The relationship of E-selectin singlenucleotide polymorphisms with breast cancer in Iraqi Arab women

Breast cancer (BC) is a significant threat to female health, with both modifiable andnon-modifiable risk factors. It is essential to monitor patients regularly and to raise population awareness. Increasing research also suggests that E-selectin (SELE) may increase tumor angiogenesis and the development of cancer. This study investigated SELE single-nucleotide polymorphisms (SNPs) in the following positions: rs5367T/C, rs5368C/T, rs5362T/G,and rs5362T/C. Using polymerase chain reaction, significant differences in allele and genotype frequencies were found between BC patients and controls. Position rs5368 was associated with an increased risk of BC for the CT and TT genotypes, with odds ratios (ORs) of16.3 and 6.90 (Fisher probability = 0.0001, p = 0.005). Women with the T allele had a 19.3-fold higher incidence of BC, while allele C may be a protective allele against BC (OR, 0.05).Heterozygous genotypes at rs5367, rs5362, and rs5362 were significantly more common inBC patients, with ORs of 5.70, 4.50, and 3.80, respectively. These SNPs may be associatedwith the risk of BC, because the frequency of mutant alleles was significantly higher in patients (OR: 4.26, 3.83, and 4.30, respectively) than in controls (OR: 0.23, 0.30, and 0.20, respectively). These SNPs may be considered a common genotype in the Iraqi population,with the wild-type allele having a protective fraction and the mutant allele having an environmental fraction. The results also revealed a 2-fold increase in gene expression in BCpatients compared to controls, with a significant effect (p = 0.017). This study's findingsconfirm the importance of SELE polymorphisms in cancer risk prediction.

Associations between single-nucleotide polymorphisms of the interleukin-18 gene and breast cancer in Iraqi women

According to long-term projections, by 2030, the world’s population is predicted to reach 7.5 billion individuals, and there will be roughly 27 million new cancer cases diagnosed. The global burden of breast cancer (BC) is expected to rise. According to the Ministry of Health-Iraqi Cancer Registry, cancer is the second largest cause of death after cardiovascular disease. This study investigated the interleukin-18 (IL18) single-nucleotide polymorphisms (SNPs) –607C/A rs1946518 and –137G/C rs187238 using the sequence-specific amplification-polymerase chain reaction approach. Regarding the position –607C/A, there was a highly significant difference between the observed and expected frequencies in patients and controls (χ 2 = 3.16 and χ 2 = 16.5), respectively. The AA and CA genotypes were associated with significantly increased BC risk (odds ratio [OR], 3.68; p = 0.004 and OR, 2.83; p = 0.04, respectively). Women with the A allele had a 5.03-fold increased susceptibility to BC. The C allele may be a protective allele against BC (OR, 0.19). Although position –137G/C showed no significant differences in the CC genotype distribution (p = 0.18), the frequency of the CC genotype was significantly higher in patients than in controls. In contrast, patients had a significantly higher frequency of GC genotypes than controls (p = 0.04), which was associated with an increased risk of developing BC (OR, 2.63). The G allele frequency was significantly lower in patients than in controls (55.0% vs. 76.2%, respectively). This SNP may be considered a common genotype in the Iraqi population, with the wild-type G allele having a protective function (OR, 0.19) and the mutant C allele having an environmental effect (OR, 2.63).

Frequency of color blindness in pre-employment screening in a tertiary health care center in Pakistan

Objective: To describe the frequency of color vision deficiency among Pakistani adults presenting for pre-employment health screening in a tertiary care hospital

Methods: The cross-sectional study was carried out at the Aga Khan University Hospital, Karachi, and the data was collected for color vision deficiency, age, gender, and job applied for from pre-employment examination during 2013-2014. IBM SPSS 20 was used for statistical analysis

Results: Three thousand four hundred and thirty seven persons underwent pre-employment screening during 2013 and 2014; 1837 [53.44%] were males and 1600 [46.65%] females. The mean age was 29.01 [+/-6.53] years. A total of 0.9% [32/3437] persons had color vision deficiency with male being 1.4% and female 0.4%

Conclusion: Color vision deficiency was observed in 0.9% of candidates screened for pre-employment health check up in a tertiary care hospital. The color vision deficiency was predominantly present in male individuals

