ABSTRACT
Introduction: Diagnosis of pulmonary tuberculosis in sputum negative patients for acid fast bacilli ischallenging till today. It is a fact that 50-60% patients of pulmonary tuberculosis are sputum negativemicroscopically. Smear microscopy is the easiest, commonest and widely employed tool for confirmatorydiagnosis of pulmonary tuberculosis, but it has low sensitivity and specificity. Sputum culture forMycobacterium tuberculosis bacteria can increase the diagnostic yield by 20-40%, but it takes long duration of2-8 weeks when solid media are used or 10-14 days when radiometric system in liquid media are used. Delayeddiagnosis causes increased rate of disease transmission in the community. The role of newly introducedcartridge based nucleic acid amplification test (CBNAAT) in the revised national TB control program (RNTCP)is highly promising with a higher yield of bacteriological diagnosis in sputum negative pulmonary tuberculosispatients with detection of rifampicin resistance within 2 hours only. Aims and objectives: The current study isto find out efficacy of CBNAAT in diagnosis of new sputum negative pulmonary tuberculosis patients. Thedetection of rifampicin resistance is also done in those patients. Materials and Methods: Sputum samples of100 sputum negative pulmonary tuberculosis patients were sent to District CBNAAT center in sterilized falcontube container. The CBNAAT result were analyzed. Results: Mycobacterium tuberculosis was detected inthirty one patients (31%). Not a single case was detected as resistant to rifampicin. Conclusion: CBNAAT helpsin increased case detection rate in lesser time in new sputum negative pulmonary tuberculosis patients.Rifampicin resistance was not detected in any patient.
ABSTRACT
Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability worldwide. Its prevalence is increasing globally, especially in countries with high frequencies of smoking combined with signifi cant environmental exposures to pollutants and biomass smoke. Currently COPD is the third leading cause of death worldwide, after ischemic heart disease and stroke. Efforts have been made to design a standard protocol for treatment of the disease, and these efforts are still in the process. Methods: The study was done on 100 subjects to assess whether steroid (inhaled or oral) actually have any role in decreasing the decline in forced expiratory volume in 1 sec and to compare the effect of both to fi nd out which one is superior. Patients were divided into two arms, inhaled steroids group (according to GOLD guidelines), and the other group was oral prednisolone 10 mg in addition to standard treatment except inhaled steroid. The effects were studied with appropriate statistical tests. Results: Our study data showed that oral steroids are more effective on symptom control as compared to inhaled steroids. Symptoms such as cough (64% vs. 82%) and breathlessness (76% vs. 94%) signifi cantly improved in the oral corticosteroids group. The rate of exacerbation also improved (22% vs. 12%) in the test group. Conclusion: The use of steroids has ever been a subject of divergence of views ever since its role in the treatment of COPD was fi rst described. Although, overall steroid in any form is benefi cial in symptomatic/subjective and objective improvements in COPD, oral steroids stand a better chance as compared to inhaled steroids.
ABSTRACT
Analysis of RB1 mRNA from blood leukocytes of patients with retinoblastoma identified the effects of mutations involving consensus splice site, exonic substitution and whole-exon deletions identified in genomic DNA of these patients. In addition, this study identified mutations in cases in which no mutations were detectable in the genomic DNA. One proband had mutation at the canonical splice site at +5 position of IVS22, and analysis of the transcripts in this family revealed skipping of exon 22 in three members of this family. In one proband, a missense substitution of c.652T>G (g.56897T>G; Leu218Val) in exon 7 led to splicing aberrations involving deletions of exons 7 and 8, suggesting the formation of a cryptic splice site. In two probands with no detectable changes in the genomic DNA upon screening of RB1 exons and flanking intronic sequences, transcripts were found to have deletions of exon 6 in one, and exons 21 and 22 in another family. In two probands, RNA analysis confirmed genomic deletions involving one or more exons. This study reveals novel effects of RB1 mutations on splicing and suggests the utility of RNA analysis as an adjunct to mutational screening of genomic DNA in retinoblastoma.
ABSTRACT
Type 2 Diabetes mellitus has reached epidemic proportions worldwide and Pakistan is no exception. This study was done to see the glycaemic control of our diabetic patients by estimating Glycosylated haemoglobin and Fasting blood glucose as poor control leads to significant complications causing enormous human suffering and socioeconomic burden. This Cross-sectional study was conducted on Type 2 diabetic patients coming to medical OPD and medical B ward of Ayub Teaching Hospital between March-September 2007 fulfilling the inclusion criteria. Among 100 patients with type 2 diabetes forty two had HbA[1]c more than 7.5%, while seventy had fasting blood glucose more than 120 mg/dl. All patients with HbA[1]c more than 7.5% had increased fasting blood glucose. While thirty out of seventy patients with fasting blood glucose more than 120 mg/dl had HbA[1]c less than 7.5%. None of the patients with fasting blood glucose less than 120 mg/dl had HbA[1]c more than 7.5%. Significant number of patients [42%] had poor control of diabetes as revealed by HbA[1]c, with FBG showing poor control in even more patients, i.e., 70%. However their blood glucose estimation was not frequent enough as required. Blood glucose results can be spuriously high and may lead to frequent change/ increase in the dose of hypoglycaemic medications. This can lead to poor compliance as well as psychological trauma to patients. HbA[1]c on the other hand is easy to interpret, reflects long term glycaemic control and cost effective. We recommend its more frequent use along with blood glucose for better glycaemic control and decreased chances of complications
Subject(s)
Humans , Male , Female , Blood Glucose , Glycated Hemoglobin , Cross-Sectional StudiesABSTRACT
Osteomalacia is a common diagnosis in the Kohistani women presenting with aches and pains. This study was conducted to assess calcium and Phosphate levels in Kohistani women with osteomalacia. 50 diagnosed cases of Osteomalacia selected from amongst the women presenting with body aches were included in the study. History regarding age, marital status, parity, dietary habits, socioeconomic status etc was taken. The median age was 23 years. 74% were married. Most of the women had 5 children [mode]. Nine [18%] patients had hypocalcaemia, 10 [20%] had hypophoshatemia. Alkaline phosphatase was elevated in 13 patients [26%]. Six [12%] patients were pregnant at the time. 74% of patients belonged to the poor class. 70% of the patients drank less than 1 cup of milk per day. Body aches [100%], waddling gait [14%], proximal myopathy [12%], bone tenderness [6%] and carpopedal spasm [8%]. Conclusions: We therefore conclude that in comparison with other parts of the world where individual risk factors cause osteomalacia, Kohistani population has a higher frequency of osteomalacia due to aggregation of three major factors namely lack of sunlight due to geographical location, excessive clothing blocking available sunlight and nutritional deficiency