ABSTRACT
Objective: to determine the causes of hypoglycemia in diabetics presenting at Liaquat University Hospital Hyderabad/Jamshoro
Study design: descriptive observational study
Place and duration: medical and Cardiology units of Liaquat University of Hospital Hyderabad Jamshoro, from June 2007 to May 2008
Patients and methods: one-hundred and one hypoglycemic cases were analyzed. A detailed enquiry about the presenting symptoms and mode of therapy was made. A thorough physical examination to look for diabetic complications and any concurrent illness was performed. Blood glucose was measured with the help of a Glucometer and response to glucose administration was also noted. Data were computed using SPSS software version 14. P-value up to 0.05 was considered significant
Results: type-2 diabetics presented more commonly with hypoglycemia in adult diabetic population 81/101 [80.1%]. Mean age for type-1 diabetics was 27.7 years and for type-2 diabetics 53.6 years. Male to female ratio was 3.3:1. Type-1 diabetic patients were either brittle diabetic with frequent dosage manipulations or those who had developed chronic complications. Majority of type-2 diabetics 74/81 [91.4%] were more than 40 years of age. Diabetic nephropathy, change in dose of hypoglycemic agents, missed meals, and use of concomitant medications were important associations with hypoglycemia in type 2 diabetic patients. All type-1 diabetics recovered completely after glucose administration. Amongst type 2 diabetics, 5 [6.41%] developed permanent disability and 6 [7.69%] patients died
Conclusion: the adult males having type 2 diabetes suffer more from this complication. Recognition of different causes of hypoglycemia in diabetes patients and prompt treatment of hypoglycemia is important to prevent complications. The reasons of developing hypoglycemia most of the times were on patient's hand
ABSTRACT
Objective: to determine the coagulation abnormalities in patients with lung cancer
Study design: case-control study
Place and duration: department of Pathology Isra University Hospital Hyderabad, Sindh - Pakistan, and Department of Medicine Liaquat University of Medical and Health Sciences Jamshoro, Sindh - Pakistan, from June 2006 to December 2007
Patients and methods: seventy subjects were recruited for the study by non-probability convenient sampling technique. Forty freshly diagnosed histopathology proven lung cancer patients were taken as cases, whereas 30 healthy subjects comprised the control group. Platelet count [PLT] was done on hematology analyzer while prothrombin time [PT], activated partial thromboplastin time [APTT] and plasma D-dimer tests were performed by commercially available kits at Department of Pathology, Isra University Hospital Hyderabad, and Sindh - Pakistan. T test was applied to determine the significance of differences between two groups whereas P value up to .05 was taken as significant
Results: the mean +/- SD PLT in cases and controls was 394 +/- 170 and 216 +/- 73 respectively. The mean +/- SD values for these respective groups were for PT 14.7 +/- 0.5 and 12.6 +/- 0.4, for APTT 41.5 +/- 6.2 and 25.8 +/- 3.7. D-dimer levels were <500 in all 30 controls whereas these were up to 2000 in cases
Conclusion: there is a strong relationship between coagulation abnormalities and lung cancer. D-dimer is very sensitive for evaluation of fibrinolysis related with lung cancer
ABSTRACT
Objective: To determine the frequency of night blindness among cirrhotic patients and evaluate the restoration of vision with vitamin A therapy. Design: - Case-control observational study. Setting: Medical ward of Liaquat University Hospital Hyderabad / Jamshoro, Sindh - Pakistan; from January 2006 to December 2007
Methods: Two hundred cirrhotic patients admitted at medical unit IV were enrolled in the study. The non-cirrhotic patients were excluded. Fifty healthy volunteers took part as the control subjects
Results: Out of 200 patient, 116[58%] were males and 84[42%] females. The mean age of the cirrhotic patients was 48.46 + 11.97 years. The cause of cirrhosis was hepatitis C virus in 146 [73%] cases, hepatitis B virus in 19[9.5%] cases, hepatitis C and B virus in 7[3.5%] cases, non B and C virus in 24[12%] cases and alcohol in 4[2%] cases. When cirrhotic patients were grouped into Child-Pugh's score, 44[22%] were in class A, 106 [53%] in class B and 50[25%] in class C. Among 200 patients, 122 [61%] had history of night blindness and 25[12.5%] had the colour blindness. Restoration of vision was observed in 105[86%] patients with vitamin A therapy [tablet Vitamin A 50,000 IU, Wilson Pharma], twice daily, for 6 weeks time
Conclusion: The history of night blindness and its restoration of vision with vitamin A therapy is a rough indicator of vitamin A deficiency in cirrhotic patients. The larger studies are required especially RBP [plasma retinol binding protein] and serum vitamin A concentration before recommendation of vitamin A replacement. The Ophthalmic changes in cirrhotic patients are preventable and treatable
ABSTRACT
Objective: To determine the prevalence of primary and secondary drug resistance to first line anti-tuberculous drugs. Study Design: A hospital-based cross-sectional observational study. Place and Duration: Department of Medicine Liaquat University Hospital Hyderabad/ Jamshoro and Institute of Chest Diseases Kotri from April 2005 to March 2007
Patients and Methods: Fifty cases of Pulmonary tuberculosis [TB] randomly selected from both institutes who fulfilled the following criteria 1] Sputa showed positive smear for Acid Fast bacilli on Zeil Nelson Stain. 2] Chest x-ray showed shadow consistent with TB. A detailed history, contact with TB patients, previous use of anti-tuberculous drugs and Chest x-ray was done. Sputa of all patients were sent for detail report and culture sensitivity. Descriptive and inferential statistical analysis was performed using SPSS version 14.0
Results: Among 50 patients, 28[56%] were males and 22[44%] females, age ranged from 16-80 years [38.14 + 15.69]. All 50 [100%] patients presented with fever and cough, haemoptysis in 36 [72%], chest pain in 9[18%] and dyspnea in 11[22%] cases, anemia in 39[78%] and lymphadenopathy in 12[24%]. On chest x-ray examination, 19[38%] patients had multiple infiltrations, cavitations in 10[20%], fibrosis in 9[18%], consolidation in 5[10%], pneumothorax in 4[8%] and pleural effusion in 3[6%] cases. Sputum for AFB was positive in all cases. Twenty-one [42%] culture positive patients were of primary resistance and 29[58%] were of secondary resistance. Twenty [40%] were sensitive to five drugs, 9[18%] resistant to one drug, 11[22%] to two drugs, 7 [14%] to three drugs, 3[6%] to four drugs and none resistant to five drugs
Conclusion: In our setting, the prevalence of resistance to anti-tuberculous drugs is high and alarming. Strategy should be made for proper treatment and compliance of patients to avoid the development of drug resistance