Microalbuminuria in diabetes mellitus type 2: association with age, sex, and body mass index: a cross sectional study

This study was aimed to determine the association of microalbuminuria with age gender, body mass index [BMI] and duration of type 2 diabetes mellitus [T2DM]. Prospective Cross sectional. This study was carried out at District Head Quarter Hospital Mirpur Azad Kashmir from July 2011and June 2012. This study included 300 patients [199 females and 101 females] with T2DM of duration of six months to 43 years. The evaluation included structured questionnaires clinical, neurological examinations and laboratory tests. Negative for albumin in urine by albustic method and micral tests were used for estimation and categorization of microalbuminuria. Chi square test revealed statistical significant association of microalbuminuria with age [<0.015] blood sugars random [p <0.015] but no statistical significant association with gender, weight, and old and new diabetics. One sample t test had shown statistical significant association of degree of microalbuminuria with BMI [p<0.001], cholesterol [p<0.001] and numbers of years of diabetes [p<0.050] In type 2 diabetic statistical significant associations has shown between degree of microalbuminuria, age, blood sugars, cholesterol, body mass index and duration of diabetes mellitus

C reactive protein concentrations can predict metabolic syndrome in adults

This study analysedthe correlations between C reactive protein [CRP] serum concentrations and demographics and anthropometric aspects of developing metabolic syndrome components in adults. A cross-sectional study. This study was carried out in Azad Kashmir Sheik Khalifa Bin Zyad Hospital Muzaffarabad from March 2012 to April 2013. Demographic, anthropometic parameters of MS such as body mass index [BMI] and waist hips ratio [WEE], biochemical and clinical data were collected from 115 adults of age ranged between 22- 55yearsold. Adults BMI had direct correlation with CRP concentrations. In our study CRP concentrations were statistical significant correlated with age [r = 0.282, p = <0.002], BMI [r = 0.787, p = <0.001], waist hips ratio [r = 0.850, p =< 0.001] and weight [r = 0.662, p =<0.001]. The height had poor correlation with CRP [r = 0.101, p = 0.825].Thecorrected CRP [r = 0.101, p =0.825] was also poorly correlated to CRP concentrations. Statistical analysis has shown there is direct correlation between BMI, WHR and CRP concentrations which suggests that inflammation might be an important event in the development of metabolic disorders in adults

Response rate of standard interferon therapy in chronic hepatitis C

Interferon combination therapy is used to eradicate the Hepatitis C Virus from infected individuals. HCV [hepatitis C virus] infections respond to standard conventional interferon [INF] therapy along with ribavirin [RBA].The aim of study was to look for response of chronic HCV infections to standard conventional combination interferon therapy and ribavirin. Interventional non randomized trial. This study was carried out at Azad Kashmir Combined Military Hospital [AK CMH]/Sheik Khalifa Bin Zyad [SKBZ] Muzaffarabad [MZD] from June 2009 to July 2012. A total of 210 patients were selected for interferon combination therapy. After confirmation of active HCV infection by PCR-RNA, conventional interferon alpha 2a with ribavirin [RBA] was given to patients for 6 months. After end of treatment [ETR], the efficacy was defined as sustained virological response [SVR] if HCV-RNA remained undetected 6 months after stoppage of combination interferon therapy. Out of total 210 patients, 144 [68.6%] showed SVR and 66 [31.4%] did not show SVR. Hence out of 68.6% were negative and 31.4% were positive for HCV RNA after 6 months of therapy. The non parametric chi squared showed age [p=<0.001], [age category p=<0.001], gender [p=<0.006], and HCV PCR response [p=<0.001] had statistical significant association. Conventional Interferon and ribavirin combination therapy [INF-RBA] remains effective in chronic hepatitis naïve patients. HCV-RNA qualitative PCR test at 6 month of ETR is important predictor of SVR. The response of antiviral therapy against HCV infection in chronic HCV patients is 68.6%. The high response rate may be due to the prevalence of IFN-responsive HCV genotypes type 3 in our country

