farrukh saeed - Academia.edu (original) (raw)

Papers by farrukh saeed

DOAJ: Directory of Open Access Journals - DOAJ, Oct 30, 2020

PAFMJ, 2021

Objective: To study the role of gastrointestinal procedures, namely oesophago-gastroduodenoscopy ... more Objective: To study the role of gastrointestinal procedures, namely oesophago-gastroduodenoscopy (OGD) and colonoscopy, in helping to establish a definitive primary tumour site in cancer of unknown primary. Study Design: Prospective observational study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore Pakistan, from Jan 2018 to Jan 2019. Methodology: A total of 115 patients included in the study were those, who underwent OGD and a colonoscopy for the diagnosis of a cancer of unknown primary. Data collected included demographics, baseline clinical characteristics, definitive diagnosis, tissue diagnosis and immune-histochemical stains. Primary outcome was the attainment of a definitive diagnosis via OGD and/or colonoscopy. Results: A total of 115 patients underwent a diagnostic gastrointestinal procedure. Of these 70 (61%) were males. Mean age was 63 ± 12.6 years (range 22-88 years). Abdominal pain comprised the most common presenting comp...

Objective: To assess association of pretreatment liver histology with serum Alanine aminotrasfera... more Objective: To assess association of pretreatment liver histology with serum Alanine aminotrasferase (ALT) level and Body Mass Index (BMI) in HCV positive patients. Material and Methods: A prospective study conducted at Pathology and Gastroenterology Departments of CMH Peshawar from June 2007 to December 2008 included 100 adult HCV RNA positive patients. Percutaneous liver biopsy was performed and analyzed for necroinflammation, fibrosis and steatosis. The observations were recorded and analyzed by using SPSS 13. Results: Fifty-four male and 46 female subjects between ages of 13-70 years were included in the study. 66% patients had ALT levels of 42-89 IU/L, 74.2% had grade II disease, 12.1% grade III disease. 34% patients had ALT levels of > 90 IU/L. 56% had grade II & 38.2% grade III disease. Correlation of ALT with disease grade was significant, P value 0.029. Association of ALT with disease stage was not significant, P value 0.139. Fifty-six percent of obese patients had elevat...

Pakistan Armed Forces Medical Journal, 2019

Objectives: To find the relative frequencies of different diseases causing dyspepsia, and to iden... more Objectives: To find the relative frequencies of different diseases causing dyspepsia, and to identify different diseases according to age. Study Design: Prospective cross-sectional study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan 2017 to Oct 2017. Material and Methods: Patients of age 18 to 80 years with dyspepsia non-responding or refractory to empiric therapy or those with alarm features were offered upper-gastrointestinal-endoscopy as per standard protocol and the results were recorded. Results: A total of 667 patients with 65% males and 35% females were enrolled. Normal endoscopy was reported in 58.8% patients with 35% males and 24% females (total=667), whereas abnormal findings accounted to 41.2% patients with 30% males and 11.2% females. Mixed symptoms were the commonest complaint (75%). The median age group was 41-50 years with median symptom duration of 1 <2 years for abnormaland normal endoscopic find...

Pakistan Armed Forces Medical Journal, 2019

Objective: To determine the important clinical features at the initial presentation of Hepatocell... more Objective: To determine the important clinical features at the initial presentation of Hepatocellular carcinoma and the treatments offered thereby. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi, from Jan 2017 to Dec 2017. Methodology: A total of 157 patients were studied. Their history, examination and relevant investigations were carried out at initial presentation to find all required details including age, gender, etiology of HCC, number and size of hepatic lesions, Child Pugh class, performance status, BCLC scoring, vascular invasion of tumor, lymph nodal involvement and metastasis; at time of diagnosis of hepatocellular carcinoma. Treatment was offered based on all these parameters, as per latest AASLD guidelines. Data were entered in SPSS version 24 for statistical analysis. Results: Of the total 157 patients, 117 (75%) were males and 40 (25%) were females. Mean age was 60.4 ± 8.67 y...

