RESUMO
Background: Irritable Bowel Syndrome (IBS) is one of the most commonly diagnosed gastrointestinal disorders, and its etiology is believed to be multifactorial. The role of smoking in the pathophysiology of IBS still remains inconclusive. Hence, we aim to investigate whether or not an association exists between smoking and IBS. Methods: A cross-sectional study was conducted in a tertiary care hospital of Karachi. A sample size of 200 smokers and 200 non smokers was selected. A two-part self-reported questionnaire was administered to the participants and the diagnosis of IBS was based on the Rome III diagnostic criteria. All data were analyzed using the Statistical Package for the Social Sciences version 17. Statistical tests employed were Independent samples t-test, chi-square test, and binary logistic regression analysis to obtain Odds Ratio (OR) for various variables. A P-value <0.05 was considered statistically significant. Results: Overall prevalence of IBS based on Rome III criteria was 9.5% (95% CI 9.45-9.60). Smoking was significantly found to be associated with IBS (P=0.002). Binary logistic regression analysis indicated that non-smokers were more likely to have IBS (Crude OR: 3.00, 95% CI 1.23-7.30) than smokers, and females were more likely to have IBS (Crude OR: 3.73, 95% CI 1.56-7.69) than males. Age, BMI, and food groups were not found to be significantly associated with IBS. Conclusion: Our study concludes that IBS was more prevalent among non-smokers and amongst females. Further studies are required to firmly establish the role of smoking in IBS.
RESUMO
OBJECTIVE: Statins are widely used drugs, known to cause myalgia, leading to high discontinuation rates. The objective of our study was to determine the frequency of myalgia in patients on everyday-dose (EDD) regimen with those on alternate-day dose (ADD) regimen. METHODS: This cross sectional study was conducted in a tertiary care hospital of Pakistan. A sample size of 400 patients between the age of 40-70 years, taking simvastatin 40mg for at least 6 months or more were selected. Patients with prior musculoskeletal or neuromuscular complains, and family history of muscular disorders were excluded. Subjects were evaluated for myalgia via a self-administered questionnaire, and those complaining of myalgia were then evaluated for serum vitamin D levels. Data was analyzed through SPSS 16.0 and compared using chi square test. RESULTS: The overall prevalence of myalgia was 7% (28/400). Frequency of myalgia in patients taking simvastatin everyday (n=20, 10%) was significantly higher compared to those taking it every alternate day (n=8, 4%) (p=0.02). There was no significant difference between the time of onset, nature, severity, type, or location of myalgia between the 2 groups. The most common cited triggering factor for pain was physical exercise. Of the patients experiencing myalgia, 13 (6.5%) from the EDD group and 6 (3%) from the ADD group had low levels of vitamin D. CONCLUSIONS: ADD regime was better tolerated by the patients than EDD regime. Alternate day therapy, with or without vitamin D supplementation, may be used by the physicians for troublesome muscular complains.
