ABSTRACT
Back ground: It is highly unfortunate that many patients are admitted daily with hematemesis and or malena due to the adverse effects of drugs either prescribed or self-medicated. Incidence of such cases can be greatly reduced if medical practitioners are not only aware of the adverse effects of drugs on gastrointestinal tract but also assess the patients for the risk factors of drug-induced UGI bleeding before prescribing these drugs and also by properly educating the patients. Aim: To study the clinical profile and risk factors in fifty cases of drug induced UGI bleeding. Materials and methods: Fifty patients (32 males and 18 females) admitted with drug-induced hematemesis and or malena were studied with respect to age group, number of bouts of hematemesis, approximate quantity of total blood loss, causative drug responsible for UGI bleeding, risk factors of GI bleeding, number of individual risk factors in each patients. The prevalence of individual risk factors in those fifty patients and the prevalence of number of risk factors in those fifty patients were studied. Thorough clinical and laboratory investigations were done. Results: Hematemesis was the common symptom. Ibuprofen was responsible for the majority of cases (38%) followed by diclofenac (22%). Prevalence of risk factors among the patients are as follows: Age > 50 years of age - 66%, ‘O’ Blood group – 50%, Alcoholism – 42%, Not using Gastro protective agents – 40%, Self-medication / OTC drugs – 36%, Smoking – 30%, Stress and Serious systemic illnesses – 12%, Helicobacter pylori – 12%, Known Peptic ulcer disease – 10% , High doses/ Chronic drug intake – 10%, Concomitant use of Steroids – 8% and Concomitant use of anticoagulants – 4%. Conclusion: NSAIDs were the commonest cause for UGI bleeding. Age > 50 years (66%) was the commonest risk factor for UGI bleeding. All those fifty cases had at least one known risk factor and majority (80%) had more than one risk factors of drug-induced UGI bleeding
ABSTRACT
Background: Non-steroidal anti-inflammatory drugs (NSAIDs) including aspirin are among the most frequently prescribed drugs worldwide and are available ‘Over-The-Counter’ (OTC) also. Though reasonably safe in most cases in prescribed dosages and for short durations, these drugs cause serious gastrointestinal toxicity in a large number of cases. They can affect all segments of the gastrointestinal tract causing ulcers, severe bleeding, perforation, and obstruction. Aim: To study the endoscopic abnormalities in fifty cases of drug induced UGI bleeding. Materials and methods: Fifty patients (32 males and 18 females) admitted with drug-induced hematemesis and or malena were studied with respect to age group, number of bouts of hematemesis, approximate quantity of total blood loss, causative drug responsible for UGI bleeding, risk factors of GI bleeding, number of individual risk factors in each patients. Thorough clinical and laboratory investigations were done. UGI scopy was done for all patients. Results: NSAIDs were the commonest cause for UGI bleeding. Age > 50 years (66%) was the commonest risk factor for UGI bleeding. It was observed that ten patients were having normal endoscopic study, twenty five patients were having lesions in stomach only, ten patients were having lesions in duodenum only and five were having lesions in both stomach and duodenum. None of the patients studied, had lesions in the esophagus. It was found that ulcers were more common than erosions. Conclusion: Stomach is the commonest site affected (50%) and ulcers (64%) were common than erosion.
ABSTRACT
Background: From the beginning of the AIDS epidemic, it was recognized first at autopsy and later by non-invasive techniques that HIV infection can cause cardiac abnormalities. Aim of the study: To assess the cardiac abnormalities in HIV patients and its relation with CD4 count and risk factors. Materials and methods: A total of 150 patients were divided into two groups depending on the CD4 count. Group I included 51 (34%) patients with CD4 count ≤ 350 cells / mm3 and Group II included 99 (66%) patients with CD4 count > 350 cells / mm3 . Among them 62 (41.3%) were males and 88 (58.7%) were females. All patients were subjected to a questionnaire to assess the risks of acquiring HIV, risk factors for cardiac disease. A thorough clinical examination was done. BMI was calculated as per WHO criteria for Asian population.CD4 count, ECG, Echocardiogram were done for all patients. Cardiologic data were correlated with age, sex, BMI, alcohol, smoking and CD4 count. Results: Our study populations mean age was 30.87± 6 years and mean BMI was 20.40 ±3.89 kg/m2 . Mean CD4 count was 473.34 ± 223.20 cell/mm3 (Group I - 261.08 ± 83.75 cells/mm3 ; Group II - 582.69 ± 191.24 cells/mm3 ). Smokers and alcoholics constituted 7.3% (11 patients) and 8% (12 patients) respectively.Heterosexual was the most common (95.3%) route of infection. Prevalence of cardiac abnormality was 16.7%. Pericardial effusion was the most common abnormality. Conclusion: Cardiac abnormalities were specifically correlated with CD4 count. There was no correlation between age, sex, BMI, smoking and alcohol with cardiac abnormalities.