chinese society of digestive endoscopologypsg2020.com/psg2020abstractbook.pdfelaborate endoscopy...

PAKISTAN SOCIETY OF GASTROENTEROLOGYPAKISTAN SOCIETY OF GASTROENTEROLOGYAND GI ENDOSCOPY KP - CHAPTERAND GI ENDOSCOPY KP - CHAPTER

PAKISTAN SOCIETY OF GASTROENTEROLOGYAND GI ENDOSCOPY KP - CHAPTER

PC Hotel, Peshawar

28 29 MARCHFEBRUARY

202001&

Chairman Organizing CommitteeDr. Bakht Biland (KP - Peshawar)

PatronProf. Aamir Ghafoor Khan

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Chinese Society Of Digestive Endoscopology

ABSTRACT BOOKABSTRACT BOOKABSTRACT BOOK

Quaid-e-Azam Muhammad Ali Jinnah

36th International Gastroenterology Conference 2020

Quaid-e-Azam Muhammad Ali Jinnah

Founder of Pakistan


The society has highlighted issues of national importance, and appraised the Government of a myriad of G.I. problems, issues of national importance in the medical arena in dealing with these problems and making policies in the health care. Organ transplant ordinance is culmination of one such effort. This congress will address more of these issues faced by the public at large. This congress has also promised an elaborate Endoscopy workshop which has always been hallmark of the PGS and G.I. Endoscopy Society. Young doctor in training and practice as well old stalwarts all benefit from these live workshops, with the international faculty in action alongside the Pakistani experts.

It gives me immense pleasure and honour to be patron in chief of , Pakistan Society of Gastroenterology and G.I Endoscopy Congress 2020, commencing at PC Hotel, Peshawar, Pakistan.

PSG and G.I Endoscopy has come a long way since its first meeting at Karachi in 1984, with its limited membership, which is now touching the figure of 1500. I profoundly thank the organizing committee as well as the scientific committee, for putting together an exciting scientific and social program for the congress.

It always is a great opportunity for the young researchers to report and express themselves on this forum; there is assured ample opportunity in this congress. I wish all the delegates local as well as foreign, an exciting, interactive congress and a very pleasant stay at the PC Hotel, Peshawar, Pakistan.

I cordialy wellcom all speakers from all over the worlds and local ones.

Patron in Chef

Prof. Dr. Najib ul Haq


As Patron Pakistan Society of Gastroenterology I would like to extend my warmest invitation for your participation in the 36st Annual International congress, of PSG, taking place in PC Hotel, Peshawar, Pakistan from February 28th, 29th to 1st March, 2020. This Congress will surely leave you a long lasting impression and contribute to the further improvement of gastroenterology knowledge, and research in Pakistan. I am convinced that PSG Conference in Peshawar will leave a landmark impression a standard for our future scientific meetings.

The field of gastroenterology is ever changing and evolving rapidly. New trends, new tools and modern techniques dealing with patients of GI diseases influence our clinical practices and teaching methodology. This meeting will provide all participants a forum to exchange latest medical information, skill & knowledge particularly in the discipline of gastroenterology. The congress will include state of art lectures by world subject experts, endoscopic techniques, original research presentations from Pakistan and young research awards. A large number of international faculty is expected to participate.

Organizing and Scientific committee is currently finalizing very attractive programme that promises a large number of highlights both scientific and social issues. I would like to express my sincere gratitude to Asst: Prof. Bakht Biland and local organizing committee for their valuable efforts to organize this event.

I am looking forward to seeing you in PC Hotel, Peshawar.Dear friends and colleagues,...

Patron's Message

Prof. Dr. Aamir Ghafoor Khan


Dear Colleagues,

It is my great pleasure to invite you to the 36th PSG conference in PC Hotel Peshawar. Pakistan Society of Gastroenterology is enjoying the privilege to invite all the participants, speakers, delegates, PGs, sponsors, exhibitors to attend this international conference, which is going to be held on 28th, 29th February and 1st March 2020 in Peshawar Pakistan.

Assalamualaikum

It will be organized under the theme "Expanding the boundaries of Gastroenterology in 21st century " which covers wide range of critically important sessions that deals with the current research & development in the field of Gastroenterology and also, dynamics of the new treatment methods which are in practice to treat various diseases in easier way. It will feature highly respected internationally renowned speakers who will share, discuss, debate, and explore significant new developments and scientific advancements that will definitely have impact on the current treatment. Sessions will include presentations by eminent researchers on evidence-based clinical research. We hope the conference will act as a platform to facilitate interaction and research networking among academia, practicing doctors and the scientific audience. Let me welcome all participants, advanced therapeutic endoscopists, young graduates and post graduate trainees from all over the country who intend to participate. I would like to take this opportunity to convey a simple message to all that with learning, attitude is the core requirement for achieving the goals. So extreme kindness, sympathy, empathy, humbleness and patience are such qualities which motivate all of us to reach to this noble objective. I invite you to contribute toward this objective and without your contribution; this dream can/ be transformed to reality. In addition the conference we will have focused sessions and state of the art lectures on various aspects of gastroenterology. The most up to date information will be presented by leading national and international experts.

With warm regards

Peshawar is a beautiful and vivacious city, well known for its hospitality and friendly people. In addition to the great scientific program participants will be able to enjoy the inspiring sights, delicious food and exceptional atmosphere of this historic city. Looking forward to welcome you all at PESHAWAR, the land of hospitality.

Prof. Dr Bakht BilandVP PSGChairman Organizing Committee

Chairman Organizing Committee

Prof. Bakht Biland


4

About Peshawar

The fortunes of Peshawar are inextricably linked to the Khyber Pass, the eastern end of which it guards. The pass seems to have been little used in prehistoric times, and even in early historic times, it was generally shunned as too narrow and thus too prone to ambush. Not until the powerful Kushans invaded Gandhara and pacied the area in the rst century AD did the Khyber become a popular trade route. Since then, many emperors and rulers have ruled over this place and during this time, Peshawar has had as many names as its rulers. Moghul emperor Akbar formally gave the city the name Peshawar which means "The Place at the Frontier". Earlier it had been known as the "City of Flowers" and the "City of Grains".

Peshawar owes its founding 2,000 years ago to these same Kushans. In the second century AD, Kanishka, the greatest of the Kushan kings, moved his winter capital here from Pushkalavati, 30 kilometres (20 miles) to the north. His summer capital was north of Kabul at Kapisa, and the Kushans moved freely back and forth through the Khyber Pass between the two cities, from which they ruled their enormous and prosperous empire for the next 400 years.

