Upper Gastrointestinal Endoscopic Findings of Patients Presenting with Dyspepsia - A Tertiary Care Centre Experience

Introduction: Dyspepsia is a common presenting complaintencountered in the outpatient department of general medicineand is the most common indication for upper gastrointestinalendoscopy. Aim of the study was to evaluate Upper GastroIntestinal endoscopic findings in patients presenting withdyspepsia, to find the relative occurrence of individual findingsin different age groups and to compare with earlier studies.Material and methods: This was a retrospective,observational study in GITAM Institute of Medical Sciencesand Research, a tertiary care centre, Visakhapatnam, AndhraPradesh, India. Data on patients presenting with dyspepsiaand scheduled for upper gastrointestinal (UGI) endoscopybetween June 2018 and June 2019were collected.Results: Two hundred and seven patients with dyspepsia wereassessed by UGI endoscopy. Out of these,121 (58.4%) weremale and 86(41.5%) were female. The mean age was 43.8±14.2years. The endoscopic findings were GERD (15.4%), erosiveesophagitis (11.1%), gastritis (52.6%), duodenitis (3.3%),duodenal ulcer (4.8%), gastric ulcer (6.7%), hiatus hernia(10.2%), and mixed findings in 37.1% of patients. Gastriccancer was identified in 2.4% of patients. Endoscopy findingswere normal in 13(6.3%) patients.Conclusion: We conclude that dyspepsia is a commonindication for endoscopy. The frequency of male subjects ishigher and gastritis is the most common pathology followedby reflux esophagitis. These were associated with increasingage. GI malignancy was uncommon and higher in elderlypatients. The upper GI endoscopy is the best investigation toolfor evaluating dyspepsia. Though it is an invasive procedure,dyspeptic patients with alarm symptoms must be evaluatedwith upper GI endoscopy. Endoscopy can be avoided in mostyoung patients with dyspepsia without alarm features.

Clinical Spectrum of Acute Undifferentiated Fever - An Experience from a Tertiary Care Centre

Introduction: Region specific awareness about majoraetiologies of acute undifferentiated fever (AUF) is importantfor effective management to reduce morbidity and mortality.Hence, we did a study to know about the aetiology and diseasespecific clinical profile of acute undifferentiated fever cases ina tertiary care centre in South India.Material and Methods: A retrospective, observational studywas conducted in a tertiary care centre (GIMSR, South India)during June 2018–June 2019. Patients aged 16 years whohad a febrile illness for < 21 days, with no localizing signs ofinfection following initial clinical evaluation were includedin the study. Peripheral smear for malarial parasite, Widaltest, Dengue rapid NS1 antigen and IgM Combo test, DengueIgM capture ELISA (MAC-ELISA), Leptospira IgM ELISA,Scrub typhus IgM ELISA, Chikungunya IgM ELISA andblood culture were routinely performed at the hospital.Results: A total of 248 AUF cases were studied: Dengue(42), Malaria(46), Scrub typhus(27), Scrub typhus withDengue(7), Chikungunya(11), Enteric fever(37), UTI(26),Leptospirosis(5), Hepatitis A(5), Hepatitis E(5) and Uncleardiagnosis(37) were noted.Conclusion: Malaria, Dengue, Enteric fever and Scrub typhuswere the most important major causes of AUF in our study.However, a greater number of undiagnosed cases (37) in ourstudy shows that further research is required in identifying theaetiology of undifferentiated fever.