Liver histology in asymptomatic Hepatitis-C virus positive blood donors

Objective: To assess the Histological alteration of liver in asymptomatic HCV PCR positive family blood donors

Methods: This is a prospective cross sectional study carried out at Blood Transfusion Services, Clinical and Molecular Laboratory and Pakistan Health Research Council, Jinnah Postgraduate Medical Centre, Karachi from January 2011 to December 2016. One hundred thirteen [113] Anti HCV and HCV RNA positive family blood donors with normal or slightly raised ALT during three consecutive bimonthly visits were included. After taking consent liver biopsy was done to see the histopathological changes in these study participants. The software program SPSS for windows [Ver.19] was utilized for all statistical analysis

Results: One hundred thirteen blood donors who were Anti HCV and HCV RNA positive were included. Ninety eight were male and 15 Female with a mean age of 32.3 +/- 6.94 years. Nineteen [16.8%] had significant inflammation of grade 2-3. Nine [8.0%] had significant fibrosis and steatosis was seen in 65 [57.5%] cases. Cirrhosis or advanced liver disease was not found in this series

Conclusion: HCV infected individual with normal ALT level having good physical health, without any sign of advanced liver disease on ultrasonography and routine laboratory investigation like AST, Gamma GT, Alkaline Phosphatase, serum albumin, A/G ratio, platelet count and PT, INR might be highly helpful to predict mild or progressive liver disease. Ultimately it reduces the need of liver biopsy, an invasive procedure having significant complications

Asymptomatic dengue infection in adults of major cities of Pakistan

OBJECTIVE@#To determine the asymptomatic dengue infection in adults of Pakistani population.@*METHODS@#This study was conducted in five major cities (Islamabad, Karachi, Lahore, Multan, and Peshawar) of Pakistan. A total of 5 230 adults aged 18 years and above without a history of dengue fever at any point in their life were enrolled from participating laboratories. Those who were confirmed for dengue previously were excluded. Of the total, 62.6% (n = 3 276) were male with an average age of 34.6 years. Participants were briefed about the objectives of the study, and written consent was obtained to perform dengue IgG test using enzyme linked immunosorbent assay. The brief information related to age, gender and area was also taken on proforma.@*RESULTS@#Overall 32.3% (n = 1 691) was having asymptomatic dengue infection which was 67.5% (n = 756) in Karachi followed by 39.1% (n = 391) in Islamabad, 29.9% (n = 316) in Lahore and 21% (n = 228) in Peshawar and none from Multan. More males were affected with asymptomatic dengue infection than females. The asymptomatic dengue infection was significantly higher in different cities; however, there was no significant difference with respect to age groups.@*CONCLUSIONS@#The asymptomatic dengue infection is higher in cities i.e. Karachi, Islamabad and Lahore which are at risk of developing secondary dengue infections. There is a need of awareness among the public about secondary dengue infection.

Asymptomatic dengue infection in adults of major cities of Pakistan

Objective To determine the asymptomatic dengue infection in adults of Pakistani population. Methods This study was conducted in five major cities (Islamabad, Karachi, Lahore, Multan, and Peshawar) of Pakistan. A total of 5 230 adults aged 18 years and above without a history of dengue fever at any point in their life were enrolled from participating laboratories. Those who were confirmed for dengue previously were excluded. Of the total, 62.6% (n = 3 276) were male with an average age of 34.6 years. Participants were briefed about the objectives of the study, and written consent was obtained to perform dengue IgG test using enzyme linked immunosorbent assay. The brief information related to age, gender and area was also taken on proforma. Results Overall 32.3% (n = 1 691) was having asymptomatic dengue infection which was 67.5% (n = 756) in Karachi followed by 39.1% (n = 391) in Islamabad, 29.9% (n = 316) in Lahore and 21% (n = 228) in Peshawar and none from Multan. More males were affected with asymptomatic dengue infection than females. The asymptomatic dengue infection was significantly higher in different cities; however, there was no significant difference with respect to age groups. Conclusions The asymptomatic dengue infection is higher in cities i.e. Karachi, Islamabad and Lahore which are at risk of developing secondary dengue infections. There is a need of awareness among the public about secondary dengue infection.