After the Kushan era, Peshawar declined into an obscurity not broken until the 16th century, following the Moghul emperor Babur's decision to rebuild the fort here in 1530. Sher Shah Suri, his successor (or, rather, the usurper of his son's throne), turned Peshawar's renaissance into a boom when he ran his Delhi-to-Kabul sultanate through the Khyber Pass. The Moghuls turned Peshawar into a owers city (one of the meanings of its name) by planting trees and gardens. In the 16th and 17th Centuries, the Moghul emperors lled Peshawar with garden mosques and monuments rivaling those in Delhi and Lahore. But the Moghuls were not able to keep control over much of the Pashtun territory beyond the Peshawar valley. Moghul emperor Aurangzeb lost the Peshawar valley to a Pashtoon Poet warrior Khushal Khan Khattak in the 1680s.

In 1818, Ranjit Singh captured Peshawar for his Sikh Empire. He burned a large part of the city and felled the trees shading its many gardens for rewood. The following 30 years of Sikh rule saw the destruction of Peshawar's own Shalimar Gardens and of Babur's magnicent fort, not to mention the dwindling of the city's population by almost half. Now, little remains of the glorious pieces of architecture and the beautiful gardens.


5

National Advisory Board

Prof Dr Najib Ul Haq

Prof Dr Sadiq Shah

Prof Dr Khalid Hameed

Prof Dr Noor Ul Iman

Prof Dr Zafar Hayat

Prof Dr Humayun Zafar

Prof Dr Humayun

Prof Dr Mian Asad Ullah Jan

Prof Dr Sultan Mehmood

Prof Dr Changez Hakim

Prof Dr Siraj uddin

Prof Dr Ijaz Muhammod Khan

Prof Dr Ikram Ullah

Prof Dr Intikhab Alam

Prof Dr Noor Muhammad

Prof Dr Habib Jadoon

Prof Dr Amjad Taqweem

Prof Dr Hashimuddin

Prof Dr Iftikhar

Prof Dr Qasim Zia

Prof Dr Nasiruddin Azam Khan

Prof Dr Aamir Ghafoor

Prof Dr Javid Iqbal Farooqi

Prof Dr Khalid Mehmood

Prof Dr Ghulam Shabir

Prof Dr Muhammad Zareef

Prof Dr Raullah

Prof Dr Faizurrehman

Prof. Dr Alaf Khan

Prof Dr Noor Wazir

Prof Dr Bakht Biland


Chairperson Workshop CommitteeProf. Dr Khalid HameedWorkshop CommitteeDr. Kamran HassanDr. HashmatConference CoordinatorsDr. Sheema KhanDr. Ihsan UllahDr. Bilal AwanDr. Aleena BadshahDr. JawadCo Secretary Organizing CommitteeDr. DaudChairperson Public Relation CommitteeDr. Amir KhanCo Chairperson Public Relation CommitteeDr. Habib UllahDr. WaheedChairperson Transport CommitteeDr. NosherwanChairperson Hospitality CommitteeDr. Iqbal HaiderChairperson Publication CommitteeDr Jehanzeb AfridiChairperson Finance CommitteeDr. Farooq KhanChairperson Food CommitteeDr Fazle WahabDr KashifChairperson Entertainment CommitteeDr. Zahid WazirChairperson Hall CommitteeDr. Muhammad Ali KhanChairperson Media CommitteeDr. Javed AfridiChairperson Souvenir CommitteeDr. Zahid FidaFinancial OmbudsmanDr. Khalil ur Rehman

Patron in ChiefProf. Dr. Najibul HaqPatronsProf. Dr. Aamir GhafoorPresident PSGDr. Muhammad Sadiq AchakzaiChair PersonProf. Dr. IjazChairman Organizing CommitteeDr. Bakht BilandSecretary Organizing CommitteeDr Fakhr AlamChairperson Scientic CommitteeDr. Sher RehmanInternational Scientic CommitteeDr. Nadeem Tehamee (For UK)Dr. Mohsin Rashid (For USA, & Canada)Scientic CommitteeDr. Nadeem (UK)Dr. Mohsin Rasheed (Canada)Dr. Muhammad ZahidDr. Dil AramChairperson Registration CommitteeDr. ZiauddinChairperson Exhibition CommitteeDr. Abbas KhattakCo Chairperson Exhibition CommitteeDr. Amjad ZamanChairperson Reception CommitteeDr. Rehmat UllahChairperson Fund Raising CommitteeDr. Amin ul HaqChairperson Audiovisual CommitteeProf. Dr. Noor WazirChairperson Accommodation CommitteeDr. Yaseen KhanChairperson Sightseeing CommitteeProf. Dr. Usman Khattak

6

Organising Committee


7

Foreign Speakers

Prof. Derek BellPresident RCSEd

Dr. Deepak DwarakanathUK

Prof. Zhining FanChina

Prof. Yousef M AjlouniMD, Senior Consultant of Gastroenterologyand Hepatology. Head of Jordanian societyof gastroenterology and hepatology (JSGH)

Prof. Bingrong LiuChina

Dr. Mohsin RashidCanada

Prof. Waqar AhmedChina

Dr. Nadeem TehamiConsultant Hepatologist & HPB Physician

University Hospital Southampton NHSFoundation Trust, UK

Prof. Bulent BehranTurkey

Prof. Murdani AbdullahIndonesia

Prof. Serhat BorPresident if Turkish Societyof Gastroenterology, Turkey

Prof. Fazal Sattar KhawajaSaudi Arabia


Foreign Speakers

8

Dr. Raheel Ahmed QureshiDr Raheel Ahmed Qureshi FRCP.

Consultant Physician and GastroentrologistQueen Elizabeth Hospital Gateshead UK.

