Comparison of clinical efficacy of combined versus monotherapy of oral zinc and probiotic in pediatric acute diarrhoea at benazir bhutto shaheed teaching hospital, abbottabad

Objective: Evaluation of effectiveness of zinc/ probiotics alone and in combination in children with acute diarrhoea

Place of Study: The study was conducted from May-Dec 2017 at Benazir Bhutto Shaheed Teaching Hospital Abbottabad

Methodology: Single centered, randomized controlled clinical trial was performed in 150 children of either sex [6 months -10 years] with acute diarrhoea having stool frequency of > 5semi liquid stools per day. Patients were divided into three groups with fifty children in each group on the basis of treatment modality given. Group A received zinc orally [1-2mg/kg/day for five days along ORS and/or IV fluids if required], Group B patients were given one to two sachets of probiotics /day [saccharomyces boulardii] according to age for five days + ORS and /or IV fluid while Group C was administered combination of zinc and probiotics for five days along with ORS and /or IV fluids. Response to treatment was determined on the basis of decrease in frequency of stools i.e. <3 formed stools /day after 72 hours of commencement of treatment. We have also studied the relationship between hygiene and food intake practices with the occurrence of diarrhoea in children

Results: Acute diarrhoea was found to be more prevalent in children with poor hygiene practices and using unboiled water. Among the treatment groups, at the end of 3rd day total of forty eight [96%] patients in group C had improved consistency of stools as well as decrease in diarrhoea frequency to less than three formed stools per day while in groups A and B thirty nine [78%] and sixteen [32%] patients respectively showed response to treatment in 72 hours

Conclusion: Combination of zinc + probiotics therapy is more effective in children with acute diarrhoea than either alone. Among the zinc and probiotics therapy, zinc is superior in terms of clinical efficacy than probiotics alone

Clinical efficacy of ceftriaxone versus ciprofloxacin in paediatric enteric fever

Objective: Determination of the clinical effectiveness of ciprofloxacin versus ceftriaxone in children with enteric fever on the basis of defervescence within 72 hours of commencement of treatment

Duration and Place of Study: This randomized controlled trial was carried out from 15th May to 15th November 2017 in pediatrics units of Benazir Bhutto Shaheed Teaching Hospital Abbottabad and Jinnah International Hospital Abbottabad

Methodology: 90 children with uncomplicated enteric fever were admitted and divided randomly into two groups, Group A was administered I/V Ceftriaxone 75mg/kg OD and Group B was given I/V Ciprofloxacin 10mg/kg BD for seven days. Response to drug was taken as defervescence within 72 hours while continued fever after 72 hours was taken as no response. The data was analyzed by using SPSS Version 21.00

Results: In our research study 53[58.9%] children were male and 37[41.1%] patients were female. The mean age was 8.43+/-3.17 years encompassing 4 to 14 years, mean weight of the patients in kg was 29.54+/-10.8 kg. Efficacy of ceftriaxone group was 93.3% while in ciprofloxacin group 62.2% patients became afebrile in 72 hours. The proportion of achieving defervescence within 72 hours was higher with ceftriaxone than with ciprofloxacin

Conclusion: Ceftriaxone is more efficacious in terms of achieving defervescence than ciprofloxacin in children having enteric fever

Role of nitric oxide in the effect of nebivolol on isolated tracheal muscle of guinea pig

The use of beta blockers is limited by their ability to produce bronchospasm in asthmatics. Third generation beta-blockers like Nebivolol may show better tolerability because they may augment the release of nitric oxide [NO] from endothelial cells. However the involvement of NO in the respiratory effect of Nebivolol remains controversial. The present study, carried out on isolated tracheal muscle strips of guinea pigs, was designed to explore this controversy. Varying concentration of histamine ranging from 10[-7] M to 10[-3] M were used to plot a concentration response curve on the isolated tracheal muscle strips of guinea pig and was used as a control. The same concentration response curve was plotted in presence of a fixed concentration of Nebivolol 10[-6] M and then again in presence of a fixed concentration of L-Nitro Arginine Methyl Ester [L-NAME] 10[-4] M and Nebivolol 10[-6] M together in a series of experiments using six sets of isolated tracheal muscle strips in each case. Nebivolol did not produce any significant shift in the concentration response curve while in the presence of L-NAME, Nebivolol shifted the histamine concentration response curve upwards and to the left. Nebivolol does not augment the histamine induced contraction of respiratory smooth muscle of guinea pig but in the presence of Nitric Oxide inhibitor L-NAME a significant augmentation of the same curve occurs, indicating a role of NO in the sparing of respiratory smooth muscle by Nebivolol

