Low levels of vitamin D[3] in people of Karachi - needs to be readdressed

Objective: The aim of this study is to see the frequency of vitamin D and its impact on the sample population

Study Design: Descriptive / cross sectional study

Place and Duration of Study: This study was conducted at Trauma and General Hospital, Karachi from January 2014 to June 2015

Materials and Methods: 205 patients were included in the study. Participants were assessed according to predesigned questionnaire. All patients were subjected to have complete blood count, serum calcium, phosphorous, albumin, alkaline phosphatase, SGPT, vitamin D and parathyroid hormone levels along with X-rays of hip joint and femur

Results: Out of total 205 patients, 12.7% were males and 87.3% were females. Mean age was 41.32 +/- 15.225 years. 5.9% had normal levels of Vitamin D[3], while 60.5%, 27% and 6.5% showed mild, moderate and severe deficiency. Serum calcium and phosphorous were deficient in 20.4% and 31.9% respectively. Serum alkaline phosphatase and parathyroid hormone were normal in most of the participants. The deficiency of Vitamin D[3] was mostly due to reduced sun exposure and excessive clothing [86.8%] while 8.3% showed malabsorption. This deficiency caused bone pains, and muscle pains in 55.6%, and 17.6% respectively. But none of the patient had any fracture

Conclusion: Levels of Vitamin D[3] are low in most of the people of Karachi but without any gross deformity. It is advisable to readdress the daily requirement of vitamin D bring the awareness among people regarding sun exposure and daily use of vitamin D supplements

Evaluation of predictors for severity of dengue fever at the beginning of the disease

To evaluate the predictors of severity of dengue at the beginning of the disease. Prospective and Observational study. This study was conducted at Shan General Hospital and Trauma and General Hospital from July 2010 to 1[st] October 2011. The study was conducted on all patients who were admitted and confirmed to have dengue fever after positive serology on day VI. There was pre-assigned protocol and every predictive marker was given one point. Patients who had > 4 points at the time of presentation had more severe illness and developed more severe complications rather than those who had

Celiac disease; a hidden cause of iron deficiency anemia?

Objective: The aim of the study is to determine frequency of celiac disease in adults with inexplicable iron deficiency Anemia

Study Design: Cross-sectional / observational study

Place and Duration of Study: This study was conducted at all Medical units of Civil Hospital Karachi from December 2009 to June 2010

Materials and Methods: The study included diagnosed cases of Iron Deficiency Anemia on basis of Iron profile without evident reason. They were evaluated for celiac disease on the basis of serological markers i.e. tissue transglutaminase antibodies [TTG] IgA type via standard laboratory procedures

Results: A total of 100 patients with Iron deficiency anemia previously diagnosed on basis of serum levels were included in this study. The average age was 37.12 + 8.2years and 44 [44%] were males.Celiac disease was found via serology in 16 [16%] of the patients. Out of these 16 Celiac disease patients 7 [43.75%] were males and 9 [56.25%] were females with 1:1.28 male to femaleratio

Conclusion: Celiac disease is an important cause of inexplicable Iron deficiency anemia especially in absence of gastro-intestinal symptoms. Serology though less sensitive, but can be an important screening tool for these patients

Clinical pattern and outcome of organophosphorus poisoning

Objectives: to determine the clinical presentation and outcome of acute organophosphorus Poisoning

Methods: this case series included 100 cases from various medical wards of Civil Hospital Karachi from February 2008 to December 2008. We included all patients of organophosphorus poisoning who showed either signs of muscarinic or nicotinic involvement. However we excluded those patients in which organophosphorus poisoning was doubtful and who were intoxicated with poisoning other than organophosphates

Results: hundred patients of organophosphate poisoning were admitted among these 68% was males and 32% were females. Modes of poisoning were suicidal in 65% of cases, accidental in 27% and 8% were homicidal. Though the clinical presentation of acute poisoning was variable however the most consistent feature was miosis [98%]. According to W.H.O. classification for severity of organophosphorus poisoning; 60% cases were moderate, 28% were severe and 12% were mild. The mortality rate was 20% and mostly among patients who presented with severe symptoms and presented late

Conclusion: pesticides are the major chemical agents which pose a health threat particularly to young people, depressed individual and farm worker so this fetal condition needs rapid diagnosis and early treatment

Comparison between helicobacter pylori fecal antigen detection and endoscopic gastric biopsy in diagnosis of H. Pylori infection in 50 adult cases

Objective: To compare the effectiveness of fecal antigen detection test with gastric biopsy via upper GI endoscopy for H pylori

Design: Comparative, observational, non- randomized

Place and Duration of Study: Sultan Qaboos University Hospital, Oman. February 2005 - February 2006

Patients and Methods: Fifty patients with epigastric pain and heart burn were subjected to upper GI endoscopy and gastric biopsy for H. pylori and at the same time stool was sent for fecal antigen detection for H. pylori

Results: Out of 30 females, 12 had biopsy proven H. pylori while 5 had positive fecal antigen test. In 20 male patients, 15 had positive biopsy while 12 had fecal antigen proven H. pylori

Conclusion: This study doesn't prove the effectiveness of fecal antigen detection test in comparison with upper GI endoscopy and biopsy, which is the gold standard test for H. pylori. Hence we cannot recommend the test to replace upper GI endoscopy and biopsy despite of the low cost and less trouble to the patient

Use of intravenous vs. intramuscular hepatitis B immunoglobulin in prevention of relapse of hepatitis B in post liver transplant patients

Object: To see the response of HBIg in post liver transplant patients in prevention of hepatitis B relapse by using two different routes of administration

