Indications and complications of bronchoscopy: an experience of 100 cases in a tertiary care hospital

To enlist the frequency of indications and complications of flexible fibreoptic bronchoscopy in a tertiary care hospital. A total of 100 patients admitted to Chest and medical units of Lady Reading hospital Peshawar who needed bronchoscopy were selected irrespective of their age, sex, occupation. All patients in whom bronchoscopy was indicated were included in the study. After detailed clinical history with thorough physical examination and relevant investigations, Bronchoscopy was performed with Olympus fibreoptic bronchoscope. Relevant data were recorded for analysis. Out of 100 patients, 64 [64%] were male, and 36 [36%] were female. Majority of patients [55%] were above 50 years of age. In 60% patients, there was radiographic abnormality on chest X-ray and C.T scan. In 25 [25%], the indication was unexplained hemoptysis and 2 [2%] patients had hoarseness. Another 13 [13%] patients were bronchos coped to see Acid Fast Bacilli in bronchial wash. These patients were suspected to have Tuberculosis but sputum smears were reported negative on repeated examinations. Complications which occurred in these patients included Pneumothorax [1%], hemorrhage [1%], hypoxemia [4%], Atrial tachycardia [3%], bronchospasm [2%], and post-bronchoscopy fever [2%]. These complications were managed accordingly and all patients recovered without any serious consequences. Most of the indications for Bronchoscopy in this hospital are diagnostic rather than therapeutic. Most common indications include radiographic abnormalities, hemoptysis, hoarseness and for isolation of ABF

Predictors of esophageal varices in patients of liver cirrhosis

To identify non-endoscopic predictors of esophageal varices in patients with liver cirrhosis. This observational and analytical study was carried at GI and Liver Clinic, Saeed Anwar Medical Center, Dabgari Gardens, Peshawar from January 2006 to August 2006. Seventy-three patients with established cirrhosis and no history of variceal bleeding were evaluated for predetermined variables and underwent endoscopy to look for esophageal varices. Out of 73 patients, 51 [69.9%] were males and 22 [30.1%] were females. Forty-four [60.3%] patients were having esophageal varices on endoscopy and 29 [39.7%] patients were having no varices. Out of 44 patients, small varices were found in 28 [63.6%] patients while large varices were found in 16 [36.4%] patients. Platelet count <65 x 103/ mico L. serum albumin <2.2 g/dl and portal vein diameter> 13mm on ultrasound were found to have significant predictive value for large varices. Platelet count less than 65 chi 103/ micro L, serum albumin less than 2.2 g/dl and portal vein diameter more than 13 mm on ultrasound are independent and significant predictors of esophageal varices on endoscopy. Therefore screening endoscopy must be done in all patients with liver cirrhosis who have no history of GI bleeding but any of these predictors