IntroductionColonoscopy is a diagnostic procedure used not only for screening and assessment but also for therapeutic management of various diseases such as removal of polyps, flat lesions, etc. In this study, we determine various outcomes of colonoscopy done in the gastroenterology unit of Ghulam Muhammad Mahar Medical College and Teaching Hospital in Pakistan.Methods and MaterialsThis retrospective cross-sectional review was carried out at the colonoscopy unit of Ghulam Muhammad Mahar Medical College and Teaching Hospital in Sukkur, Pakistan. Data was gathered from medical records of patients and by calling their physicians if necessary from July 1 to December 31, 2018. ResultsIn our study, the most common site for colonoscopy was a rectosigmoid colon (37.85%, n=134), almost parallel to the anal canal (37.57%, n=133). Normal colonoscopy was reported in 25.42% (n=90). The most common pathology was hemorrhoids (32.48%, n=115), followed by ulcers (17.79%, n=63).ConclusionColonoscopic detection of hemorrhoids was the most common finding in colonoscopy. Normal colonoscopy was less compared to other literature, suggesting physicians are carefully screening patients in advising colonoscopies.

Introduction: In low-income and high hepatitis B and C virus burden countries like Pakistan, it is important to develop cheap yet efficient strategies in diagnosing as well as treating hepatitis. The aim of this study is to assess the sensitivity and specificity of serum hepatitis B surface antigen (HbsAg) via Rapid Immunoassay Chromatographic Test (RICT) for the screening of hepatitis B, compared to the gold standard laboratory-based method. Methods: The study was conducted in the Hepatology Clinic of Civil Hospital, Sukkur. All records of the clinic from June 1, 2018, to December 31, 2018, were accessed for identification of the records in which hepatitis B screening via RICT and then confirmatory polymerase chair reaction (PCR) by gene amplification with forward and reverse primers was done. Results: There were 151 samples in this study. There were 32 (94.1%) true-positive and three (5.8%) false-negative samples. There were two (2.5%) false-positive and 114 (97.4%) true-negative samples. The sensitivity of HbsAg detection via RICT for the screening of 1-1B V was 91.43%, specificity was 98.28% and the accuracy was 96.69%, compared to PCR. Conclusion: The RICT method has high sensitivity and specificity. In low-income and high-hepatitis B virus-burden countries like Pakistan, it serves as a very efficient screening tool that is easy to use, cheaper in cost, and gives rapid and accurate results.

Introduction: Coenzyme Q10 (CoQ10) has a potential role in reducing the risk of myocardial infarction by slowing the progression of atherosclerosis and improving ischemia. In this study, we will assess the role of coenzyme Q10 in prophylaxis for reducing myocardial infarction and mortality related to myocardial infarction. Methods: This open-label two open placebo-controlled randomized clinical trial was conducted in a tertiary care hospital in Sukkur, Pakistan from April 2016 to September 2019. Eight hundred nighty-two (892) patients with clinically diagnosed and documented evidence of hypertension were enrolled in the study from the outpatient department. Participants were randomized into two groups by 1:1 ratio using an online randomizer software, Research Randomizer ( https://www.randomizer.org /). Group A received 100 mg coenzyme Q10 daily (coenzyme Q10 group) in addition to standard therapy and group B received standard therapy only (placebo group). Results: Participants who received coenzyme Q10 had fewer incidence of non-fatal myocardial infarction over 12 months (5.4% vs 8.4%) with relative risk reduction of 2.92 (confidence interval 95%, 0.55-2.76). The number needed to treat to prevent one non-fatal myocardial infarction was 34. Participants who received coenzyme Q10 had fewer incidence of fatal myocardial infarction over 12 months (1.5% vs 3.1%) with relative risk reduction of 1.65 (confidence interval 95%, 0.39-3.69). Number needed to treat to prevent one fatal myocardial infarction was 60. Conclusion: According to this study, coenzyme Q10 reduced the incidence of fatal and non-fatal myocardial infarctions. Clinicians should consider adding coenzyme Q10 to the treatment regimen of high-risk patients of myocardial infarction. We suggest coenzyme Q10 may be an effective prophylactic agent in patients at risk of myocardial infarction and it may help in reducing burden on the health care system.

