ABSTRACT
Objective: To evaluate with endoscopy the common causes of upper gastrointestinal bleeding in patients presenting with hematemesis within 24 hours of admission
Design: A cross sectional observational study
Setting: Medical unit III, LUMHS Jamshoro
Duration: Six months from 1[st] Jul, 2014 - 31[st] Dec, 2014
Methods: One hundred cases of hematemesis were included in the study. Patients who refused endoscopy and those on NSAIDs, anticoagulants and steroids were excluded from study. Upper gastrointestinal endoscopy was performed within 24 hours of admission
Results: Out of 100 patients selected, 51 [51%] were males and 49 [49%] females. Majority of patients were between 30-60 years with mean age of 43.97 years +/-SD 7.8. Variceal bleed was the most common cause n=54 [54%] followed by peptic ulcer disease [PUD] n=20 [20%]. Esophagitis was noted in ten [10%] patients, gastric erosions in nine [9%], tumors of upper gastrointestinal tract in six [6%] and Mallory-Weiss tear was responsible in only one [1%] cases
Conclusion: Variceal bleeding secondary to portal hypertension is the most frequent cause of bleeding in upper gastrointestinal tract. Increased prevalence of hepatitis B virus [HBV] and hepatitis C virus [HCV] in this part of the world has resulted in increased incidence of liver cirrhosis and portal hypertension highlighting the importance of prevention of HBV and HCV
ABSTRACT
Objective: to find Public awareness regarding stroke and the cause of delayed presentation of stroke patients in our setup at Services Hospital Lahore
Material and Methods: this prospective study was conducted on 113 patients in Department of Neurology, Services Hospital, and Lahore over a period of one year from January, 2012 to December, 2012. The time of presentation was divided into 4 segments; within 6 hours of stroke onset, within 6-12 hours of stroke onset, within 12-24 hours of stroke onset and more than 24 hours of stroke onset with diagnosis of cerebral infarction. Also knowledge of patients regarding tPA and cause of delay was assessed
Results: there were 68 males and 45 females with age range of 27 to 83 years. Only 9 patients presented within 6 hours, 22 within 6-12 hours, 4 7 within 12-24 hours and 35 more than 24 hours. A very little percentage of patients with cerebral infarction landed in Emergency department within 6 hours of stroke onset. Also 91.1 % of patients were unaware of thrombolytic therapy. When asked for a single factor for pre-hospital delay, 67% of patients labelled transportation issues as a cause
Conclusion: because early presentation is a prerequisite for thrombolysis for acute ischemic stroke we recommend to start educational programs that increase public awareness of the need to seek medical help promptly after stroke and word stroke should be replaced with brain attack and measures to improve the traffic sense should also be undertaken