What diabetics know about diabetes?

Patient's lack of understanding of disease hinders in proper control of disease thus increasing the morbidity and mortality. Review of the studies done in this region, dose not provide a detail account of patients understanding about the disease. Majority of patients when interviewed in clinics do not know the right answer to cause, level of desired sugar, possible complication. Hospital-based cross-sectional KAP study was conducted on diabetic patients visiting the diabetic clinic in two tertiary care Hospitals and a diabetic poly clinic in different areas of Karachi during the month of September 2012. The mean age was 56 years, with 122 male and 118 female, 40.4% patients were uneducated, 22.9% metric, 12.9% intermediate and 22.9% were graduate. Considering the knowledge, as to what is diabetes? only 46% answered correctly. What could cause the disease? 35% thought there was no reason for sugar. Regarding most frequent symptom, 27% thought there were no specific symptoms, 24.2% weight loss and 23.8% excessive urine and 21.7% thought not healing of wound was first indicator and 2.1% thought that increase appetite is the cause. The desired levels of random sugar only 24.2% thought it be around 180 mg /dl while 32.5% had no idea about the value. Desired fasting sugar was correctly known by 34.6% as less than 100 mg/dl and 22.9% as less than 120 mg/dl., Duration of treatment was believed to be life long treatment by 85%. Oral hypoglycemic were consumed by 68%, 24% were on insulin. And 6% were using both.75% patients did not do exercise regularly. Regarding the harms created by diabetes, 51.3% knew that heart or kidneys may get damaged. Regular doctor visits were done by 80%, and 85% were satisfied with the level of care. The average sugar check cost was less than 100 rupees for 62.1%. Lack of proper concepts regarding the disease, desired level of sugars, possible complications could be a big hinder in achieving good diabetic control. Thus by addressing the specific deficiencies in the knowledge and practices of patients, a better outcome may be achievable

Modified Hodge test: a simple and effective test for detection of carbapenemase production

Resistance among bacterial isolates is the leading cause of increased mortality and morbidity worldwide. Carbapenems once thought to be effective are becoming ineffective mostly due to the emergence of carbapenemase. This study was designed to determine in vitro efficacy of Modified Hodge test for detection of carbapenemase production in Gram negative rods. The study was done in the Department of Microbiology, Armed Forces Institute of Pathology Rawalpindi Pakistan from January 2010 to December 2010. A total of 200 Gram negative rods from different clinical samples were taken. Those isolates which showed intermediate or susceptible zones i.e 16mm-21mm on disc diffusion were included in the study. These isolates were then subjected to Modified Hodge test. Out of 200 isolates, 138 [69%] were positive for carbapenemase production by Modified Hodge test. Out of 138 MHT positive organisms, the frequency of E. coli was 38%, followed by Pseudomonas aeruginosa [30%], Klebsiella pneumoniae [17%], Acinetobacter baumannii [12%], Citrobacter diversus [2%] and Enterobacter agglomerans [1.4%]. Modified Hodge test is a simple test which can be performed in the routine lab for detection of carbapenemases in isolates showing intermediate or sensitive zone diameter on disc diffusion

Hepatitis B vaccination status in health care workers of two university hospitals

Hepatitis B virus [HBV] infection is the leading cause of hepato-cellular carcinoma and acute liver failure in Asia. It usually transmits through parenteral routes. The health personnel are at high risk for acquiring HBV infection. This study was designed to determine the immunization status for HBV infection in healthcare workers [HCWs] of two university hospitals in Sindh, Pakistan. The healthcare workers of two university hospitals [Liaquat University Hospital, Jamshoro and Isra University Hospital, Hyderabad] were selected and divided into ten different groups. There were total 923 participants including 649 [70%] males and 274 [30%] females. The mean age of participants was 29.6 years. A total of 596 [64.6%] participants were immunized for HBV infection and 392 [66.2%] were inoculated three or more than three doses of vaccine. The pre vaccination HBSAg status was checked in 380 [41.2%] and it was positive in 18 [4.7%] participants. The frequency of immunization was highest in doctors [92.4%] and lowest in nursing assistants [18.9%]. A good number of HCWs is vaccinated against HBV infection in these two university hospitals of Sindh compared to general population of Pakistan. This study shows the need for a more aggressive approach to get HCWs vaccinated, because a significant percentage of them is not protected

Antituberculosis drug induced hepatitis

To study the incidence of drug induced hepatitis due to antituberculosis therapy. Descriptive study. Department of Internal medicine, Isra University Hospital Hyderabad, from January 2004 to December 2004. Medical records of all patients treated with antituberculosis therapy were ret rospectively reviewed. 215 patients were treated and 18 [8.4%] patients developed hepatitis. Rifctmpicin caused hepatitis in 2 [0.9%] patients. Isoniazid caused hepatitis in 11 [5.4%] cases. In 5 [2.3%] cases causative drug was unknown. In these cases, the patient died [four cases] or was lost to follow up [one case]. Among 215 treated cases, 4 patients [1.86%] died. Patients should be carefully monitored for the side effects of antituberculous sis chemotherapy

Posters as a tool for disseminating health related information in a developing country: a pilot experience

