer, and there-with misoprostol have shown that in high risk groups.14
8
Ray Sahelian.J Pineal . [2011.] Stomach and duodenal ulcer diet, herbs,
vitamins, natural treatment with diet, supplements and home remedy There are many
herbs, nutrients, and plant products that have been found to play a role in protecting or
helping to heal stomach and peptic ulcers. Probiotics such as those found in yogurt
probiotics are friendly bacteria such as Acidophilus, Lactobacillus and Bifidobacterium.
Aloevera herb may help with gastric ulcer healing. Artichoke leaf extract has been tested
in rodents as a beneficial supplement to reduce gastritis. Amla is used in Ayurvedic
medicine. Asparagus extract has been studied for ulcer prevention in patients treated Two
groups (A, B ) of 14 patients in each treatment group with gastro-duodenal chronic ulcers
were treated with omeprazole (20
20
mg twice daily) combined either with placebo
(group A), melatonin (group B). On day 7, omeprazole by itself (group A) had not healed
any ulcers, but four ulcers were healed with omeprazole plus melatonin and two with
omeprazole plus tryptophan. At day 21, all ulcers were healed in patients treated with
melatonin, but only 10-12 ulcers were healed in placebo-treated patients. Plasma gastrin
level also rose significantly during treatment with omeprazole plus melatonin, but it was
also significantly increased in patients treated with omeprazole plus placebo. Plasma
gastrin levels did not change significantly after treatment with melatonin, while plasma
leptin increased significantly in patients treated with melatonin but not with placebo. The
study concluded that melatonin, when added to omeprazole treatment, accelerates ulcer
healing and this likely depends mainly upon the significant increments in plasma
melatonin.15
Elise Marie [2010] conducted a study on Whole Foods Used to Treat Peptic
Ulcers ;One of the very best whole foods for peptic ulcers is pure organic natural honey.
Honey contains natural antibacterial and antiviral properties to it that helps fight off and
kill the helicobacter pylori bacteria which means this is an effective natural treatment for
peptic ulcers. Honey is also very soothing to the lining of the oesophagus, stomach, and
intestines and will help coat the ulcer sores. By coating the ulcer sores there is less burning
sensations and other peptic symptoms. Honey has works as an antiseptic and antiinflammatory which means it help cleanse the painful ulcer sores and relief the
inflammation and swelling they are causing in the lining of the digestive tract. The best
way to get the healing benefits of honey is by taking 2 to 3 tablespoon of it a day by
mouth.
9
Garlic is another excellent whole food to use for treating peptic ulcers. Garlic contains
natural antibacterial and antiviral properties to it which also help fight off and destroy the
harmful bacteria that causes peptic ulcers. Sometime garlic has been known to help
completely cure ulcers when used with other whole foods because it is so potent and full
of antioxidants that help heal and protect the body from infections such as peptic ulcers.
The best way to get the healing benefits of garlic is by eating 3 to 4 cloves a day in a meal
or alone with a tablespoon of two of honey. Garlic is found to be more effective when it is
chopped up and mixed together with a couple tablespoons of honey.
Another fabulous whole food to eat for treating and relieving peptic ulcers is cabbage.
Cabbage contains potent substances in it such as amino acids, L-glutamine, and Gefarnate.
These substances help protect the lining of the digestive tract so the ulcers can heal and
new ones can be prevented. The best way to get cabbage into your diet to help heal and
treat your peptic ulcers is by eating 2 to 3 cups of raw cabbage a day with a salad or meal.
Yogurt and cottage cheese are other whole foods that helps treat and heal peptic ulcer. The
reason yogurt is so helpful with treating and healing peptic ulcers is because it contains
loads of healthy amounts of good bacteria that help fight off and kill the helicobacter
pylori bacteria. Yogurt and cottage cheese can also help coat the ulcers in the stomach
which also helps soothe them from that ugly burning sensation and other painful
symptoms. Eating 1 to 2 cups of organic natural yogurt a day with live active cultures will
do the trick with helping to relieve and treat peptic ulcers. The famous plantain fruit is an
excellent whole food for treating and soothing peptic ulcers. Plantains contain starches that
help soothe, coat, and relieve the inflammation caused by peptic ulcers. Plantains even
contain antibacterial properties to it that can help fight off that nasty bacteria that cause the
peptic ulcers.16
6.4 PROBLEM STATEMENT
A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING
PROGRAMME ON HEALTHY LIFESTYLE PRACTISES IN PREVENTION OF
PEPTIC
ULCER
DISEASES
AMONG
COLLEGES IN BANGALORE.
10
ADOLESCENTS
IN
SELECTED
6.5 OBJECTIVES:
1. To assess the knowledge regarding maintenance of healthy lifestyle practices in
prevention of peptic ulcer diseases.
2. To administer a structured teaching program on healthy lifestyle practices in prevention
of peptic ulcer diseases among adolescents in selected colleges in Bangalore.
