ABSTRACT
Background and Objective: Urinary tract infection is one of the commonest infections seen in clinical practice. Lack of compliance and unjustified antibiotic prescriptions has resulted in bacterial resistance and is proving as a major challenge in the management of these infections. Our aim was to identify the sensitivity pattern of commonly used antibiotics against urinary tract infections so as to suggest an improvised line of action against bacteria causing urinary tract infections
Method: This was a hospital based cross sectional study extended over a period of four months. Patients were recruited from outpatients department of a tertiary care hospital in an industrial area of Karachi. Adult patients with symptomatic and documented UTI in urine detailed report [pus cells >10] were enrolled after informed consent. A clean catch midstream urine was collected for culture and sensitivity testing using the standard microbiological procedure. Data is analyzed on SPSS 16
Results: A total of 184 samples were collected in 4 months. The Male to Female ratio was 1:2 [n=58/126] with mean age 48.5+/-12 years. 83[45.6%] patients were between 45-60 years. Most common isolated pathogen was Eschericia coli 108[59%] followed by staphylococcus aureus 30[16.4%] and Klebsiella 20[11%]. 55[30%] pathogens showed sensitivity to 4-6 antibiotics, 22[12%] strains to 7-9 antibiotics, 33[18%] were sensitive to
Conclusion: In this low socioeconomic cohort with UTI nearly half the isolated pathogens has shown resistance to most of the commonly used antibiotics recommended in the guidelines especially the floxacin group probably because of its unwarranted use. Therefore, a revised line of management should be developed locally in accordance with the susceptibility pattern of the urinary pathogens to avoid further resistance as well as morbidity of the patient
ABSTRACT
Background: Anemia is seen in a large proportion of the population especially in developing countries. It poses a major challenge to improving the health indices especially in the female and pediatric populations. Anemia causes increased disability, morbidity and mortality. Presence of anemia prolongs hospital stay and increases the possibility of re-admission. The diagnosis and management of anemia in hospitalized patients will improve outcomes of this population
Objective: The objective of this study was to determine the prevalence of anemia, its etiology and its association with various risk factors
Study Design: Cross-sectional study
Place and Duration of Study: Department of Medicine, United Medical and Dental College, Karachi from May, 2016 to December, 2016
Methodology: All adult patients admitted in the medical wards of Creek General Hospital were included in the study. Anemia was defined as a hemoglobin of <13g/dl in males and <12g/dl in females. All anemic patients were taken as cases while non-anemic patients were taken as controls. Critically ill patients, patients with active bleeding and pregnant women were excluded from the study. The data was recorded on a detailed proforma, and the etiology, severity, type of anemia and associated factors were recorded. The data was presented as means with standard deviation for continuous variables and as percentages for categorical variables. Comparison of different factors with anemia was computed using SPSS 20.0. Chi-square and student t- test were used and p-value of <0.05 was considered significant
Results: Around 71% of the patients were found to be anemic. 72.5% of the female population and 67% of the male population were anemic. The commonest cause of anemia was infection. Majority of the women had microcytic anemia. There was no relationship of age, income, educational status, number of dependents and diet on the presence of anemia. In women anemia was significantly related to breast feeding and parity. Infectious diseases, nutritional deficiency and gastrointestinal loss were the most common causes of anemia in the studied population
Conclusion: Anemia is very common in hospitalized medical patients. Infection and nutritional deficiencies are the most cause of this anemia
ABSTRACT
Objective: To determine the frequency and pattern of skin disorders in patients with type 2 diabetes mellitus and their association with glycemic control in our diabetics
Methods: This descriptive, cross-sectional study was conducted at departments of Medicine and Dermatology, Sir Syed College of Medical Sciences and Hospital, Karachi from 1[st] January to 30[th] June 2014. Adult patients belonging to both genders having diabetes mellitus type 2 with cutaneous manifestations were included. After taking the informed consent, demographic details, duration of diabetes, mode of treatment for diabetes, types of footwear, foot care and glycemic profile were documented
Results: In 203patients [41% male and 59% female], mean age was 50 +/- 11 years and mean duration of diabetes 8.5 +/- 7 years. Mean HbA1c was 8.6 +/- 1.5 with 68% patients having unsatisfactory glycemic control. Most frequently observed skin disease was bacterial infections [26%], followed by fungal infections [22%], acanthosis nigricans [20%], diabetic foot [16%], nail changes [16%], acrochordons [10%], diabetic dermopathy [9%], necrobiosis lipoidica [9%], viral infections [8%] pruritus [8%] and xanthelasma [8%]. There was significant association of unsatisfactory glycemic control with bacterial infections [p = 0.037] and fungal infections [p = 0.023]. Females especially had a higher frequency of association with acanthosis nigricans [p = 0.030]
Conclusion: Patients with type 2 DM have high frequency of infections especially bacterial and fungal. Other manifestations like acanthosis nigricans and diabetic foot are comparatively less common
ABSTRACT
Background: In addition to its effect on the bones, vitamin D has a myriad of extra skeletal roles. It has been implicated both in the development of type 1 and type 2 diabetes mellitus as well as glycemic control. There is widespread vitamin D deficiency in Pakistan. Incidence of diabetes mellitus is also increasing exponentially. There is a need to define the relationship between 25 hydroxy vitamin D and type 2 diabetes
Objective: The purpose of this study was to determine the prevalence of hypovitaminosis D in type 2 diabetes and its association with the level of control of diabetes mellitus
