Shafqat Ur Rehman Orakzai

Khyber Teaching Hospital

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Amanullah Khokhar

Isra University

Maliha Saad

Karachi Medical and Dental College

Hajra Noor

Khawaja Farid Social Security Hospital

Saeed Rehman

South China University of Technology

Adnan Ghafoor

Foundation University Medical College

Sayad Ahmad

Ayub Medical College

Humera Javed

Jinnah Medical & Dental College

Sana Noor

GIFT University

Muhammad Mushtaq

Pir Mehr Ali Shah Arid Agriculture University

Maria Arabdin

Gandhara University

Cooperative Institutions

Lady Reading Hospital

Behman Hospital

Hayatabad Medical Complex

Isra University

Khyber Medical College

Khyber Teaching Hospital

Karachi Medical and Dental College

Khawaja Farid Social Security Hospital

COMSATS University Islamabad

South China University of Technology

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Comparison of Prognostic Scores for Upper Gastrointestinal Bleeding in the Hepato-Gastro-Enterology Department

Saeed Rehman Azhar Saeed Adnan Ghafoor Shafqat Ur Rehman Orakzai Ajmaal Jami

Objectives: The goal of this study is to assess the relative value of individual UGIB prognostic scores in predicting patient outcomes. Patients and Methods: This study was a descriptive cross-sectional analysis of data collected before. Included were patients admitted to the Al Tibri Medical college and hospital Malir Karachi Center and Fauji foundation Rawalpindi with upper GI bleeding and treated in the Gastroenterology Division. Analyses in this study compared the predictive power of five different prognostic scores (the Glasgow Coma Scale, modified Glasgow Coma Scale, coagulation risk score, and acute ischemic stroke severity score; together, these scores are known as GBS, mGBS, FRS, CRS, and AIMS65) for the occurrence of death and rebleeding within 42 days. ROC (Receiver Operating Characteristic) curves were used to compare the various scores. Results: A total of 314 individuals were enrolled in the study, with a male-to-female sex ratio of 2.48. In 70.94% of cases, fibroscopy revealed UGIB due to portal hypertension unrelated to peptic ulcer disease. The "FRS" score was the most reliable predictor of mortality or rebleeding for all patients. Compared to other scores, the "FRS" provided the best reliable forecast of whether or not patients would have spots. The "FRS" score was the most reliable one for predicting mortality. Patients deemed to be at low risk (below the threshold value) had a mortality rate of 2.2% according to the "FRS," 9.3% according to the "CRS," 0% according to the "GBS" (p = 0.565), 50% according to the "mGBS," and 11.42% according to the "AIMS65." The predictive value of UGIB scores was higher for incidental portal hypertension. Conclusion: Upper gastrointestinal hemorrhage cases can be accurately predicted using the "FRS" and "CRS" scores. But in the setting of portal hypertension, these scores did badly. UGIB Keywords: Prognostic Scores, Upper Gastrointestinal Bleeding, Rockall, Glasgow-Blatchford

Upper Gastrointestinal Bleeding

Stroke

Gastro-

10.53350/pjmhs22169784

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Correlation between serum leptin level and body mass index (BMI) in patients with type II diabetes mellitus

Journal of the Pakistan Medical Association (2019)

Adnan Khan Tahir Ghaffar Abroo Kainat Maria Arabdin Shafqat Ur Rehman Orakzai

To correlate serum leptin levels in obese and non-obese type 2 diabetic patients and compare them with healthy individuals.The case-control study was conducted at the Lady Reading Hospital, Peshawar, and the Rehman Medical College, Peshawar, Pakistan, from June to November 2017, and comprised type 2 diabetic patients and and an equal number of healthy controls. Fasting blood glucose, glycated haemoglobin, serum leptin, and body mass index were assessed in obese and non-obese subjects. Relation between body mass index and serum leptin level was explored. Data was analysed using SPSS 20.Of the 96 subjects, 48(50%) were in each of the two groups. Among the cases, there were 23(48%) men and 25(52%) women with an overall mean age of 51.27±11.7 years. The control group had 28(58%) men and 20(42%) women with an overall mean age of 49.3±12.1 years. Serum leptin levels were significantly higher in obese 9.42±1.87ng/ml and non-obese 7.21±3.78 ng/ml patients than the controls 5.38±2.20 ng/ml (p<0.05). Serum leptin concentration was significantly correlated with body mass index, fasting blood glucose and BMI, FBG and glycated haemoglobin (p<0.001 each).Increased levels of serum leptin could be used as a risk factor in the development of type 2 diabetes mellitus.

