scholarly journals Clinical profile and pattern of bacterial isolates from bile aspirates of cholecystectomy patients

2019 ◽  
Vol 7 (11) ◽  
pp. 4010
Author(s):  
Shewtank Goel ◽  
Pooja Tripathi Pandey ◽  
Abhay Kumar ◽  
Deval Kumar Arora ◽  
Nidhish Kumar ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Bacterial Growth ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Bacterial Isolates ◽  
Group Iii ◽  
Group I ◽  
Number Of Patients ◽  
Group Ii ◽  
Study Participants

Background: Antibiotic policy and appropriate antibiotic prophylaxis cannot be designed unless data is available about bacteria colonizing the bile associated with gall bladder disease.  Authors aim was to assess the clinical profile and pattern of bacterial isolates from bile aspirates of cholecystectomy patients seeking care at a tertiary care teaching hospital.Methods: Patients who underwent cholecystectomy for various hepatobiliary ailments during year 2017-18 formed the study population. Bile aspirates were collected during cholecystectomy and sent to the microbiology laboratory. Ultrasonography, computed tomography and MRCP were done to confirm the gall bladder pathology before surgery.Results: Out of total eighty-six patients, bacterial growth was observed in 28 (32.56%) subjects. As per division of bile samples, maximum number of study participants (39.29%) having bactibilia were seen in Group II. Group with second highest number of patients showing bactibilia was Group III with 9 subjects (32.14%). Eight subjects (28.57%) exhibited bacterial growth in bile aspirates in Group I subjects. Three patients (10.71%) showed bile infected with multiple bacteria i.e. polymicrobial infection. The gram-negative preponderance was seen in all the three groups with Escherichia coli being most common in group I and II. Pseudomonas aeruginosa was isolated in majority of the patients in group II and III.Conclusions: It is advised that all patients undergoing cholecystectomy must have their bile aspirated during cholecystectomy and sent for microbiological examination and culture. It will help in choosing appropriate antibiotic to prevent infection.

scholarly journals Prevalence of anaemia among children under five years in tertiary care hospital of Nepal.

2015 ◽  
Vol 13 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Sundari Joshi ◽  
Megha Pradhan Pradhan ◽  
Ujjwal Joshi
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Care Hospital ◽  
Cross Sectional ◽  
Children Under Five ◽  
Group Iii ◽  
Under Five ◽  
Group I ◽  
Group Ii

Introduction: Anaemia is a pathologic deficiency in oxygen-carrying haemoglobin in red blood cells which may be the result of genetic diseases, infections and deficiency of several nutrients. Nepal is one of the developing countries where anaemia is one of the most serious public health problems. So, a study was planned to evaluate the prevalence of anaemia among children under five years in tertiary care hospital of Nepal. Methods: A cross-sectional study was carried out from August 2011 to January 2012 using a structured questionnaire interview and observation. The children were divided into three groups: group I (0-1 years), group II (>1-3 years), group III (>3-5 years). Anaemia was assessed using  haemoglobin measurement in gram in decilitre on Sysmex KX -21 (automated haematology analyzer). The severity of anaemia were grouped as follows: severe anaemia, < 7.0 g/dL; moderate anaemia, 7.0 to 8.9 g/dL; and mild anaemia, 9.0 to 10.9 g/dL as per WHO classification. Stool test was also carried out to assess worm infestation. Data were analysed using SPSS 11.5. Results: There were 208 children among which 52.9 % were male while 47.10 % were female.  The overall prevalence of anaemia was found to be 49.5% of which 43.3% had mild, 15.8% had moderate and 0.5% had severe anaemia. Out of 20 children in group I, 70 % were anaemic. Among the 94 each in group II and group III, children suffering from anaemia were 51% and 43% respectively. The stool investigations showed that 5.3 % children suffered from worm infestations.   Conclusions: prevalence of anaemia was seen in 49.5% of children below five years age group and the diet and worm infestations didn’t affect it.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12998

scholarly journals Survival among patients admitted in PICU (Pediatric Intensive Care Unit) of tertiary childcare hospital.

