Creatinine clearance as effective non-invasive marker in determining Gastrointestinal Lesions and Helicobacter Pylori infection

Objective: The objective of this study focuses to unfold the importance of creatinine clearance in determining the gastrointestinal mani-festations and Helicobacter Pylori infection

Study Design: Cross-sectional comparative study

Place and Duration of Study: Medicine department of Fauji Foundation Hospital Rawalpindi, from Jun 2015 to Dec 2016

Material and Methods: Creatinine clearance of 73 CKD patients was calculated. UGI endoscopy was performed to detect gastro-intestinal lesions. H.pylori was detected by histopathology of gastric mucosal biopsy. The diagnostic accuracy of CCl in determining the presence of gastrointestinal [GI] lesions was determined by receiver operating characteristic [ROC] curve [AUC]. Cut-off value, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios were obtained by Youden index

Results: Mean CCl was 27.09 +/- 12.16 ml/min. Diabetes mellitus was the top most cause of CKD [45.2 percent]. Upper GI endoscopic lesions were present in 68.5 percent patients [p-value<0.05]. The most common abnormality was erythematous gastritis. H. pylori infection was lower in disease group compared to controls, but statistically insignificant [p>0.05]. The AUC for CCl in determining the gastrointestinal lesions was 0.8 [p-value

Conclusion: CCl was found, noninvasive marker in predicting the GI abnormalities. It can be used to identify the high risk patients. Such patients then can undergo endoscopy for further management. H.pylori eradication therapy should be offered to those patients in whom its presence is proven by other tests as well

Caustic ingestion injuries - at Military Hospital Rawalpindi

To study the pattern and endoscopic severity of caustic ingestion injuries presenting at Military Hospital Rawalpindi. Descriptive study. The study was conducted at Medical and Gastroenterology Department Military Hospital Rawalpindi from August 2012 to April 2013. Patients were selected from those who presented with caustic ingestion history in Medical OPD, ER and in medical wards. After informed consent the patient underwent upper gastrointestinal [GI] Endoscopy. Endoscopic findings were recorded. Out of 50 patients, 21 [42%] were males and 29 [58%] were females. Ingestion was accidental in 19 [38%] and was with intent of suicide or self-harm in 31 [62%] patients. Mean age was 33.2 years [SD +/- 13.2]. All the patients were subjected to upper GI endoscopy and findings were recorded. Endoscopic findings were grade 0 in 4 [8%], Grade 1 in 6 [12%], grade 2a in 7 [14%], grade 2b in 10 [20%], grade 3a in 6 [12%] and grade 3b in 17 [34%] patients. Caustic ingestion injuries were seen more in younger females with predominant cause as suicidal intent. On endoscopic examination severe corrosive injuries were more frequent

Different clinical presentations of dengue at astth

Objective: to observe the different clinical presentations of dengue fever in patients presenting with acute febrile illness

Material and Methods: this retrospective observational study was conducted in medicine department, Akhtar Saeed Trust Teaching Hospital, Lahore in September 2011. Patients presenting with acute febrile illness in both OPD and emergency were included. History was taken and clinical examination was done. Blood samples were collected for Complete blood count, Liver function tests, renal function tests and serology for Dengue virus lgM by ELISA. Symptoms and investigations were analyzed

Results: total 300 patients were included in the study. Females were187 [62.3%] and males were 113 [37.7%]. Mean age of patients was 33.4 years. Headache was the most common presentation in 284 [94.6%] patients, myalgia was present in 271 [90.3%] patients, fever was present in 257 [85.6%] patients, vomiting in 190 [63.3%] and rash with petechie in 53 [17.6%] patients. Leukopenia and thrombocytopenia was present in all 300 patients. Liver function tests were deranged in 209 [69.7%] patients and dengue lgM was present in 127 [42.3%] patients. Serum urea was deranged in 113 [37.7%] patients

Conclusion: fever associated with chills and rigors, headache, myalgia, vomiting, rash, petechie and hemorrhagic manifestations, leucopenia, thrombocytopenia and raised ALT are satisfactory parameters to screen for suspected dengue virus infections. However, diagnosis cannot be confirmed unless supported by dengue specific lgM serology

Frequency of helicobacter pylori (H. pylori) in patients of acid peptic disease

To find the frequency of H. pylori positivity in patients of acid peptic disease. This descriptive study was conducted in Akhtar Saeed Trust Teaching Hospital, Lahore from September 2011 to December 2011. History and physical examination was recorded and oesophagogastroduodenoscopy [OGD] was done. Findings were noted and antral biopsy samples preserved in 10% formalin were sent for histopathological examination for the presence of H. pylori. Fifty patients with mean age 41 years were included. Most of them were males .H. pylori was positive in 72% on histopathology report and in this 82% were males and 46% belonged to lower socioeconomic group. 57% were positive for H. pylori in NSAIDs users. Most frequent complaint was epigastric pain [92%] and 80% had nausea and vomiting. Endoscopy showed gastritis in 54% and duodenitis/duodenal ulcer in 14%. High frequency of H. pylori in patients of acid peptic disease suggest that it is the most common cause especially in middle aged and lower socioeconomic group males. It should be promptly diagnosed and treated

Frequency of antiphospholipid syndrome in deep vein thrombosis

To determine the frequency of antiphospholipid syndrome in patients of DVT. Single center descriptive study. It was carried out at Military Hospital Rawalpindi, from May to Oct 2003. Fifty patients of either sex with Deep vein thrombosis [DVT] legs, who were diagnosed clinically and later on confirmed on doppler ultrasound, were selected through non-probability convenience sampling. doppler ultrasound was done to diagnose DVT and antiphospholipid antibodies tested namely lupus anticoagulant and anticardiolipin antibodies. Other associated risk factors were also documented. Data collected and organised, descriptive statistics were applied to calculate the frequencies. The results were organised in graphs and tables. Out of 50 patients of DVT 38 [76%] were males and 12 [24%] were females. Mean age for males was 44.94 +/- 14.92 years whereas for females it was 27.66 +/- 5.97 years. Antiphospholipid syndrome was detected in 13[26%] patients; 11 [22%] were males and 2 [4%] females. Only lupus anticoagulant was detected in 9 [18%] patients. Anticardiolipin antibodies were detected in 3 [6%] patients. In 1 [2%] both lupus anticoagulant and anticardiolipin antibodies were detected. There is an association between antiphospholipid syndrome and DVT. Association of lupus anticoagulant is more, as compared to anticardiolipin antibodies with DVT. Additional risk factors make a person further susceptible to DVT