Correlation of BMI with cholesterol and sugar in adults

This study was aimed to find the correlation of BMI with cholesterol and sugar level in adult. This study was carried out in Department of Medicine, Combined Military Hospital [CMH] Quita from 2006 to 2009. Prospective observational cross sectional studies. Individuals with different ages, sex were selected as study population. The cholesterol and fasting blood sugar were measured according to standard protocol. Height in centimeter and weight in kilograms of each individual was recorded and BMI calculated as kg/m[2]. Physical examination was done for everybody. The SPSS-20 was used for statistical significant analysis. The frequencies of variable and correlation between BMI, heights, weight, sugar and cholesterol were comprehensively analyzed. A total of 2,174 adults, 1,947 [89.56%] male and 227 [10.44%] female were included in study. Age range was between 20 and 55years.The mean age was 38.47 +/- 12.66. Mean BMI was 23.57 +/- 2.58.Mean cholesterol was4.57 +/- .60. Mean fasting blood sugar [FBS] was 4.67 +/- .75.Mean weight 70.32 +/- 9.1 Mean height 172.73 +/- .7.85.The correlation analysis revealed that weight, fasting blood sugar [FBS] and cholesterol had positive correlation with BMI [correlation coefficient of 0.734 [p<0.000], 0.167 [p<0.000], 0.164 [p<0.000] respectively and height had negative correlation with BMI [-0.123 [p<0.000]. BMI is positively correlated with weight, RBS and cholesterol. The effect of age, sex, exercise and current medical status, this correlation is reduced

Helicobacter pylori infection C-reactive protein in patients

To determine the frequency of raised C-reactive protein in patients with Helicobacter pylori infection. Design: Cross sectional descriptive study. Setting: Department of Medicine at Liaquat University Hospital [tertiary care teaching hospitals]. April 2012 to September 2012. All patients above 12 years of age, of either gender with history of nausea, vomiting, recurrent abdominal pain, dyspepsia or abdominal discomfort, heartburn, bloating and halitosis through casualty outdoor department [COD] or admitted in medical unit were evaluated and enrolled in the study. For the detection of Helicobacter pylori the 3 cc venous blood sample of relevant'patients was taken in a disposable syringe. After detecting the H. pylori infection, the H. pylori individuals were further evaluated for serum C-reactive protein by taking 3cc venous blood sample in a disposable syringe and sent to laboratory for analysis. The patients with raised CRP were also evaluated for their lipid profile to detect dyslipidemia. The data was collected on predesigned proforma and then entered, saved and analyzed in SPSS version 10.00. During six month study period total 92 patients with Helicobacter pylori infection were recruited and studied for serum C-reactive protein. The mean age +/- SD for overall population was 43.22 +/- 8.31, whereas the mean age +/- SD for male and female population was 41.24 +/- 7.94 and 44.76 +/- 9.42 respectively. The raised CRP was detected in 61[66%] patients [p=0.02]. The mean value +/- SD of raised CRP in male and female population was 6.30 +/- 2.86 and 7.82 +/- 3.21 respectively. Of 61 [66%] patients with raised CRP the dyslipidemia was identified in 45[74%] patients [p=0.03]. Out of 45, the raised triglycerides was observed in 08[18%] patients, low HDL in 10[22%] patients, raised LDL in 13[29%], raised cholesterol in 07[16%] whereas 07[16%] patients had mix dyslipidemia. The raised CRP was identified in patients with Helicobacter pylori infection, the dyslipidemia was observed in raised CRP population

Sexually transmitted infections in Pakistan

Sexually transmitted infections [STIs] represent a major global health problem leading to morbidity, mortality and stigma. Prior to this study there was no information on the prevalence and knowledge of STIs in Faisalabad, Pakistan. Prospective, cross-sectional study in patients attending STI clinics from July 2006 to September 2009. After obtaining consent, patients completed structured questionnaires used for behavioral surveys. Blood and urethral swabs were collected and tested for syphilis, gonococcus, genital herpes, chlamydia and chancroid. Mean [standard deviation] age of the 1532 participants was 38.9 [9.4] years, including 37.8 [10.2] years for males and 35.5 [6.3] years females. Male gender [n=1276, 83.3%], low socioeconomic class [n=1026, 67.0%] and residence in rural suburbs [n=970, 63.3%] were more common. Most [n=913, 59.6%] were aware of the modes of transmission of STIs and the associated complications, 20% [n=306] were condom users, and 21.2% [n=324] had knowledge of safe sex. Opposite-sex partners were preferred by 972 [63.4%] patients, while 29.9% [n=458] had both homosexual and heterosexual sex partners. Syphilis was present in 29.5% of patients [n=452]; gonorrhea, in 13% [n=200], HSV-2, in 3.2% [n=49], chlamydia, in 4.7% [n=72] and chancroid, in 1.3% [n=20]. This report establishes baseline local prevalence rates for STIs. Syphilis emerged as the most prevalent STI in Faisalabad. Population-based studies are required to study the epidemiology of STIs, along with initiation of national health-education campaign

