Experience of acute systemic lupus erythematosus in indoor and outdoor patients

The aim of this study was to determine spectrum of clinical and Laboratory diagnosis of Systemic lupus erythematosus at tertiary care unit. Descriptive type, [cross sectional]. This study was conducted at the Department of General medicine and Paediatric Medicine in indoor and outpatients CMC, Shaheed Muhatarma Benazir Bhutto University Medical Larkana from February 2010 to February 2012. We studied prospectively 44 patients with SLE who were seen consecutively either as inpatients or outpatients. All were met the American College of Rheumatology [formerly American Rheumatism Association, ARA] revised criteria for SLE and underwent medical interview as well as routine general physical examination by a researcher, and the laboratory investigations were carried out from single laboratory of Larkana, all these characteristics features of patients were collected in a protocol form. These investigations were includes the CBC, serology for ANA, anti dsDNA and urine for protienuria. X-ray chest and echocardiography was also done for pleural and pericardial effusion. Forty-four patients fulfilled the ACR criteria for SLE, most common presentation were cutaneous 30 [68.2%] cases, mucocutaneous ulceration 26 [59.1%] Fever 26 cases [59.1%], pallor 47 [67.14], cough 34 [48.57%], swelling of body 12 [17.14%], headache in 10 [22.7%] and Major physical signs were arthritis and arthralgia 30 [68.2%], Hepatosplenomegaly 20 [45.5%], generalized lymphadenopathy 12[27.3%], pleural effusion 08 [18.2%] and 02 [4.5%] patients had pericardial effusion, Raynaud's phenomenon 10 [22.7%], while direct comb test, ANA, anti dsDNA antibodies were found to be positive in 10 [22.7%], 42 [95.5%], 34[77.3%] cases respectively. Most patients presented almost universally with fever and arthralgias or arthritis in combination with malar rash or oral ulcers and in some patients a combination of all of the above was observed. A combination of positive anti nuclear antibody test, increased ESR and proteinuria were found to be a sensitive and cost effective set of laboratory findings for the diagnosis of patients suffering from SLE. The set of these clinical and laboratory features would help in the correct and early diagnosis of patients suffering from SLE, a relatively rare disease, in the busy medical outpatient and inpatient departments in our set up

Pancytopenia; study of 40 patients at cmc hospital larkana

Pancytopenia is said to exist in an adult when the hemoglobin level is less than 13.5gm/dl in males and 1l.5gm/dl in females, white cell count less than 4x10[9]L[1] and platelet count less than 150x10[9]/L[1]. The causes of pancytopenia are aplastic anemia, subleukemic leukemia, myelodysplasia [2] multiple myeloma, nutritional deficiencies leading to megaloblastic anemia, hypersplenism, paroxysmal nocturnal hemoglobinuria, AIDS, infections such as miliary tuberculosis, leishmaniasis, brucellosis etc. To determine the frequency of various causes of pancytopenia in gender at Chandka Medical College, Larkana. Cross Sectional Study. OPD and Medical Ward-ll, Chandka Medical College Hospital Larkana. 01 years study from February 2007 to February 2008. Patients of either sex, who attended medical ward-ll of Chandka Medical College Hospital Larkana, either as inpatient or out patient department, from February 2007 to February 2008 and fulfilled the inclusion criteria, were included in this study. Pancytopenia was considered as hemoglobin value less than 13.5gm/dl in males or 11.5gm/dl in females, a white cell count less than 4x10[9]/L and Platelets count less than 150x10[9]/L. Patients of less than 12 years and pregnant females were excluded from the study. Out of 40 patients, 29 [72.5%] were males and 11 [27.5%] were females. Female to male ratio was 1:2.6. The mean ages of males were 29.10 +/- 16.46 years whereas of females 36.14 +/- 15.6 years [P = 0.22]. Aplastic anemia was the most common pathology encountered and was diagnosed in 13 cases [31.5%], followed by hypersplenism 09 [22.9%], Megaloblastic anemia 06 [15%] and hodgkin's lymphoma in 04 [10%] cases. Other less common causes detected were multiple myeloma 02 [5%], drug induced 02 [5%] and malaria, milliary tuberculosis, myelodysplastic syndrome, emophagocytic syndrome was 01 [2.5%] case in each. We concluded that aplastic anemia was the most common cause in our patients and more than 2/3rd patients were young males. We think the causes of aplastic anemia in this study may be misuse of drugs, kushtas, exposure to chemicals and viral infections

Prevalence of hepatitis-C virus infection in Khairpurnathan Shah and Shahdakot: a city based screening program

The world health Organization estimates that approximately 3% of the world population is infected with hepatitis-C virus [HCV] and there are more than 170 million individuals with chronic HCV infection who are at risk of developing liver cirrhosis, decompensated liver disease and hepatocellular carcinoma while in Pakistan according to a safe estimate, approximately 10 million people are infected with HCV. To observe the prevalence of HCV infection in our remote areas and to find out the possible causes for the spread of HCV infection, among the individual of Khairpur Nathan Shah and Shahdadkot. One day city based HCV screening program was conducted in the two cities i.e. Khairpur Nathan Shah and Shahdadkot. Cable and papers were used to invite subjects to come in for free HCV screening. The over all seropositivity among 406 subjects was 30.29%. The prevalence of HCV infection was higher in males [76.1% as compared to females [23.9%] and it was highest in subjects between 31-40 years of age [34.2%]. In this city based screening program, we found a high prevalence of HCV infection among the residents of Khairpur Nathan Shah and Shahdadkot. Broader based studies for HCV screening program are suggested in the remote areas of Pakistan

Frequency of gallstones in type II diabetes mellitus

To determine the frequency and factors predisposing patients with type-Il diabetes mellitus to gallstones disease. Case-control study. Medical and surgical OPD, Chandka Medical College Hospital Larkana from January 2007 to December 2007. Total no: of 200 patients with one hundred diabetes mellitus type-2 with gallstones and one hundred age gender matched controls were taken. All the patients were examined for body mass index, waist hip ratio and investigated for blood sugar levels and lipid profile and pan abdomen ultrasound. Fifteen percent of diabetic patients had ultrasound evidence of gallstones as compared to 7% in non diabetic controls. There was significant increase in frequency of gallstones in diabetic patient's increasing age with peak incidence in seventh decade i.e. 60-69 years, and decline in 8th decade i.e. 70-79 years. The average age of diabetic patients with gallstones disease, was significantly higher than without gallstones disease. [p=-00 1]. The mean duration of disease in diabetic patients with gallstones disease was 5.0+ 4.8 years compared with 4.5+ 3.5 years in diabetic patients without gallstones disease [P=0.722]. The mean serum cholesterol and triglycerides levels 4.3.3 mmol/L and 1.5+ 0.8 mmol/L respectively in the diabetic patients with gallstones disease was higher than those without gallstones disease was higher than those without gallstones disease 3.4:f 0.5 mmol/L [P=0.0941] and 1.4 +/- 0.7 mmol/L [p=0-712] respectively, the mean body mass index with diabetic patients with gallstones disease was 26.2+ 5.5 kg/m2 compared with 25.7 +/- 6.7 kg/m2 in those without gallstones disease The frequency of gallstones disease in diabetes mellitus type II increasing with age female gender, obese hyperlipidemia and longer duration of disease