ABSTRACT
The objective of this study was to find the role of High Resolution Computed Topographic [HRCT] scan of the chest in the diagnosis of Interstitial Lung Diseases [ILD] in our local population. A prospective study of fifty patients already diagnosed as ILD on transbronchial or open lung biopsy was performed in the Medical B Unit of the Department of Medicine Khyber Teaching Hospital, Peshawar from January, 2008 to December, 2008. Both male and female admitted patients above 15 years of age were included in this study. Of the fifty patients meeting the inclusive criteria 18 were male and 32 were female. The commonest affected age was 40-60 years. The commonest symptoms were shortness of breath and cough respectively. Inspiratory crepts and wheezes were the most common physical findings followed by clubbing, raised jugular venous pressure and edema feet. HRCT Scan revealed ILD in 88% with sensitivity of 95% and specificity of 75% having 95% positive predictive value and 75% negative predictive value. HRCT Scan of chest is the most sensitive non invasive test in the diagnosis of ILD compared to chest X ray, pulomary faction tests and can abate the need of lung biopsy in many cases
ABSTRACT
To analyze comparatively the risk factors and complications of hepatitis B and C infections at Khyber Teaching Hospital, Peshawar. A cross-sectional observational study was conducted in Department of Medicine, Khyber Teaching Hospital, Peshawar, from March 2005 to October 2006. Relevant information's were obtained from the patients with the aid of a pre-designed questionnaire prepared in accordance with the objectives of the study. A total of 432 patients with positive anti-HCV antibody 252 [58.33%] and positive HBs Ag 180 [41.66%] were included. The age range of the patients with anti-HCV antibody was from 11 to 84 years with the mean age of 47.5 years, while in HBV cases was 50.5 years [range: 7 to 87 years]. In HCV positive cases, 165 [65.47%] were males and 87 [34.52%] were females while in HBV patients, 123 [68.33%] were males and 57 [31.67%] were females. The risk factors of HCV patients were: intravenous drug users, 23.81%; HCV positive sexual partners, 15.07%; blood or blood products transfusion, 13.49%; and occupational acquired-HCV, 7.14%. The major risk factors of HBV were: intravenous drug users, 33.88%; HBsAg positive sexual partners, 23.33%; blood transfusion, 14.44%; and dental procedures [tooth extraction or root canal treatment], 9.44%. Unknown source of infection was recorded in 25% of HCV and 10.56% of HBV patients. Complications consequences in HCV patients were: chronic hepatitis, 34.52%; liver cirrhosis, 16.26%; hepatocellular carcinoma, 0.79%; fulminant hepatitis, 0.79%; while 47.61% were asymptomatic or sub-clinical symptomatic. In HBV patients, complications were acute hepatitis, 5.56%; fulminant hepatitis, 0.5%; chronic healthy carriers, 31.67%; chronic hepatitis, 24.44%; liver cirrhosis, 6.11%; and hepatocellular carcinoma, 1.10%; while 40.55% were clinically asymptomatic or with sub-clinical disease. Coexistence of HCV and HBV were recorded in 52 [12.03%] patients. History of sexual transmission favors HBV infection while blood transfusion and occupational exposure were recorded mainly in HCV positive patients. Chronic persistent hepatitis and liver cirrhosis were recorded more significantly with HCV infection while HBV favor carrier state or presents as a sub-clinical disease