Studies on effectiveness of DOTs and weekly three times treatment of sputum positive tuberculosis patients

The purpose of this study was to compare the effects of DOTs [Daily Observe Therapy Strategy] and three days in a week, in the treatment of patients of pulmonary tuberculosis. This study was conducted at Free TB clinic, Muhammad Medical College Hospital Mirpurkhas from December 31, 2008 to December 30, 2009. 200 Patients were registered at free TB clinic of Muhammad Medical College Hospital Mirpurkhas during the period of study. In tables and figures showed in DOTs therapy Mean +/- St.D,S.E.M45.5 +/- 26.1,2.7,and 8, 4.50 +/- 2.45,.87 patients were dropped from study period, weights of patients were increased after treatment 56.7 +/- 10.4, 1.0 and result showed significant >0.05. And in three times therapy in week Mean +/- St.D,S.E.M30.50 +/- 17.46,2.25 and 38, 19.50 +/- 11.11, 1.80 patients did not improve from study period, weights of patients were increased after treatment 59.1 +/- 10.4, 1.2 and result showed non-significant <0.05. It means that in DOTs group showed significant results as compared three times treatment in a week. DOTs showed significant results as compared three times in a week in the treatment of pulmonary tuberculosis

Hyperkalemia - frequency in a group of hypertensive diabetics

To evaluate the frequency of hyperkalemia in a cohort of hypertensive diabetic patients. A prospective analytical cohort study. The study was carried out in department of medicine [nephrology] Military Hospital [MH] and Armed Forces Institute of Urology [AFIU] Rawalpindi from Jun 2007 - Jun 2009. A total of 110 hypertensive, middle aged diabetic patients attending medical OPD in MH and AFIU. Rawalpindi were followed over two years from Jun 2007 - Jun 2009 for development of hyperkalemia and monitored for changes in eGFR, Serum Urea, creatinine and blood glucose random besides changes in blood pressure and ECG findings. SPSS version 13 was employed for statistical analysis. During the course of study 9 patients were lost to follow up. There were 7 deaths among study subjects before the end of study after about ten to twelve months. Out of the 94 patients followed up mean Serum Urea at the end of study was 13.50 mmol/l against a serum creatinine level of 2.26mmol/l and an estimated GFR of 21.08 ml/ min. The frequency of raised serum Potassium of 5.1-6.0 mmol/l was 46.08% and 26.59% of the patients had serum Potassium of 6.1-7.2 mmol/l at the end of study. This was against an initial level of 4.5-5.0 mmol/l in 100% of the study subjects. Paired sample t-test revealed significant changes in each variable studied but a borderline positive correlation of 0.619 was observed only between serum potassium and change in eGFR at the end of study. The mean blood glucose random dropped from 16.14 mmol/l to 10.41 mmol/l. at the end of study mean systolic BP was 122mm Hg and diastolic BP 80.2mm Hg. The ECG revealed tall T waves in 64.9% of cases while at the start of study all subjects had their electrocardiograms within normal limits. There was a trend of increase in frequency of tall T waves with the rise of serum potassium levels. Raised serum potassium is a significant potential complication among long standing diabetics with covert nephropathy treated with ACE inhibotrs, ARBs, potassium sparing diuretics or a combination of these drugs. Co morbidities and development of this complication must therefore be considered by physicians when dealing with such patients

Thyroid carcinoma in Pakistan: a retrospective review of 998 cases from an academic referral center

To address the need for epidemiologic data on thyroid carcinoma in Pakistan, we evaluated the frequency and types of thyroid carcinoma with respect to age and sex. In a retrospective study conducted at the Jinnah Postgraduate Medical Centre in Karachi, we reviewed thyroid lesions reported over a period of 5 years, from July 2000 to June 2005. Pathology slides were studied to determine the types and frequencies of malignant lesions of the thyroid. Of 998 thyroid lesions reviewed, 153 cases were malignant. Papillary carcinoma was the commonest malignant lesion with a frequency of 90.2%, followed by 4.5% for medullary carcinoma, 2% for follicular carcinoma, 2% for undifferentiated carcinoma and 0.7% each for mixed medullary and papillary carcinoma and poorly differentiated carcinoma. Females were predominant [82.4%] as compared with males [17.6%] for a female-to-male ratio 4.7:1. The maximum number of the patients were in the fourth decade of life followed by the third and second decades. The commonest malignant thyroid lesion was papillary carcinoma. Thyroid cancer was more common in females. Papillary, medullary and follicular carcinomas were found in patients in the third and fourth decades of life, while poorly and undifferentiated carcinomas were diagnosed from the fifth to seventh decades of life

Frequency and pattern of intestinal parasitic infestation in upper neelum valley

The public health importance of intestinal parasitic infestations can not be denied because of their high prevalence and global distribution. It is an established fact that intestinal parasitic infestations can lead to a number of adverse affects like anaemia, stunted physical and mental growth, abdominal colic, cholestasis, cholecystitis and pancreatitis. To assess the frequency and pattern of intestinal parasitic infestation in upper Neelum Valley [Azad Kashmir]. The study was conducted at Military Field Hospital Neelum Valley Azad Kashmir from July 2004 to Jun 2006. The patients presenting with various abdominal complaints were included in the study. The stool samples of a total of 638 patients were examined by Direct Microscopy as well as by Formal Ether Concentration Method wherever necessary. One hundred and fifteen 155 [18.02%] non duplicate stool samples were positive for intestinal parasites. There was no statistically significant difference in incidence with regard to age or gender [P > 0.05]. Ascaris lumbricoides was the most common parasite 58 [50.43%] cases followed by Tinea saginata 31 [26.96%] cases and Giardia lamblia 11 [9.57%] cases. Hymenolepis nana 6 [5.22%] cases, Trichuris trichura 5 [4.35%] cases, Entrobius vermicularis 3 [2.60%] and Entamoeba histolytica 1 [0.87%] cases were less frequent. No case of Hookworm was seen. The percentage of intestinal parasites [18.03%] is quite high in upper Neelum Valley. The helminthes are more common than protozoa. Ascaris lumbricoides is the most common parasite followed by Tinea saginata and others. Appropriate steps be taken at District level for provision of safe drinking water schemes and improvement in local sanitary conditions. The Health and Education departments should help by inculcating awareness among the general public about importance of safe drinking water, environmental and personnel hygiene alongwith periodic de-worming programmes. These measures would help in reducing the occurrence of intestinal parasites and associated adverse affects