PAFMJ, 2021

Objective: To assess the severity of ulcerative colitis on first colonoscopic examination. Study ... more Objective: To assess the severity of ulcerative colitis on first colonoscopic examination. Study Design: Prospective cross-sectional (correlational) study design. Place and Duration of Study: Study was conducted in Gastroenterology Outpatient Department of Pak Emirates Military Hospital, Rawalpindi, from Nov 2017 to Oct 2018. Methodology: An aggregate of 200 patients within the age range of 12-70 years, were included in the studythrough non-probability consecutive sampling. The data was collected by the self-administered questionnaireincluding age, gender, stool frequency, P/R bleed, systemic features of ulcerative colitis & colonoscopic findings.Effectiveness of the procedures was noted on a pre-designed performa and the endoscopic assessment was based upon mayo score severity of colitis graded from Normal (0) to Severe (3). Data was analyzed by using SPSS-19. Results: The mean age of the participants was reported 38 ± 2.1 years. Out of 200 participants 104 (52%) weremale, diarrhea...

doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by pee... more doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.

Reactions, 1986

A rare case of halothane-induced fulminant hepatic failure is reported in a 22 years old male, wh... more A rare case of halothane-induced fulminant hepatic failure is reported in a 22 years old male, who developed fever, jaundice, coma and deranged coagulation profile, 2 days after undergoing laparotomy under halothane anaesthesia. Despite all supportive care, he died of fulminant hepatic failure, 6 days after surgery. Postmortem liver biopsy revealed massive predominantly centrilobular hepatic necrosis.

Journal of the College of Physicians and Surgeons--Pakistan: JCPSP

Objective: To measure the effects of awareness campaign on the frequency of EDTA contamination. S... more Objective: To measure the effects of awareness campaign on the frequency of EDTA contamination. Study Design: A cohort study. Place and Duration of Study: The study was carried out in Combined Military Hospital, Peshawar, from October to December 2008. Methodology: A cohort of 200 doctors, nurses and paramedical staff involved in sample collection for laboratory investigations were selected for this three phased study. In all samples with plasma potassim level > 6.0 mmol/L, plasma Ca was measured for one month before, during and after a campaign of correct filling order of sample tubes for two weeks. Renal function test and LDH were also measured to rule out chronic renal failure and in-vitro haemolysis, respectively. Fisher’s exact test was used for comparison of frequency of hyperhalemia. Results: There was a significant decrease (75%, p < 0.01) in the cases of spurious hyperkalaemia and hypocalcaemia. Conclusion: EDTA contamination is a common and important source of pre-an...

JPMA. The Journal of the Pakistan Medical Association, 2014

Budd Chiari syndrome (BCS) is a heterogeneous group of disorders characterized by hepatic venous ... more Budd Chiari syndrome (BCS) is a heterogeneous group of disorders characterized by hepatic venous outflow obstruction at any level from the small hepatic veins to the atrio cava junction. BCS could have serious consequences if not treated promptly. Comprehensive angiographic studies, computerised tomography, liver ultrasonography, histology and pathologic analyses are essential for establishing the disease severity, stratifying risk factors, choosing the appropriate therapy and objectively assessing the response. The main objective of therapy is to alleviate portal and IVC hypertension. Here we present a report of a young man with BCS who underwent mesocaval shunt. The eight months follow up showed that patient was free of symptoms and duplex scans confirmed the patency of the shunt.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2007

Minimally invasive, image guided radiofrequency ablation RFA now provides an effective local trea... more Minimally invasive, image guided radiofrequency ablation RFA now provides an effective local treatment of isolated or localized neoplastic diseases, and is also being used as an adjunct to conventional surgery, systemic chemotherapy or radiation. It is now the front line treatment in unresectable hepatocellular carcinoma and its use in other neoplastic diseases continues to expand. This update introduces the technique to alleviate inoperable tumours and application of RFA in therapeutic imaging.