Metal complexes of isonicotinylhydrazide and their antitubercular activity

The development and spreading of Multi Drug Resistant TB strains is hampering endeavours for the control and administration of tuberculosis [TB]. The expansion episodes of multi-medication safe strains of Mycobacterium tuberculosis against first and second line antituberculosis drugs on one side and the unfavourable effects of these drugs on the other side has led the enthusiasm of researcher towards the synthesis of metal complexes of various medication. This approach is born with the expectation of finding new antituberculous operators without or least reactions as well as being active against the resistant strains of Mycobacterium tuberculosis. This study concentrates on the screening of five metal complexes of isoniazid [INH] against five Mycobacterium tuberculosis strains. These strains have been confirmed by WHO being active and even proliferating safely even in the presence of pyrazinamide, isoniazid [INH], ethambutol and rifampicin. In this work INH was taken as reference medication. All synthesized complexes and INH were subjected for a month and a half in BACTEC MGIT 960 technique. INH and its Fe [II] complex restrained the development of all bacterial strains for merely two weeks, while the Fe[III], Cu[II], Co [II] and Mn [II] complexes repressed the development five strains for three weeks. Conclusively, the strains utilized in this study were discovered to be more susceptible to the later four complexes than the ligand [INH] drug and its Fe [II] complex. Furthermore, elemental analysis and atomic absorption of all complexes were conducted for the determination of metal to ligand ratio

Effect of half adult dose of oral Rifampicin [300mg] in patients with idiopathic central serous chorioretinopathy

Objectives: To evaluate the effect of half adult dose of oral Rifampicin on mean change in best corrected visual acuity and central macular thickness in patients with central serous chorioretinopathy

Methods:Thirty-eight eyes of 31 patients with idiopathic central serous chorioretinopathy [CSCR] were registered. Unaided Visual acuity, best corrected visual acuity was documented and detailed slit lamp examination along with dilated ophthalmoscopy was performed. All subjects were treated with oral Rifampicin 300 mg [half adult dose] daily for 03 months. Patients underwent a complete ocular and systemic examination as well as central macular thickness [CMT] measurement by optical coherence tomography [OCT] every month after starting treatment until four months. Fundus fluorescein angiography [FFA] was performed in recurrent cases. Liver function tests were carried out prior to the treatment and during follow up period

Results:A total of 38 eyes of 31 patients [24 males, 07 females] were included in the study. Mean age of patients was 36.16+/-3.19 years [range 30-44]. Mean best corrected visual acuity [BCVA] before treatment was 0.56+/-0.11 and improved to 0.47+/-0.14 at 04 weeks [P<0.001] of treatment. The mean CMT at the time of presentation was 494.39+/-96.29 um and was decreased to 306.90+/-50.71 um after 04 weeks of treatment [P<0.001]. The mean induced reduction in CMT was 187.48+/-122 um [P<0.001] while that in BCVA 0.41+/-0.16 at 04 weeks of treatment [P<0.001]. Liver function tests were within normal range before and after the treatment

Conclusion:Half adult dose rifampicin [300mg] is effective and safe in treatment of central serous chorioretinopathy without causing any systemic imbalance

Medium optimization for the production of amylase by Bacillus subtilis RM16 in Shake-flask fermentation

This study was carried out in shaking incubator and covers the optimization of culture conditions of Bacillus subtilis for the maximum production of amylase. Optimal activity was found to be 350 Uml[-1] when soluble starch was used as a substrate. Parameters taken into consideration to observe their effect on the optimum production of amylase include incubation time, incubation temperature, pH, inoculum size, carbon source, nitrogen source and metallic ions. All parameters were monitored in order to obtain high level of the enzyme units in cell-free broth. The established optimized conditions for Bacillus subtiliss train RM16 were found to be: incubation time 24 hours, temperature 40[degree]C and pH 8.0. Inoculum size was 5%, starch [1%] as a carbon source while yeast extract [1.5%] as a nitrogen source. Magnesium ions [0.1%] exerted maximum stimulating effect for the production of amylase which can be further used at large scale applications

stitch in time, saves life; should B-Lynch suture be the first line surgical option for control of massive primary PPH due to refractory uterine atony? An experience at D.H.Q Hospital Faisalabad

Objective: to see the effectiveness of B-Lynch brace suture as first line surgical option to control massive primary postpartum hemorrhage due to uterine atony refractory to medical treatment