Frequency of hepatitis D CO and super infection in hepatitis B patients

To determine the frequency of co/super infection of hepatitis D in patients with hepatitis B related liver disorders. Descriptive study. The hepatitis Centre Ghulam Mohammad Mahar Medical College Hospitals Sukkur and Khairpur, from January 2009 to December 2009. All patient registered for HBV associated infections were selected. Blood was drawn from 200 patients who fulfilled the inclusion criteria. Those with an incomplete test profile were excluded. All clinical conditions were investigated through liver function tests, coagulation profile, abdominal ultrasonography, upper gastrointestinal endoscopy and liver biopsy. Liver cirrhosis and hepatocellular carcinoma [HCC] were diagnosed either on the basis of histology, or on a combination of radiological, endoscopic and laboratory data. Hepatitis B virus DNA was extracted from serum by real time PCR. Descriptive statistics were used for frequency and mean determination. The 129 patients finally selected for statistical analysis included 108 [84%] males and 21 [16%] females. The ages ranged from 6-68 years [mean=31.5 +/- 12.39 years]. There were 70 [54.2%] patients of non-cirrhotic, chronic hepatitis [CLD], 38 [29.4%] carriers, 12 [9.3%] cirrhotic and 9 [6.9%] hepatocellular carcinoma [HCC] patients. Among the 129 patients, 45 [34.9%] were positive for double infection with HDV. These included 35 CLD cases, 7 cirrhotic and 3 carriers. The frequency of co/super infection of hepatitis D was found to be highest in HBV cirrhosis patients compared to patients having chronic liver disease [non-cirrhotics] and carriers

Tuberculous patients; demographic data

To evaluate Demographic Data of tuberculous patients in Faisalabad catchments areas. Rehmat Ward at Divisional Head Quarter Hospital Faisalabad a teaching Pulmonary Unit of Punjab Medical College Faisalabad. 1st Jan 2006 to 30th June 2006

Psychiatric referrals in a multidisciplinary Hospital

To evaluate the pattern of psychiatric referrals and to study the various diagnostic categories associated with physical disorders. The study was conducted at Khyber Teaching Hospital Peshawar over a period about three months. There were 100 psychiatric referrals during the study period. Patients were assessed on a structured proforma and psychiatric morbidity was classified according to ICD-10. Out of 100 patients, females [62%] outnumbered the males. The most common reasons for the referral were unexplained physical symptoms [40%] and disruptive behavior [15%]. Depression was the most common diagnosis made [40%]. More than two third of the patients [72%] were referred from medical units. 8% had no psychiatric morbidity. There is a need for greater dialogue and interactions between referring doctor and consultant psychiatrists

Comparison of body temperature recordings using mercury and liquid crystal forehead thermometers

The study was carried out to compare the recordings of body temperature using oral mercury thermometer and liquid-crystal forehead thermometer, so as to assess and ascertain the accuracy and validity of the later method. Setting: Hira General Hospital, Abbottabad. Subjects and Materials: Simultaneous recordings were made using the two devices in randomly enrolled 147 patients. The ages of patients ranged from 10 years to 90 years. FeverScan liquid-crystal forehead thermometer, Boots [UK] was used for forehead temperature while Chinese made mercury thermometer [Safety] was used to check oral temperature. Significant difference existed between the recordings of two devices. The mean difference was 1.19 degree F [p<0.001]. FeverScan liquid-crystal forehead thermometer recorded higher temperatures. In patients without pyrexia both devices recorded temperature within normal range. Conclusions: The sensitivity of FeverScan liquid-crystal forehead thermometer to detect fever was comparable to mercury thermometer but was unreliable in grading fever and showed a tendency to over estimate the temperature. It is a good device for home use but health providers should not use it. Mercury thermometer remains the gold standard

