Frequency of osteoporosis in patients with cirrhosis due to hepatitis B and hepatitis C: a study of 100 cases

Osteoporosis is the disease of bone that affected King David of Israel 3000 years ago. This condition is no long considered to be due to aging alone and is increasingly recognized as a major health concern and accounts for about 1.5 million fractures annually in United States. Objective of this study was to see the frequency of osteoporosis in patients with cirrhosis due to Hepatitis B and C, and any correlation between the Bone Mineral Density [BMD] and duration and stage of the liver disease. The study was conducted in the Department of Gastroenterology, Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar, from January 2008 to December 2008. All patients from the OPD or Ward fulfilling the criteria and consenting were included. Physical examination, with special emphasis on any signs of chronic liver disease was performed. Full blood count, platelet count, prothrombin time and INR, liver function tests including serum albumin, and renal function tests were done on all patients. Viral serology was checked for those patients who were either newly diagnosed as cirrhotic or were cirrhotic but not screened for viral markers. Abdominal sonogram was recorded on all patients. The child's score was calculated for each patient using the clinical and lab parameters. The BMD was calculated for all patients using computer based ultrasound probe. Calcaneum was used for evaluation of BMD. The information collected was entered on structured data collection sheets and was analysed using SPSS version 11. Osteoporosis was found in 26% of subject and osteopenia in 42%, while 32% had BMD in the normal range. The mean T score was -1.483 [ +/- 1.29]. The mean duration of liver disease was 3.77 [ +/- 1.56] year. Majority of the patients [81%] were in Child's Class C, followed by Class B and A [16% and 3% respectively]. Fifty-nine percent of the patients were males with a mean age of 37.65 years, while 41% were females with mean age of 37.76 years. Osteoporosis is a common finding in patients with cirrhosis due to Hepatitis B and C. Osteoporosis is more frequent in patients with long duration of liver disease but there is no significant correlation between the aetiology or severity of liver disease and osteoporosis

Enucleation of pancreatic pseudocyst in a patient suffering from chronic pancreatitis

Pseudocysts in chronic pancreatitis have a higher incidence as compared to acute pancreatitis. We report case of a young girl suffering from chronic pancreatitis with pseudocyst formation. The pseudocyst was successfully enucleated, though enucleation has yet to be accepted as a treatment modality

Laparoscopic vs. open cholecystectomy surgical audit

Over a period of 14 months 200 patients were randomly placed into 2 equal groups, one group was subjected to open cholecystectomy and the other treated by laparoscopic cholecystectomy. Patients with suspected stones in the common bile duct and jaundice were the only exclusion from laparoscopic group. In the open group there was a higher number of major complications, as compared to laparoscopic group. In the open group there were three deaths in addition to three re-explorations due to bile peritonitis, bleeding and retained stone in the common bile duct. In contrast to this, the laparoscopic group had only one death and none of the above complications, however nine patients were converted to open. The hospital stay was greatly reduced in laparoscopic group