ABSTRACT
Introduction: Normal blood pressure has a certain normal range and therefore it is common to see people having blood pressure towards lower range but considering it as "low blood pressure". Among these majority of the people including medical students consider "low blood pressure" as a disease which once diagnosed, needs to be treated
Objective: The objective of this study is to evaluate the knowledge and attitude of medical students towards low blood pressure
Methodology: This cross-sectional study was conducted by recruiting medical students [MBBS] of Dow Medical College, Civil Hospital Karachi during October 2016 to February 2017. A total of 306 students from first year to final year were approached through after an informed consent and questionnaire regarding the symptoms of low blood pressure were noted. The students were divided equally into pre-clinical [1[st] and 2[nd] year students] and clinical [3[rd], 4[th] and 5[th] year] groups to assess difference in between their knowledge based on their clinical exposure. Every participant underwent blood pressure measurement regardless of the symptoms. Results were compared and analyzed using SPSS software version 16.0
Results: 171 [n=100 from clinical and n=71 from pre-clinical group] students out of a total of 306 participants do not consider low blood pressure a disease. They also believe that low blood pressure among healthy people neither presents with any symptoms nor requires any treatment
Conclusion: It is concluded by our study that most of the students enrolled in a medical college believe that low blood pressure is a normal entity for a person which doesn't require any intervention
ABSTRACT
Background: With the increased life expectancy, there is rise in geriatric diabetic population. A knowledgeable diabetic in collaboration with physician can contribute to a successful diabetes management plan. Current study was conducted to determine the diabetes knowledge, its associations and risk factors in elderly type 2 diabetics
Methods: This descriptive cross sectional study was conducted at outdoor Medicine Dept. Rawal Institute of Health Sciences Islamabad over 8 months period from January to August 2015. Geriatric type 2 diabetics [>65 years] were included. Critically ill patients, having physical or mental limitation to answer the questionnaire were excluded. The demographic details, socioeconomic class, literacy level, duration of diabetes, other modes of therapy and glycemic control documented. Michigan Diabetes Knowledge Questionnaire [DKQ-24] was applied with outcome of diabetes knowledge as good, acceptable and poor. Data analyzed by SPSS version 17 with significant p-value < 0.05
Results: Among 163 diabetics [21.5% males and 78.5% females], mean age was 64.7+5.6 years and mean duration of diabetes 8.4+6.6 years. Diabetes knowledge was poor in 86[52.8%], acceptable in 37[22.7%] and good in 40[24.5%] diabetics. Poor diabetes knowledge was found to be associated with illiteracy, poverty, unsatisfactory glycemic control, practicing other modes of therapy and poor dietary control
Conclusion: The unsatisfactory diabetes knowledge in geriatric diabetic population needs to be addressed. Illiteracy and low socioeconomic class are the contributory factors in addition to advanced age. Imparting knowledge to geriatric group about diabetes and its complications, dietary advice supplemented by easy to interpret diet charts and literature may lead to empowerment of geriatric diabetics for better diabetic control and reduced diabetes related morbidity
ABSTRACT
Background: In addition to its effect on the bones, vitamin D has a myriad of extra skeletal roles. It has been implicated both in the development of type 1 and type 2 diabetes mellitus as well as glycemic control. There is widespread vitamin D deficiency in Pakistan. Incidence of diabetes mellitus is also increasing exponentially. There is a need to define the relationship between 25 hydroxy vitamin D and type 2 diabetes
Objective: The purpose of this study was to determine the prevalence of hypovitaminosis D in type 2 diabetes and its association with the level of control of diabetes mellitus
Materials and methods: This descriptive cross sectional study was conducted at the Department of Internal Medicine, Sir Syed College of Medical Sciences and Hospital Karachi from January to June 2015. Total 168 adult cases of Male and Females patients having type 2 Diabetes Mellitus were included. After taking the informed consent; demographic details, duration of diabetes, and modes of treatment for diabetes were recorded. The glycemic profile and levels of vitamin D were assessed. Glycemic control was categorized as satisfactory and unsatisfactory glycemic control while vitamin D levels were categorized as sufficient, insufficient and deficient. The data was analyzed on SPSS version 20.0. Mean +/-SD was computed for quantitative variables. Frequency and percentages was computed for categorical variables. Relationship of the glycemic control with vitamin D was computed through Chi-square test. P-value of <0.05 was considered significant
