Medicine and Health Sciences Commons^™

Efficacy Of Octreotide In Diarrhoea Due To Vibrio Cholerae: A Randomized, Controlled Trial, Z Abbas, I Moid, A H. Khan, S M. Jafri, S H. Shah, S Abid, S Hamid

Section of Gastroenterology

Although octreotide, a long-acting analogue of somatostatin, is currently used in the treatment of chronic secretory diarrhoea due to various causes, its role in the management of acute secretory diarrhoea is not well established. In the present study, therefore, the therapeutic value of octreotide in the management of cholera, a classical example of acute secretory diarrhoea, was investigated. During an outbreak of cholera, patients admitted with acute secretory diarrhoea of < or = 24 h duration and a purging rate > 100 ml/h were enrolled on the study and randomly assigned to octreotide (N = 17) and control (N = 16) groups. All 33 patients received intravenous fluid replacement and antibiotic …

Fulminant Hepatic Failure In Pregnant Women: Acute Fatty Liver Or Acute Viral Hepatitis?, S S. Hamid, S M. Jafri, H Khan, H Shah, Z Abbas, H Fields

Section of Gastroenterology

Background: Hepatitis E virus, which is endemic in our region, can cause severe liver dysfunction in pregnant women and this can be clinically confused with acute fatty liver of pregnancy.

Methods: We studied the clinical and laboratory data as well as the maternal and fetal outcomes of 12 pregnant women presenting with fulminant hepatic failure in order to determine the etiology of the disease. The clinical diagnoses were subsequently correlated with serologic assays for acute HEV infection. All patients were severely ill with deep jaundice, grade 3-4 encephalopathy and abnormal prothrombin times.

Results: A clinical diagnosis of acute viral …

Community Acquired And Post-Transfusion Hepatitis C "Is There A Difference?", A R. Qureshi, S Hamid, W Jafri, F Ejaz, H Shah, Z Abbas, S Abid, H Khan

Section of Gastroenterology

We analyzed 77 consecutive hepatitis C antibody positive patients to compare the history, laboratory data and histological features of community acquired (CA) and post-transfusion (PT) hepatitis C. Forty-six patients had "CA" and 31 "PT" hepatitis C. Mean age in both groups was same (45.67 vs 46 years). Male to female ratio was 2:1 in the CA group and 1:2.4 in the PT group. Mean duration between jaundice and first presentation was 8.9 years in the CA group and the mean duration between transfusion and first presentation was 9.8 years in PT group. No significant difference was found between two groups …

A Young Boy With Abdominal Pain, A Jabbar, A Afaq, W Jafri, M Siddiqi, M Ahmed, S Hasan

Section of Gastroenterology

At times, acute diffuse abdominal pain can be a diagnostic dilemma, especially when the symptoms appear to be out of proportion to the findings on physical examination. The case of a young boy with abdominal pain is presented.

A Change Of Il-2 And Il-4 Production In Patients With Helicobactor Pylori Infection, X. G. Fan, Javed Yakoob, X. J. Fan, P. W. N. Keeling

Section of Gastroenterology

Helicobactor pylori is the most common cause of gastroduodenal inflammation. However, the exact immune pathogenesis is not fully understood. To look for evidence of the immunological mechanism in H. pylori associated disease, we measured cytokine interleukin-2 (IL-2) and IL-4 levels produced by peripheral blood lymphocytes (PBL) and gastric biopsies in 20 subjects with or without H. pylori infection. H. pylori can stimulate IL-2 and IL-4 production from PBL in H. pylori negative as well as H. pylori positive individuals. The spontaneous IL-2 production by PBL and gastric biopsies was greater (p < 0.0025, <0.001)in H. pylori negative individuals than that in H. pylori infected patients. Increased IL-4 levels from PBL in H. pylori infected patients were found in the presence of H. pylori (p < 0.0025). An increased spontaneous production of IL-4 from gastric biopsies was also observed in H. pylori infected patients (p < 0.025). In conclusion, an enhanced type 2 cytokine production was observed in H. pylori infected patients, which may be responsible for H. pylori chronic infection.

Cholera Admissions In Adults 1989-1994: A Hospital Based Study, Z Abbas, S M. Jafri, S Abid, H Khan

Section of Gastroenterology

In order to gain insight into the distribution of cholera over the years and proportion of monthly admissions under our adult medical services, we scrutinized our records of hospital discharges between 1989 and 1994. Only culture positive cases were included. Each year most of the cases of cholera are admitted between May and November with almost disease free interval from December to April. In 1992 admission rate was 4.24/1000 medical admissions which increased to 12.65 in 1993 and 13.73 in 1994. Though the Vibrio cholerae 01 Ogawa was the major isolate upto May, 1993, Vibrio cholerae non-01 serogroup 0139 dominated …

Dysplasia And Surveillance In Ulcerative Colitis, S M. Jafri

Section of Gastroenterology

No abstract provided.

