Objective: To determine frequency of general and specific endoscopic findings in patients diagnosed with dyspepsia and to determine association of age and gender with organic dyspepsia. Study Design: Cross sectional study. Place and Duration of Study: Gastroenterology department, Combined Military Hospital, Kharian, from Jul to Dec 2018. Methodology: A total of 180 patients participated in the study after being selected through non probability consecutive sampling. Age, gender and history of dysphagia, weight loss, gastrointestinal bleeding, and smoking were recorded. All underwent standard electronic video upper gastrointestinal endoscopy. Abnormal findings of inflammation, narrowing, strictures, furrowing, erosions, ulcers, atrophy, nodularity, polyps, masses and malignancy were recorded. The abnormal findings were presented as frequency and percentages. On the basis of endoscopic findings the sample was divided into two groups of functional (normal endoscopy) and organic dyspepsia. Chi-square test was selected to compare the frequencies of organic and functional dyspepsia with age and gender. Results: Majority 99 (55%) of the patients with dyspepsia had a normal endoscopic finding while in organic dyspepsia, reflux esophagitis 41 (22.8%) was the most common finding followed by gastritis 16 (8.9%), duodenal ulcer 12 (6.7%) and gastric ulcer 9 (5%). Three patients with organic dyspepsia had malignancy. Most common specific findings were non erosive esophagitis 25(30.8%). Age above 40 years and male gender was found to be statistically significantly associated with organic dyspepsia (p<0.01). Conclusion: Majority of the patients with dyspepsia have a normal endoscopic finding. There is a higher incidence of organic dyspepsia in males and in patients..................

Objective: To share the experience of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)-COVID-19 at a tertiary care hospital in Quetta, Baluchistan. Study Design: Cross-sectional study. Place and Duration of Study: Department of Pathology, Combined Military Hospital Quetta, from Mar to Dec 2020. Methodology: This study included 14,741 study participants presenting to CMH Quetta with signs and symptoms of Coronavirus Disease-19 (COVID-19) and others undergoing COVID-19 PCR for screening purpose. Nasopharyngeal swab collected from these study participants were tested for COVID-19 viral RNA by real-time Reverse Transcription Polymerase Chain reaction (RT-PCR) assay. Results: Out of these 14,741 study participants, 1886 (12.7%) were found to be SARS-CoV-2 PCR positive. Among 1886 study participants, 1503 (80%) were males while 383 (20%) were females. Mean age of the study participants was 36 ± 14 years. Most frequent clinical presentations were body aches (96.5%), fever (94.1%), cough (66.8%) and loss of appetite (68.2%). Around 67 (3.5%) positive study participants were asymptomatic. Conclusion: In this study, we observed male predominance but severity of signs and symptoms among female study participants. SARS-COVID-19 caused disease with wide range of clinical spectrum and disease can be fatal as well.

Objective: To assess the frequency of stress hyperglycemia and mortality in patients with hyperglycemia admitted in medical Intensive Care Unit. Study Design: Cross-sectional study. Place and Duration of Study: Medical Intensive Care Unit, Combined Military Hospital Quetta, from Nov 2018 to Jun 2019. Methodology: A total of 150 adult patients of age between 18-80 years, of both genders, with Intensive Care Unit stay >24 hours, who were treated in medical Intensive Care Unit during study period, were included in the study. Those patients with duration of stay <24 hours, paediatric patients, surgical and pregnant patients and those who were on chronic steroid therapy and those who were given TPN and dextrose infusions were excluded. The blood sugar fasting was measured daily and blood sugar random was measured on admission and twice daily. The patients were segregated into three groups: Normoglycemia, Diabetes mellitus and Stress hyperglycaemia. The frequency of patients and outcome of patients in terms of death was observed in all groups. Results: The mean age of study population was 55.02 ± 18.14 years, with 99 (66%) were males while 51 (34%) were females. Among study population 77 (51.3%) had normoglycemia, 46 (30.7%) had Diabetes Mellitus while 27 (18%) had stress hyperglycaemia. Out of 77 patients with normoglycemia 10 (12.9%) died, while number of deaths in patients with diabetes mellitus and stress hyperglycaemia was 21 (45.6%) and 15 (55.5%) respectively. The mean maximum blood glucose in those who survived and died was 214.39 ± 100.69 mg/dl and 295.26 ± 122.60................

Objectives: To determine the efficacy (in terms of recurrence) of rifaximin in Hepatic Encephalopathy (HE) in chronic liver disease. Study Design and Setting: A descriptive study carried out from 4th September 2018 to 3rd March 2019 at the department of Medicine, Combined Military Hospital, Quetta. Methodology: A total of 104 patients of chronic liver disease with HE, 25-65 years and both genders were included. Patients with gastrointestinal hemorrhage, chronic renal insufficiency and anemia were excluded. Then tab Rifaximin 550 mg twice daily along with standard prescription i.e. Lactulose 30 to 60 ml in two to three divided doses per day was given to each patient and efficacy was noted. Statistical analysis was carried out using SPSS version 20.0. Age, duration of disease and Conn’s score was presented as mean and standard deviation. A p value = 0.05 was considered as significant Results: Age range in our study was from 25 to 65 years with a mean of 45.73 ± 8.13 years. Most of the patients 54 (51.92%) were between 46 to 65 years of age range. Out of the 104 patients, 77 (74.04%) were male and male to female ratio was 2.9:1. Mean duration of disease was 13.66 ± 3.77 months. Mean conn’s score was 4.77 ± 1.43. Efficacy (no recurrence) of rifaximin in HE in chronic liver disease was found in 85 (81.73%) patients. Conclusion: It was inferred that rifaximin is useful in decreasing the recurrence of HE in chronic liver disease patients with previous episode/s of encephalopathy

Objective: The aim was to assess the safety of Remdesivir in Patients with Acute and Chronic Kidney DiseaseMethodology: Quasi-experimental study was conducted at the Pak Emirates Military Hospital Rawalpindi from March 2021 to April 2022. A sample was collected through a non-random sampling method, recruiting those who were diagnosed with pneumonia caused by the COVID-19 virus. A total of 56 patients with acute or chronic kidney disease were the participants of our study. The inclusion criterion was patient with positive COVID PCR 7-10 days prior to the commencement of the study. Patients admitted to the hospital nephrology ward with any stage of AKI were also considered for inclusion in the study. However, patients under the age of 18 and those who refused to participate were excluded.Results: The serum creatinine value were 125.15 ± 8.61 u/L and 126.44 ± 5.72 micromoles/L before and after Remdesivir use respectively. The serum ALT changed from 34.55 ± 2.69 u/L to 33.26 ± 1.85 u/L while Serum AST changed from 54.69 ± 4.04 u/L to 55.42 ± 3.09 u/L in patients with renal diseases when treated with Remdesivir for COVID-19.Conclusion: This study concluded that Remdesivir had no statistically significant effect on serum creatinine, AST and ALT. It also showed that these values showed and above normal pattern from baseline before and after the administration of Remdesivir when given in participants of the study undergoing COVID treatment with AKI or CKD.