Body mass status of school children of Dera Ismail Khan, Pakistan

Childhood obesity is a global epidemic involving both developed and developing countries. It is a stare of over-nutrition with long term complications such as dyslipidemia, hypertension, and coronary artery disease and type-2 diabetes. Underweight is the result of under nutrition leading to reduction in growth and development of every body organ especially the Central Nervous System. Long term under-nutrition causes failure in linear growth [height] of the child. Growth is further retarded by the repeated attacks of respiratory infections, diarrhea and anemia as a result of reduced immunity. This study was carried out eight primary schools of Dera Ismail Khan [Private, semi government organizations, and welfare foundations] having mixed population with some of the wards belonging to high socioeconomic group. Thorough clinical examination excluded those suffering from chronic heath problems. Height and weight of each one was taken body mass index of determined according to 'Quatelet's' index. Body mass index number was plotted on the CDC S age and gender specific growth charts 2-20 years for BMI-for age percentile and body mass status [underweight, normal weight, overweight/at the risk of overweight and obese/overweight. Total 1338 school going children [6-11years] were examined with 865 [67.75%] boys and 471 [35.25%] as girls. 13.39%, 72.15%, 8.83% and 5.61% as underweight, normal weight, overweight and obese respectively. Percentage of underweight was higher in girls [25%] than boys [13.22]. Percentage of obesity was higher [5.17%] in boys than girls [1.39%]. Awareness about balanced diet, improvement in the level of education and socioeconomic conditions, easy access to health facilities and prevention of the gender discrimination, are the remedial measures to be taken to redress the situation

Comparison of lipid profile and apoprotein in sedentary workers and those involved in regular exercise

One of the important effects of exercise on human body is on the metabolic system especially on lipids; elevated lipids and lipoprotein are risk factors for coronary heart disease. This case-control study was conducted to compare the lipid profile and apo-protein B levels in sedentary workers and subjects involved in regular exercise. The study was conducted at Women Medical College Abbottabad, from July 2004 to January 2005. Subjects were civilians and army men involved in regular exercise for more than 6 months duration [test group] and sedentary workers [control group]. The age, body weight, height, waist hip ratio and other related findings were recorded on a special proforma. Fasting blood samples were taken and were analyzed for lipid profile and apoprotein B levels. Statistical analysis was done by the Chi square and the Student t tests and level of significance was recorded. The subjects comprised 29 army men, 24 civilians and 39 sedentary workers. Significant differences were found between the control and test groups for WHR, total cholesterol, HDL, LDL, Triglycerides, Apo B, and Cholesterol/HDL ratio; in addition the civilian group also showed significant differences from the control group in BMI values. Although LDL levels were lower in army than sedentary group, the difference was statistically nonsignificant. Significant differences were found between the army and civilian groups in age, HDL, Triglycerides and Apo B values. Long term aerobic exercise has beneficial effects in decreasing Apo- protein B levels, LDL levels and total cholesterol /HDL ratio. Exercise habits should be encouraged in general population to decrease the cardiovascular disease risk

Epidemiological risk factors and composition of urinary stones in Riyadh Saudi Arabia

The purpose of this study was to perform the chemical analysis of stones to know the pattern of biochemical composition of stones and to determine epidemiological risk factors for stone formation in Riyadh Saudi Arabia. 307 renal stones were analyzed during one year period from September 2000 to August 2001. These stones were sent to central lab Riyadh for analysis from different hospitals attached to this region. The stones were analyzed by semiquantitative method. The kits supplied by Maascia Bruneli SPA. [Italy] was used for chemical analysis of stones. The powered stones and standards both were analyzed for uric acid, cystine, oxalate, carbonate, phosphate, ammonia, calcium and magnesium contents. Male to female ratio was 5:1. The stone frequency was 2.5 times more in Saudis as compared to non-Saudis. Maximum number of stones were analyzed in peak summer months. Calcium oxalate stones were the commonest followed by uric acid and phosphate stones. No cystine stone was found in the series analyzed. From the study of epidemiological factors it seems that the Saudis are more prone to development of stones. A clear stone season seems to exist in the area corresponding to the summer months. The relative increased frequency of stones in the region indicates that nutritional, environmental and genetic factors play a role in the occurrence of stones

Spectrum of malaria in hajj pilgrims in the year 2000

This study was carried out to investigate the country wise distribution of malarial parasite in Muslim pilgrims. This study was conducted at Ajyad Hospital, Makkah Al-Mukarmah, Saudi Arabia during peak Hajj season, from February to March 2000. The peripheral blood smears for malarial parasites were examined from one hundred and thirty patients suspected to be suffering from malaria. A positive identification of malarial parasite was possible in 19.2%. Seventy-six% patients were suffering from Plasmodium falciparum infection, while 24% had Plasmodium vivax infection. Fifty% of patients from Sudan and Saudi Arabia had P. vivax malaria while in the rest of the countries only P. falciparum infection was found. The patients presented with protean clinical manifestations. Conclusions: Malaria is prevalent in many Muslim countries and the frequency of falciparum species seems to increase as compared to vivax malaria. The majority of falciparum malaria patients develop haematological complications

Intussusception in infants and children - an analysis of 130 cases in Abbottabad and Hazara division