2021 ◽  
Vol 28 (12) ◽  
pp. 1773-1777
Author(s):  
Fatima Jabeen ◽  
Asim Khurshid ◽  
Maria Saleem
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Care Hospital ◽  
Group Iii ◽  
Group I ◽  
Male Patients ◽  
Study Participants

Objective: To determine the frequency of survival among patients admitted in Paediatric Intensive Care Unit (PICU) of tertiary care hospital according to disease severity score PRISM III. Study Design: Descriptive study. Setting: PICU of The Children’s Hospital and Institute of Child Health, Multan. Period: October 2019 to April 2020. Material & Methods: A total of 205 admitted children in PICU were recruited. PRISM III forms were filled and PRISM III score was calculated for all study participants. Results: Of these 205 study cases, 124 (60.5 %) were male patients while 81 (39.5 %) were female patients. Mean age of our study cases was 3.64 ± 1.96 years. Mean duration of PICU stay was 4.52 ± 3.59 days and 139 (67.8%) patients had PICU stay for upto 5 days. Mean PRISM III score was 11.25 ± 4.69 and 69 (33.7%) had group I score, 118 (57.6%) had group II score, 14 (6.8%) had group III score and 4 (2%) had group IV score. Of these 205 study cases, mortality was noted in 31 (15.1%). Conclusion: High Frequency of mortality among children admitted to pediatric intensive care unit (PICU) was observed and mortality was found to be increasing with increasing PRISM III score.

“ROLE OF PARTOGRAM IN MANAGEMENT OF LABOUR IN PRIMIGRAVIDA PATIENT AT TERTIARY CARE CENTRE”

2021 ◽  
pp. 49-53
Author(s):  
Surabhi Gupta ◽  
Preeti Sharma
Keyword(s):  
Tertiary Care ◽  
World Health ◽  
Normal Vaginal Delivery ◽  
Tertiary Care Centre ◽  
Obstructed Labor ◽  
Group Iii ◽  
Group I ◽  
Management Protocol ◽  
Prolonged Labor ◽  
Group Ii

Introduction: Although labor is a natural physiological process characterized by progressive increase in frequency, intensity and duration of uterine contractions, resulting in effacement and dilatation of cervix, with descent of the fetus through the birth canal, this physiologic process many a time may lead to prolonged labor. The partograph developed by World Health Organization is the best-known partograph in the lowresource setting. Partograph when used with dened management protocol is an inexpensive tool which can effectively monitor labor and be helpful in reducing incidences of both maternal and fetal morbidity and mortality by reducing the number of operative interventions, prolonged labor, obstructed labor and caesarean section. Then WHO in 1994 endorsed the partogram and later modied in 2000 and removed latent phase and dened active phase at 4 centimetres instead of previously used 3 centimetres. WHO advocated its use as a necessary tool in management of labor and recommended its universal use during labor. Objective: To analyse the patterns of labor amongst spontaneous parturient using a WHO modied partogram and to compare outcome of labor and neonatal outcomes in relation to partogram ndings. Methods: This prospective study was carried over a period of 18 months on 100 parturients. Modied WHO Partogram was used to assess the progress of the labor. Parturients were divided on basis of partogram ndings. Group-I (n=64), where parturients partogram remained to the left of alert line, Group-II (n=20), where parturients partogram remained between the alert and action lines and Group-III (n=16), where parturients partogram crossed the action line. In these three groups, the maternal and fetal outcomes were assessed. Results: Normal vaginal delivery was done in 95.3% of Group-I, 80% of Group-II and 43.75% of Group-III parturients. Instrumental delivery was done in 1.56% of Group-I, 10% of Group-II and 18.75% of Group-III parturients. LSCS was done in 3.1% of Group-I, 10% of Group-II and 37.5% of Group-III parturients. Instrumental / LSCS deliveries were higher in Group-II and Group-III parturients. Alarge proportion of newborns of Group-II and Group-III parturients had Apgar Score <7. Conclusion: The Modied WHO partogram is very helpful in the prediction of maternal and fetal outcome. It is highly recommended for use in resource decient medical facilities, where early decision for delivery or referral can be taken on the basis of partogram ndings..

