RESUMO
Objective: To evaluate the frequency and contributing factors for acute pancreatitis after endoscopic retrograde cholangio-pancreatography in patients with obstructive jaundice. Study Design: Descriptive case series. Place and Duration of Study: A descriptive case series conducted at department of Gastroenterology, Shaikh Zayed Hospital, Lahore in the period of six months
Material and Methods: Two hundred and thirty patients diagnosed as having obstructive jaundice and undergoing ERCP who fulfilled the inclusion criteria were included in the study from the outpatient and indoor department of Gastroenterology-Hepatology Shaikh Zayed Hospital Lahore. Informed consent was taken. After the selection of the cases, patients were evaluated for the presence or absence of contributing factors like age, gender, cannulation attempts, cannulation time, percutaneous papillotomy, pancreatic duct contrast injection and previous history of post ERCP pancreatitis. Data was analysed by using the statistical software for social sciences [SPSS] version 15
Results: In our study, mean age was 44 +/- 14.12 years. Out of 230 patients 42.17% [n=97] were male and 57.83% [n=133] were females. Frequency of acute pancreatitis after ERCP in patients with obstructive jaundice was 4.78% [n=11] while 95.22% [n=219] had no findings of acute pancreatitis after ERCP. Frequency of factors for acute pancreatitis after endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice was recorded which shows that out of 11 cases, 45.45% [n=5] were females, 36.36% [n=4] had previous history of Post ERCP Pancreatitis, 27.27% [n=3] had >5 attempts of cannulation, 36.36% [n=4] had >5 minute time for cannulation, 54.55% [n=6] had pre-cut papillotomy while 63.64% [n=7] had pancreatic duct contrast injection
Conclusion: We concluded that frequency of acute pancreatitis after endoscopic retrograde cholangiopancreatography in patients with obstructive jaundice was found not very high in our practice. Female gender, precut papillotomy and pancreatic duct contrast injection were the most important risk factors for the development of acute pancreatitis
RESUMO
The objective of this study was to assess patients regarding their knowledge and perception of the anaesthetists' role in patient care in a developing country. The audit was conducted at the Aga Khan University Hospital, Karachi. Two hundred surgical and 102 medical out-patients were included in the audit prospectively who filled a detailed questionnaire. Fifty-six% of the patients knew that anaesthetists were medically qualified but only 20% and 27% had an idea about their role in the intraoperative and immediate postoperative period. 14.6% were aware of the anaesthetists role outside the operating room. No difference was observed between the two groups of patients except that a higher percentage of surgical patients were interested in having more information regarding anaesthesia and wanted to choose their anaesthetist if the need arose. Gender difference was observed in answer to two questions only. A higher percentage of males know the role of anaesthetist in the recovery room whereas a greater number of females who had surgery before remembered their anaesthetist postoperatively. The results of this audit show a poor perception of the anaesthetists role both inside and outside the operating room. Although public knowledge surveys have been carried out in developed countries there is a pressing need to repeat these in developing countries since the image as perceived by public may have a direct bearing on the recruitment of young doctors into an already shortage specialty in these less affluent countries