Intussusception is the commonest cause of intestinal obstruction in children. We reviewed 130 cases over a period of 10 years at DHQ hospital, Abbottabad to assess their mode of presentation, methods of investigation, management and out come. A retrospective review was performed of the case notes of presentation, investigation, management and subsequent out come. Although majority of patients presented with the classical triad of abdominal pain 88%, vomiting 82% and rectal bleeding 54%. There were some who varied in their mode of presentation. A presumptive initial diagnosis of infective diarrhoea or colitis and referral for a medical rather than surgical opinion was made in 86 [69%] cases. Hydrostatic reduction was done in 79% of cases, 29 being successful. Laparotomy was done in 101 cases. In 6 patients [6%] spontaneous reduction occurred between barium enema reduction and subsequent laparotomy. Simple manual reduction after laparotomy was done in 45 cases. Resection of the gangrenous intestine was done in 13 patients. In the rest of 37 patients, various operations like right hemicolectomy and appendectomy were done. The male to female ratio in our series was almost equal. No variation in the relationship between incidence and season or type of feeding was found. Ilecocolic intussusception was found to be the commonest type at the laparotomy in our series

Tumor necrosis factor in falciparum malaria

To investigate the relationship of TNF alpha levels to Plasmodium falciparum [PF] infection, plasma TNF alpha concentrations were measured in Pakistani adults and children with mild, severe, cerebral and chronic falciparum malaria and healthy [control] subjects. The initial geometric mean plasma concentrations of TNF alpha in adult patients with severe malaria [187.6 pg/mL] were significantly higher than mild malaria patients [87.1 pg/mL, P < 0.001]. TNF alpha levels were not correlated to parasite density, cerebral malaria, young age, hypoglycemia or fatal outcome; however, they were associated with severe anemia, and hepatic and kidney dysfunction. TNF alpha levels were not significantly increased in 16 patients with hyperparasitemia and were significantly elevated [P < 0.02] in chronic malaria patients as compared to control subjects. TNF alpha levels were elevated independently in patients with anemia, hypoglycemia [P < 0.001, P < 0.05], and hepatic and kidney [P < 0.001 each] dysfunction. In this study, high TNF alpha levels were associated with several manifestations of severe malaria and were not specific to cerebral malaria and hyperparasitemia

Haematological changes in falciparum malaria and tumor necrosis factor

Tumor necrosis factor and various haematological parameters were studied in 90 patients suffering from falciparum malaria. They were divided into three groups on the basis of haemoglobin level. The difference in haemoglobin level between group-1 [Hb<7 gm/dl] and group-2 [Hb 7-10 gm/dl], as well as group-I and group-3 was statistically significant. The geometric mean TNFalpha concentrations in group-1 [193.9 pg/ml] and group-2 [132.2 pg/mI] were higher as compared to group-3; however, the difference was statistically non-significant. The TNF concentration in group-2 correlated negatively with haemoglobin level [r=-.43, p=.05]. As a whole, 21% patients had leukocytosis, 3% leukopenia, 46% increased ESR and 26% elevated levels of fibrin degradation products. The platelet count was done only in 4 patients with bleeding problems. Twenty-five healthy subjects were included in the study as controls. The difference between TNF and haemoglobin level in group-1 and controls was statistically significant [p<.05, p<.001 each]. The role of tumor necrosis factor in the production of these changes is discussed

Unusual presentations of falciparum malaria

Two hundred and eighty cases of malaria were diagnosed by our clinical laboratory during the year 1988-1989. Two hundred and fifty two [90%] were suffering from Falciparum malaria while twenty eight [10%] were having VIVAX malaria. Thirteen cases [5.2%] of Falciparum malaria presented with diverse clinical haematological and biochemical pictures the so called pernicious syndromes of Falciparum malaria. In all these cases the film for malarial parasites showed heavy parasitaemia. The abnormal presentations were epistaxis, bloody diarrhoea, urticaria, hepatic coma, abortion, uraemia and polyarthritis respectively. These diverse manifestations may be due to the role of genetic immunological and environmental factors

Comparative study of sensitivity and specificity of beta monoclonal agglutination inhibition and sandwich immunometric assay tests in the diagnosis of pregnancy

Urine of 30 pregnant females was tested for gravidex test. Both concentration and agglutination inhibition [Beta monoclonal] tests were performed on the same urine specimens. Results showed that the sensitivity and specificity of the concentration [colour] test was much higher than that of the B monoclonal test

Study of serum isoenzymes of creatine phosphokinase and lactate dehydrogenase in myocardial infarction

Total serum enzyme levels of creatine phosphokinase and lactate dehydrogenase as well as their isoenzymes CKMB and HBDH [LDH]1 were measured in 92 patients [74 males and 18 females] admitted consecutively to coronary care unit. The isoenzymes were determined on first day of admission while the total enzymes were measured on first three consecutive days of admission. The patients were divided into two main groups, which were further classified in four subgroups according to age, E.C.G changes, location of infarct and the frequency of attack and its repetition The combined use of CPK and LDH isoenzymes provided the best specificity for the diagnosis of acute myocardial infarction, and a good correlation with clinical and electrocardiographic findings