ABSTRACT
Objective: To determine the frequency of hepatic hydrothorax and its association with Child Pugh Class in patients with liver cirrhosis
Study Design: Descriptive, analytical study
Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-Ill, [Ward- 7], from June 2012 to May 2013
Methodology: All patients with established diagnosis of decompensated chronic liver disease were included. Detailed history, thorough physical examination, routine laboratory investigations, chest X-ray and abdominal ultrasound were carried out in all patients to find out the presence of pleural effusion and ascites, respectively. Fifty milliliters of pleural fluid was aspirated in all patients with pleural effusion using the transthoracic approach, taking ultrasound guidance, wherever required. Fluid was sent for microscopic, biochemical, and microbial analysis. SBEM defined if pleural fluid with polymorphonuclear [PMN] cell count > 500 cells/mm[3] or positive culture with PMN cell count > 250 cells/mm[3] with exclusion of a parapneumonic effusion
Results: Two hundred and six patients met the inclusion criteria, with mean age of 41.25 +/- 13.59 years. Among them, 149 [72.3%] were males and 57 [27.7%] females. Twenty-three [11.2%] had hydrothorax; right sided involvement was in 18 [78.3%] subjects, 3 [13%] had left sided while bilateral pleural effusion was found in 2 [8.7%] cases. SBEM was found in 07 [30.43%] cases. Mean serum albumin 3.125 +/- 0.71 gram/dl. There was association between serum albumin levels and hydrothorax. A significant association of hydrothorax with Child Pugh scoring system [p=0.018], but not with serum albumin [p=0.15]
Conclusion: The frequency of hepatic hydrothorax has a significant association with hepatic function as assessed by Child Pugh scoring system, but not with serum albumin
ABSTRACT
Objective: To evaluate the gastroesophageal reflux symptoms in Chronic Obstructive Pulmonary Disease [COPD] patients and Upper Gastrointestinal [GI] endoscopy findings in these patients
Study Design: Cross sectional study
Place and Duration of Study: This study was conducted at Dow University Hospital and Civil Hospital Karachi from January 2013 to December 2013
Materials and Methods: 100 of COPD were selected and assessed for presence of gastro esophageal reflux [GERD] symptoms. Data was analyzed on SPSS version 13
Frequency and percentage were computed for categorical variable like gender, gastro-esophageal reflux symptoms and upper GI endoscopy finding in COPD patients with gastro esophageal reflux symptoms. Mean standard deviation was computed for quantitative variables like age, smoking [pack year], solid fuel and tea consumption [cup/day]
Results: In this study of 100 patients 95 were males and 5 were female. Cough was the commonest symptom that was found in 85% patients followed by sputum production in 71% patients, retrosternal burning [68%], acid reflux [54%] and dysphagia [11%]
Gastro-esophageal reflux symptoms were observed in 54 patients. Out of these 54 patients who had GER symptoms, 33 [61%] patients had erosive gastro-esophageal reflux disease while 21[39%] patients non-erosive gastro esophageal reflux disease on upper GI endoscopy
Conclusion: Our study shows that higher proportion of Gastro esophageal reflux symptoms is present in COPD patients. Moreover, upper GI endoscopy can be normal in COPD patients with significant GERD symptoms
ABSTRACT
Objective: To determine the prevalence of restless legs syndrome [RLS] in elderly patients with pure sensory polyneuropathy and correlate the findings with other clinical features
Study Design: Observational / cross sectional study.Place and Duration of Study: This study was conducted at the Dow University Hospital and Civil Hospital Karachi from 2013 to 2015
Materials and Methods: 48 patients with Restless leg syndrome were evaluated in our multicenter, prospective study in 2 years for evidence of pure sensory neuropathy either they have demyelinating or axonal type. Patients were evaluated according age at which symptomsstarted, the severity of symptoms, typical clinical findings and laboratory investigations
Results: In 21 of the 48 [43.7%] patients, peripheral neuropathy was detected. Ten patients had pure sensory polyneuropathy and remaining have mixed sensory motor polyneuropathy. The pure sensory neuropathy group had comparatively intense and frequent symptoms of Restless leg syndrome. Some of them have family history of Restless leg syndrome. Patients with Mixed sensory motor polyneuropathy did not have similar strong symptoms of Restless leg syndrome and pain in legs
Conclusion: The result suggests that Restless leg syndrome is triggered by painful paresthesias is primarilyrelated with pure sensory neuropathy. Patients with mixed sensory motor neuropathy have less intense feature of restless leg syndrome. So the treatment options should be focused on medicines used for neuropathic pain
ABSTRACT