Study Design: quasi experimental

Place and duration of study: this research work was done in D.H.Q Hospital Faisalabad from 2002-2004. During the study period 21 women underwent B-Lynch Brace suture to halt bleeding resulting from refractory uterine atony. Data was collected in prospective manner on a specialized proforma from attending house officers and postgraduate trainee registrars. The B-Lynch technique was used. Postoperatively the patients were kept in high dependency area within labor room for 24-48 hours. Follow up was done in O.P.D after discharge

Materials and Methods: the women who had severe/ persistent primary postpartum hemorrhage due to uterine atony were initially resuscitated and simultaneously managed with ecbolics as per unit protocol [i-e; 40 units oxytocin in 1000cc Normal Saline infusion, inj. methergen [withheld women with specific contraindications for methergen], inj. F2 alpha in each uterine cornu, and per rectal misoprostol. However those women who remained unresponsive to the medical treatment, underwent B-Lynch Brace suture as first line surgical option

Results: the success rate was 85.7% [n18] in terms of control of hemorrhage and hysterectomy was averted in 95% [n20] of women. Whereas in two women it needed to be integrated with stepwise uterine de-vascularization procedures

Conclusion: B-Lynch suture is effective as first line surgical option to arrest postpartum hemorrhage due to refractory atonic uterus

Analyses of bile from gallbladders of fish [Arius platystomus, Arius tenuispinis, Pomadasys commersonni and Kishinoella tonggol]

Bile from gallbladders of Arius platystomus [Singhara], Arius tenuispinis [Khagga], Pomadasys commersonni [Holoola] and Kishinoella tonggol [Dawan] were derivatised and analysed by GC-MS for identification of bile acids and bile alcohols. Cholic acid and Chenodeoxycholic acid were found as major bile acids in Arius platystomus, Arius tenuispinis and Pomadasys commersonni. Other bile acids identified in Arius platystomus were allochenodeoxycholic acid, allodeoxycholic acid, 3 alpha,7 alpha,12 alpha -trihydroxy-24-methyl-5beta-cholestane-26-oic acid, and 3alpha,7alpha,12alpha, 24-tetrahydroxy-5alpha-cholestane-26-oic acid. Cholesterol was found as major bile alcohol in Arius platystomus, Arius tenuispinis and Pomadasys commersonni. Cholic acid was the major bile acid identified in the bile of Kishinoella tonggol while other bile acids included 3 alpha,7 alpha,12 alpha -tridydroxy-5alpha-cholestanoic acid and 3 alpha,7 alpha,12 alpha -tridydroxy-5beta-cholestanoic acid. Bile alcohol 5beta-cyprinol was present in significant amounts with 5beta-cholestane-3 alpha,7 alpha,12 alpha,24-tetrol being the other contributors in the bile of Kishinoella tonggol

Chronic hepatitis; HCV genotypes in correlation with alanine aminotransferase level in patients in interior of Sindh

Objective: To determine the correlation between HCV genotypes and serum ALT levels in various patients of chronic hepatitis induced by hepatitis C virus, in our setup. Design: A prospective study carried out from August 2006 to December 2009. Setting: Research Medical Center LUMHS Jamshoro, Pathology Department Peoples University of Medical and Health Sciences Nawabshah and Biotechnology Department University of Karachi

Patients: A total of 344 HCV-PCR positive patients with different genotypes were evaluated 239 men and 105 women with ages between 18-55 years of age years were included in the study

Methodology: All the patients went for ELISA test for the presence of HCV antibodies by ELISA kit of Biokit Spain, then a 10.0 ml sample of blood was collected in a tube with separating gel, to obtain serum, which was O stored at -80°C, for the determination of HCV RNA by RT- PCR [Real time cephid smart cycler] and for determination of HCV-RNA genotypes by comparison in sizes of the products amplified by RTPCR using HCV genotype- specific primers, then subjecting the product to electrophoresis by Anagen kit. 5.0 ml of blood was also collected in a tube with separating gel, to obtain serum, which was stored at room temperature for the determination alanine aminotransferase by using UV enzymatic kinetic method

