Chronic gastritis and helicobacterpylori: a histopathological study of gastric mucosal biopsies

The aim of this study was to observe the histological features of chronic gastritis and associated effects due to Helicobacter pylori infection in 176 randomly selected antral biopsy specimens of chronic gastritis cases. The specimens were reviewed for the presence or absence of H.pylori. The activity [neutrophilic infiltration] of gastritis and the presence or absence of mucosa-associated lymphoid tissue [MALT] were also noted. Chi-square test [Pearson value] was used to analyze categorical variables. H.pylori was detected in 110 [62.5%] cases of chronic gastritis. There was a significant association between H.pylori infection and activity of chronic gastritis [p=0.002]. Lymphoid aggregates were significantly more frequently noted in H pylori-positive patients [68.2%] vs. H.pylori negative group [47%], [p=0.005]. It is concluded that H.pylori is significantly associated with active chronic gastritis and with formation of mucosa-associated lymphoid tissue [MALT], which may develop into gastric lymphoma [MALT type]

Characteristics of patients with Guillain Barre syndrome at a terrtiary care centre in Pakistan, 1995-2003

To study the clinical presentation, hospital course and outcome of patients admitted with Guillain Barre Syndrome [GBS] to a tertiary care hospital in Karachi, Pakistan. The charts of patients conforming to International Classification of Diseases [ICD] code 9.0, for GBS, from September 1995 to January 2003 were reviewed. Clinical data was recorded on a standardized questionnaire, which included patients' age, sex, antecedent events, neurological signs and symptoms and ventilation requirement. The hospital course was analyzed, including nosocomial infections, therapy given and the functional status of patients, using the Rankin scale [0-6]. Standard SPSS 11.5 software [Windows] was used for data analysis. Thirty-four cases of GBS were admitted to the hospital during the study period, with an age range of 3 to 70 years. The mean age for disease onset was 35.2 years for female patients, compared to 30 years for males; the male/female ratio was 1.6:1.Gastrointestinal infections [12/22, 54.6%] were the most common antecedent event, followed by upper respiratory tract infections [9/22, 40.9%] and skin lesions [1/22, 4.5%]. Most patients developed GBS within one month of the preceding infection. Cranial nerve abnormalities [30/34, 88.2%], autonomic dysfunction [21/34, 61.8%] and respiratory failure requiring intubation [19/34, 55.9%] were also common. The median Rankin score of patients at admission, and at 30 and 60 days thereafter was 5, 4 and 3.5 respectively. The in-patient mortality was 1 of 34 [2.4%]. We found that GBS occurred at all ages and was slightly more common in males. Majority of patients had an antecedent history of infection and had severe disease on presentation. The patients were treated with either plasmapheresis or intravenous immunoglobulins and there was no significant difference in outcome in the two groups. Despite severe persistent disability, in-hospital mortality was low

Does malaria during pregnancy affect the newborn?

To investigate the effect of malarial infection during pregnancy on the newborn. A retrospective cohort study was conducted at The Aga Khan University Hospital [AKUH], Karachi, using in-patient hospital records over an 11-year period from 1988 to 1999. The incidence of preterm delivery, low birth weight [LBW] and intrauterine growth retardation [IUGR] in 29 pregnant women with malaria, was compared with that in 66 selected pregnant women without malaria, who delivered at the AKUH during the same time period. Pregnant women with malaria had a 3.1 times greater risk of preterm labor [p=0.14]. They were more likely to be anaemic compared to women without malaria [RR=2.9, 95% CI=1.6-5.4] and had a significantly lower mean haemoglobin level [p=0.0001]. Maternal malaria was significantly associated with LBW babies [p=0.001]. The mean birth weight of infants born to pregnant women with malaria was 461 g less [p=0.0005]. No significant association was, however, found between malarial infection during pregnancy and IUGR [p=0.33]. Malarial infection during pregnancy is associated with poor maternal and fetal outcome. It is significantly associated with maternal anaemia and LBW infants. Appropriate measures must, therefore, be taken to prevent malaria during pregnancy, especially in endemic areas