Association of inflammatory markers with physical activity, family history and other diabetic complications in patients of diabetic retinopathy

Objective: To study the association of inflammatory markers with physical activity, family history and other complications among patients of diabetic retinopathy

Study Design: Cross sectional comparative study

Place and Duration of Study: Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi in collaboration with Armed Forces Institute of Ophthalmology [AFIO] and Military Hospital Laboratories, Rawalpindi from Jan 2016 to Jun 2016

Material and Methods: A total of 90 diagnosed patients of diabetic retinopathy of ages 40-70 years were enrolled from Armed Forces Institute of Ophthalmology, Rawalpindi. Their inflammatory markers [ESR and CRP] were assessed and their levels were compared with their physical activity, family history and other complications of diabetes already developed in them. These were then compared with those of 90 normal healthy controls enrolled from general population using independent student's t test and one way Anova test for scale variables and Chi square test for nominal variables

Results: Both patients and controls were age and gender matched with mean age of 60 +/- 8.9 years in patients and 59 +/- 13.02 years in controls. Among 90 patients enrolled 51[56.7%] were males and 39 [43.3] were females. And among 90 controls 49 [54.4%] were males and 41[45.6%] were females. An inverse association was observed between inflammatory markers and physical activity with ap-value of 0.001. On the contrary a strong positive association was observed between inflammatory markers and family history and complications of diabetes with a p-value 0.001

Conclusion: There is an inverse association of inflammatory markers with physical activity and a direct association of these with family history and complications of diabetes among patients of diabetic retinopathy

relation of c-reactive protein, erythrocyte sedimentation rate and body mass index with diabetic retinopathy in patients enrolled from a tertiary care hospital

Objective: To study the relation of C-Reactive Protein [CRP], Erythrocyte Sedimentation Rate [ESR] and Body Mass Index [BMI] with diabetic retinopathy in patients enrolled from a tertiary care hospital

Study Design: Cross sectional comparative study

Place and Duration of Study: Centre for Research in Experimental and Applied Medicine [CREAM-1] at Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi in collaboration with Armed Forces Institute of Ophthalmology [AFIO], Rawalpindi over a period of 6 months from Jan 2016 to Jun 2016

Material and Methods: There were 90 patients of diabetic retinopathy enrolled from AFIO. Their ages were in range 40-70 years. Their levels of ESR, CRP and BMI were assessed. These were then compared with 90 normal healthy controls from general population. Independent student's t-test was applied for scale variables and Chi square test was applied for nominal variables

Results: Patients and controls were age and gender matched. Their mean ages were 60 +/- 8.9 years in patients and 59 +/- 13.02 years in controls. In 90 patients enrolled 51 [56.7%] were males and 39 [43.3] were females. And in 90 controls considered 49 [54.4%] were males and 41 [45.6%] were females. Both scale variables gave following results ESR= 27.9 +/- 6.96 in patients and 16.02 +/- 7.6 in controls with a p-value of <0.001 and BMI = 28.9 +/- 2.94 in patients and 26.02 +/- 4.16 in controls with a p-value of <0.001. CRP being a nominal variable gave p-value <0.001. Diabetic retinopathy gave a significant positive association with all the three variables under study

Conclusion: There is a direct relationship of ESR and CRP with retinopathy signifying that inflammatory processes may be one of the underlying biochemical mechanisms in development of retinopathy. Moreover a direct relationship also exists between BMI and retinopathy indicating the contribution of weight gain in development of retinopathy

Health care service quality: a comparison of public and private hospitals in karachi

The objective of the study was to compare the levels of patient satisfaction with the health service quality between the public and private hospitals in Karachi, so that their gaps, if any, may be identified and incorporated in future programs and policies. Cross sectional comparative study. This study was conducted in one public and one private hospitals in Karachi from May 2013 to July 2013. A random sample of 400 patients, 200 each from both public and private hospitals was drawn. Data was collected, on a pre-tested and pre coded questionnaire, and analyzed using SPSS version 16.0 level of satisfaction between patients in both the public and private health care settings were compared. The results of the study revealed that 75% of the patients availing health care services at the public hospital were not satisfied with the overall hygiene and cleanliness. 58.5% of the patients at public hospital were not involved in decision making regarding their own treatment. As for the patients availing services at the private hospital, 83.5% mentioned that they were provided with adequate privacy by their physician and hospital staff;however, 51% of the respondents replied that they had to pay huge medical bills which were beyond their affordability. Significant difference was found in the patients' satisfaction level with the quality of health care services provided in the private and public hospitals, with private hospitals performing better in most of the aspects of health care service delivery

