Dyslipidemia; Helicobacter pylori infected patients

To determine the frequency of dyslipidemia in Helicobacter pylori infected patients. This cross sectional descriptive study of six months study was conducted at Liaquat University Hospital Hyderabad from 01-03-2012 to 31-08- 2012. All the patients between 19 to 60 years of age present with symptoms of dyspepsia, bloating or epigastric discomfort for more than 01 week duration were admitted and evaluated for Helicobacter pylori infection. Thereafter the positive cases [Helicobacter pylori infected patients] were further evaluated for dyslipidemia. During six month study period, total 144 patients [95 males and 49 females] with Helicobacter pylori infection were evaluated for dyslipidemia [lipid profile]. Majority of patients were from urban areas 110/144 [76%]. The mean +/- SD for age of patients with Helicobacter pylori infection was 35.94 +/- 10.77. The mean age +/- SD of dyslipidemic patient was 32.62 +/- 6.52. The dyslipidemia was identified in 87 [60.4%] patients, of which 51[58.6%] were males and 36[41.4%] were females. Regarding the pattern of dyslipidemia, ten [11.4%] patients had raised serum triglycerides level, twenty eight [32%] had raised LDL-C level, twenty six [28.9%] had raised serum cholesterol level, seven [8.7%] had low HDL-C level and sixteen [18.3%] had mixed dyslipidemia. The mean +/- SD of hypertriglyceridemia, [Upwards Arrow] HDL-C, [Upwards Arrow] LDL-C and hypercholesterolemia in dyslipidemic Helicobacter pylori infected was 280.72 +/- 22.85, 24.21 +/- 2.63, 180.63 +/- 12.98 and 285.21 +/- 23.63 respectively. The H. pylori infected patients are prone to acquire dyslipidemia, therefore the present study observed 60.4% prevalence of dyslipidemia with male predominance [58.6%]

Serum iron level; patients with Helicobacter pylori infection

To determine the serum iron level in Helicobacter pylori infected patients. This cross sectional descriptive study was conducted at Liaquat University Hospital [a tertiary care teaching hospital] Hyderabad from July 2013 to December 2013. All the patients with history of presented with acute abdominal pain, dyspepsia, bloating and epigastric discomfort were evaluated for Helicobacter pylori infection by serology. Thereafter the Helicobacter pylori positive individuals were further evaluated for serum iron level. The data was collected, saved and analyzed in SPSS version 11.00. During six month study period total one hundred patients of H. pylori infection was recruited, of which sixty three [63%] were males and thirty seven were females. Sixty six [66%] patients belonged to urban areas while thirty four [34%] were rural population. The mean age +/- SD for overall population was 37.35 +/- 14.0 where as the mean age +/- SD of male and female population was 38.88 +/- 6.77 and 35.67 +/- 8.87 respectively. The serum iron was low in 68% Helicobacter pylori infected patients, of which 48 were males and 20 were females [p=0.02]. The overall mean +/- SD for serum iron level in study population was 49.17 +/- 37.86 mmol/L whereas the mean +/- SD of serum iron for male and female Helicobacter pylori infected population was 42.69 +/- 34.15 and 60.18 +/- 41.66 [p=0.03]. An association was identified between Helicobacter pylori and iron deficiency

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

MELD Era: is this time to replace the original child-pugh score in patients with decompensated cirrhosis of liver