The purpose of this study is to check out the spread rate of Hepatitis B Virus in the districts of Mardan and Charsadda, KPK Pakistan. As we know that Hepatitis results in damaging liver tissues, so it is one of the serious threats to the human health across the world. Hepatitis can give rise to acute and chronic infection which give rise to Liver cancer or Liver cirrhosis. It may be transfer from one person to another. Its transmission routs are oral, fecal and parental. The purpose of this paper is to check and judge health condition. Blood serum was collected from Mardan Medical Complex, Mardan and District Head Quarter, Charsadda. The paper was design to calculate anti-HBV antibody positive patients with ICT(immune-chromatography technique)based detection among various patients in MMC Mardan and DHQ hospital Charsada and from various regions of Mardan and Charsadda, KPK Pakistan.  Total of 10852 patients of HBV in Charsadda and 14168 patients of HBV in Mardan. The blood samples were collected from Oct 2017 to May 2018 from both districts of KPK. The method for testing blood sample was ICT (immune chromatography technique). Our study about 10852 patients in district Charsadda who were at the risk of HBV infection, 103 were screened positive with the prevalence ratio of 0.949%. On the other hand, 14168 patients`s samples were collected in district Mardan, among them 149 were detected positive and ratio of prevalence is 1.051%. According to the above study the ratio of prevalence is lower in Charsadda as compare to Mardan

No abstract

Background and Aim: Ulcerative colitis (UC) is a subtype of inflammatory bowel disease that can develop extra-intestinal manifestations (EIMs) in a subgroup of patients. There is a scarcity of data on the prevalence of extra-intestinal manifestations (EIMs) in inflammatory bowel disease and their risk factors analyses. The present study aimed to evaluate the prevalence of extra-intestinal manifestations in ulcer colitis and its associated risk factors. Methodology: This prospective study was conducted on 334 inflammatory bowel disease patients who were followed for identification of EIMs associated risk factors in the Department of Medicine and Pulmonology, Ghulam Muhammad Medical College and Hospital (GMMCH)/ Civil Hospital, Sukkur for the duration of six months; from April 2021to September 2021. All the patients above 16 years and who had ulcerative colitis and Crohn’s disease (CD) were enrolled. Patient’s demographic and clinical details such as gender, education, age, smoking history, diagnosis of EMIs, age at IBD, different IBDs, surgical, and treatment details were recorded. Results: Out of 334 IBD patients, the prevalence of ulcerative colitis (UC) and Crohn’s disease (CD) was 38.9% (n=130) and 61.1% (n=204) respectively. The overall mean age of UC and CD patients was 38.6±6.8 and 42.7±8.5 years respectively. Of the total 130 CD patients, the prevalence of arthritis, aphthous stomatitis, uveitis, erythema nodosum, ankylosing spondylitis, pyoderma gangrenosum, primary sclerosing cholangitis and psoriasis was 20.8% (n=27), 3.8% (n=5) 4.6% (n= 6), 3.1% (n=4) , 2.3% (n=3), 3.8% (n=5), and 1.5% (n=2) respectively. Out of 204 CD patients, the incidence of arthritis, aphthous stomatitis, uveitis, erythema nodosum, ankylosing spondylitis, pyoderma gangrenosum, primary sclerosing cholangitis, and psoriasis was 32.8% (n=67), , 9.8% (n=20) , 5.9% (n=12) , , 6.4% (n=13) , 2% (n=4) , 1% (n=2) and 2% (n=4) respectively. Risk factors for EMIs were identified using multiple logistic regression. In ulcerative colitis patients, no risk factors were identified. Conclusion: Our study concluded that extra-intestinal manifestations are a major issue in ulcerative colitis and Crohn’s disease patients. Moreover, the ongoing EIMs in Crohn’s disease patients are significantly associated with inflammatory bowel disease positive family history, and active disease. Therapeutic management and diagnostic facilities can be improved with the determination of extra-intestinal manifestation prevalence and related risk factors. Keywords: Crohn’s Disease, Extra-intestinal Manifestation, Inflammatory Bowel Disease

