Prevalence of hypertension in diabetic patients

Objective: To find out the prevalence of hypertension in diabetic patients

Study Design: Observational / descriptive study

Place and Duration of Study: This study was carried out in the Department of Medicine, Sir Ganga Ram Hospital and Fatima Jinnah Medical College, Lahore from December 2013 to May 2014

Materials and Methods: A total of 100 patients were included in the study

Patient's demographic features and all the data were recorded on predesigned proforma and were analysed through SPSS version 16.0

Results: Out of 100 patients, 55 [55%] were male and 45 [45%] were female. Age range was 30-65 years with mean age of 48.4+9.3 years. Weight varied from 50-100 kg with mean weight of 68.2+8.5 kg. Prevalence of hypertension was 30%. Hypertension was more prevalence in elderly diabetics [53.3+7.8 years], in patients of longer duration of diabetic [7.66+2.84 years]

Retinopathy, ischemic heart disease [IHD] and neuropathy occurred frequently in diabetic hypertensive patients

Conclusion: Diabetic and hypertension are highly associated with each other

Risk factors for decompensation of heart failure in patients with established left ventricular dysfunction

Objective: This study was aimed to identify the risk factors for decompensation of heart failure in patients with established left ventricular dysfunction

Study Design: Observational / descriptive / cross-sectional study

Place and Duration of Study: This study was carried out at Sandeman provincial hospital, Quetta from 15[th] March till 14[th] September 2015

Materials and Methods: One hundred fifty patients of decompensated HF with established left ventricular dysfunction [Ejection Fraction <40 %] were included in the study. Information about factors for decompensation of HF was collected from patients through a proforma during their hospital admission

The data was analyzed on statistical package for social sciences [SPSS] version 16

Results: Out of 150 patients, 59 % had ischemic heart disease while 41 % had non-ischemic heart disease. Non-compliance with diet and/or drug therapy [56.7% and 37.3%, respectively], cardiac arrhythmias [34%], lack of follow-up [26.7%], and intake of medications precipitating heart failure [20%] were the most common risk factors for decompensation of heart failure. Among other significant risk factors were infections [11.3%], anemia [10.7%] and myocardial ischemia [10.7%]. Pregnancy [2.7%] and thyroid disorders [2.7%] were less common risk factors

Conclusion: Majority of the risk factors for decompensation of heart failure appear to be preventable, and should thus be avoided with a better and more comprehensive control of heart failure in these patients

E. coli resistance to ciprofloxacin and common associated factors

Objective: To determine the frequency of E. coli resistance to ciprofloxacin and common factors leading to it among patients presenting with urinary tract infection

Study Design: Descriptive cross-sectional study

Place and Duration of Study: Department of Medicine, Ayub Teaching Hospital, Abbottabad, from December 2011 to June 2012

Methodology: A total of 166 patients, > 18 years of age of both gender, who presented with features of UTI and had urine culture positive for E.coli were included in the study. The urine samples were further tested for ciprofloxacin resistance and the patients were further checked for the common factors leading to E.coli resistance to ciprofloxacin

Results: Among 166 patients, 41 were male and 125 were female patients. Sixty-six [39.8%] E. coli isolates showed ciprofloxacin resistance. Male gender [p-value 0.001], previous history of recurrent UTI [p = 0.008, OR = 2.37], history of prior use of ciprofloxacin [p = 0.018, OR = 2.16] and history of catheterization [p = 0.005, OR = 4.80] were independent risk factors found in this study for the development of ciprofloxacin resistant UTIs

Conclusion: Ciprofloxacin resistance rates of E.coli were high at over 39.8%. The risk factors that affected the ciprofloxacin resistance rates of E.coli were prior use of ciprofloxacin, recurrent UTI, previous catheterization and male gender. Ciprofloxacin should be prescribed cautiously in patients with these risk factors and urine culture and sensitivity test should be performed for optimal treatment