To compare the predictive value of MELD [Model of end stage liver disease] and Child-Pugh [CP] scores in patients with decompensated cirrhosis of liver. Descriptive study. Medical Department, Liaquat University of Medical and Health Sciences, Jamshoro/ Hyderabad, from August 2006 to October 2007. This study included 110 consecutive patients with decompensated cirrhosis of liver diagnosed either clinically or radiologically were followed-up during hospital stay. Studied variables included demographic data, cirrhosis related complications and investigations. Patients were classified according to original CP classification into A, B and C. MELD score was estimated from serum bilirubin, serum creatinine and INR [International normalized ratio] of the patients. Duration of hospitalization and in-hospital mortality were made as the end points of the study. T-test and Chi-square test were done for continuous and categorical data. Original CP and MELD score were compared by the ROC curve. 0.05 was kept as the level of significance. There were 110 patients with decompensated cirrhosis of liver. Mean age was 46.76 +/- 12.93 years. There were 72 [65%] male and 38 [35%] females patients. Hepatitis C was the most prevalent cause of cirrhosis of liver present in 60/110 [60%] cases. Ascites was present in 93/110 [83%] patients. The mean MELD scores were 2.23 +/- 0.712 [95% CI 2.09-2.36] and for CTP 2.52 +/- 0.586 [95%; CI 2.41-2.63]. The outcome of the patients were 12 deaths [11%]; 54 [49%] remained hospitalized for up to 14 days and 44 [40%] for>14 days. The majority of deaths and prolong hospitalization were found in patients with MELD score>15 as well as with Child-Pugh grade C. The c-statistic was 0.726 [p=0.001] for CP score, and 0.642 for MELD score [p=0.021]. The MELD score was not found to be superior to CTP score for short-term prognostication of patients with cirrhosis in this study

Validation of three non-invasive markers in assessing the severity of liver fibrosis in chronic Hepatitis C

To compare various biochemical markers i.e. APRI [AST to platelet ratio index], aspartate aminotransferase [AST] alanine aminotransferase [ALT] ratio, FIB-4 [AST, platelet, AST and age] with biopsy for assessing the severity of hepatic fibrosis in patients with hepatitis C. Study Design: Descriptive study. Medical Department, Liaquat University of Medical and Health Sciences, Jamshoro, from July 2005 to March 2007. Consecutive hepatitis C virus RNA positive and previously untreated patients were studied. Liver biopsy with histological evaluation and AST/ALT ratio, AST to platelet ratio index and FIB-4 were assessed in all patients. Receiver operative curves were developed. There were 158 patients [109 males, 49 females]. On histological grounds non-advanced fibrosis [F0-1] was present in 74 [46.5%] of cases, whereas 84 [53.5%] patients had advanced [F2-4] fibrosis. The area under the receiver operating characteristic curves of APRI < 0.05-1 and FIB-4 < 1.45 were 0.7 and 0.74 respectively, which means that APRI < 1 and FIB-4 < 1.45 will exclude advanced fibrosis in 70% and 74% of patients respectively. An APRI of > 1 and FIB-4 will predict advanced fibrosis in 87% and 98% of patients respectively. AST/ALT ratio was inferior to both of these biomarkers. Both APRI and FIB-4 not only exclude minimal fibrosis but can predict advanced fibrosis in the majority of the patients. The simultaneous use of several indirect markers of liver fibrosis does not improve their diagnostic accuracy

Serum zinc level in patients with liver cirrhosis

To determine the serum zinc level in patients with liver cirrhosis. This descriptive cross sectional study was conducted at Liaquat University Hospital Hyderabad Sindh, Pakistan. All patients above 12 years of age, of either gender and known [diagnosed] cases of liver cirrhosis were further evaluated for their serum zinc level. The data was analyzed in statistical software [SPSS] and the p value <0.05 was considered as statistically significant. One hundred twenty seven cirrhotic patients with means age 42.7559 +/- 15.8894 were evaluated and assessed. The serum zinc was low in 69% patients. According to Child-Pugh classification 72% zinc deficient cirrhotic subjects were in class C, 16% in class B and 12% in class A. 94% subjects had hepatitis C virus infection, 4% had hepatitis B virus infection and 2% had history of alcoholism. The serum zinc level was low in patients with liver cirrhosis

Stroke: frequency of risk factors in patients admitted at Liaquat university hospital Hyderabad/Jamshoro

