scholarly journals SPECTRUM OF HISTOPATHOLOGICAL PATTERNS OF DUODENAL BIOPSIES IN PATIENTS WITH UNEXPLAINED ANAEMIA AND CHRONIC DIARRHEA AND THEIR CORRELATION WITH ENDOSCOPIC FINDINGS AND SEROLOGICAL MARKERS

2021 ◽  
Vol 71 (5) ◽  
pp. 1893-96
Author(s):  
Muhammad Awais Yasin ◽  
Muhammad Asif Farooq ◽  
Nasir Uddin ◽  
Bushra Parveen ◽  
Asma Asghar ◽  
...  

Objective: To evaluate different histopathological patterns and correlate them with indications, findings of Esophagogastroduodenoscopy Esophago-gastro-duodenal (EGD) and serological markers in patients presenting of unexplained anemia and chronic diarrhea. Study Design: Cross sectional study. Place and Duration of Study: Departments of Pathology and Gastroenterology, Combined Military Hospital Lahore Pakistan, from Jul to Dec 2020. Methodology: Histopathological patterns of endoscopic duodenal biopsies, submitted for evaluation of unexplained anemia and chronic diarrhea were studied. Hemoglobin and anti-tTG levels were recorded. Adults with history of unexplained diarrhea and anaemia were included. Biopsies with malignant diagnosis or unfit for evaluation were excluded. Histopathological patterns were correlated with indications and findings of Esophagogastroduodenoscopy and serological markers of celiac disease. Results: The most common indication for Esophagogastroduodenoscopy in 145 patients was chronic diarrhea. Upper gastrointestinal endoscopy in 2/3rd of patients revealed no pathology. Histopathological patterns of duodenal biopsies revealed only 15% cases suggestive of celiac disease. Only 12 patients were suggestive of celiac disease both on Esophagogastroduodenoscopy and histopathology combined. Half of patients with anti tTG level >100 u/ml, showed histopathological features of celiac disease on. There was no correlation between histopathological patterns, indications of Esophagogastroduodenoscopy, morphology of Esophagogastroduodenoscopy and serological markers of celiac disease. Conclusion: Indications for Esophagogastroduodenoscopy, Esophagogastroduodenoscopic findings and histopathological patterns cannot diagnose celiac disease alone.

2021 ◽  
Vol 16 (2) ◽  
pp. 40-43
Author(s):  
Md Shirajul Islam Khan ◽  
Hossain Md Emran ◽  
ATM Rezaul Karim

Introduction: Herpes zoster (HZ) is characterized by an extremely painful vesicular rash, which may be complicated by secondary infection and post-herpetic neuralgia. To date, multiple risk factors associated with HZ have been established, including endocrine diseases, immunosuppressive conditions, cancers, and other chronic medical conditions. Objectives: To assess the profile of herpes zoster associated with co-morbid condition. Methods and Materials: This cross sectional study was conducted among purposively selected 130 HZ patients in the department of Dermatology and Venereology, Combined Military Hospital (CMH) Dhaka from January 2017 to December 2018. Data were collected through face to face interview using pretested semi-structured questionnaire. Results: Out of 130 patients, majority of the patients were male (69.2%) and mean age was 53.5±9.8 years and majority gave the history of chicken pox 60% and common site of involvement were chest (right and left) 33.1% and 48.5%, upper back (right and left) 30.8% and 43.1% and upper right arm 33.1%. About 66.9% patients gave the history of having co-morbid condition like Diabetes 30.8%, Stroke 9.2%, Hypertension 2.3%, Myocardial infarction 3.8%, Peptic ulcer disease 10.0%, Malignancy 2.3%, Tuberculosis 2.3% and Irritable bowel syndrome 2.3%. Conclusion: Based on our study finding, we can conclude that herpes zoster is a disease that is associated with other co-morbid conditions. If herpes zoster is an early manifestation of undiagnosed co-morbid condition, patients should undergo testing for undiagnosed disease when they present with herpes zoster. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 40-43


2021 ◽  
Vol 71 (6) ◽  
pp. 2057-60
Author(s):  
Irfan Khattak ◽  
Samina Naseem Khattak ◽  
Ayesha Imran ◽  
Khawar Kamal ◽  
Umairah Yaqoob

