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2.  Role of vitamin K2 in preventing the recurrence of hepatocellular carcinoma after curative treatment: A meta-analysis of randomized controlled trials 
BMC Gastroenterology  2012;12:170.
Background
Hepatocellular cancer is notorious for recurrence even after curative therapy. High recurrence determines the long term prognosis of the patients. Vitamin K2 has been tested in trials for its effect on prevention of recurrence and improving survival. The results are inconclusive from individual trials and in our knowledge no systematic review which entirely focuses on Vitamin K2 as a chemo preventive agent is available to date. This review is an attempt to pool all the existing trials together and update the existing knowledge on the topic.
Methods
Medline, Embase and Cochrane Register of Controlled trials were searched for randomized controlled trials where vitamin K2 or its analogues, in any dosage were compared to placebo or No vitamin K2, for participants of any age or sex. Reference lists and abstracts of conference proceedings were searched by hand. Additional papers were identified by a manual search of the references from the key articles. Attempt was made to contact the authors of primary studies for missing data and with the experts in the field.
Trials were assessed for inclusion by two independent reviewers. Primary outcomes were recurrence rates and survival rates. There were no secondary outcomes. Data was synthesized using a random effects model and results presented as relative risk with 95% Confidence Intervals.
Result
For recurrence of hepatocellular cancer after hepatic resection or local ablative therapy, compared with controls, participants receiving Vitamin K2, pooled relative risks for hepatocellular cancer were 0.60; 95% CI: 0.28–1.28, p = 0.64) at 1 yr 0.66; 95% CI: 0.47–0.91), p = 0.01) at 2 yr; 0.71; 95% CI: 0.58–0.85, p = 0.004) at 3 yr respectively. The results were combined using the random analysis model.
Conclusion
Five RCTs evaluated the preventive efficacy of menatetrenone on HCC recurrence after hepatic resection or local ablative therapy. The meta-analysis of all five studies, failed to confirm significantly better tumor recurrence- free survival at 1 year. Improved tumor recurrence at 2nd and 3rd year may be just due to insufficient data. There was no beneficial effect on the overall survival. However, to confirm the beneficial effect or lack of it, large, higher quality randomized controlled trials are still required.
doi:10.1186/1471-230X-12-170
PMCID: PMC3574058  PMID: 23191943
3.  Prevalence of Hepatitis ‘B’ and Hepatitis ‘C’ among preoperative cataract patients in Karachi 
BMC Research Notes  2012;5:492.
Background
To report the findings of preoperative screening regarding prevalence of Hepatitis B and Hepatitis C in patients presenting for cataract surgery.
Findings
A descriptive study was conducted among 377 patients presenting for cataract surgery to Department of Ophthalmology Unit I, CHK from April 2010 to May 2011. Convenience sampling was done to recruit the participants aged 18 years and above. The patients were screened for Hepatitis B and C infections and findings were recorded on a structured compilation sheet.
The total prevalence of both Hepatitis B and Hepatitis C in preoperative Cataract patients was found to be 49 out of 377(12.99%). Overall, 8 out of 377 (2.1%) patients were HBsAg positive and 42 out of 377 (11.1%) were Anti-HCV positive. Only 1 patient was found with a co-infection with both HBsAg and Anti-HCV positive.
Conclusions
High proportions of Hepatitis B and C are reported among preoperative cataract patients of Karachi. Routine serological screening prior to surgery should be made mandatory so that asymptomatic patients would no longer pose a threat to its spread.
doi:10.1186/1756-0500-5-492
PMCID: PMC3444920  PMID: 22954334
Hepatitis B; Hepatitis C; Cataract
4.  Prevalence and factors associated with irritable bowel syndrome among medical students of Karachi, Pakistan: A cross-sectional study 
BMC Research Notes  2012;5:255.
Background
Irritable bowel syndrome (IBS) and its association with stress, has not been studied among university students in Pakistan. We investigated the prevalence and the pattern of anxiety related IBS symptoms among medical students of Karachi.
Findings
An observational case–control study was carried out at three medical colleges of Karachi, Pakistan. Random sampling was done on 360 medical students. Data was collected using validated tools “Rome III Criteria” and “Generalized Anxiety Disorder Questionnaire”. Participants with IBS were diagnosed on the criteria having experienced abdominal discomfort at least 2–3 days/month associated with high level of anxiety. The apparent prevalence of IBS was found to be 28.3%, with a predominance of 87 (85.29%) females (85.29%) over males (14.71%). The psychological symptoms of anxiety were encountered in 57 (55.8%) participants with IBS, among which males were 15.7% and females 84.2% respectively.
Conclusion
Students who more frequently suffer with mental stress and anxiety are more associated with IBS.
doi:10.1186/1756-0500-5-255
PMCID: PMC3434121  PMID: 22624886
Irritable bowel syndrome; Anxiety; Stress; Abdominal discomfort; Medical students
5.  Serum ferritin levels, socio-demographic factors and desferrioxamine therapy in multi-transfused thalassemia major patients at a government tertiary care hospital of Karachi, Pakistan 
BMC Research Notes  2011;4:287.
Background
Beta thalassemia is the most frequent genetic disorder of haemoglobin synthesis in Pakistan. Recurrent transfusions lead to iron-overload manifested by increased serum Ferritin levels, for which chelation therapy is required.
Findings
The study was conducted in the Pediatric Emergency unit of Civil Hospital Karachi after ethical approval by the Institutional Review Board of Dow University of Health Sciences. Seventy nine cases of beta thalassemia major were included after a written consent. The care takers were interviewed for the socio-demographic variables and the use of Desferrioxamine therapy, after which a blood sample was drawn to assess the serum Ferritin level. SPSS 15.0 was employed for data entry and analysis.
Of the seventy-nine patients included in the study, 46 (58.2%) were males while 33 (41.8%) were females. The mean age was 10.8 (± 4.5) years with the dominant age group (46.2%) being 10 to 14 years. In 62 (78.8%) cases, the care taker education was below the tenth grade. The mean serum Ferritin level in our study were 4236.5 ng/ml and showed a directly proportional relationship with age. Desferrioxamine was used by patients in 46 (58.2%) cases with monthly house hold income significant factor to the use of therapy.
Conclusions
The mean serum Ferritin levels are approximately ten times higher than the normal recommended levels for normal individuals, with two-fifths of the patients not receiving iron chelation therapy at all. Use of iron chelation therapy and titrating the dose according to the need can significantly lower the iron load reducing the risk of iron-overload related complications leading to a better quality of life and improving survival in Pakistani beta thalassemia major patients.
Conflicts of Interest: None
doi:10.1186/1756-0500-4-287
PMCID: PMC3162919  PMID: 21834969
Beta thalassemia major; Ferritin; Desferrioxamine; Socio-demographic factors; Pakistan

Results 1-5 (5)