Materials and methods: This descriptive cross sectional study was conducted at the Department of Internal Medicine, Sir Syed College of Medical Sciences and Hospital Karachi from January to June 2015. Total 168 adult cases of Male and Females patients having type 2 Diabetes Mellitus were included. After taking the informed consent; demographic details, duration of diabetes, and modes of treatment for diabetes were recorded. The glycemic profile and levels of vitamin D were assessed. Glycemic control was categorized as satisfactory and unsatisfactory glycemic control while vitamin D levels were categorized as sufficient, insufficient and deficient. The data was analyzed on SPSS version 20.0. Mean +/-SD was computed for quantitative variables. Frequency and percentages was computed for categorical variables. Relationship of the glycemic control with vitamin D was computed through Chi-square test. P-value of <0.05 was considered significant
Results: Among 168 cases [45.2% males and 54.8% females], mean age was 46.7+/-12 years and mean duration of diabetes 7+/-4.4 years. Mean HbA1c was 8.3 +/-2.28 with 62% patients having unsatisfactory glycemic control. A large proportion of the patients had vitamin D deficiency [80.8%]. Deficiency of vitamin D was significantly associated with both fasting and random blood glucose levels as well as HbA1c
Conclusion: A large majority of patients with type 2 diabetes mellitus have vitamin D deficiency and the poorly controlled diabetes mellitus is significantly associated with vitamin D deficiency
ABSTRACT
To determine the frequency of various cutaneous manifestations in patients with obesity and correlate these skin changes with the grades of obesity. The study was conducted at Departments of Medicine and Dermatology, Sir Syed College of Medical Sciences and Hospital Karachi from 1[st] January 2014 till 30[th] June 2014. Patients belonging to both sexes and different age groups having body mass index [BMI] >/=25kg/m[2] with cutaneous manifestations of obesity were enrolled. Patients with skin changes secondary to other systemic illnesses, pregnancy and drugs were excluded. After an informed consent, demographic details, height and weight were documented. A clinical dermatological diagnosis was established after a detailed history and examination. Appropriate investigations were performed where required. 196 patients, 76 males [39%] and 120 females [61%] completed the study. Mean age was 43.6 +/- 10.8 years, age range being 19-70 years. Mean BMI 34 +/- 4.73 kg/m[2] [range 25-50], grade I obesity in 75 [38%] and grade II obesity in 121 [62%] cases. The most common finding observed was acanthosis nigricans [49%], followed by striae [17%], fungal infections [15%], acrochordons [12%], viral infections [11%], hirsutism [11%] and bacterial infections [7.5%]. Other less common associations included: xanthomas, corns, plantar hyperkeratosis and acne. Acanthosis nigricans and viral infections were significantly more among females; corn and callus among males. Obesity grade II was significantly associated with acanthosis nigricans, viral infections, hirsutism, striae and stasis dermatitis. Obesity is commonly associated with a wide range of dermatological manifestations like acanthosis nigricans, striae, hirsutism, skin infections. Other less common associations include: xanthomas, corns, plantar hyperkeratosis and acne
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Skin , Dermatology , Body Mass IndexABSTRACT
OBJECTIVE: To identify the risk factors contributing towards deliberate self-poisoning
METHODOLOGY: A prospective and descriptive study of patients admitted in National Poisoning Control Centre, Ward-5, Jinnah Post Graduate Medical Centre, Karachi conducted over six months. All adult patients presenting with deliberate self-poisoning were included in the study
The cases with accidental or homicidal poisoning and poisoning for purpose of theft and burglary were excluded from the study. The information was gathered using a questionnaire generated from World Health Organization IPCS INTOX "Recording Format for Toxic Exposure".The data was analyzed on computer package SPSS ver. 14.0. The results were obtained as numbers and percentageswith means and standard deviation where applicable
RESULTS: 374 patients were analyzed during this period. The age group most frequent [54.3 %] is within the range of 15-24 years and 61.5 % of the subjects were male. Most of the patients were illiterate, with no employment and were unmarried. The toxic substance most commonly employed for attempted suicide was pesticide; it was taken most frequently orally, at home and during daytime. It was the first attempt for the majority of the subjects. Most subjects belonged to lower socioeconomic class and had no dependents. 34.5 % had history of drug abuse, 16.3 % had history of psychiatric illness. Few subjects had physical illness or history of suicide or parasuicide in family
CONCLUSION: Deliberate self-poisoning is a significant problem among the male youth in Pakistan
Lower socioeconomic status, changing social mores and stress contribute towards deliberate self-poisoning
ABSTRACT
OBJECTIVE: Malaria is a major health problem in South Asia. It can be associated with many complications. Thrombocytopenia is the most common hematological complication of malaria
Our aim was to assess the severity and frequency of thrombocytopenia in malaria
DESIGN: This was a descriptive case-series study. A total of 69 admitted patients diagnosed with malaria were assessed for thrombocytopenia using automated quantitative D3 Analyzer
The data was analyzed using SPSS version 16.0. The results were obtained in numbers and percentages
Data was expressed as means with standard deviation
RESULTS: Out of the sample population 64 patients were diagnosed with vivax malaria and 3 with falciparum malaria while 2 patients had mixed infection. About 86% of patients with vivax malaria had thrombocytopenia while 66% of patients with falciparum malaria had thrombocytopenia
Mean platelet count in vivax malaria was 84.02x10[3]/microL with a range of 15-213x10[3]/microL
Platelet count of <20,000/microL was seen in only 2 patients with vivax malaria and none of the patients with falciparum malaria
CONCLUSION: Thrombocytopenia is a common feature in malaria. In patients having fever with thrombocytopenia, malaria should be on top of differential diagnosis. Viral hemorrhagic fevers can also present as fever but in these cases the complete blood counts has other features such as high hematocrit and leucopenia along with thrombocytopenia. Our finding can have therapeutic implications in the context of avoiding unnecessary platelet transfusion with the relatively more benign course in vivax malaria. In our study the commonest cause of thrombocytopenia in malaria was vivax malaria