Frequency of infantile pyloric stenosis and ocular abnormalities in Turner's syndrome in Bahawalpur city

Turner's syndrome is one of the most common of all chromosomal abnormalities. Pyloric stenosis is the most common pediatric surgical disorder of infancy that requires surgery for associated emesis.4 Ocular abnormalities are common in Turner's syndrome, but are under estimated and often neglected. The study that was hospital - based observational, was conducted from September 1[st], 2005 to August 31, 2011 in the Al-Noor Hospital Yazman [Bahawalpur] in collaboration with ophthalmology department, Bahawal Victoria Hospital Bahawalpur. Laboratory investigations including electrolytes, blood gas analysis, and osmolality were done in pathology department, Quaid-e-Azam Medical College Bahawalpur. Frequency of pyloric stenosis in infants from 0 - 6 months 64.95% and infants 6 - 12 months is 35.09%, the ocular abnormalities amblyopia 19%, strabismus 23%, phoria only 43.5%, epicanthus 10%, hypertelorism 3%, ptosis 1%, nystagmus 0.5%. There is a high frequency of ocular abnormalities and pyloric stenosis in infants with karyotype XO. Timely diagnosis may save from devastating effects of ocular complications leading to blindness and life threatening alkalosis due to pyloric stenosis in infants below one year of age

Hyperuricaemia and the risk of ocular complications in tuberculous patients during therapy

Objective: To determine the risk of ocular complications due to hyperuricaemia in tuberculous patients during therapy. Material and Methods: The study was canducted in chest ward and eye ward BVH, Bahawalpur in collaboration with Department of Chemical Pathology, QMG, Baharvalpur from July 2009 to July 2011 One thousand and fifty tuberculous patients [850 males and 200 females, aged 18 - 70 years] receiving four standard drugs i.e; rifampicin. pyrazynamide, ethambutol, and isoniazid, were included in the study. Approved and fixed dose combination of four drugs of proven bio equivalency was used Serum uric acld and creatinlne levels were estimated on fujly automated chemistry analyzer SELECTRA-XL [Merck Diagnostics] using Merck reagents. before the commencement of treatmenl. Ophthalmic examination of all the patients included in the study was also done by funduscopy and on slit lamp before starling therapy. At 8-1 2 weeks after commencement of therapy serum uric acid and crealinine levels were measured along with fundoscopic and slit lamp examination on all patients under srudy subjects to diagnose any ocular complication by an ophthalmologist. Results: All patients study subjects had hyperuricaernia [mean=9.60 mg/dl +/- 3.4 SD] and ncrmal creatinine. Syrnploms of visual blurring from the corneal haze or foreign body sensation due to epithelial breakdown were found in 86% of study subjects. Uveitis was found in 2 percent of the patients. Scleritis and Episcleritis was seen in 4% of the patients. Corneal deposits of urates were found in 0.5% subjects whiie conjuntiual urate crystals were found in 8.5% of the subjecls Conclucian: Hyperuricaemia is an important risk factor for ocular complications and starts almost after 8-12 weeks of cornmcncement of antituberclosis treatment. If it is left undiagnosed, sight-threatening effects can occur

Role of relaxant prostaglandins in the effect of nebivolol on isolated tracheal muscle of guinea pig