Objective: To determine the frequency of Pregnancy-related acute kidney injury in the Pakistani population and its effect on maternal health. Study Design: Cross-sectional study. Place and Duration of the Study: Department of Nephrology and Obstetrics and Gynecology, Combined Military Hospital Kharian, from Jan 2018 to Dec 2020. Methodology: All pregnant women with normal renal functions at the time of enrolment in the study and no previous history of any kidney disease or renal procedure in the recent past (at least 3 months) before conception were included in our study at Combined Military Hospital Kharian. All participants had serum creatinine tested at enrolment and were inquired specifically about any history of renal disease or any renal procedure in the recent past (at least 3 months old). Results: Mean maternal age in the study was 29 ± 7.67 years however it ranged from 16-41 years. Around a quarter of acute kidney injury cases occurred in the first and second trimesters combined, with 26 (12%) and 24 (11%) cases in the first and second trimesters, respectively. Thirty percent of acute kidney injury cases were diagnosed in the third trimester. A substantial number 58 (27%) of cases developed azotemia which persisted beyond three months and developed chronic kidney disease of various stages. Regarding maternal outcomes, 166 (77%) mothers recovered completely. However, 43 (20%) patients had some degree pf azotemia, a few cases required permanent renal replacement therapy. Conclusion: Acute kidney injury is a common problem in our community leading to suboptimal maternal outcomes..............


2015 ◽  
Vol 22 (01) ◽  
pp. 072-075
Author(s):  
Sana Zulfiqar ◽  
Amin Fahim ◽  
Aneela Qureshi ◽  
Sadia Adnan ◽  
Shomail Saeed Siddiqui ◽  
...  

Objective: To find out the Modified Marsh type of celiac disease (CD)patients on histopathological examination of duodenal (D2) biopsies and to correlate it withtissue transglutaminase IgA levels. Study Design: Cross sectional study. Place of Study:Histopathology laboratory (Department of Pathology), Isra University Hospital and AsianInstitute of Medical Sciences (AIMS), Hyderabad. Duration of Study: July 2013 to December2013. Materials and Methods: 96 patients with a history of malabsorption or atypical symptomswith clinical suspicion of CD were subjected to endoscopy. Endoscopic duodenal (D2) biopsieswere taken regardless of age and gender. D2 biopsies were processed for histopathologicalexamination under light microscopy. Results: Out of 96 patients, 45 (46.9%) patients hadmoderate type of lamina propria inflammation along with highly significant p-value (0.0001).CDtype 3a was observed in 34 patients (35.4%). In this study the comparison of serological level oftissue Transglutaminase IgA (tTGA) and histological severity revealed significant correlation. AllModified Marsh types of CD with tTGA level seen in our study were highly significant (p-value0.001). Conclusion: In this study strong correlation was observed between the serologicaltTGA level and histological findings by Modified Marsh classification along with lamina propriainflammation of duodenal mucosa in CD patients.


Author(s):  
Omar Ahmed Ismael Al-dossary ◽  
Redhwan A. Ahmed ◽  
Khaled Abdulkareem A Al-Moyed ◽  
Azhar Azher Mohammed Al-Ankoshy ◽  
Mohammed Mohammed Ali Al-Najhi ◽  
...  

Background and objectives: Celiac disease is a long-standing autoimmune illness that principally affects the small intestine. Typical symptoms comprise digestive problems such as chronic diarrhea, flatulence, malabsorption, loss of appetite, and failure of children to grow normally. The prevalence of celiac disease has not been established in Yemen, either in the general population or in symptomatic patients. Therefore, the current study aimed to assess the prevalence of disease in symptomatic patients and to investigate associated symptoms and signs; and whether prevalence of CD varies greatly between different ages and genders in a hospital in Sana'a.  Methods: A cross sectional study based on the results of serological markers; IgA anti-tissue glutaminase and small bowel biopsies of 600 patients with gastrointestinal symptoms who were all patients who attended in the research period. Data were collected from hospital records during the period from March 2014 to December 2018. 600 suspected patients (245 males and 355 females) were subjects and the mean age of ±SD patients was 30.6±14.5 years (range 2-92 years). Results: The prevalence of CD among patients with gastrointestinal symptoms was 9.2%. There was a significant association between CD with females (rate being 11.3% , OR=1.9, p=0.03), and  2-19 years age group (21.4% , OR=4.3, p<0.001), Considering the clinical signs and symptoms there was a significant association between celiac disease and chronic diarrhea (OR=18.4), steatorrhea ( OR=9.6), foul odor (OR=8.3), weight loss (OR=5.7), anemia (OR=10.2), abdominal distension (OR=3.1), mouth ulcers (OR=7.2), abdominal bleeding (OR=13.5), diabetes mellitus I  (OR=18), and hypothyroidism (OR=79.3). Conclusion: A high rate of CD was identified among gastrointestinal symptoms patients arriving at the general hospital in Sana’a, Yemen, and this demonstrates the importance of general practitioners in identifying patients with CD, especially in the absence of a medical facility for CD, and this was facilitated through the serological markers test.                     Peer Review History: Received: 11 September 2021; Revised: 12 October; Accepted: 29 October, Available online: 15 November 2021 Academic Editor:  Ahmad Najib, Universitas Muslim Indonesia,  Indones UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Dr. Gulam Mohammed Husain, National Research Institute of Unani Medicine for Skin Disorders, Hyderabad, India, [email protected] Dr. Vanina Doris Edo’o, University of Yaounde I, Yaounde, Cameroun, [email protected] Similar Articles: THE ASSOCIATION OF ADULT MALE AND FEMALE INFERTILITY WITH CELIAC DISEASE PATIENTS IN YEMEN


