Risk Factors of hepatitis B and C transmission in patients coming to a hepatology out patients clinic

To see the possible risk factors for the transmission of hepatitis B and C in patients suffering from hepatitis B and C. Hepatitis B and C patients coming to a public sector hepatology centre and a private clinic. All patients suffering from hepatitis B and C of all ages and both gender were included in the questionnaire based study following a verbal consent form all participants. The data was collected over 1 year by 1 doctor at both the OPD and the private clinic. Data on 497 cases was collected, of the total cases 199 were suffering from chronic hepatitis B [HBV] and 298 from hepatitis C [HCV]. Males were more infected with chronic liver disease but hepatitis B was more prevalent in males. Majority of HBV [55.8%] and HCV [49.3%] cases were between 25-44 years age group and 40% HBV and 35% HCV cases were educated up to the secondary level. In 9% HBV and 10% HCV cases the father was also suffering from liver disease and 15% HBV and 13% HCV cases had a death of a family member due to liver disease. Risk factors like injections for various ailments was seen in 189 cases [95%] suffering from HBV and 286 [96%] from HCV, similarly past history of surgery and dental treatment and blood transfusion was significantly more in HCV, when compared with HBV. Though both HBV and HCV are blood born diseases but interfamilial spread of these viruses needs to interpreted with caution as it appears that the virus is coming from the community to the house hold members and the possible sources are treating physicians using a reused syringe, a dentist and barbers

Gastroscopy [a preliminary communication]

A preliminary report of 29 gestroscopies done on 28 patients is presented. Six patients had gastric ulcers, 3 had gastritis and one each had gastric erosions, a neoplasm and a marginal ulcer. In 17 patients, no lesions were detected in the stomach

Plasma vitamin 'A' levels in hepatitis and cirrhosis

Plasma vitamin A carotene levels were estimated in 46 normal healthy adults, 34 patients with acute viral hepatitis and 12 patients with cirrhosis. Low vitamin A levels were observed in 16 [48 percent] cases of hepatitis and 9 [75 percent] cases of cirrhosis. Significant [P = 0.05] lowering of plasma vitamin A was observed in both the conditions. Carotene levels were normal in all the cases

Liver disease in hepatitis B antigen [HBAg] positive blood donors

Clinical examination and liver function tests of 14 HBAg positive and 8 HBAg negative blood donors were done. A history of jaundice, contact with hepatitis and hepatosplenomegaly were more frequently observed in the antigen positive donors. Two of the 7 biopsies obtained from donor with persistant HB antigenaemia were normal while 5 showed minimal structural changes. The likely causes of differences in the hepatic response to HBAg and other factors in different ethnic groups is discussed. The incidence of liver disease in asymptomatic individuals with persistant antigenaemia is variable. Banke et al [1971] found no morphological abnormalities in 17 out of 18 biopsies, while changes varying from minor structural distortion to well established chronic aggressive hepatitis and cirrhosis were observed in 14 out of 23 liver biopsies done in HBAg carriers by Prince et al [1969]. Of the 18 biopsies reported by Bolin et al [1973] 5 had chronic aggressive, 8 chronic persistant and 1 acute hepatitis. Changes consistant with past hepatitis were observed in 1, nonspecific changes in 2 and only 1 biopsy was reported as normal. This study is the part of a survey conducted at the blood bank of this center to determine the incidence of HBAg carrier state and the differences in the pattern of liver disease in HBAg positive donors observed here as compared to those reported by others

Clinical and biochemical study of 114 cases of cholelithiasis

During a period of 16 months 114 patients with cholelithiasis were studied. The diagnosis was confirmed by cholecystogram in 41 cases, by surgery in 28 and both surgery and the x-ray in 45 cases. There were 100 females and 14 males and their average age was 43.2 years. The average number of pregnancies in females was 6.5. Clinically the jaundice was observed in 9 percent and the gall bladder was palpable in 47 percent of cases. Cholelithiasis appeared to be related to increased parity but not to the body weight

Gall-stone composition and biochemical alterations in the serum of patients with cholelithiasis

The levels of cholesterol, calcium and bilirubin were determined in the seruih and gall stones in 47 cases with cholelithiasis. The mixed stones were observed in 87.5 percent, high cholesterol stone in 8.5 percent and high bilirubin stones in 4.2 percent. Serum and stone cholesterol levels were inversely proportional and the bilirubin levels were directly proportional to each other

Aflatoxin and liver cancer in Karachi - A preliminary survey

A cause and effect relationship of Aflatoxin and liver cancer is well established. The incidence of liver cancer is 3.6 percent in Karachi [Zuberi et ail., 1976] and Aflatoxin have been detected in 43 percent of 28 samples of food analyzed in this study. The long term ingestion of aflatoxin with food may have some effect on the existing pattern of liver cancer in Karachi

