Hepatitis 'B' infection: experience in a tertiary care hospital of Peshawar

Hepatitis B virus infection is one of the major health problems in the developing countries including Pakistan. The present study was conducted to determine the symptomatology, risk factors and complications of hepatitis B infection in a tertiary care hospital in Peshawar. A prospective observational study was conducted in the Department of Medicine, Khyber Teaching Hospital Peshawar, from January 2006 to November 2006.A total of 180 HCV positive patients were selected, 123 were males and 57 females. Relevant information was obtained from the patients with the help of a pre-designed questionnaire prepared in accordance with the objectives of the study. A total of 180 hepatitis B surface antigen [Hbs Ag] positive were included. 68.33% were males and 31.67% females. The age range was 7 to 85 years, with mean of 50 years. The risk factors distribution were: intravenous drug abuse 33.88%, Hbs Ag positive sexual partners 23.33%, blood transfusion 14.44%, dental procedures [tooth extraction or root canal treatment [RCT] 9.44%, shaving from community barbers 8.33%, past surgical history 6.67%, medical endoscopy 5.56%, occupational exposure 5%, tattooing 1.6%, and history of homosexuality and hemodialysis 0.5% each. No risk factors were recorded in 10.56% and multiple risk factors were observed in 20% cases. Clinical presentations at time of interview were fever 47.78%, jaundice 43.33%, malaise 37.77%, maculopapular rash 5.56%, urticaria in 3.8% and polyarthritis in 1.66% patients. Multiple complaints were recorded in 9.44%, and 28.88% were asymptomatic. Complications due to hepatitis B infections were: chronic healthy carriers 31.67%, chronic hepatitis 14.44%, liver cirrhosis 6.11%, acute hepatitis 5.56%, acute fulminant hepatitis 0.5%, and hepatocellular carcinoma in 1.10% cases, while 40.55% were clinically asymptomatic or with sub-clinical features. Chronic HBV infection coexistence with chronic HCV infection was recorded in 8.89%. Intravenous drug abuse, positive sexual partners, blood or blood product transfusion and dental procedures are main risk factors for HBV infection. Fever, jaundice and malaise are main symptoms while chronic carrier state, chronic hepatitis and liver cirrhosis are main sequelae of the disease

Hepatitis 'B' infection: Experience in a tertiary care hospital of Peshawar

Hepatitis B virus infection is one of the major health problems in the developing countries including Pakistan. The present study was conducted to determine the symptomatology, risk factors and complications of hepatitis B infection in a tertiary care hospital in Peshawar. A Prospective observational study was conducted in medicine department, Khyber Teaching Hospital Peshawar, from January 2006 to November 2006.A total of 180 HCV positive patients were selected, 123 were males and 57 were females. Relevant information was obtained from the patients with the help of a pre-designed questionnaire. A total of 180 hepatitis B antigen [HBs Ag] positive individuals were included. Out of those 68% were males. The ages ranged from 7 to 85 years [mean= 50]. Prior intravenous drug abuse [34%], HBs Ag positive sexual partners [23%], blood transfusion [14%], dental procedures [tooth extraction or root canal treatment [9%], shaving from community barbers [8%], past surgical history [7%], medical endoscopy [6%], occupational exposure [5%], tattooing [2%], and history of homosexuality and hemodialysis in 0.5% each were identified among HBs Ag+ individuals. No risk factors were recorded in 11% and multiple risk factors were observed in 20% cases. Patients presented with fever [48%], jaundice [43%], malaise [38%], mucopapular rash [6%], urticaria [4%] or poly arthritis [2%]. Multiple complaints were recorded in 9% and 29% were asymptomatic. Complication of Hepatitis that were observed were: chronic healthy carriers [32%], chronic hepatitis [14%], cirrhosis [6%], acute hepatitis [6%], fulminant hepatitis 0.5%, and hepatocellular carcinoma in 1% cases while 41% were clinically asymptomatic or with sub-clinical features. Chronic HBV/ HCV co-infection was seen in 9% cases. Major associations of HBV infection along with clinical picture and complications of HCV infection were identified in a tertiary care hospital

Comparative analysis of associated complications of type-1 and type-2 diabetes mellitus

To analyse the associated complications of Type-1 and Type-2 diabetes mellitus in two tertiary care hospitals of Peshawar. A comparative cross sectional observational study was conducted at Khyber teaching hospital and Lady Reading hospital, Peshawar from January 2004 to February 2005. A total of 532 diagnosed patients of diabetes mellitus who had developed further complications were included. Patients were interviewed according to a pre-designed questionnaire. Out of 532 patients, 437 [82.1%] were Type-2 diabetics and 95 [17.9%] were Type-1 diabetics. Two hundred and seventy eight [52.25%] were females and 254 [47.74%] were males. Two hundred and seventy six [60.33%] patients had more than 10 years of duration of diabetes. The common complications in type-2 diabetics were coronary artery disease [CAD] in 268 [49.81%] cases, cerebrovascular accidents in 61 [11.46%] cases and diabetic ulcers in 59 [11.09%] cases. In type-1 diabetics, common complications were cardiovascular diseases in 38 [7.14%] cases, surgical ulcers in 16 [3%] cases, neuropathies in 15 [2.81%] cases and nephropathy in 9 [1.69%] cases. Type-2 diabetes coexists with hypertension in 112 [36.60%] cases of CAD and 31 [46.26%] cases of CVA cases. The frequency and morbidity of Type 2 diabetes is more common than Type 1 diabetes in our selected patients