2021 ◽  
Vol 71 (2) ◽  
pp. 567-70
Author(s):  
Safia Batool ◽  
Muhammad Usman Sajid ◽  
Jamal Waris ◽  
Shahzeb Ahmed Satti ◽  
Fayyaz Hassan ◽  
...  

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..................


2016 ◽  
Vol 12 (1) ◽  
pp. 83-87
Author(s):  
Syeda Zeenat Laila ◽  
Anjuman Ara Beauty ◽  
Md Mahboob Hasan ◽  
Md Mizanur Rahman Khan

Introduction: Infantile colic is defined as excessive crying for more than three hours a day at least three days a week for one week or more in an otherwise healthy baby. It is most frequently observed in neonates and infants aged two weeks to four months. Objective: To assess the incidence of infantile colic and effectiveness of conventional therapy. Materials and Methods: This was a prospective cross sectional study of 50 cases carried out in Paediatric out patient department in Combined Military Hospital (CMH) Ghatail during the period of September 2010 to August 2012. Data recorded including demographics, clinical presentations, management and the outcome of therapy. Results: Out of the total 50 patients, 24(48%) were male and 26(52%) were female. Male:Female=1:1.08. Babies delivered vaginally suffered more 32(64%), full term delevered babies 33 (66%) suffered more than that of gestational age group <37 wk. Non-exclusive Breastfed (Formula fed, combination of breastfed and formula fed) babies having more incidence of colic 31(62%). Maximum patients 26(52%) had history of cry 4-5 hours per day. Motion (Rocking, bouncing, walking etc) 18(36%), change of diet 14(28%) were considerable satisfactory treatments. Conclusion: Since it is a self limiting condition, conventional therapy should be tried for instant relief. Journal of Armed Forces Medical College Bangladesh Vol.12(1) 2016: 83-87


2021 ◽  
Vol 14 (4) ◽  
pp. 176-179
Author(s):  
Mohammad Ahmed Saifullah ◽  
Amer Ahmad Khan ◽  
Sarmad Zahoor ◽  
Sidra Saif ◽  
Javed Sajjad Hashmi ◽  
...  

Background: Many studies have been conducted worldwide to evaluate the proportion of patients with Celiac disease (CD) in persons presenting with Irritable Bowel Syndrome (IBS), showing a positive association between the two diseases. However, reports from Pakistan remain scanty. This study aims to find out the prevalence of CD in patients presenting with IBS and to establish the correlation of both diseases. Patients and methods: It was a descriptive cross-sectional study conducted at Combined Military Hospital, Lahore (CMHL) from January 2018 till March 2019. Consecutive, nonprobability sampling was used to include 210 patients of both genders with the age range of 15-65 years fulfilling ROME IV criteria and were not previously diagnosed as CD or CKD or CLD. Demographic data was noted. Serum Anti tTG levels and Duodenal Biopsy from the second part was assessed to diagnose CD. CD was labeled if the disease was present on both serological and Histopathological reports. Data were analyzed by using SPSS version 20. Descriptive statistics were calculated and a Chi-square test was used to compare the outcome variables with P-value < 0.05 as significant. Results: Of 210 enrolled patients, 113 (53, 8%) were male and 97 (46.2%) were female. The mean age of the patients was 28.40 ± 5.06 years. Eight patients (3.8%) were positive for Anti tTg and on histopathological findings suggestive of CD. Seven of 8 were less than 35 years old. Out of 8 positive patients, 6 (75%) were females. However, the p-value was found to be insignificant for age (0.549) and gender (0.096). On stratification with respect to duration of IBS, all 8 patients diagnosed with celiac disease were having symptoms of IBS for less than 12 months (100%) which was significant statistically (7.1% vs 0.0%; p=0.007). Conclusion: The frequency of CD was 3.8% among IBS patients. Considering this percentage of CD in IBS patients s, a high index of suspicion for CD in IBS patients is required,


2021 ◽  
Vol 71 (6) ◽  
pp. 2180-83
Author(s):  
Muhammad Hasan Saleem ◽  
Shazia Nisar ◽  
Muhammad Zulqurnain Saleem ◽  
Husnain Saleem ◽  
Shoaib Mukhtar ◽  
...  

