Gerd symptoms and body mass index: a study in outpatients of Abbasi Shaheed hospital

This study aimed to determine the association between GERD [Gastro-Esophageal Reflux Disease] symptoms and Body Mass Index [BMI] in the outpatients of Abbasi Shaheed Hospital, Karachi. A comparative cross-sectional study was conducted in Abbasi Shaheed Hospital, Karachi from December 2008 to March 2009. By convenient sampling method, 200 outpatients who met the inclusion criteria were enrolled in the study, visiting the hospital with symptoms of epigastric pain, nausea, vomiting, acid regurgitation, heart burn, burping, belching, and feeling of wind. A questionnaire was filled, which contained patient's demographic profile, information on the frequency of all GERD symptoms and severity of main GERD symptoms. History of smoking, alcohol, drugs or any illness were also inquired and noted. Statistical analysis was done by SPSS version 16. Among 200 outpatients, 65% were females and 35% were male. Mean age was 38.4 years. Nausea was complained in 87%, epigastric pain in 66%, acid regurgitation in 66% and heart burning in 64% of patients. The frequency of heartburn and acid regurgitation was seen once a week in 39% and 45% of patients respectively while severity of heartburn and acid regurgitation was found 25% and 33% of patients respectively and there relation with body mass index were found insignificant. Co-relation of body mass index was not associated with symptoms of gastro-esophageal reflux disease i.e.: nausea [p=0.06], epigastric pain [p=0.658], acid regurgitation [p=0.935], heart burn [0.525]. Our study concludes that in our setting, the symptoms of GERD occur independently of body mass index. It seems that high BMI plays a more important role to cause symptoms of GERD among western population but not in Asian populations. However, further studies in Asian communities are also required in this regard

Serodiagnosis of dengue infection using rapid immunochromatography test in patients with probable dengue infection

To determine the frequency of seropositive dengue infection using rapid immunochromatographic assay in patients with probable dengue infection as per WHO criteria. A cross-sectional observational study was conducted at Abbasi Shaheed Hospital, Karachi from July 2008 to January 2009. Patieats presenting with acute febrile illness, rashes, bleeding tendencies, leucopenia and or thrombocytopenia were evaluated according to WHO criteria for probable dengue infection. Acute phase sera were collected after 5 days of the onset of fever as per WHO criteria. Serology was performed using rapid immunochromatographic [ICT] assay with differential detection of IgM and IgG. A primary dengue infection was defined by'a positive IgM band and a negative IgG band whereas secondary infection was defined by a positive IgG band with or without positive IgM band. Among 599 patients who met the WHO criteria for dengue infection, 251[41.9%] were found to be ICT reactive among whom 42 [16.73%] had primary infection. Secondary infection was reported in 209 [83.26%]. Acute phase sera of 348 [58.09%] were ICT non reactive. Four patients died because of dengue shock syndrome among which three had secondary infection. Early identification of secondary infection in acute phase sera using rapid ICT is valuable in terms of disease progression and mortality. However in highly suspected cases of dengue infection clinical management should not rely on negative serological results

Risk factors for recurrent cerebral ischemic stroke

Recurrent ischemic strokes are common and often fatal. Hypertension, diabetes mellitus and Cigarette smoking have been recognized as modifiable risk factors for first ever stroke. This study aims to determine the frequency of these risk factors in recurrent ischemic stroke. It was a cross sectional analytical study carriedout at Medical Unit I, Abbasi Shaheed Hospital. 50 patients of both genders, and between ages of 14-80 years, admitted with diagnosis of CT scan confirmed acute ischemic stroke and whose medical history and CT scan [previous or recent showing old ischemic infarct consistent with neurological deficit] confirmed that there was a prior ischemic stroke, were enrolled for the study. All patients admitted in one year meeting the inclusion criteria were analyzed according to the questionnaire for three selected variables, namely, Hypertension, Diabetes and Cigarette smoking. Average age of patients was 61.4 +/- 8.01 years. There were 64% males. Hypertension was found to be a risk factor in 76% of patients while Cigarette smoking and Diabetes in 42% and 36% of Patients respectively. A combination of Hypertension and Diabetes was seen in 18% while Hypertension and Smoking were found in 22% simultaneously. Among the three factors analyzed, data revealed a significant effect of Hypertension in recurrent ischemic stroke as compared with Diabetes mellitus and Cigarette smoking. Combination of Hypertension and Diabetes and Hypertension and Smoking are the commonly occurring co-morbidities in patients with recurrent stroke