PAFMJ

Objective: To assess the non-invasive biomarkers of fibrosis for predicting varices-needing-treat... more Objective: To assess the non-invasive biomarkers of fibrosis for predicting varices-needing-treatment in patients with cirrhosis secondary to chronic-hepatitis-C. Study Design: Cross sectional comparative study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan 2017 to Dec 2017. Methodology: A total of 153 patients aged 18-79 with cirrhosis, whether compensated or decompensated, secondary to chronic-hepatitis-C were enrolled. Relevant serum tests were used to calculate non-invasive fibrosis indices and their diagnostic performance to predict the presence of varices and varices-needing-treatment was calculated. Results: King’s score showed the best performance in detecting varices due to high positive predictive value of 96.4% and positive likelihood ratio of 2.4. Overall, all the non-invasive fibrosis indices exhibited good performance with positive predictive value >85% but none could rule out the presence of varices...

PAFMJ, 2021

Objective: To assess the adherence to antivirals in Hepatitis B Virus (HBV) infected patients and... more Objective: To assess the adherence to antivirals in Hepatitis B Virus (HBV) infected patients and to determine various social and demographic factors which can have an impact on it. Study Design: Cross- sectional study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan to Mar 2019. Methodology: Patients on oral anti-viral agents for hepatitis B virus infection were enrolled from outdoor clinics using consecutive sampling technique. Medication adherence was assessed using the 4-item Modified Morisky Score Questionnaire. Data was also collected about different variables that could potentially affect compliance, such as age, gender, education, residence, total number of pills prescribed for each day, travelling time to hospital, attendant’s company, adverse effects of treatment, presence of co-morbid conditions, patients’ knowledge regarding importance of adherence and whether they followed any particular routine in taking ...

DOAJ: Directory of Open Access Journals - DOAJ, Oct 1, 2020

PAFMJ, 2021

Objective: To find out the underlying causes of chronic diarrhea in soldiers and how it differs f... more Objective: To find out the underlying causes of chronic diarrhea in soldiers and how it differs from general population. Study Design: Prospective comparative study. Place and Duration of Study: Combined Military Hospital (CMH) Multan and Pak Emeritus Military Hospital (PEMH) Rawalpindi, from Dec 2017 to Jan 2020. Methodology: All soldiers in active service, having diarrhea more than 4 weeks in study and non-soldiers of the same age were included in the control group. There were inquired in details about the diarrhea symptoms and investigations carried out accordingly to find out the underlying cause. The two groups were compared to find out any differences. The data were analyzed by SPSS version 22. Results: Seventy one in study and 50 patients in control had their mean ages of 34.61 ± 8.35 and 32.42 ± 10.28 years. Mean duration of symptoms were 18 and 15 months in study and control groups respectively. Irritable Bowel Syndrome (IBS) was more common in both groups i.e. 14 (20%) and...

Cureus, 2021

Introduction Helicobacter pylori (H. pylori) infection is prevalent worldwide. H. pylori therapie... more Introduction Helicobacter pylori (H. pylori) infection is prevalent worldwide. H. pylori therapies' adverse effects can contribute to noncompliance among patients. This study aimed to assess the association between compliance to H. pylori eradication therapy and adverse effects using various drug regimens. Method We conducted an observational study from September 2017 to February 2020 in two tertiary care hospitals in patients with dyspeptic symptoms. H. Pylori detection was done by histopathological examination of gastric mucosa during upper gastrointestinal endoscopy or stool for H. pylori antigen. Patients with positive results were randomly assigned one of the nine different regimens consisting of a combination of proton pump inhibitors along with at least two antibiotics. The antibiotics used in different combinations were amoxicillin, clarithromycin, metronidazole, doxycycline, levofloxacin, and bismuth sulfate. The treatment groups received standard triple therapy with and without probiotics, sequential, concomitant, levofloxacinbased triple therapy, or sequential and bismuth-based quadruple treatments. All treatments were given for two weeks. At the end of the treatment period, patients were interviewed about completing treatment and any adverse effects they may have experienced during therapy. Data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, Version 22.0 (Armonk, NY: IBM Corp.). Results A total of 250 patients were included in the study (62% males, 38% females) with a mean age of 37 years ± 13 years (range 12-84 years). Most patients completed the treatment regimen (80.4%), and 19.6% did not complete treatment because of adverse effects (p<0.005). The levofloxacin-based, concomitant, and standard triple regimen with probiotic treatments had the highest tolerance (≥85%). Common adverse effects were abdominal and epigastric pain (11%), alteration of taste, and diarrhea (6.5%). Conclusion H. pylori eradication therapy is always a challenge. Patient compliance to the treatment can only be ensured by medicines with fewer adverse effects. In our study, levofloxacin-based triple, concomitant, and standard triple regimens with probiotics are maximally acceptable treatments.

