ABSTRACT
Objectives: To evaluate the effects of Metformin on outcomes of pregnancy in patients of polycystic ovarian syndrome who conceived on Metformin and then continued it till they delivered, compared to patients where use of metformin was stopped on conception
Study design: This open label randomized study was conducted from October 2010 to October 2012 at the outpatients department of Maroof International Hospital, Islamabad
Place and duration: 46 patients with polycystic ovarian syndrome who conceived on Metformin [both with and without the help of ovulation inducing agents] were included in the study. Out of these 23 patients discontinued the use [of Metformin] and remaining 23 never stopped using Metformin throughout pregnancy, both these groups were compared to each other in their outcomes
Methodology: Forty six patients having polycystic ovarian syndrome and infertility were treated with Metformin1gm/day with or without other ovulation induction agents [Clomiphene and injections of Human Menopausal Gonadotropins]. Twenty three patients were continued with Metformin 1gm/day throughout pregnancy [group A], and in the second group consisting of twenty three patients [group B] Metformin was discontinued after they conceived. The were first trimester abortions, preterm delivery, Live birth rate, Birth weight, gestational diabetes and fetal anamolies
Results: The incidence of first trimester abortions in group B patients of polycystic ovarian syndrome was 34.7% as compared to group A where the incidence was 4.3% [where Metformin was continued throughout pregnancy].The incidence of gestational diabetes was 8.6% in group A [when Metformin was continued] and 26 % in group B [when Metformin was not continued]. There were no fetal anomalies in the women receiving Metfromin during pregnancy
Conclusion: Metformin reduces the incidence of first trimester abortions gestational diabetes and impaired glucose tolerance, when the drug was continued throughout pregnancy in subjects with polycystic ovarian syndrome. In addition no adverse effects on the mother or fetus were seen
ABSTRACT
Objective: To investigate hearing threshold of industrial workers and correlate between noise exposed and unexposed groups
Study design: An observational cross sectional study
Place and duration of study: Study was conducted at medical testing and research organization located at Islamabad from January 2010 to May 2010
Methodology: 50 industrial workers [Gp A] exposed to constant high level noise were integrated in study and compared with matched control group [Gp B]. Pure tone audiometry [subjective test] was carried out to measure the hearing threshold at various frequencies
Results: Hearing loss was more prevalent in group A. A characteristic dip of hearing threshold was noted at 4000 Hz in Gp A
Conclusion: Industrial workers are at higher risk of developing Sensor-neural hearing loss [SNHL] as compared to general population. These individuals can easily be picked in early stages by audiometry and appropriate protective measures advised to prevent or interrupt the silent progress of disease
ABSTRACT
Chondrocalcinosis and Menicial injuries are both common findings on knee X ray and MRI [magnetic resonance Imaging] respectively. When both findings coexist in the setting of a painful knee effusion, they can lead to a diagnostic dilemma which is not always easy to sort out. This case report describes such a situation
ABSTRACT
OBJECTIVE: To assess the role of Disodium pamidronate [ 3-amino-1-hydroxypropylidine-1,1-bisphosphonate] in the management of Rheumatoid Arthritis
STUDY DESIGN: A prospective, open, randomized, observational, dose response comparasion [30 mg vs 15 mg of Disodium Pamidronate] study done in the medical department of Cantonment General Hospital Rawalpindi over a three month period
PATIENTS AND METHODS: 16 patients of both genders with rheumatoid arthritis were divided into two groups of 8 each. [Designated A and B.].All patients had established Rhuematoid Arthritis according to 1987 American Rheumatology association revised criteria for the diagnosis of Rheumatoid Arthritis. Each group was randomly allocated to receive a single infusion of Disodium Pamidronate of either 15 [group A] or 30 mg [group B] . A number of parameters of disease activity were recorded [Grip strength [dominant hand; mean of three readings],Ritchie articular index, and early morning stiffness among others]. All patients were admitted and directly observed initially
RESULTS: Group A: Was given 15 mg Pamidronate infusion.Two [2] patients [25 %] showed improvement in clinical parameters and biochemical parameters. 6 patients showed biochemical improvement alone
Group B: Was given 30mg Pamidronate infusion. Five [5] patients [70%] showed rapid clinical and biochemical improvement which was relatively sustained for 1-3 months. All the 8 patients showed biochemical improvement. A transient flu like illness observed in one patient only however he was a responder
CONCLUSIONS: 30mg of single Disodium Pamidronate infusion in an efficacious and rapidly acting management strategy in the therapy of active rheumatoid arthritis. The response is dose related
ABSTRACT
OBJECTIVE: To evaluate the spectrum of common health problems in a group of male senior managerial officers in an autonomous organization in Pakistan and to analyze the results obtained for any expected or unexpected patterns of total disease burden
STUDY DESIGN: A Cross-sectional study
PLACE AND DURATION: Out patients of PTCL [Pakistan Telecommunication Company limited] health centers over a six months period from Jan 2004 to June 2004
METHODOLOGY: Fifty senior managerial officers of BPS [Basic Pay Scale] 18 to 21 were selected for the purpose of this study. The survey was done over a six month period on outpatient basis [Jan 2004 to June 2004].The subjects ranged from 45y to 59y [mean age 53y]. All the subjects were assessed first with a detailed history and physical examination followed by a health questionnaire [to be filled by the subjects]
Subjects were then tested for Complete blood count, fasting serum lipids , Renal function tests, liver function tests, chest X-ray, ECG, abdominal and pelvic ultrasound and a second layer of tests as guided by physical examination , answers to the questionnaire and the first battery of tests
RESULTS: Eosinophilia and raised triglycerides were both seen in 30% [n=15] of the subjects each. Other derangements of lipid were also seen in 10% [n=5] percent of patients. Osteoarthritis of the knee [clinically suspected and radiological confirmed] was seen in 12% [n=6] of the subjects. Prostatic symptoms, Diabetes, Systemic Hypertension and renal stones were seen in 8 % [ n=4] of the patients. Raised serum uric acid and other problems were seen less frequently. Lipid derangements and Eosinophilia were seen as the most frequent abnormal finding and osteoarthritis leads as most frequent health problem
CONCLUSION: There are very few officers in this group without any health problems or deranged lab indices. However significant serious disease burden [especially cardiovascular disease] was not a very a prominent feature in this group
ABSTRACT
Tietze syndrome is a rare condition. It is sometimes classified as a seronegative arthropathy
Its importance lies in the fact that it is often confused with costochondritis and ischaemic heart disease [much more common conditions] even though it is a distinct clinical entity
This article reviews the current concepts regarding this disease
ABSTRACT
Costochondritis is one of the most common causes of chest pain a physician or a cardiologist is likely to come across in his clinical practice. Its importance in the differential diagnosis of chest pain cannot be underemphasized, yet it is a much under discussed topic in clinical literature. This review article is written to summarize the current state of understanding of this relatively benign but important condition