Data on socio-demographic characteristics, clinical and other related factors were collected using a structured questionnaire by trained nurses. For laboratory data, 4ml of the venous blood sample was collected in ethylenediaminetetraacetic acid (EDTA) tubes by laboratory technologists from each dyspeptic patients for hematological parameter analysis and blood film preparation. Hematological parameters were determined using automated blood analyzer Mindray BC-3000 plus (Shenzhen Mindray Bio-Medical Electronics, China).

Anemia in adult dyspeptic patients was defined according to the World health organization (WHO) cutoff value as an HGB concentration <12 g/dl in women and < 13 g/dl in men. It is categorized as mild (HGB,11–11.9 g/dl in women and 11–12.9 g/dl in men), moderate (HGB, 8–10.9 g/dl in both men and women), and severe anemia (HGB, < 8 g/dl in both men and women) [26]. It can be classified as microcytic (MCV, <80 fl), normocytic (MCV, 80 fl-100 fl) and macrocytic (MCV, >100 fl) [27, 28]. Thin blood films were prepared, air-dried, labeled and then stained by wrights stain to evaluate RBC morphology of anemic study participants.

Also, after explaining how to collect representative stool specimen clean cupped plastic container was given to the participants. Approximately five gram of stool specimen was collected from each dyspeptic patients and checked for the presence of H. pylori antigen by wondfo one step H. pylori feces test (Guangzhou Wondfo Biotech, China) and intestinal parasites were detected by saline wet mount techniques. Anthropometric measurements (height and weight) were measured from all study participants and body mass index (BMI) was computed as weight in kilogram divided by the square of height in meter and categorized in a four groups; BMI<18.5 kg/m2 as underweight, BMI = 18.5–24.9 kg/m2 as normal weight, BMI = 25–29.9 kg/m2 as overweight, and BMI ≥ 30 kg/m2 as obese [29].

To ensure the quality of data, training was given to data collectors, completeness of each questionnaire was checked regularly, reagents and test kits were checked for their expiry date. All laboratory tests were done by following the standard operating procedures (SOPs) and manufacturer instructions.

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