3. To evaluate the effectiveness of structured teaching program on healthy lifestyle
practices in prevention of peptic ulcer diseases among adolescents in selected colleges in
Bangalore.
4. To associate the knowledge on healthy lifestyle practices in prevention of peptic ulcer
diseases among adolescents in selected colleges in Bangalore.
6.6 HYPOTHESIS
(H1)- There will be significant difference in the pre test and post test knowledge score of
the adolescents on healthy lifestyle practices in prevention of peptic ulcer diseases.
(H2) - There will be significant association between the pre test and posttest knowledge
score in prevention of peptic ulcer diseases among adolescents with their selected
demographic variables.
6.7. VARIABLES UNDER STUDY:
i.Independent variable:
structured teaching programme regarding healthy lifestyle
practices in prevention of peptic ulcer disease.
ii.Dependent variable: knowledge of adolescents regarding healthy life-style practices in
prevention of peptic ulcer diseases.
iii.Extraneous variable : Age, sex, educational status, religion, family type, Income of
the family, race, geographical condition
6.8 OPERATIONAL DEFINITIONS:
a) Assessment: It refers to evaluate the responses of subjects on knowledge regarding
prevention of peptic ulcer diseases by means of
questionnaire.
11
structured self administered
b) Effectiveness:
It refers to significant gain in knowledge among the subjects. It
measures or determines the changes in pre test and post test knowledge score among the
subjects.
c) Structured teaching programme:
It refers to a planned teaching program related
according to the needs of the subjects which helps in improving their knowledge regarding
preventive measures of peptic ulcer disease.
d) Knowledge: It refers to assess the aptitude or level of understanding of the subjects
both before the Structured teaching programme is given, development of skills or increase
in the level of understanding after the structured teaching programme is given.
e) Adolescents : It refers to subjects in the age group of 15-18yrs of age.
6.8 ASSUMPTIONS:

Peptic ulcer diseases are preventable by adopting healthy lifestyle practices.

The adolescent age group is at more risk for acquiring peptic ulcer diseases.

The structured teaching programme on healthy lifestyle practices in prevention of
peptic ulcer diseases can bring desirable changes in the adolescent group.
6.9DELIMITATIONS:
1. The study is limited to adolescent age group of 15-18yrs in age.
2. The study is limited to students selected from selected colleges in Bangalore.
3. The study is limited to only 60 samples.
7.0 MATERIALS AND METHOD:
7.1 SOURCE OF DATA: The data will be collected from students studying in
selected
P.U.Colleges in Bangalore.
12
7.2 METHODS OF DATA COLLECTION
7.2.1 Research design:
The research design adopted for the study is quasi experimental one group pre test and
post test research design
7.2.2 Setting of the study:
The study will be conducted at selected P.U. college in Bangalore.
7.2.3 Population:
The target population for the study is comprised of adolescents from selected
P.U.
colleges in Bangalore.
7. 2.4 Sample size:
The sample size consists of 60 adolescents from selected P.U.colleges in Bangalore.
7.2.5.CRITERIA FOR SAMPLE SELECTION:
INCLUSION CRITERIA:
Adolescents who are:
a) Willing to participate in the study
b) Who can speak English or Kannada and understand the medium of language being
taught.
EXCLUSION CRITERIA
1. Students who are below the age group of 15years and above 20years.
2. Adolescents who are not willing to participate in the study.
3. Students other than P.U. colleges in Bangalore.
4. Students of the professional courses and degree college.
5. Adolescents who do not understand English or Kannada.
13
7.2.6. SAMPLING TECHNIQUE:
The sampling technique selected for the study involves simple random sampling.
7.2.7.TOOL FOR DATA COLLECTION
SECTION A:
Demographic data to assess the age, sex, religion, educational status, family type, family
income, geographical condition and source of information.
SECTION B:
Structured self administered questionnaire to assess the knowledge among adolescents,
regarding healthy lifestyle practices in prevention of peptic ulcer
7.3COLLECTION OF DATA
 Prior permissions obtained from the school authorities.
 Consent will be taken from the selected samples before the study conducted.
 The proposed duration of study is 30 days.
7.4 .PLAN FOR DATA ANALYSIS
The data will be analyzed by using descriptive and inferential statistics.
DESCRIPTIVE STATISTICS
Frequency and percentage distribution, mean and standard deviation will be used to
analyze the level of knowledge among adolescents.
INFERENTIAL STATISTICS
 Co-relation co efficient will be used to identify the relationship between the mean post
test knowledge score and selected demographic variable.
 Paired t- test will be used to evaluate the effectiveness of structured teaching program
among adolescents.
 Chi-square will be used to associate the knowledge in prevention of peptic ulcer
14
diseases with their selected demographic variables.
 The analyzed data will be presented in the form of tables ,diagrams and graphs
7.5 Does the study require any investigations to be conducted on
patients or other humans or animals? If so briefly describe?