The present study was therefore aimed to evaluate the role of relaxant prostaglandins in modulating the effect of Nebivolol on tracheal muscle of guinea pig since the exact mechanism underlying its effects on tracheal muscle has not been established yet. The use of beta blockers is limited by their ability to produce bronchospasm in asthmatics. Third generation beta blockers like Nebivolol may show better tolerability since there may be involvement of relaxant prostaglandins in its effect. However the involvement of prostaglandins in the respiratory effects of Nebivolol remains unexplored. The present study, carried out on isolated tracheal muscle strips of guinea pigs was designed to explore this controversy. Experimental Study. This study was conducted at the department of Pharmacology, Army Medical College, Rawalpindi since April 2010 to November 2010. varying concentration of histamine ranging from 10[-7]M to 10[-3]M were used to plot a concentration response curve on the isolated tracheal muscle strips of guinea pig and was used as a control. The same concentration response curve was plotted in presence of a fixed concentration of Nebivolol 10[-6]M then again in presence of a fixed concentration of Indomethacin 10[-6]M and Nebivolol 10[-6]M together in a series of experiments using six sets of isolated tracheal muscle strips in each case. Nebivolol did not produce any significant shift in the concentration response curve in the presence and absence of Indomethacin. Nebivolol does not augment the histamine induced contraction of respiratory smooth muscle of guinea pig in the presence of Indomethacin, prostaglandin synthesis inhibitor indicating no role of relaxant prostaglandins in the sparing of respiratory smooth muscle by Nebivolol

Prevalence of impaired glucose tolerance among obese teenagers

Obesity has been accompanied by an increase in the prevalence of type-2 diabetes among adolescents. We determined the prevalence of impaired glucose tolerance in a cohort of 100 obese teenagers. Department of Medicine, BV Hospital, Bahawalpur. From January 2005 to January 2007. All subjects underwent a two-hour oral glucose-tolerance test [1.75 mg of glucose per kilogram of body weight], and glucose levels were measured fasting and during the first 30 minutes after the ingestion of glucose. Impaired glucose tolerance was detected in 21 percent of the 100 obese adolescents [11 to 19 years of age]; silent type-2 diabetes was identified in 4 percent of the obese adolescents. After the body-mass index had been controlled for, insulin resistance was greater in the affected cohort and was the best predictor of impaired glucose tolerance. Impaired glucose tolerance is highly prevalent among adolescents with severe obesity, irrespective of ethnic group. Impaired oral glucose tolerance was probably associated with insulin resistance

Intervention of insulin resistance at two stages in the evolution of type 2 diabetes

The purpose of this study was to compare the impact of treating insulin resistance with a thiazolidinedione drug before versus at the onset of diabetes on as per diagnosed by glucose levels and funduscopy. The study was conducted in Medical OPD, BVH, BWP from January 2001 to January 2007. One hundred twenty six non-diabetic young women who were 18-30 year old, with a history of GDM in the prior 4 year and a total glucose level on a 75-g oral glucose tolerance test [oGTT] above the median for women with gestational diabetes mellitus [GDM]were randomized to troglitazone [early intervention], 400 mg/d, or placebo [later intervention]. Women who developed diabetes were placed on open-label troglitazone. Glucose tolerance, insulin resistance, and funduscopy were measured at randomization, at the diagnosis of diabetes, and 8 months post trial to determine the long-term impact of the two treatments strategies on glucose levels and eye. During a mean follow-up of 4.3 year between baseline and post-trial tests, glucose tolerance [oral glucose tolerance test, P<0.04] and insulin resistance [P< 0.02] worsened more in women randomized to late intervention [n= 69] than to early intervention [n = 57]. Among women in the late intervention group who developed diabetes, retinopathy and cataract deteriorated significantly during development of diabetes on placebo and then did not change significantly [P >0.50] during treatment with troglitazone and post-treatment washout. In high-risk women, amelioration of insulin resistance can stabilize glycemia at the time diabetes develops. These findings highlight the role of insulin resistance in the genesis of progressive evolution of type 2 diabetes and successful treatment of insulin resistance in young, nondiabetic women with recent GDM lowered endogenous insulin requirements and stabilized pancreatic-cell function, thereby preventing type 2 diabetes in later life

HBV and HCV infection: incidence and risk factors among injecting drug users in Bahawalpur city

