Medicine and Health Sciences Commons^™

Perception Of Non-Alcoholic Fatty Liver Disease: Real-Life Experience From Pakistan, Nazish Butt, Muhammad Ali Khan, Lajpat Rai, Riaz Hussain Channa, Hanisha Khemani, Amanullah Abbasi

Section of Gastroenterology

Introduction: Non-alcoholic fatty liver disease (NALFD) has become one of the most pervasive causes of hepatic pathology. Because of its marked association with metabolic syndrome, type II diabetes and cardiovascular disease, NAFLD has gained substantial focus recently. Its prevalence and incidence are on the rise in Pakistan. However, due to its indolent and mostly asymptomatic course, NAFLD is often overlooked. This reckless behavior towards a potentially deadly disease is influenced most notably by disinformation or flawed perception, although there are a number of other complex socioeconomic components to this as well. With respect to NAFLD, the gap between disease understanding …

Adenoma Detection Rate As A Quality Indicator For Colonoscopy: A Descriptive Cross-Sectional Study From A Tertiary Care Hospital In Pakistan, Mian Shah Yousaf, Shameel Shafqat, Roger Christopher Gill, Asfia Arham Khursheed, Om Parkash

Section of Gastroenterology

Background and study aims: Adenoma detection rate (ADR) is validated for measuring quality of colonoscopy, however there is lack of colorectal cancer (CRC) screening program in South Asia. The purpose of this study is to analyze and review the polyp detection rate (PDR) and ADR and provide insight into the factors that influence them in Pakistan.
Patients and methods: This retrospective, cross-sectional study was performed at the Aga Khan University Hospital, Karachi, Pakistan, on patients ≥ 18 years, who underwent colonoscopy between January 1, 2017 and June 30, 2018.
Results: Of 1985 patients, 59 % were male and 41 % …

Varied Presentation Of Celiac Disease In Pakistani Adults, Zaigham Abbas, Sajjad Raza, Javed Yakoob, Shahab Abid, Saeed Hamid, Hasnain Shah, Wasim Jafri

Section of Gastroenterology

he objective of this retrospective study was to evaluate presentation of celiac disease in adults. It included 77 patients, 41 (53.2%) males with median age 26 years and median body mass index of 18 (16 â�� 22) kg/m2. Typical presentation with gastrointestinal symptoms was seen in 76.6%. Atypical presentation with extra intestinal complaints in 7.8% and silent presentation in 15.6%. Major symptoms were diarrhea in 64.9%, weight loss 36.4%, abdominal pain 35.1%, vomiting 32.5%, pallor 24.7%, and weakness 13%. Iron deficiency was documented in 20.8%, B12 deficiency in 9.1%, folic acid deficiency in 6.5% and vitamin D deficiency in 10.4%. …

Changing Trends Of Hepatitis B Seromarkers Amongst Pakistani Population: A Laboratory-Based Review, Afia Zafar, Erum Khan, Muhammad Shoaib Khan, Bushra Moiz, Wasim Jafri

Section of Gastroenterology

Objective:

To study the changing trends of hepatitis B markers tested at Aga Khan University Hospital clinical laboratory according to the internationally recognised classification of hepatitis B profile.

Methods:

The retrospective study involved analysis of laboratory records of hepatitis B profiles of all patients collected from January 2001 to December 2008 at the Aga Khan University Hospital\'s clinical laboratory. Patients with complete profile tested were categorised according to the Centre for Diseases Control classification of hepatitis B profile. SPSS 16 was used for statistical analysis. R

Results:

A total of 185,825 patients had serological markers for hepatitis B tested. Mean-age …

Hepatocellular Carcinoma In Pakistan: Where Do We Stand?, Amna Butt, Zaigham Abbas, Wasim Jafri

Section of Gastroenterology

Context:

From the 1970s till the mid 1990s, hepatitis B was the most common etiological factor for hepatocellular carcinoma (HCC) in Pakistan. Afterwards, a shift in HCC etiology was observed with a steady rise in hepatitis C virus (HCV) related HCC cases. HCV-3a, which is the most prevalent genotype, is also most frequent in HCV related HCC. There was an increase in the proportion of non-B non-C (NBNC) HCC cases as well, which might be attributed to an increase in non-alcoholic fatty liver disease.

