Frequency of HBeAg positivity in chronic hepatitis B infected patients

Objective: To determine the frequency of HBeAg positivity in chronic hepatitis B infected patients

Methodology: This descriptive cross-sectional study was carried out for one year between June 01, 2014 till May 30, 2015 in a private consulting clinic at Ibrahimi Hospital, Dabgari Gardens, Peshawar - Pakistan. A total of 149 patients were included in the study. All patients of either gender between 15 to 70 years of age, newly diagnosed with HBV infection in the form of positive HBsAg on third generation ELISA were included in the study. In all the patients, HBeAg was checked. Data were analyzed using SPSS version 20.0

Results: Out of the total 149 patients between 20 to 60 years [mean 41 +/-8.7] included in the study, the males 112 [75.2%] outnumbered the females 37 [24.8%]. The prevalence of HbeAg in chronic HBV was 28.2 % [males 16.10 %, females 12.08%] with more patients [22.14%] between 21 and 40 years of age

Conclusion: The frequency of HbeAg was found in a significant number of chronic HBV patients. Its frequency was more in males and in the age group of 21 to 40 years

Telbuvidine monotherapy in the treatment of HBeAg positive chronic hepatitis B infection with normal baseline ALT levels

To study the effect of Telbuvidine [LDT] mono therapy in the treatment of HBeAg positive Chronic Hepatitis B infection [CHB] with normal ALT levels. Ninety HBe antigen [HBeAg] positive CHB infection patients were enrolled and followed between June 2008 and June 2011. All of them had ALT levels less than twice the upper normal limit [Mean 36.9 SD 19.9]. All patients were HBeAg positive, had serum DNA level >10[4] copies/ml and never had previously received anti HBV treatment. All patients were given LDT 600mg daily as initial antiviral treatment for two years. Out of 83 patients who continued the treatment as per protocol, 59 were males and 24 were females between ages of 21 and 50 years. Baseline HBV DNA levels were 7.82x10[7] copies/ml [Range 4.8x10[4]-8.3x10[9] copies/ml]. By the end of first year [52 weeks] the mean decrease in serum HBV DNA levels was 7.88 log[10] copies/ml and the proportion of patients having undetectable HBV DNA levels was 73%. At the end of second year of therapy [96 weeks] the percentage of undetectable HBV DNA levels increased to 86%. At the end of 1[st] [52 weeks] and 2[nd] [96 weeks] HBeAg seroconversion rates were 62% and 86% while HBsAg seroconversion was 8% and 13% respectively. LDT is a reasonable cost effective therapy for HBeAg reactive CHB patients with normal baseline ALT levels resulting in a significant serological and virological response and was well tolerated in our population of Khyber Pukhtunkhwa

Frequency of helicobacter pylori in patients with upper G.I symptoms

Our study aimed to determine the frequency of H pylori infection in our local population. 100 sequential patients undergoing upper gastrointestinal endoscopy were tested for the presence of H pylori infection by the urease test. All patients were tested for the presence of H pylori regardless of endoscopic findings. Of 100 patients, 39 were male and 61 were female. Patients age ranged from 13 years to 85 years, mean age being 39.9 years. Positive endoscopic findings were detected in 32% cases. 65% cases [42 female, 23 male] tested positive for H pylori infection. Of those who tested positive, 20 patients [30.7%] had significant upper Gl pathology detected. Of patients who were negative for H pylori infection, 12 [34.28%] had significant upper Gl pathology detected. Of a total of 61 female patients undergoing endoscopy, 68.8% tested positive for infection with H pylori, whereas 58.9% of the male patients test positive. Of 100 patients, 47 were aged 40 or above of which 55.3% were H pylori positive; 53 patients were below 40 years of age and of them, 75.3% were H pylori positive. We conclude that significant proportion of Pakistani population harbours H. Pylori and due consideration should be given to H. Pylori status of a person presenting with diseases with strong link with this organism

