ABSTRACT
To assess the utility of liver function tests [LFTs] for early recognition and prediction of severity of Dengue fever in hospitalized patients. An analytical study. Services Institute of Medical Science and Fatima Memorial Hospital, Lahore, from September - December 2010. Admitted cases of Dengue fever were divided into 3 groups; mild, moderate and severe increases in aminotransferases. Elevation in LFTs was co-related with good or bad outcome i.e. [survival or complication free stay] or [death or complications]. Results were analyzed in SPSS version 18. Out of the 353 patients with mean age of 37.12 +/- 15.45 years, 245 [69.4%] were males and 108 [30.6%] were females. Seventy five patients [21.2%] had mild elevation of aminotransferases [2 fold increases], 265 patients [75.1%] had moderate increases [3 to 4 fold] and 13 [3.7%] had severe [> 4 fold increase]. ALT was statistically higher in patients with septicemia, hepatic and renal failure [p-value [2] 0.05]. AST was higher in almost all complications. Prolonged hospital stay was associated with raised LFTs and greater complications and mortality. AST was found to be twice as much raised as ALT. AST and ALT were statistically higher in patients with worse outcome thus can lead to early recognition of high risk cases
ABSTRACT
Background: it has been found that frequency of pulmonary fibrosis increases in patients with cirrhosis of liver. We hypothesized that as the stage of cirrhosis advances, the frequency of pulmonary fibrosis should increase. We used child's pugh classification to stage the cirrhosis of liver
Material and Methods: fifty five patients of age range 16 to 80 years, both males and females having established cirrhosis of Fiver on ultrasonography, regardless of etiology, visiting the outpatient and inpatient department for treatment were selected. Patients were divided into three groups according to child's criteria i.e. group A, group B, and group C. HRCT of chest was performed on patients in all three groups to look for pulmonary fibrosis
Results: 27 [49%] patients were found to have pulmonary fibrosis on HRCT. The frequency of pulmonary fibrosis in different groups of child's classification was also assessed and it was found that class C and class B, are affected more than A
Conclusion: pulmonary fibrosis progresses with severity of liver cirrhosis
ABSTRACT
Objective: to compare the efficacy of topical glycerin triturates with capsaicin in painful diabetic peripheral neuropathy
Material and Methods: this quasi experimental study was conducted in Diabetes Management Centre Medical Unit-IV Services Hospital, Lahore over a period of six months from 01-06-2008 to 30-11-2008. Sixty-two patients of diabetes mellitus having symptoms of neuropathy were included in this study and were divided into two groups of thirty one patients each: .In group A topical capsaicin cream was applied twice a day for thirty minutes for the period of seven days aft he strength of 0.075% w/w. In group B glycerin triturate cream was applied twice a day for thirty minutes for the period of seven days at the strength of 2% w/w. After seven .days of treatment, intensity of numbness and par aesthesia and tissue perfusion were again assessed using visual analogue scale and Perl scan respectively. Perl scan and visual analogue chart assessment were repeated after the seven days wash out period and patients were .crossed over to the other treatment group. Numbness and para aesthesia were reassessed at the end of last treatment on visual analogue chart and Perl scan were repeated as well for tissue perfusion
Results: the age of the patients in group .A. was49:90+/-8.06 years and in group B were 49.58+/-6.62 years. In group A, the efficacy of GTN in peripheral neuropathy was 38.7% as compared to capsaicin which was only 19.3%. Similar results were seen in group B, in which efficacy of GTN in peripheral neuropathy was 51.6% as compared to capsaicin that was 29%.The overall results when combined in both the groups showed a response to capsaicin in 15 [24.2%] patients only versus 28 [45.2%] to GTN. This difference was statistically significant [p=0.02356]
Conclusion: there is a significant difference in efficacy of topical glycerin triturates and capsaicin in the management of diabetic peripheral neuropathy. GTN cream, a well-tolerated drug, provides significant improvement in painful diabetic neuropathy
ABSTRACT
Background: Diabetes mellitus, a metabolic disorder of absolute or relative insulin deficiency, is characterized by micro and macro-vascular complications. This process of vascular pathology proceeds at a uniform rate throughout the body. Eventually it may be manifested as atherosclerotic changes in cerebral, coronary and peripheral arteries Variables like central adiposity, altered metabolism, elevated blood pressure, proteinuria causes resistance
