Clinical presentations and biochemical profile in adult celiac disease patients in Hyderabad: Pakistan

To see the various clinical presentations and biochemical profile in adult celiac disease patients of Hyderabad Sindh. A total 60 suspected cases of adult celiac disease, both males and females were screened out from liaquat University of Medical and Health Sciences hospital and private clinics at Sadar Hyderabad Sind by non probability purposive sampling during a period from July 2011 to December 2012.Age ranged between 18 to 55 Years. A detailed history and clinical examination was done. Patients already on gluten free diet, age < 12years, tuberculosis or cancer of intestine/colon and patients of diabetes and thyroid disorder were excluded, while patients having positive ant tTG [value > 15 iu/ml detected by ELISA] were included. The biochemical profile including serum albumin, calcium, ferritin, SGPT, Alkaline phosphatase and Haemoglobin were estimated in central Diagnostic laboratory LUMHS by taking 10 cc centrifuged blood sample. The data was plotted on SPSS 16, mean and percentages were calculated. All patients were divided in to three groups according to age. The most common group was 18-30 years; [mean, 23.5 +/- 5.6] comprised 56.6%. The commonest clinical presentation was diarrhoea in 50%, menstrual irregularity in 21%, walking problems 21%, undue fatigue in 15% and edema in 15%. P values calculated in quantitative variable of males and females. The p value was significant in between serum calcium [p 0.004], haemoglobin [p 0,004], serum ferritin [< 0.005] and alkaline phosphatise [< 0.005]. This study showed that Adult celiac disease was present with entirely different clinical and biochemical profile in patients in this region

Distribution frequency of hepatitis C virus genotypes in pateints attending liaquat university hospital Jamshoro/Hyderabad

To assess the frequency of different genotypes of Hepatitis C virus in patients attending Liaquat University Hospital [LUH] Jamshoro Sindh. This descriptive cross sectional study was carried out at Department of Medicine at Liaquat University hospital Jamshoro from June to December 2012. A total of 107 patients with Hepatitis C fulfilling the selection criteria and with informed consent were included in the study. Blood samples were taken from patients for HCV genotyping. A qualified pathologist performed HCV genotyping. Total 107 patients of Hepatitis C were selected by non probability consecutive sampling. Mean age was 36.58 +/- 10.5 years. Fifty six [52.3%] were male and fifty one [47.7%] were female. The commonest genotype was genotype 3 [72.9%] followed by genotype 2 [18.7%], genotype 1 [7.5%] and genotype 4 [0.9%]. The commonest HCV genotype 3 subtype was subtype a [73.8%] followed by subtype b [25.2%] and subtype c [0.9%]. HCV genotype 3 with distribution frequency of 72.9% and subtype a with distribution frequency of 73.8% were the commonest in our study population.

Serum vitamin D level in type 2 diabetic patients

To find out serum vitamin D levels in type 2 DM patients in Hyderabad. Cross sectional study. Private clinics, OPDs of government hospitals like Qasimabad, Latifabad and Pretabad. Duration: January to July 2013. Total 550 patients were selected, 450 patients [250 males and 200 females] taken from different OPDs of Hyderabad and towns or Tehsils with diagnosis of type 2 Diabetes mellitus and another 100 patients were taken as control [60 males and 40 females]. The mean age was 45.6 years. The written consent was obtained and demographic features were noted, 3cc of blood was taken for estimation of vitamin D levels. The level of vitamin D was done on an Electrochemiluminescence Immuno Assay [ECLIA] at Diagnostic and Research laboratory Liaquat University of Medical and Health sciences [LUMHS] Jamshoro, Sind. Out of 550, 450 diabetic subjects tested for vitamin D, females were 44.4%and 55.5% were males. The deficiency was seen in 33.7% patients [p <0.04] and Vitamin D insufficiency was observed in20% in both sex. In control group, the deficiency was observed in 23% in females and 20% in males while insufficiency noted in 5% in both sex. The study showed significant decreased levels of vitamin D in type 2 Diabetic subjects than normal individuals. The vitamin D deficiency increased considerably in females with diabetes type 2

Frequency and clinical presentation of dengue fever at tertiary care hospital of Hyderabad/Jamshoro

