Prevalence of viral hepatitis in patients attending medical camp

Objective of this study was to check prevalence of Viral Hepatitis in Patients attending Medical Camp Cross sectional study. This study was conducted in free Medical Camp of Shaheed Mohtarma Benazir Bhutto Medical University Larkana from 01.07.2011 to 31.12.2011. An advertisement was given one week prior via media for awareness of people. The camp was organized by the faculty of Medical unit III on 1[st] July 2011. This camp, apart from necessary medicines, equipped with diagnostic facilities to diagnose hepatitis B and C viruses. Patients willing to participate in this study were enrolled; patients with known hepatitis B and C were excluded. ELISA technique was used to diagnose. This study was approved by Ethical committee of Shaheed Mohtrama Benazir Bhutto Medical University. SPSS version 19 was used for data analysis. Total of 400 peoples were seen at the camp, 96 of them were already known cases of hepatitis B and C and were excluded from analysis. Of 304 patients 246 were males and 154 were females. From 304 patients 32 [10.5%] patients had hepatitis C and 16 [5.3%] had hepatitis B and rest were seronegative. The frequency of HCV and HBV was common in patients with age between 20 to 40 years. This was a small effort to increase awareness in local population regarding the course of viral hepatitis. We also collected data regarding present prevalence of chronic viral hepatitis in rural areas of interior Sindh. Much more is to be done to control this misery of our community

Frequency of hepatotoxicity caused by ATT in pulmonary tuberculosis

Tuberculosis is common disease caused by Mycobacterium Tuberculosis. Tuberculosis is one of the world's most widespread and deadly illnesses and infects an estimated 20-43% of the world's population and kills about 3 million people each year in the world. The common side effect of antituberculous drugs is hepatotoxicity. This study was carried out to determine the magnitude of hepatotoxicity caused by antituberculous drugs in patients of pulmonary tuberculosis. To determine the frequency of hepatotoxicity caused by ATT in pulmonary tuberculosis. Frequency of hepatotoxicity. Cross sectional study. This study was carried out in collaboration of Department of Medicine and Department of Pulmonology, Chandka Medical College, Civil Hospital Larkana from November 2010 to May 2011. Subjects: All consecutive sputum smears or culture positive patients or radiological evidence of active pulmonary T.B of either sex, older than 15 years of age were included in the study. After approval of ethical committee for medical research of Shaheed Mohtarma Benazir Bhutto University Larkana, informed written consent was taken from newly diagnosed patients of pulmonary tuberculosis for participation in the study. Blood samples were taken, coded and sent for determination of liver function test. Final outcome was measured at the end of 4th week. The data was analyzed using SPSS version 17. A total of 256 patients were enrolled in this study during study period. The mean age of enrolled participants is 41.5 +/- 18.1. Of 256 patients, 132 [51.6%] were male and 124 [48.4%] were female. The male to female ratio was 1.06:1. Mean serum bilirubin was 1.5 +/- 0.7 mg/dl [Range l.l-3.9mg/dl], the mean alanine transferase level was 34.7 +/- 11 IU/L [Range 11- 109 IU/L], aspartate transferase level was 35.4 +/- 19.3 IU/L [Range 11-112 IU/L] and alkaline phosphatase level was 150 +/- 38 IU/L [Range 95-280 IU/L].The frequency of hepatotoxicity was 51 [19.9%]. Hepatotoxicity was observed in 25-35 age group was 21.7% and 56-65 years was 26%. Hepatotoxicity was observed in 23.4% female and 16.7% male. It is concluded from this study that patients taking anti tuberculosis therapy are vulnerable to hepatotoxicity. Screening should be done after starting of ATT in order to avoid liver damage

Association of hepatitis [B, C and D] viral infection to gallstones in cirrhosis of liver

To observe the association between hepatitis viral [B, C and D] infection to gallstones in liver cirrhosis. A cross-sectional and hospital based study. This study was carried out at the Hepatology Clinic of CMC, Larkana during January 2011 to December 2011. 913 patients of cirrhosis of liver presenting at Hepatology Clinic of CMC, Larkana during January 2011 to December 2011 were enrolled for study. After informed written consent, blood samples were drawn for HBsAg, anti -HCV antibodies, and anti-HDV Antibodies by ELISA. Ultrasound of all cases was performed to detect gallstones and study the related radiological features. The data was transferred and analyze using SPSS version 17. Means of numeric response variables and categorical response variables were compared by chi-square test and odd ratios calculated when and where applicable. P value less than 0.05 was taken as statistically significant. HBsAg, Anti-HCV Ab and Anti-HDV Ab were documented in 272 [42.2%], 253 [39.3%] and 178 [27.6%] patients respectively. HCV co infection with HBV and HDV was documented in 56 [8.7%] and 44 [6.8%]. Gallstones were detected in 269 [29.5%] cirrhotic patients, of these 136 [14.9%] were multiple. Statistically significant association was observe between gallstones and HBsAg seropositivity with odd of 2.17 [95% CI: 1.62 - 2.90] and p value less than 0.001. There was no statistically significant association between Anti-HCV Ab and Anti-HDV Ab seropositivity with gallstones in cirrhosis of liver. HBV infection is documented more frequently in cirrhosis with gallstone. Female were more likely to be infected. HBV infection may be one of the risk factor for development of gallstones in cirrhosis of liver