Hepatitis and hepatitis B surface antigen in health-care personnel

The frequency of hepatitis, Hepatitis B surface antigen [HbsAg] and antibody [HbsAb] among health care personnel [HCP] was 'compared with that of matched controls with no exposure to blood or blood products. Nine of the 11 HbsAg positive HCP but none of the controls presented with classical acute viral hepatitis. Hepatomegaly was present in 6 HbsAg positive HCP presenting with acute hepatitis while, it was absent in the solitary HbsAg positive control. Hepatic enlargement was noted in 36 [9.7 percent] HbsAg negative HCP and 4 [5.30 percent] controls. Serum transaminases abnormalities without the presence of HbsAg or HbsAb were present in 61 [16.7 percent] HCP and in 9 controls [12.3 percent]. The frequency of HBs antigen in 383 HCP was 2.8 percent and in 76 controls 1.3 percent. Frequency of antibody was 27.5 percent in HCP and 38.1 percent in controls by the RIA method and by the CIEP method it was 1.5 percent in the former and 3.9 percent in the latter indicating that the general population is more likely to develop antibodies probably due to exposure to the Hepatitis B virus in small doses by the non-parentral route

study of the bacteriological pattern in gall bladder disease

Causative infective agent in most of the 46 percent positive bile cultures was a single bacterium, Ech. Coli was the organism mainly isolated, followed by other bacteria. Kanamycin and Gentamycin were the most effective antibiotics

Serum aspartate animo transferase and alanine amino transferase levels in apparently healthy population in Karachi

The reference values for AST and ALT were determined at 37°C in 0.2 ml serum from 339 apparently healthy individuals [188 males and 151 females]. The normal ranges for AST and ALT varied from 1-50 units in both groups irrespective of age. Males had significantly higher levels of enzymes than females. Age had no effect on enzyme levels in males but levels were significantly higher in females above 15 years. Using the formula [mean +/- 2 SD] most of the values of two enzymes in both groups were in 95 percent confidence intervals

Helicbacter pylori clearance and eradication with triple therapy in duodenal ulcer patients

Triple therapy was given to 49 chronic helicobacter pylori positive chronic duodenal ulcer cases to see its efficacy in H. pylori clearance, eradication and ulcer healing. H. pylori clearance and eradication rates at weeks 5 and 8 were 87.8 percent and 81.5 percent while ulcer healing rates 68.2 percent and 81.5 percent respectively. Seven [18 percent] cases failed to clear H. pylori and were classified as non-responders. Histologically 60 percent showed post-treatment regression of gastritis. Tolerance to drugs was excellent with a good compliance rate

Risk factors for gall bladder cancer in Karachi

Frequency of gallbladder cancer in Karachi has been reported to be 8% and that from other parts of Pakistan varies between 6-7%. This is very high as compared with the Western studies. With this in mind a case control study was designed to identity risk factors responsible for gallbladder cancer. This case control study included 107 histologically proven cases of gall bladder cancer from Jinnah Postgraduate Medical Center, Civil Hospital and two private hospitals of Karachi. Age and sex matched controls were of two types. Those with and without cholelithiasis screened sonographically. Demographic, socio-economic factors, life-style, dietary habits and dietary intake were recorded on a proforma. The cases and controls were compared for various factors using odds Ratio. Among 107 cancer cases 27 were males and 80 females [M:F=1:3]. Mean age of males was 59 years [range 35-82 years] and females 53years [range 31-70 years]. One hundred and five [98%] had associated choleliathiasis. Important risk factors appeared to be gallstones, high parity, young age at first delivery, low fiber and Vitamin A intake [p<0.01], high fat intake [p<0.01], prolonged fasting hours/habit of missing dinner[OR:6.8], using repeatedly boiled or improperly stored ghee or oil[OR:2.6]. Conclusions: According to this case-control study major risk factors for gall bladder cancer were gallstones, dietary mal practices and poorly balanced diet. Poorly stored/ processed food acts as a promoter in the presence of gall stones and may favour cancer development

Bacteriological protozoal study on domestic water supply in Karachi

Four hundred and fifty eight water samples collected from domestic tanks and taps and community taps were analysed for bacterial contamination. Faecal pollution was more in domestic tanks and taps in Mehmoodabad, Korangi and least in water collected from community taps of Liaquatabad, Korangi and Mehmoodabad. Bacteria isolated were mostly E.coli, Enterobacter sp, Klebsiella sp. and A. faecalis, while other organisms [except Pseudomonas] were found In lower numbers. Salmonella paratyphi A and paratyphi B, Shigella dysenteriae and Aeromonas sp. were found in Clifton area. Parasite [Fluke] was isolated from one water sample only

Biliary tract dyskinesia

The radiological report of gall bladder contraction 60 minutes after fatty meal, was compared with the computed volume and contraction of gall bladder using Siffert's technique. Of 46 oral cholecystograms, 34 were reported to be normal and 12 as poor contraction. On computation only 14 were found to be and 32 showed poor contraction. The difference was statistically significant