Objectives: The aim of this study is to observe the clinical presentation and frequency of dengue as a cause of fever in our setup

Methods: This retrospective study comprising of clinically suspected dengue infection, admitted to Liaquat University Hospital Hyderabad, during an epidemic from August 2006 to August 2007. Only adults with acute febrile illness were evaluated for clinical features of dengue fever, dengue hemorrhagic fever and dengue shock syndrome

Results: Patients with acute febrile illness were evaluated during this study. Fifty [5%] patients presented with typical features of dengue fever. Age of the patients ranged between 13 and 70 years. All patients were males with mean age of 35 years. Only 20/50 [40%] were dengue proven while 30/50 [60%] were dengue suspected. Out of dengue proven, 18 patients had dengue fever and 2 had dengue hemorrhagic fever. Typical clinical features included chills and rigors in 16 [80%], myalgia in 14 [70%], vomiting in 12 [60%], headache in 10 [50%], rash in 5 [25%]. Unusual clinical features were pharygitis in 7 [35%] and bleeding manifestations in 5% of patients. Laboratory investigations showed leucopenia [<4.0x10[9]/L] in 80%, thrombocytopenia [<150x10[9]/L] in 90%, and serum ALT was elevated [>40 U/L] in 40% cases

Conclusions: Fever associated with chills and rigors, bodyaches, bone pain, headache, myalgia, rash, low platelet count, decreased total leukocyte count, raised serum ALT, and hemorrhagic manifestations are satisfactory and important parameters to screen the cases of suspected dengue virus infection; however the diagnosis cannot be confirmed unless supported by molecular studies or dengue specific IgM

Serum zinc and magnesium in Type-2 Diabetic Patients

To assess serum zinc and magnesium level in type-2 diabetic patients and the effect of age, gender, glycemic control and duration of diabetes on these trace elements in comparison with those of control subjects. Non-interventional case control study. Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, from October 2007 to March 2008. There were 42 diabetic patients and 42 age matched non-diabetic [control] subjects included in this study. Serum zinc, serum magnesium and fasting blood sugar measured among the diabetic and control groups and association of both trace elements were assessed with glycemic status, age, gender and duration of diabetes using SPSS version 16.0 for analysis. Serum zinc level was significantly lower [mean 2.03+0.39 mg/dL] in diabetic patients as compared to control subjects [4.84 +/- 4.217 mg/dL, p = < 0.001]. No significant difference was found in serum magnesium level with mean of 22.67 +/- 24.5 mg/dL in diabetic patients as compared to controls [18.3 +/- 3.4 mg/dL, p = 0.26]. Serum zinc level was significantly lower in type-2 diabetics, whereas no significant difference was found in serum magnesium level when compared with control subjects. There was no association of age, gender, glycemic status and duration of diabetes on the serum concentration of these trace elements in type-2 diabetic patients

Frequency of thyroid disorders during interferon and ribavirin therapy in chronic hepatitis C infection

The objective of this study was to assess the frequency of thyroid dysfunction in response to combination of interferon and ribavirin therapy in chronic hepatitis C [CHC] patients and HCV outcome. Descriptive study. This study was conducted at Outpatient Department of Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad from September 2005 to September 2007. One hundred cases of CHC, proven by anti-HCV and HCV RNA-positive with baseline TSH, FT[4] and FT[3] within the normal reference range, who were treated with interferon alpha-2b [3 million unit subcutaneously three times per week] and oral ribavirin [1000-1200 mg per day] were included in this study. All patients were assessed for TSH, FT[4], FT[3] levels at 12 weeks and 24 weeks during therapy. Among the 100 patients, overt thyroid disease developed in 13 [13%] and sub-clinical thyroid disease in 5 [5%]. Out of 13 patients of overt thyroid disorders, 11 [84.6%] had hypothyroidism and 02 [15.3%] hyperthyroidism. Four [80%] patients were of sub-clinical hypothyroidism and 01 [20%] patient was of sub-clinical hyperthyroidism. Overall, thyroid disorders developed in 18 [18%] both as overt and sub-clinical thyroid disorders. Ninety one [91%] patients became negative by HCV RNA. Treatment of HCV with IFN-alpha and ribavirin can be safely continued in patients with over and sub clinical hypothyroidism because thyroid disease responds well to treatment