Assessment of characteristics of patients with cholelithiasis from economically deprived rural Karachi, Pakistan

Abstract

BackgroundGallstones have been regarded as one of the most expensive diseases in Gastroenterology, posing a great economic burden on developing nations. The majority of Pakistani people live in rural areas where healthcare facilities are not available or are very primitive. We aim to assess the characteristics among cholelithiasis patients from rural Karachi so that a prevention campaign can be launched in rural underprivileged settings to reduce the economic burden of this preventable disease.MethodA total of 410 patients were included in the study after giving verbal consent as well as written consent. Variables such as age, weight, height, body mass index (BMI), blood pressure, waist circumference, number of children, monthly family income, number of siblings, and number of family members, were considered in this questionnaire. All data was analysed by SPSS ver. 16.0. Mean and standard deviation (SD) were calculated for continuous variables. Frequency and percentages were calculated for categorical variables.ResultsNearly 85.4% of the participants were female. The mean ± S.D. for age was 43.8 ± 9.59. Nearly 61% of the patients were illiterate. All of our patients were from low socioeconomic status and their mean salary ± S.D. was 6915 ± 1992 PKR (1 US $ = 90.37PKR). 75% of them were smokers with mean consumption ± S.D. of 7.5 ± 10 cigarettes per day. Fibre in diet was not used by 83.65% of patients. 40.2% were living in combined families. 61% were living in purchased homes. A positive history of diabetes mellitus was given by 45.1%, family history of cholelithiasis by 61% and history of hypertension by 31.7% of subjects. Soft drink consumption was given by 45.1% of patients; while only 8.5% used snacked daily. Tea was consumed by 95.1% of the subjects. Daily physical activity for 30 minutes was reported by only 13.4% of participants.ConclusionIn conclusion, rural dwellers from low socioeconomic strata are neglected patients and illiteracy further adds fuel to the fire by decreasing the contact with the health professionals. Assessment of the characteristics are very important because considering the great socio-economic burden, an intervention strategy in the form of mass media campaign as well as small group discussions in such rural areas can be formulated and applied to high risk populations to reduce the burden and complications of gallstone disease.

Risk Factors for Gallstones; Is 5 F Mnemonic Still Valid?

“…In all over the world, Gallstones are two times common in middle age females as compared to men, similar is found in our study. [21][22][23][24][25] As 100% of our patients were married so our study also proves another Study done in Australia, which showed major association between marital status and gallstone incidence. 26 The normal mean values of serum Triglycerides, Cholesterol and LDL found in our study are not in that much accordance with earlier studies of serum lipids and cholelithiasis, which showed elevated Triglycerides, Cholesterol and LDL level but the low HDL values in our study are in evidence that altered serum lipids levels is a risk factor for gallstone formation.…”

Cost-effectiveness Analysis of Per-abdominal and Laparoscopic Cholecystectomy

“…26.7% patients were illiterate, followed by 16.7% patients had primary level education, 21.7% patients had secondary level education. Similar findings were reported in a study that nearly 61% of the patients were illiterate and the remaining included primary (14.6%), middle (8.5%), secondary (4.9%) and post-secondary (10.9%) education (Naeem, M. et al, 2012).…”

“…So, economically more solvent patients preferred laparoscopic method whereas low income patients preferred per-abdominal method. In a study conducted in Pakistan showed that All of the patients were from low socioeconomic status; therefore, the mean(± SD) salary was PKR.6915(± 1992) (Naeem, M. et al, 2012).…”

An observational study on the association of nonalcoholic fatty liver disease and metabolic syndrome with gall stone disease requiring cholecystectomy

“…It is one of the commonest ailments presenting to surgical units. A study reported an incidence of 9.03% [9]. Nearly 75% of the patients with gall stones are symptomless [10].…”