Background and Aim: Globally public health has been drastically affected by the Coronavirus disease (COVID-19) pandemic. There is a scarcity of data regarding risk factors, cardiac injury, and the treatment of cardiovascular disease associated with coronavirus disease. The present study aimed to assess the pattern of cardiovascular disease in COVID-19 patients referred to Tertiary Care Hospital. Methodology: This retrospective study was conducted on 446 adult patients with new-onset or existing cardiovascular disease patients at the department of Cardiology, PNS Shifa hospital Karachi during the period from February 2021 to July 2021.Demographic details, physical examination, comorbid conditions, and laboratory findings were used for data collection from the patient’s admission file. All the patients above 18 years and positively diagnosed with COVID-19 infections through rapid antigen test were enrolled and admitted with cardiovascular disease. The clinical features, chest X-ray, echocardiography, biochemical parameters, and electrocardiogram (ECG) were analyzed for each individual. Congenital heart disease,coronary artery disease, cardiomyopathy, heart failure, arrhythmias, peripheral arterial disease, and myocarditis were different cardiovascular diseases. Statistical analysis was carried out in SPSS version 23. Results: Of the total 446 cardiovascular disease patients, about 334 (74.9%) were male and 112 (25.1%) were females. The overall mean age was 52.82±10.62 years. Out of 446 CVDs patients, the incidence of preexisting and new cardiovascular disease was 225 (50.4%) and 221 (49.5%) respectively. Acute coronary syndrome was the prevalent (50.7%) cardiovascular manifestation followed by elevation myocardial infarction. The incidence of myocarditis, Rhythm and conduction abnormalities was 45 (10.1%) and 126 (28.3%) respectively. QT prolongation and hospital mortality was seen in 45 (10.1%) and 85 (19.1%) respectively. The prevalence of pre-existing cardiovascular disease, atrial fibrillation, cardiogenic shock, and renal failure were predominantly higher in mortality group compared to survival group. Conclusion: Our study found acute coronary syndrome was the prevalent cardiovascular disease. Elevated serum ferritin, lymphopenia, advanced age, cardiogenic shock, lower haemoglobin, renal failure, pre-existing heart failure, and leukocytosis were significantly related to cardiovascular disease increased mortality.

Background and Aim: Respiratory symptoms are mostly present in Coronavirus disease 2019 patients; however, a manifestation of gastrointestinal symptoms can be presented alone or with respiratory symptoms. The present study aimed to evaluate the prevalence and outcomes of gastrointestinal symptoms in corona virus disease-19 patients. Methodology: This multi-center cross-sectional study was conducted on 486 confirmed coronavirus disease-19 patients in the Department of Gastroenterology at Tertiary Care Hospitals (KMU IMS Kohat, Poonch medical college / CMH Rawlakot Azad Kashmir, and Bhitai Dental and Medical College Mirpurkhas) from May 2021 to October 2021. COVID-19 disease was confirmed through polymerase chain reaction testing. The patient’s demographic details, symptoms, and clinical history were recorded. Intensive care admission, mortality, and intubation were determined based on medical queries. Demographic details such as gender, age, and BMI were calculated based on multivariate logistic regression. SPSS version 21 was used for data analysis. Results: Of the total 486 corona virus-positive patients, the prevalence of gastrointestinal disease patients was 30.04% (n=146) whereas the incidence of fever, cough, and short breathiness was 181 (37.2%), 211 (43.5%), and 191 (39.4%) respectively. Out of gastrointestinal patients, diarrhea was the prevalent symptom whereas abdominal pain, vomiting, and decreased appetites were the other symptoms. The prevalence of abdominal pain, vomiting, and decreased appetites was 5.6% (n=8), 12.6% (n=18), and 10.5% (n=15) respectively. Mortality rate caused by diarrhea was higher (OR 2.81; p=0.005, CI; 1.43-5.95) and needed intensive care unit (ICU) admission (OR 1.89; p=0.021; CI 1.14-3.9), and intubation (OR 3.23; p=0.001; CI 1.6-5.53). Acute kidney injury, vasopressors, and shock presence were additional outcomes. These outcomes were more prevalent in coronavirus patients with gastrointestinal symptoms of diarrhea. Conclusion: Our study found that the prevalence of gastrointestinal symptoms in coronavirus patients was 30.04%. COVID-19 patients with respiratory symptoms are frequently followed by gastrointestinal symptoms such as diarrhea and vomiting. These patients should be given extra attention to avoid misdiagnosis or delayed treatment. Keywords: Coronavirus disease, Gastrointestinal Symptoms, Outcomes