Sequential therapy versus the best quadriple drug therapy for helicobacter pylori eradication

INTERVENTION: Control group: Pantoprazole 40mg (BD) + Amoxicillin 1g (BD) + Bismuth 240mg (BD) for 2 weeks and Furazolidone 200mg (BD) just during the first week Intervention 1: Intervention group: Pantoprazole 40mg (BD) for 10 days + Amoxicillin 1g (BD) just during the first 5 days + Clarithromycin 500mg (BD) and Tinidazole 500mg (BD) just during the second 5 days. Intervention 2: Control group: Pantoprazole 40mg (BD) + Amoxicillin 1g (BD) + Bismuth 240mg (BD) for 2 weeks and Furazolidone 200mg (BD) just during the first week. Intervention group: Pantoprazole 40mg (BD) for 10 days + Amoxicillin 1g (BD) just during the first 5 days + Clarithromycin 500mg (BD) and Tinidazole 500mg (BD) just during the second 5 days Treatment ‐ Drugs CONDITION: Duodenal ulcer Peptic Ulcer Disease (H. Pylori eradication). ; Duodenal ulcer PRIMARY OUTCOME: Helicobacter pylori eradication. Timepoint: 2 months after the completion of treatment course. Method of measurement: urease breating test. SECONDARY OUTCOME: Side effects of drugs. Timepoint: daily recording during and after the treatmen course. Method of measurement: classifying as mild, moderate or severe side effects. INCLUSION CRITERIA: INCLUSION CRITERIA: age more than 18 years Exclusion criteria: Previous history of receiving any H.p eradication regimen, Taking H2 blocker, proton pump inhibitor, Bismuth or Antibiotics during the 2 weeks prior to the study, Taking anticoagulants, ketoconazole or corticosteroids, History of gastric or esophageal surgery, Severe cardiovascular, pulmonary or endocrine disease, Renal failure, Hepatic diseases, Malignancies, Alcoholism, G6PD deficiency, Pregnancy or breast feeding