Search

Objective: To assess the association of fatty liver with type 2 diabetes and other socio-demographic factors among the patients at Pak Emirates military hospital Rawalpindi. Study Design: Cross-sectional analytical Study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan from Aug 2019 to Jan 2020. Methodology: This study was conducted on 300 patients of type 2 diabetes mellitus reporting for a routine checkup at the medical Outpatient department. Fatty liver was diagnosed on ultrasound by a consultant radiologist. Results: Out of three hundred patients with diabetes mellitus included in the final analysis, 225(75.0%) were males, and 75(25.0%) were females. 176(58.6%) had fatty liver on ultrasound, while 124(41.4%) had no fatty liver on ultrasound examination at the time of the study. we found that increasing age, long duration of diabetes and poor control of illness had a statistically significant relationship with the presence of fatty liver among the target population (p<0.05). Conclusion: Patients with type 2 diabetes had a high frequency of fatty liver on routine ultrasound examinations. In addition, patients with more age, long duration of diabetes mellitus and poor control of illness were at a high risk of developing fatty liver among the study participants. [ABSTRACT FROM AUTHOR]

Objective: To find out the underlying causes of chronic diarrhea in soldiers and how it differs from general population. Study Design: Prospective comparative study. Place and Duration of Study: Combined Military Hospital (CMH) Multan and Pak Emeritus Military Hospital (PEMH) Rawalpindi, from Dec 2017 to Jan 2020. Methodology: All soldiers in active service, having diarrhea more than 4 weeks in study and non-soldiers of the same age were included in the control group. There were inquired in details about the diarrhea symptoms and investigations carried out accordingly to find out the underlying cause. The two groups were compared to find out any differences. The data were analyzed by SPSS version 22. Results: Seventy one in study and 50 patients in control had their mean ages of 34.61 ± 8.35 and 32.42 ± 10.28 years. Mean duration of symptoms were 18 and 15 months in study and control groups respectively. Irritable Bowel Syndrome (IBS) was more common in both groups i.e. 14 (20%) and 20 (40%) in study and control groups respectively but frequency was more in second one. Seropositive celiac disease 13 (18.5%), seronegative villous atrophy 10 (14%) in study and Inflammatory Bowel Disease IBD 6 (12%) in control group were second most common conditions. Conclusions: Irritable bowel syndrome is common in this age group. Celiac and seronegative villous atrophy is second common conditions in the study group. [ABSTRACT FROM AUTHOR]

Objective: To find out association of gender and age with compliance of H Pylori eradication therapy. Study Design: Cross sectional comparative study. Place and Duration of Study: Combined Military Hospital, Multan and Pak Emirates Military Hospital, Rawalpindi, from Sep 2017 to Feb 2020. Methodology: Two hundred and fifty patients with dyspepsia were included through convenient sampling after getting informed consent. The patients already under H Pylori eradication therapy were excluded from the study. Diagnosis of H Pylori infection was done by histopathology report of gastric mucosal biopsy on upper GI endoscopy in some individuals and H Pylori antigen on stool examination in others. They were placed in eight different groups keeping in mind their previous history of use of antibiotics and known side effects with the particular antibiotic. Results: There were 154 (61.60%) males and 96 (38.40) females with mean age of 36.71 ± 13.23 years. The frequency of male patients who complied to treatment (130/84.4%) was significantly higher as compared to the frequency of female patients (71/74.0%) at p-value of 0.04 and odds ratio of 1.9 (1.01-3.58). The study also showed that the difference of mean age between the patients who completed and those who did not complete the treatment was statistically not significant (36.33 ± 12.78 vs 38.24 ± 14.94 years). Conclusion: Compliance to H Pylori eradication therapy is associated with gender but not with age. [ABSTRACT FROM AUTHOR]

