Frequency of rectal varices in patients with cirrhosis

To document the frequency of rectal varices in patients with cirrhosis of liver and compare it with that of oesophageal varices in liver and to compare the frequency of rectal varices with non-cirrhotic controls. Design: A cross-sectional analytical survey. Place and Duration of Study: The study was conducted in the medical wards of Civil Hospital, Karachi from August 2000 to July 2001. Patients and All patients of confirmed cirrhosis of liver, presenting during the study period, were selected for initial workup. On the basis of upper gastrointestinal [GI] endoscopy, patients were segregated into those with oesophageal varices [Group-A] and those without them [Group-B]. A matched control group [Group-C] was added, which consisted of patients of irritable bowel syndrome [IBS] who underwent sigmoidoscopic/colonoscopic examination during the study period. Fiberoptic sigmoidoscopy was done in all selected patients. Statistical analysis for continuous variables was done by student's 't' test while non-continuous variables were analyzed by Mann-Whitney-U test. A total of 104 patients [males 61; females 43] were included. Hepatic encephalopathy grade was significantly lower in Group-B [p < 0.0001]. Grade-I varices were seen in 13 patients, Grade-II in 38 and Grade-III in 33 patients of Group-A. Rectal varices were present in 59.9% of patients in Group-A as compared to Group-B in which no one had them [p<0.0001]. Rectal varices are common in patients of portal hypertention

open evaluation of fluconazole as a single dose oral treatment for vaginal infections with candida

The clinical and mycological efficacy of single-dose oral treatment with Fluconazole 150mg was evaluated in 29 patients with vaginal candidiasis confirmed by microscopic and culture examination. Clinical and mycological evaluations were done at 5-9 days after treatment and again at 4-6 weeks after treatment. Fluconazole produced rapid relief of signs and symptoms [erythema, excoriation, erosion, discharge, pruritis and burning/irritation] and this relief persisted in 80 to 90% of patients 4-6 weeks after treatment. At 5-9 days post treatment, 93% of patients were clinically cured or improved while 76% of patients were mycologically cured. At long term follow-up visit 4-6 weeks after treatment, 100% of patients were found clinically cured or improved while 97% were determined candida-free on microscopic/culture examination. Overall therapeutic response [combining clinical and mycological response to treatment] at the end of the study was rated excellent or good in 93% of the patients. Toleration of the drug was exceptional as no side effect was reported by the patients during the study. Results of this study suggest that fluconazolc as a single dose oral treatment is effective in providing both short-term and long-term control of vaginal candidiasis clinically as well as mycologically, with no problem of toleration