Dr Mumtaz HayatConsultant Gastroenterologist, Head

of Service Gastroenterology NorthumbriaHealthcare NHS Trust, Lead Colonoscopist,

North of Tyne, Bowel Cancer Screening Programme

Dr. Athar Ahmed SaeedFRCP, Consultant Gastroenterologist,

Queen Elizabeth Hospital Gateshead, UK

Dr. Fahim ButtUK

Prof. Abe Al LehbiSaudia Arabia

Prof. Martin JamesUK

Dr. KhalidUK

Dr. Ishfaq AhmadMB BS FRCP Consultant Physician &

Gastroenterologist Examiner Royal College ofPhysicians UK Worcestershire Acute NHS Trust

Dr. Raja Affendi Raja AliProfessor of Medicine & Consultant

Gastroenterologist, Malaysia

Dr. Syed Zafar AbbasMBBS, FRCP, FEBG, FACP, AGAF,

Consultant Physician & Gastroenterologit,Northumbria Healthcare NHS Trust, UK

Prof Iftikhar Jan SulemanFRCS, FRCS (Ed), FEBPS, FCPS,

FACS, Consultant - Pediatric Surgery

Dr. Iftihkar ButtBahrain


Scientific Program at A Glance

9

DATE DAY SCIENTIFIC PROGRAM

Wednesday

Thursday

Friday

Saturday

Sunday

th26 Feb, 2020

th27 Feb, 2020

th28 Feb, 2020

th29 Feb, 2020

st01 Mar, 2020

Therapeutic Endoscopy Workshop

Advanced Endoscopic Workshop

Morning

Workshop on Disinfection

Specialists to Meet the Press

st1 Plenary Session

Scientic Sessions

Evening

Inaugural Session

Lifetime Achievement Award

Inaugural Dinner

Breakfast Session

nd2 Plenary Session

Scientic Sessions

Pre-Lunch Symposium

Lunch

Executive Committee Meeting of PSG

Scientic Sessions

General Body Meeting of PSG

Gala Dinner

Breakfast Session

rd3 Plenary Session

Scientic Sessions

Closing Sessions

Lunch


Foreign Faculty

10

UKProf Derek Bell (president RCPEd)Dr. Gary DaviesDr. David NylanderDr. Harry DultonDr. Martin JamesDr. Deepak DwakanarathDr. BidourDr. HamidDr. Qazi Nayyar ZamanDr. Faheem ButtDr. Zafar AbbasDr. Mumtaz HayatDr. Saqib ahmadDr. Nadeem TehamiDr. Waqar AhmadDr. Athar SaeedDr. Farooq KhanDr. Ishfaq AhmadDr. Tajamul Malik

USADr. Khalid HassanDr. Alain Bernard Labrique

ChinaProf. Enqiang Linghu'sProf Fan ZhiningProf. Bingrong LiuDr. Meidong XuDr. Yunshi ZhongDr Liping YeDr. Guoliang yeMs. Sarah Fling

ThailandProf Varocha MahachaiDr. PisesDr. Sakkarin

TurkeyProf Serhat BorDr. Bulent Baran

Saudia ArabiaProf. Fazal Sattar KhwajaProf. Abed H. Al Lehibi

CroatiaProf. Goran HauserProf. Davor Stimac

CandaDr. Mohsin Rashid

UAEProf Iftikhar Jan

IndonesiaProf. Murdani Abdullah

VietnamThirumalaisamy P. Velavan

MalaysiaDr. Raja Affendi

BahrianDr Iftikhar Butt


Scientific Program



Our Partners

Our Partners


Our Partners


Abstract

S.No. Abstract Title Author(s)

1 Correlation between Alanine Aminotransferase and Left Ventricular Mass in patients with Non-Alcoholic Fatty Liver Disease

Ali Asad Khan, Muhammad Arshad Khan

2 LONG-TERM RENAL SAFETY OF TENOFOVIR DISOPROXIL FUMARATE IN CHRONIC HEPATITIS B PATIENTS

Nazish Butt, Lajpat Rai, Riaz Hussain, Hanisha Khemani, Sabir Ali, Amanullah Abbasi

3 LONG-TERM BONE SAFETY OF TENOFOVIR DISOPROXIL FUMARATE IN CHRONIC HEPATITIS B PATIENTS

Nazish Butt, Riaz Hussain, Lajpat Rai, Hanisha Khemani, Sabir Ali, Amanullah Abbasi

4 Temporal Trends in Prevalence of Hepatitis B, Hepatitis C and Human ImmunoDeficiency virus in Blood Donors of Pakistan

Ansar ullah , Muhammad Ateeq ur Rehman , Hizbullah , Atifa Shuaib

5 Ergonomic injuries in endoscopists and their risk factors Dr. Hamid Ali, Dr. Lubna kamani

6 Assessment of liver fibrosis with transient Elastography in NAFLD patients

Lajpat Rai, Nazish Butt, Riaz Hussain, Hanisha Khemani, M. Ali Khan, Dr Sabir Ali, Amanullah Abbasi

7 Role of antibiotic prophylaxis to prevent post-endoscopic retrograde cholangiopancreatography (ERCP) cholangitis A single-center cross- sectional study

M. Zeeshan Siddique, M. Saqib, Zaeem Sibtain, Shafqat Mehmood, Salma M. Abbas, M. Abu Bakar, M. Aasim Yusuf

8 Mucosal transplantation for the management of stricture after endoscopic submucosal dissection

Saif Ullah, Yang-yang Zhou, Li-Xia Zhao, Bing-Rong Liu

9 Relationship of LFTs with systemic hypertension in Hepatitis C infected patients with ESRD

Dr. Israr ul Haque Tor, Dr. Junaid Mushtaq, Azhar Hussain, Dr. Muhammad Nadeem Tehami, Saliha Yousaf, Ayesha Irfan

10

Risk of hepatocellular carcinoma (HCC) occurrence in HCV infected cirrhotic patients after SVR treated with triple therapy of Ribavarin-Sofosbuvir-Dactlasavir- A single center retrospective cohort study

Azhar Hussain, Dr. Muhammad Nadeem Tehami, Muhammad Abdullah Iqbal, Hafiz Ahmad Ayyan, Dr. Muhammad Akif Dilshad, Dr. Israr ul Haque

11 Relationship of serum sodium and creatinine with liver function tests (LFTs) and their association with interdialytic weight gain (IDWG) in Hepatitis C infected patients with ESRD

Dr. Israr ul Haque Tor, Dr. Junaid Mushtaq, Azhar Hussain, Dr. Muhammad Nadeem Tehami, Sania Siddiqa, Nimra Naeem

12 Non Alcoholic fatty liver disease: Its frequency and association with diabetes control in non-obese Type 2 diabetics

Muhammad Omar Malik, Muhammad Umair Khan, Syed Hamid Habib

13 Relationship of LFTS with IDWG and its complications in Hepatitis C positive ESRD patients

Sania Siddiqa, Nimra Naeem, Azhar Hussain, Dr. Israr ul Haque Tor

Participants bring their Abstract's poster


Abstract

Acute liver failure (ALF) is dened as a rapid hepatic dysfunction and encephalopathy in the absence of pre-existing liver disease. It is relatively uncommon worldwide, however, it progresses rapidly with high mortality. Globally, viral hepatitis is responsible for the majority of cases of ALF. This study aimed to determine the etiology, outcome and predictive factors for in-hospital mortality in ALF patients.