Frequency of hepatitis D virus infection in hepatitis B surface antigen-positive liver diseases

To determine the frequency of HDV among hepatitis B surface antigen [HBsAg]-positive liver disorders. An observational cross-sectional study. Medical Unit I, Chandka Medical College Hospital, Larkana, from July 2003 to June 2008. Adult patients with HBs liver related disorders were evaluated for the presence of delta antibodies using commercially available ELISA kits. Descriptive statistcs were used for describing data. Proportions of anti D antibodies between gender and age were compared using chi-square test with significance at p < 0.05. Of the 774 cases, 438 were males [60.4%] and 336 were females [39.6%]. The mean age was 36.5 +/- 14.39 for males and 34.03 +/- 13.16 years for females ranging from 15 to 60 years. Anti-HDV was positive in 183 patients [23.6%].The frequency of HDV was not significantly different between the gender groups [p=0.718]. HDV infection was markedly higher in chronic than acute liver disorders. The HBV/HDV co-infection is frequent in the studied area. Therefore, practitioners and health care managers should be made aware of the risk of dual infection with HBV and HDV

Stapled hemorrhoidectomy in third degree hemorrhoids: a prospective study

To study the outcome of Stapled haemorrhoidectomy in 3rd degree hemorrhoids. 50 patients, who underwent stapled hemorrhoidectomy, were included in this study. The study took place at Surgical Unit-I, Civil Hospital, Karachi, from January 2009 to December 2010. Prospective interventional study. Stapled hemorrhoidectomy [SH] was performed in 3rd degree haemorrhoids in 50 patients. 3 patients had minimum pain and only 1 patient had persistent pain and one patient had post-operative minor bleeding which was managed conservatively. SH is an effective surgical procedure for the treatment of 3rd degree haemorrhoids. There is strong evidence that SH results in less postoperative pain than other procedures as well as earlier mobility. In our experience, SH is the treatment of choice for third degree hemorrhoids in hospitalized patients

Effect of piroxicam and zinc on morphological and histochemical changes in mice liver

To observe the morphological and histochemical findings, produced by piroxicam and zinc in mice liver and correlate with serum hepatic enzyme. For this experimental study 30 adult mice [25 -30 grams] were obtained from animal house of Jinnah Postgraduate Medical Center, and divided into three groups i.e. A, B and C. Group A served as control and received normal diet, Group B received piroxicam 0.3 mg /Kg body weight intraperitoneally and Group C 1mg/Kg body weight of zinc intraperitoneally and piroxicam in the same dose as group B. After completion of study [6 weeks] animals were scarified and their livers were removed and after processing paraffin section were made and stained with Haematoxylin and Eosin for histological and histochemical examinations and correlate with serum hepatic enzyme level. Haematoxylin and Eosin stained section of group A indicated the normal histology and morphometry, the group B showed distorted hepatic lobular architecture. Central vein and sinusoids was dilated and congested, kupfer cell prominent and pyknotic cells and mono nuclear infiltration were seen. Group C showed altered histological findings comparable to group A. The Histochemical findings of group B showed depletion in glycogen content marked fibrosis of reticulin fibres and increased deposition of calcium phosphate crystals. In group C effect of zinc improve glycogen content and reticulin fiber deposition and decreased deposition of alkaline phosphatase crystals. The serum enzyme level of Alkaline Phosphatase and Serum Gulutamin Phosphatase significantly increased in group B animals and less significantly increase in group C as compared to group B animals. It was concluded that piroxicam in therapeutic dose, was toxic and produced hepatic injury and zinc along with piroxicam improved the hepatic damage

Radioprotective role of methycobal on perkinje cells of young albino rats

Therapeutic radiation used for the tumors of brain and head and neck, may damage normal brain tissue Cerebellum also shows disturbances in Its function and architecture The present experimental study was designed to observe histological changes produced by radiation in the purkinje cells of cerebellum. A prospective experimental study Place Anatomy Department Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre. Karachi. October 2008-November 2008. 30 Albino litters [day 01] were selected and divided in three groups Group "A" served as control, group "B" is radiated group and group "C" as treated group. Group B and C received radiation at the dose of 3Gy [Gray] for 202 mm in the field size of 15 x15 cm on clay 08 Group C received injection Methycobal 200 meg / kg body wt. [ip] daily from the day of radiation: Animals were sacrificed on day 15.3 micro thick paraffin embedded sections of cerebellar tissue were made and stained with haematoxylin and eosin for Morphometric study of Purkinje cell. Methycobal induces the protective effects on the distorted size and monolayer of purkinje cells. The results are indicative of ameliorating effects ot Methycobal on irradiated purkinje cells of cerebellum

