Background and Aim: Gastroesophageal reflux disease (GERD) is a physiological passage of stomach contents into the esophagus. It is basically the pathological complications and symptoms. Endoscopy is a gold standard investigation tool that eliminates the gastroesophageal reflux disease co-morbidities such as malignancy and Barret’s esophagus. The present study was carried out to evaluate the correlation between endoscopic findings and symptoms of gastroesophageal reflux disease. Materials and Methods: This intervention cross-sectional study was carried out on 109 gastro esophageal reflux disease patients in Gastroenterology department of Isra University Hospital, Hyderabad for six months duration from January 2021 to June 2021. Suspected gastroesophageal reflux disease patients were assessed thoroughly by physical examination, history, and endoscopy for gastrointestinal symptoms. Severity, symptom type, duration, and frequency were assessed as clinical symptoms. The upper gastrointestinal endoscopy findings were evaluated in terms of esophageal erosions, and their grades such as Grade A, Grade B, Grade C, and Grade D. The endoscopy abnormal findings such as hernia, esophagus, malignancy, and Barret’s esophagus were correlated with gastroesophageal reflux disease. Result: Out of 109 patients, 78 (71.5%) were females while 31 (28.5%) were male. The mean age of the patients was 43.54 ± 7.3 years with an age range between 25 and 67 years and the mean BMI was 43.34 ± 5.76 kg/m2. Gastro esophageal reflux disease symptoms such as malignancy and Barrett’s esophagus shown no evidence on pre-operative endoscopy. About 29 (26.6%) patients had normal endoscopy. The symptomatic patients were 80 (73.4%) which were categorized based on LA classifications into Grade A 62 (77.5%), Grade B 13 (16.3%), Grade C 3 (3.8%) and Grade D 2 (2.5%). Based on the reflux score system, patients were distributed as mild 43 (53.8%), moderate 11 (13.8%), severe 5 (6.3%), and very severe 21 (26.3%). Conclusion: Our study found a significant correlation between gastro esophageal reflux disease and endoscopy esophagitis findings. Pre-operative endoscopy should be carried for abnormal endoscopy in both symptomatic and asymptomatic patients. Keywords: Gastro-oesophageal reflux disease, Endoscopy, Esophagitis

Background and aim: The association of gastro esophageal reflux disease with oral health manifestations faced major challenges in terms of invasive investigative approaches to be performed on patients for necessary treatment. The current study aimed to evaluate the risk factors and impact of gastro-esophageal reflux disease on oral health. Materials and Methods: The cross-sectional study was carried out on 194 gastro-oesophageal reflux disease in Gastroenterology department of Isra University Hospital, Hyderabad for duration of six from July 2020 to December 2020. The individuals underwent duodenoscopy for oesophago–gastro–reflux disease and met the inclusive criteria were enrolled. The gastro-oesophageal reflux disease patients were categorized into two group’s namely chronic gastro-oesophageal reflux disease as a group I (97 patients), while mild GORD was group II (97). The exclusion criteria for this study was individuals with limited mouth opening and unconscious patients. Mucosa oral lesion and abnormal conditions were measured as primary and secondary outcomes. Oral Health Impact Profile-14 was utilized for assessment of life quality changes with hard and soft tissue. Results: Of the total 194 patients, 113 (58.2%) were male while 81 (41.8%) were females. The mean age was 48.32±7.56 years with an age range of 20-80 years. The socioeconomic status of the participants was as follows; urban residents 127 (65.5%) and rural 67 (34.5%). The gastro-oesophageal reflux disease prevalence was found 35.6% (n=69) out of which 34.8% (24) were dental erosion (DE). Group I and II had 97 patients each. The group I was comprised of significantly common diseases such as ulceration 52 (53.6%), Oral submucous fibrosis 59 (60.8%), and xerostomia 42 (43.3%). Chronic gastro-oesophageal reflux and dental erosion diseases were statistically significant with an unhealthy pattern of diets such as ulceration, nausea/vomiting, gingivitis, angular cheilitis, and oesophagitis. The prevalence of overall oral tobacco and smoking addiction was 59 (30.4%) and 52 (26.8%). Tea was the most prevalent consumed beverage 141(72.7%). Gastro-oesophageal reflux and dental erosion diseases were positively correlated with oral health assessment scale-14 (p-value <0.05). The psychological discomfort, psychological disability, physical disability, and functional limitation were the notable impacts with their respective ranks correlation coefficient (rs) 0.29, 0.26, 0.28, and 0.19. Conclusion: Gastro-oesophageal reflux and dental erosion disease had higher severity among patients of oral manifestation compared to those with no gastro-oesophageal reflux and dental erosion disease. The systemic and oral disease severity needs to be assessed routinely with dental checkup. Keywords: Oral manifestations, Gastro-oesophageal reflux disease