Results:

The in-hospital mortality of ALF was signicantly high with raised INR, MELD (>32), KCC (2/5) and sepsis. Hence, they are poor prognostic factors.

Methods:A descriptive study was conducted with ALF patients hospitalized at the Gastro-Hepatology Department of Asian Institute of Medical Sciences, Hyderabad from May 2018 to September 2019. A total of 31 patients having clinical and biochemical markers suggestive of ALF were included in the study and evaluated for etiology, prognostic factors and outcome during the hospital stay. International Normalized Ratio (INR), sepsis (2 SIRS + conrmed or suspected infection), prognostic scores {King College Criteria (KCC) and Model End-Stage Liver Disease (MELD)} and other prognostic factors were compared.

Introduction:

Acute Liver Failure: Outcome and prognostic predictors

Conclusion:

Thirty-one patients with a mean age of 22 years, 21 (67.7%) were males. Most common etiology was indeterminate 21 (67.7%) while 5 (16.15%) had Hepatitis B and 5 (16.15%) had Hepatitis E. The in-hospital mortality was 19 (61.3%), out of which 14 (73.3%) were males and 12 (38.7%) recovered spontaneously. INR > 5.00 ( 1 survivor and 7 non-survivors, Mean= 3.12 and 4.02 in both groups respectively, p=0.02), MELD score >32 ( 3 survivors and 12 non-survivors, Mean= 29.58 and 33.31 in both groups respectively, p=0.049), KCC 2 or more out of 5 ( 1 survivor and 7 non-survivors, Mean= 0.83 and 1.31 in both groups respectively, p=0.068), and sepsis (0 survivors and 8 non-survivors, p= 0.008) were independently associated with in-hospital mortality.

Mohsin Ali, Jalpa Devi, Amerta Bai, Adil Hassan, Saadat Ali, Muhammad Sadik. (Asian Institute of Medical Sciences, Hyderabad, Pakistan)


Abstract

Department of Oncology, Jinnah Postgraduate Medical Centre (JPMC), Karachi, Sindh, Pakistan.

This retrospective study covered all histopathologically conrmed cases of esophageal carcinoma, presented within the 10 year period from January 2010 to 20 December 2019.

Epidemiology And Clinical Characteristics Of Esophageal Cancer: Ten Year Experience In A Tertiary Care Hospital Karachi, Pakistan.

Esophageal cancer (EC) is an aggressive tumor that carries a poor prognosis. EC is the fourth commonest malignant tumor reported in Pakistan. Aim of this study was to assess epidemiological and clinical characteristics of esophageal cancer, identied over a 10-year period at the largest referral centre of Karachi, Pakistan.

Methods:

Background and Aim:

Sabir Ali, Nazish Butt, Ghulam Haider, Lajpat Rai, Hanisha Khemani, Riaz Hussain Channa, Aemon Zehra, Ghulam Basit Mahesar.

EC is the most prevalent cancers in Pakistan, and its incidence is increasing day by day. The reason for raised incidence was associated with increased consumption of beetle nuts and gutka in certain parts of the country. It is hoped that this study will be an important step towards developing a comprehensive laws against consumption of gutka and beetle nuts.

Department of Gastroenterology, Medical unit IV, ward 23, Jinnah Postgraduate Medical Centre (JPMC), Karachi, Sindh, Pakistan,

Over the period of 10 years, 1066 patients with EC had been identied, 57 patients were excluded due to incomplete records. Their ages ranged from 15 to 92 years with a mean of 49.26 ±14.24 years. Female were 566 (56.1%) and male 443 (43.9%). Dysphagia and weight loss were the most common symptoms. Most of the patients were belonging to the province of Sindh 849 (84.1%). Beetle nuts, pan and gutka were the most predominant risk factors among 768(76.1%) of patients. The most common EC type was Squamous cell carcinoma 834(83%) followed by Adenocarcinoma 175 (17%) of patients. EC predominantly involved mid to distal esophagus (67%).

Conclusion:

Keywords:Esophagus, squamous cell carcinoma, adenocarcinoma, female, beetle nuts.

Results:


Abstract

Key Words:

Fulminant Hepatic Failure Etiology, Clinical Manifestations, and Outcome: An Experience of Tertiary Care Hospital of Karachi, Pakistan

The mortality rate of FHF is very high which can be reduced to some extent in a non-liver transplant areas by controlling the risk factors associated with poor outcome.

This was a cross-sectional study conducted at the Department of Gastroenterology, Jinnah Postgraduate Medical Centre, Karachi, Pakistan from January 2018 till to date. All patients of both gender ≥16 years were recruited and investigated for acute viral serology, complete blood count, liver function tests, renal function tests, serum creatinine, MELD score parameters, King's college criteria (KCC) parameters. Data were analyzed by logistic regression analysis to identify predictors of poor outcome.

During the study period, 40 patients were enrolled, out of which 25 (63%) were males and 15 (37%) were females with a mean age of 26.03 ± 9.95 years. Hepatitis E was found to be the most common cause of FHF 21 (51%). Thirty ve (88%) of patients died and ve patients recovered and were discharged symptom free. Variables i.e. presence of viral hepatitis E, serum creatinine >2.5 mg/dl, and sepsis were found to have signicant association with mortality on linear correlation. Only serum creatinine more than 2.5 mg/dl and development of sepsis were found to predict the outcome after multivariate analysis. The KCC criteria cut off point was reached in a total of 23 patients (out of 40) of which 35 patients died.

Jinnah Postgraduate Medical Centre, Karachi,

INTRODUCTION:Fulminant hepatic failure (FHF) is characterized by the development of severe liver injury with impaired synthetic capacity and encephalopathy in patients with previous normal liver or at least well compensated liver disease. The etiology of fulminant hepatic failure refers to a wide variety of causes, of which toxin-induced or viral hepatitis are most common. The prognosis of such patients is quite poor particularly in areas have no liver transplant facility. Lack of scientic data in our area led us to conduct this study and to evaluate the etiology, clinical manifestations and outcome of patients with FHF.

RESULTS:

Dow University of Health Sciences Ojha campus Karachi, Pakistan.

Nazish Butt, Hanisha Khemani, Lajpat Rai, Riaz Hussain, Sabir Ali, Amanullah Abbasi.