To determine the incidence and risk factors in a well characterized cohort of injecting drug users who have been monitored in Psychiatry and Behavioral Sciences Department, Bahawal Victoria Hospital, Bahawalpur. Prospective and experimental. April, 06 to April, 08 in Psychiatry and Behavioral Sciences Department, QAMC and Bahawal Victoria Hospital, Bahawalpur. The 12 month incidence of HCV infection was relatively high in IDUs aged 24 years or younger [36%] and also elevated in 26-40 years old [23%] compared with older injectors [12%]. Statistically significant [P=<0.01] differences in incidence was found in subjects who belonged to low socioeconomic group [67%] verses high socioeconomic group [19%]. Similarly higher incidence [P=<0.23] seen in heterosexuals [20%] verses homosexuals IDU's [10%]. HCV incidence was particularly higher among IDU's who had been injecting for more than 6 years [P<0.01], whereas HBV incidence was not associated with duration of drug [P<0.7]. High incidence of HCV and HBV infection is seen in IDU's. Patients with age groups < 24, lower socioeconomic status and sharing of syringes among drug users and showed statistically significant [<0.05] higher chances of HBV and HCV infection

Clinical chemical pathology of diabetics at the time of diagnosis at bahawal victoria hospital, bahawalpur

To determine the clinical chemical pathology of diabetes mellitus [DM] in patients at the time of diagnosis at Bahawal Victoria [BV] Hospital Bahawalpur. A hospital -based observational and prospective study. Bahawal Victoria Hospital, Bahawalpur.Jan 2000- Jan 2005. 210 consecutive cases of diabetes mellitus [males=99, females=111, aged 20-80 years] presenting to the out patient department with varying complaints were included. A detailed history with special emphasis on symptoms and signs was conducted and the findings observed were noted on a previously made performa. The diagnosis of diabetes mellitus was made on WHO Criteria as follows: Fasting plasma >=126mg/dl and/or 2hour postglucose load >=200mg/dl. Differentiation between Type 1 and Type 2 was based on age of onset and mode of treatment. Subjects with unequivocal results were further investigated by OGTT. The OGTT and its interpretation was carried out according to the recommendations of WHO Expert Committee on Diabetes. Plasma Lipids were determined all of the study subjects. Only 9.52% of the study population presented with the classical symptoms of diabetes mellitus at BV Hospital Bahawalpur. Most of the diabetics presented to the BV Hospital with symptoms as generalized weakness with aches and pains, numbness of feet, infertility, vulvovaginitus, blindness etc. Although, in total, a high percentage of the patients had complaints of polyuria, polydipsia and decreased body weight but in most of them these were not their presenting complaints.These study subjects did not necessarily have one specific presenting complaint. Different patients had different combinations of complaints. Dyslipidaemia was found in 39% males and 48% females of the study subjects. 33.31% males and 19.82% females had a positive family history for diabetes mellitus 39.29% males and 24.73% females had hypertension, 26.36% males and 26.78% females were obese. On funduscopic examination of the diabetics 1%males and 2% females were found to have retinopathy. Macular edema was noted in one patient. Classical symptoms of Diabetes metlitus may not be present at the time of diagnosis. Dyslipidemia is present in many cases with a high incidence of hypertension and obesity. Due to high morbidity and complications, physicians should be vigilant in making an early diagnosis of diabetes mellitus

Estrogen replacement therapy for depression in perimenopausal women

To determine the effect of a four-week course of oral estrogen therapy on depression in aging women. Quasi experimental. The OPD, Bahawal Victoria Hospital, Bahawalpur, from September 2000 to January 2004. Forty-two depressed women [aged 42-57] who were either perimenopausal [n=20] or postmenopausal [n=22] received open label treatment with oral estrogen tablets[1.25mg/day] for 4 weeks. The Montgomery-Asberg Depression Rating Scale and the Beck Depression Inventory were used to assess depressive symptoms, the Greene Climacteric Scale was used to assess menopause-related symptoms, and the Clinical Global Impression[CGI] was used to assess global clinical improvement in these women at baseline and after treatment. Remission of depression was defined as a score <10 on the Montgomery-Asberg Depression Rating Scale and a score < 2 on the CGI at week 4. The women who completed the study had a median Montgomery-Asberg Depression Rating Scale score of 20 [range= 15-32] at study entry and 11.50 [range= 10-31.0] at week 4 [z = -3.43, p<0.01]. This improvement was consistent with that reported by the women themselves on the Beck Depression Inventory [rs=0.86, n=20, p<0.01]. The improvement measured by CGI scores was also significant [p<0.01]. Remission of depression was noted in 5 of the 40 women [after 1 year] who completed the study. Anti-depressant response was not associated with severity or subtypes of depression at study entry or with concomitant improvement in menopause-related symptoms. Perimenopausal and postmenopausal women benefit from short-term use of estrogen therapy. Antidepressant effect of estrogen therapy is independent of improvement in menopause-related symptoms