Journal of Ayub Medical College, Abbottabad : JAMC, 2021

BACKGROUND Coronavirus disease 2019 (COVID-19) is a multisystem disorder and haematological abnor... more BACKGROUND Coronavirus disease 2019 (COVID-19) is a multisystem disorder and haematological abnormalities are frequently documented in affected patients. Methods This retrospective study included 549 patients hospitalized with COVID-19 from 1st June to 15th July 2020 at Pak Emirates hospital, Rawalpindi Pakistan. p<0.05 was considered statistically significant. RESULTS Median age was 60 years (range 12-94 years), males 442 (80.5%) and females 107 (19.5%). There was no patient with mild illness, 181 (32.9%) had moderate, 158 (28.7%) severe and 210 (38.2%) patients had critical disease. Patients with severe and critical disease had lower absolute lymphocyte count (ALC) and platelets (p<0.001 for both) while higher white blood cell count (WBC), neutrophil lymphocyte ratio (NLR), C-reactive protein (CRP), interleukin-6 (IL-6) and lactate dehydrogenase levels (LDH) levels (all p<0.001). Overall survival of study cohort was 83.2% (n=457). Median haemoglobin and platelet count wer...

DOAJ: Directory of Open Access Journals - DOAJ, Oct 30, 2020

PAFMJ, 2021

Objective: To study the role of gastrointestinal procedures, namely oesophago-gastroduodenoscopy ... more Objective: To study the role of gastrointestinal procedures, namely oesophago-gastroduodenoscopy (OGD) and colonoscopy, in helping to establish a definitive primary tumour site in cancer of unknown primary. Study Design: Prospective observational study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore Pakistan, from Jan 2018 to Jan 2019. Methodology: A total of 115 patients included in the study were those, who underwent OGD and a colonoscopy for the diagnosis of a cancer of unknown primary. Data collected included demographics, baseline clinical characteristics, definitive diagnosis, tissue diagnosis and immune-histochemical stains. Primary outcome was the attainment of a definitive diagnosis via OGD and/or colonoscopy. Results: A total of 115 patients underwent a diagnostic gastrointestinal procedure. Of these 70 (61%) were males. Mean age was 63 ± 12.6 years (range 22-88 years). Abdominal pain comprised the most common presenting comp...

Objective: To assess association of pretreatment liver histology with serum Alanine aminotrasfera... more Objective: To assess association of pretreatment liver histology with serum Alanine aminotrasferase (ALT) level and Body Mass Index (BMI) in HCV positive patients. Material and Methods: A prospective study conducted at Pathology and Gastroenterology Departments of CMH Peshawar from June 2007 to December 2008 included 100 adult HCV RNA positive patients. Percutaneous liver biopsy was performed and analyzed for necroinflammation, fibrosis and steatosis. The observations were recorded and analyzed by using SPSS 13. Results: Fifty-four male and 46 female subjects between ages of 13-70 years were included in the study. 66% patients had ALT levels of 42-89 IU/L, 74.2% had grade II disease, 12.1% grade III disease. 34% patients had ALT levels of > 90 IU/L. 56% had grade II & 38.2% grade III disease. Correlation of ALT with disease grade was significant, P value 0.029. Association of ALT with disease stage was not significant, P value 0.139. Fifty-six percent of obese patients had elevat...

