Hematological adverse effects in HCV patients treated with pegylated interferon and ribavirin in a Tertiary Care Hospital Peshawar

To know the frequency of common hematological adverse effects during treatment of HCV. Comparative study. This study was carried out OPD of gastroenterology unit HMC Peshawar from November 2013 to August 2014. This study comprising of 42 patients. Patient age more than 17 years, both genders, previously treatment experienced patients with normal hematologic and radiological parameters were included in the study. Patients age more than 70 years, patients with uncontrolled depressive illness, pregnant ladies, treatment naive patients and decompensated cirrhotics were excluded from the study. Patients were evaluated for treatment with pegylated and ribavirin by history, clinical examination, routine laboratory investigations, ultrasound abdomen, HCV genotyping and upper GI endoscopy where considered necessary. Patient's who fulfilled the inclusion criteria were included in the study. Total of 42 patients, 24 [57.14%] male and 18 [42.85%] female were included in this study. The mean age was 39.05 +/- 8.54 with minimum age of 18 years and maximum age of 55 years. Genotype 3 was the most frequent genotype, present in 26 [61.90%] patients followed by untypeable genotype, present in 12 [28.57%] patients. Anemia was present in 18 [42.85%], thrombocytopenia in 10 [23.80%] patients. Leucopenia was present in 6 [12.28%] patients. Haematological abnormalities are common during treatment for HCV, so patients should be regularly followed to diagnose and treat the cytopenias in time

Gastric carcinoma: location, morphological and histological profile

To know the common tumor location, morphological and histological types of gastric carcinoma. This cross sectional study was conducted in gastroenterology unit HMC from January to August 2010. One hundred and thirteen patients of more than 30 years of age and having endoscopic and biopsy proven gastric carcinoma were included in the study. All patients after necessary investigation were prepared for endoscopic examination, upper gastrointestinal endoscopy was done and findings were recorded. Biopsies of the lesions were taken for histopathological confirmation. Seventy five [66.4%] patients were male and 38 [33.6%] were female. The mean age was 56.02 +/- 12.11 years. Antrum was involved in 29[25.7%] cases alone, body alone was involved in 16[14.2%] cases, body and antrum in combination were involved in 15[13.3%] cases, cardia and fundus in 15[13.3%] cases, cardia alone in 13[11.5%] cases, fundus alone in 6[5.3%] cases, fundus, antrum and body in combination in 5[4.4%] cases, cardia, fundus and body in combination in 3[2.7%] cases and cardia and body in combination were involved in 2[1.8%] cases, while stomach was diffusely involved in 9[8.0%] cases. Tumor was polypoid/fungating in 51[45.1%] cases, ulcerated in 43[38.1%], infiltrating in 17[15.0%] and fungating and ulcerated in 2[1.8%] cases. Intestinal type gastric carcinoma was present in 39[34.5%] cases and diffuse type gastric carcinoma was present in 74[65.5%] cases. Gastric carcinoma is a male predominant neoplasm which commonly involves the antrum, usually as fungating or ulcerated lesion and majority of gastric carcinoma are diffused type gastric carcinomas

Management of foreign bodies in the upper gastrointestinal tract with flexible endoscope

To evaluate the management of foreign bodies in the upper Gastrointestinal tract in a tertiary care hospital in Peshawar. In this descriptive study, conducted at Gastroenterology Department Hayatabad Medical Complex Peshawar from May 2002 to May 2009, a total of 40 consecutive patients presenting with history of foreign body ingestion were included. Radiological survey was made before endoscopy in all the patients. Flexible endoscope, esophageal over tube and other accessories were used for removal of the foreign bodies. Female to male ratio was 1.5:1. The mean age of the sample was 19.92 +/- 23.5. Dysphagia [n=18, 45%] was the most common symptom in the esophageal foreign bodies followed by retrosternal pain or discomfort [n=11, 27.5%]. The most common foreign body was coin ingestion [n=24, 60%]. Meat bolus and bone chip impaction was present in 9 [22.7%] patients. The success rate in case of esophageal foreign bodies was 93.75%. While in the case of gastric foreign bodies, it was 100%. There was a small perforation which occurred in only one patient with esophageal foreign body which was managed conservatively. In the case of gastric foreign bodies, no procedure related complications occurred. Flexible endoscopy was a safe and effective technique for the management of foreign bodies in the upper gastrointestinal tract in our study