Diabetes mellitus [diagnosed and undiagnosed] in acute myocardial infarction

To determine the proportion of Diabetes Mellitus [DM] in patients with documented first episode of Acute Myocardial Infarction [AMI], in both genders. A prospective, case control observational study. Emergency Room, CCU and Medical wards of Chandka Medical College Hospital Larkana, Pakistan, from January 2005 to August 2005. 200 patients 100 consecutive males and 100 consecutive females, presenting with definite first episode of AMI. Diagnosis of D.M established on previous history of D.M, medical record and medications used by patient, patients without previous diagnosis of D.M [Undiagnosed], were diagnosed by performing Fasting Plasma Glucose [FPG], once within around 72 hours and 8 weeks later on. Out of 200 patients 49 [24.5%] were known diabetics, 20 [10%] revealed hyperglycemia [suspected diabetics] on routine plasma glucose level and Fasting Plasma Glucose [FPG] petformed within 72 hours of the onset of AMI and on subsequent follow up after 8 weeks, FPG level performed revealed 12 [6%] newly diagnosed definitive diabetics, while 5 [2.5%] revealed Impaired Glucose Tolerance Test [GTT] and 3 [1.5%] were found to be non-diabetics, so that a total 61 [30.5%] were labeled as diabetics. one out of every three patients with AMI had DM, elevated levels of random blood glucose and FPG at the time of admission are not reliable measures to establish the diagnosis of diabetes in cases of AMI and thus follow up measurements after a period of 6-8 weeks are necessary to establish the diagnosis. Awareness in general public regarding deleterious effects of DM should be promoted

Predicting factors of Seroma formation after Breast cancer surgery

To determine the frequency of seroma formation, and the role of hypertension, diabetes mellitus, neoadjuvant chemotherapy and nodal dissection in the development of seroma after breast surgery. Hospital based prospective study with descriptive design [interventional descriptive] from April 2002 to March 2005. Setting: Department of General Surgery [Ward-2], Jinnah Postgraduate Medical Centre, Karachi. 160 patients of Carcinoma Breast who underwent elective surgery. Patients were divided into two groups viz. those who developed seroma [Group-A] and those who did not [Group-B]. The data was tabulated on SPSS version 10.0. Demographic data was represented in frequencies. The effect of various risk factors [hypertension, diabetes mellitus, nodal status, tumour histology] was calculated and presented as relative risk [RR]. Out of 160 patients, there were 157 females and three males, with a sex ratio of 53F:1M. Their ages ranged from 23 to 100 years. A total of 144 patients underwent modified radical mastectomy and 16 breast conservation. Seroma formed in 28 [17.5%] cases. Out of 36 hypertensive patients 22 developed seroma [RR=12.72], while amongst the 28 diabetics two and amongst the 64 patients that received neoadjuvant chemotherapy 12 developed seroma. The total number of axillary lymph nodes in patients who developed seroma ranged from 4-28 as compared to non-seroma group with 4-30; an average of nine [0-25] positive nodes were seen in both the groups. Seroma formation is a common complication of the modified radical mastectomy. The only factor that appeared to contribute to seroma formation in this series was hypertension. Neoadjuvant chemotherapy marginally increased the risk, but diabetes had no role in seroma formation

Abdominal wound dehiscence: frequency and risk factors

To determine the frequency and associated risk factors in patients with abdominal wound dehiscence. A descriptive study. Surgical Unit-I, Chandka Medical College Teaching Hospital, Larkana, between May 2002 toApril 2005. This study included patients with various etiologies of emergency and elective midline laparotomies. The patients operated with other incisionswere excluded. The data obtained was analyzed for each patient and postoperative complications were documented. Out of total 300 patients, 16 developed wound dehiscence giving an overall frequency of5.33%. Age ranged from 10-82 years with mean age of 33.5. Male to female ratio was 1:0.58. The frequency was greater in males than females with ratio 3:1. Majority of the patients had gut perforation with peritonitis. Out of twenty one patients with hypoalbuminemia, 09 develops wound dehiscence. Emergency surgery showed a higher frequency of wound dehiscence 7% [14/200] compared to elective surgery 2% [2/100]. Wound infection was a major factor to wound failure. Old age was also associated with greater frequency. The mortality rate of abdominal wound dehiscence was 25%, due to septicemia and multiple organfailure.Abdominal wound dehiscence still continues to be a major postoperative complication, with a high morbidity and mortality, and has significant impact on health care cost. The significant risk factors in this study were primary disease presented with peritonitis, emergency surgery, old age, male gender; wound injection and technique of closure. Less significant factors were jaundice, uremia, diabetes, and type of suture material used