To determine the comparative values of lipid profile between ischemic and hemorrhagic stroke

Objectives: To determine the relationship of total cholesterol, HDL-C and their ratio among ischemic and hemorrhagic stroke

Study Design: An observational prospective comparative study

Place and duration: This research work was carried out from 1[st] June 2014 to 31[st] December 2014 at department of medicine Bahawal Victoria Hospital Bahawalpur

Methedology: Hundred patients between 30 to 90 years of age, who were admitted by the department of general medicine BVH Bahawalpur with first ever stroke and verified by CT scan brain, were included in the study. Patients who had history of coronary heart disease or lipid lowering drugs, neurological deficits secondary to epilepsy, infective or metastatic disorder, or pre-existing severe cognitive disorder were excluded from this study. A detailed history and physical examination details along with fasting lipid profile were collected from patient records in the hospital medical department. Mean values of quantitative data were presented as mean SD [standard deviation].Frequency percentage of total cholesterol, high density lipoproteins and triglycerides in both groups of ischemic and hemorrhagic stroke, were determined and compared using proportion test for any significant difference taking p-value of < 0.05 as significant

Results: Quantitative data of CVA, comprising [50 each of ischemic and hemorrhagic cases] was analyzed. Mean age of presentation was 56 years. In 50 ischemic patients mean total cholesterol was raised above normal reference range. It was 218.30 +/- 79mg/dl in ischemic stroke while it was 194 +/- 26.7mg/dl in hemorrhagic cases and it was highly significant at P value of < 0.001.The mean HDL concentration was 33.10 -7.33 in patients of ischemic stroke while it was 39.02-4.22 in hemorrhagic cases with p value of o.oo2 [highly significant]. Serum triglycerides levels turned out to be normal in both groups

Conclusion: Hypercholesterolemia and low HDLC was seen significantly in ischemic CVA group as compared to hemorrhagic counterpart

Gender difference in components of metabolic syndrome among patients of Type 2 diabetes

Diabetes mellitus, hypertension, obesity and dyslipidemia are the integral components that constitute metabolic syndrome. It has emerged as cause of substantial mortality with gender difference. To compare the gender characteristics of metabolic syndrome in subjects of type 2 diabetes mellitus. This observational comparative prospective study was conducted in medical ward of BVH Bahawalpur over period of 6 month from January 2014 to June 2014. Sample size of 100 diagnosed cases of type 2 diabetics [comprising equal number of males and females] were collected. As defined by WHO and IDF, variables of metabolic syndrome studied were BMI, hypertension, hyperglycemia and hyperlipidemia. The lipid values were interpreted in normal or high risk category by applying NCEP ATPIII criterion. Fasting sample were collected for sugar and lipid profile. Anthropometric, demographic and biochemical data was tabulated. Continuous and categorical variables were displayed as mean +/- standard deviation and percentage respectively. Student 't' test was use to assess the difference for the lipid profile at 5% significance level. Female patients were found to be overweight, hypertensive and had uncontrolled hyperglycemia as compared to male subjects. Their systolic blood pressure was 150 +/- 25.75 and diastolic was 90 +/- 17mm/hg. The mean blood glucose concentration was 246.64 +/- 105mg/dl. In age group 35-44 years, the mean triglycerides and cholesterol levels in females were 184.54 +/- 42.05 and 192.5 +/- 34mg/dl respectively. HDL-C was 33.2 +/- 5.19mg/dl. In females with age group of 45-54 years, the mean concentration of triglycerides, total cholesterol and HDL-C were 217.75 +/- 77.6mg/dl, 190.95 +/- 14.4mg/dl and 31.75 +/- 3.8mg/dl respectively, and all were in high risk category when compared to cut off values determined by NCEP/ADA. While in females of age group 55-64 years, the values of TGs, total cholesterol and HDL-C were 204 +/- 154.11mg/dl, 200.09 +/- 47.8 mg/dl and 33.4 +/- 4.6mg/dl respectively and again all these values were significantly raised. Female genders were affected in all respects. They had higher BMI, hypertension, hyperglycemia and hyperlipidemia as compared to male counterparts

Effects of George Ohsawaone [macrobiotic] on biochemical and haematological parameters other than prothrombin time and activated partial thromboplastin time in rabbits

Objective: To determine the effects of George Ohsawa One [GO1] on sodium, potassium, calcium, hemoglobin and platelet count in rabbits with and without anticoagulated blood

