Hypoglycemia; patients with liver cirrhosis

To determine the frequency and severity of hypoglycemia in patients with liver cirrhosis. Cross sectional case series study. Six months. Liaquat University Hospital Hyderabad. All the patients of liver cirrhosis, of >12 years of age and of either gender were evaluated for hypoglycemia by assessing the glycemic status through random or fasting blood glucose level. The severity of liver cirrhosis was identified according to the Child-Pugh classification whereas the severity of hypoglycemia was grouped in mild, moderate and severe categories. The data was entered and saved in SPSS and frequency and percentage was calculated for hypoglycemia in patients with liver cirrhosis. The stratification was done for age, gender, hypoglycemia and severity of the disease and hypoglycemia. The chi-square test was applied between categorical variables at 95% confidence interval and p -value

Metabolic syndrome; gamma glutamyltransferase in patients

To determine the role of gamma glutamyltransferase as a biochemical marker for the diagnosis of metabolic syndrome. Cross sectional descriptive study. One year. Department of Medicine, Liaquat University Hospital Hyderabad / Jamshoro. All the patients with metabolic syndrome visited at OPD / admitted in the ward were further evaluated for serum gamma-glutamyltransferase level. The data was analyzed in SPSS 16 and the frequency and percentage was calculated. During one year study period, total one hundred patients [23 males and 77 were females] with metabolic syndrome were recruited and study for gamma glutamyl transferase level. The mean age +/-SD for overall population was 56.84+/-6.52 whereas it was 48.92+/-5.82 and 58.61+/-7.73 in male and female population respectively. The mean +/- SD of systolic and diastolic blood pressure [mmHg], triglycerides [mg/dl], high density lipoprotein pressure [mg/dl] and fasting blood sugar [mg/dl] in overall population was 161.20 +/- 16.74 and 95.60 +/- 8.34, 176.38 +/- 11.93, 29.44 +/- 2.90 and 108.42+/- 6.25. The mean gamma glutamyl transferase level in overall population was 86.75+/-7.74 while it was 84.83+/-5.32 and 89.52+/-6.84 in male and female population respectively. The gamma-glutamyltransferase was raised in 75 patients of which 13 were males and 62 were females [p=0.02] and majority of patients were 50-59 year age group [p <0.01]. It is concluded that GGT is a good diagnostic tool in metabolic syndrome with statistical significant results

Study of snake bite cases at Liaquat University Hospital Hyderabad/Jamshoro

Envenoming resulting from snakebites is an important public health hazard in many regions. It is common in rural areas not to delay access to life saving anti-venom. The objectives of this study were to know about common types of snakes in local areas, clinical features in snakebite victims, complications in snakebite case, and mortality rate in snakebite victims in rural Sindh. This descriptive study was conducted at 4 medical wards of Liaquat University Hospital Hyderabad/Jamshoro, Sindh from 1st January 2006 to December 2006. One hundred cases with history of snakebite were analysed. Both genders were included in study. Patients with history of trauma, insect bite or thorn prick were excluded from the study. Clotting time [CT] was the main bedside procedure, to assess the degree of envenomation. One hundred [100] cases from both genders, from 8 to 55 years age were reviewed. There were 57 [95%] viper bites [haemotoxic] having haemostatic abnormalities and 3 [5%] elapid [neurotoxic] bites presented with neuroparalytic symptoms. Most cases were from Tando Mohammad Khan and Hyderabad [rural] districts of Sindh. All victims had localized oedema at the site of bite. Fang/teeth marks were noted in [90%] cases. Majority [80%] were bitten on the legs below knee. Some 40% of the cases of snakebite occurred when the patient was asleep. Urban to rural ratio was 1:4.5 and male to female ratio was 4:1. Mean time to arrival at our hospital after the bite was 3 hours and mean duration of hospital stay was 4 days. One patient had acute renal failure [ARF] and disseminated intravascular coagulation [DIC], 3% cases of elapid bites were shifted to ICU for assisted ventilation, 4 patients [5.5%] had adverse effects after anti-venom administration and needed intravenous hydrocortisone, promethazine and subcutaneous adrenaline. The average dose of anti-venom was 60 vials for viper bites and 10 vials for elapibites. Overall mortality rate was 4%. Snakebites are common in the rural population of developing countries. There is need to educate the public about the hazards of snake bite, early hospital referral and treatment