Objective: To find out the risk factors for developing Hepatic Encephalopathy in patients suffering from Chronic liver disease.Background: Hepatic encephalopathy (HE) is a neuropsychiatric disorder that is caused by liver damage.  In its pathology, alterations in normal brain function are associated with an increase in blood ammonia, benzodiazepine like substances, products of neurotoxic fatty acids, and other gut derived toxins, which gain access to the brain as a result of liver dysfunction. Study Design: Hospital based descriptive, cross sectional study. Setting: Medical Unit 1, Ward- 5, Jinnah Post Graduate Medical Centre, Karachi.Duration:  July 2013 to December 2013Patients and Methods: About 150 patients admitted in medical unit 1 with a diagnosis of chronic liver disease in a state of hepatic encephalopathy were included in this study. Patients suffering from viral or bacterial encephalitis, stroke, brain tumor, Wernicke’s encephalopathy were excluded from the study.Results and Observations: There were 96 (64%) female and 54 (36%) were male patients. Mean age of the patients was 52.45 (±12.271) years. 80 (53.33%) patients were having constipation. Infection was found in 55 (36.66%) cases. Upper GI Bleed was present in 51 (34%) patients. 44 (29.33%) patients had moderate to severe electrolyte imbalance as the cause. Constipation alone was the cause in 11.33% of cases. More than one factor was found to be responsible in around 56% of patients while in 6.6% of cases none of these precipitating factors was isolated.Conclusion: Constipation is the commonest cause of hepatic encephalopathy followed by infection, upper GI bleed and electrolyte imbalance.DOI: http://dx.doi.org/10.3126/ajms.v6i2.11099Asian Journal of Medical Sciences Vol.6(2) 2015 36-43

Objective: To find out the changes in lipid metabolism among patients suffering from chronic liver disease secondary to hepatitis C. Study Design: Hospital based observational study. Setting: Medical Unit-I, Ward-5, Jinnah Postgraduate Medical Centre, Karachi. Duration: July 2013 to December 2013. Patients and Methods: About 110 patients admitted in Medical Unit-I with a diagnosis of chronic liver disease were included in the study. Patients suffering from DM, HTN, CKD were excluded from the study. Fasting lipid profile was done in all cases. Results and Observations: There were 44 (40%) male and 66 (60%) female patients. Mean age of the patients was 50.18 (±11.7) years. Total cholesterol was decreased in 76 (69.09%) patients. Normal range was present in 34 (30.91%) patients. None of the patient had hypercholesterolemia. Serum triglyceride levels were low in 14 (12.72%) patients, normal in 82 (74.54%), borderline high in 7 (6.36%) and hypertriglyceridemia was seen in 7 (6.36%). HDL-c was below normal in 26 (23.63%) cases, normal in 78 (70.91%), and high in 6 (5.45%). LDL was near optimal/above optimal in only 5 (4.5%) patients. Mean TC/HDL ratio was 2.53 (±1.02). Mean LDL/HDL ratio was 1.23 (±0.73). Mean TC of HCV +ve patients was 130.5 mg/dl as compared to that of HCV -ve patients which was 82.85 mg/dl (P-value: 0.011). Mean TGs of HCV +ve group was 151.5 mg/dl while that of HCV -ve was 79.9 mg/dl (P-value: 0.025). Mean HDL & LDL levels were 43.67 mg/dl and 39.78 mg/dl in HCV group while 34.83 mg/dl & 64.67 mg/dl in the other group with P-value of 0.026 and 0.081 respectively. Conclusion: When it comes to its relationship with lipid metabolism, HCV is a remarkable virus. Its interaction with lipoproteins and its ability to induce massive steatosis are quite unique and idiosyncratic. Despite of causing hepatic steatosis, How to cite this paper: Arisar, F.A.Q.,

Objectives: To assess the clinical, environmental, and socio-demographic characteristics leading to gender disparity in tuberculosis in Pakistan. Study Design: Prospective Comparative study. Study Setting and Duration: The Indus Hospital, Karachi Pakistan, from Jul 2020 to Dec 2020. Methodology: A sample of 200 patients with diagnosed tuberculosis (detected on an acid-fast bacillus (AFB) smear with radiographic abnormalities) irrespective of gender, sensitivity, or site of tuberculosis, were included in the study. Data of gender, personal history, substance abuse history, and dietary habits was documented. Results: Pulmonary tuberculosis was significantly more common in female patients than in males (p<0.001). The mean age of male patients was 30.16 ± 9.47 years. Male patients were significantly older than their female counterparts (p=0.003). The diabetes mellitus in male patients was significantly higher than in female patients with TB (p=0.01). Similarly, substance abuse history was more frequently positive in male patients as compared to female patients, 28 (40.60%) vs 9 (6.70%); p-value <0.001. There was no significant difference in the occurrence of drug-resistance tuberculosis between the two genders. However, pulmonary tuberculosis was significantly more common in female patients than in males (p<0.001). Conclusion: We reported some distinctive differences between male and female tuberculosis patients. Young females had more predilections toward tuberculosis as compared to men. Diabetes mellitus and substance abuse history were more common in male tuberculosis patients than in females.

Objective: The study compared the demographics, clinical characteristics and site of infection leading to community acquired and hospital acquired sepsis. Secondly, the study further compared the distribution of the isolated organisms and complications caused by community and hospital acquired sepsis. Methods: A prospective cohort study was undertaken at the intensive care unit, high dependency unit, and critical care unit at the Indus Hospital, Karachi, Pakistan between 14-April-2021 to 15th-April-2022. All the individuals diagnosed with sepsis, admitted through the Emergency Department or transferred from a ward were included in the study. Age < 15 years or who were shifted from another hospital were removed from the study. The data on demographics, vital signs, SOFA score, site of infection, laboratory parameters, radiological investigations, culture results, and complications, if any, were filled on a pre- designed Performa. Results: Age of the participants was 42.1 ± 17.4 years with a predominance towards female gender. Urinary tract was the most common site from which the organisms were isolated with a frequency of 35 (28.9%). Table 3 revealed that gender was significantly associated with gender (p=0.008). It was found that the majority of the community acquired sepsis were reported in males while the majority of the hospital acquired sepsis was reported in females. Furthermore, marital status (p=0.019) and site of infection were significantly correlated with the hospital acquired sepsis. It was further found that mean creatinine was significantly lower in community acquired sepsis than those with hospital acquired sepsis [(7.83 ± 4.85) vs (15.4 ± 10.4); p<0.001]. Conclusion: The study revealed both hospital acquired and community acquired sepsis are life threatening conditions that may add significant burden on the healthcare facility while at the same time placing significant financial burden upon the patients. Keywords: Sepsis; Community-acquired infections; Nosocomial; Mortality