Evidence Acquisition:

The age-standardized rate for HCC is 7.64/100 000 in males and 2.8/100 000 in …

Irritable Bowel Syndrome And Psychiatric Disorders In Pakistan: A Case Control Study., Amna Subhan Butt, Mohammad Salih, Wasim Jafri, Javed Yakoob, Mohammad Wasay, Saeed Hamid

Section of Gastroenterology

Background:The psychiatric disorders like anxiety and depression could have a profound influence on onset, expression, and course of Irritable bowel syndrome (IBS). Aim: To estimate the frequency and strength of association of common mental disorders (CMDs) in Patients with IBS and Patients with other chronic diseases, that is, migraine and hypertension. Method: This was a case control study. Individuals aged 18-70 years diagnosed as IBS were enrolled as cases. The control groups consisted of Patients without IBS but diagnosed to have a chronic disease, that is, migraine or HTN. Self-Reporting Questonnaire-20(SRQ-20) was used as a screening tool for the …

Irritable Bowel Syndrome And Health Seeking Behaviour In Different Communities Of Pakistan, Wasim Jafri, Javed Yakoob, Nadim Jafri, Muhammad Islam, Qazi Masroor Ali

Section of Gastroenterology

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 …

Hepatitis B And C: Prevalence And Risk Factors Associated With Seropositivity Among Children In Karachi, Pakistan, Wasim Jafri, Nadim Jafri, Javed Yakoob, Muhammad Islam, Syed Farhan Ali Tirmizi, Tazeen Jafar, Saeed Akhtar, Saeed Hamid, Hasnain Ali Shah, Sheikh Qamaruddin Nizami

Section of Gastroenterology

Background

Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) can lead to chronic liver disease and hepato-cellular carcinoma (HCC). This cross-sectional study estimated the prevalence and identified risk factors associated with Hepatitis B surface antigen (HBsAg) and HCV antibody (anti-HCV) sero-positivity among children 1 to 15 years of age.

Methods

The study targeted the low to middle socioeconomic population that comprises 80% to 85% of the population. Consent was obtained from parents of the eligible children before administering questionnaire and collected a blood sample for anti-HCV and HBsAg serology.

Results

3533 children were screened for HBsAg and …

Role Of Rapid Urease Test And Histopathology In The Diagnosis Of Helicobacter Pylori Infection In A Developing Country, Javed Yakoob, Wasim Jafri, Shahab Abid, Zaigham Abbas, Saeed Hamid, Muhammad Islam, Kashif Anis, Hasnain Ali Shah, Hizbullah Shaikh

Section of Gastroenterology

Background

The aim of this study was to determine the effect of commonly self-prescribed proton pump inhibitors (PPI) on the results of rapid urease test and histology for the diagnosis of H. pylori infection.

Methods

One hundred-nine consecutive patients with dyspeptic symptoms attending the endoscopy suite were enrolled in this study. Antrum biopsy specimens were collected at endoscopy for the rapid urease test (Pronto Dry, Medical Instrument Corp, France) and histopathology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and like-hood ratio of a positive and negative of Pronto Dry test were compared against histology. The gold standard …

Candida Esophagitis: Risk Factors In Non-Hiv Population In Pakistan, Javed Yakoob, Wasim Jafri, Shahab Abid, Nadim Jafri, Muhammad Islam, Saeed Hamid, Hasnain Ali Shah, Akbar S. Hussainy

Section of Gastroenterology

AIM:

Candida esophagitis is a frequent infection in immunocompromised patients. This study was designed to determine its characteristics in non- human immune deficiency virus (HIV) infected patients attending a teaching hospital.

METHODS:

Clinical records of all patients coded by international classification of diseases 9th revision with clinical modifications' (ICD-9-CM), with candida esophagitis diagnosed by esophagogastroduodenoscopy (EGD) and histopathology over a period of 5 years were studied.

RESULTS:

Fifty-one patients (27 males, 24 females, range 21-77 years old and mean age 52.9 years) fulfilled the criteria (0.34% of the EGD). The common predisposing factors were carcinoma (OR 3.87, CI 1.00-14.99) and …

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 …