Moderate to severe hyperphosphataemia as an independent prognostic factor for 28-day mortality in adult patients with sepsis

2020 ◽  
Vol 37 (6) ◽  
pp. 355-361
Author(s):  
Dong-Hyun Jang ◽  
You Hwan Jo ◽  
Jae Hyuk Lee ◽  
Joonghee Kim ◽  
Seung Min Park ◽  
...  
Keyword(s):  
Tissue Injury ◽  
Tertiary Care ◽  
Prognostic Indicator ◽  
Group Iv ◽  
Phosphate Concentration ◽  
Group Iii ◽  
Risk Of Death ◽  
Group I ◽  
Group Ii ◽  
Cox Proportional Hazard Regression

BackgroundIschaemic tissue injury caused by tissue hypoperfusion is one of the major consequences of sepsis. Phosphate concentrations are elevated in ischaemic tissue injury. This study was performed to investigate the association of phosphate concentrations with mortality in patients with sepsis.MethodsThis was a retrospective cohort study of patients with sepsis conducted at an urban, tertiary care emergency department (ED) in Korea. Patients with sepsis arriving between March 2010 and April 2017 were stratified into four groups according to the initial phosphate concentration at presentation to the ED: group I (hypophosphataemia, phosphate <2 mg/dL), group II (normophosphataemia, phosphate 2–4 mg/dL), group III (mild hyperphosphataemia, phosphate 4–6 mg/dL), group IV (moderate to severe hyperphosphataemia, phosphate ≥6 mg/dL). Multivariable Cox proportional hazard regression analyses were performed to evaluate the independent association of initial phosphate concentration with 28-day mortality.ResultsOf the 3034 participants in the study, the overall mortality rate was 21.9%. The 28-day mortality rates were group I (hypophosphataemia) 14.6%, group II 17.4% (normophosphataemia), group III (mild hyperphosphataemia) 29.2% and group IV (moderate to severe hyperphosphataemia) 51.4%, respectively (p<0.001). In the multivariable analyses, patients with severe hyperphosphataemia had a significantly higher risk of death than those with normal phosphate levels (HR 1.59; 95% CI 1.23 to 2.05). Mortality in the other groups was not significantly different from mortality in patients with normophosphataemia.ConclusionsModerate to severe hyperphosphataemia was associated with 28-day mortality in patients with sepsis. Phosphate level could be used as a prognostic indicator in sepsis.

scholarly journals AB0797 THE ROLE OF ULTRASOUND CRITERIA IN ASSESSING PAIN SYNDROME IN THE KNEE JOINT IN PATIENTS WITH RHEUMATOID ARTHRITIS AND OSTEOARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1423.1-1423
Author(s):  
N. Aleksandrova ◽  
A. Aleksandrov
Keyword(s):  
Rheumatoid Arthritis ◽  
Knee Joint ◽  
Synovial Membrane ◽  
Pain Syndrome ◽  
Synovial Proliferation ◽  
Group Iii ◽  
Joint Cavity ◽  
Group I ◽  
Number Of Patients ◽  
Group Ii

