Gestational diabetes; accuracy of glucose challenge test [GCT] for screening

To determine the Accuracy of GCT for screening of gestational diabetes in high risk population comparing oral Glucose Tolerance Test [GTT] as gold standard. Accuracy of GCT. Cross-sectional study. The study was conducted in outpatient department of Punjab Medical College and affiliated hospitals, Faisalabad. 207 patients. High risk women from outpatient department were recruited on the basis of inclusion and exclusion criteria after explaining pros and cons of procedure. These women were subjected to GCT and GTT. GTT was taken as gold standard test and results of GCT were compared with it. Main outcome measures recorded and results obtained. Out of 207 women, GCT truly diagnosed 24 women as having diabetes [true positive] and 175 women were found to have normal glucose metabolism [true negative]. GCT failed to diagnose 5 diabetic women [false negative] and wrongly diagnosed 3 normal women as diabetics [false positive] against gold standard GTT. So GCT has diagnosed Gestational diabetes mellitus with the sensitivity of 82.7%, specificity of 98.3%, positive predictive value of 88.8%, and negative predictive value of 97.2% and accuracy of 96.1%. GCT is a simple, easy, convenient and sensitive test that has no limitation for time or prior fasting for gestational diabetes screening

case of dupable duple duplicity and duplexity

Duplication anomalies are quite common with ureteral duplication anomalies being the most frequent. Despite the relatively frequent incidence of a horseshoe kidney and duplication anomalies in any individual patient, the combination of horseshoe kidney and bilateral ureteric duplication is a very rare entity and very few cases have been reported to date. We present a case of a patient with novel combination of horse shoe kidney and congenital renal anomalies and their sequelae

Ectopic pregnancy medical management

To assess the effectiveness of systemic methotrexate for treatment of unruptured ectopic pregnancy. Ectopic Pregnancy is pregnancy that occurs in any location other than the uterus. 95% to 98% are tubal ectopics, but the number of ovarian, abdominal and cervical implantations is rising as does the number of heterotopic pregnancies. Prospective experimental study. DHQ Hospital affiliated with Punjab Medical College Faisalabad. Jan-2009 to Dec-2009. A total of 45 women were admitted with diagnosis of extrauterine pregnancy. But only 10 women fulfilled the criteria for medical management. Out of these 80% patients required no surgical intervention. However 20% needed surgery. 60% patients suffered from lower abdominal or pelvic pain. 20% required 2nd dose of methotrexate. Average IJ-hCG resolution time was 35 days. With early diagnosis and proper selection criteria adoption, medical treatment of ectopic pregnancy with systemic methotrexate is an effective and safe alternative to surgical interventions

Asymptomatic bacteriuria among pregnant women

Objective: To determine the prevalence of asymptomatic bacteriuria [AB] during pregnancy

Study Design: Non interventional, cross sectional study

Place and Duration of Study: Department of Obst. and Gynae DHQ Hospital Faisalabad from May 2010 to July 2010

Materials And Methods: A total of 400 consecutive pregnant women were recruited for this study. All subjects were clinically identified to have no signs and symptoms of UTI. Clean catch midstream urine sample was collected from each patient into sterile container. The urine samples were examined microscopically and by cultural method

Socioeconomic Status and Education: Socioeconomic status is defined by key demographic and economic characteristics [reported in Government of Pakistan Economic Survey of Pakistan-2001-2, Islamabad, Ministry of Finance, June [2002].The most important variable describing and classifying SES was annual house hold income [US$<500 = Low, US$500-1000 = Middle]

Result: A total of 20 [5%] were positive for significant bacteriuria. Significant relationship was found between ASB with ages, parity and socioeconomic status. With regard to age, 5 [25%] women were below 25yrs 11[55%] between 25-35 and 4[20%] were above 35yrs. Regarding parity, 4[20%] were primigravida and 16[80%] were multigravida. As far as socioeconomic status is concerned 12 [60%] belong to low socioeconomic class and 8[40%] from middle. No significant relationship was determined between AB and gestational age and diabetes

Conclusion: Asymptomatic bacteriuria is not uncommon among antenatal patients. Routine urine cultural test should be carried out on all antenatal patients in order to identity any unsuspecting infection

Clinical spectrum and outcome of patients with tuberculous meningitis

The study was basically conducted to analyze the various clinical presentation in patients with tuberculous meningitis and to access their outcome. Descriptive study. Medical Unit II, Civil Hospital Karachi from October 2005 to September 2006. Forty patients of either sex admitted in Medical ward showing signs and symptoms suggestive of TBM were selected in this study. All patients were analyzed by using SPSS version 10.0. The age of patients range between 14-75 years. Mostly they were young and the mean age was 29.65 years. Mean duration of illness was 45 days. Majority of the patients were presented with fever, headache, vomiting, neck stiffness and altered consciousness. 12 [30%] were having fits. Hemiparesis/hemiplegia was seen in 5 [12.5%] cases. Cranial nerve palsies in 9 [22.5%]. Hydrocephalus was observed in 10 [25%] patients. Mostly patients showed lymphocytic pleocytosis with high protein and low sugar in their CSF except in two cases where it was neutrophilic predominance. X-ray chest was suggestive of pulmonary tuberculosis in 14 [25%] cases. Among 40 cases 16 [40%] patients fully recovered without complications, 14 [35%] had partial recovery with complications and 10 [25%] were expired. TBM is a chronic serious illness with varied presentation and relatively high mortality and morbidity. Early treatment has considerable impact to decrease both