367 research outputs found
An open study to assess the safety and efficacy of Heprovac-B vaccine 10 mcg-dose for adults
Heprovac B is a novel recombinant vaccine. There are many vaccines available in Pakistani market but Heprovac B claims to be immunogenic even at 10 meg dose. Aim of the study is to determine whether using 10 meg of Heprovac B vaccine is safe and effective in producing sufficient immunity in Pakistani population. One hundred and twenty five subjects, who fulfilled the Inclusion criteria, were enrolled for the study. Heprovac B was administered in a three-dose regimen given at 0, 1 and 6 months and adverse events were recorded. Immunogenicity was tested by measuring hepatitis B surface antibody one month after each dose received. One month after the 3rd dose 98.7% of the subjects were found to be seroprotected with geometric mean titer of 488.83 mIU/1 after the third dose. Heprovac B, vaccine was well tolerated with minimal reported adverse events. It is safe and 10 mcg is immunogenic in producing antibodies in Pakistani population against Hepatitis B virus
Phloroglucinol in Irritable Bowel Syndrome
Objective: To determine the efficacy and tolerability of phloroglucinol, an antispasmodic agent in the treatment of Irritable Bowel Syndrome (IBS). Methods: It was an open label (quasi interventional) study. One hundred patients coming to the gastroenterology clinics of Aga Khan University Hospital with IBS as defined by the Rome II criteria were enrolled between February 2004 and September 2004 to participate in the trial and were treated as outpatients. Phloroglucinol (Himont) 50mg orally three times daily was given for two months. Symptoms were assessed before and during treatment using a questionnaire. Results: One hundred patients were enrolled in the study. Of them 61% (61/100) were males and 39% (39/100) were females. Their mean age was 41±14 years. Sixty-eight patients completed the study and 28 dropped out. On Phloroglucinol treatment there was an overall statistically significant improvement in abdominal pain (p\u3c0.001), frequency of stools per day (p\u3c0.001), urgency (p\u3c0.001), passage of mucus per rectum (p\u3c0.001),sense of incomplete defecation (p=0.001) and bloating (p=0.001). However, no response was seen in the feature of straining in both genders (p=0.676). The difference in response to treatment according to gender separately showed statistically significant improvement in the sense of incomplete defecation in females alone(p=0.003). Conclusion: Phloroglucinol in a dose of 50mg three times daily is effective and well tolerated by the IBS patients. It relieves most of the symptoms of IBS (JPMA 56:5;2006
Frequency of poor quality of life and predictors of health related quality of life in cirrhosis at a tertiary care hospital Pakistan
Background
Cirrhosis produces variety of symptoms which eventually lead to a negative impact on Health Related Quality of Life (HRQOL). The general aim of this study was to evaluate the magnitude of poor HRQOL and to assess factors related with HRQOL in patients with CLD in Pakistan. Findings
This was a cross sectional study conducted in gastroenterology outpatient clinics of Aga Khan University Hospital, Karachi on adult patients with cirrhosis. In this study chronic liver disease questionnaire (CLDQ) was used to assess HRQOL of these patients and CLDQ score was used as an outcome measure to determine factors related with HRQOL.
273 participants were recruited in the study; 155 (57%) were males. Mean age of participants was 49 ± 11 years. The most common cause for cirrhosis was viral infection 247(91.5%). Mean Model for End Stage Liver Disease (MELD) score was 12.6 ± 6.8 and 2/3 of patients 209 (76.6%) had advanced cirrhosis in Child Turcot Pugh (CTP) B or C stage. Poor HRQOL was seen in 187(69%; 95% C.I.: 63%, 74%) of the participants. Mean CLDQ score was 4.36 ±1.1. Amongst all of the domains, fatigue domain had lower CLDQ score. Hemoglobin (β = 0.09 [SE = 0.04]), Albumin (β = 0.32[SE = 0.09]), Diastolic Blood Pressure (DBP) (β = 0.01[0.005) prior history of decompensation (β = 0.98[SE = 0.39] were significant factors associated with HRQOL in patients with liver cirrhosis. Conclusion
Frequency of poor health related quality of life determined by CLDQ score is high in patients with liver cirrhosis. Hemoglobin, serum albumen, prior history of decompensation (like encephalopathy and upper gastro intestinal bleed), are associated with health related quality of life
Helicobacter pylori infection and micronutrient deficiencies.
It is known that deficiencies of micronutrients due to infections increase morbidity and mortality. This phenomenon depicts itself conspicuously in developing countries. Deficiencies of iron, vitamins A, E, C, B12, etc are widely prevalent among populations living in the third world countries. Helicobacter pylori (H pylori) infection has a high prevalence throughout the world. Deficiencies of several micronutrients due to H pylori infection may be concomitantly present and vary from subtle sub-clinical states to severe clinical disorders. These essential trace elements/micronutrients are involved in host defense mechanisms, maintaining epithelial cell integrity, glycoprotein synthesis, transport mechanisms, myocardial contractility, brain development, cholesterol and glucose metabolism. In this paper H pylori infection in associated with various micronutrients deficiencies is briefly reviewed
Is there an association of giardiasis with beta-thalassemia minor?