Pakistan Armed Forces Medical Journal, 2019

Objectives: To find the relative frequencies of different diseases causing dyspepsia, and to iden... more Objectives: To find the relative frequencies of different diseases causing dyspepsia, and to identify different diseases according to age. Study Design: Prospective cross-sectional study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan 2017 to Oct 2017. Material and Methods: Patients of age 18 to 80 years with dyspepsia non-responding or refractory to empiric therapy or those with alarm features were offered upper-gastrointestinal-endoscopy as per standard protocol and the results were recorded. Results: A total of 667 patients with 65% males and 35% females were enrolled. Normal endoscopy was reported in 58.8% patients with 35% males and 24% females (total=667), whereas abnormal findings accounted to 41.2% patients with 30% males and 11.2% females. Mixed symptoms were the commonest complaint (75%). The median age group was 41-50 years with median symptom duration of 1 <2 years for abnormaland normal endoscopic find...

Pakistan Armed Forces Medical Journal, 2019

Objective: To determine the important clinical features at the initial presentation of Hepatocell... more Objective: To determine the important clinical features at the initial presentation of Hepatocellular carcinoma and the treatments offered thereby. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi, from Jan 2017 to Dec 2017. Methodology: A total of 157 patients were studied. Their history, examination and relevant investigations were carried out at initial presentation to find all required details including age, gender, etiology of HCC, number and size of hepatic lesions, Child Pugh class, performance status, BCLC scoring, vascular invasion of tumor, lymph nodal involvement and metastasis; at time of diagnosis of hepatocellular carcinoma. Treatment was offered based on all these parameters, as per latest AASLD guidelines. Data were entered in SPSS version 24 for statistical analysis. Results: Of the total 157 patients, 117 (75%) were males and 40 (25%) were females. Mean age was 60.4 ± 8.67 y...

PAFMJ, 2021

Objective: To assess the severity of ulcerative colitis on first colonoscopic examination. Study ... more Objective: To assess the severity of ulcerative colitis on first colonoscopic examination. Study Design: Prospective cross-sectional (correlational) study design. Place and Duration of Study: Study was conducted in Gastroenterology Outpatient Department of Pak Emirates Military Hospital, Rawalpindi, from Nov 2017 to Oct 2018. Methodology: An aggregate of 200 patients within the age range of 12-70 years, were included in the studythrough non-probability consecutive sampling. The data was collected by the self-administered questionnaireincluding age, gender, stool frequency, P/R bleed, systemic features of ulcerative colitis & colonoscopic findings.Effectiveness of the procedures was noted on a pre-designed performa and the endoscopic assessment was based upon mayo score severity of colitis graded from Normal (0) to Severe (3). Data was analyzed by using SPSS-19. Results: The mean age of the participants was reported 38 ± 2.1 years. Out of 200 participants 104 (52%) weremale, diarrhea...

doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by pee... more doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.

Reactions, 1986

A rare case of halothane-induced fulminant hepatic failure is reported in a 22 years old male, wh... more A rare case of halothane-induced fulminant hepatic failure is reported in a 22 years old male, who developed fever, jaundice, coma and deranged coagulation profile, 2 days after undergoing laparotomy under halothane anaesthesia. Despite all supportive care, he died of fulminant hepatic failure, 6 days after surgery. Postmortem liver biopsy revealed massive predominantly centrilobular hepatic necrosis.