Methods: A retrospective cross-sectional study was carried out on 4482 diabetic patients attending the [Diabetes Management Center] Services Hospital, Lahore. Known determinates of past vascular disease PVD were assessed. An artery disease index was formulated by the presence or absence of lower limb pulses
Results: Past history of OVA was significantly associated with PVD with a p-value of 0.002. Similarly past history of M1 [p=0.000], hypertension [p=0.000], proteinuria [p=0.000] were all significantly present in patients with PVD. There was lack of association between cigarette smoking [p= 0.463] and PVD
Conclusion: Past hlstay o! CVA and MI, Hypertension and Protienuria are all significantly present in Diabetic patients with Peripheral Vascular disease
ABSTRACT
Background: Vascular disease Games the maximum mortality and morbidity burden in diabetic patents. Peripheral vascular disease is generally considered to be similar in its etiology and pathology to vascular disease in other tissue fields and its risk factors are also believed to be a part of larger atherogenic vascular picture
Methods: The study was conducted on a cohort of individuals suffering from Diabetes MelIitus registered at the [The Diabetes Management Center]. A total of 1160 cases were selected on the basis of presence or absence of peripheral artery disease with an aim to study the prevalence of peripheral vascular disease In diabetic and ascertain if total cholesterol, age and duration of diabetes play a role in the development of peripheral vascular disease
Results: Our study showed that presence of peripheral vascular disease in diabetics is significant; associated with increased age, increased duration of diabetes, history of intermittent claudication, delayed wound healing and Increased area of skin ulcers. There is no significant difference in total cholesterol level, LDL HDL, and triglyceride levels amongst those diabetics that developed PVD than those who did not The role of genetic susceptibilities leading to altered metabolism with due contribution by environmental factors may come to light by further analysis of other variables involved In artery disease picture
Conclusion: Presence of peripheral vascular disease in diabetics is significantly associated With Increased age Increased duration of dIabetes and history of intermittent claudication, delayed wound heating and increased area of skin ulcers. There is no significant difference in total cholesterol level LDL HDL and triglycerides levels amongst those diabetics that developed PVD than those who did not
ABSTRACT
Background: Diabetes leads to a dysmetabolic state in the body. A cluster of bio chemical and anthropometeric factors have been found to cause pro inflammatory state in vascuIar endothetium. The role of anthropomeric measures in development of atherosclerosis in patients with cardiovascular disease has been extensively studied. The aim of this study is to assess the influence of these factors in peripherai vascular disease
Materials and Methods: Queries were run on a cohort of diabetic patients and anthropometric measurements were made. Peripheral vascular disease was assessed by presence or absence of pulses
Results: The factors found to be significantly different in patients with peripheral vascular diseases versus those without peripheral vascular disease include waist circumference and waist Hip ratio, diastolic, systolic blood pressure and delayed wound healing
Conclusion: Distribution of adipose tissue and its possible endocrine control plays a significant role in subsequent development of vascular Injury and atherosclerosis in Diabetics
ABSTRACT
Objective: To find out whether peripheral artery disease followed the same pattern, set of risk factors and indicators as macro vascular disease in the coronary arteries and cerebral arteries disease
Study design: This was a randomized cross sectional retrospective analysis
Place and duration: Study was carried out at The Diabetes Management Center at The Services Hospital Lahore, during June 1999 to June 2001
Patients and methods: A total of 580 patients were selected from the diabetic data base that had absent pulsations in the any of the four arteries of the lower limbs. Another set of 580 diabetics with presence of pulsations in all the arteries of the lower and upper limbs was randomly selected to match the cases
Results: Diabetics with peripheral vascular disease had a significant positive history of past CVA and past MI
Conclusion: Presence of peripheral vascular disease is significantly associated with presence of history of past CVA and past MI, raised systolic BP, diastolic BP, and mean BP and increased proteinurea