No,
The study will be conducted on adolescents in selected colleges from Bangalore.
7.6 Has ethical clearance been obtained from your institution?
Yes,
1. Permission is obtained from the research committee of R.R.COLLEGE of nursing.
2. Permission is obtained from the school authorities of the selected P.U.colleges in
Bangalore.
3. Privacy, confidentiality and anonymity will be guarded.
4. Scientific objectivity of the study will be maintained with honesty and impartiality
15
8.LIST OF REFERENCES
1. Bonnenberg A. Everhart J.E. Health Impact Of Peptic Ulcer In The United States.
AM J Gastroenterol 1997; 92: 614-620.
2. Ostenson.M.,Gudmudson.T..L. Smoking And Alcohol And Familial Factors : Any
Assosciation With Peptic Ulcer2003. Jannuary.1227-1235.
3. Hua. M.C, Kong M.S. Division Of Paediatric Hospital ,Taiwan. April 2000.
4.
J. College Physicians, Tobacco Use As Contributory Factor In Peptic Ulcer Disease.
2003 July; 13 (7): Page No:385-7.
5. M. S .Khuroo, R. Mahajan,Et Al. Prevalence Of Peptic Ulcer In India : An Endoscopic
And Epidemiological Study In Urban Kashmir;Gut.2011,Page Number:930-934
6. WHO STUDY ;Incidence Rate Of Peptic Ulcer Diseases In India.2011.
7. El Mouzan, Abdullah.A.M ; Division Of Gastroenterology; College Of Medicine,
King Khaled University Hospital.Riyadh.December 2004,Page No:328-330.
8. Deckelbaum
Richard,
J.Roy,
Claude.C,
Canadian
Medical
Association
Journal.2000;Page No:225-228
9. Hua. M.C, Kong M.S. Division Of Paediatric Hospital ,Taiwan. April 2000
10. Ostenson.M.,Gudmudson.T..L. Smoking And Alcohol And Familial Factors : Any
Assosciation With Peptic Ulcer2003. Jannuary.1227-1235.
11. Rosentock.S, Jorgenson.T,Et Al. Journal Of Preventive Medicine: Risk Factors For Peptic
Ulcer Diseases.Denmark.2003.Page Nos:86-193.
12. Moshkowitz.M. Journal Of Gastroenterology .2000.Decemeber.Page Nos;892-898
13. Scand.J.Gasterol. Genetic And Lifestyle Determinants Of Peptic Ulcer Diseases.
Epidemiological Research Unit, Bisperjerg Hospital. Denmark. January 1999.Page
No:12-17.
14. Frank Lanza. Practice Parameters Committee Of American College Of Gastroenterology
Guideline For Treatment And Prevention Of NSAID Related Ulcers.2009;728-738 .
15. Harvard School Of Public Health; Nutritional Aspects In Prevention Of Peptic Ulcer.
December;2010.
16. Bayo Spieglen.D.L, R. Giovancucci. Journal Article Research And Support Unit.
Channing Laboratory . Birmingham. 2010; 541-555.
16
17. Ray Sahelian. American Journal Of Clinical Nutrition: Stomach And Duodenal Ulcers
Diet, Supplements And Home Remedy.2011.
18. Elsa Marie. Whole Foods To Treat Peptic Ulcer. December; 2010.
19. Jiaoh., J.N REEDY,Et Al. Epidemiology And Genetics : A Combined Healthy
Lifestyle Scoreand Risk For Pancreatic Cancer.2009.April;Page No: 764-770.
20. Sur D, Mukhopadhyay SP, A Study On Smoking Habits Among Slum Dwellers And
The Impact On Health And Economics. J. Indian. Med Assoc. 2007 Sep: 105(9) :
492-6, 496.
21. Kanbay M, Gur G, Arslan H, The Relationship Of ABO Blood Group, Age, Gender,
Smoking, And Helicobacter Pylori Infection, Dig, Dis Sci. 2005 Jul: 50(Y) : 12141217.
22. Benjamin.C, Charles Patrick. Helicobacter Pylori: Leading Cause Of Peptic
Ulcerdiseases.May2012
17
9
SIGNATURE OF THE CANDIDATE
10
REMARKS OF THE GUIDE
The study may be feasible and useful in
creating
awareness
among
adolescents
regarding prevention of peptic ulcer disease.
11
NAME AND DESIGNATION
Mr.M.Kalyanasundaram
11.1 GUIDE
HOD
11.2 SIGNATURE
Department Of Medical Surgical Nursing
R.R.College Of Nursing
11.3 CO-GUIDE
11.4 SIGNATURE
11.5 HEAD OF THE DEPARTMENT
Mr. M.Kalyanasundaram
11.6 SIGNATURE
12
12. 1 REMARKS OF THE CHAIRMAN The study selected by the student is relevant
OR PRINCIPAL
and forwarded for needful action
12.2 SIGNATURE
18