Cardiovascular and renal protection in type 2 diabetic hypertensive patients. the role of calcium channel blockers

To study the effects of Calcium Channel Blocker [Amlodipine] as monotherapy in diagnosed hypertensive, non-insulin dependent diabetes mellitus [NIDDM] patients. Prospective study. This study was conducted at Jinnah post graduate medical centre [JPMC] Karachi, in collaboration with the department of medicine JPMC, Karachi from July 2010 to January 2011. This study is to examine the effects of Amlodipine in type 2 diabetic hypertensive patients with base line proteinuria. 20 normal subjects were also selected as a control group with CCB [Amlodipine] baseline to final change for SBP as well as DBP was significantly reduced i.e.24.70 % [p<0.001] and 16.20% [p<0.001] respectively. CCB showed 44% [p<0.001] reduction in FBS, creatinine clearance reduced by 8.10% [p<0.5], serum potassium reduced by 4.50%, non significant increase in serum urea i.e.3.70% and serum creatinine i.e. 3.8% was observed. Aim of treating hypertension is to control or limit its cardiovascular complications; CCB and are the drug of choice in controlling blood pressure and to prevent the progress of cardiovascular events in patients without diabetic nephropathy as well as reserves for add-on therapy in hypertensive patients complicated with diabetic nephropathy

Effect of metformin on ovulation in PCOS

To evaluate the effect of metformin on ovulation in patients having Polycystic Ovarian Syndrome [PCOS]. This clinical trial was carried out in a private infertility clinic of Karachi on fifty infertile PCOS females with individual study period of 3 months. A total of 57 infertile PCOS females with ages between 20-40 years were enrolled after a written consent. Only 50 subjects completed the study. Metformin HC1 thrice daily was given to fifty infertile PCOS females with ages between 20-40 years for three months. Plasma progesterone level was done at day-0 and day-90, besides fasting serum glucose, insulin, follicle stimulating hormone, luteinizing hormone, prolactin and testosterone at day- 0 as per requirement for the diagnosis of PCOS. 33 [66%] patients developed regular cycles and 11 [22%] patients showed improvement in their cycles at day-90. Serum progesterone level showed an increase from a mean +/- SD of 1.3 +/- 0.3 to 9.5 +/- 5.1 at day-0 to day-90. On statistical evaluation it was found to be significant with P-value of 0.001. Metformin promotes ovulation in PCOS patients

Comparison of propofol and sevoflurane for laryngeal mask airway insertion [LMA] in adults

To compare the effects of Porpofol and Sevoflurane in Laryngeal Mask Airway insertion. This study was quasi experimental was carried out in the Department of Anesthesiology, Surgical Intensive Care and Pain Management, Dow Medical College and Civil Hospital Karachi, Dow University of Health Sciences. The duration of the study was six months. In this study 60 patients schedule for elective surgery were enrolled which were divided into two groups. The average age of the patients was 25.1 +/- 10.6 years [95% CI; 23.7-29.0]. Out of 60 patients, 28 [46.6%] were males and 32 [53.3%] were females with 1:0.8 male to female ratio. Gender difference was not statistically significant between the groups [Chi-Square= 0.601; P=0.44]. The average age, weight and LMA insertion time were not statistically significant between groups. Induction time was significant between groups. Induction time was significantly higher in porpofol group [B] than in the sevoflurane group [A]. Condition of LMA insertion of 24 [80%] patients were excellent [score = 18] and 6 [20%] patients were satisfactory [Score between 16 to 17] in group A while condition of LMA insertion of 28 [93.3%] were excellent and 2 [6.7%] were satisfactory in group B. This study concludes that porpofol is a better anesthetic agent for insertion of LMA as compared to sevoflurane by using loss of eye lash reflex as the end point for induction