Varied presentation of celiac disease in Pakistani adults

The objective of this retrospective study was to evaluate presentation of celiac disease in adults. It included 77 patients, 41 [53.2%] males with median age 26 years and median body mass index of 18 [16 - 22] kg/m[2]. Typical presentation with gastrointestinal symptoms was seen in 76.6%. Atypical presentation with extra intestinal complaints in 7.8% and silent presentation in 15.6%. Major symptoms were diarrhea in 64.9%, weight loss 36.4%, abdominal pain 35.1%, vomiting 32.5%, pallor 24.7%, and weakness 13%. Iron deficiency was documented in 20.8%, B12 deficiency in 9.1%, folic acid deficiency in 6.5% and vitamin D deficiency in 10.4%. Half of the patients had haemoglobin less than 11 g/dl. Osteoporosis and osteomalacia, hypothyroidism, diabetes and atrophic gastritis were seen in 2.6% each. Raised alanine aminotransferase was documented in 23.4%. Duodenal biopsy, done in 39 patients, revealed increased intraepithelial lymphocytes in 11, along with crypt hyperplasia in 3, partial villous atrophy in 15 and sub-total villous atrophy in 10. In conclusion, celiac disease in adults should be looked for in patients with chronic diarrhea or irritable bowel syndrome like symptoms, underweight, anaemic, or having nutritional deficiencies

Dietary modification, Body Mass Index [BMI], Blood Pressure [BP] and cardiovascular risk in medical students of a government medical college of Karachi

To determine the prevalence of major risk factors including dietary modification, Body Mass Index [BMI], Blood Pressure [BP] and physical activity in medical students of government teaching hospitals of Karachi. A cross sectional study was conducted on students of Dow Medical College, Karachi, Pakistan through a structured pre-tested questionnaire. Non-probability purposive sampling was used. Smoking, hypertension, family history of cardiovascular disease [CVD], overweight and low physical activity levels are risk factors the presence of which can lead to development of CVD. Prevalence of these risk factors was determined by asking appropriate questions and through measurement of BMI and blood pressure for overweight and hypertension respectively. Awareness of risk factors was determined through knowledge of the effect of various food substances on development of CVD and of adoption of dietary changes keeping in mind the risk of developing CVD. SPSS 16.0 was used for statistical analysis. A total of 132 medical students were included in the study of which 57 [43.2%] and 75 [56.8%] were male and female respectively with mean age of 20.85 +/- 1.21 years. About 15.9% of students had elevated blood pressure i.e. > 140/90 mmHg. Twenty eight percent of the total students were found to be underweight and 17.4% were overweight, 5% had some history of CVD, 56.8% had family history of CVD, 9.4% were smokers and 29.5% had high physical activity level. About 87.1% had modified their diet for preventing CVD. Most of the students had adequate knowledge about the cardiovascular risk factors Majority of students were not overweight. A high prevalence of cardiovascular risk factors; family history and elevated blood pressure was present. Awareness in terms of knowledge was satisfactory but implementation in terms of diet modification and adequate physical activity was lacking

Frequency and awareness of hepatitis B and C in visitors of hepatitis awareness mela

To observe the frequency of Hepatitis B and C in a section of society that is presumably healthy and educated and to evaluate the awareness about the modes of transmission of hepatitis B and C, in this segment. A total of 504 individuals visiting the Awareness Mela arranged to observe World Hepatitis Day were screened for Hepatitis B and C. In addition, 106 conveniently selected individuals of age 16 years or more were asked to fill out a questionnaire which enquired on the modes of transmission of the diseases. A total of 504 individuals were screened; 351 males [69.6%] and 153 females [30.4%]. Mean age 34.2 +/- 11.7 years; range 11-66 years. Twenty nine [5.75%] were found positive for either hepatitis B or C, mean age being 28.43 years and 92% of the affected being males. Out of the 106 questionnaire takers, 25 were females [23.6%] and 81 males [76.4%]. The mean age was 33.2 +/- 11.1 years. Majority [94.7%] believed that used syringes were amongst the main causes of spread of hepatitis B and C while 40.6% did not know about the risks of sharing toothbrushes and towels. Seventy three respondents did not have prior vaccination of Hepatitis B. In addition 2 males and 1 female of study subjects were anti-HCV positive and 1 male HBsAg positive. In the educated class, prevalence of hepatitis B and C appears lower than the general population. They have the knowledge of the mode of spread of these viruses though there is room for further improvement. Many still confuse it with orofaecal transmission. Knowledge on vaccination is also unsatisfactory