To investigate the effectiveness of posters as a tool, for imparting information related to high blood pressure. The intervention involved hanging posters conveying information about blood pressure, in the waiting rooms of 339 health facilities. The impact of this intervention was assessed after 30 days of hanging the posters with the main assessment component of the survey aimed at the target audience at the facilities. 1017 people attending the facilities were interviewed. Mean age of this population was 40.4 [SD 11.06] years. There were 79% males and 21% females. 80.2% [n=816] of the respondents had noticed the posters. 84.5% of the people were of the opinion that the poster was good. 63.7% of the people understood the overall message of the poster correctly. Regarding change in behaviour, 96.7% [n=789] of the people thought that the poster was asking them to do something; 85.9% [n=501] of these got their blood pressure checked compared to 60.9% [n=14] of those who did not think the poster was asking them to do anything [p=0.004]. Of those who said that the poster was asking them to do something, there were varied responses as to what they thought the poster was asking them to do. If the response was that they should have their blood pressure checked, it was taken as a correct response. 87.3% of those who said that the poster was asking them to get their blood pressure checked, actually got their blood pressure checked compared to 83.7% of those who did not understand this message [p= 0.241]. Given the limitations of the study it is difficult to assess the effectiveness of the poster in changing people's behaviour regarding blood pressure check up. This experience will serve as a pilot for a larger prospective study to assess poster as a tool for prompting people to get their blood pressure checked

In vitro culture of Helicobacter pylori: comparative analysis of different media and sensitivity testing

100 gastric biopsies, in two transport media, were homogenized and cultured on three media under microaerophilic conditions. Columbia agar with commercial antibiotic supplement [containing 10 mg Vancomycin, 05mg trimethoprim, 05 mg cefsulodin and 05 mg ampotericin B per litre] yielded the best results. Growth was obtained in 3-7 days. The resistance to nalidixic acid and rapid urease production of H. pylon could be used to differentiate this species form cainpylobacter spp. Metronidazole resistance was found in 27/43[63%] of isolates. All the isolates were found to be sensitive to Amoxycillin, Clarithromycin and Tetracycline

Prevalence of pulmonary tuberculosis in Karachi juvenile jail, Pakistan

Jail inmates may be at increased risk of contracting tuberculosis [TB]. We studied 386 detainees [mean age 17.7 years] in Karachi juvenile jail to determine the prevalence of TB and possible risk factors for contracting TB. We found a 3.9% prevalence of TB among the inmates, significantly higher than the estimated 1.1% prevalence in the general population of Pakistan. Positive family history of TB was a significant risk factor for TB. Poor adherence of previously diagnosed patients to anti-TB treatment was found. Our study highlights the vulnerability of inmates to TB owing to the presence of highly infectious cases, along with environmental conditions such as overcrowding and poor ventilation. This study strongly indicates the need for an effective treatment programme in the jails as well in the general community

Extra-corporeal shock-wave lithotripsy for renal calculi in children

Fifty four children underwent lithotripsy for renal calculi. Out of these sixteen were lost to follow-up. Results of thirty-eight were analysed. They were 2.3% of all the patients undergoing lithotripsy. Male to female ratio was 1.8 : 1. Treatment in 29 cases [76.3%] was declared successful, whereas in 9 cases [23.7%] it was declared failed. About half of the children undergoing lithotripsy had transient haematuria, but no other serious complication was observed. There is however, concern about the long term consequences of lithotripsy in children and its use in growing kidney. Although results to date have shown it to be a safe and effective treatment modality in children

Isolation and characterization of NGS mutant of Saccharomyces cerevisiae that is deficient in adaptive repair

Saccharomyces cerevisiae is an ideal eukaryotic unicell system for the study of the 'damage and repair'. In order to understand the genetics and mechanism of adaptive repair to alkylation stress the isolation and characterization of ada mutants [like ngs] bear important implications. We report for an ethyl methane sulfonate [EMS] - induced ngs MR0192 mutant of S. cerevisiae. The mutant cells showed a decreased survival after nitrosoguanidine [MNNG] treatment [doses >1.5 micro g mL -1 proved lethal] compared to is its parent strain [that survived upto 5 micro g mL -1] and failed to manifest adaptive repair. This ada mutant suffered from a cumulative effect of MNNG dose and cyclohexamide protein synthesis inhibitor]. The results have helped to elucidate the role of ada gene in alkylation mediated repair in S. cerevisiae

Study of arterial aneurysms

A review of 46 patients operated for arterial aneurysms over an eight years period is presented. Twenty-nine patients developed aneurysm following vascular trauma while 17 had atherosclerotic aneurysms. Thirty-one patients presented with painless swelling or swelling with mild pain and four patients with frank rupture. Reconstruction was successful in all cases with a peri-operative mortality of only 4.3%. Unlike western countries, trauma is the leading cause of aneurysm and aneurysms can be managed with minimal morbidity and mortality

systematic approach to laboratory investigation of monoclonal gammopathy in a selected group of patients in Qatar

Numerous laboratory procedures have been described to investigate the presence of monoclonal protein [M-protein] in blood or urine of patients suspected of multiple myeloma. It is, however, essential to follow a systematic approach to laboratory investigation in order to reach a rapid diagnosis and to avoid unnecessary testing and waste of test materials and time. We describe our experience with a systematic protocol and report our results of various investigations on 465 patients suspected of M-protein abnormality