prevalence of liver diseases and etiological factors among the patients of Jinnah post graduate medical centre [JPMC], Karachi

Objective: To determine the frequency and etiological factors of nonneoplastic and neoplastic liver diseases

Study Design: Observational / analytic study

Place and Duration of Study: This study was conducted at the Department of Pathology, BMSI, JPMC from 1st January 2012 to 31st September 2014

Materials and Methods: A total of 288 liver biopsycases of formalin fixed liver tissue biopsies were selected and analyzed for morphological features and grading received from January 2010-December 2012, at the department of Pathology, Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre. Most common liver disease was CLD [88.54%]. Most common age for CLD was between 3rd-5th decades of life with male predominance. HCV was the most common etiological factor. Out of total cases, 6.59% were hepatocellular and bile duct carcinomas. Most common age for liver cancers was 5th-7th decade of life with male predominance. The data feeding and analysis were on computer package SPSS [Statistical Packages of Social Sciences] version 20.0. In all statistical analysis only p-value <0.05 was considered significant

Results: The most commonly encountered liver disease CLD was found as a major liver disease [71%] of the samples were suffering from CLD, while 25 % were suffering from HCC, Hepatitis C was the major cause of the liver diseases, [55.56%] of the liver patients were earlier suffering from the Hepatitis C

Conclusion: In conclusion we observed that the most common liver disease in biopsy cases is chronic liver disease [chronic hepatitis], mostly occur between 21-50 years of age with male predominance and most frequent etiological factor is HCV

Expression of Cox-2 in non- liver diseases

Objective: To determine the frequency of liver diseases and evaluate the expression of COX-2 in non-neoplastic and neoplastic liver lesions

Methodology: This cross sectional study is based on the analysis of liver biopsies received at department of pathology, BMSI, JPMC from 1st January 2010 to 31st December 2012. Approximately 71 cases of formalin fixed liver tissue biopsies were selected and analyzed for morphological features, grading and results of immunohistochemical staining for COX-2. The data feeding and analysis were on computer package SPSS [Statistical Packages of Social Sciences] version 16.0. In all statistical analysis only p-value <0.05 was considered Significant

Results: The most commonly encountered liver disease, out of the total 288 cases ,was chronic liver disease [CLD] including 255 cases [88.54%] out of these 12[4.17%] showed full- fledged cirrhotic nodule. Mean age was 33 yrs. for chronic liver disease. Male female ratio was 1.6:1 for CLD while for hepatocellular carcinoma and bile duct carcinoma M/F ratio was 2.8:1. The etiological distribution of 255 cases of CLD cases revealing that hepatitis C is the most common cause of chronic hepatitis accounting for 70% of cases. On immunostaining using COX-2 antibody for CLD with mild inflammatory grade cases, only 14.2% showed strong staining and all the 19 HCC and bile duct carcinoma 78.94% displayed strong positivity

Conclusion: There is progressive increase in staining expression of COX-2 in non-neoplastic and neoplastic liver lesions. An early inhibition of COX-2 via selective COX-2 inhibitors may prevent further exacerbation of disease

Clinical spectrum of post-stroke seizures

To determine the characteristics of post-stroke seizures and compare these in early vs. late post-stroke seizures. Observational study. Department of Neurology, Liaquat National Hospital, Karachi, from March to September 2007. All admitted patients aged over 25 years, with diagnosis of post-stroke seizures were included. Those with known epilepsy, sepsis and eletrolyte imbalance were excluded. Age, co-morbid condition, details of seizures and radiological findings regarding type and location of stroke were collected and entered in a pre-formed proforma. Results were described as frequency and mean. Association of variables was determined through chi-square test with significance at p < 0.05. Out of the 50 patients, there were 28 [56%] males and 22 [44%] females with the mean age of 56.86 +/- 15.26 years. Thirty-one [62%] patients had history of hypertension. Early seizures i.e. within 2 weeks were seen in 29 [58%] patients. Generalized seizures were seen more frequently i.e. in 37 [74%] patients. Thirty-one [62%] subjects experienced more than 2 seizures. Forty [80%] had an ischemic stroke including 36 [72%] arterial infarct and 3 [6%] venous infarcts. Intracerebral hematoma was seen in 10 [20%] of subjects. Comparison between early and late onset seizures revealed significant association between ischemic heart disease [IHD], old stroke, hypertension and late onset seizures [p < 0.05]. Post-stroke seizures were more frequent in males, with history of hypertension, and with cortical ischemic strokes. Early seizures, multiple episodes and generalized seizure type were more common. Venous infarcts were chiefly associated with seizures at presentation. History of old stroke, ischemic heart disease, hypertension and hypercholesterolemia showed a strong relationship with the occurrence of late onset seizures