Microalbuminuria: incidence in patients of diabetes mellitus at Bahawalpur

To determine the incidence of microalbuminuria in patients of diabetes mellitus.[type 1 and type 2] at Bahawalpur. Comparative, cross-sectional study. Bahawal Victoria Hospital, from September 99 to December. 02. 120 patients [Males=52; Females=68, aged 10-80 years]; with DM [Type 1 or 2] were included in the study. Detection of proteinuria was done by dry chemistry system using Medi-Test [Combi 10-Macherey-Nagel]. Proteinuria was confirmed by repeated testing and by measuring urinary protein excreted in 24 hours. Patients with proteinuria were not screened for microalbuminnuria. Screening for microalbuminuria was done on spot urine samples by dry chemistry systems using Micral -Test [Roche Diagnostic]. If the urine was positive for albumin, the test was repeated on two further occasions, over the next few weeks; if on two of three tests raised, 24- hour collection of urine was done to measured the albumin excretion rate [AER]. If AER was increased monitoring at each review visit was done. Funduscopy of all study subjects was done. Blood pressure was recorded on each visit and if raised, treatment with an ACE inhibitor was started; Baseline GFR was measured. If AER was normal on two of three occasions, AER was re-measured at the next review appointment. Out of 120 diabetics studied, 43.33% were males and 56.67% were females. Fifty percent of the females with DM and 29.1% of the males had microalbuminuria. Twenty [16.7%] of the diabetics had type 1 DM, out of them 50% had microalbuminuria. The duration of diabetes did not affect the incidence of microalbuminuria. Hundred [83.3%] of the studied patients had type 2 DM, 45% of this group was found to have microalbuminuria. Neither the incidence of proteinuria nor that of microalbuminuria was affected by the duration of diabetes. Fifty eight of the diabetics studied were hypertensive. 48.2% of hypertensive diabetics had microalbuminuria and 24.1% proteinuria. Incidence of microalbuminuria [73.9% and 72.72% of patients with type 1 and type 2 diabetes respectively] was common in diabetics with age ranging between 40-69 years. Incidence of microalbuminuria is high on our setup, reflecting poor glycaemic control

Clinical chemistry laboratory testing; Evaluation at Quaid-E-Azam medical college, Bahawalpur after autonomy

To determine the affect of autonomy on clinical chemical testing in pathology department Quaid-i-Azam Medical College and to assess the change in the attitudes of laboratorians and physicians Retrospective and comparative. 1-11-93 to 01-11-03. A retrospective study was carried out from 1-11-93 to 01-1103 in which records from 1-11-93 to 1-11-03 were collected and evaluated. Separate record of each month's revenue from clinical chemistry section was calculated. In order to determine what changes have been brought about after autonomy a universal questionnaire was used to assess the attitudes of physicians and surgeons of hospital inquiring whether they noticed any improvement in the efficiency of clinical chemical test results after autonomy. 620 doctors were interviewed through structured questionnaire. The questionnaire was designed to assess the knowledge, attitude and practices of doctors towards autonomy. In order to determine that who is the most beneficent of autonomy, different records were collected and discussions were made with consultants. Autonomy brought about a healthy change in the staff of clinical chemical section. Quality control has improved the morale of lab staff since technical deviations are more readily identified and corrected within the lab, gross errors are rarely found by the clinicians and so their respect for and confidence in the lab has strengthened Replenishment of chemicals/reagents are timely made. The number of available test has significantly increased which in turn has significantly raised the revenue generated since autonomy is awarded. Pilferage of chemicals has been stopped. Turn around time has been decreased. Clinical Chemical section participates in External Quality Assessment Scheme, NEQAPP [National External Quality Assessment Program Pakistan], which is an essential pad of the routine of a well-run lab. Patient is the most beneficent since autonomy is awarded to QMC/BVH, BWP. A significant improvement in the efficiency of the analytical performance has strengthened the faith of laboratorians and physicians in the test results after autonomy