Effects of noise on rickshaw drivers of Karachi city

Hearing loss is the most obvious threat posed by noise pollution. Road noise is a major contributor to perceived environmental noise. The objective of this study was to assess hearing loss in rickshaw drivers of Karachi due to rickshaw noise and to analyze the non-auditory effects of noise that is hypertension and mood changes... It was a descriptive cross-sectional study. The study was conducted at Patel Paara, Karachi. Fifty one rickshaw drivers who had been driving for at least past 5 years and were below 50 yrs of age were selected. The mean age of rickshaw drivers was 35 years. Questionnaire was filled which was translated into Urdu. Blood pressure was checked and tuning fork tests and proper Audiometry was done in all study subjects Interviews of 51 rickshaw drivers were completed. All subjects were male. They were investigated regarding. sensorineural and conduction hearing loss, blood pressure, effect of duration of driving on hearing and tinnitus. Audiometry results clearly showed that hearing of most of the rickshaw drivers was affected. The hearing loss observed in most of the study subjects was sensorineural in type, while few of the subjects also showed conduction loss. Majority of the subjects was found to be hypertensive on examination. There was loss of hearing and tinnitus among rickshaw drivers that seems to be most probably a result of their noisy occupation. Noise was also found to be a risk factor for developing mild to moderate hypertension. Use of silencers by rickshaw drivers and proper legislation by the government can result in less hearing loss and less noise pollution in the envioronment

One week eradication therapy for helicobacter pylori

1. To determine the efficacy of one week treatment in the cure of Helicobacter Pylori [H pylori] infection using triple regimen including Clarithromycin, Amoxicillin, and a Proton Pump Inhibitor [PPI]. 2. To identify the differences, if any, in response to treatment between patients from Pakistan and the rest of the world. Patients with endoscopically proven peptic ulcer disease and H pylori infection confirmed by urease test were given PPI based triple therapy for one week and then PPI was continued for another week. After two weeks, endoscopy and urease test was repeated to assess H pylori eradication. There were 32 patients [20 male, 12 female, mean age 38.9 years] included in the study. All had endoscopically proven peptic ulcer at initial diagnosis and all were positive for H pylori infection. On repeat endoscopy two weeks later, 27 patients [84.3%] showed complete ulcer healing and PPI was stopped, whereas 5 patients showed signs of partial healing. In the latter, PPI was continued for another week, and on repeat endoscopy at end of therapy, all ulcers showed complete healing. Urease test was repeated in all patients at second endoscopy and was negative in 28 patients [87.5%]. We conclude that one week of triple therapy followed by PPI for one week is sufficient for eradication of H Pylorl

One week eradication therapy for Helicobacter pylori

Studies have been published from most parts of the world regarding optimal duration of treatment for peptic ulcer disease and for eradication of Helicobacter Pylori with some statistical differences therein. Worldwide consensus on this issue has still not been reached. The primary objective of the present study was to elucidate the role of the duration of treatment in the cure of H. Pylori infection. We aimed to determine whether one-week triple therapy is effective for eradication of H Pylori, so that a cost-effective protocol could be developed. Also to see if there was any difference in response in patients from this part of the world, as no such study has been previously reported from Pakistan. Patients with endoscopically proven peptic ulcer disease and H Pylori status confirmed by urease test were given PPI based triple therapy for one week and then PPI was continued for another week. After two weeks, endoscopy and urease test was repeated to assess H Pylori eradication. There were 32 patients [20 male, 12 female, mean age 38.9 years] included in the study. All had endoscopically proven peptic ulcer at initial diagnosis and all were positive for H Pylori infection. On repeat endoscopy two weeks later 27 patients [84.3%] showed complete ulcer healing 'and PPI was stopped, whereas 5 patients showed signs of partial healing. In the lattei PPI was continued for another week, and on repeat endoscopy at end of therapy, all ulcers showed complete healing. Urease test was repeated in all patients at second endoscopy and was negative in 28 patients [87.5%]. Our results were in keeping with other similar studies from different parts of the world. We conclude that one week of triple therapy is sufficient for eradication of H Pylori