Objective: To assess the increased frequency of serum C-peptide levels in patients of colorectal carcinoma. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jul 2018 to Jan 2019. Methodology: A total of 100 cases of colorectal carcinoma were enrolled. Blood samples were obtained to assess C-peptide level. The C-peptide serum concentrations were deliberate through the Cobas 6000 by using the electro-chemi-luminescence immunoassay (ECLIA) method. If level of C-peptide was >2 pmol/mL, then it was noted. Results: The mean age of all patients was 58.3 ± 5.4 years. There was a total of 136 (68%) females and 64 (32%) were males. The mean BMI of patients was 28.96 ± 12.31 kg/m2. The family history of colorectal carcinoma was positive in 6 (6%) cases. The mean C-peptide level was 4.55 ± 2.37 pmol/L. There were 33 (33%) patients with raised C-peptide level while 67 (67%) had normal c-peptide level. Conclusion: It is concluded that increased C-peptide level is high in patients with colorectal cancer.


2008 ◽  
Vol 15 (04) ◽  
pp. 479-485
Author(s):  
RAFI UD DIN ◽  
MANZAR ZAKARIA ◽  
MUJEEB-UR-REHMAN ABID BUTT

Objective: To determine the frequency of large bowel causes of chronic diarrhea in adult Pakistani patients. StudyDesign: Cross sectional study. Setting: Medical unit 1 at Combined Military Hospital Lahore, Pakistan. Duration: Six months (from 01-11-2007 to 30-4-2008). Subjects and Methods: Fifty adult patients with chronic diarrhea, irrespective of their gender were selected by nonprobability convenient sampling. Patients already diagnosed with diseases known to cause diarrhea and those with toxic mega colon wereexcluded from the study. All patients were subjected to fiberoptic colonoscopy and findings were recorded. Biopsies were taken fromsuspected lesions or from normal looking mucosa. Diagnosis was made with colonoscopic and histopathologic findings. Results: Thirty two(64%) patients had abnormal findings visible on colonoscopy. Histopathology was normal in 18 (36%). Twenty (40%) patients hadulcerative colitis, seventeen (34%) had IBS, five (10%) had CA colon and three (6%) patients had crohn’s disease. Other diagnosesincluded non specific colitis, tubulovillous adenoma and infection. Twenty three out of 24 patients (95%) who had blood in stools had avisible abnormality on colonoscopy whereas colonoscopy was positive in only 33% of patients who did not have blood in stools.Conclusion: Most causes of large gut chronic diarrhea can be identified by colonoscopy and biopsy. Colonoscopy has a very high yield inchronic diarrhea and should be recommended for its work up. Its yield is even higher in patients with bloody diarrhea.


Crisis ◽  
2020 ◽  
pp. 1-6
Author(s):  
Mohammed Madadin ◽  
Ritesh G. Menezes ◽  
Maha A. Alassaf ◽  
Abdulaziz M. Almulhim ◽  
Mahdi S. Abumadini ◽  
...  

Abstract. Background: Medical students are at high risk of suicidal ideation. Aim: We aimed to obtain information on suicidal ideation among medical students in Dammam located in the Eastern Province of Saudi Arabia. Method: This cross-sectional study was conducted at the College of Medicine affiliated with Imam Abdulrahman Bin Faisal University in the Eastern Province of Saudi Arabia. Suicidal ideation in the past 12 months was assessed based on responses to four questions in the depression subscale of the General Health Questionnaire 28 (GHQ-28). In addition, data were collected to examine the association of suicidal ideation with various factors. Results: We found that 1 in 3 medical students in the study had suicidal ideation in the past 12 months, while around 40% had lifetime suicidal ideation. Suicidal ideation was associated with feelings of parental neglect, history of physical abuse, and dissatisfaction with academic performance. Limitations: The cross-sectional nature of this study limits its ability to determine causality regarding suicidal ideation. Conclusion: These rates are considerably high when compared with rates from studies in other countries around the world. This study provides a reference in the field of suicidology for this region of Saudi Arabia.


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