ABSTRACT
Objective: To evaluate the hemostatic abnormalities in patients with cirrhosis and their relation with severity of liver dysfunction as assessed by Child Pugh Score
Background: Important role is played by liver in hematopoeisis as well as hemostasis. Therefore liver dysfunction due to any reason is associated with hematological and complex hemostatic abnormalities. Important abnormalities include decreased production of coagulation and anticoagulation factors, excessive fibrinolysis, low platelet count etc. These are manifested by abnormal laboratory tests for these variables. For descriptive or prognostic indicator of these abnormalities Child- Pugh score is generally used
Material and Methods: Present study was done at the Postgraduate laboratory and hospital of ISRA University Hyderabad. The study was approved by ethical committee of ISRA University. Sixty four patients with liver cirrhosis were taken for study and divided according to Child Pugh Score as Class A, B and C; 47 were males and 17 were females. All age groups were included and mean age of group A, B and C was determined. The patients fulfilled inclusion and exclusion criteria. Data was collected after taking consent and blood was drawn to perform Coagulation parameters, platelets and fibrinolytic parameters in their respective analyzer machines
Results: In Child Pugh Score A , B and C patients, Mean Platelet count was 375.36 +/-39.479, 343.30 +/- 58.793, 277.03 +/-55.061 per uL and Mean Fibrinogen level was 333.90 +/-45.007, 261.07 +/-70.622, 207.33 +/- 38.484 per mg / dl respectively which showed a significant decrease in patients from Child Pugh Score A through C and Mean Platelet count and Mean Fibrinogen level Showed a negative Correlation with Child Pugh Score having r- = -0.640, p = 0.0001 and r- = -0.579, p 0.0001 respectively. In Child Pugh Score A , B and C patients, Mean Prothrombin time was 11.09 +/-0.831, 12.15 +/-2.828, 16.66 +/-2.541 per second, Mean Activated partial thromboplastin time was 27.09+/- 4.657, 33.50 +/-2.284, 35.62 +/-1.779 per second, Mean D-dimer level was 195.45 +/-13.633, 212.96 +/-37.845, 234.14 +/-47.287 per ug/L and Mean bleeding time was 4.63 +/-1804, 7.88 +/-2.833, 9.33 +/-2.496 per minute respectively which showed a significant increase in patients from class A through C and showed a positive correlation with Child Pugh score
Conclusion: It was concluded that PT, APTT, BT and D-dimer correlated positively while Fibrinogen level and Platelet count correlated negatively with Child Pugh score
ABSTRACT
Objectives: The present study was conducted to estimate brain natriuretic peptide [BNP] in heart failure patients and its association with left ventricular ejection fraction [LVEF]
Study design: Case control study
Place and duration: Department of Medicine, Cardiology and Physiology, Isra University, Hyderabad from July 2014- Dec 2014
Subjects and methods: A sample of 60 subjects comprising of 30 normal controls [group I] and 30 diagnosed cases of heart failure [group II] were selected through non-probability purposive sampling as per inclusion and exclusion criteria. Blood samples were collected for the estimation of BNP. Left ventricular function was assessed by echocardiography. Data were analyzed on SPSS 21.0, Student's t-test and chi-square test were used for continuous and categorical variables respectively. Pearson's correlation was used for association of BNP and LVEF. P value
Result: Mean age [+/-SD] of controls and cases were 51.5+/-5.56 and 50.6+/-5.25 years respectively [p=0.91]. of 60 subjects; 46 [76.6%] were male and 14 [23.3%] were female. BNP in controls and cases was noted as 77.06+/-,24.02pg/ml and 17506.3 +/-13348 pg/ml respectively. BNP was significantly increased in heart failure patients and it showed inverse correlation with ejection fraction [r =-0.76, p=0.0001]
Conclusion: It is concluded that the BNP may be used an indicator of left ventricular function in settings where echocardiography facility is not available
ABSTRACT
Objectives: To compare the lipid lowering affects of Atorvastatin in hypertensive dyslipidemic patients receiving Enalapril and Amlodipine
Study Design: Prospective descriptive and comparative study
Place and Duration: Study was conducted by the Department of Pharmacology LUMHS Jamshoro from 2007 to 2009 at Red Crescent Hospital Hyderabad
Methodology: One hundred essential hypertensive dyslipidemic patients were enrolled in the study. Study was approved by the ethical committee. After taking written consent patients were divided into two Groups [A and B] each group comprising of 50 patients. Atorvastatin 20 mg was combined to Group A patients at the bed time along with Enalapril 10 mg in the morning and to group B patients at the same time along with 5 mg of Amlodipine in the morning. Lipid profile was done at the base line and after 03 months [at the end of the study]
Results: At the end of the study when both groups were compared for the lipid lowering effect of Atorvastatin it was found that serum cholesterol reduced to 184.48 in group A [243.26 +/- base line] and 185.08 +/- 15.09 mg/dl in group B [240.44 +/- 31.5mg/dl base line] p value 0.78, LDL Cholesterol in group A decreased to 111.08+6.13 [243.26 +/- 22.70 at the base line] group B the LDL was decreased 104.40 +/- 4.37 which is highly significant HDL cholesterol was increased to 33.502 +/- .05 [29.90+2.65 base line] in group A, while in group B it was increased to 33.40 +/- 2.09 [29.240 at base line] triglycerides were reduced in both groups and the result were not significant. Results were compared and analyzed statistically by the SPSS version 16. Statistically the result was taken as significant. P value
Conclusion: There is significant mean change in the LDL cholesterol in group B [Atorvastatin + Amlodipine]
ABSTRACT
Objectives: this study was carried out to compare the placentae from hypertension associated pregnancies and normal pregnancies
Design: comparative study
Setting: Isra University Hospital Hyderabad Sind
