Predictive accuracy of model for end stage liver disease [MELD] as a prognostic marker for cirrhosis in comparison with Child - Pugh score

To compare Model for End Stage Liver Disease [MELD] and Child-Turcott-Pugh [CTG] scoring as predictors of survival in cirrhotic patients. Observational prospective study. Military Hospital, Rawalpindi from 1[st] Dec 2008 to 30[th] April 2009. The study was carried out at Military Hospital, Rawalpindi a tertiary care hospital of Pakistan. Study included 55 patients suffering from cirrhosis of both genders being above 12 years of age, admitted in medical wards during the period from 1[st] December, 2008 to 30[th] April 2009. Each patient was assigned a MELD and CTP score. On discharge, these patients were followed up at 03-months, O6months and 1-year duration through telephone. Thirty seven [67.3%] patients were male while 18 [32.7%] were female patients, with age ranging from 27 years to 75 years [mean 53]. Fourteen [25.4%] patients were dead at 3-months, 22 patients [40%] were dead at 6- months and 29 [52.7%] patients were dead at 1-year follow up. MELD score proved to be a better indicator of survival than CTP score over a period of 01 year follow-up. MELD score is a better prognostic marker for cirrhotic patients as compared to CTP score

Free medical camps in rural areas of Azad Jammu and Kashmir

To describe the demographics, diagnoses and treatment offered to the people attending five free medical camps in various rural areas of Azad Jammu and Kashmir [AJK] during 2012. Cross sectional descriptive study. Bhimber district of AJK from January 2012 to December 2012. Five free medical camps each of two days duration were established during this period in Nihala, Gola, Poona, Nalee and Barroh which are located in the Bhimber district. Camps were staffed by Army doctors and nursing assistants. The particulars of the attending patients were recorded at the reception and diagnoses along with the medicines dispensed noted at the dispensary. A total of 7320 patients attended the five medical camps. The age of the patients ranged from 05 days to 101 years, mean age being 35 years. Females constituted 59% [4319] of the patients. Majority of the patients were agricultural workers. The most frequent complamts were gastrointestinal [30.4%] musculoskeletel [25.5%] and visual acuity problems [15.1%]. Other common complaints were related with dermatology, ear, nose and throaf [ENT] and gynecology. A total of 5010 prescriptions were recorded and the commonest medicines prescribed were multivitamins [30.5%], analgesics [28.3%], antibiotics [22.3%] and antihelminthics [21.7%].Gastrointestinal and musculoskeletal ailments dominate in the rural population of AJK. Recruiting a pediatrician, gynecologist and ophthalmologist in rural medical camps would greatly improve the efficiency of such camps and increase patient satisfaction. Such camps are recommended until the indigenous healthcare system is developed enough

Various risk factors for irritable bowel syndrome

To assess the frequency of various known risk factors in patients with irritable bowel syndrome [IBS]. Descriptive study. Combined Military Hospital Okara on 60 patients [convenience sampling over a period of 01 year] who had been diagnosed with irritable bowel syndrome [IBS] and paid regular follow-up visits to the medical OPD. Each patient in the study was investigated for the presence of various risk factors of IBS i.e. their age, sex, weight, socioeconomics, state of education, any coexistent ailment [DM, HTN etc] and any history of enteritis and food intolerance. The frequency of each risk factor in this sample of patients was then analyzed. Two third of the patients were within the age bracket of 20-30 years showing a male predominance. Body mass index and educational status had no effect on the frequency of the disease. Neither could any co-existing ailment or food intolerance be linked with the disease. Relatively high socioeconomic status and a history of enteritis prior to developing IBS did show a positive co-relation with IBS. IBS is more common in young adult males. The disease shows a positive co-relation with a history of prior acute enteritis. It has a slight predilection for high socioeconomic status but its frequency is not related to food intolerance, any co-existing disease or BMI

Combat trauma experience at forward treatment centre during Swat operation

To have an overview of combat trauma experience at Forward Treatment Centre during Swat Operation. Descriptive study. Forward Treatment Centre of a medical battalion in Swat from Jan 2009 to August 2009. All battle casualties of different age groups operated under general anaesthesia were included in the study. Surgeries performed under local anaesthesia were excluded. Relevant information was recorded in specially prepared proforma. Two hundred and sixty eight surgeries were performed under general anaesthesia over the course of eight months. Twenty two [8.2%] were officers, 12 [4.5%] JCOs and 234 [87.3%] were soldiers. Majority of the casualities were between 20 -30 years of age [86%]. 73.9% of the casualities reached Forward Treatment Centre within 4 hours while 3.3% reached after 24 hrs. Most of the patients sustained injuries due to bullets [50.7%] and splinters [39.9%]. Most of the patients were putting on bullet proof jackets at the time of injury and sustained injuries to the limbs [237/268, 88.4%]. Blood transfusion was carried out in 32 [11.9%] cases. Fifteen [5.6%] cases required less than two and 17 [6.3%] cases required more than two units of blood transfusion. Most of the casualities were sustained by younger age group and were caused by bullets and splinters. Majority of the injuries were sustained on the limbs and less on the chest and abdomen. Blood transfusion and timely evacuation to a Forward Treatment Centre providing effective trauma surgical care to combat casualities saved a number of lives

Is it worthwhile to treat h pylori in all dyspeptic patients?

To evaluate the efficacy of H pylori eradication in patients with nonulcer dyspepsia, an interventional study was carried out in the Dept. of Gastroenterology, MH Rawalpindi from Jan to Feb 2004. Five hundred consecutive patients, who were referred for UGI Endoscopy, were studied. Out of these 500 patients, gastric biopsy was done in 245 patients. The patients in whom gastric biopsy was done, histopathology revealed gastritis in 187 patients and 129 [69%] were found H pylori positive. The subgroup of patients who were H pylori positive was further studied. These patients were given one week's course of eradication therapy and subsequently followed up. Sixty three percent [n=81] responded to treatment and reported improvement in their symptoms; whereas in thirty seven percent [n=48] of patients the dyspeptic symptoms persisted. In our set up where H pylori infection is pandemic, in the absence of alarm symptoms; all patients with nonulcer dyspepsia below 45 years of age should be considered for H pylori eradication