Muhammad Hanif, Amir Hussain, Muhammad Aamer, Muhammad Adrees, Salman Shakoor.
Comparison between Combination of Band ligation and Propranolol with Propranolol alone in Secondary Prophylaxis of Variceal bleed.
Annals Punjab Med Coll Jan ;11(2):141-5.

Introduction: Variceal bleeding is the one of the most important complication of cirrhosis of liver and also the common cause of death in cirrhotics. Cirrhotics with varices have 60% chance of re-bleeding within two years of the index bleed and each re-bleeding episode is associated with a 20% to 35% mortality risk. Endoscopic band ligation and pharmacotherapy are recommended therapeutic modalities for the prevention of secondary variceal re-bleeding. Objective: To compare the efficacy of combination of band ligation and propranolol with propranolol alone in secondary prevention of re-bleed in cirrhotics. Study design: Randomized control trial. Study duration and settings: The study was completed in Medical Unit-II Allied Hospital, Faisalabad for six months from 1st March 2015 to 31st August 2015. Methods: A total number of 60 cirrhotic patients with variceal bleed were randomized into two groups, each group containing 30 patients. Group A, receiving a combination of band ligation and propranolol and Group B, receiving propranolol alone. Any evidence of variceal bleed was observed during the research period confirmed by endoscopy. Results: 60 patients were included in the study with a mean age 56.97 ± 5.886. In Group A, 38 (63.3%) were male, 22 (36.7%) were female (table-5). In Group B, 13 (43.3%) were male and 17 (56.7%) were female (table-5). In Group A, bleeding occurred in 3 patients (10%). In Group B, bleeding occurred in 12 patients (40%). P-value was .007. Conclusion: Combination therapy of EBL+propranolol was superior in providing secondary prophylaxis than propranolol alone.

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