Genitourinary infections: a leading cause of chronic urticaria in married females

Chronic urticaria [CU] is a common clinical problem in dermatological practice. Characterized by intense itching and fleeting erythematous weals, the condition persists beyond six weeks. It can occur at any age and in both sexes. Many etiological agents may be held responsible, but in a sizeable number of patients it is difficult to reach a definitive cause. It was our clinical impression that CU in married ladies was commonly related to genitourinary tract infections [GUTIs] but no clinical details were available. Therefore we designed this study to work out causes of urticaria in married ladies, and the possible role of GUTIs in this condition. All the married ladies with urticaria of more than 6 weeks were enrolled from outdoor clinics of dermatology, Quaid-e-Azam Medical College, Bahawal Victoria Hospital and Allama Iqbal Medical college, Jinnah Hospital Lahore, over a period of 18 months. They were thoroughly investigated, managed and findings were recorded. Along with recurrent weals, almost half of the patients had additional symptoms. GUTIs lead to CU in 39 ladies, drugs in 13, scabies in 6, helminthiasis in 3, intrauterine contraceptive device [copper T] in 2, dental caries, chronic hepatitis, amoebiasis and chronic sinusitis 1 patient each. In 36 cases no cause was found for CU and were labelled as idiopathic. It is therefore concluded that GUTIs are an important cause of CU and should be looked for while investigating such a case

Etiology of ICU infections and antibiogram of the isolates at referral center in Riyadh

Patients undergoing treatment in intensive care unirs [ICU] are prone to increased risk of developing serious and life-threatening infections. These infections become more significant in immunocompromised particularly those caused by multi-resistant pathogens. In order to determine the etiology of intensive care unit [ICU] acquired infections and identify the predominant infecting organisms in a tertiary care hospital in Riyadh. We retrospectively examined the sites of infections, causative agents and their susceptibility to commonly used drugs. Of the 984 specimens processed in 1994, 261 grew normal flora; pathogenic bacteria were isolated from 672 patient specimens. The majority of the specimens yielding pathogens came from respiratory tract [385], followed by blood [149], urine [40], and others. Most frequently isolated pathogens were pseudomonas aeruginosa [153], escherichia coli [152], staphylococcus aureus [103], klebsiella pneumoniae [99] and serratia marcescens [48]. Seven% of the infections were polymicrobial. Susceptibility of the organisms to following drugs was tested: ampicillin amoxicillin and clavulanic acid amikacin, cephazolin, cefoxitin, ceftriaxone, ceftazidime, clindamycin, erythromycin, gentamicin, imipenem, oxacillin, penicillin, piperacillin, and vancomycin. The most inhibitory antimicrobial agent was imipenem which inhibited 98% of both gram-positive and gram-negative clinical isolates

Antibacterial activity of fluoroquinolones local clinical isolates from a referral centre in Riyadh

A total of 1,034 clinical isolates from a tertiary care center were tested against six fluoroquinolones, namely norfloxacin, ciprofloxacin, lomefloxacin, sparfloxacin, temafloxacin, and CI-960. Bacteria tested consisted of 579 strains of Enter obacteriaceae, 98 pseudomonads, 51 Acinetebacter, 56 enterococci and 250 isolates of staphylococci. All six fluoroquinolones showed excellent in vitro activity inhibiting >90% of Escherichia coli at an MIC of < 0.03-0.5 mg/L, Klebsiella pneumoniae at 0.12-2.0 mg/L, Enterobacter at 0.12-2.0 mg/L, Serratia marcescens at 0.12-2.0 mg/L, Pseudomonas aeruginosa at 0.5-2.0 mg/L, Staphylococus aureus at < 0.03-1.0 mg/L, and coagulase negative staphylococci at an MIC of 0.12-2.0 mg/L Xanthomonas maltophilia showed some resistance to norfloxacin, ciprofloxacin, lomefloxacin and temafloxacin, but was inhibited by sparfloxacin and CI-960. A majority of isolates of enterococci were resistant to norfloxacin, ciprofloxacin, lomefloxacin and CI-960, but sparfloxacin and temafloxacin inhibited 92% and 82% of these strains, respectively