Objective: To compare the outcomes of three-port versus four-port laparoscopic cholecystectomy (LC) and assess the safety and efficacy of three-port LC as routine procedure. Study Design: Retrospective comparative study. Place and Duration of Study: Combined Military Hospital Kohat/CMH Multan, from Oct 2013 to Dec 2016. Methodology: Total of 403 patients were selected and were divided into two groups based on the principles of non-randomized clinical trial; group A having three-port laparoscopic cholecystectomy (LC) and group B having four-port laparoscopic cholecystectomy (LC). Fourth port in right axillary line at umbilicus level was not established in group A. Outcomes were recorded in terms of operating time, complications, pain assessment/analgesic requirement and hospital stay. Results: A total of 218 (54.09%) patients in group A and 185 (45.91%) patients in group B were assessed. The difference in terms of verbal pain score, analgesic requirement and duration of hospital stay/return to activity were significant statistically, all being less in group A. Cosmetic outcome as perceived by patients was also better in the group A because of less numbers of scars. Operative time (minutes) was less in group A in our study (35.59 ± 10.75) as compared to group B (50.17 ± 10.14). Results of other variables including intra-operative/postoperative complications were comparable among the two groups. Conclusion: Three-port LC has advantages of being less painful, with less analgesics requirement and reduced hospital stay without compromising the safety and efficacy. It is more acceptable to patients due to less numbers of scars and better cosmesis. [ABSTRACT FROM AUTHOR]

Objective: To determine the demographic variance in location and histopathological findings of esophageal carcinoma in Punjab-Pakistan. Study Design: Observational cross sectional study. Place and Duration of Study: This study was conducted in Multicentre Tertiary Care Hospitals of Combined Military Hospital/Pak Emirates Military Hospital/Army Medical College Rawalpindi, Combined Military Hospital Kharian and Combined Military Hospital Multan from 2010 to 2017. Methodology: Patients with dysphagia and histopathology proven malignancy were included in this study. All patients had undergone flexible upper gastrointestinal endoscopy. Patients with lesions other than carcinoma, causing dysphagia and those with inconclusive histopathology were excluded from our study. The morphological site of the carcinoma were divided into upper, middle, lower and at gastro-esophageal junction. Histo pathologically proven carcinoma of esophagus was reviewed for subtype of grading differentiation. Statistical analysis was done using IBM version SPSS 22. Results: Out of 150 patients, 85 (57%) were males and 65 (43%) were females. Their age ranged between 30 to 85 ± 12.33. Among one hundred and fifty patients 107 (71.33%) had Squamous Cell Carcinoma, 42 (28%), Adenocarcinoma and metastasis in two cases. Frequency of distribution of esophageal carcinoma in North, East and South Districts of Punjab was 73%, 18% and 9% respectively. Esophageal Carcinoma in upper, middle, lower and Gastroesophageal junction was 22.5%, 35%, 15% and 27.5% respectively. Frequency of well differentiated SCC was 46 (30.6%) and well differentiated AC 31 (20.7%) respectively. Conclusion: SCC with male preponderance is more common in North of Punjab. Lower 1/3rd and GE junction esophageal tumor are the commonest sites in all North, East and South Punjab. Histopathological differentiation revealed Well Differentiated SCC along with significant rise in Adeno-carcinomas compared to previous national studies. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To determine the association of malabsorption in celiac disease with anaemia and other sociodemographic factors at a tertiary care hospital in Pakistan. Study Design: Cross sectional study Place and Duration of Study: Department of General Medicine Military Hospital Rawalpindi from Jul to Dec 2019. Methodology: A total of 300 adults were included in the study, 150 cases were patients with the diagnosis of celiac disease, and the other 150 were controls without celiac disease. Celiac disease was diagnosed based on biopsy findings by a consultant gastroenterologist. Defined was defined based on haemoglobin levels. In addition, the relationship between age, gender, anaemia, and the presence of comorbidities was assessed with the presence of celiac disease among the adults included in the study. Results: Out of 300 cases and controls, 116 (38.7%) patients were males, and 184 (61.3%) were females. One hundred and forty-eight (49.3%) did not show the presence of anaemia, while one hundred and fifty-two (50.7%) showed the presence of anaemia. we found a statistically significant difference in cases and controls regarding the presence of comorbidities and the presence of anaemia (p<0.05). Conclusion: Patients with celiac disease showed a greater frequency of anaemia as compared to those who were not having celiac disease. Therefore, patients with celiac disease are at high risk for developing anaemia, or patients with anaemia should be screened for malabsorption problems. In addition, patients with celiac disease were also at high risk for acquiring other systemic disorders. [ABSTRACT FROM AUTHOR]