Evaluation of dyspepsia by upper gastrointestinal tract endoscopy - a tertiary care hospital experience

To evaluate the underlying disorders in patients suffering from dyspepsia by upper gastrointestinal endoscopic examination. Descriptive analytical study. Study was conducted at department of medicine and Gastroenterology, Combined Military Hospital Malir Cantonment from June 2007 to December 2008. Patients having dyspepsia for more than six months or inadequate response to empiric treatment with anti-secretory drugs for three months and presence of alarm symptoms like weight loss, age > 50 years were included in this study. Patients with history of peptic ulcer, gall stones, renal stones, cardiac diseases, pancreatic diseases and abdominal surgeries were excluded from this study. Endoscopies were performed by single operator after local anaesthesia and sedation and findings classified according to defined standards. Out of 98 patients 62 [63.3%] were male and 36 [36.7%] were female with mean age of 40.72[ +/- 13.7] years. The vast majority [71] of patients had no ulcer/functional dysepsia as they had only gastritis or normal study. Upper gastrointestinal endoscopy is an essential requirement to evaluate patients of dyspepsia and vast majority of these patients are suffering from functional/non ulcer dyspepsia.

Clinicohaematological features of iron deficiency anaemia in children between 1-5 years of age

To study the clinicohaematological features of iron deficiency anaemia in children between 1-5 years of age. Children between 1-5 years of age suffering from iron deficiency anaemia were included in this study. Personal and family data was obtained for each child. Height and weight were recorded and degree of malnutrition determined as per modified Gomez classification. Samples for blood counts were taken in K[3]EDTA and complete blood counts were performed. Differential leucocyte count and RBC morphology was done by visual reviewing of slides. Ferritin was measured for each patient. Cut off value for defining anaemia was set at 11 g/dl as per WHO criteria. SPSS computer software was used for mean and SD calculations. Different clinical features were cross tabulated with measured Hb levels to evaluate their correlation. Chi-Square test was used to see the significant level. A total of 191 patients were studied with mean age of 1.9 [SD 0.89] years. Male to female ratio was 2:1. Overall, 121[63.3%] children had varying degrees of malnutrition. Mean Hb was 8.2 g/dl [SD 1.3]. Majority of the patients [62.3%] had Hb between 6.1-8 g/dl. Sixty patients had Hb>8 g/dl while 12 had Hb

Role of isoniazid prophylaxis for prevention of tuberculosis in haemopoietic stem cell transplant recipients

To evaluate the role of isoniazid prophylaxis in prevention of tuberculosis among allogeneic stem cell transplant recipients. This study was conducted at Armed Forces Bone Marrow Transplant Center Rawalpindi, Pakistan from July 2001 to October 2003. Patients suffering from various haematological disorders undergoing allogeneic stem cell transplantation were included in the study. The demographic information, primary diagnoses and relevant investigations were recorded. Patients had negative tuberculin skin tests and chest X-Ray at pre-transplant assessment. First 25 patients [group I] did not receive isoniazid prophylaxis while the next 25 [group II] were given isoniazid in a dose of 5-10 mg/kg [maximum 300 mg/day]. Isoniazid prophylaxis was started on day-1 and continued for 6 months post transplant. The patients developing tuberculosis were treated with rifampicin, ethambutol, isoniazid, and pyrazinamide during first 3 months followed by 2 drugs for a total duration of 12 months. Minimum follow up in group I and II was 783 and 403 days respectively. There was significant difference [p<0.001] in frequency of tuberculosis between two groups. In group I, four patients developed Tuberculosis [frequency 16%] whereas none of the patients in group II had the disease. Out of these four cases 3 had extrapulmonary disease. One patient died two weeks after the start of anti tuberculosis treatment while others successfully completed the treatment. Tuberculosis in stem cell transplant recipients is an important opportunistic infection especially in areas of high disease prevalence like Pakistan. Isoniazid prophylaxis for 6 months is effective in preventing tuberculosis among this class of patients

Childhood visceral leishmaniasis in Muzaffarabad, Azad Jammu and Kashmir: frequency and response to treatment in 61 cases

To study the epidemiology and status of resistance to antimonial compounds of paediatric hospital population with visceral leishmaniasis in Muzaffarabad, Azad Jammu and Kashmir, Pakistan. Children admitted between January to December 1999 in Azad Kashmir Combined Military Hospital Muzaffarabad and diagnosed as Visceral Leishmaniasis by demonstration of Leishmania parasites in bone marrow aspirate were included in the study. Patients received meglumine antimoniate for 21 days. The demographic information and time taken for resolution of fever after initiation of treatment were recorded. During study period out of 3520 paediatric admissions, 61 patients had visceral leishmaniasis. The frequency of disease was 1.73%. Median age of the patients was 18 months. Eighty two percent cases reported during non-winter seasons. Fifty nine [96.7%] patients responded to treatment with antimonial compounds. Median time taken for resolution of fever was 5.7 days. Two of the patients died during the study period. Childhood visceral leishmaniasis is common in Muzaffarabad and there is no resistance to antimonial compounds