Background: Helicobacter pylori ( H. pylori ) is one of the most common human infections worldwide particularly in the developing countries. We aimed to study an association of H. Pylori infection with endoscopic and histological findings in the Nepalese population. Materials and Methods: We conducted a study between Oct 2014 and Jan 2015 after meeting inclusion and exclusion criteria. Institutional Review Board approval was obtained from National Academy of Medical Sciences. Endoscopic findings and histopathological diagnosis were documented and data were analysed. Results: A total of 113 patients who had complete endoscopy were enrolled. The prevalence of H. pylori infections recorded was 27 (23.9%) patients. There were 17 (62%) male and 10 (37%) female infected with H. pylori ( P = 0.33). All biopsied specimens were sent to pathology lab for examination. The most common endoscopic findings was erythematous antral gastritis (40.7%) followed by erosive gastritis 34 (30.1%), pangastritis 10 (8.8%), duodenal ulcer 13 (11.5%), gastric ulcer 9 (8%), erosive fundal gastritis 2 (1.8%), reflux esophagitis 10 (37%) ( P < 0.04). Histology revealed that 23 (85.2%) patients had chronic active gastritis (CAG); ( P < 0.001). Conclusions: Our study revealed that H. pylori infection is strongly associated with chronic active gastritis (CAG) and Reflux esophagitis in Nepalese adults.
Posterior reversible encephalopathy syndrome (PRES), first introduced in 1996, is a neurotoxic state characterised by seizures, headache, vision change, paresis, nausea and altered mental status. Risk factors include hypertension, eclampsia/pre-eclampsia, infection/sepsis and cancer chemotherapy. Although exposure to toxic agents is a common occurrence in patients who develop PRES, oxaliplatin has rarely been associated with it, with only 10 cases reported worldwide. We present the case of an oxaliplatin-induced PRES in a 23-year-old male patient who was started on oxaliplatin/capecitabine as adjuvant chemotherapy for anal canal adenocarcinoma. The patient developed symptoms of headache, slurred speech and left-sided facial weakness on the ninth day after the first dose of oxaliplatin that lasted for 6-8 hours. The patient experienced another episode next day with similar symptoms that lasted for 8 hours. Oxaliplatin was withheld and the patient was discharged on capecitabine only. The patient had no new episodes since discharge on follow-up.
Multisystem involvement has not been uncommon in SARS-CoV-2 infection. There has been reports of devastating neurological complication both during the infection and after the virus clears out. Here we present a rare case of sino-orbital mucormycosis, diagnosis of which was confirmed only on histopathology. Our patient presented with headache, 18 days after her recovery from SARS-CoV-2 infection and was extensively worked up for the cause. Initially she was treated as a severe sinusitis but failure to response to antibiotics treatment warranted for further investigations and imaging. Our patient had to undergo right eye enucleation plus debridement under general anesthesia under the care of ENT, Ophthalmology, Neurosurgery and Neurology. She is currently on anti-fungal treatment as advised by infectious disease department.
Epidural Haematoma (EDH) develops in 1-3% of all major head injuries and most common in the young. This crosssectional descriptive study was done to find out the management strategy and outcome of EDH in relation to clot volume. This study was performed from December'2006 to November'2007, by purposively selecting 77 cases of EDH from the Department of Neurosurgery, Dhaka Medical College Hospital (DMCH), Dhaka. The study showed that highest number of patients was in most active period of life, with male predominance (Male: Female =7.5:1). Causes of EDH were mostly due to assault (37.7%), followed by RTA (32.5%) and fall from height (29.8%). The study showed Patient having EDH Volume (EDHV) > 30ml will have 8.55 times more chance of having unfavorable outcome than patient having EDHV < 30 ml. Patient having EDHV > 30 ml will have 187.83 times more chance of requiring surgical intervention than those having EDHV <30 ml, which is statistically highly significant (p<0.001). Mortality rate of EDH can be reduced by giving early management either conservative or surgery. Delay in the management of EDH patients with poor level of consciousness and EDHV >30 ml has adverse effect on mortality and morbidity. Key words: EDH; EDHV; Burr hole; GOS; GCS. DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9208 FMCJ 2011; 6(2): 89-91
Objective: To compare the findings of magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatographyin patients presenting with bile duct disorders. Methodology: The retrospective secondary-data study was conducted at the Gastroenterology Department of Lady Reading Hospital, Peshawar, Pakistan,and comprised data of patients who presented with bile duct disordersfrom June2019 to May2020. Data was analysed using SPSS 25. Results: Of the 92 patients, 41(44.6%) were males and 51(55.4%) were females. The overall mean age was 50.12 years with a standard deviation of 16.70 years (ranged: 13-80 years). Out of 28 bile duct calculi cases detected by endoscopic retrograde cholangiopancreatography, 25(89.3%) were detected by magnetic resonance cholangiopancreatography, and, of the 64 without calculi, it detected 50(78.1%). Out of 8 bile duct strictures detected by endoscopic retrograde cholangiopancreatography, 3(37.5%) were correctly diagnosed by magnetic resonance cholangiopancreatography, and, of the 84 unaffected patients, it excluded 79(94%). Out of 64 bile duct dilatation cases, magnetic resonance cholangiopancreatography correctly diagnosed 59(92.2%), and, of the 28 unaffected patients, it excluded 27(96.4%). Conclusion: For bile duct stone and dilation, magnetic resonance cholangiopancreatography was found to have high diagnostic accuracy. Key Words: Choledocholithiasis, Cholangiopancreatography, MRCP, ERCP. Continuous...
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