CONCLUSION:

Patients and Methods:

Fulminant Hepatic Failure, Etiology, Clinical Manifestations, Outcome, Pakistan


Abstract

Key Words:

Conclusion:

A hospital based Quasi interventional study was conducted from May 2016 to December 2019. We followed clinical status of patients who had Pneumatic (PD) for Achalasia. All patients were followed up periodically for a minimum of 2yrs.Structured interviews were conducted regarding symptoms severity, health related Quality of life and patient satisfaction using SF-8TM Health survey Questionnaire (minimum score 0, max score 80) and achalasia severity Eckardt score (no symptom= 0 , max symptom severity=12).Scores were presented as median with interquartile range. Wilcoxon signed ranked test was used for statistical Analysis.

Results:

Improvement in Health related Quality of Life and Patient satisfaction after Pneumatic Dilatation in Achalasia Patients: Results of a Prospective Follow upDr. Shahid Rasool, Dr. Soa Hanif, Dr. Ahmad Nawaz Babar

Aims & Objectives:

Methods:

Background:

A total of 40 patients (55% males,45% females) were treated by PD. Mean patient age was 37 + 10yrs.On evaluation, PD was found to be very effective in 37/40 patients (92.5%). Only 3 patients required a 2nd session of PD over this time interval. No signicant immediate or late complication was noted. There was signicant improvement (P value <0.05) in achalasia severity eckardt scores (10 Vs 2) as well as SF8-Health Survey scores (30 Vs 80) in the follow up period.

Dept. of Gastroenterology, Madina Teaching Hospital, Faisalabad

PD is an effective and safe long term therapy for achalasia patients. It improves Health related Quality of life and patient satisfaction in long term follow up.

Achalasia, Pneumatic Dilatation, Eckardt Score.

Achalasia is a benign but debilitating primary esophageal motility disorder which may have a detrimental effect on Quality of life. Improvement of symptoms is the main goal of therapy. Pneumatic dilatation, per oral endoscopic myotomy, Heller's myotomy and botulinum toxin injections are the treatment options.

Our aim was to objectively determine the changes in Health related Quality of Life in the long term clinical course of patients after Pneumatic Dilatation.


Abstract

A chi square test of independence established that the association between BMI & hiatus hernia was signicant (p<.01) but no signicant association was found between BMI and esophagitis (p=.14). A series of logistic regression analyses showed that BMI was not a signicant predictor of hiatus hernia though age and gender were signicant predictors. It was also revealed that normal BMI was a signicant predictor of Grade I esophagitis.

During this descriptive case series, 372 patients were selected who presented with epigastric pain or refractory GERD. All the patients underwent gastroscopy using Olympus CLV-260 series gastroscope. Endoscopic ndings were observed for grades of hiatus hernia (Hill classication) and stages of esophagitis (Savary-Miller classication). BMI was calculated using height and weight of the patients.

CONCLUSION

Body Mass Index, Hiatus Hernia, Esophagitis, Endoscopy.

RESULTS

BMI is not a signicant predictor of the grades of hiatus hernia and esophagitis. Further studies need to be conducted to establish stronger predictors of severity of hiatus hernia and esophagitis.

KEYWORDS

METHODS

OBJECTIVESHiatus Hernia is one of the leading gastrointestinal problems in Pakistan. The study was conducted to establish the association between BMI and hiatus hernia and assess the predictive value of BMI in patients of hiatus hernia and esophagitis.

Predictive value of body mass index for hiatus hernia and esophagitis in gastroesophageal reux disease patientsAli Asad Khan (Assistant Professor, North Medical Ward, KEMU/Mayo Hospital Lahore), Ali Salman Khan (Medical Ofcer. NHS, UK), Anam Ali (Clinical Psychologist, Institute of Child Health), Yasir Sha (Mecical Ofcer, Mayo Hospital Lahore), Sajid AbaidUllah (Professor & HOD, North Medical Ward, KEMU/Mayo Hospital Lahore)


Abstract

Diagnostic Delay in Esophageal Carcinoma in Diverse Population of a Metropolitan CityDr Mohsin Javed, (presenting author) MBBS, Jinnah Sindh Medical University (JSMU) Karachi Pakistan.Dr Irtiza Bhatti, MBBS, Jinnah Sindh Medical University (JSMU) Karachi PakistanDr Nazish Jaffar, Assistant Professor, Department of Pathology, Jinnah Sindh Medical University (JSMU) Karachi Pakistan

METHODS:

OBJECTIVE:

A multi-institutional prospective cross-sectional study was conducted at Oncology ward, Jinnah Post Medical Centre (JPMC) and Atomic Energy Medical Centre (AEMC) Karachi. Non-probability convenient sampling technique was implemented. Chi square/Fisher Exact was applied to observe any association between ethnic groups, grade, stage and risk factors of delayed diagnosis.

CONCLUSION:

Dr Ghulam Haider, Associate Professor, Department of Oncology, Jinnah Postgraduate Medical Centre (JPMC) Karachi Pakistan

Out of 93 EC patients, Squamous cell carcinoma (ESCC) was the most common (80.6%) histologic type. Most frequent tumor location was lower 1/3 rd in 53.8%. Sindhi speaking was the most commonly effected (33.3%) ethnicity. Moderately differentiated was the most common (67.7%) grade. First visit to a general physician (GP) was within a month in 54.8% patients. In 21.5%, rst visit was delayed by more than 2 months. Biopsy was delayed in 19.4% cases. Signicant association was found between delayed diagnosis and factors including late referral to medical specialist by general physician (GP) (P 0.003), non-availability of laboratory (P 0.018), location of tumor (P 0.000), age and size of tumor (P 0.001).

To determine the frequency of Esophageal Carcinoma (EC) in different ethnic groups and to identify factors responsible for late stage diagnosis of EC.

RESULTS:

ESCC was the most common histological type. Sindhi population was ost frequently affected. No signicant association was observed between ethnicity and EC grading or staging. Initial diagnosis of most of the patients was made in late stage. Important contributing factors of late diagnosis were inadequate knowledge of patients, delayed initial investigations, poor socioeconomic status and late referrals to medical specialist by General Physicians.


Abstract

“Frequency of raised intraepithelial lymphocytes in duodenal biopsies among dyspeptic patients ”DR. RAVI RAJResident Gastroenterology,Liaquat National Hospital,Karachi.

Functional Dyspepsia (FD) is one of the most common causes of gastrointestinal symptoms aetiology of which is poorly understood. Duodenal intraepithelial lymphocytosis (DIL) is a histological nding characterized by the increase of intraepithelial CD3T-lymphocytes over the normal value without villous atrophy. The aim of this study was to investigate the frequency of raised intraepithelial lymphocytes in duodenal biopsies among dyspeptic patients.Objective:To determine the frequency of raised intraepithelial lymphocytes in duodenal biopsies among dyspeptic patients, at a tertiary care Hospital, KarachiSetting:Study was conducted on inpatients and out patients Department of Gastroenterology, Liaquat National Hospital, Karachi. Study Design:It was cross-sectional study.Duration of study:

Introduction:

Was 6 months from 17th Feb 2019 to 17th Aug 2019

All patients who fullled the inclusion criteria in the Department of Gastroenterology, Liaquat National Hospital Karachi were included. After taking informed written consent history and clinical examination was done and duodenal biopsies were checked to assess the outcome i-e frequency of raised intraepithelial lymphocytes.