Results: Among 168 cases [45.2% males and 54.8% females], mean age was 46.7+/-12 years and mean duration of diabetes 7+/-4.4 years. Mean HbA1c was 8.3 +/-2.28 with 62% patients having unsatisfactory glycemic control. A large proportion of the patients had vitamin D deficiency [80.8%]. Deficiency of vitamin D was significantly associated with both fasting and random blood glucose levels as well as HbA1c
Conclusion: A large majority of patients with type 2 diabetes mellitus have vitamin D deficiency and the poorly controlled diabetes mellitus is significantly associated with vitamin D deficiency
ABSTRACT
Background: Dengue fever, an emerging public health issue in Pakistan bears considerable morbidity and mortality. This descriptive cross sectional study was conducted to analyze clinical, hematological and serological characteristics of dengue fever variants and to identify biomarkers that predict its severity
Methods: 105 dengue cases [>12 years] were selected after ethical approval from Rawal Institute of Health Sciences and Benazir Bhutto Hospital Rawalpindi over 6 months [July to Dec 2015]. Patients having pre-existing hematological disorder, liver disease, malaria and typhoid co-infection were excluded. Demographic data, clinical findings, hematological and serological profile documented. Patients were classified as classic dengue fever [DF], dengue hemorrhagic [DHF] and dengue shock syndrome [DSS]. Data analyzed via SPSS version 17
Results: Among 105 cases, there were 79[75%] males and 26[25%] females. Mean age was 30 +/-12.8 years and mean duration of symptoms 5 +/-2 days. Dengue fever was found in 75[75%], dengue hemorrhagic fever 24[23%] and dengue shock syndrome 2[2%]. Gender, mean age and duration of symptoms were comparable between DF, DHF and DSS. Common clinical features were fever [100%], headache [56%], muscle pain [43%], vomiting [43%], retro-orbital pain [23%], bleeding [12%] and hypotension [10%]. Thrombocytopenia, leukopenia and pancytopenia were frequent in DHF vs. DF. Dengue NS-1 antigen positive in 71[90%] of DF cases vs 16[57%] DHF and 1[50%] DSS. Dengue-IgM positive in 32[47%] DF vs. 19[79%] DHF and 2[100%] DSS. Dengue -IgG detected in 33[42%] DF vs. 17[71%] DHF and 1[50%] DSS. 101[96%] dengue cases were treated successfully and one case expired
Conclusion: Dengue-IgG and IgM are better predictive variables for dengue hemorrhagic fever as compared to NS-1 antigen that predicts classic dengue fever. Utilizing these predictive variables, imminent severe dengue may be identified and with vigilant monitoring, fluid resuscitation and pre-hand arrangement of blood products we may reduce complications and mortality in high risk cases
ABSTRACT
OBJECTIVE: Malaria is a major health problem in South Asia. It can be associated with many complications. Thrombocytopenia is the most common hematological complication of malaria
Our aim was to assess the severity and frequency of thrombocytopenia in malaria
DESIGN: This was a descriptive case-series study. A total of 69 admitted patients diagnosed with malaria were assessed for thrombocytopenia using automated quantitative D3 Analyzer
The data was analyzed using SPSS version 16.0. The results were obtained in numbers and percentages
Data was expressed as means with standard deviation
RESULTS: Out of the sample population 64 patients were diagnosed with vivax malaria and 3 with falciparum malaria while 2 patients had mixed infection. About 86% of patients with vivax malaria had thrombocytopenia while 66% of patients with falciparum malaria had thrombocytopenia
Mean platelet count in vivax malaria was 84.02x10[3]/microL with a range of 15-213x10[3]/microL
Platelet count of <20,000/microL was seen in only 2 patients with vivax malaria and none of the patients with falciparum malaria
CONCLUSION: Thrombocytopenia is a common feature in malaria. In patients having fever with thrombocytopenia, malaria should be on top of differential diagnosis. Viral hemorrhagic fevers can also present as fever but in these cases the complete blood counts has other features such as high hematocrit and leucopenia along with thrombocytopenia. Our finding can have therapeutic implications in the context of avoiding unnecessary platelet transfusion with the relatively more benign course in vivax malaria. In our study the commonest cause of thrombocytopenia in malaria was vivax malaria