Diagnosis and treatment of Hodgkin's lymphoma: at times a challenge

Hodgkin's lymphoma has been traditionally defined as a hematopoietic neoplasm composed of diagnostic Reed-Sternberg cells. More than 70% of the cases involve cervical or supraclavicular lymph nodes. Isolated sub-diaphragmatic lymphadenopathy or organ involvement is rare. We present the case of Hodgkin's lymphoma in a 51 years old female, who presented with obstructive jaundice and lymphadenopathy, empirically treated previously as a case of tuberculosis. Chemotherapy with modified ABVD protocol was given with dose modification according to LFT's. Her liver functions returned to normal levels after the first cycle. The main purpose of reporting the case is to stress definitive diagnosis of the disease before initiating treatment and the modified chemotherapy regimen used in this infrequent presentation of the disease

Malaria in children: study of 160 cases at a private clinic in mansehra

This Study was conducted in a private clinic to report frequency, presentation and management of malaria in children presenting with fever. 160 Children of age varying from 42 days to 15 years were included in this study, during a period of 1999-2004. Malaria was confirmed in 154 cases, including 114 male and 46 female children. In 6 cases malarial parasite was not seen on microscopic examination of their blood films. 142 cases were found to be suffering from vivax and 12 were suffering from falciparum malaria. Most of the cases were treated with amodiaquine and some of them were treated with other antimalarial drugs

Effectiveness of routine urine analysis of patient attending rural health centers in Abbottabad

Renal diseases may be discovered accidentally during routine urinalysis. This study was done to see the significance of urinalysis and study the magnitude of abnormal urinalysis in patients with no symptoms of renal disease. From 15th February to 16th March 2005, a total of 1000 samples of urine were collected from the patients attending three rural health centers of Abbottabad. Dipstick Method was used for urinalysis. there were 600 males and 400 female patients. The age ranged from 1 to 55 years. Proteinuria was present in 2.3%, hematuria in 4.8% patients, pyuria in 10.2% and glycosuria in 2% patients. In our setup routine urine analysis should be performed in all patients to identify the presence of unrecognized renal diseases which may benefit from simple therapeutic measures

Atrial fibrillation in mitral stenosis and its correlation with left atrial size, mitral valve area and left atrial thrombus

Chronic rheumatic heart disease is the commonest cause of mitral stenosis. Incidence of rheumatic MS parallels that of acute rheumatic fever. Atrial fibrillation usually develops in the presence of pre-existing ECG evidence of left atrial enlargement and is related to the size of the chamber, the extent of fibrosis of the left atrial myocardium, the duration of the atriomegaly and the age of the patient. The tendency for development of systemic embolization correlates directly with the patient's age and the size of the left atrial appendages and inversely with the cardiac output. Eighty percent of the patients of MS in whom systemic emboli develop are in atrial fibrillation. A descriptive study was designed in the Department of Medicine, K E Medical College / Mayo Hospital and Punjab Institute of Cardiology, Lahore. A total of 129 conservative cases of mitral stenosis were included in this study, based upon convenient patient sampling. A total of 112 patients were followed up properly, the remaining 17 were lost to follow. The results showed left atrial size and MVA have an inverse correlation [p = 0.017]. LAT has a strong association with AF in cases of MS [p = 0.002]. The severity of MS does not influence the frequency of AF [p = 0.24]. It was thus concluded that left atrial size and MVA have an inverse correlation [p = 0.017]. LAT has a strong association with AF in cases of MS [p = 0.002]. The severity of MS does not influence the frequency of AF [p = 0.24]

study of the inhibitory effect of aspirin on platelet aggregation induced by adenosine diphosphate

Aspirin in low dose is a commonly used drug in the prophylaxis of platelet aggregation. This study was done to observe the inhibitory effect of Aspirin on platelet aggregation induced by adenosine diphosphate. Platelet rich plasma was prepared from the blood of 36 male and 35 female subjects. Adenosine diphosphate was used as an aggregating agent. Reduction in platelet aggregation by aspirin was observed by the method of Born and Mustard. It was found that there was 5.96% reduction in the platelet aggregation due to aspirin. It is concluded that aspirin has significant inhibitory effect on platelet aggregation induced by adenosine diphosphate