Objective: To determine the frequency of ethnicity and other etiological factors of hepatocellular carcinoma. Methodology: This cross-sectional study was conducted at the Liaquat University Hospital Hyderabad, Department of gastroenterology. The study occurred from March 2018 to February 2019 for a total period of one year. All the patients diagnosed as the cases of hepatocellular carcinoma; age more than 20 years of both genders were included. All the patients were assessed regarding their ethnicity and risk factors of hepatocellular carcinoma. A self-made study proforma was used for the data collection and data was analyzed by using the SPSS version 26. Results: A total of 80 patients of hepatocellular carcinoma were studied, their average age was 53.12+9.69 years, average CLD known duration was 05.40+3.90 years and the average known duration of HCC was 01.17+0.79 years. Males were in majority 76.3% and 40.0% of the cases had advanced disease. According to the ethnicity of the cases, Sindhi patients were 70.0%, followed by 6.3% were Punjabi, 1.3% were Pathan, 7.5% were Baloch and 15.0% were others. HCV was the most common cause 83.8%, 7.5% cases had HBV, followed by 2 cases had HBV+HDV and one case had HCV and HBV co-infection, while four cases were NBNC HCC patients. Tumor stage was statistically insignificant according to ethnicity (p-0.495). Conclusion: Sindhi and Punjabi population was observed to be mostly affected and HCV was concluded the most common causative factor of hepatocellular carcinoma. Keywords: Ethnicity, causes, HCC
Objective: To determine the liver function assessment in the patients presented with hepatocellular carcinoma. Methodology: This cross-sectional study was done at the gastroenterology departments of Liaquat University Hospital Hyderabad and Indus Medical College TM Khan. Patients with an age range of 20 to 70 years, both genders, and having hepatocellular carcinoma were included in the study. A 5 mL blood sample was taken from each participant and sent to the hospital diagnostic laboratory to assess the serum bilirubin level and albumin level. The albumin-bilirubin (ALBI) score was used for hepatic function. Data was collected using a self-made research proforma, and it was analyzed using SPSS 26. Results: A total of 58 cases having HCC were assessed regarding hepatic function. The mean age of the patients was 55.39+12.39 years. Males were in the majority 75.9%, and females were 24.1%. The majority of the patients (72.4%) had child Pugh class C, 12.1% had child Pugh class B, and 15.5% of the cases had child Pugh class A. Elevated bilirubin levels of albumin levels and Alpha-fetoprotein levels were significantly associated to the child Pugh class C (p= <0.05). Most of the cases, 67.3%, had an ALBI score > − 1.39, 10.3% cases had ALBI score − 2.59 to − 1.39, and 22.4% of patients had an ALBI score ≤ − 2.60. Conclusion: Severe hepatic dysfunction was observed to be frequently high among patients having hepatocellular carcinoma, as most of the cases had Pugh class C and ALBI stage 3. Due to the extremely small sample size used in this study, the results are not trustworthy. Keywords: HCC, Hepatic function, Bilirubin, Albumin, ALBI
Objective: To determine the frequency of vitamin D deficiency among liver cirrhosis patients and presented at Isra university hospital Hyderabad Study design: Cross-sectional Study setting: Gastroenterology department of Isra university Hospital, Hyderabad Sind Pakistan Study duration: January 2018 to July 2018 All patients with age between 30 and 60 years, both genders and having evidence of cirrhosis of liver were selected in the study. Disease severity was evaluated by the Child–Pugh’s classification. For the assessment of vitamin D levels, the blood samples from all patients were sent to the diagnostic laboratory. During the hospital stay and subsequent follow-up visits, the patients were monitored. All the data were collected via study proforma for the purpose of analysis. Results: A total of 120 cases of liver cirrhosis were studied, their average age was 50.58+5.15 years. Males were commonest 55.0% compared to females 45.0%. Hepatitis C was the most common etiological factor 65.8%. Child–Pugh grade C was most common 57.5%. Mean of the vitamin D level was 19.16+ 6.74 ng/ml. Almost all patients were with vitamin D deficiency as 90.0%. Vitamin D deficiency was significantly associated to the old age, HCV, alcoholic and fatty liver disease (p-<0.05), while statistically insignificant according to gender (p-0.142). Conclusion: It was concluded that the deficiency of vitamin D was highly prevalent 90.0%. It was significantly linked to the HCV, age and alcoholic hepatic disease. Key words: Liver cirrhosis, vitamin D
Objective: To document different indications and findings of upper GI Endoscopy in our endoscopy suite. Methods: A descriptive study of 500 patients who underwent upper gastrointestinal (UGI) endoscopy was conducted in the Endoscopy Unit of PNS DRIGH LUMHS Jamshoro and Civil Hospital Hyderabad from April to September 2020. Included patients underwent UGI endoscopy. Demographic data including indications and endoscopic findings of the patients was collected via study proforma. Results: Total five hundred patients were studied; their mean age was 42.4±16.8 years. Out of all 52.8% were males. Upper GI bleed was the commonest indication (33.2%) followed by dysphagia (21.6%), epigastrium pain (10%), surveillance and screening of varices (9% and 8.2% respectively). The most common endoscopic findings were esophageal varices (32.2 %), gastritis (18.8%), and normal (11.4%). In patients with esophageal varices, 77.4% had chronic liver disease with positive serology for HCV and HBV in 63.4% and 23% respectively. Conclusion: The most common indication was upper GI bleed with esophageal varices for upper GI endoscopy. The underlying etiology of varices reflects the high burden of chronic liver disease due to viral hepatitis.
Colonoscopy is one of the most important diagnostic tools to assess the structural abnormalities of the large intestine and distal ileum. To date, there is a paucity of data in Pakistan on indications and findings of colonoscopy. Therefore, our study aimed to evaluate the indications and endoscopic findings of patients who underwent colonoscopy at a tertiary care hospital in interior Sindh, Pakistan. This prospective cross-sectional study of 125 patients who underwent lower gastrointestinal endoscopy was conducted in the Endoscopy Unit of LUMHS Civil Hospital Hyderabad / Jamshoro from April 2020 to September 2020. To be eligible participants had to be 14 years or older, of either gender and giving informed consent. Data regarding demographic characteristics, indications, and endoscopic findings were gathered on a pre-designed proforma. A total of 125 participants were recruited with a mean age of 39 ± 20, out of which 60% were males. Rectal bleeding was the most common indication (70.4%) followed by abdominal pain (9.6%), chronic diarrhea (8%), altered bowel habits (6.4%), constipation (2.4%), post-cancer surveillance (1.6%), weight loss, and anemia (0.8%) each. The most common colonoscopy findings were hemorrhoids (29.6%),and suspected tumor/growth (14.4%), while 22.4% were normal. The most common indication in our study was per rectal bleeding with hemorrhoids as the most common endoscopic finding on colonoscopy.
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