10.5455/jpma.301135

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Clinical, Laboratory and Virological Characteristics of Patients with Positive Hepatitis B Surface Antigen

Hajra Noor Sana Noor Abdullah Tanveer Faiz Ahmed Faiz Shafqat Ur Rehman Orakzai

Background and Aim: Globally, Hepatitis B virus (HBV) infection is a major health issue contributing to various diseases such as hepatocellular carcinoma (HCC) and liver cirrhosis. Virus replication complex interaction with host immune system response causes dynamic interplay leading to HBV infection. In developing countries, HBV infection plays a significant role in higher rates of morbidities and mortalities. The present study aimed to assess the clinical, laboratory, and virological characteristics of patients with positive HBV surface antigen. Methodology: This cross-sectional study was carried out on 182 positive HBV surface antigen (HBsAg) in the department of Medicine, Social Security Hospital, Multan Road Lahore from April 2021 to March 2022. All the patients with positive HBsAg and negative hepatitis C were enrolled. Patients with a history of chronic liver disease, acute hepatitis B infection, and antiviral therapy were excluded. All patients underwent CBC, liver function tests, clinical evaluation, and abdominal ultrasonography examination, HBV serological marker’s assessment, HBV transmission risk factors, and HBV-DNA quantitative detection. SPSS version 25 was used for data analysis. Results: Out of 182 HBV infected patients, there were 162 (89%) males and 20 (11%) females. The overall mean age was 38.6 ± 8.6 years. The most prevalent complaint and common findings was arthralgia and hepatomegaly with reported incidence of 32 (17.6%) and 16 (8.8%) respectively. Based on ultrasonography imaging results, the incidence of normal liver, coarse liver, splenomegaly, and cirrhosis were found in 81.3% (n=148), 12.6% (n=23), 5.9% (n=11), and 6.6% (n=12) respectively. Based on laboratory results, normal alanine aminotransferase, normal aspartate aminotransferase, reduced serum albumin, and low platelet count were found in 76.9%, 84.8%, 4.9%, and 10.2% respectively. Regarding laboratory, clinical, and imaging characteristics, HBV-DNA positive and negative had no significant differences. Conclusion: The present study found that HBV infected patient’s clinical manifestations were fatigue, bleeding gums, abdominal pain and fatigue. Majority of patients had normal liver on liver function tests and ultrasonographic examination. Most patients had negative HBV infection antigen. Based on comparisons made between HBV-DNA negative and positive, no substantial variations were reported on laboratory, clinical, and imaging characteristics. Keywords: HBV antigen, Virological characteristics, HBV

Abdominal ultrasonography

Liver function

Hepatitis B

Liver disease

10.53350/pjmhs22169701

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Portal Thrombosis: Clinical, Etiological and Therapeutic Aspects in the Hepato-Gastroenterology

Maliha Saad Sayad Ahmad Azhar Saeed Shafqat Ur Rehman Orakzai Muhammad Mushtaq

Objective: Our study aimed to assess the frequency of PT, outline its clinical and etiological manifestations, and detail its therapeutic therapy in the field of hepato-gastroenterology. Study Design: Retrospective study Place and Duration: In the department of Medicine and Gastroenterology of Ayub Teaching Hospital Abbottabad and HBS Dental and General Hospital, Islamabad for the duration of six months from June 2021 to November 2021. Methods: There were 94 patients of both genders had symptomatic gastro abnormalities included in this study. After getting informed written consent detailed demographics of enrolled cases were recorded. Patients were underwent for CT scan and ultrasound for image examination. Prevalence, etiology, therapeutic and clinical aspects of PT were assessed. SPSS 22.0 was used to analyze all data. Results: The mean age of the patients was 40.3±8.60 years and had mean BMI 24.4±6.30 kg/m2. There were majority males 53 (56.4%) and 41 (43.6%) females. Majority were from urban areas. Most common symptoms were abdominal pain, ascites and gastrointestinal bleeding. Prevalence of PT was found in 3 (3.2%) cases. Majority patients 65 (69.1%) were diagnosed with ultrasound and 29 (30.9%) patients received CT scan of abdomen. Frequency of complete thrombosis was found in 63 (67.02%) cases. Most common etiology was cirrhosis followed by hepatocellular carcinoma. Conclusion: According to the findings of our study, the prevalence of PT in hepato-gastroenterology is 3.2%. Cirrhosis exacerbated by HCC is the principal cause of the chronic form, which has a very high prevalence rate. Keywords: Cirrhosis, Hepatocellular Carcinoma, Portal Thrombosis

Etiology

Demographics

10.53350/pjmhs22168912

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