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Upper Gastrointestinal Endoscopic Outcomes in Patients with Gastrointestinal Symptoms: Retrospective Analysis at a Tertiary Care Hospital

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Open Journal of Gastroenterology 2019年第8期9卷 141-157页

作者： Iftikhar Haider Naqvi Abu Talib Muqadus Tabraze Omer Mustafa Siddiqui Maheen Fatima Hussaini Neha Saleem Paryani Rida Effendi Samrah lnam Siddiqui Syeda Zuhaa Hassan maham munawar Zaiya Waseem Ameer Ahmed Khan Zafir Zohab Hussain Khan S. Zain Naeem Rizvi Sofia Fatima Farooqui Misbah Munaf Hasan Obaid Faryal Khan Dow University of Health Sciences Department of Medicine Karachi Pakistan

Background: Endoscopic procedures are frequently performed to rule out any disease process which eventuates with either a positive or negative outcome. Association of patient demographics, clinical features with endoscopic outcomes are of paramount importance for better understanding and practice of endoscopy. Objectives: This study aimed to determine the frequency of positive endoscopic findings in patients with gastrointestinal symptoms compared to those with negative findings. As a secondary objective, the association between relevant demographics, symptoms, laboratory investigations and procedural outcomes of the participants and positive endoscopic findings were also assessed. Methods: A retrospective analysis of all the patients who underwent esophagogastroduodenoscopy from January 2017 to December 2017 was conducted. A total of 1066 endoscopy records were retrieved and using a convenience sampling technique, relevant data were manually entered to the questionnaires. Records with incomplete or inconsistent data were disregarded as per the exclusion criteria, resulting in 1011 patient records ultimately utilized for the study. All data were entered and analyzed using IBM SPSS 23.0. Results: The study comprised a total of 1011 patients where 52.2% were females and 47.8% males while the mean age of patients was 42.16 ± 15.45. Positive endoscopic findings were observed in 88.1%, where the most common finding was gastritis (49.1%). Approximately 14.5% had positive investigation findings for HBsAg and 23.1% were seropositive for anti-HCV antibody. P-values statistically significant were for age (p = 0.044), hematemesis (p = 0.002), betel quid addiction (p = 0.044), anti-HCV antibody (p = 0.043), HCV-RNA (p = 0.041) and “H. pylori” antigen (p = 0.032). Conclusion: Both genders were almost equally included where most patients presented between the 3rd and 5th decades of life. A high incidence of gastritis was noted. Positive endoscopic findings were associated with be

关键词： Esophagogastroduodenoscopy Endoscopy Gastritis Esophageal Varices

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Knowledge and practices of primary care physicians on the current referral system of diabetic retinopathy in Islamabad and Rawal-Pindi, Pakistan

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International Journal of Ophthalmology(English edition) 2019年第12期12卷 1885-1892页

作者： Muhammad Shakaib Anwar Baila Shakaib Waseem Akhtar Erum Yusufzai maham Zehra Hajira munawar Kinza Azhar Department of Ophthalmology Rawal Institute of Health and SciencesIslamabad 44000Pakistan Medical College Rawal Institute o f Health and SciencesIslamabad 44000Pakistan

AIM: To assess the current knowledge and practices in diabetic eye care and referral system regarding diabetic retinopathy(DR) in health centers of Islamabad and RawalPindi. METHODS: A cross-sectional study was carried out in 4 government and private health centers in RawalpindiIslamabad from May 2018 to Oct. 2018. A total of 38 Primary Care Physicians(general practitioners, family physicians, and internists) were recruited out of which data for 2 were either not returned, or were missing partially. Data were collected through a 27-item consented & validated, multiple-choice questionnaire based on physician characteristics, knowledge and practice of diabetic eye care and challenges faced due current DR referral system. Descriptive analyses for all variables were performed including, mean and standard deviation. Analytical analyses were also conducted to study association between different study variables. RESULTS: Mean scores of knowledge for general practitioners, family physicians, and internists were 41.7%, 42.0% and 46.6% respectively. A lack of knowledge, and suboptimal practices were observed regarding signs, symptoms, screening, testing, evaluation and referral of DR regardless of physicians’ specialty, or years in practice. Lack of expertise regarding direct ophthalmoscopy, interpretation of findings, and referral to an ophthalmologist were noted. Physicians who performed consultation and counselling according to patients’ needs referred more patients to an ophthalmologist than those who restricted their consultationto a fixed amount of time and had more patients per unit time(P=0.01). Physicians who had taken care of less than 5 number of patients with DR marked less incorrect answers with no significantly greater number or correct answers compared to physicians who had taken care of more than 5 number of patients with DR(P=0.044). An association of more than 5 patients with DR taken care of with more need based patient consultation and counselling was also

关键词： diabetic retinopathy referral of diabetic retinopathy diabetic retinopathy guidelines primary care physicians

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