Hepatitis C infection; type II diabetes mellitus patients in a tertiary care hospital, Karachi

Objectives: To determine the prevalence of Hepatitis C virus infection in Type II Diabetes Mellitus patients and its associated risk factors in our population

Duration and Place of Study: Study was conducted in Jinnah Post graduate Medical Centre, Karachi between December 2013 to December 2014

Study Design: It is a Cross-sectional study

Data collection and Results: Data was collected from registered diabetic patients, 355 diagnosed Type II diabetes mellitus patients including 128[36.1%] males and 227[63.9%] females were selected and their Hepatitis C screening was done by ICT method. The bio-data of the patients, history and duration of diabetes mellitus, history of blood transfusion, previous surgery, accidents, shaving from barber, tattooing, nose piercing, acupuncture, insulin use were recorded on a proforma. Out of the 355 diabetes mellituspatients tested, 33 were positive for anti-HCV antibodies giving a prevalence of 9.3%

Conclusion:There is increased prevalence of HCV infection in diabetic patients when compared with general prevalence of HCV in Pakistan

Solitary plasmacytoma; osteolytic lesion of clavicle-case report

Solitary plasmacytoma of bone is one of the subtypes of plasma cell neoplasms. Solitary plasmacytoma is a kind of malignant tumor characterized by localized collection of monoclonal plasma cells. It is most frequently seen in vertebrae and long bones. Plasmacytoma of clavicle is very rare. We report a case of solitary plasmacytoma of lateral end of clavicle in a 30 year old male presented with complaint of pain and swelling around the right shoulder region, though SPB can involve any bone of body but SPB involving the lateral end of clavicle is very rare presentation

Obesity and Diabetes: an experience at a public sector tertiary care hospital

To detect the frequency of Obesity in type 2 diabetic patients. It was a Cross Sectional study carried out at Diabetes Clinic, Medical Unit III, Jinnah Postgraduate Medical Centre Karachi from 1[st] Jan 2012 to 30[th] June 2012. Three hundred and eighty seven [387] type II diabetic patients of either sex and any age were included in the study. Non-purposive convenience sampling technique was used to enroll patients in the study. History regarding diabetes, hypertension [HTN], Cerebrovascular Accidents [CVA], smoking and other tobacco exposure was taken. Physical examination was carried out and height, weight, body mass index [BMI], blood pressure, peripheral pulses and anklebrachial index [ABI] was calculated. Categorical variables such as Gender, Age groups, BMI groups, HTN, smoking, hyperlipidemia and ABI were expressed as frequencies and proportions. Means with standard deviations were calculated for continuous variables such as age, duration of diabetes, BMI, duration of HTN and duration dyslipidemia. For categorical variables, differences between patients were tested using the chi-square test. P value of

Bile duct injury: management and outcome

To describe the management and outcome of bile duct injury. Descriptive case series. Surgical Unit II Civil Hospital, Dow University of Health Sciences Karachi, from July 2008 to June 2011. Patients who sustained bile duct injury were included in this study. Mode of admission, type of injury, procedures for reconstruction and outcome were recorded. There were sixteen patients with bile duct injury. Twelve [75%] patients were females and four [25%] males. Mean age was 40 year. In six [37.5%] patients injury occurred in our unit during surgery while four [25%] patients were referred from other tertiary care hospitals. Three [18.75%] patients were sent from district hospitals, one [6.25%] patient from taluka hospital and two [12.5%] from other private hospitals. Nine [56.25%] patients sustained injury during open cholecystectomy and in five [31.25%] during laparoscopic cholecystectomy. Ten patients [62.5%] underwent end to end repair over T-Tube. Two patients [12.5%] underwent hepaticojejunostomy. Morbidity noted in 37.5% [n=6] and mortality was 18.75% [n=3]. Bile duct injury occurred more with open cholecystectomy and end to end repair over T tube was most frequently used procedure. Mortality remained significant

Peripheral artery disease in type II diabetes

To determine the frequency of peripheral arterial disease [PAD] in type 2 diabetic patients. Cross-sectional observational study. Diabetes Clinic, Medical Unit III, Jinnah Postgraduate Medical Centre, Karachi, from January to June 2010. Three hundred and eighty seven [387] type II diabetic patients of either gender and any age were included in the study. Patients with a previous history of trauma to the arterial vasculature, pregnancy and those who underwent arterial graft procedures were excluded. Non-purposive convenient sampling technique was used to enroll patients in the study. PAD was diagnosed when ankle-brachial index [ABI] was less than 0.9. A p-value of less than 0.05 was considered statistically significant. Out of 387 studied patients, 128 were males [33.1%] and 259 were females [66.9%]. Mean age was 52.22 +/- 9.671 [22 -76] years in the entire cohort. Mean duration of diabetes was 9.38 +/- 6.39 years. PAD was detected in 152 [39.28%] of the total study subjects. Thirty-one of 128 male patients [24.22%] had PAD disease while 121 out of 259 female patients [46.71%] had evidence of PAD [p = 0.001]. Hypertension was a significantly associated factor [p = 0.002]. A high frequency of PAD was observed in the diabetic population particularly with hypertension and more prevalent in females

Clinical features, diagnostic techniques and management of dual dengue and malaria infection

To find out clinical features, diagnostic techniques and management outcome of patients having dual dengue and malaria infection. A case series. Medical Unit-III, Ward- 7, Jinnah Postgraduate Medical Centre, Karachi, from September 2007 to January 2008. Patients presented with fever of less than or equal to 10 days duration, severe body aches, rash and bleeding manifestations were included. Patients with obvious features of other diseases like typhoid, hereditary bleeding diathesis and hematological malignancies and only malarial parasite positive with high grade intermittent fever without rash and myalgia were excluded from the study. Diagnosis of dengue and malaria was based on history, clinical features, laboratory parameters and malarial parasite test by thin and thick films. Serological evaluation was done by dengue IgM and IgG by ELISA test kit. Patients were divided into three groups. Group A was dengue IgM positive plus MP positive, group B was dengue IgM positive and MP negative and group C was dengue IgM negative and were clinically suspected dengue and malaria. The clinical manifestations and laboratory parameters of dual dengue and malaria positive patients were compared with malaria and dengue negative patients. One hundred and fourteen patients were seen during the study period. Antibody titer [IgM] tested in all patients was found positive in 78 patients [69.64%]. Among those 78 patients, 26 [23.21%] were concomitantly positive for malarial parasite [Group A]. Plasmodium vivax was positive in 25 patients and falciparum in one patient. Fifty-two patients [46.42%] were dengue IgM positive and MP negative [Group B]. Thirty four [30.35%] patients were MP and dengue IgM negative [Group C] but were strongly suspected for DHF and malaria on clinical and hematological basis. The hemoglobin of 34.61% of patients of group A, 5.76% of group B and 14.7% of group C were low, hematocrit level was also low in group A[92.3%], group B [15.38%] and group C [70.58%] patients. The platelet count was markedly low in 84.61% of patients of group A, 57.69% of group B and 94.11% of group C. Leukopenia was found in 34.61% of patients of group A, 78.84% in group B and 29.411% in group C. The liver function tests were deranged in all groups. The frequency of dual dengue and malaria infection was 23.21%. The serology of the dengue and malaria showed negative results in 30.35%. The diagnosis of dual infections could be made on the basis of history, clinical examination supported by hematological results. It is recommended that all the patients suspected for dual infections should be treated concomitantly for dengue and malaria in malaria endemic areas