Results: when HCV genotypes were correlated with serum ALT levels, 09 cases were found < 50 mg % and among these 06 cases were of genotype 1a, 02 cases were of genotype 2a and one case of untyped. 55 cases shows serum ALT level between 50-100 mg % and among this majority of cases belongs to untyped category. 209 cases shows serum ALT level between 100-200 mg % and among this majority of cases belongs to genotype 3a. 71 cases shows serum ALT level >200 mg % and among this majority of cases belongs to genotype 3a

Conclusions: The data in the current study indicates the strong correlation between HCV genotypes and serum ALT levels. The genotypes 3a, 3b and 2 were found associated with high serum ALT levels and the genotype 1 was found associated with low levels of serum ALT

Efficacy of gatifloxacin in acute bacterial corneal ulcer

To assess the efficacy of Gatifloxacin 0.3% ophthalmic solution in infective corneal ulcer. This observational [non comparative] clinical analysis was done at the Department of ophthalmology unit-ll, Liaquat University Eye hospital Hyderabad of Liaquat University of Medical and Health Sciences Jamshoro / Sindh, Pakistan from April 2010 to March 2012. All the subjects who fulfilled the inclusion criteria were registered. Anterior segment examination was performed. Corneal staining and sensitivity test was done to exclude viral and paralytic element. Corneal samples were collected for gram's staining and culture sensitivity tests. After getting the preliminary laboratory results, Gatifloxacin 0.3% ophthalmic solution was used in bacterial corneal ulcer every 30 minutes for first twenty four hours, and every one hour till three days. On obtaining better response the drops were used every two hours up to 7 days. The treatment was continued with tapering of dosage for three weeks. After total recovery [re-epithelialization of corneal epithelium] the drops were used two times a day for one more week. The total of 170 patients [male=68.8%; female=31.2%] were recruited. Culture sensitivity examination revealed staphylococcus [36.5%], followed by fungi [24.1%]. Pseudomonas thus detected were 10%. Gatifloxacin showed highest sensitivity and lowest resistance i.e. 87.65% and 12.35% respectively against gram positive and gram negative isolates. Gatifloxacin 0.3% ophthalmic solution due to its strong activity against various gram-positive and gram-negative microbes is strongly effective in the treatment of acute bacterial keratitis

Periocular infantile haemangioma and the role of propranolol

This case of a four and a half-month-old girl describes periocular infantile haemangioma which was treated successfully with propranolol. She developed a red coloured lesion around the left upper eye lid at one week of age. A gradual increase was noticed in the size of the lesion and by the age of four and a half months, the swelling had increased enough to cover her visual axis, completely occluding her left eye. Oral propranolol therapy was initiated with a daily dosage of 1 mg/kg body weight. The dose was increased gradually, and there was an excellent response to propranolol treatment. A complete eye opening was observed 8 months after the initiation of this treatment

Visual acuity outcomes after intra vitreal ceftazidime in acute post-operative endophthalmitis

To determine effectiveness of ceftazidime as an intraocular antibiotic in the treatment of acute post operative endophthalmitis. This was an observational clinical analysis conducted on patients presenting with acute post-operative endophthalmitis. The study was conducted at Liaquat University Eye Hospital of Liaquat University of Medical and Health Sciences /Jamshoro, Pakistan. Both culture positive and negative subjects were enrolled. Anterior segment slit lamp examination and if possible posterior segment examination was performed. After completing emergency investigations, vitreous tap was carried out followed by intravitreal injection of ceftazidime [2.25%] through pars planna approach. The post-resolution best corrected visual acuity was recorded. Out of thirty four subjects, 32.4% [11 Eyes] showed good response with post treatment visual acuity of 6/24 and better. 41.2% [14] eyes had moderate improvement with visual outcome of 6/60 and better. Intravitreal injection ceftazidime was repeated on nine subjects after forty eight hours of first injection. Four [11.7%] patients out of nine with repeat injection improved to 6/60 and better, and five [14.7%] with poor response were referred to vitreo retina department. Ceftazidime has proved to be quite effective in acute post operative endophthalmitis caused by both gram positive and gram negative organisms

Comparative evaluation of some commercially available brands of pharmaceutical preparations for Na, K and Mg concentrations

