ABSTRACT
Objectives: To observe the frequency of QTc [corrected QT] interval prolongation in patients with chronic liver disease in our population
Study design: A cross-sectional analytical study
Place and duration: Department of Gastroenterology, Liaquat National Hospital and Medical College, Karachi from May 2009 to October 2009
Methodology: A non- probability, purposive sampling is used in already diagnosed cirrhotic patients. Patients between 25-70 years were included. These patients were divided into three groups according to their Child-Pugh [C.P.] classification [class A, class B and class C]. An electrocardiogram [ECG] of all patients was obtained and QT intervals corrected for heart rate [QTc] were calculated. Analysis of data was done by SPSS 17
Results: 121 cirrhotic patients were inducted in this study. 10 patients belonged to C.P. class A, 49 to C.P. class B, and 62 to C.P. class C. Prolonged QTc interval was observed in 48 [39.7%] patients while in 73 [60.3%] patients QTc interval was normal. Occurrence of prolonged QTc interval was greater in C.P. class-C [50%] followed by C.P. class-B [30.6%], p value 0.045 and 0.016 respectively
Conclusion: Significant number of cirrhotic patients had prolonged QTc interval and this prolongation of QTc interval was directly associated with more advanced liver disease
ABSTRACT
To determine the frequency of factors leading to post endoscopic retrograde cholangiopancreatography [ERCP] pancreatitis. Case series. Department of Gastroenterology, Liaquat National Hospital, Karachi, from November 2007 to October 2008. Fifty [50] patients of diagnosed cases of post-ERCP pancreatitis were included in this study. The collected data included age, gender, previous post-ERCP pancreatitis, recurrent pancreatitis, recurrent abdominal pain, number of attempts of common bile duct [CBD] cannulation, difficult CBD cannulation, precut sphincterotomy, biliary sphincterotomy, pancreatic duct contrast injections, primary diagnosis, device used, therapeutic procedure undertaken and the pancreatic enzymes level. Results were described as frequency percentages. Out of 50 patients, 32 [64%] were females. The average age of the patients was 52.23 +/- 13.4 years. Frequency of common factors regarding post-ERCP pancreatitis were age 2 60, [n = 38, 76%] patients, female gender [n = 32, 64%], precut sphincterotomy [n = 34, 68%], pancreatic duct contrast injections [n = 27, 54%], biliary sphincterotomy [n = 25, 50%]. Higher number of attempts of CBD cannulation and difficult CBD cannulation were recognized as factors for post ERCP pancreatitis. Other factors like previous history, post-ERCP pancreatitis, recurrent pancreatitis, and recurrent abdominal pain were not found in this study. Age, female gender, precut papillotomy, pancreatic duct contrast injections and biliary sphincterotomy were common factors for post-ERCP pancreatitis. Risk stratification will allow endoscopists to better identify patients who are at risk and permit detailed informed consent in high-risk groups or to adapt the measures to prevent the complications and reduce the risk related with the procedure