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Evaluate the efficacy of Two different regimens of proton pump inhibitors High against Low in the management of acute peptic ulcer bleeding

Evaluate the efficacy of Two different regimens of proton pump inhibitors in the management of acute peptic ulcer bleeding First: loading dose 80 mg then 8mg/h iv continuous infusion for 3 days Second Loading dose 80 mg the 40 mg every 12 h for 3 days

Inclusion Criteria:

• High risk ulcers defined according to the Forrest classification With respect to high-risk stigmata,
• active bleeding was defined as a continuous blood spurting (Forrest IA)
• oozing (Forrest IB) from the ulcer base.
• A non-bleeding visible vessel at endoscopy was defined as a discrete protuberance at the ulcer base(Forrest IIA).
• An adherent clot was one that was resistant to forceful irrigation or suction (Forrest IIB).

Exclusion Criteria:

• ulcer was malignant
• non ulcerative bleeding such as angiodysplasia , a Mallory-Weiss tear....