Effect of pregnancy on diabetic nephropathy and retinopathy

To determine whether pregnancy worsens renal function in women with diabetic nephropathy and the effect of pregnancy on diabetic retinopathy. Design: Cross-sectional analytical study. Place and Duration of Study: The study was conducted in OPD, Bahawal Victoria Hospital, Bahawalpur from September 1997 to June 2003. Subjects and Thirty-five patients [aged 20-36 years] identified with diabetic nephropathy and moderate to severe renal dysfunction[creatinine [Cr] > 1.4 mg/dl] at pregnancy onset by retrospective chart review. Alterations in glomerular filtration rate [GFR] were estimated. An equal number of non-pregnant premenopausal type I diabetic women with similar degrees of renal dysfunction served as controls for non-pregnant rate of decline of renal function and potential contributing factors. Student's t-test and repeated measures analysis of variance were analyzed. Mean serum Cr rose from 1.8 mg/dl prepregnancy to 2.5 mg/dl in the third trimester. Renal function was stable in 27%, showed transient worsening in pregnancy in 27%, and demonstrated a permanent decline in 45%. Proteinuria increased in pregnancy in 79%.Exacerbation of hypertension or pre-eclampsia occurred in 73% and 71% of these showed acceleration of disease during the pregnancy. All the patients had diabetic retinopathy, though proliferative retinopathy was diagnosed and treated in only 54.5.% prepregnancy. The retinopathy progressed, requiring laser therapy, in 45.4%. Macular edema was noted in 6 of the patients. Other diabetic complications included peripheral and autonomic neuropathy in 8 patients. Pregnancy induced progression is seen in the decline of renal functions. Patients with diabetic nephropathy were found to have a > 40% chance of accelerated progression of their disease as a result of pregnancy. Forty-five% of the patients had permanent decline in GFR in association with pregnancy

Effect of storage temperature, duration and added preservative on estimation of serum cortisol

To determine the effects of temperature and duration on the stability of cortisol measurement as well as to ascertain the role of citric acid as preservative. Design: Prospective experimental study. Place and duration of Study: The study was conducted at Armed Forces Institute of Pathology, Rawalpindi, from July 1995 to September 1996. Subjects and Blood samples were collected from 58 healthy volunteers and stored at different temperature [room temperature, 4oC and -20oC], for various lengths of time [24 and 72 hours], with or without citric acid as preservative. Serum Cortisol assay was performed using chemiluminiscent immunoassay technique. Results were compared using Wilcoxan Paired Signed Rank test. Cortisol assays showed stable results when the samples were stored at 4oC or '20oC with or without citric acid as preservative. Samples kept at room temperature for 72 hours only showed stability when the samples contained citric acid as preservative. Blood samples for cortisol measurement should be taken in containers having citric acid as preservative. If samples are kept at room temperature for 72 hours, there is significant decrease in the value of cortisol measured. Blood samples can be stored at 4oC for analysis up to 72 hours. For storage beyond 72 hours, storage at '20oC is recommended

