determine frequency of etiological factors in short statured patients presenting at an endocrine clinic of a tertiary care hospital

To determine the frequency of etiological factors in short statured patients presenting at endocrine clinic of National Institute of Child Health, Karachi. This descriptive cross sectional study was conducted at Endocrine clinic of National Institute of Child Health, Karachi. One hundred children [48 boys and 52 girls] aged 3-15 years [mean 9.9 +/- 3.4] with short stature from January 2007 to July 2007 were evaluated during that period. Constitutional growth delay [CGD] and familial short stature [FSS] were identified as the most common, 55% of all short stature cases. Non-endocrinal causes as a single entity was detected in 17 children. Most common etiological factors in order of frequency were normal variant of growth [CGD, FSS], Hypothyroidism, Growth Hormone deficiency [GHD], and Celiac disease. GHD was found in 13% of total cases and it comprises 44% among endocrinal causes. Boys outnumbered girls with ratio of 2.7:1 [p < 0.05]. Most common cause of short stature was normal variants of growth as a group. Children with height falling below 0.4th percentile are more likely to have pathological cause

Celiac disease; effectiveness of treating previously untreated patients with both a gluten free diet and bisphosphonate, gluten free diet alone

To evaluate effectiveness of treating previously untreated patients with celiac disease with both a gluten free diet and bisphosphonate in order to significantly increase their BMD's to a greater extent than a gluten free diet alone. The study was conducted in National Institute of Child Health [NICH] Karachi to evaluate the effectiveness of treating previously untreated patients with celiac disease with a gluten free diet and bisphosphonate in terms of increase in bone mineral density in comparison to a gluten free diet alone over a period of three months [January 2013 - March 2013]. The study includes 30 children patients below fifteen years of age either sex. All study subjects were untreated celiac patients diagnosed by clinical presentation, small bowel histology and serologic testing. On day dexa scan was done. Fifteen patients kept on Gluten Free Diet [GFD] and remaining 15 patients kept GFD plus tablet of bisphosphonate. After three months dexa scan was repeated. The patients with other disease of bone or mineral metabolism, as well as subjects taking systemic glucocorticoids or high doses of thyroid hormones, were excluded. A total of 30 patients with celiac disease were included in this study. Out of 30 patients 18 [60%] were female and 12 [40%] male [M: F = 1:1.5]. Thirty patients were divided in two equal groups [15 patients in each group]. In group-I we gave gluten free diet and in group-II we gave gluten free diet and one tablet of bisphosphonate. Mean +/- SD of Bone Mineral Density [BMD] in group-I was 0.402 +/- 0.081 gm/cm2 [range=0.234 - 0.503 gm/cm2], and in group-II was 0.543 +/- 0.098 gm/cm2 [range= 0.402 - 0.743 gm/cm2], mean difference of bone mineral density was significant between two groups [P-value=0.0002]. At three months DEXA scan showed a significant rise in BMD in group-II as compared to group-I

Control of hypertension; efficacy and safety of losartan and atenolol alone and in combination

To compare the efficacy and tolerability of Losartan and Atenolol in alone and combination in treatment of hypertension. Comparative study. Medical out patients department of Jinnah Postgraduate Medical Centre Karachi from January 2007 to June 2007. There were 60 patients previously untreated with mild and moderate essential hypertensions were registered for study. The selected patients were divided into three groups. Group A was given atenolol, Group B was given Losartan, and Group C was given both drugs. The target blood pressure was 120-140/80-90 mmHg. There were 42 males and 18 females with age range 25-65 years. The mean baseline score of groups A, B and C were showed systolic blood pressure 182 +/- 19, 174 +/- 20 and 168 +/- 12 respectively. The diastolic blood pressure was 104.5 +/- 11, 102.5 +/- 9 and 104.5 +/- 10 respectively. The difference in mean systolic and diastolic blood pressure was not significant statistically as P=0.06 and 0.76 respectively. After 4 months of treatment with atenolol, systolic blood pressure decreased to 147 +/- 17, and diastolic blood pressure fell to 87 +/- 4. Losartan decreased systolic blood pressure 138 +/- 13 and diastolic blood pressure 87 +/- 4 in 4 months of treatment. The combined therapy decreased systolic blood pressure 115 +/- 4.6 and diastolic blood pressure 75 +/- 4.7. The effect of treatments on systolic and diastolic blood pressure was significantly different as [p<0.001] and [p 0.036] respectively. Side effects observed in 2 [10%] patients from group C, 8 [40%] in group A and 4 [20%] in group B. Combination therapy proved more effective in controlling hypertension than mono therapy and also fewer side effects. Patients showed better control on combination therapy as compared to mono therapy. Losartan proved a little better in controlling hypertension then atenolol and was more expensive. Patients showed better results with combination therapy for hypertension compared to individual drug