Frequency of hepatitis B and C seropositivity in prisoners

This study was conducted on prisoners of Central Jail, Bahawalpur and on blood donors at Blood Bank Bahawal Victoria Hospital [BVD], Bahawalpur from Ist August 2005 to 30th November 2005. The intension was to study the seroprevalence of hepatitis B and C in prisoners and to note risk factor if any predisposing to the infection. All the prisoners of central jail Bahawalpur present during the study period, aged more than 18 years of either sex were included as the study group and a comparative group was blood donors presenting to blood bank BVH, Bahawalpur during this period. All the cases in study group [2086] as well as control group [9714] were screened for hepatitis B [HBs Ag] and hepatitis C [anti-HCV] infection detected on serum by One Step Test Device. All the positive cases were confirmed by Enzyme Linked Immunosorbant Assay. After an explanation, verbal consent was taken and a questionnaire was filled before taking samples from all the study group cases. On the basis of screening, prisoners were de vided into seropositive group and sero-negative group. The different variable applied on both the groups were age, sex, occupation, residence, marital status, self shaving / by barber, family history of [H/o] jaundice, H/o blood trans-fusion, operation, tattooing and body piercing, drug abuse, same sex/ extramarital sex and hepatitis B vaccination status. Total prisoners screened were 2086. Out of them 2072 were males [99.3%]. Mean age was 34 years. Total seropositive cases were 249 [11.9%] While during the same period seropositivity in blood donors [control group] was 5.9%. Seropositivity of HBV was 5.6% in study group and 3.1% in control group [p<0.001], HCV was 6.3% Vs 2.8% [p<0.001], statistically very significant difference. Risk factors analysis among prisoners revealed that drug abuse was significantly associated with seropositivity [27% Vs 12%, p value <0.001]. Among drug abusers, very high percentage of intravenous drug users was positive [89.2%, 25 out of 28]. Prisoners shaved by barber were also a t higher risk than self shaving [p value <0.001]. H/o operation [p<0.02] and rural origin [p<0.02] were other significant risk factors. Other risk factors evaluated were not statistically significant. Seroprevalence of hepatitis, both B and C is more in prison inmate than healthy blood donors. Main risk factor in them i is drug abuse, especially intravenous. Other significant risk factor is shaving by barber. There s a need to make some strategy to reduce the risk factors

Functional outcome of ischemic stroke in diabetics

Objective was to determine whether the outcome of ischemic stroke is different or not in diabetics than nondiabetics. Prospective observational. analytical study Study place and Duration; It was conducted in medical unit-2 Bahawal Victoria Hospital, affiliated with Quaid-e-Azam Medical College Bahawalpur from October I, 2004 to September 30. 2005. 132 patients of ischemic stroke, confirmed by CT scan, were enrolled during one year study period. The patients of hemorrhagic stroke, TlA, focal deficits of non-vascular origin and infratentorial lesions were excluded. Patients were devided into two groups; diabetics and nondiabetics and were studied regarding their in hospital outcome according to the modified Rankin Scale. The variables applied were age, sex, hypertension and type of infarct [lacunar/cerebral]. Out of 132 ischemic stroke patients 36 [27%] were diabetics and 96 were nondiabetics. Hjipertension was present in 83 [62%]. Overall mortality wa s 11.3%. Mortality was significantly more frequent in diabetics than nondiabetics [16.6% Vs 9.3% p<0.05]. Disability was also more frequent in diabetics [25% Vs 13.5% p<0.05]. In diabetic group good recovery [8.8% Vs 12.5%] as well as partial recovery [50% Vs 64.5%] was less frequent. Patients <40 years were few in number with good recovery in both diabetics as well as nondiabetics. Diabetics of 40-60 years were found to have significantly high number of deaths [15.3% Vs 7% p<0.05] and disability [15.3% Vs 10.7% p<0.05] than non-diabetics. Similar pattern was seen in patients >60 years. Increasing age was found to be associated with poor outcome in both the groups but poorer in diabetics. Sex did not discriminate the poor outcome in diabetics. The presence of hypertension worsened the out come in both the groups but more in the diabetic group both in term of mortality [20.8% Vs 11.8% p<0.05] as well as disability [33.3% Vs 15.2% p<0.05]. Lacunar infarct was found in few patient with good prognosis while cere bral infarct was associated with poor prognosis and put the diabetics at higher risk in term of mortality [17.6% Vs 9.8% p<0.05] as well as disability [26.4% Vs 14.2% p<0.05]. Diabetes Mellitus is associated with poor outcome of ischemic stroke patients both in terms of mortality and morbidity during acute hospitalization. Hypertension. increasing age and large infarct size further worsens the outcome