Background:Pain syndrome and pathological changes in the synovium detected by ultrasound can be early signs of various diseases of the joints [1].Objectives:the use of ultrasound criteria for changes in the synovial membrane of the joint cavity to assess the severity of pain in patients with rheumatoid arthritis (RA) and osteoarthritis (OA).Methods:The study included 36 patients with RA (32 women and 4 men aged 22 to 55 years old) and 38 patients with OA (30 women and 8 men aged 30 to 50 years old) with lesions of the knee joints. A visual analogue scale (VAS) was used to determine the severity of pain. The severity of pain in the knee when walking was at least 40 mm according to the VAS in all examined patients. Joint ultrasound examination was carried out according to the standard technique using a linear transducer with a frequency of 5–12 MHz on an Accuvix V10 ultrasound diagnostic system (Samsung Medison, South Korea). The evaluation of ultrasound changes in the upper inversion of a knee joint was carried out according to the following criteria: the severity of intra-articular effusion (1), synovial proliferation (2), local vascularization of the synovial membrane using power Doppler (3) (Table 1).Table 1.Parameters of ultrasound criteria for assessing changes in the synovial membrane of the joint cavityNormal indicators1 - width of the suprapatellar turn is 6 mm2 - thickness of the synovial membrane is 3 mm (from the anterior approach)3 - lack of vascularization lociMinimum changes1 - delamination of the suprapatellar curl leaves from 7 to 9 mm2 - thickness of the synovial membrane 3.1–4.5 mm3 - appearance of single loci of vascularization (1-2 in the Doppler field)Moderate changes1 - delamination of the leaves of the suprapatellar twist 10-14 mm2 - thickness of the synovial membrane is 4.6–6.4 mm3 - appearance of moderate (> 5) vascularization lociSevere changes1 - delamination of suprapatellar folds of more than 15 mm2 - thickness of the synovial membrane is more than 6.5 mm3 - multiple foci of vascularization (> 5, merging in places)Results:Correlations of various severity were found between pain indices according to VAS and the thickness of the synovial membrane of the knee joint (r = 0.33, p = 0.019) and the number of vascularization foci (rS = 0.29, p = 0.04) in RA patients, as well as between pain according to VAS and the severity of intra-articular effusion (r = 0.28, p <0.002) in patients with OA.The patients were divided into three groups according to the severity of pain in the knee joint: group I - 41-59 mm (12 patients with OA and 9 patients with RA), group II - 60-79 mm (16 patients with OA and 12 patients with RA), group III - 80–100 mm on the VAS scale (10 patients with OA and 15 patients with RA). Group I was dominated by OA patients with minimal changes in intra-articular effusion and local vascularization of the synovial membrane, with moderate synovial proliferation (28.6% of the total number of patients in the group). In group II patients with OA with moderate severity of intra-articular effusion and local vascularization (21.4%) and patients with RA with moderate changes in the thickness of the synovium and local vascularization (25%) were equally common. Group III was dominated by RA patients with severe synovial proliferation and moderate local vascularization (28%), as well as patients with OA with moderate intra-articular effusion (20%).Significant differences in the thickness of the synovium in patients with RA in the first and third groups were noted (H-test = 5.9, p = 0.025).Conclusion:The additional use of ultrasound criteria for changes observed in the synovial membrane of the joint cavity in patients with RA and OA can help predict pain in the knee joint. The manifestation of pain syndrome in patients with OA is most associated with the severity of synovitis in the joint, and in patients with RA - with the severity of synovial proliferation.References:[1]Sarmanova A et al. Arthritis Res Ther. 2017;19(1):281.Disclosure of Interests:None declared

scholarly journals Effectiveness of Different Bristle Designs of Toothbrushes and Periodontal Status among Fixed Orthodontic Patients: A Double-blind Crossover Design

2018 ◽  
Vol 19 (2) ◽  
pp. 150-155 ◽  
Author(s):  
Md Jalaluddin ◽  
Sandhya P Naik ◽  
Sameer Punathil ◽  
Praveena Shetty ◽  
Ipsita Jayanti ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Crossover Design ◽  
Test Phase ◽  
Double Blind ◽  
Periodontal Status ◽  
Group Iii ◽  
Group I ◽  
Orthodontic Patients ◽  
Group Ii ◽  
Study Participants

ABSTRACT Aim The aim of the present study was to evaluate the effectiveness of different bristle designs of toothbrushes and the periodontal status among patients undergoing fixed orthodontic treatment. Materials and methods This randomized controlled trial (RCT) consisted of 45 adolescents (comprising 20 males and 25 females) undergoing fixed orthodontic treatment. The study participants were randomly allocated to three groups, each group being assigned a locally available toothbrush with a particular design of toothbrush bristle. In the first test phase, group I study participants were allocated to toothbrush with flat bristles, group II study subjects were allocated to toothbrush with zigzag bristles, and group III study participants were allocated to toothbrush with crisscross bristles. The study participants were recalled after 4 weeks to check the effectiveness of the allocated toothbrushes. A washout period of 1 week was maintained to ensure that there was no carryover effect of the different bristle designs. In the second test phase, each patient used the opposite toothbrush bristle design (group I: toothbrush with zigzag bristles, group II: toothbrush with crisscross bristles, and group III: toothbrush with flat bristles). Plaque scores were measured using Turesky—Gilmore—Glickman modification of Quigley-Hein plaque index (PI). Results In both phase 1 and 2 of this RCT, toothbrush with crisscross bristles exhibited maximum plaque reduction among the three different bristle design toothbrushes following 30 days (p = 0.312 ± 0.102 and 0.280 ± 0.110, respectively), which was statistically significant. Conclusion It was concluded that all the three designs of toothbrushes were effective in removing plaque in patients with fixed orthodontic appliances. But among the three different toothbrushes, toothbrush with crisscross bristles showed the highest mean plaque reduction. Clinical significance Plaque accumulation around the orthodontic brackets and gingival margins is quite common among the fixed orthodontic patients, who encounter difficulty in maintaining good oral hygiene. Specially designed toothbrushes are very essential for effective plaque removal among the patients undergoing fixed orthodontic treatment. How to cite this article Naik SP, Punathil S, Shetty P, Jayanti I, Jalaluddin M, Avijeeta A. Effectiveness of Different Bristle Designs of Toothbrushes and Periodontal Status among Fixed Orthodontic Patients: A Double-blind Crossover Design. J Contemp Dent Pract 2018;19(2):150-155.

