Qureshi H

The incidence of vaccine preventable influenza-like illness and medication use among Pakistani pilgrims to the Haj in Saudi Arabia.

Over the 33-day duration of the 1999 Haj in Saudi Arabia, we collected daily health status reports for 2070 Pakistani pilgrims over 13 years of age, 54% of whom had elected to receive influenza vaccine immediately before departing for the Haj. We calculated vaccine preventable outcome incidence as the difference in attack rates between vaccinated and unvaccinated persons. The incidences of vaccine preventable influenza-like illness (sore throat in combination with cough or fever of at least 38 degrees C), fever, and any symptom of upper respiratory infection were 22, 17, and 24 per 100 pilgrims per Haj. For every 100 persons who attended the Haj, 17 had a course of antibiotics and 23 had a course of nonprescription cold medication that was preventable with influenza vaccine use. Influenza leads to significant morbidity and medication use among Haj pilgrims. Vaccine against influenza should be considered for pilgrims before entry into Saudi Arabia.

Hepatocellular carcinoma in Karachi

The present study defines the clinical presentation and examines possible aetiological factors in the occurrence of hepatocellular carcinoma in Karachi, Pakistan.

Efficacy of Oral Propranolol and Injection Sclerotherapy in the Long-Term Management of Variceal Bleeding

Three treatment regimens were tried in 145 portal hypertensives with bleeding oesophageal varices to test the efficacy of each regimen in the prevention of rebleeding. Forty-seven cases received oral propranolol, 57 sclerotherapy, while 41 who did not receive any treatment except conservative management served as controls. Patients were followed up at 6 weeks, 6 months, 1 and 2 years to see the frequency of bleeding with each regimen. No significant difference was seen at 6 weeks with either of the three regimens but at 6 months and 1 year the frequency of bleeding was significantly less (p less than 0.05) in the propranolol group than in the other two groups while at 2 years results were significantly better with both propranolol (p less than 0.05) and sclerotherapy (p less than 0.001) than in controls. Efficacy of propranolol when compared with sclerotherapy showed similar results. The results of the present study are different from most of the western reports where sclerotherapy was found to be superior to propranolol. Variations in the results are likely to be due to differences in the etiology of portal hypertension in different countries.

Ulcerative colitis in Karachi

Abstract Experience of 189 patients with non‐specific ulcerative colitis has been reviewed. The majority of patients was in the 21–30 year age group, and neither sex predominated. Seventy‐two percent had mild to moderate disease. The disease was mainly confined to the left colon (60%) and 13% had total colitis.

Effect of thiamine on glucose utilization in hepatic cirrhosis

Abstract Thiamine, an essential co‐enzyme, improves glucose utilization. Thiamine hydrochloride (50 mg per capita per day for 30 days), given to 25 patients with liver cirrhosis who had hyperglycaemia, produced a significant reduction (P < 0.001) in blood glucose levels. It is therefore suggested that thiamine supplements be given to cirrhotics with hyperglycaemia, to improve glucose utilization.

Correlation of Histology, CLO, Dental Plaque, and Saliva in Patients Undergoing Upper GI Endoscopy

Correlation of Histology, CLO, Dental Plaque, and Saliva in Patients Undergoing Upper GI Endoscopy

Idiopathic portal hypertension:an overlooked entity

Abstract Following the criteria laid down by the Japanese Committee on Idiopathic Portal Hypertension (IPH), 89 cases of IPH were diagnosed. Though not confirmed, infections appeared to play some role in its etiology. Major presenting features were haematemesis and anaemia; one third of cases had haemoglobin of less than 7 g/l; hypersplenism was present in 14%. Liver function test were within normal range in the majority of the cases. Long term control of rebleeding was achieved satisfactorily with oral propranolol. Of the shunting procedures, proximal splenorenal shunt showed better results. It is concluded that IPH can be managed well with good long term survival. The diagnosis of IPH as the cause of portal hypertension assures an optimistic prognosis.

A double‐blind study of misoprostol (SC‐29333) in the healing of duodenal ulcer

In a double‐blind randomized placebo controlled trial, 50 patients with endoscopically confirmed duodenal ulcer were treated with either misoprostol 200 μg or placebo in q.i.d. doses for 4–8 weeks. Of 25 patients in the placebo group, four defaulted and two were withdrawn due to worsening of symptoms. Of 25 misoprostol‐treated cases, 17 cases (68%) and 21 cases (84%) healed at 4 and 8 weeks respectively, compared with three (14%) and five (24%) of the 21 placebo‐treated cases (P < 0.001). Except for diarrhoea in 2 patients in each group and itching in one with misoprostol, no serious side effects were noted.