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Background and Aim: Liver Cirrhosis patients are more prone to lower gastrointestinal (GI) bleeding hypothetically caused by portal hypertensive colopathy (PHC) and anorectal varices (ARVs). The present study aimed to determine the incidence of colopathic lesions and investigate their association with cirrhosis severity and portal hypertensive colopathy manifestation. Patients and Methods: This cross-sectional study was carried out on 80 liver cirrhosis patients in the Department of Gastrointestinal, CMH Hospital Lahore from January 2021 to December 2022. Individuals aged >18 years with liver cirrhosis were enrolled. Each individual underwent laboratory, clinical, and ultrasonographic examinations. Upper gastrointestinal endoscopy was used to detect the PHC. Based on the colopathic lesions severity, patients were categorized into three grades: grade I (colonic mucosa), grade II (mucosa with mosaic-like pattern), and grade III (angiodysplasia-like colon lesions). SPSS version 27 was used for data analysis. Results: The overall mean age was 48.62±5.6 years with an age range 19 to 70 years. Of the total patients, there were 60 (75%) male and 20 (25%) females. Child-Pugh classification of patients were as follows: Class A 16 (20%), Class B 29 (36.3%), and Class C 35 (43.7%).

Background and Aim: Hepatitis C is a viral infection that cause liver’s inflammation. Numerous studies have found a significant frequency of hepatitis C virus (HCV) infection in non-lymphoma Hodgkin's patients. B-cell non-Hodgkin's lymphoma (B-NHL) development could be significantly caused by HCV. The purpose of the current study was to investigate the hepatitis C virus role in the pathogenesis Hodgkin lymphoma patients. Patients and Methods: This prospective study was carried out on 60 B-cell non-Hodgkin's lymphoma. (B-NHL) and 30 (healthy) control group in PAF Hospital Lahore Department of Internal Medicine and Oncology Department CMH, Lahore from May 2022 to October 2022. Study protocol was approved by institute ethical committee. Each individual provided written informed consent. All the patients were subjected to history taking, clinical examination, CBCs, kidney and liver function assessment, B2 microglobine, erythrocyte sedimentation rate determination, serum uric acid, abdominal ultrasound for lymphadenopathy and organomegaly, serum LDH, proper diagnosis and staging through CT abdomen, PCR, biopsy of bone marrow, and ELISA. Data analysis was done using SPSS version 27. Results: Of the total 60 B-NHL patients, there were 32 (53.3%) male and 28 (46.7%) females. The overall mean age was 42.8± 10.8 years with an age range 16-65 years. There were 20 (66.7%) male and 10 (33.3%) females in control group and their mean age was 28.4± 11.6 years with an age range 12-60 years. Based on ELISA test, the incidence of for positive and negative anti-HCV antibodies were 34 (56.7%) and 26 (43.3%) respectively. The incidence of positive and negative anti-HCV RNA was 36 (60%) and 24 (40%) respectively. Conclusion: The present study revealed that higher incidence of HCV infection play significant role in the pathogenesis of Hodgkin’s lymphoma patients. This increases the likelihood of HCV infection playing a role in the development of B-NHL. Keywords: Hepatitis C virus, Hodgkin lymphoma, Pathogenesis

Background and Aim: One of the most common and obvious signs of liver cirrhosis is fatigue, which can limit daily activities, minimizes physical activity. Fatigue was reported to be prevalent in 60-80% of cirrhotic individuals in early publications on the clinical profile. The purpose of the current study was to evaluate the prevalence and etiology of fatigue in chronic liver disease. Patients and Methods: This cross-sectional study was carried out on 320 chronic liver disease patients in Department of Medicine PAF Hospital Lahore and Department of Gastroenterology CMH Lahore from June 2022 to December 2022. Study protocol was approved by institute ethical committee. We recruited (a) those who had ongoing liver disease caused by HCV or HBV, (b) patients between the ages of 16 and 70, and (c) patients who had not previously received any particular HCV or HBV therapy. Patients were divided into five groups: Group-I comprised of chronic hepatitis patients, Group-II had Child class A Cirrhosis, Group-III had Child class B cirrhosis, Group-IV had Child class C cirrhosis, and Group-V had hepatocellular carcinoma (HCC) patients. Patients were subjected to abdominal ultrasonography, laboratory investigations, and upper endoscopy.

According to the WHO 50 million people suffer from epilepsy; 80% of them live in resource poor countries (WHO, 2001). In these settings, classification of seizures in view of adequate treatment has been difficult due to lack of diagnostic tools such as electroencephalograms (EEG) and imaging. Drawing from a vast working experience of many years in neurology in developing countries, the authors developed a classification system for seizures suitable for local circumstances. Considering clinical, diagnostic, prognostic and therapeutic needs, we adjusted the International Classification of Epileptic Seizures (ICES) and opted for a simple-structured, easy-to-understand classification of epileptic seizures which is still in accordance with the ICES and in fact shares many similarities with the ILAE version of guidelines for epidemiologic studies on epilepsy (ILAE 1981, ILAE 1993. EEG and neuroimaging are normally not available in developing countries, thus the diagnosis is based on clinical symptomatology alone. We suggest the following classification: 1) Generalised types of seizures:Generalised seizures within a specific age range: primary generalised seizures that start within a specific age group (mainly between 6 and 25 years). There is no obvious cause for the seizures, brain damage is absent. There may however be a positive family history, suggesting a possible genetic background. Seizures of this group may also be termed idiopathic generalised epilepsies.Generalised seizures outside a specific age range: primary generalised seizures that lie outside the specific age range of most of the idiopathic generalised epilepsies, but have no focal start and no clinical signs of brain damage. There may be a cause which cannot be diagnosed with the currently available ancillary means, thus these seizures may be termed "cryptogenic". 2) Partial types of seizures:Generalised seizures with diffuse brain damage: clinically seizures start in a generalised way, however, diffuse brain damage is obvious, which is the major difference when compared to group 1. Causes are mainly due to static encephalopathies. All age groups can be affected, but there tends to be a shift to the younger ages.Generalised seizures with focal signs: secondary generalised seizures with a focal start or clear unilateral seizures but without major brain damage. There may be developmental delay, subtle signs of brain damage and/or focal neurology. Causes are often due to progressive encephalopathies. All age groups can be affected.Complex partial seizures: as defined by the ILAE (ILAE 1981).Simple partial seizures: as defined by the ILAE (ILAE 1981). 3) Other types of seizures:Two different seizure types: the patient has more than one type of seizure. Possible combinations are simple partial or complex partial seizures with any of the generalised seizures of group 2 or generalised seizures of group 1 and pseudoseizures.Unclassified epileptic seizures: include all those seizures that cannot be classified because of incomplete data.The first diagnostic gro...

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