ABSTRACT
Colonoscopy is one of the most important modalities to investigate complaints related to lower gastrointestinal tract. Terminal ileum is an essential part of the complete colonoscopic examination. Objectives: To observe the diagnostic yield of ileoscopy in patients undergoing colonoscopy. Design: Retrospective and observational study. Period: January 2010 to May 2014. Setting: Liaquat National Hospital and Medical College. Patients and methods: Patients undergoing colonoscopy fulfilling inclusion and exclusion criteria were enrolled. Terminal ileum was examined and biopsies taken if abnormality present. Statistical analysis was done by SPSS- 18. Result: A total of 1296 patients were included, 884 [68.2%] were male and 412 [31.8%] were female. Age ranged from 15-90 years. The commonest indication was bleeding per rectum [35.6%].1133[87.4%] patients had normal mucosaand163 [12.6%] had abnormal mucosa on ileoscopy. Of these 163 patients, 68 had ulcers, 56 had inflammation, 29 had nodular mucosaand10 had polyp. Histopathological examination showed non-specific inflammation in 139 patients; granulomatous inflammation in 7; reactive lymphoid hyperplasia in 8; 3 had normal result; biopsies were not taken in remaining 6 patients. By using chi-square test we found a significant statistical relationship between macroscopic abnormality of terminal ileum mucosaandage of patients, weight loss, chronic diarrhoea, and abdominal pain. On logistic regression, age group, chronic diarrhoeaandweight loss retained strong relationship with macroscopic abnormality of terminal ileum mucosa. Conclusions: Though a large number of patients [12.6%] had abnormal terminal ileum mucosa, histopathological analysis did notshow any significant yield of ileoscopy. Terminal ileal abnormality was more common in young and middle aged patients and in patients presenting primarily with chronic diarrhoeaandweight loss.
ABSTRACT
Adolescent and post adolescent females presented to Dermatology Out patients with white comedones and inflamed papules, situated mainly on cheeks and forehead. Most of these patients related the onset of these lesions after continuous use of a beauty cream to improve complexion. Twenty four patients presenting to the Outpatients Department of Dermatology at Abbassi Shaheed Hospital and Burhani Community Hospital, were collected. Subjects were questioned about their acneiform eruption. Each patient was examined and beauty products and 17 betamethasone valerate cream were shown to them for correct identification. All patients related the lesions after continuous application of the beauty cream obtained after mixing 5gm tube of betamethasone valerate cream with one tube each of two famous beauty products. The average daily application lasted for about three months. The predominant lesions were white comedones and inflamed papules [100%]; macular erythema and telangiectasia were seen in [16%.] The cheeks and forehead were universally involved in all patients and the chin was involved in four [16%]. The majority belonged to middle and low-income families. Conclusions: Since time immemorial, females have used beauty products to improve their complexion. The recent amateur addition of 17- betamethasone valerate to commercial beauty creams has led to more acneiform eruptions