Method: eighty full term placentae were collected; 40 from normal and 40 from hypertensive pregnant women. Gross features of placentae were noted and then stained for their microscopic features. Birth weight and Apgar score of the newborn were recorded
Results: the weight and surface areas of placentae were significantly low in the hypertensive group whereas thickness of placenta and number of cotyledons were almost same in hypertensive and control groups. Microscopically increased number of syncytial knots, chorionic villi with excessive collagen was observed in placentae of hypertensive women. In hypertensive group birth weight of neonates was significantly low than control group while difference in APGAR score between two groups was statistically insignificant
Conclusion: hypertension during pregnancy is associated with remarkable changes in the placentae
ABSTRACT
Objectives: to assess the sleep pattern among teaching faculty of Isra University using Pittsburgh sleep quality index and Epworth sleepiness scale
Design: descriptive study
Setting: Isra University Medical College and Hospital Hyderabad Sindh
Method: eighty three members of teaching faculty of Isra were randomly selected for this study. These were divided into 02 groups, basic and clinical teachers. All were given instructions to fill the questionnaires of Pittsburgh sleep quality index and Epworth sleepiness scale. These were then collected and analyzed
Results: among faculty members mean Epworth score was 8.2 +/- 0.58 and mean Pittsburgh score was 5.7 +/- 0.54. Both the scores in two groups were within normal range. In males Epworth and Pittsburgh scores were 8.3 +/- 0.85 and 5.6 +/- 0.72 respectively while in females these scores were 8.01 +/- 0.73 and 6.67 +/- 0.86. Pittsburgh score was significantly higher in females as compared to males
Conclusion: it is concluded that sleep as assessed by using Pittsburgh sleep quality index and Epworth sleepiness scale was within normal range among the faculty members of Isra University. Female faculty members had significantly higher Pittsburgh score as compared to male faculty members signifying worse sleep quality
ABSTRACT
Objectives: this study was carried out to evaluate homocysteine as a risk factor for ischemic Stroke
Design: descriptive study
Setting: isra University and Liquate university of Medical and health sciences Jamshoro [LUMHS]
Study design: twenty five diagnosed cases of ischemic stroke were selected from different wards of two hospitals. Twenty five healthy age matched persons were taken as controls having no risk factors for stroke. Serum homocysteine level was determined by enzyme immunoassay using commercially available kit
Results: serum homocysteine level in patients with stroke was 14.0 +/- 1.9 [micro]mol/Lit and in healthy controls it was 9.0 +/- 0.58 [micro]mol/Lit. There was statically significant difference [p < 0.05] in the homocysteine level between the two groups yet the level was within normal range
Conclusion: serum homocysteine level is significantly increased in patients with ischemic stroke as compared to the normal healthy individuals having no ischemic stroke risk factors
ABSTRACT
OBJECTIVES: To compare the antihypertensive effect of Enalapril and Amlodipine along with Atorvastatin in hypertensive dyslipidemic patients
STUDY DESIGN: Prospective and descriptive case study
PLACE AND DURATION: Study was conducted by the Department of Pharmacology and Therapeutics, LUMHS, Jamshoro at Red Crescent hospital, Latifabad, Hyderabad, Pakistan from 2007 to 2009
METHODS: One hundred [100] essential hypertensive, dyslipidemic patients were enrolled in the study
Protocol was approved by ethical committee. After taking written consent patients were divided into two groups [A and B[, each comprising 50 patients. Group A received Enalapril 10mg in the morning along with 20mg Atorvastatin at bed time while group B received 5mg of Amlodipine in morning along with 20mg of Atorvastatin at bed time. Blood pressure and lipid profile were done at the start [Baseline] and after 3 months [end of study] by mercury sphygmomanometer. Results were compared and analyzed statistically by using SPSS-V16 at the end
RESULTS: At the end of the study when both groups were compared for antihypertensive effects. It was observed that the both the antihypertensive drugs have significantly lowered the blood pressure separately but when the effects were compared for both groups there was no significant change at the end of study. Enalapril reduced mean systolic blood pressure from 155.7 + 16.38mmHg at baseline to 140.1 + 8.36 mmHg and diastolic blood pressure to 93.6 + 5.81mmHg to 82.6 + 10.65 mmHg [P value 0.001]. Amlodipine reduced the systolic blood pressure from 157 + 16.72 mmHg to 142.1 + 9.37 mmHg and diastolic blood pressure from 95.6 + 7.11mmHg to 81.4 + 11.06 mmHg [P value 0.001]
Mean systolic blood pressure after treatment in group A was 140.1 + 8.36 mmHg and in group B was 142.1 +9.37 and mean diastolic blood pressure in group A and B after treatment was 82.6 + 10.65 mmHg and 81.4 + 11.06 mmHg respectively [P value 0.58]
CONCLUSION: Both drugs individually reduced the systolic and diastolic blood pressure significantly but when compared, there was no significant change noted and both were equally effective
ABSTRACT
A prospective study of stroke patients with diabetes was carried to determine the outcome of stroke. All the patients with stroke admitted were included and risk factors, such as, hypertention, smoking, obesity, hypercholestraemia and heart diseases were investigated. The study was conducted at Liaquat Medical College, City Hospital, Hyderabad over a period of eight month. 50 stroke patients, male and female, with all known diabetics were included. Blood Glucose, CT scan, Urine DR, ECG, Serum Electrolytes, Blood Urea, Serum Creatinine, Serum Cholesterol, were determined. During stay of patients in hospital, 16 patients showed complete recovery, 14 patients expired, 14 had residual defect and 6 patients were handicapped. Recovery from stroke was slow, with high morbidity and mortality with 28%