Study Design: prospective comparative study

Place and Duration of Study: Sultan Qaboos University Hospital, Oman. From December 2001 - December 2007

Patients and Methods: Total 32 patients who underwent cadavaric liver-transplantation due to hepatitis B related end-stage liver disease were included in this study. Patients were divided into two groups by simple random technique. HBIg was administered through intravenous route to subjects of Group 1, whereas to subjects of Group II it was administered through intramuscular route. All patients received full recommended dose of HBIg with oral lamirudine for the prevention of relapse. Subjects were followed up for 30-months to record any event of relapse in both groups

Results: There were 24 [75%] males and 8 [25%] females, with median age of 37 years. Pretreatment HBV - DNA was detected in 28 [87.5%] and anti-HBS levels were <10-IU in all patients. During the course of treatment HBV-DNA found to be un-detectable and anti-HBS levels were maintained >100 in all patients. None of the study subjects in both groups had relapse of Hepatitis B

Conclusion: Intramuscular route of administrating HBIg in post liver transplant cases secondary to hepatitis B was found to be as effective as intra venous route

Extra-intestinal manifestations of ulcerative colitis in Omani population: a study of 100 cases

Object: to identify the extra intestinal manifestations of Ulcerative Colitis in Omani population

Study design: observational study

Place and duration of study: Sultan Qaboos University Hospital, Oman from January, 2002 to January, 2006

Patients and Methods: inclusion Criteria: All patients seen in Gastroenterology out patient's clinic with bleeding per rectum and diagnosis of ulcerative colitis by colonoscopy and subsequent confirmation by biopsy. Exclusion Criteria: All patients with other systemic illness

Results: total 100 Patients were included in the study, among them 61 were males. Extra intestinal manifestations were observed in 6 males and 5 females. Among 6 male patients 2 had more than one complication while 4 had only one complication. Among 5 female patients 2 had more than one, while 3 had only one complication

Conclusion: it is thus concluded that incidences and severity of extra intestinal manifestation is much less in the Omani population as compared to the Western population

Birth order and depressive disorder

Objective: to determine any relationship of birth order with depressive disorder

Method: this is a retrospective study from record of twelve hundred and eight patients who attended psychiatric department in OPD and wards of Isra University Hospital Hyderabad between January 2002 and February 2004 out of which 626 were diagnosed as cases of Depressive Disorder who were compared with the rest of the population. These were also studied with reference to gender, catchment area, and family type. Data were analyzed on 13th version of SPSS

Results: cases with depressive disorder were clustered in birth order-two; 36.42% of depression patients were found out to be birth order-two. The pattern remains almost the same irrespective of gender, catchment area, and family type

Conclusion: birth-order two is found to be more vulnerable to depressive disorder in our sample

Spectrum of complications in post liver transplant patients: a study of 30 cases

Objective: To study the complications encountered in post liver transplant patients performed due to different etiologies leading to end stage liver disease. Study Design: Cohort and observational study. Place and Duration of Study: Sultan Qaboos University Hospital, Oman. From Dec 2001- July 2006

Patients and Methods: The study was conducted on all patients having cadavaric liver transplantation outside Oman. All patients were followed up for at least 18 months after enrolling in the study. They all had certain routine tests at the start of the study and were repeated according to the requirement of the individual patients. All patients had tacrolimus as an immunosuppressive agent. Patients with hepatitis B had hepatitis B immunoglobulin, alongwith lamivudine for relapse prophylaxis

Results: Complications of liver transplantation was observed in 21 patients, out of total 30 patients. Thirteen patients developed new onset diabetes mellitus, among them 7 had other complications as well. Eight patients had different hepatic complications and 7 had non hepatic problems. Total 5 patients expired during our follow up

Conclusion: The complications of liver transplantation can be controlled and managed if diagnosed promptly and treated early

Correlation of obsessive compulsive disorder with birth order - one

Objective: The study sought to explore, whether Obsessive Compulsive Disorder has any relation with birth order-one

Method: This a retrospective study from record of twelve hundred and eight patients who attended psychiatric department of Isra University Hospital Hyderabad, out of which 138 were OCD; who were compared with the rest of the population. These were also studied with reference to gender, catchment area and family type

Results: Cases with obsessive compulsive disorder were clustered in birth order-one. Total 44% of OCD patients were found out to be birth order-one as compared to 19.40% of the rest of the psychiatric population

Conclusion: Current study supports the hypothesis that in our sample birth order-one is correlated with Obsessive Compulsive Disorder

Socio-demographic correlates of stigma attached to mental illness

Objective: To identify socio-demographic correlates of stigma attached to psychiatric illnesses

Method: This is a retrospective study. Data of the patients who had attended psychiatry department; either as a referral or direct consultation; and as in-patient or outpatient; at Isra University Hospital at Hyderabad during the years 2001 to 2004, were reviewed and presence or absence of stigma feelings were compared to their socio-demographic backgrounds. Demographic characteristics of a total of 1208 patients with different psychiatric illnesses were recorded. Data obtained, was subjected to analysis using SPSS 13[th] version

Results: Feelings of stigma was present in forty seven percent of the studied population. Males had slightly more feelings of stigma. People from urban areas were also carrying more feelings of stigma but it was statistically insignificant. Apart from people with no formal education who had maximum stigma feelings; education level was found to increase such feelings, in the population studied

Conclusion: In our studied population, feeling of stigma seems to prevail in every demographic class; this is specially so among neurotics, male gender, urban patients. Level of education has interesting relation with the feeling of Stigma, which is found to increase with level of education