scholarly journals Self-Reported Disability in Adults with Severe Obesity

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
I. Kyrou ◽  
G. Osei-Assibey ◽  
N. Williams ◽  
R. Thomas ◽  
L. Halder ◽  
...  
Keyword(s):  
Severe Obesity ◽  
Daily Life ◽  
Health Assessment ◽  
Group Iii ◽  
Daily Life Activities ◽  
Healthcare Needs ◽  
Group I ◽  
Degree Of Disability ◽  
Group Ii ◽  
Study Participants

Self-reported disability in performing daily life activities was assessed in adults with severe obesity (BMI ≥ 35 kg/m2) using the Health Assessment Questionnaire (HAQ). 262 participants were recruited into three BMI groups: Group I: 35–39.99 kg/m2; Group II: 40–44.99 kg/m2; Group III: ≥45.0 kg/m2. Progressively increasing HAQ scores were documented with higher BMI; Group I HAQ score: 0.125 (median) (range: 0–1.75); Group II HAQ score: 0.375 (0–2.5); Group III HAQ score: 0.75 (0–2.65) (Group III versus IIP<0.001; Group III versus IP<0.001; Group II versus IP=0.004). HAQ score strongly correlated with BMI and age. Nearly three-fourths of the study participants reported some degree of disability (HAQ score > 0). The prevalence of this degree of disability increased with increasing BMI and age. It also correlated to type 2 diabetes, metabolic syndrome, and clinical depression, but not to gender. Our data suggest that severe obesity is associated with self-reported disability in performing common daily life activities, with increasing degree of disability as BMI increases over 35 kg/m2. Functional assessment is crucial in obesity management, and establishing the disability profiles of obese patients is integral to both meet the specific healthcare needs of individuals and develop evidence-based public health programs, interventions, and priorities.

scholarly journals Trail without Catheter after Transurethral Resection of Prostate: Clamp It or Not?

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Vikash Talreja ◽  
Aun Ali ◽  
Summaya Saeed ◽  
Kiran Rani ◽  
Sunil Sadruddin Samnani ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Transurethral Resection ◽  
Foley Catheter ◽  
Tertiary Care ◽  
Transurethral Resection Of Prostate ◽  
Care Hospital ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Study Participants

Background.There has been argument between clinical practitioners about clamping catheter or not prior to its removal after transurethral resection of prostate (TURP). We conducted a clinical trial to assess whether clamping has any role in early bladder tone recovery particularly in patients who undergo TURP.Methods.Randomized clinical trial was conducted at a tertiary care hospital, Karachi from January 2014 to July 2015. Eighty-six study participants who underwent TURP were randomly allocated into two groups of 43 participants each. In Group I, patient’s Foley catheter was not clamped prior to its removal and in Group II Foley catheter was clamped. Data of all subjects were analyzed using SPSS version 20.Results.There was no significant difference in age and weight of resected tissues between two groups. Among 4 patients in Group I who required recatheterization, 1 patient was discharged with catheter as compared to Group II in which 2 patients were discharged with catheter (P=0.99). Only 1 patient (2.3%) in Group II had bleeding which required recatheterization. Length of stay was significantly affected by early and free removal of Foley catheter (P<0.001).Conclusion.The results of current study identified that clamping whether done or not had no significant impact on urinary retention.

scholarly journals Analysis of clinical profile, growth and developmental pattern of twin babies in a tertiary care hospital of central India

2018 ◽  
Vol 5 (3) ◽  
pp. 754
Author(s):  
Pawan K. Ghanghoriya ◽  
Avyact Agrawal ◽  
Uthara Mohan ◽  
Keerthi K. ◽  
Shivraj Singh
Keyword(s):  
Birth Weight ◽  
Growth Pattern ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Neurodevelopmental Outcome ◽  
Clinical Profile ◽  
Care Hospital ◽  
Group Iii ◽  
Group I ◽  
Increased Risk