Objective: To determine the frequency of Hyperamylasemia leading to respiratory failure in patients of organophosphate poisoning
Study Design: Observational / descriptive study
Place and Duration of Study: This study was conducted at the Department of Medicine Dow University of Health Sciences, Karachi from June 2014 to June 2015
Materials and Methods: A total of 168 patients of Organophosphate poisoning fulfilling the inclusion criteria were included in the study. Blood was drawn after aseptic measures by a trained phlebotomist for Serum Amylase level and Arterial blood gases. Value more than 101U/L was taken as hyperamylasemia. PaO[2] less than 60mmHg or PCO[2] greater than 55mg was labeled as respiratory failure. All information was noted on proforma
Results: There were 59% were male and 41% were female. Frequency of hyperamylasemia in patients of organophosphate poisoning was 44%. Frequency of respiratory failure in hyperamylasemia in patients was observed in 68%. Respiratory failure was significantly high in male than female [70% vs. 30%; p=0.019]
Conclusion: Hyperamylasemia is more frequently seen in organophosphate poisoning. In patients with respiratory failure the mortality is very high; therefore we recommended early diagnosis, careful monitoring and appropriate management of complications in reducing the mortality rate
ABSTRACT
The objective is to observe relationship between low serum magnesium level and Migraine. Prospective Observational. This study was conducted in Dow University Hospital, Dow University of Health Sciences, Karachi from 1[st] January 2013 to 31[st] December 2014. One hundred and fifty patients attending the medical and Neurology OPD at Dow University Hospital were included in study. They were diagnosed according to International Headache Society [HIS] criteria for migraine headache. 150 patients were enrolled in study 49 [32.7%] were male and 101 [67.3%] were female patients mean age was 28 [ +/- 6.2] years, After excluding other causes migraine was diagnosed in 102 [68%] patients. Out of 102 patients 71 [69.7%] were have low serum magnesium level. In the remaining patients with non migrainous headache, only 6 patients [12.5%] have low serum magnesium level because of some other causes for example medications. Migraine is frequently associated with Serum low level of Magnesium compare to patient with nonmigrainous headache
Subject(s)
Humans , Male , Female , Adult , Headache , Migraine DisordersABSTRACT
Objective: To determine the frequency of impaired glucose tolerance in patients presenting with active pulmonary tuberculosis in tertiary care hospital, Karachi
Study Design: Cross sectional study
Place and Duration of Study: This study was conducted at Dow University Hospital [Dow University Health Sciences Karachi] from 1stJune 2014to 30thNovember 2014
Materials and Methods: A total of 110 diagnosed adult cases of active pulmonary tuberculosis on the basis of sputum smear positivity were included in this study. Blood samples were drawn for investigations and sent to the same reference laboratory to minimize bias.Data was collected on a pre-tested self administered Performa
Results: There were 59.1% were male and 40.9% were female. Frequency of impaired glucose tolerance in patients presenting with active pulmonary tuberculosis was observed in 20.9%. Rate of impaired glucose tolerance was highly associated with above 40 years of age patients and with family history of diabetes
Conclusion: In Pakistan DM is on the rise and TB has one of the highest incidence in the world. There is emerging evidence that one disease is fuelling the other. The interest in diabetes and TB is mounting rapidly, so the clinician and researchers should prepare themselves to meet the challenges of the two diseasecombined
ABSTRACT
Interferon Alfa has been widely used to treat chronic hepatitis C virus infection. In this report, we present a case series of two patients referred to Sarwar Zuberi Liver Centre, Civil Hospital Karachi, who suffered from chronic hepatitis C. After getting detailed clinical examination and baseline work up prior to starting treatment, these patients were offered therapy with usual recommended dose of 3 million units of alpha-interferon subcutaneously thrice weekly. Both these patients developed clubbing of fingers during the course of treatment, one developing it during the 2[nd] month while the other during the 4[th] month. It was of grade II in one patient and of grade III in another and was bilateral in both the cases. Clubbing was not presented prior to start of treatment and no other secondary cause of clubbing was found in any of the case. These patients were not on any other drug that is known to interfere with interferon or can be associated with clubbing. No national or international data regarding such unusual side effect is available. Whether this effect is idiosyncratic or dose related and whether it is reversible or not after completion of treatment is yet to be established