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Biomedical subjects

Farzana Shafqat

Publications and source records attributed to Farzana Shafqat.

6 recordsLinked to original sources

A study of colorectal polyps.

OBJECTIVE: To determine various features of colorectal polyps and to evaluate the safety of colonoscopic polypectomy. DESIGN: Case series. PLACE AND DURATION OF STUDY: The Department of Gastroenterology and Hepatology, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore, from January 1987 to January 2004. PATIENTS AND METHODS: This study was based on data analysis of 393 patients who underwent colonoscopic polypectomy at our institution during 17 years from January 1987 to January 2004. Presenting complaints of patients were noted. Polyps were evaluated in terms of size, site, number and histopathology. RESULTS: Among 393 patients, 268 were male and 125 female. Presenting complaints were bleeding per rectum in 339 patients, diarrhea with blood in 34 and without blood in 6 patients, and lower abdominal pain in 12 patients. Two patients were being investigated for iron deficiency anemia. Two hundred and sixty-four patients had juvenile polyps, 39 had adenomatous polyps, 39 hyperplastic polyps, 39 inflammatory polyps, 3 malignant polyps and 2 patients had familial polyposis. Histopathological reports were not available in 7 patients. Size of the polyps ranged from 0.3 cm to 3.0 cm. Left colon was involved in 353 patients, transverse colon in 15, right colon in 8 patients and diffuse involvement of colon found in 17 patients. Bleeding following polypectomy occurred in 2% of the patients. No other procedure related complication occurred. CONCLUSION: Juvenile polyps were the commonest variety of polyps in our study. Colonoscopic polypectomy has very low complication rate.

Colonic Polyps↗

Bedside diagnosis of spontaneous bacterial peritonitis using reagent strips.

OBJECTIVE: To determine the efficacy of reagent strip for bedside diagnosis of spontaneous bacterial peritonitis (SBP). DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: Shaikh Zayed Postgraduate Medical Institute from November 2003 to August 2004. PATIENTS AND METHODS: Patients with cirrhosis and ascites underwent diagnostic paracentesis. Fluid was checked for leukocyte esterase released by PMN by using Combur 10 urine strip and graded for color change from 0-3. Fluid was also analyzed by cytology for PMN count. Results of both methods were compared to determine sensitivity, specificity and accuracy of strip for diagnosis of SBP. RESULTS: Of 214 paracentesis performed, SBP was diagnosed in 38 patients whereas 176 were negative for infection. Strip test was 97.7% sensitive and 89.4% specific with positive predictive value of 90%, negative predictive value of 97.7% and accuracy of 96.2%, when reagent strip grade 3 was considered as positive for diagnosis. CONCLUSION: Reagent strip is a quick bedside test, highly sensitive and specific for the diagnosis of SBP, based on polymorphonuclear count in ascitic fluid, to initiate early treatment, thus improving patient's outcome.

Adult↗

Non-endoscopic prediction of presence of esophageal varices in cirrhosis.

OBJECTIVE: To identify hematological, biochemical and ultrasonographic predictors of esophageal varices in patients of cirrhosis. DESIGN: Cross-sectional, analytical study. PLACE AND DURATION OF STUDY: Department of Gastroenterology, Shaikh Zayed Postgraduate Medical Institute, Lahore, from September 2003 to March 2004. PATIENTS AND METHODS: One hundred and one patients with established cirrhosis and no history of variceal bleed underwent physical examination, hematological, biochemical tests and abdominal ultrasound examination. Esophagogastroduodenoscopy (EGD) was carried out in all patients. Presence of varices on EGD was correlated with hematological, biochemical and ultrasonographic variables by regression analysis. RESULTS: Esophageal varices were seen in 65 patients while 36 patients had no varices. High grade varices were seen in 15 patients and 50 patients had low grade varices. Serum albumin less than 2.95 g/dl, platelet count less than 88 x 103/muL and portal vein diameter more than 11 mm were associated with presence of varices. High grade varices were predicted by serum albumin < 2.95 g/dl and portal vein diameter more than 11 mm. CONCLUSION: Patients with serum albumin < 2.95 g/dl, platelet count < 88 x 103/muL and portal vein diameter > 11 mm are more likely to have high grade varices. These patients are candidates for surveillance endoscopy.

Adult↗

Precut papillotomy outcome.

OBJECTIVE: To determine the success and complications of precut papillotomy using needle knife technique in common bile duct cannulation. DESIGN: Quasi interventional. PLACE AND DURATION OF STUDY: The Department of Gastroenterology and Hepatology, Federal Postgraduate Medical Institute, Sheikh Zayed Hospital, Lahore from April 2001 to August 2003. MATERIALS AND METHODS: From April 2001 to August 2003, a total of 347 ERCPs were performed at our institution. During this period, precut papillotomy was carried out in 79 patients. The data of these patients was evaluated for the success of the procedure and occurrence of short-term complications. Other parameters such as age and gender of patients, appearance of ampulla, and the diagnoses were also recorded. RESULTS: Forty-five patients were women and 34 men. The mean age was 52 years (range 12-80 years). Precut helped to cannulate common bile duct in 67 patients at first attempt and in further 5 patients at second attempt with an overall success rate of 91.14%. Complications occurred in 8 (10.1%) patients. These include hemorrhage in 5 (6.3%) patients and pancreatitis in 3 (3.8%). All complications were managed conservatively. CONCLUSION: Precut papillotomy is an effective technique in cannulating common bile duct in difficult cases with margin of safety, dependent on expertise.

Adolescent↗

Ectopic intestinal varices as a rare cause of lower gastrointestinal haemorrhage.

Ectopic intestinal varices are rarely responsible for lower gastrointestinal (GI) haemorrhage. A case of 55 years old male with recurrent melena is being presented, who was found to have scattered varices on small as well as large intestine. Selective review of literature regarding presentation, diagnosis and management of these cases is also part of presentation.

Antihypertensive Agents↗

Effect of band ligation on portal hypertensive gastropathy and development of fundal varices.

BACKGROUND: Use of endoscopic therapies for esophageal varices has resulted in increased prevalence of fundal varices and severe portal hypertensive gastropathy. This study was meant to compare the effect of band ligation and sclerotherapy on development of fundal varices and portal hypertensive gastropathy. METHODS: Patients with esophageal varices presenting in the endoscopy unit of Shiakh Zayed Hospital, with at least one previous endoscopy were included. Patient's past record was reviewed for findings and type of treatment given for varices during first endoscopy, number of endoscopies till date, number of esophageal varices band ligation (EVBL) or sclerotherapy sessions. All patients underwent upper GI endoscopy and findings were recorded. Type of treatment patient rendered during first endoscopy either EVBL or sclerotherapy was correlated to the presence of fundal varices and severity of portal hypertensive gastropathy observed on present endoscopy, using Chi square test (chi2). RESULTS: Eighty one patients were included. Mean age of patients was 48.70 +/- 12.63. Esophageal varices band ligation was carried out during first endoscopy in 49 (60.5%) patients and sclerotherapy in 31 (38.2%) patients. On fresh endoscopy, fundal varices were seen in 25 (30.8%) patients. Severe portal hypertensive gastropathy was found in 26 (32.1%) and mild in 54 (66.7%) patients. Severity of portal hypertensive gastropathy and presence of fundal varices in recent endoscopy was significantly more in patients with EVBL in first endoscopy. CONCLUSION: Band ligation of esophageal varices is associated with more frequent development of fundal varices and worsening of portal hypertensive gastropathy compared to sclerotherapy.

Esophageal and Gastric Varices↗