Gastroesophageal reflux disease in patients with chronic obstructive pulmonary disease

Objective: To evaluate the gastroesophageal reflux symptoms in Chronic Obstructive Pulmonary Disease [COPD] patients and Upper Gastrointestinal [GI] endoscopy findings in these patients

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted at Dow University Hospital and Civil Hospital Karachi from January 2013 to December 2013

Materials and Methods: 100 of COPD were selected and assessed for presence of gastro esophageal reflux [GERD] symptoms. Data was analyzed on SPSS version 13

Frequency and percentage were computed for categorical variable like gender, gastro-esophageal reflux symptoms and upper GI endoscopy finding in COPD patients with gastro esophageal reflux symptoms. Mean standard deviation was computed for quantitative variables like age, smoking [pack year], solid fuel and tea consumption [cup/day]

Results: In this study of 100 patients 95 were males and 5 were female. Cough was the commonest symptom that was found in 85% patients followed by sputum production in 71% patients, retrosternal burning [68%], acid reflux [54%] and dysphagia [11%]

Gastro-esophageal reflux symptoms were observed in 54 patients. Out of these 54 patients who had GER symptoms, 33 [61%] patients had erosive gastro-esophageal reflux disease while 21[39%] patients non-erosive gastro esophageal reflux disease on upper GI endoscopy

Conclusion: Our study shows that higher proportion of Gastro esophageal reflux symptoms is present in COPD patients. Moreover, upper GI endoscopy can be normal in COPD patients with significant GERD symptoms

Association of sensory polyneuropathy with restless legs syndrome

Objective: To determine the prevalence of restless legs syndrome [RLS] in elderly patients with pure sensory polyneuropathy and correlate the findings with other clinical features

Study Design: Observational / cross sectional study.Place and Duration of Study: This study was conducted at the Dow University Hospital and Civil Hospital Karachi from 2013 to 2015

Materials and Methods: 48 patients with Restless leg syndrome were evaluated in our multicenter, prospective study in 2 years for evidence of pure sensory neuropathy either they have demyelinating or axonal type. Patients were evaluated according age at which symptomsstarted, the severity of symptoms, typical clinical findings and laboratory investigations

Results: In 21 of the 48 [43.7%] patients, peripheral neuropathy was detected. Ten patients had pure sensory polyneuropathy and remaining have mixed sensory motor polyneuropathy. The pure sensory neuropathy group had comparatively intense and frequent symptoms of Restless leg syndrome. Some of them have family history of Restless leg syndrome. Patients with Mixed sensory motor polyneuropathy did not have similar strong symptoms of Restless leg syndrome and pain in legs

Conclusion: The result suggests that Restless leg syndrome is triggered by painful paresthesias is primarilyrelated with pure sensory neuropathy. Patients with mixed sensory motor neuropathy have less intense feature of restless leg syndrome. So the treatment options should be focused on medicines used for neuropathic pain

Incidence of hyperamylasemia leading to respiratory failure in patients of organophosphate poisoning

Objective: To determine the frequency of Hyperamylasemia leading to respiratory failure in patients of organophosphate poisoning

Study Design: Observational / descriptive study

Place and Duration of Study: This study was conducted at the Department of Medicine Dow University of Health Sciences, Karachi from June 2014 to June 2015

Materials and Methods: A total of 168 patients of Organophosphate poisoning fulfilling the inclusion criteria were included in the study. Blood was drawn after aseptic measures by a trained phlebotomist for Serum Amylase level and Arterial blood gases. Value more than 101U/L was taken as hyperamylasemia. PaO[2] less than 60mmHg or PCO[2] greater than 55mg was labeled as respiratory failure. All information was noted on proforma

Results: There were 59% were male and 41% were female. Frequency of hyperamylasemia in patients of organophosphate poisoning was 44%. Frequency of respiratory failure in hyperamylasemia in patients was observed in 68%. Respiratory failure was significantly high in male than female [70% vs. 30%; p=0.019]

Conclusion: Hyperamylasemia is more frequently seen in organophosphate poisoning. In patients with respiratory failure the mortality is very high; therefore we recommended early diagnosis, careful monitoring and appropriate management of complications in reducing the mortality rate

Serum magnesium level in migraineurs versus non migraineurs

The objective is to observe relationship between low serum magnesium level and Migraine. Prospective Observational. This study was conducted in Dow University Hospital, Dow University of Health Sciences, Karachi from 1[st] January 2013 to 31[st] December 2014. One hundred and fifty patients attending the medical and Neurology OPD at Dow University Hospital were included in study. They were diagnosed according to International Headache Society [HIS] criteria for migraine headache. 150 patients were enrolled in study 49 [32.7%] were male and 101 [67.3%] were female patients mean age was 28 [ +/- 6.2] years, After excluding other causes migraine was diagnosed in 102 [68%] patients. Out of 102 patients 71 [69.7%] were have low serum magnesium level. In the remaining patients with non migrainous headache, only 6 patients [12.5%] have low serum magnesium level because of some other causes for example medications. Migraine is frequently associated with Serum low level of Magnesium compare to patient with nonmigrainous headache

Frequency of impaired glucose tolerance test in patients with active tuberculosis

Objective: To determine the frequency of impaired glucose tolerance in patients presenting with active pulmonary tuberculosis in tertiary care hospital, Karachi

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted at Dow University Hospital [Dow University Health Sciences Karachi] from 1stJune 2014to 30thNovember 2014

Materials and Methods: A total of 110 diagnosed adult cases of active pulmonary tuberculosis on the basis of sputum smear positivity were included in this study. Blood samples were drawn for investigations and sent to the same reference laboratory to minimize bias.Data was collected on a pre-tested self administered Performa

Results: There were 59.1% were male and 40.9% were female. Frequency of impaired glucose tolerance in patients presenting with active pulmonary tuberculosis was observed in 20.9%. Rate of impaired glucose tolerance was highly associated with above 40 years of age patients and with family history of diabetes

Conclusion: In Pakistan DM is on the rise and TB has one of the highest incidence in the world. There is emerging evidence that one disease is fuelling the other. The interest in diabetes and TB is mounting rapidly, so the clinician and researchers should prepare themselves to meet the challenges of the two diseasecombined