Intraepithelial lymphocytosis, functional dyspepsia, histopathology

Subject & Methods:

Result:

Conclusion:Raised intraepithelial lymphocyte count is a condition not very common in functional dyspepsia. But functional dyspepsia may be considered as a possible explanation for duodenal intraepithelial lymphocytosis with normal villous architecture

Total of 122 patients with functional dyspepsia were included. 66 patients (54.1%) were males & 56 (45.9%) were females with the mean age of 37.041+11.821 years. The raised LEL count was seen in 5 patients (4.1%).

Key words:


Abstract

Dr. Hamid Ali, Dr. Lubna kamani

Female patients may feel uncomfortable during endoscopy especially colonoscopy with male doctors. The aim of this study is to assess the gender preferences of endoscopists, and the impact on acceptance for endoscopy.

Subject & Methods:

Gastroenterology department, Liaquat National Hospital, Karachi

Objective:

Patients have an increased gender preference for the endoscopists especially colonoscopist because of embarrassment. Taking this into account can increase patient satisfaction during endoscopy.

IMPORTANCE OF THE DOCTOR’S GENDER AND PATIENTS PREFERENCES FOR ENDOSCOPIC PROCEDURES

Introduction:

To assess importance of the doctor’s gender and patients preference for endoscopic procedures at a tertiary care hospital, Karachi

All patients who fullled the inclusion criteria in the Department of Gastroenterology, Liaquat National Hospital, Karachi were included. After taking informed written consent, patients or their families were interviewed and asked to ll the performa to determine the outcome i-e preference for endoscopist’s gender. Chia square test and multiverate logistic regression was used. P-value <0.05 was considered as signicant. Designs of Study:Cross sectional, prospective study. Results:A total of 1108 patients or their relatives coming for endoscopy will be included. 595 patients (53.7%) were male with the mean age of 43.56+15.802 years. 194 (17.5%) from JPMC & 914 (82.5%) were from liaquat National hospital, Karachi. 352 patients (31.8%) preferred male endoscopists, 367 (33.1%) preferred female endoscopists. 740 patients (66.8%) were satised. 533 patients (48.1%) waited for doctor and the mean waiting time was 8.87+8.063 days. In sub group analysis 267 (24.1%) preferred female endoscopist, 87 (7.9%) preferred male while no gender preference was noted in 159 (14.9%) (p-value=0.000). family pressure was more in female patients to get endoscopy from their family chosen endoscopists. Doctor’s gender preference was more in educates patients. No signicant of gender preference was noted with age, (p-value=0.188).Conclusion:

Endoscopy, colonscopy, gender preferance.Key Words:


Abstract

Biland B, Haq M, Kashif A, Haq N

Abstract:

The distribution of Hepatitis C Virus genotypes with reference to age and gender in Khyber Pakhtunkhwa, Pakistan: Real world data

Peshawar Medical College, Peshawar, Khyber Pakhtunkhaw, Pakistan.

Pakistan has the second largest prevalence of hepatitis C in the world after Egypt.Viral hepatitis is a leading cause of morbidity and mortality in Pakistan and worryingly reinfection rates are on the rise. This epidemiological study aimed to nd the most common genotypes with reference to age and gender. We collected 1259 HCV positive blood from patients visited to Prime Teaching Hospital/Peshawar Medical Collegefrom different districts of Khyber Pakhtunkhwa. HCV RNA was quantied by Real time PCR. HCV RNA positive samples underwent genotyping. Predominant genotypewas 3a followed by the 1a, mixed and3b.The genotype 2a and1b were the least prevalent genotypes in Khyber Pakhtunkhwa. The overall prevalence of HCV in Khyber Pakhtunkhwa was signicantly high in the females 634 (50.29%) patientsas compared to males 625 (49.71%)patients. The most common mixed genotype was 3a+1a observed in females with high value as compare to males. The ratio of infected people was recorded high in the age group of 41-50. Infection rate was comparatively low in other age groups. Our study suggests that the patients with high viremia were females from Peshawar region. The signicant difference was observed in HCV prevalence genotype 3a and 2a in different districts of Khyber Pakhtunkhwa.It is concluded from present study that the most prevalent genotype is 3a and high prevalence is seen in female than male and the common age group is 41-50 years in the infected population of Khyber Pakhtunkhwa.


Abstract

Three months survival of patients in advanced Hepatocellular carcinoma with supportive care and various factors inuencing poor outcome.Shaikh Sana, Memon Sadik

OBJECTIVETo determine three months survival of patients in advanced Hepatocellular carcinoma with supportive care and various factors inuencing poor outcome.

METHODOLOGY The patients presenting to gastroenterology OPD/Emergency department with a diagnosis of HCC were enrolled in this study. Patients were followed up to three months and then the outcome was evaluated. Overall survival (OS) was calculated as the time from inclusion in our study until death from any cause. The effect modiers were controlled through stratication of age, gender, and cause of HCC to see the effect of these on outcome variables by applying chi square and sher’s exact tests. P value of < 0.05 will be taken as statistically signicant.

RESULTSTotal of 94 patients were selected and their mean age was 49.13 years (9.61 ±SD) with male predominance (62.76%), most common cause of HCC was due to HCV infection (43.61%, N = 41). Most of the HCC cases had massive ascites (54.25%, N = 51) and BCLC stage C was most common as compared to Stage D among our study subjects, (56.38%, N = 53 and 43.16, N = 41, respectively).The death rate is high 30.85% (N = 29) in HCC patients managed conservatively during three months of our study duration. Poor outcome signicantly observed in patients with HCV induced HCC, increased total bilirubin levels (≥1.72 mg/dL), decreased serum albumin (≤1.77 mg/dL) and platelet count (≤85.42 x 109), massive ascites, BCLC stage D, and raised serum AFP levels (≥608.52 ng/mL, p value <0.05).

HCC, Three Months Survival, Conservative Management.

Three months survival is low in HCC patients managed conservatively and when these complicated with BCLC stage D, raised serum AFP levels, thrombocytopenia are signicantly associated with poor outcome in three months.