Background: Twin birth is associated with increased risk of neonatal morbidity and mortality and disadvantages in growth and neurodevelopmental status than singletons. Objective of present study was to analyze the clinical profile, growth pattern and neurodevelopmental outcome of twin babies on follow up for 6 months corrected gestational age.Methods: A prospective observational study was done in a tertiary care NICU in 81 pairs of twins (162 neonates). Initial assessment in terms of morbidities and mortality was followed by growth pattern and neurodevelopmental assesment using DDSTII of survived infants upto 6 months corrected gestational age.Results: Prematurity was present in 75% of twin gestation. 95.1% were LBW, 4.9% were normal birthweight. 38.9% were AGA babies and 61.1% were SGA babies. Moderate to severe growth discordancy, was identified in 17.2% of the twins. Mortality was inversely proportional to birth weight and gestational maturity and directly proportional to birth weight discordance. Most of the complications were attributed to prematurity and low birth weight. RDS, hypoglycemia (16%), Perinatal asphyxia (19%), NEC, shock, hyperbilirubinemia were major complications. Feeding difficulties need special attention. Group I (28-32 weeks) lagged behind group I (32-37 weeks) and group III (>37weeks) in all anthropometric parameters like weight, height and head circumference at all the ages. Growth velocity was in the order group I (28-32 weeks) >group II (32-37) >group III (>37). At 6 months of there was high incidence of abnormal neurodevelopmental outcome among twins according to gestational age. Hypoglycemia, Perinatal asphyxia, RDS, and NEC were risk factors of NDD.Conclusions: There is higher incidence adverse outcomes in terms of morbidity, mortality, growth and development among twins.

scholarly journals Gastroesophageal reflux disease: Treatment options are beyond the proton pump inhibitors.

2020 ◽  
Vol 27 (07) ◽  
pp. 1401-1407
Author(s):  
Abdul Rabb Bhutto ◽  
Amanullah Abbasi ◽  
Sultan Ahmed Chandio ◽  
Aftab Ahmed Lolai ◽  
Muhammad Arsalan
Keyword(s):  
Proton Pump ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Tertiary Care ◽  
Female Gender ◽  
Care Hospital ◽  
College Hospital ◽  
Group Iii ◽  
Group I ◽  
Group Ii

Objectives: To observe the effects of different combinations of medicines in GERD patients by using FSSG score. Study Design: Observational Study. Setting: Al-Tibri Medical College Hospital, Isra University Karachi Campus Karachi. Period: June 2017 to December 2017. Material & Methods: The study was conducted on GERD patients at Tertiary Care Hospital of Karachi. Adult patients from male and female gender with clinical symptoms suggestive of GERD were included. During clinical history taking patients were interviewed to respond symptoms frequency of FSSG questionnaire score from 0 to 4 on each question. All 154 eligible patients enrolled in the study and divided into three groups Group I (PPI alone), Group II (PPI with prokinetic) and Group III (PPI, prokinetic and SSRI). After 2 weeks of treatment, FSSG score of every participant was calculated. Results: Results of 134 patients 72 (53.3%) males and 63 (46.7%) females were analyzed. The cumulative mean age was 37.12±8.221 (range 16 – 60) years. The patients were grouped by single blind randomization method, each group I and group II consisted of 45 subjects and 44 patients were enrolled in group III. The mean FSSG score prior to treatment and after treatment was 21.194±4.786 and 14.962±3.696 respectively, hence, the gradient of pre-treatment and post-treatment was 6.231±4.601. The three groups shown significant improvement in FSSG score after treatment but the group III had shown highest improvement in mean FSSG score of 7.522±3.592, followed by group II with 7.2889±3.805and group I had shown the lowest improvement of 3.911±5.346 but statistical analysis revealed these improvements within each group as insignificant while turned to be significant when groups were analyzed with each other. (p 0.003). Conclusion: The results of this study suggests that PPIs alone have good therapeutic role but as dysmotility aspect of GERD and psychological comorbidity is very common in those patients and is likely to play an important role in response, or failure of response, to proton pump inhibitor treatment. Hence, addition of prokinetic and anxiolytics can augment the response rate.

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