Frequency of hepatitis D virus infection in hepatitis B surface antigen-positive liver diseases.

OBJECTIVE: To determine the frequency of HDV among hepatitis B surface antigen (HBsAg)-positive liver disorders. STUDY DESIGN: An observational cross-sectional study. PLACE AND DURATION OF STUDY: Medical Unit I, Chandka Medical College Hospital, Larkana, from July 2003 to June 2008. METHODOLOGY: Adult patients with HBs liver related disorders were evaluated for the presence of delta antibodies using commercially available ELISA kits. Descriptive statistics were used for describing data. Proportions of anti D antibodies between gender and age were compared using chi-square test with significance at p < 0.05. RESULTS: Of the 774 cases, 438 were males (60.4%) and 336 were females (39.6%). The mean age was 36.5 ± 14.39 for males and 34.03 ± 13.16 years for females ranging from 15 to 60 years. Anti-HDV was positive in 183 patients (23.6%).The frequency of HDV was not significantly different between the gender groups (p=0.718). HDV infection was markedly higher in chronic than acute liver disorders. CONCLUSION: The HBV/HDV co-infection is frequent in the studied area. Therefore, practitioners and health care managers should be made aware of the risk of dual infection with HBV and HDV.

Pyrazinamide induced hyperuricemia in patients taking anti-tuberculous therapy.

OBJECTIVE: To record the effect of pyrazinamide on uric acid in patients of tuberculosis. DESIGN: Descriptive and observational study. PLACE AND DURATION OF STUDY: Chandka Medical College Hospital, Larkana from February 2000 to January 2003. PATIENTS AND METHODS: All patients receiving anti-tuberculosis drugs with pyrazinamide were included. Serum uric acid levels were monitored at weeks 0, 2, 8 and 12 of therapy. Serum creatinine was done at weeks 0, 8 and 12. RESULTS: Results were reported on 216 patients. Mean uric acid and creatinine levels at the start of therapy, i.e., week '0' were 5.07 -/+ 0.57 mg/dl and 0.87 -/+ 0.11 mg/dl respectively. The results show significant increase in uric acid levels from week '0' to week '2', at the end of week '8', the levels remained elevated and there was no statistical significant difference from that at week '2'. The uric acid levels reduced at week '12' after pyrazinamide was stopped and the difference was significant. Despite that renal function steadily improved with the treatment of tuberculosis to the extent that comparable pre-treatment values were obtained at the end of treatment. CONCLUSION: Anti-tuberculous therapy with pyrazinamide affects the uric acid levels early. This change is reversible after the withdrawal of the agent.

Frequency and transmission mode of hepatitis C virus in northern Sindh.

OBJECTIVE: To study the frequency of hepatitis C and mode of transmission in patients of chronic liver disease (CLD). DESIGN: A descriptive, non-interventional study. PLACE AND DURATION OF STUDY: The study was conducted in the department of Medicine, Chandka Medical College Hospital, Larkana over a period of 6-year (January 1997-December 2002). PATIENTS AND METHODS: The study included 1074 patients of chronic liver disease admitted to the department of medicine due to HCV. Their variables were recorded and analyzed. RESULTS: A total of 1074 patients, comprising of 564 of chronic hepatitis (group I) and 510 of cirrhosis liver (group II) respectively were studied. The male to female ratio was 2:1 in both groups. Anti-HCV antibody was present in 51% in group I and 57% in group II. Use of syringes (62%) was an important risk factor. CONCLUSION: HCV is a leading cause of CLD. The leading risk factor identified is the use of contaminated syringes.