Journal of the College of Physicians and Surgeons--Pakistan: JCPSP

Objective: To measure the effects of awareness campaign on the frequency of EDTA contamination. S... more Objective: To measure the effects of awareness campaign on the frequency of EDTA contamination. Study Design: A cohort study. Place and Duration of Study: The study was carried out in Combined Military Hospital, Peshawar, from October to December 2008. Methodology: A cohort of 200 doctors, nurses and paramedical staff involved in sample collection for laboratory investigations were selected for this three phased study. In all samples with plasma potassim level > 6.0 mmol/L, plasma Ca was measured for one month before, during and after a campaign of correct filling order of sample tubes for two weeks. Renal function test and LDH were also measured to rule out chronic renal failure and in-vitro haemolysis, respectively. Fisher’s exact test was used for comparison of frequency of hyperhalemia. Results: There was a significant decrease (75%, p < 0.01) in the cases of spurious hyperkalaemia and hypocalcaemia. Conclusion: EDTA contamination is a common and important source of pre-an...

JPMA. The Journal of the Pakistan Medical Association, 2014

Budd Chiari syndrome (BCS) is a heterogeneous group of disorders characterized by hepatic venous ... more Budd Chiari syndrome (BCS) is a heterogeneous group of disorders characterized by hepatic venous outflow obstruction at any level from the small hepatic veins to the atrio cava junction. BCS could have serious consequences if not treated promptly. Comprehensive angiographic studies, computerised tomography, liver ultrasonography, histology and pathologic analyses are essential for establishing the disease severity, stratifying risk factors, choosing the appropriate therapy and objectively assessing the response. The main objective of therapy is to alleviate portal and IVC hypertension. Here we present a report of a young man with BCS who underwent mesocaval shunt. The eight months follow up showed that patient was free of symptoms and duplex scans confirmed the patency of the shunt.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 2007

Minimally invasive, image guided radiofrequency ablation RFA now provides an effective local trea... more Minimally invasive, image guided radiofrequency ablation RFA now provides an effective local treatment of isolated or localized neoplastic diseases, and is also being used as an adjunct to conventional surgery, systemic chemotherapy or radiation. It is now the front line treatment in unresectable hepatocellular carcinoma and its use in other neoplastic diseases continues to expand. This update introduces the technique to alleviate inoperable tumours and application of RFA in therapeutic imaging.

PAFMJ

Objective: To assess the non-invasive biomarkers of fibrosis for predicting varices-needing-treat... more Objective: To assess the non-invasive biomarkers of fibrosis for predicting varices-needing-treatment in patients with cirrhosis secondary to chronic-hepatitis-C. Study Design: Cross sectional comparative study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan 2017 to Dec 2017. Methodology: A total of 153 patients aged 18-79 with cirrhosis, whether compensated or decompensated, secondary to chronic-hepatitis-C were enrolled. Relevant serum tests were used to calculate non-invasive fibrosis indices and their diagnostic performance to predict the presence of varices and varices-needing-treatment was calculated. Results: King’s score showed the best performance in detecting varices due to high positive predictive value of 96.4% and positive likelihood ratio of 2.4. Overall, all the non-invasive fibrosis indices exhibited good performance with positive predictive value >85% but none could rule out the presence of varices...

PAFMJ, 2021

Objective: To assess the adherence to antivirals in Hepatitis B Virus (HBV) infected patients and... more Objective: To assess the adherence to antivirals in Hepatitis B Virus (HBV) infected patients and to determine various social and demographic factors which can have an impact on it. Study Design: Cross- sectional study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan to Mar 2019. Methodology: Patients on oral anti-viral agents for hepatitis B virus infection were enrolled from outdoor clinics using consecutive sampling technique. Medication adherence was assessed using the 4-item Modified Morisky Score Questionnaire. Data was also collected about different variables that could potentially affect compliance, such as age, gender, education, residence, total number of pills prescribed for each day, travelling time to hospital, attendant’s company, adverse effects of treatment, presence of co-morbid conditions, patients’ knowledge regarding importance of adherence and whether they followed any particular routine in taking ...

