Correlation between glycosylated hemoglobin and platelet activity among patients with type 2 diabetes mellitus

To determine the correlation between glycosylated hemoglobin level and platelet activity among patients with type 2 diabestes mellitus [T2DM]. This study was conducted in the Department of Medicine, Khyber Teaching Hospital, Peshawar from January to June 2012. Through a Comparative Cross Sectional Study Design, a total of 80 patients with T2DM were selected from Medical Wards and OPDs and were grouped into those with glycated hemoglobin [HbA1c] levels < 7% [Group A, n=33] and those with HbA1c >/= 7% [Group B, n=47 patients]. Both the groups were compared with regards to MPV and HbA1c. The mean age of patients was 47.41 +/- 6.74 years. In group A there were 45.5% [15] males and 54.5% [18] females. In group B there were 48.9% [23] males and 51.1% [24] female patients. MPV was significantly higher in group B as compared to group A [9.21 +/- 0.76 fl vs. 8.29 +/- 0.46 fl; P < 0.001]. Among the group B patients, a positive statistical Pearson's correlation was seen between MPV and HbA1c levels [r = 0.589; p < 0.001]. However, no statistical correlation was seen between MPV and the duration of DM and BMI. There is a significant association between poor glycemic control and increased platelet activity in patients with uncontrolled T2DM

Prognostic significance of serum bilirubin in stroke

Background: Oxidative injury is an important cause of the neurologic lesion in stroke. Serum bilirubin is considered a natural antioxidant that may affect the prognosis of stroke. The purpose of this study was to evaluate the prognostic significance of bilirubin in stroke patients. Methods: A prospective cross-sectional study was conducted in Medical Units of Khyber Teaching Hospital, Peshawar. Inpatients admitted with acute attack of stroke were included in this study. Data regarding serum bilirubin and concurrent cerebrovascular risk factors were collected. National Institutes of Health Stroke Scale [NIHSS] and modified Rankin Scale [mRS] were used to analyse stroke's severity and functional outcomes, respectively. Results: Hypertension, diabetes mellitus and heart diseases were the most common risk factors. Patients were divided into 3 groups on the basis of serum bilirubin, i.e., =0.6 mg/dl [Group-1], 0.7–0.9 mg/dl [Group-2], and =1.0 mg/dl [Group-3]. The mean pre-hospitalisation NIHSS score for Groups 1, 2 and 3 was 5.62, 11.66 and 25.33, respectively; and post-hospitalisation score was 0.875, 3.76 and 16.26, respectively. The pre hospitalisation mRS score was 4 for Group-1, 4.52 for Group-2 and 4.93 for Group-3; while post-hospitalisation Mrs Score was 1.50, 2.38 and 4.26, respectively. Average serum bilirubin level was significantly higher in patients with poor outcomes as compared with good outcomes [p<0.01]. Conclusions: This study suggests that higher serum bilirubin levels were associated with increased stroke severity, longer hospitalisation and poor prognosis. Keywords: Stroke severity, stroke outcome, stroke prognosis, serum bilirubin, National Institutes of Health Stroke Scale [NIHSS], modified Rankin Scale [mRS]