Spectrum of iodine deficiency in school children of Rawalpindi

Pakistan is recognized as one of the severely affected regions of the world regarding iodine deficiency disorders [IDD] and the Northern areas of Pakistan are highly endemic. According to a press release issued by UNICEF in 1994, IDD prevalence of 72% in a city like Islamabad was quoted. Hence a study was carried out to find the prevalence and severity of iodine deficiency disorders in school children of Rawalpindi based on the estimation of urinary iodine, serum thyroid stimulating hormone [TSH] levels and presence of goitre. School children aged 8-12 years were randomly selected from four different schools. The goitre was assessed by visual and palpation method. The blood was analyzed for TSH and spot urine for urinary iodine excretion. The values of TSH ranged between 0.5-7.39 mIU/l [within batch and between batch cv of 5.7 and 7.3% respectively]. Only 4% children had TSH above the reference range [0.4-4 mUI/l]. Low urinary iodine was found in 109 children which ranged between < 2-10 ug/dl. No significant difference was noted regarding the use of iodized salt in the children as the urinary iodine excretion was almost the same in the two groups. Goitre assessment showed a total goitre rate of 9.5% in the children [n=210]. Reference range [8.6-18.2 ug/dl] for urinary iodine was established for urinary iodine in children with normal TSH [n=210]. It is concluded that the severity of IDD is not more than 10% and definitely not high as already published

Criteria for detecting gestational diabetes mellitus: national diabetes data group versus world health organization

Early detection of Gestational Diabetes Mellitus [GDM] and meticulous glycaemic control during the first eight weeks of pregnancy can significantly decrease the risk of congenital malformations. All pregnant women not identified as having glucose intolerance must be screened for GDM between 24-28 weeks of gestation. Diagnosis of GDM by two sets of internationally accepted criteria i.e. National Diabetes Data Group [NDDG] and World Health Organization [WHO] were compared. NDDG and WHO criteria were significantly different when compared with normal oral glucose tolerance test [OGTT] by each criteria for age, BMI, pregnancy induced hypertension, caesarian delivery, macrosomia and neonatal hypoglycaemia. A total of 709 pregnant women [24-28 weeks of gestation] were screened by 50-gm glucose screening test and 75-gm OGTT in the same week. After the 50-g glucose screening test, the blood glucose was measured after 1 hour and if found to be >= 7.8 mmol/l a diagnosis of GDM was confirmed by a 100-g OGTT within a week after a 75-g OGTT. Prevalence of GDM by NDDG criteria was 1.4%[10/709] and by WHO criteria [2 hour >= 7.8mmol/l] was 15.7% [111/709]. All those women who were diagnosed to have GDM by using NDDG criteria, had an abnormal 75-gm OGTT [WHO criteria]. Six of the 14 women with macrosomic infants had an abnormal WHO test while three of the 14 had an abnormal NDDG test. These findings suggest that WHO criteria is a better and less cumbersome criteria for the detection of GDM and all cases of GDM diagnosed by NDDG criteria were also diagnosed by WHO criteria

prevalence of diabetes mellitus in the general population of Bahawalpur city

In orer to determine the prevalence of diabetes mellitus in the general population of Bahawalpur a survey was conducted among 1012 subjects aged between 16-68 years [males= 600; females=412]. WHO study protocols and diagnostic criteria were used to determine the prevalence of diabetes. The results showed that the overall prevalence of diabetes was 5.33% and it increases with age. Highest prevalence occurred in people > 65 years of age. Prevalence is higher among males than females in younger age groups. However in the older age groups females are affected more than the males. Obesity hypertension and a family history of diabetes all correlated closely with the prevalence of diabetes. This survey reflects the growing prevalence of diabetes in the population

Stability of total cholesterol and triglyceride in whole blood with regard to storage temperature and duration

This study was conducted in order to determine the effect of storage conditions [temperature and duration] on the level of plasma total cholesterol and triglyceride. Venous blood from 23 volunteers with over night fast was collected in commercial heparin tubes. Aliquots of 0.5 ml were transferred to 1.5 ml polypropylene tubes, plasma from 1 aliquot was immediately separated and analyzed [zero time value] and remaining plasma preserved at 4°C and reanalyzed daily for 7 days. The remaining aliquots containing whole blood were kept at room temperature. The results showed that the specimen at 4°C did not show statistically significant difference in total cholesterol and triglyceride concentrations when compared to zero time value. But the specimen preserved as whole blood at room temperature showed a continuous rise in plasma total cholesterol concentration and fall in plasma triglyceride concentration over 72 hours. This concludes that proper storage conditions are necessary for correct reliable results in blood chemistry