Synergistic effect of antibiotics against bacterial pathogens causing diarrhea isolated from children <5 years of age

Background: Infant mortality rate due to diarrhea is high in Pakistan. The alarming increase in antimicrobial resistance of bacterial pathogens causing diarrhea has made the treatment more complicated. This study was designed to determine the in vitro synergistic [combined] effect of different antibiotics against these pathogens in order to determine whether the combined antibiotic therapy may be used to treat diarrhea

Objectives: To study the antibiotic resistance pattern of bacterial pathogens causing diarrhea isolated from children <5 years. To study the synergistic effect of antibiotics against bacterial pathogens causing diarrhea. Study design, settings and duration: A cross sectional study conducted at Pakistan Health Research Council [PHRC], Jinnah Postgraduate Medical Center and National Institute of Child Health, Karachi over a period of twenty months

Materials and Methods: Bacterial pathogens including Salmonella, Shigella, Vibrio, Escherichia coli and Aeromonas causing diarrhea were collected. Their sensitivity and resistance pattern was performed by disk diffusion method and combined the effect of existing antibiotics including ampicillin [AMP], cefotaxime [CTX], Cefixime [CFM], Co-trimoxazole [SXT] and Ofloxacin [OFX] was performed by checkerboard method. The study was approved by Ethical Review Board of National Institute of Child Health, Karachi

Results: Most of the combinations showed indifferent and antagonistic activity against bacterial pathogens causing diarrhea. But only AMP-SXT and CFM-OFX yielded synergistic activity against Vibrio and Aeromonas respectively. AMP-CFM and AMP-OFX exhibit synergistic effect against Escherichia coli while no combination of antibiotics proved as synergistic for Salmonella and Shigella

Conclusion: Little synergistic activity of different antibiotic combinations was observed against diarrheal isolates and most of the combinations exhibited indifferent and antagonistic activity. Hence this can be concluded that single antibiotics are effective than combination

Screening of HBsAg and anti HCV from tertiary care, private and public sector hospitals

To find out the frequency of hepatitis B surface antigen and hepatitis C antibodies in patients referred from a tertiary care public sector hospital, other public sector and private hospitals of Karachi. Pakistan Medical Research Council's Specialized Research Centre for Gastroenterology and Hepatology, at Jinnah Postgraduate Medical Centre Karachi from January to December 2009. A cross sectional study was conducted where patients were referred from different departments of Jinnah Postgraduate Medical Centre [tertiary care public sector hospital], other public sector hospitals, private hospitals and clinics for the screening of hepatitis B and C virus infection. Three ml blood was collected from each patient, serum separated and tested for HBsAg and Anti HCV using Abbott Murex 4th Generation ELISA kits. A total of 2965 cases were referred in a year. Overall seroprevalence of HBsAg and Anti-HCV was 5.9% and 12.8% respectively. HBsAg positivity in patient referred from public sector hospitals was 5.8%, those from private 12.5%, 16.7% and 8.5% respectively. Co-infection of hepatitis B virus and hepatitis C virus was seen in 0.9, 2.5 and 1.4% cases respectively. breakdown of viral positivity within different departments of Jinnah Postgraduate Medical Centre Karachi showed HBsAg positivity of 7.1%in Medical department, 5.2% in Surgical department, 5.0% in Gynaecology department, 6.6% in other departments of Jinnah Postgraduate Medical Centre while, only 1.7% were positive from Pakistan Railway, hospital Anti HCV positivity was maximally [20.3%] seen in medical department followed by 14% in other departments, 10.9% in surgical department, 7.9% in gynaecology and 5.1% in railway hospital. Co-infection of HBV and HCV was seen in 2% cases referred from medical department, while rest of the departments had less than 1% positivity of co-infection. Both genders were equally infected with HCV, but males were predominantly more infected with HBV, with a male to female ratio of 2:1 [p>0.001]. High frequency of HBV and HCV infection is due to a biased population of hospitalized cases. High referral from medical and gynaecology department indicates high awareness about these diseases in the health care providers and similar awareness needs to be created in other departments of public and private sector hospitals. Serious efforts need to be done to inculcate awareness regarding HBV and HCV in all departments of public and private hospitals

single nocte dose of famotidine in the treatment of duodenal ulcer

Fifty three patients with duodenal ulcer were treated with 40 mg of famotidine at bed time. Repeat endoscopy showed healing rates of 69.8% and 83% at 4 and 6 weeks respectively. Seven patients were kept on a maintenance dose of 20 mg nocte for one year, of these one had a relapse despite taking the drug regularly. No appreciable side effects were observed with the drug

Alpha-fetoprotein in liver disease

Alpha fetoprotein [AFP] was determined using Radioimmunoassay [R IA] in 278 patients with various liver diseases. Titres were raised in hepatic malignancies as well as in other liver disorders. No correlation was found between the titres of AFP with age, sex, liver function tests and HBsAg positivity