A study was carried out to investigate the concentrations of macro-elements [Na[+], K[+] and Mg[+2]] in twelve commercially available pharmaceutical preparations used as sex stimulant, by Atomic Absorption Spectrophotometer. A wet digestion method was adopted to prepare the samples. The results indicated that sodium concentration was maximum [3702 +/- 29 micro g g[-1]] in LB and minimum [495 +/- 06 micro g g[-1]] in H-E-H. Potassium concentration was maximum [6337 +/- 13 micro g g[-1]] in NBA while minimum [150 +/- 06 micro g g[-1]] in ZGRA. Magnesium concentration was maximum in V-100 [9226 +/- 11 micro g g[-1]] and minimum in FGRA [1194 +/- 25 micro g g[-1]]. The concentration of macro-elements in the imported herbal preparations was in the order of Mg>Na>K and in the local herbal preparations as follows: Mg>K>Na. Some of these herbal preparations contain high level of macro-elements than the recommended daily dietary allowances. The excessive use of such preparations may cause severe allergic reactions, kidney damage and pulmonary atherosclerosis

Prevalence of hepatitis in neonates and children in Karachi

Inflammation of liver is known as "hepatitis" is commonly found in infant as neonatal hepatitis and in children as acute and chronic hepatitis. Neonatal hepatitis is a general term for inflammation of the liver that occurs shortly after birth in newborns [less than 3 months of age] for which a specific cause cannot be identified. To provide an overview of current childhood statistics of hepatitis and jaundice to facilitate analysis of the impact of past research discoveries on outcome and provide essential information for prioritizing future research directions. Experimental Study. This study was conducted at the Department of Histopathology, BMSI, JPMC, Karachi from May 2004 to March 2005. Slides / paraffin blocks of liver biopsies from patients under 15 years of age. The cases were of two categories i.e. retrospective and prospective. The distribution of 480 cases of hepatitis was according to Age and Sex. Total 200 [41.7%] cases were encountered in the youngest of 0-5 years age group, 180 [37.5%] cases in 6-10 years and only 100 [20.8%] cases in 11-15 age group. The distribution of 24 cases of hepatitis was according to Age and Sex. Total 200 [41.7%] cases were encountered in the youngest of 0-5 years age group, 180 [37.5%] cases in 6-10 and only 100 [20.8%] cases in 11-15 age group. It is observed that the tendency of liver inflammation was decreased with increase in age and sexual differentiation showing male predominance with male to female ratio of 2:1. The inflammation of liver /hepatitis in young children, can be caused by infectious, metabolic, and genetic disorders. Physiological jaundice or neonatal hepatitis is mostly reported in male population than females, in children. In Karachi this is found that neonatal jaundice can be recovered with the growing age and it is found to be a common cause for enlargement of liver and associated liver diseases in infants and children that can lead to higher risks of acute or chronic liver diseases in adulthood

Fall of platelet count in children with traumatic brain injury: is it of value? / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Trauma is the leading cause of mortality and morbidity among young age groups in Saudi Arabia and developed countries. This study aimed to evaluate the fall of platelet count in children with traumatic brain injury (TBI) as a potential predictor for clinical severity and outcome.</p><p><b>METHODS</b>Totally 74 patients with TBI were admitted to the Pediatric Intensive Care Unit (PICU) of our hospital from the beginning of January 2008 to the end of March 2010 (27 months). Baseline enrolling criteria were age less than or equal to 12 years, admission within 4 hours after trauma event, and abbreviated injury scale (AIS) less than 3 for extracranial injuries. Injury severity was classified as mild, moderate and severe according to their Glasgow Coma Scale (GCS) scores. Clinical outcomes at discharge were defined as poor (death, severe neurological morbidity) and favorable (moderate disability and good recovery). Platelet count was taken 2-3 times on the first day after admission and thereafter once daily. The percentage fall of platelet count (PFP) was calculated and taken as an index of change. PFP was considered zero if the platelet count was higher than the initial value.</p><p><b>RESULTS</b>PFP was significantly higher in patients with poor outcomes (mean 56.0%+/-3.8%, median 55.5%) compared to those with favorable outcomes (mean 25.3%+/-3.2%, median 20.5%, P less than 0.01). PFP was also closely related to the severity of TBI, GCS score, clinical outcome and length of stay for survivors (P less than 0.01 for each). The frequency of thrombocytopenia was significantly higher in poor outcome patients than in favorable outcome patients (P less than 0.05). The validity of thrombocytopenia as a risk factor to predict poor outcome after TBI was: specificity, 77.4%; odd ratio (OR), 3.1; relative risk (RR), 2.15. Receiver operating characteristic (ROC) curve and Youden index showed that the optimum cutoff point of PFP was at 51.5%.</p><p><b>CONCLUSION</b>PFP is increased with the severity of TBI and it can be taken as a significant independent predicting factor for its outcome as well.</p>

