ABSTRACT
Objective: To determine the frequency of hepatic hydrothorax and its association with Child Pugh Class in patients with liver cirrhosis
Study Design: Descriptive, analytical study
Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-Ill, [Ward- 7], from June 2012 to May 2013
Methodology: All patients with established diagnosis of decompensated chronic liver disease were included. Detailed history, thorough physical examination, routine laboratory investigations, chest X-ray and abdominal ultrasound were carried out in all patients to find out the presence of pleural effusion and ascites, respectively. Fifty milliliters of pleural fluid was aspirated in all patients with pleural effusion using the transthoracic approach, taking ultrasound guidance, wherever required. Fluid was sent for microscopic, biochemical, and microbial analysis. SBEM defined if pleural fluid with polymorphonuclear [PMN] cell count > 500 cells/mm[3] or positive culture with PMN cell count > 250 cells/mm[3] with exclusion of a parapneumonic effusion
Results: Two hundred and six patients met the inclusion criteria, with mean age of 41.25 +/- 13.59 years. Among them, 149 [72.3%] were males and 57 [27.7%] females. Twenty-three [11.2%] had hydrothorax; right sided involvement was in 18 [78.3%] subjects, 3 [13%] had left sided while bilateral pleural effusion was found in 2 [8.7%] cases. SBEM was found in 07 [30.43%] cases. Mean serum albumin 3.125 +/- 0.71 gram/dl. There was association between serum albumin levels and hydrothorax. A significant association of hydrothorax with Child Pugh scoring system [p=0.018], but not with serum albumin [p=0.15]
Conclusion: The frequency of hepatic hydrothorax has a significant association with hepatic function as assessed by Child Pugh scoring system, but not with serum albumin
ABSTRACT
Objective: To assess the demographic, clinical, endoscopic and histological spectrum of Solitary Rectal Ulcer Syndrome [SRUS]
Study Design: Cross-sectional observational study
Place and Duration of Study: Medical Unit-III, Civil Hospital Karachi [CHK] and Ward 7, Jinnah Postgraduate Medical Centre [JPMC], Karachi, from January 2009 to June 2012
Methodology: Patients with SRUS, based on characteristic endoscopic and histological findings, were enrolled. Patients were excluded if they had other causes of the rectal lesions [neoplasm, infection, inflammatory bowel disease, and trauma]. Endoscopically, lesions were divided on the basis of number [solitary or multiple] and appearance [ulcerative, polypoidal/nodular or erythematous mucosa]. Demographic, clinical and endoscopic characteristics of subjects were evaluated
Results: Forty-four patients met the inclusion criteria; 21 [47.7%] were females and 23 [52.3%] were males with overall mean age of 33.73 +/- 13.28 years. Symptom-wise 41 [93.2%] had bleeding per rectum, 39 [88.6%] had mucous discharge, 34 [77.3%] had straining, 34 [77.3%] had constipation, 32 [72.7%] had tenesmus, 5 [11.4%] had rectal prolapse and 2 [4.5%] had fecal incontinence. Twelve [27.27%] patients presented with hemoglobin less 10 gm/dl, 27 [61.36%] with 10 - 12 gm/dl and 05 [11.36%] subjects had hemoglobin more than 12 gm/dl. Endoscopically, 26 [59.1%] patients had mucosal ulceration, 11 [25.0%] had mucosal ulceration with polypoid characteristics; while only polypoid features were found in 7 [15.9%] subjects
Conclusion: Solitary rectal ulcer syndrome affects adults of both genders with diverse clinical presentation and nonspecific endoscopic features
ABSTRACT
To assess the Vitamin D levels in patients diagnosed as fibromyalgia in patients attending Dow University Hospital Karachi. Descriptive study. This study was conducted at Dow University Hospital, Karachi from 21[st] January 2013 to 30[th] December 2013. 83 patients were selected from the outpatient department of medicine OPD. among 83 patients who were enrolled in the study 60 [72.71%] were male and 23were [27.71] were females ages were between 7 and 70 years, the vitamin D levels ranged between 2 and 58with mean vitamin D level found to be 12,58 which is counted as moderate deficiency. 83 patients with fibromyalgia were included in study. Among them who were enrolled in the study 60 [72.28%] were male and 23 [27.71%] were females .The subjects included in study age between 17 and 70 with mean age of 39.69 years. The fibromyalgia was gauged on clinical assessment. Vitamin D levels were classified. Vitamin D levels ranged between 2 and 58 with mean 12.58. As objective of study to assess vit D levels in diagnosed fibromyalgia patients in our population it was found that relationship between two parameters in significant. Vitamin D deficiency is frequently diagnosed in patients with fibromyalgia and nonspecific musculoskeletal pain in study population