الفهرس 
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Abstract
This work was carried out to study the role of melatonin, omeprazole and the combination of both drugs in the treatment of duodenal ulcer and the correlated changes of COX-2 by using immunohistochemistry. A total of 36 subjects were included in this study. Twenty seven patients attending the outpatient clinics of The Gastro-Enterology Center, were suffering from duodenal ulcer. Nine healthy volunteers with age and sex matched were taken as controls. The age of both the control group and the duodenal ulcer patients ranged from 32 to 64 years. Patients selected were classified into the following groups; group I: included 9 patients suffering from duodenal ulcer disease and receiving melatonin alone for treatment of DU in a dose of 3 mg once daily at the bed time for the following durations: 4 weeks (Ia), 6 weeks (Ib) and 8 weeks (Ic). Group II: included 9 patients suffering from duodenal ulcer disease and receiving omeprazole alone for treatment of DU in a dose of 40 mg once daily for the following durations: 4 weeks (IIa), 6 weeks (IIb) and 8 weeks (IIc). Group III: included 9 patients suffering from duodenal ulcer disease and receiving omeprazole and melatonin for treatment of DU in the same dose of each of them for 4weeks (IIIa), 6 weeks (IIIb) and 8 weeks (IIIc). At the end of duration of experiments, duodenal biopsy samples were taken by the gastro-duodenal endoscopy from all individuals sharring in the study either controls or patients. Paraffin sections were prepared from the duodenum and stained with haematoxylin and eosin, mallory trichrome stain, periodic acid schiff and immunohistochemical stain for the detection of cyclo-oxygenase-2 (COX-2). from this study it could be concluded that melatonin can be used in the treatment of duodenal ulcer either alone or in combination with omeprazole (a proton pump inhibitor). The combination therapy of both melatonin and omeprazole is prefferable as melatonin accelerates the healing effect of omeprazole and therefore shortens the duration of treatment and minimizes its side effects. Lasltly, COX-2 enzyme is overexpressed in the duodenal ulcer and during its healing process and its role in facilitating the healing is well manifested.