ABSTRACT
Objective: to determine the frequency of H. pylori in cases of hepatic encephalopathy with liver cirrhosis
Study design and place: cross-sectional study to observe the role of H. pylori in HE patients of liver cirrhosis, conducted in Department of Medicine with collaboration to Intensive Care Unit [ICU] from January 2009 to December 2009 at Liquate University of Hospital Jamshoro/ Hyderabad
Results: out of 66 patients of HE, 44[66.7%] were male and 22[33.3%] were female, between 20 and 80 years of age. Based on Child-Pough's criteria, severity of hepatic decompensation Grading was as; in grade 1= 07 [10.6%], in grade 2= 21 [31.8%], in grade 3= 20 [30.3%] and in grade 4= 18 [27.3%]. Based on Child-Pough's criteria in class A= 01 [1.5%], in class B= 27 [40.9%] and in class C= 38 [57.6%]. Etiological factors for HE were as; HCV antibodies were positive in 32 [48.48%], HBsAg was positive among 18 [27.27%], HBsAg and HCV antibodies both were positive in 09 [13.64%], Alcoholics were 07 [10.6%] and Frequency of H. pylori was found in 47 [71.2%]
Conclusion: in our study we found that before and after 10 days H. pylori eradication therapy, there was no significant improvement in HE grade and other parameters. While the finding of high frequency of H. pylori in HE patients may be either co-incidence or co-relation that needs further vast studies
ABSTRACT
To determine the frequency of cirrhotic cardiomyopathy in patients with liver cirrhosis. This Descriptive case series study was conducted in Medical Department of Liaquat University Hospital Jamshoro / Hyderabad from 3rd January 2009 to 16th June 2009.This study included 74 consecutive cases of cirrhosis of liver of either sex above 14 years of age. Firstly, resting ECG was done in all the patients. QTc values were calculated from lead II. QTc interval of > 0.44 sec were considered as prolonged. Systolic dysfunction was assessed by ejection fraction [value of >55% was considered as increased]. Diastolic dysfunction manifested by reduced E/A ratio [< 1 was considered as decreased]. Thirdly, all patients had determination of proBNP levels. The presence of cirrhotic cardiomyopathy was confirmed by abnormal ECG or echocardiography, along with proBNP abnormalities. Statistical package for social sciences [SPSS[TM]] version 16 was used for data processing purpose. Means +/- Standard Deviation of age and pro BNP levels were calculated. Frequency and percentage were computed for cirrhotic cardiomyopathy in cirrhosis patients. A total of 74 patients were selected for this study, out of which 41 [55.41%] were male and 33 [44.59%] were female. The mean age was 46.2 years [ +/- 10.8 SD]. Out of 74 patients 9 [12.2%] belonged to child Pugh A, 29[39.2%] to child-Pugh B and 36[48.6%] in child-Pugh C. Elevated pro BNP was present in 42[56.8%] cases, E/A ratio < 1 in 15 [20.3%] cases, prolong QT interval [>0.44sec] in 16 [21.6%], Ejection fraction [EF] >/= 0. 55 was present in 25 [33.8%] patients. Cirrhotic cardiomyopathy was present in 33[44.6%] cases. A strong relation was found between cardiomyopathy and severity of cirrhosis of liver [p=0.001], pr0-Bnp levels [p=0.003], QTc > 44 sec [0.004], Ejection fraction > 55% [0.004] and E/A ratio < 1 [p=0.005]. Cirrhotic cardiomyopathy was present in a sizeable proportion of cirrhotic patients, more so in the later stages of cirrhosis of liver
ABSTRACT
Objective: to determine the frequency and pattern of herpes zoster at Liaquat University Hospital, Hyderabad
Patiehts and methods: this hospital based descriptive study of six months was carried out at Liaquat University Hospital, Hyderabad [Sindh] Pakistan; from March 2008 to August 2008. All patients who were above 12 years of age, attended the dermatology OPD and were diagnosed as cases of Herpes Zoster were evaluated and enrolled in the study. The diagnosis was established by history and relevant clinical examination. The data were collected on pre-designed proforma, saved and analyzed in SPSS version 10.00. The frequency and percentage of herpes zoster was calculated by detecting the number of positive cases while the pattern was assessed through prodromal, presenting symptoms, dermatome involved and observation of certain complications
Result: one hundred and ten patients were diagnosed as herpes zoster infection with mean age 38.9 +/- 10.79 years. Majority [80%] of the patients was presented in the Department of Dermatology and 76% were males. The most common prodromal symptom was paresthesia in 40 patients, itching in 35 patients, fever and headache in 20 patients, tingling in 15 patients, watering from eyes in 12 patients and burning in 10 patients. The dermatomes involved were thoracic in 78 patients, trigeminal nerve in 12 patients, lumber in 10 patients, cervical in 08 patients, and sacral in 02 patients. The complications seen were secondary infection in 42 [38%] patients, scarring in 18 [16%] patients, and post-herpetic neuralgia [PHN] in 15 [14%] patients
Conclusion: herpes zoster is a common viral infection and can be prevented when necessary by patient isolation and passive prophylaxis with varicella-zoster immune globulin. An experimental live vaccine also prevents varicella, but problems regarding its virulence for immunosuppressed patients and the durability of the protective response are still being addressed