Principal causes of coma in medical units of a tertiary care hospital of Peshawar

To determine the principal causes of coma in patients admitted to the medical units of a tertiary care hospital of Peshawar. This cross sectional study was conducted at department of Medicine, Khyber Teaching Hospital Peshawar, from July 2006 to August 2007. All patients were randomly selected. Relevant information was recorded on a questionnaire prepared in accordance with the objectives of the study. A total of 124 patients with coma, 96[77.41%] males and 28[22.58%] females were included in the study. The age range of patients was from 12 years to 72 year with mean age of 50.5 years. The principal causes of coma were: cerebrovascular accident [CVA] 73.38% [n=91], epilepsy in 10.48% [n=13], head injury 5.64% [n=11], hepatic coma 2.41% [n=3], central nervous system [CNS] infections 2.41% [n=3], metabolic acidosis, drug abuse [1.61%] [n=2] each and cerebral malaria, hypoglycemia and uremia 0.8% [n=1] each. Risk factors for stroke recorded were hypertension in 46.2% [n=42/91], diabetes in 15.4% [n=14/91], ischemic heart disease 12.1% [n=11/91], smoking 5.5% [n=5/91], hyperlipedemia 3.3% [n=3/91] and atrial fibrillation 1.1% [n=1/91]. Scoring on Glasgow coma scale showed that 74.2% [n=92] patients scored 3-8, 25.8% [n=32] scored9-12 and none of the patients scored 13-15. In our setup CVA is the most common cause of coma followed by epilepsy, and head injury Other minor causes recorded were metabolic acidosis, drug abuse, central nervous system infections, cerebral malaria, hypoglycemia and uremia

Upper gastrointestinal endoscopic assessment of patients presenting with dyspepsia

To evaluate common causes of dyspepsia and to correlate endoscopic findings with histological examination of biopsy specimens. Material and This observational descriptive study was conducted at department of medicine Khyber Teaching hospital Peshawar, from 1st June 2006 to 31st December 2006. Detailed history, thorough physical examination and relevant investigations were done in each patient. All patients underwent upper gastrointestinal [GI] endoscopy. Biopsies were taken in every patient from oesophagus, stomach and duodenum. Histological examination was done from single pathologist. The endoscopic findings of 50 patients with dyspepsia were studied. Out of 50 patients, 35[70%] were males while 15[30%] were females. Eighty two percent [41/50] were in the age group of 30-50 years. The most common presentations were epigastric pain in 45 [90%] cases, heartburn in 36 [72%] and flatulence in 35 [70%] cases. The endoscopic findings were normal in 25 [50%] patients. The abnormal findings included esophagitis in 6 [12%] patients, gastric ulcer in 5 [10%] patients, duodenal ulcer in 4 [8%] patients, gastritis in 4 [8%] patients and duodenitis in 2 [4%] patients; while esophagogastritis, gastroduodenitis, esophagogastroduodenitis and carcinoma stomach were present in 1 [2%] patient each. All the endoscopically abnormal as well as normal findings were confirmed by histopathology. The endoscopic findings were normal in majority of patients with dyspepsia. The common abnormal endoscopic findings included esophagitis, gastric ulcer, duodenal ulcer and gastritis. The endoscopic findings were, matching with histological diagnosis