Study Design: Interventional study

Place and Duration of Study: This study was conducted at the Department of Pharmacology, FederalPost Graduate Medical Institute and National Health Research Complex, PMRC, Sheikh Zayed Hospital Complex, Lahore from January 2010 to August2011

Materials and Methods: Forty eight [n=48] male rabbits were included in the study. They were divided into two groups which were further divided into two subgroups each. About 700 grams of GO1 was used in the study

Results: The effect of GO1 on platelet count, hemoglobin, serum sodium, potassium and calcium were found to be insignificant

Conclusion: This work on the effect of GOI is first of its kind on biochemical and hematological parameters other than prothrombin time and activated partial thromboplastin time in rabbits measured quantitatively. Although theuse of herbal products may not be dangerous per se, further research work is required to explore the benefits of GO1 on biochemical and hematological parameters before it can safely be used in humans as an anti-hemorrhagic agent

To evaluate comparative values of HDL cholesterol among male and female patients of type 2 diabetes

Objectives: To assess and compare the HDL Cholesterol among male and female type 2 diabetics and to look for the blood pressure and glycemic stats between both genders

Study design: An observational comparative prospective study

Place and duration: The study was conducted in Medical Unit-2 of Bahawalpur Victoria Hospital over a period of 6 months from June 2012 to December 2012

Methodology: A sample size of hundred diagnosed cases of type 2 diabetes was collected. Those who had hyperlipidaemia due to secondary causes like nephrotic syndrome, hypothyroidism and drugs were excluded. Fasting blood samples were collected for sugar and lipid profile. All collected data was analyzed through software SPSS version 10

Results: Female patients were found to be overweight and hypertensive and they had uncontrolled hyperglycemia as well. The mean values of lipoprotein were deranged in females as compared to males. By applying NCEP ATP III criterion, lipid level were classified into different risk categories. In female patient the mean concentrations of HDL-C was 32+2.4mg/dL [T-Value = -23.57 very highly significant] and was in high risk category while LDL-C was 191+31.81mg/dL [T-Value = -2.01 significant] and was in borderline risk. LDL: HDL ratio was 6.0 and significantly raised. Triglycerides were within normal range. In male patients the mean concentration of LDL was borderline risk 174+41mg/dL [T-Value = 13.2] while HDL-C was 40mg / dL [T-Value = -6.53], both in borderline category. LDL: HDL ratio was also in acceptable range in males. Triglycerides values turned out to be within normal range in both gender

Conclusion: HDL cholesterol was frequently reduced and was in high risk category in female diabetic patients as compared to male counterparts and LDL values were borderline. Hence they are at more risk of complications as they were hypertensive and had more uncontrolled hyperglycemia as well

How we helped 3[rd] year medical students' transition from basic sciences to bedside; experience at a tertiary care teaching hospital

Clinical bed side teaching to learn the art and science of reaching an appropriate diagnosis is the most important part of training of medical students. Transition from basic science teaching to the complex world of clinical problem solving dealing with real patients is a difficult task to which some adapt quickly while for others it is a challenging proposition. Clinical faculty needs to focus on facilitating this transition helping medical students adjust and adapt to their new roles as future doctors

Study design: Cross sectional non comparative study

Place and duration of study: Gastroenterology Department, Shaikh Zayed Postgraduate Mediical Institute, Lahore from March to May 2013

Methodology: A total of twenty seven 3[rd] year MBBS students already experienced in history taking and clinical examination techniques were included. Facilitator adopted a constructivist approach with schema activation recalling applied aspects of anatomy, physiology and biochemistry relevant to diagnostic approach to 6 patient scenarios of which one is presented. A 7 item questionnaire recorded responses of students on a 5-point Likert scale

Results: Seventy seven percent medical students reported an improved ability to appreciate the relevance of knowledge gained in basic sciences to bed side teaching. Role of teacher was declared positive by 83%, 85% had improved their ability to correlate basic sciences to clinical inferences. Seventy five percent appreciated that mistakes identified helped them in improving performance with 92% confident of applying clinical reasoning skills obtained in solving future clinical problems

Conclusion: Clinical teaching should be based on the principles of adult learning employing a constructivist approach. Linking previous knowledge of basic sciences to the information obtained from bed side examination is the key to help medical students learn the art and science of medicine and become lifelong self-directed learners