ABSTRACT… Objectives:To assess the diagnostic validity of FIB-4 for predicting hepatic fibrosis in patients of chronic hepatitis C genotype 3. Study Design: Cross-sectional study. Setting: Department of Gastroenterology and Hepatology, Isra University Hospital, Hyderabad through convenient sampling. Period: June 2013 to June 2014. Methods: Diagnostic validity of FIB-4 index for predicting hepatic fibrosis was determined by measuring sensitivity, specificity, positive productive, negative predictive value, and compared these parameters with liver biopsy. The liver histology was determined by METAVIR score. Results: A total 115 patients were enrolled with mean and SD of age was 39.6 ± 9.3 years. Dividing FIB-4 index into three categories as <1.45, 1.45 -3.25, and >3.25; by using the Obuchowski method the AUROC was 0.93 (with 95% CI 0.91, 0.95). When dividing the FIB-4 index in to three categories as <1.45, 1.45 -<2.25 and >2.25; the AUROC by using Obuchowski method was 0.87 (with 95% CI 0.83, 0.91). Similarly for the diagnosis of Cirrhosis (F = 4 METAVIR) on the predictive value of the non-invasive test FIB-4 while using Obuchowski method the AUROC was 0.85 (with 95% CI 0.83, 0.87). Conclusion: The FIB-4 index is a simple, inexpensive, non-invasive, and a quick test for predicting liver fibrosis in patients of chronic Hepatitis C genotype 3. Key words:Liver biopsy, Metavir, Non-invasive, Cirrhosis, Fibrosis, Pakistan.

Objective: To determine the frequency of seropositive helicobacter pylori (H. pylori) among patients presented at outpatient department (OPD) with dyspepsia at tertiary care Hospital. Methodology: This descriptive case-control study was conducted at medicine department of Peoples University of Medical and Health Sciences for women Nawabshah (SBA). Study duration was six months from October 2018 to March 2019. All the patients of age 18-70 years, presented with complaint of dyspepsia, either of gender were included in the study. After taking informed consent all the patients underwent serological assessment for H. pylori. From each study participant a 5ml blood sample was taken and sent to the laboratory for the diagnosis of H. pylori. After collection of the laboratory reports, all the data was collected via self-made study proforma. Data analysis was done by using SPSS version 20. Results: Total 78 patients of dyspepsia were enrolled, their mean age was34.23+6.22 years and average duration of symptoms was 15.23+7.14 months. Males were 43(55.1%) and females were 35(44.9%). Feeling of abdominal distension after meal was among 21(26.9%) cases, epigastrium pain was in 14(17.9%) cases, heart burn was among 32(41.0%) patients, 07(09.0%) had belching and 19(24.4%) had multiple complaints. Seropositivity rate of H. pylori was 33.30% among patients of dyspepsia and it was statistically insignificant according to gender and socioeconomic status (p->0.05). Conclusion: As per study conclusion the seropositivity of H. pylori was observed to be higher among patients of dyspepsia and seropositivity of H. pylori was insignificantly linked to gender and socioeconomic status. Keywords: Dyspepsia, H. pylori, seropositive

Objective: To determine the frequency of modifiable and non-modifiable risk factors of functional dyspepsia in our population. Materials and Methods: This cross-sectional study has been conducted department of gastroenterology of Isra University Hospital from February 2019 to January 2020. All the patients of all age groups presented with functional dyspepsia and either of gender were included in the study. Patients were interviewed regarding modifiable and nonmodifiable risk factors like age, gender, smoking, body mass index, alcohol consumption and stress. All the data was gathered via study proforma. Results: Total 200 cases of functional dyspepsia were studied for modifiable and non-modifiable risk factors. Mean age of the cases was 49.45+6.33 years. Most of the cases were more than 40 years of the age. Males were 64.5% and females were 40.5%. According to the ethnicity Sindhi and Punjabi were commonest as 40.5% and 35.0% respectively. Inadequate physical activity and smoking habits were highly prevalent as 57.5% and 36.0% respectively. Conclusion: As per study conclusion age more than thirty years, male gender, ethnicity of Sindhi and Punjabi, smoking and inadequate physical activity were observed to be highly prevalent modifiable and non-modifiable risk factor of the functional dyspepsia.