Objective: To determine the frequency of various risk factors for stroke and its sub-types among males and females. Design: Cross sectional /Observational study. Place and Duration of Study: The study was conducted at the Medical Department of Liaquat University Hospital Hyderabad/Jamshoro from January 2006 to March 2007

Material and Methods: Patients with features of stroke confirmed by CT scan brain were enrolled. Brain imaging showing abnormality e.g. brain tumour, meningitis, multiple sclerosis and metabolic derangements that could explain focal neurologic deficit were the exclusion parameters. The frequency of various risk factors for stroke and its types among males and females were evaluated

Results: Out of total 100 patients, 78[78%] presented with infarction stroke and 22[22%] with hemorrhagic stroke. Their mean age at presentation was 56.89 with SD=8.92 years. Hypertension 35[59.3%] and smoking 18[94.7%] were the most important risk factors among males, while the presence of diabetes mellitus 16[55.2%] and IHD 10[62.5%] were found to be more common among females. Forty-two [42%] and 11[11%] males, while 36[36.3%] and 11[11%] females suffering from cerebral infarction and cerebral hemorrhage respectively. In-hospital mortality was 09[09%]

Conclusion: Frequency of various risk factors was high in this study which is similar to that observed in developed countries. Hypertension and smoking were the major risk factors for males, while diabetes mellitus and IHD were more common in females. We did not find any significant gender difference between the two stroke types. Category: Internal Medicine

Frequency of control of blood glucose in patients with type 2 diabetes mellitus at tertiary medical care unit

Objectives: Diabetes mellitus is a medical disorder characterized by varying or persistent hyperglycemia resulting from the defective secretion or action of the insulin. As the serious complications of diabetes mellitus are associated with control and duration of the disease, so this study was planned to observe the frequency of control of blood glucose in patients with diabetes mellitus. Design: A descriptive study Setting: This study was designed at Mohammad Medical College Mirpurkhas Sind. Patients were collected in months of Jan-Mar 2008 in a weekly blood sugar camp arranged at MMC hospital

Methods: Five hundred diagnosed patients of Type 2 diabetes mellitus were included in this study. Their parameters were recorded in detail on pre-designed proforma. Control of blood sugar was evaluated by fasting blood sugar, 2 hours postprandial blood sugar, urine detailed report and hemoglobin A1C

Results: Majority of patients had unacceptable control of diabetes mellitus. Three hundred and sixty-six [73.2%] patients had poor control of blood glucose, while only 134[26.8%] patients had acceptable control of blood glucose

Conclusion: This study proved that control of blood glucose remained poor, i.e. 73.2% patients remained uncontrolled even after attempts to treat the disease; it shows that because of this poor control of blood glucose huge number of patients in future will land up with serious complications. Huge number [93.2%] patients had no knowledge about the disease

Hepatitis-B surface antigen [HBSAG] screening and vaccination experience in Tharparkar

Hepatitis B is a very common communicable viral disease due to multiple uses of syringes and infusions, unsafe blood transfusions. Tharparkar desert where doctors and health facilities are less as compare to other parts of Sindh Province, a study based on proforma filled during free hepatitis B vaccination and Hepatitis B surface antigen [HBsAg] tests, conducted with the sponsorship of pathologist and philanthropists In two towns [Naukot and Chalhar total population of 10,000] of Tharparkar desert selected for this services during January 2005 to January2006. Total 612 residents of theses towns were enrolled for screening and and vaccination services of Hepatitis B out of 612, residents 321 were male 291 were female their age was ranging, from less than 10 years to more than 60 years. The HBsAg surface antigen was positive in 45 males and 28 females showing 73 out of 539 +ve cases giving HbsAg positive rate 11.9%. which is more than the national average of 10%. Study found early adolescence and teenagers showed high carrier rate. This is an alarming situation and needs urgent remedlal steps to prevent this growing problem HBV Vaccine in EPI is showing positive results and children below 10 are showing low infection rate than adults showing and adolescent ages