Objective: The objective behind this study was to determine the frequency of gastrointestinal signs and symptoms in patients with dengue fever in tertiary care hospital Methods: A cross sectional observational study was conducted on all adult patients diagnosed with dengue disease after taken informed consent from the patients and approval from the ethical committee of the hospital. All these patients were evaluated for the presence or absence of gastrointestinal (GI) manifestations. Those who had GI symptoms were further evaluated for the frequency of different types of GI symptoms. All baseline and clinical data were taken using a structured questionnaire and then entered & analysed using SPSS v. 26. Results: A total of 174 patients who were dengue virus positive were included for final analysis. Overall mean age and SD was 29.22±8.14 years and majority belongs to young age group, ≥16 – 40 years (60.11%, n = 104). Most of our study participants were males (75.86%, n = 132). Hypertension was the most common comorbid condition observed in our study participants (12.06%, n = 21). The overall prevalence of GI manifestations in our study who were dengue positive was 62.64% (n = 109). The most common GI symptom was presence of nausea/vomiting (70.64%, n = 77). Conclusion: The prevalence of GI manifestations in patients with dengue is quite high. Nausea/vomiting was the most common GI manifestation while patients with hepatomegaly and GI bleeding were also prevalent. Keywords: Dengue fever, gastrointestinal symptoms, clinical manifestation, Pakistan
A case of Quebec platelet disorder is hereby reported. A 33 years old woman presented with history of epistaxis and gum bleeding since childhood and menorrhagia and bleeding per vaginum after puberty, also had history of excessive blood loss after birth of child. Her coagulation profile was normal but platelet function testing by platelet aggregation assay showed abnormal aggregation of platelet with epinephrine. This type of response is seen in "Quebec platelet disorder" which is a rare autosomal dominant disorder of platelet function characterized by increased bleeding after any injury or trauma.
Objective: The aim of this study is to analyze significant findings of upper gastrointestinal endoscopy in patients having alarming features of dyspepsia. Study Design: Retrospective study Methodology: This retrospective study was conducted in the Gastroenterology Department at RIHS Islamabad from March 2021 to March 2022 and included adult patients presenting with alarm features and were referred for gastroscopy for dyspepsia. Those ageing below 18 years were excluded. The information including demographic data, referral for the procedure, endoscopic findings and present alarm features and dyspeptic symptoms was recorded. The diagnosis was made on the basis of visual examination. Results: A total of 140 patients who underwent gastroscopic procedures were included in the study. Most of the subjects (74.1%) reported epigastric burning, 10.8% complained of heartburn, 10.8% of regurgitation and 8% reported globus. Few of the participants reported symptoms such as bloating (5.3%), burping (5.3%), abdominal fullness (3.8%), chest pain (3.8%) and early satiety (0.8%). No significant relation was observed between warning signs and findings from the endoscopy. Conclusion: Dyspeptic patients showing alarming signs such as vomiting, dysphagia and upper gastrointestinal bleeding must be prescribed immediate endoscopy. Keywords: Dyspepsia, gastroenterology, endoscopic findings, epigastric burning
Introduction: Stroke is a major cause of death and disability globally, with anexpected rise in number of patients with ageing and economic transition of developing countries.Pneumonia is one of the major complications after stroke. Stroke associated pneumoniaincreases risk of death by three fold and is the major cause of morbidity and mortality afterthe stroke. Objective: To determine the frequency and factors leading to stroke associatedpneumonia in all acute stroke patients admitted at a tertiary care hospital. Study Design: Caseseries. Setting: Medical Department, Aga Khan University Hospital (AKUH), Karachi. Period:six months and extended from 1st July 2015 to 31st December 2015. Material and methods:All adult patients (age 14 years and above) admitted through emergency room in the medicalward of Aga khan university hospital Karachi with the diagnosis of acute stroke on the basis ofMRI findings were enrolled after taking informed consent through Non purposive consecutivesampling technique. Demographic data like age and sex were recorded. Diagnosis of strokeassociated pneumonia was made on basis of CDC criteria for pneumonia. All analyses wasconducted by using the Statistical package for social science SPSS (Release 19.0, standardversion, copyright © SPSS; 1989-02). Results: A total of 157 patients admitted with a mean ageof the inducted patients were 61.75 ± 13.91 years. According to this stratification, 23 patients(14.65%) were aged less than 45 years and remaining 134 subjects (85.35%) were above theage of 45 years among them 110 were males (70.1 %) and 47 were females (29.9 %). Strokeassociated pneumonia was found in 33 (21%) out of 157 patients. Out of 33 patients havingstroke associated pneumonia; 14 (42.4%) patients had Diabetes mellitus. Out of 33 patientshaving stroke associated pneumonia; 28 (84.8%) patients had hypertension. Out of 33 patientshaving stroke associated pneumonia; 2 (6%) had COPD. Out of 33 patients having strokeassociated pneumonia; 2(6%) had Chronic Atrial Fibrillation. Out of 33 patients having strokeassociated pneumonia; 21 (63.6%) patients had impaired swallowing. Conclusion: Strokeassociated pneumonia is the common and serious complication after stroke. All the effortsshould be taken to control various factors leading to stroke associated pneumonia like DM,hypertension, and impaired swallowing to improve stroke outcome.
Objectives: To determine the clinical outcome of acute pancreatitis in relation with major etiologies (Gallstones, Alcohol, and Drugs). Study Design: Cross sectional hospital based study. Setting: Aga Khan University Hospital. Period: 16 years (from 1st January 2001 to 30th June 2016). Methods: All patients with acute pancreatitis admitted. Major risk factors of pancreatitis such as gallstones, alcohol, and drugs were evaluated and outcomes assessed for the development of complications and mortality. Results: We evaluated 3049 patients with acute pancreatitis, the causative agents found, 80.35% (N = 2450), followed by Alcohol 13.05% (N = 398) and drugs 6.59% (N = 201), respectively. Patients with alcohol abuse were relatively older 53.74 years compared to patients with gallstones 39.54 years and drugs induced 43.26 years AP. Among them, the overall complication rate was 5.05% (N = 155). The most common complication was development of sepsis 45.8% (N = 71) and the overall mortality rate observed was 0.91% (N = 28). Conclusions: Gall stones are the leading cause of acute pancreatitis while drugs are the rare cause, however in significant number of patients cause remained obscure. Based on the above results patients with drug induced pancreatitis have good outcome as compared to gall stones and alcohol induced acute pancreatitis, however further studies warranted.
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