Serum vitamin D deficiency, a new epidemic

Vitamin D deficiency has profound adverse effects on health. Serum calcium, phosphorus and even alkaline phasphatase cannot predict underlying vitamin D deficiency. 1. To determine the frequency of vitamin D deficiency in outpatient private clinic 2. To determine the relation of vitamin D deficiency with the presenting symptom of bone or body aches. To see the relation of its deficiency to the serum calcium, alkaline phosphate and phosphate levels. Descriptive study. One of the local private clinic. 800 patients who presented to the clinic due to any ailment, having presenting complains with bone or body aches or not, were included in this study. The duration of study was 7 months from June to December 2008. The study showed among total 33% [n=264] were male and 67% [n=536] were female. 33 patients [4.1%] were below age of 20 years, 364 patients [45.2%] were having age between 20-40 years, 252 [31 .5%] were between 41 -60 years, 1 43 [1 7.8%] were between 61 -80 years and only 8 patients [1%] were above 80years. Over all vitamin D present in sufficient amount [>30 ng/ml] in only 4 patients [0.5%], reaming patients [n=796, 99.5%] were deficient in vitamin D were further divided into those who were having deficiency [serum level <20 ng/ml] [n=636, 79%] and insufficiency [serum level between 21-29 ng/ml] [n=160, 20%]. All the deficient patients were having normal serum calcium and phosphate levels and only 33 patients were having modestly raised serum alkaline phosphate. Among the sample only 318 [39.7%] were having bone or body aches as a presenting feature while remaining 482 [60.3%] were having no pains. More ever pain has got insignificant relation to any level of serum vitamin D level [p-value=0.201], however younger deficient patients were having lesser chance of bone or body aches as compared to age more then 60 year [p-value<0.001]. Vitamin D deficiency is more prevalent in our community, as compared to published data, targeting young population. Vitamin D supplementation should be planned to decrease its varied and multidimensional ill effects on health

Diabetes mellitus; prevalence of high blood cholesterol, obesity, smoking and physical activity in urban population of Faisalabad

To estimate the prevalence of diabetes high total cholesterol obesity smoking and physical activity in urban population of Faisalabad. The project was limited to population based screening for above mentioned variables using WHO criteria. Study was conducted by holding numerous screening camps in different urban areas over the course of two years. People age 20 years or above were included in the study. Total 5349 people, 58% males [3102] and 42% females [2247] were screened for diabetes and high blood cholesterol. Body mass index was calculated by measuring height in meter square and weight in kilograms. People were interviewed for smoking and physical activity and relevant data was entered in the designed proforma. Within the chosen age range, total prevalence of diabetes was 16% and among them 11% were previously diagnosed and 5% were unaware of their diabetes [newly diagnosed]. Cholesterol was high [>/= 200 mg/dl] in 48% males and 34% females. 9.2% of the males were found to be obese [BMI>30] in comparison to 14.3% of females whereas 36.26% of males and 36.84% of females were overweight [BMI >/= 25 to 29.9 kg/m[2]]. The prevalence of smoking was 38.8% in males and 1.2% in females respectively. In daily routines only 6.8% of the males were doing the physical exercise [30 minutes exercise five days a week or equivalent] whereas among females it was 1.9%. Diabetes and metabolic syndrome in adults is now a global health problem, and the population of developing countries like Pakistan are facing this menace especially in the urban areas where it is on the rise with each passing day

Haemorrhoidectomy

Haemorrhoids are among the commonest surgical problems of anorectal region. Chronic constipation, straining, at defecation or micturation is the main predisposing factors but exact aetiopathogenesis remain unclear. Most patients in the initial stages are treated with conservative or minimally invasive approaches. However haemorrhoidectomy has proven long-term efficacy in the treatment of third degree haemorrhoids. There is still controversy whether open or closed haemorrhoidectomy is treatment of choice. Haemorrhoidectomy whether open or closed is associated with postoperative complications. This study was carried out to compare postoperative complications of both procedures to improve the management of haemorrhoids. To compare postoperative complications in open and closed haemorrhodectomy. Quasi- experimental. Surgical unit-1, Allied Hospital Faisalabad. One year [20/06/o6 to 20/06/07]. 100 cases [50 cases in each]. Convenience sampling. Patients with 3[rd] degree haemorrhoids. * Complicated third degree haemorrhoids. * Patients with other causes of bleeding per rectum. * Patients having associated medical problems. * Patients not willing for surgery. Out of 100 patients 7 had severe postoperative pain, 5 from open and 2 from close group.50 patients had moderate pain, 30 from open and 20 from closed group.8 patients, 5 from open and 3 from closed group got urinary retention. 2 patients both from open group had anal stricture. Closed haemorrhoidectomy is more advantageous with respect to less postoperative pain