Microscopic Colitis: A Diagnosis To Consider, S Hamid, W Jafri, Z Abbas, H Shah, S Abid, H Sheikh, A Hussainy, H Khan

Section of Gastroenterology

Microscopic colitis is a syndrome of chronic watery diarrhoea for which no cause can be identified other than the presence of diffuse, chronic inflammation in the lamina propria on colonic biopsy. Endoscopically and radiologically the colon appears normal. We studied case records of 215 patients presenting to our institution over a three year period with chronic diarrhoea. Nineteen patients were included in the study where two pathologists agreed on the presence of chronic inflammation on colonic biopsies. All patients had watery diarrhoea with urgency. Stool examination, laboratory indices, radiology of the large and small bowel and colonoscopy were normal in …

Sequential Induction Of Aplastic Anemia And Acute Leukemia By Chloramphenicol, Z Abbas, I Malik, A Khan

Section of Gastroenterology

No abstract provided.

Lymphoma Complicating Ulcerative Colitis, S H. Shah, A H. Khan, H Shaikh, A Ahmed

Section of Gastroenterology

No abstract provided.

Omeprazole In Short Term Treatment Of Reflux Oesophagitis, W Jafri, Z Abbas, S Hamid, S Abid, H Shah, H Khan

Section of Gastroenterology

No abstract provided.

Yoghurt (Dahi): A Probiotic And Therapeutic View, Z Abbas, W Jafri

Section of Gastroenterology

No abstract provided.

Randomised Comparison Of Oral Ofloxacin Alone With Combination Of Parenteral Antibiotics In Neutropenic Febrile Patients, I A. Malik, Z Abbas, M Karim

Section of Gastroenterology

Prompt treatment with empirical antibiotics in neutropenic febrile patients reduces morbidity and mortality. Most patients have been treated with parenteral combination antibiotics, but newer antibiotics with broad-spectrum bactericidal activity have made monotherapy feasible. Ofloxacin, a broad-spectrum fluoroquinolone, has the additional advantage that bactericidal concentrations can be achieved with oral administration. We have compared ofloxacin as an oral single agent with standard parenteral combination antibiotics for the management of neutropenic febrile patients in a prospective, randomised trial. Patients with severe neutropenia (absolute neutrophil count less than or equal to 0.5 x 10(9)/l), fever above 38 degrees C, and ability to take …

Prevention Of First Variceal Bleeding: New Prospects, S Hamid, W Jafri

Section of Gastroenterology

No abstract provided.

Eosinophilic Gastroenteritis, S H. Shah, Z Abbas, S Abid, H Shaikh, T Qaseem, H Khan

Section of Gastroenterology

No abstract provided.

Supervised Training Of Practical Procedures In The Internal Medicine Residency, Z Abbas, S Abid, J A. Khan, A Jabbar

Section of Gastroenterology

In order to get feedback whether the medical residents are getting adequate supervised training to perform practical procedures, a questionnaire was distributed among the residents asking their involvement in sixteen frequently performed procedures in the medical unit of the Aga Khan University Medical Centre. Though the residents were satisfied about their training in doing lumbar punctures, pleural and peritoneal aspirations, bone marrow aspiration and trephine and chest tubes placement, they showed their concern about training in putting central lines, venous cut downs, cardiac pacing and biopsies. A better schedule training programme, organized subspecialty rotation, continuous evaluation of resident's skill, credentialing …

Yet Another Cause Of Chronic Viral Hepatitis?, H A. Shah, S Abid, S Hamid, S W. Jafri, Z Abbas, T Qaseem, H Shaikh, A H. Khan

Section of Gastroenterology

The clinical features, course and histology of liver in 20 patients; mostly middle aged to elderly females, closely resembling chronic Non A Non B hepatitis is presented. They presented quite late in their disease and therefore, complications such as variceal bleeds, ascites and encephalopathy were frequent. Our patients were negative for hepatitis B and C virus serology. Metabolic and immune causes of chronic liver disease were also ruled out. To the best of our knowledge, this is the first study of its kind elaborating the clinical features, course and histology of liver in chronic Non B Non C hepatitis and …

Collagenous Colitis, Z Abbas, S Abid, S Hamid, W Jafri, H Khan

Section of Gastroenterology

No abstract provided.

Epidemic Non-A Non-B Hepatitis In Urban Karachi, Pakistan, R A Jr Smego, A A. Khaliq

Section of Gastroenterology

An outbreak of icteric non-A non-B (NANB) hepatitis occurred in a residential community of urban Karachi, Pakistan, from August 1986 through October 1986. Of the 114 cases reported from this community during the 1986 calendar year, a clustering of 85 cases was seen during the above period. Twenty-seven percent of 226 households and 9% of 1,250 individuals were affected. Five persons were hospitalized and 1 death occurred in a young pregnant woman. Cases occurred predominantly in the less than or equal to 29-year-old age group (72%), with a male:female ratio of 1.8:1. Thirty-four cases occurred singly within households, while in …