CONCLUSION

KEY WORDS:


Abstract

Dr. Faiza Sadaqat Ali, Dr. Bader Faiyaz Zuberi, Dr. Rabeea Abbas

28 years old female patient, know case of cryptogenic cirrhosis and Diabetes Mellitus presented with 6 months history of chronic episodic diarrhea. Upper gastrointestinal endoscopy showed multiple hyperplastic polyps seen in fundus and body of stomach. Biopsy and histopathology was consistent with well differentiated Neuroendocrine tumor NET G2 according to the WHO classication of tumors of digestive system. Immunohistochemical stains showed positivity for Cytokeratin AE1/AE3 P, Synaptophysin, Chromogranin, CD5/6 with Ki67 index 3-5%, with normal serum levels of Gastrin and 5 hydroxy indole acetic acid (5HIAA). Her Ga-68-DOTATOC PET/CT scan sowed contrast enhancing FDG enhancing lesion seen in body of stomach along the greater curvature in posterolateral wall measuring 1.1x1.0x1.5 cm (TS X AP X LS), SUV max 21, without any metastasis.

A RARE ASSOCIATION OF TYPE III GASTRIC NEUROENDOCRINE TUMOR WITH CRYPTOGENIC CIRRHOSIS AND DIABETES MELLITUS, PRESENTING AS CHRONIC NON RESOLVING DIARRHEA

We describe a case of type III gastric Neuroendocrine tumor with Cryptogenic cirrhosis and Diabetes mellitus, presented as chronic non resolving diarrhea.

Consultant Physician, Dow Medical College, Dow University of Health Sciences, Karachi

INTRODUCTION:

PRESENTATION OF CASE:

Professor, Head of department & Chairperson, Dow Medical College, Dow University of Health Sciences, Karachi

Gastric neuroendocrine tumors are extremely rare tumors, accounting for 4% of all neuroendocrine tumors of the body and 1% of all neoplasms of the stomach. Association of pancreatic NETS was found with sinistral portal hypertension but we did not nd any literature mentioning association of gastric NETs with Cryptogenic cirrhosis and por tal hyper tension. Although functional Gastrointestinal NETs, mainly carcinoid tumors and VIPomas usually present as diarrheal symptoms, but here patient with nonfunctional type III gastric NETs presented as non-resolving chronic episodic diarrhea.

DISCUSSION:

Post Graduate Trainee, Dow Medical College, Dow University of Health Sciences, Karachi.

Keywords:Gastric neuroendocrine tumor; cryptogenic cirrhosis.


Abstract

Conclusion:

Material and Methods:

Department of Gastroenterology, The First Afliated Hospital of Zhengzhou University, Zhengzhou, China.

Background and Aim:

A snare assisted pure NOTES retrograde cholecystectomy using a single channel exible endoscope: a pilot experiment in a porcine model

Under general anesthesia, an incision is created on the posterior vagina wall and an endoscope with a snare attached on transparent cap is introduced into the pelvic cavity and then upward into peritoneal cavity. After locating the liver and gallbladder, the fundic wall of gallbladder was grasped using a biopsy forceps and a snare was released to ligate the fundus. The gallbladder is then carefully dissected from the gallbladder bed using hook/IT knives with the assistance of the snare. The cystic duct and cystic artery are identied, clipped twice and isolated from the gallbladder using hook knife to cut between the clips. The specimen is then removed through the vagina using the snare.

This procedure was successfully performed in 8 consecutive porcine models. The average procedure time was 53 min (range, 40-60 min). No severe bleeding or any other complication was observed either during or after the procedure in any animals Normal diets were given on the same day of the procedure. All animals recovered uneventfully.

We successfully performed snare-assisted pure NOTES retrograde cholecystectomy in pigs using standard endoscopic instruments. In our experience, pure NOTES cholecystectomy using the retrograde approach performed with a single channel exible endoscope proved safe and feasible with a short procedure time and quick recovery. The translation of this technique to human subjects seems straight forward and provide a new tting path to pure NOTES..

Saif Ullah MD, De-Liang Li, MD, Dan Liu, MD, PhD, Li-Xia Zhao, MD, Bing-Rong Liu MD, PhD.

Natural orice transluminal endoscopic surgery (NOTES) cholecystectomy is a new development that is still considered experimental. However, interest is ongoing and development in this area have been rapid. Although, NOTES cholecystectomy is less invasive, it has failed to gain traction. Here, we share our experience of snare-assisted pure NOTES retrograde cholecystectomy using porcine models.

Results:


Abstract

We found that a comprehensive public health awareness to NAFLD is lacking in the surveyed Pakistani population. This includes policy in the form of a strategy, clinical guidelines, awareness campaigns, civil society involvement, and health systems organisation, including registries. Moreover, further exploration into the awareness and attitudes of NAFLD is needed to develop strategies for combating this disease, specially in Pakistan.

A survey on Perceptions of Non-alcoholic fatty liver disease: A real life experience from Pakistan.

A Cross-sectional study was undertaken at the Department of Gastroenterology, Jinnah Postgraduate Medical Centre and and Medical Unit II, Dow University of Health Sciences Ojha campus Karachi, Pakistan. After obtaining ethical approval, all patients >18 years, with a suspected diagnosis of NAFLD, those with abnormal liver function tests, or abnormal imaging consistent with fatty liver were included in the study. All patients with, hepatitis, hepatic malignancies, hepato-biliary infections, and biliary tract disease were excluded from the study. Perceptions of NAFLD were assessed using a self-administered survey questionnaire.

Jinnah Postgraduate Medical Centre, Karachi.Dow University of Health Sciences Ojha campus Karachi, Pakistan

Nazish Butt, Lajpat Rai, Riaz Hussain, Hanisha khemani, Ali Khan, Sabir Ali, Amanullah Abbasi

Background and Aims:Non-alcoholic fatty liver disease (NAFLD) is associated with metabolic syndrome components such as obesity, insulin resistance, hypertension, and hypertriglyceridemia. An overall prevalence of 47% was found in a previous study from Pakistan, however there is no community based study from Pakistan about perception and awareness of NAFLD in patients who are actually suffering from it. Here we aim to explore the awareness and perceptions of patients with NAFLD.