Beta–thalassemia minor is a symptomless carrier state of a hemoglobinopathy which predisposes to bacterial infections. We report three cases presenting with giardiasis, a parasitic infection of gastrointestinal tract caused by Giardia lamblia. Patients presented with recurrent diarrhea and abdominal pain for over a year. An esophagogastroduodenoscopy finding varied from normal to acute duodenitis. Duodenal biopsy demonstrated changes consistent with mild chronic non-specific inflammation with G. lamblia trophozoites. All three patients were diagnosed as β -thalassemia minor hemoglobin electrophoresis. They were treated with Diloxanide furoate 500 mg and Metronidazole 400mg three times daily for five days. Their symptoms resolved and a stool test repeated one week after the end of treatment was normal. The host immune system both humoral and cellular components have a role in protection and clearance of Giardiasis. However, β -thalassemia minor patients have an observed probability of gardiasis but not a confirmed incidence
Burden of common mental disorders in patients with functional dyspepsia
OBJECTIVE: To assess the frequency of common mental disorders among diagnosed functional dyspepsia patients.METHODS: A case-control study with 150 cases of functional dyspepsia (FD) and 150 healthy controls were recruited from Gastroenterology Clinic at the Aga Khan University Hospital Karachi from 1st March 2009 through 31st August 2009. Urdu version of WHO-developed Self-Reporting Questionnaire (SRQ) was administered to diagnose patients of FD and healthy controls. A cut off score of 8 on SRQ was used to confirm cases of Common mental disorders (CMD). Data was entered and analyzed by SPSS version 16.0.RESULT: There was significant difference in CMD i.e. 107 (71.33%) versus 23 (15.33%) in cases and controls respectively (p
Irritable bowel syndrome and health seeking behaviour in different communities of Pakistan
OBJECTIVE:
To investigate the frequency of irritable bowel syndrome (IBS) and health seeking behaviour in patients belonging to different ethnic groups and their squatter settlements in two cities of Pakistan. METHODS:
Questionnaire based on Rome II criteria for the diagnosis of IBS was sent to 1167 persons living in, Karachi and Bahawalpur and their squatter settlements in Baloch Colony and Tibba Badar Sher respectively. About 90% (1048) completed the questionnaire. RESULTS:
The overall frequency of IBS was 14% with a mean age of 30 +/- 12.5 years and range of 16-85 years. Of the IBS positive patients, 56% (82/146) were males. IBS was significantly more common (p = 0.05) in males belonging to age group 16-30 years. The most common presenting symptoms were abdominal pain (100%), altered bowel habits (51%), and diarrhoea (54%). There was no difference in the prevalence of IBS in Karachi and Baloch Colony as compared to Bahawalpur and Tibba Badar Sher. IBS patients seeking health care advice were 17.6% as compared to 12.6 % non healthcare seekers. Of the healthcare seekers there were 29 (35.4%) males (p = 0.002). The overall mean age of health care seeking IBS patients was 32.8 +/-13.8 years (p \u3c 0.001). All IBS patients seeking healthcare advice had abdominal pain (p \u3c 0.001), while 61% had altered stool consistency (p \u3c 0.001) and 46% had stool frequency (p \u3c 0.001) as compared to IBS non healthcare seekers. CONCLUSION:
IBS is seen in both urban and suburban communities. Health seeking behaviour is common in males and with abdominal pain
Frequency of irritable bowel syndrome in college students.
Background:
This study was carried out to investigate the presence of irritable bowel syndrome (IBS) in college students and compare its distribution in the non-medical college and medical college students.
Methods:
We collected data from 508 students by inviting them to fill out a questionnaire based on Rome II criteria for the diagnosis of IBS from November 2001 to February 2004. Two major cities Karachi and Bahawalpur were selected and it was coordinated by the section of Gastroenterology, Department of Medicine, Aga Khan University Hospital and Quaid-e-Azam Medical College, Bahawalpur.
Results:
A total of 508 subjects with males 43 %(220/508) and female 57 % (288/508) mean age 22 ± 2.8 years responded to the questionnaire.The overall frequency of IBS among college students was 34 % (171/508).There were 41 % (107/263) non-medical college and 26 % (64/245) medical college students with IBS. Abdominal pain was present in 100 % (171/171) with altered frequency of stool in 58 % (100/171) (p\u3c 0.001,OR 12.5, CI 7.9-20.0) of students with IBS. The medical advice was sought by 38 % (65/171) in IBS group with 46 % (30/65) non-medical college school and 54 % (35/65) medical student (p=0.001, OR 1.9, CI 1.3-2.8).
Conclusion
IBS is common in younger adult population of Pakistan. Its prevalence is higher in non-medical college students but health care seeking behavior was more common in medical students
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