Objectives: This study was aimed to describe the endoscopic findings in patients with refractory dyspepsia. Study Design: Observational study. Setting: Rehman Medical Institute Peshawer. Period: March 2017- Feb 2019. Material & Methods: All the patients who were referred for endoscopy for refractory dyspepsia were included by consecutive non probability sample technique. Data was entered and analyzed on SPSS version 22. Results: Out of 727 patients, 51.6% (n=375) were male. Mean age was 43.09±15. 54.30% (n=395) endoscopies were normal. Antral gastritis, Fundal gastritis and Pangastritis were noted in 14% (n=102), 4.40% (n=32) and 8.50% (n=62) patients respectively. Gastroenteritis was found in 5.40 %( n= 39) while 3.20 %( n=23) patients had duodenitis. Reflux oesophagitis was observed in 2.50% (n=18) patients. 1.20 %( n= 9) had erosions while 0.80% (n=6) had gastric ulcers, 1.20% (n=9) had carcinoma, 2.30% (n=17) had hiatal hernia and 2.10% (n=15) had other gastric pathologies. Functional dyspepsia was seen in 89.9% patients. It was observed more in young age, female gender, and in patients from Afghanistan, frequency being 66.3%, 63.4% and 59% respectively. Conclusion: Most patients with refractory dyspepsia had normal endoscopy, it was common in females, young age and Afghanistan patients. Reflux oesophagitis was common pathological finding with predominance in elderly.
Introduction: Research has implicated an exaggerated or self-directed immune response as a factor in determining patient outcome in COVID-19. Initial reports identify lymphopenia as having a predictive role in COVID-19 related disease severity.Objective: To document the occurrence of lymphopenia in COVID-19 patients and explore its association with demographic factors and disease course.Materials & Methods: This cross sectional, observational study was conducted at Rehman Medical Institute, Peshawar from May, 2020 to August, 2020. All patients admitted to the hospital with COVID-19 diagnosis were included. Relevant information including demographics, disease severity, laboratory findings & outcomes were noted in a predesigned Performa. The data were analyzed on SPSS 22 for descriptive and comparative statistics; p≤0.05 denoted significance.Results: A total of 216 patients were included, of whom 172 (79.6%) were males. The mean age was 54.61 ± 14.35 years. Classic lymphopenia was found in 67 (31.5%), 66 (31.0%) had borderline lymphopenia, and 80 (37.6%) had no lymphopenia. Of the classic lymphopenia group, 14 (20.9%) had mild disease, 21 (31.3%) had moderate disease, 18 (26.9%) had severe disease & 14 (20.9%) had critical disease. In patients with borderline lymphopenia 31 (47.0%) had mild disease, 17 (25.8%) moderate disease, 14 (21.2%) had severe disease and 04 (6.1%) had critical disease. In patients with no lymphopenia, 32 (40.0%) had mild, 32 (40.0%) had moderate, 14 (17.5%) had severe & 02 (2.5%) had critical disease. Mortality associated with classical lymphopenia was 37.3% (n=25) whereas 43.3% (n=29) patients recovered. Male gender, disease severity and outcome were statistically linked to lymphopenia; no statistical significance was observed with age.Conclusion: A statistically significant association of lymphopenia with severe/critical disease and adverse outcomes was noted.Keywords: Lymphopenia, COVID-19, Pandemic.
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