Occurrence of multidrug resistant and ESBL producing E. coli causing urinary tract infections

Urinary tract infection [UTI] forms the largest single group of hospital-acquired infection and account for about 40-50% of the total nosocomial infections. Present study indicates that there is a high prevalence of multidrug resistant E. coli in UTI. Purpose of this study was to find out the occurrence of multidrug resistance among the Escherichia coli, which is the causative agent in more than 80% of urinary tract infection. In this study, 100 isolates were taken from UTI patients and their susceptibility pattern was studied. Minimum inhibitory concentration [MIC] of 11 antibiotics was studied using agar dilution method. The isolates were highly susceptible against imipenem i.e. 91% and were least susceptible to ampicillin and tetracycline. The resistance against ciprofloxacin was also very high i.e. 85%. ESBL production among these E.coli isolates was checked by combination disc method and about 54% isolates were found to be ESBL producers. So our result indicates the fact that the physicians should be aware of this increasing resistance among our local clinical isolates and should change their therapy regime accordingly

Plasma exchange in patients with the diagnosis of Guillain-Barre syndrome: an experience in intensive care unit

To assess the effectiveness of plasma exchange in patients with Guillain-Barre syndrome. This descriptive study was conducted at Intensive Care Unit Lady Reading Hospital Peshawar from March 2008 to July 2010. Twenty eight patients were included in study after fulfilling inclusion criteria. All the diagnosed cases of Guillain-Barre syndrome were admitted in Intensive care Unit Post Graduate Medical Institute Lady Reading Hospital Peshawar and 4 sessions of plasma exchange therapy was initiated in every patient after informed written consent. Out of 28 patients 19 were male [67.85%] and 9 were female [32.14%]. Mean age was 32.32 years and mean duration of stay in Intensive Care Unit was 6.32 days. Out of these 28 patients, 60.71% [17] recovered and 39.3% [11] expired despite treatment and 2 patients developed adverse events secondary to Plasma Exchange. In 25 [89.29%] patients breathlessness was reported as their major symptom beside motor weakness, while in 19 [67.85%] patients, pain was also reported. Early referral to Intensive Care Unit, management of complications, good nursing care and specific therapy with Plasma Exchange within seven days of onset of symptoms improve prognosis and Plasma Exchange has proved beneficial to supportive treatment alone in Guillain-Barre syndrome with minimal side effects

Diagnostic upper gastrointestinal endoscopy

To evaluate Oesophagogastroduedenscopy [OGD] in term of its indications and endoscopic findings. Retrospective audit. Medical "C" unit Department of Medicine Government Lady Reading Hospital Post Graduate Medical Institute Khyber Medical University Peshawar from July 2002 to June 2007. Adult patients who underwent upper gastrointestinal [GI] endoscopies during the last 5 years period were included in the study. The procedure was performed as per the standard protocol with diagnosis based on established criteria. A total of 2282 were scoped 53.3% [n=1216] were female and 467% [n=1066] male. The mean age of the study population was 43.75 Standard Deviation [SD] +/- 1800 Dyspepsia [54.5%], upper GI bleed [12.3%], recurrent vomiting [11.1%] and dysphagia [7.8%] accounted for the common indications of the procedure. Endoscopy was normal in 164% [n=374] of patients Amongst the others [n=1908] single endoscopic diagnosis was made in 91% of the patients and in the remaining 9% of patients combination of lesions were seen. The endoscopic findings included gastritis and duodenitis alone or in combination [29.4%] oesophagitis [13.9%] duodenal ulcer [6.6%] gastric ulcer [7.4%] oesophageal varices [3.7%] and growth oesophagus [2.9%]. Gastric ulcer was more common than duodenal ulcer. Upper GI endoscopy is safe and an excellent diagnostic modality with high diagnostic yield. Dyspepsia upper GI bleed recurrent vomiting and dysphagia are the commonest indication for OGD. Gastro-duodenitis oesophagitis peptic ulcer disease oesophageal varices and growth oesophagus are the common endoscopic diagnosis