DOAJ: Directory of Open Access Journals - DOAJ, Oct 1, 2020

PAFMJ, 2021

Objective: To find out the underlying causes of chronic diarrhea in soldiers and how it differs f... more Objective: To find out the underlying causes of chronic diarrhea in soldiers and how it differs from general population. Study Design: Prospective comparative study. Place and Duration of Study: Combined Military Hospital (CMH) Multan and Pak Emeritus Military Hospital (PEMH) Rawalpindi, from Dec 2017 to Jan 2020. Methodology: All soldiers in active service, having diarrhea more than 4 weeks in study and non-soldiers of the same age were included in the control group. There were inquired in details about the diarrhea symptoms and investigations carried out accordingly to find out the underlying cause. The two groups were compared to find out any differences. The data were analyzed by SPSS version 22. Results: Seventy one in study and 50 patients in control had their mean ages of 34.61 ± 8.35 and 32.42 ± 10.28 years. Mean duration of symptoms were 18 and 15 months in study and control groups respectively. Irritable Bowel Syndrome (IBS) was more common in both groups i.e. 14 (20%) and...

Cureus, 2021

Introduction Helicobacter pylori (H. pylori) infection is prevalent worldwide. H. pylori therapie... more Introduction Helicobacter pylori (H. pylori) infection is prevalent worldwide. H. pylori therapies' adverse effects can contribute to noncompliance among patients. This study aimed to assess the association between compliance to H. pylori eradication therapy and adverse effects using various drug regimens. Method We conducted an observational study from September 2017 to February 2020 in two tertiary care hospitals in patients with dyspeptic symptoms. H. Pylori detection was done by histopathological examination of gastric mucosa during upper gastrointestinal endoscopy or stool for H. pylori antigen. Patients with positive results were randomly assigned one of the nine different regimens consisting of a combination of proton pump inhibitors along with at least two antibiotics. The antibiotics used in different combinations were amoxicillin, clarithromycin, metronidazole, doxycycline, levofloxacin, and bismuth sulfate. The treatment groups received standard triple therapy with and without probiotics, sequential, concomitant, levofloxacinbased triple therapy, or sequential and bismuth-based quadruple treatments. All treatments were given for two weeks. At the end of the treatment period, patients were interviewed about completing treatment and any adverse effects they may have experienced during therapy. Data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, Version 22.0 (Armonk, NY: IBM Corp.). Results A total of 250 patients were included in the study (62% males, 38% females) with a mean age of 37 years ± 13 years (range 12-84 years). Most patients completed the treatment regimen (80.4%), and 19.6% did not complete treatment because of adverse effects (p<0.005). The levofloxacin-based, concomitant, and standard triple regimen with probiotic treatments had the highest tolerance (≥85%). Common adverse effects were abdominal and epigastric pain (11%), alteration of taste, and diarrhea (6.5%). Conclusion H. pylori eradication therapy is always a challenge. Patient compliance to the treatment can only be ensured by medicines with fewer adverse effects. In our study, levofloxacin-based triple, concomitant, and standard triple regimens with probiotics are maximally acceptable treatments.

Journal of Ayub Medical College, Abbottabad : JAMC, 2021

BACKGROUND Coronavirus disease 2019 (COVID-19) is a multisystem disorder and haematological abnor... more BACKGROUND Coronavirus disease 2019 (COVID-19) is a multisystem disorder and haematological abnormalities are frequently documented in affected patients. Methods This retrospective study included 549 patients hospitalized with COVID-19 from 1st June to 15th July 2020 at Pak Emirates hospital, Rawalpindi Pakistan. p<0.05 was considered statistically significant. RESULTS Median age was 60 years (range 12-94 years), males 442 (80.5%) and females 107 (19.5%). There was no patient with mild illness, 181 (32.9%) had moderate, 158 (28.7%) severe and 210 (38.2%) patients had critical disease. Patients with severe and critical disease had lower absolute lymphocyte count (ALC) and platelets (p<0.001 for both) while higher white blood cell count (WBC), neutrophil lymphocyte ratio (NLR), C-reactive protein (CRP), interleukin-6 (IL-6) and lactate dehydrogenase levels (LDH) levels (all p<0.001). Overall survival of study cohort was 83.2% (n=457). Median haemoglobin and platelet count wer...