Results:

Method:

A total of 162 patients with NAFLD were enrolled in the study with a mean age of 39.60±9.74 years. One hundred & eight (67%) belonged to the lower socioeconomic class. Out of which 41 (25%) were male and 121 (75%) were female. Forty-two patients (26%) knew about their disease while only 26 (16%) knew what fatty liver is. The majority 100 (62%) considered themselves overweight while 113 (70%) were called upon by others as overweight. Almost half of the population 82 (51%) thought of the weight as having edema and most of them 127 (78%) felt they need to lose weight. Around 108 (67%) of the cohor t believed they exercise enough while 90 (56%) considered it as the chores of the house. 82 (51%) of them believed that they overeat while 70 (43%) thought that they eat inappropriate food. Moreover, only 23 (14%) knew about the co-morbids of NAFLD. When inquired about alternative medications, 40 (25%) were taking it while 32 (20%) considered those harmful.

Conclusion:


Abstract

EUS-FNA and ancillary studies and their clinical utility in patients with mediastinal, pancreatic and other abdominal lesions.M. Saqib, last name: Saqib. Maheen Maruf, last name: Maruf. Sehar Bashir, last name: Bashir. Shafqat Mehmood, last name: Mehmood. Noreen Akhter, last name: Akhter. M. Aasim Yusuf, last name: Yusuf. Asif Loya, last name: Loya.

Introduction:Endoscopic ultrasound guided ne needle aspiration is an important modality to obtain the tissues diagnosis from mediastinal, pancreatic and intra-abdominal lesions in close proximity to pulmonary and gastrointestinal tract. It is considered relatively safe, rapid and minimally invasive technique with low complication rates. Aims: To determine the diagnostic accuracy, sensitivity, specicity, positive predictive value, negative predictive value and outcome of the EUS guided FNA and histological correlation where applicable.

Endoscopic ultrasound guided ne needle aspiration (EUS-FNA), Rapid onsite evaluation (ROSE), ancillary studies.

Data of all 1059 consecutive patients who underwent EUS-FNA from 1st January 2005 to 31st December 2018 at Shaukat Khanum Memorial Cancer Hospital Lahore was reviewed in this retrospective study. The major sites that were targeted for EUS-FNA were pancreatic 476/1059, mediastinal 376/1059 and other abdominal lesions 260/1059.

Conclusion:EUS-FNA is a very sensitive and specic diagnostic tool with minimal complication rate. Ancillary studies helped to increase the sensitivity as well as diagnostic yield.

Average numbers of passes per patient were 2.22. The rapid onsite evaluation (ROSE) was performed in all the cases and it was adequate in 969 (91.4%) patients, whereas it was inadequate in 91 (8.6%) patients. Concordance between ROSE and nal cytology was 99.5%. Follow up was available in 810(76.4%) patients. Overall diagnostic yield was 87.5 % (n: 927) however on nal evaluation 72 patients were true negative thus raising the diagnostic yield to 94.3 %. The ancillary studies including immunohistochemical stains, and ow cytometry helped to increase the diagnostic yield from 78.1% to 94.3%. The overall sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy for EUS-FNA were 94.8%, 98.6%, 99.9%, 65.5% and 95.1% respectively. 7(0.6%) out of 1059 developed major complications that required hospitalization; however all were discharged home safely.

Key words:

Results:

Methods:


Abstract

Dr. Abdul Latif, Dr. Hamid Ali Kalwar, Dr Lubna Kamani

F r e q u e n c y o f d u o d e n a l u l c e r s a m o n g d y s p e p t i c p a t i e n t s u n d e r g o i n g esophagogastroduodenoscopy at a tertiary care hospital, Karachi.

Gastroenterology department, Liaquat National Hospital, Karachi

Background and Aims:Dyspepsia is a common presenting complaint of various upper gastrointestinal disorders. One of the common endoscopic nding in patients with helicobacter pylori infection is duodenal ulcers, which can present with upper gastrointestinal bleed. The aim of this study was to investigate the frequency of duodenal ulcers among dyspeptic patients undergoing esophagogastroduodenoscopy.

Subject & Methods:All patients who fullled the inclusion criteria in the Department of Gastroenterology, Liaquat National Hospital & Medical College, Karachi were included. After taking informed written consent history was taken, clinical examination was done and esophagogastroduodenoscopy (EGD) was done to assess the outcome i-e frequency of duodenal ulcers.

Results:A total of 156 patients with dyspepsia were included. 87 (55.8%) were male & 69 (44.2%) were female with the mean age of 36.967+11.718 years. The most common symptom at presentation was epigastric burning seen in 76 (48.7%) followed by postprandal fullness in 59 (37%). Duodenal ulcers were noted in 18 patients (11.5%). Duodenal ulcers were signicantly associated with alcohol intake, smoking, epigastric pain, postprandal fullness with the p-value of 0.001, 0.001, 0.001 & 0.013 respectively.

Duodenal ulcer is not a common endoscopic nding in dyspeptic patients. it is common in smokers, alcoholics and patients presenting with epigastric pain & postprandal fullness.

Conclusion:

Key word:Dyspepsia, Duodenal ulcer, Esophagogastroduodenoscopy, Smoking.


Abstract

A total of 75 (72.1%) out of 104 celiac patients were diagnosed based on biopsy results while 29 (27.9%) were diagnosed without biopsy. 82 (78.8%) patients were stunted and among them only 21 (25.6%) were wasted. 48 (46.2%) celiac patients had a family history of celiac disease. Only 11 (20%) out of 51 patients were exclusive breast-fed for 6 months. Bottle feeding was initiated at an early age of 1 to 3 months among 39 (52.7%) out of 74 bottle-fed infants. Early introduction of gluten to 29 (27.8%) patients while late introduction of gluten to 58 (55.7%) celiac patients was observed.

Design:

A total of 104 diagnosed celiac patients aged between 1 to 7 years, including 54 male and 50 females were enrolled and data regarding different characteristics were obtained.

INAPPROPRIATE FEEDING PRACTICE AMONG CHILDREN DURING FIRST YEAR OF LIFE; A POSSIBLE CAUSE OF CELIAC DISEASE

Celiac disease, Early initiation of bottle milk, Early introduction of gluten, Breast milk

Results:

Method:

Subjects:

Objective: To determine the affect inappropriate feeding practice in rst year of life on the occurrence of celiac disease.

Pediatric ward, Nutritional Rehabilitation Unit/Stabilization Center (NRU/SC), MTI Lady Reading Hospital Peshawar.

Conclusion:

Bushra Khalil, Muhammad Jamal Khan, Aamir Ghafoor and Sajid Iqbal

Keywords:

Cross sectional study.

Setting:

After the conrmation of celiac disease. Interviews were conducted from patient’s mother. Data regarding diagnosis, clinical manifestations, socio-demographic, nutritional status, and feeding practices were obtained and analyzed.

Inappropriate feeding practices increase the risk of developing celiac disease in early life stages.


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