Background: Helicobacter pylori (H. pylori) remains one of the most common worldwide human infections and is associated with a number of important upper gastrointestinal (GI) conditions including chronic gastritis, peptic ulcer disease, gastric carcinoma and special type of lymphoma. Anaemia is a common disorder in developing countries and the commonest cause is iron deficiency. There are many causes for high prevalence of this disorder in our society, many are well-known and investigated while some are new and not well established. Although H. pylori associates peptic ulcers and gastric malignancy can cause bleeding, resulting in iron deficiency, but majority of patients infected with H. pylori does not have ulcer or malignancy. They usually have chronic gastritis that is not associated with GI bleeding. About 35% of iron deficiency anaemia cases remain unexplained after a gastrointestinal evaluation. Recently investigation focused on the role of H. pylori, in the development of extra-gastrointestinal diseases including Iron deficiency anaemia. Methodology: This observational, cross sectional study was carried out at BSMMU, Dhaka from July 2010 to October 2011 to find out the association between H. pylori infection and iron deficiency anemia in Bangladeshi adults. Patients with dyspepsia and indication of upper GI endoscopy were initially enrolled in the study and finally a total of 168 subjects were included based on inclusion and exclusion criteria.Result : Among 168 patients, 105 (62.5%) were male and 63(37.5%) were female with the mean age of 33.25 years. On endoscopy, 147(87.5%) of the patients had normal findings and 21(12.5 %) had erosive gastritis. None of them had hemorrhagic erosive gastritis. Among 168 patients, 115(68.45%) were positive and 53(31.55%) were negative for H. pylori by rapid urease test. In our study, we have found a significant low mean serum ferritin level (P<0.001) in H. pylori infected patients. This result is consistent with most of previous data concerning the effect of H. pylori infection on iron metabolism. This study has also revealed a significant (P<0.001) lower value of mean MCV and MCH in H. pylori positive patients.Regarding hemoglobin value, our study has showed no significant (P>0.05) different in hemoglobin level according to H. pylori status.
Introduction: Non-alcoholic fatty liver disease (NAFLD) is a distinct clinicopathologic entity characterized histologically by a spectrum ranging from simple steatosis to steatohepatitis (NASH), cirrhosis and even hepatocellular carcinoma (HCC).Objective: To determine the incidenceand identify the risk factors of NAFLD in non-obese patients.Methods: It was a cross sectional study done in Department of gastroenterology, Nuclear Medicine and ultrasound, Radiology and Imaging, Virology, Biochemistry, BSMMU, Dhaka from March 2012 to June 2014. The patients more or equal to 18 years, non-obese were included. In this study total 190 patients were enrolled.Results: Among them 38 patients were with fatty liver and 152 patients without fatty liver on the basis of ultrasonogram. Where 141 were male and 49 were female with mean age was 49.24 + 9.05 years. Among total, 18.9% had diabetes mellitus, 28.4% had dislipidaemia 24.4% had history of hypertension. Total 18.9% patients having history of diabetes mellitus, normal vs fatty liver disease (20% vs 42.1%, p <0.001) and history of dyslipidemia (10.5% vs 100% , p <0.001), Haemoglobin percentage was 12.16 + 1.32 gm/dL, urine routine microscopic examination glucose present in 9.5% patients. SGPT 56.34 + 16.09 IU/L, SGOT 41.62 + 5.94 IU/L, alkaline phosphatase 99.31+ 19.76 IU/L. We found 6.3% patients were HBsAg positive and no patient was Anti HCV positive.Conclusion: Sedentary life style, Metabolic syndrome, DM, dyslipidameia, are risk factors of NAFLD in non obese person. Elevated liver enzymes are consequences of NAFLD. Though this study has some limitations, it will give some information about emerging liver disease without viral hepatitis.J MEDICINE July 2015; 16 (2) : 89-92
Gastro Esophageal Reflux Disorders(GERD) are group of conditions where gastric contents are refluxed into the esophagus and produce troublesome symptoms mainly heartburn and regurgitation. It may present with complications as well. Atypical presentation is also not very uncommon. Proper diagnosis and differentiation from other diseases can ensure appropriate treatment and thus better quality of life. Unlike many other diseases, diagnosis of GERD is relatively straight forward through symptomatology and a few investigations, even though few cases require special and technologically newer modalities of investigative tools for confirmation. Option for treatment are many and mostly medical; surgical and other methods are very rarely needed to pose better life. New molecules are recently being used with variable promising results and need exploration. [J Shaheed Suhrawardy Med Coll, 2013;5(2):30-33]
Malnutrition is a common but frequently overlooked problem among patients with cirrhosis of liver. Malnourished cirrhotic patients have a higher rate of complications and an overall increased mortality. Identifying these patients is of great clinical importance. This study was carried out to assess nutritional status of cirrhotic patients to identify those who are malnourished and to see the relationship between severity of liver disease and malnutrition. 105 patients were selected by purposive type sampling. Nutritional status was assessed by 3 anthropometric assessment tools-body mass index (BMI), mid upper arm muscle circumference (MAMC) and triceps skin fold thickness (TST). Severity of liver disease was assessed by Child-Pugh (CP) score. Severe malnutrition was defined as MAMC and TST <5th percentile, calculated from standard tables, and as BMI <16. Among 105 patients 18, 49 and 38 were of Child-Pugh group (CP group) A, B and C respectively. Anthropometric assessment revealed that, when assessed by MAMC 63% of the study population were severely malnourished. Based on MAMC, severe malnutrition was present in 39%, 63% and 73% patients in CP group A, B and C, respectively (P<0.05). So, percentage of severely malnourished patient increased with the increase in severity of liver disease. Based on TST, 28%, 34% and 50% patients were severely malnourished in CP-A, CP-B and in CP-C (p>0.05) respectively which showed a trend similar to that by MAMC. Whereas, based on BMI, 0%, 8% and 2% patients were severely malnourished respectively (p>0.05). It showed a decrease in the percentage of severely malnourished patient in CP group C than in CP group B. In this study, nutritional assessment by TST and MAMC revealed that severe malnutrition was common in our study population and assessment by MAMC showed a statistically significant association of severity of liver disease with severe malnutrition.
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