ABSTRACT
Portal hypertensive colopathy [PHC] is a clinical entity in liver cirrhosis. The frequency and profile of colonic mucosal lesions of this entity are not well studied. The aim of this study is to evaluate the prevalence of colonic mucosal changes in patients with liver cirrhosis and their clinical significance. Forty patients with post-viral liver cirrhosis and portal hypertension [PHT] underwent upper gastrointestinal endoscopy as well as a full length colonoscopy to detect changes in colonic mucosa. PHC was diagnosed endoscopically by the presence of vascular ectasia, diffuse hyperaemic mucosa and rectal varices. Biopsies were obtained from the recto-sigmoid area as well as from any abnormal mucosal lesions apart from angiodysplastic areas. Diffuse hyperaemia, angiodysplasia and rectal varices were found in 40%, 32.5% and 17.5% of patients while haemorrhoids in 42.5%, respectively. The prevalence of PHC increased with worsening Child-Pugh class, the mere presence of oesophageal varices while platelet count was significantly associated with angiodysplastic lesions only. None of other upper endoscopic features of PHT was significantly related to PHC. Moreover, history of lower gastrointestinal [GI] bleeding was significantly associated with the presence of rectal varices and haemorrhoids. Colonoscopic features of PHC were significantly associated with the histopathological diagnosis revealing 79% sensitivity and 66.6% specificity. Conclusion: PHC is a frequent finding in patients with PHT. Colonoscopic features suggestive of PHC were in concordance with the histopathological evidence. Although the presence of haemorrhoids is not a feature of colopathy, yet it should be considered together with anorectal varices as a cause of lower GI bleeding
Subject(s)
Humans , Liver Cirrhosis/complications , Chronic Disease/etiology , Prevalence , Biopsy , Chronic Disease/diagnosis , Endoscopy, Digestive System , ColonoscopyABSTRACT
To determine the specificity and specificality of X-rays paranasal sinuses [water's view] in patients of chronic maxillary sinusitis. A prospective, comparative study between radiological findings and lavage of the maxillary sinuses. ENT department Combined Military Hospital Quetta over a period of 6 months. A total of 110 patients with suspected chronic maxillary sinusitis were selected for the study from general population; mostly defence personnel and few civilians reporting to ENT department of Combined Military Hospital Quetta, which is the only tertiary referral Military Hospital in Baluchistan. Provisional diagnosis of maxillary sinusitis was made on history and clinical examination. X-ray paranasal sinuses [water's view] was carried out in all cases. Radiological findings were classified as clear, mucosal thickening, opaque or fluid level. Antral lavage was also carried out in all cases and fluid return was classified as clear, mucoid or mucopurulent. X-ray PNS [water's view] had a sensitivity of 77% and specificity of 37% in chronic maxillary sinusitis when compared with the findings of lavage of the maxillary sinuses. Despite the fact that affluent countries have adopted CT scan as the diagnostic tool of choice in diagnosing sinusitis', it is fair to conclude that plain X-rays remain the preferential investigation in diagnosing chronic maxillary sinusitis in third world countries like ours
Subject(s)
Humans , Male , Female , Chronic Disease/diagnosis , Radiography , Paranasal Sinuses/diagnostic imaging , Therapeutic IrrigationABSTRACT
Twenty-three cases of chronic subdural hematoma were admitted and treated at the neurosurgery department of Allied Hospital, Faisalabad, from 1991 to 1993. All these patients were treated with simple burr holes and drainage. Six patients developed post-operative complications; infection in one, cerebral oedema in two, haematoma recurrence in two. There was no mortality. Follow-up revealed that 18 patients recovered completely, one still had neurological or mental deficit and four suffered epileptic seizures
Subject(s)
Chronic Disease/diagnosisABSTRACT
Calcificaçöes pancreáticas em crianças tem sido descritas com pouca frequência, sendo a associaçäo com ingestäo crônica de álcool ainda mais rara. Os autores apresentaram o caso de uma criança de nove anos de idade com calcificaçöes pancreáticas e dores abdominais recorrentes, causadas pela pancreatite crônica alcoólica. Essa etiologia foi determinada por anamnese, dados epidemiológicos, exames laboratoriais e diagnóstico por imagem