Frequency of non-alcoholic fatty liver disease in newly diagnosed cases of Hepatitis C virus infection and its correlation with genotypes in normal weight patients

Objective: To determine the frequency of non-alcoholic fatty liver disease [NAFLD] in newly diagnosed cases of hepatitis C virus [HCV] infection and its association with genotypes in normal weight patients

Study Design: Descriptive cross-sectional study

Place and Duration of Study: Departments of internal medicine and diagnostic imaging, Combined Military Hospital Okara, from Oct 2013 to Mar 2014

Material and Methods: We included 211 patients from Okara through consecutive sampling who were found positive for anti HCV antibodies and HCV RNA after informed consent. The sampled patients were evaluated for liver echotexture through ultrasonography and genotype analysis by polymerase chain reaction. Variables were defined qualitatively and quantitatively and frequencies, percentages, means, and standard deviations were calculated. For the association of ultrasonographic findings with the genotypes, Pearson's Chi-square or Fischer's exact tests were applied where appropriate. All the data were analyzed using statistical package for social sciences version 20. A p-value <0.05 was considered significant

Results: The mean age was 32 +/- 6 years with a range of 21 +/- 47 years. Most [85.3 percent, n=180] were married. The majority [62.1 percent, n=131] hailed from the Punjab province and from the age-group of

Conclusion: Fifty-three percent patients with positive HCV RNA had NAFLD identified on ultrasonographic examination. The genotype 3 of HCV RNA was particularly affiliated with NAFLD

Differentiation of beta thalassemia trait from iron deficiency anemia by hematological indices

Objective: We aimed at finding out reliable parameter in the differentiation of iron deficiency anemia [IDA] and beta-thalassemia trait [beta -TT] in the adult population subjected to Saudi Arabian Premarital Screening Program

Methods: A total of 620 adults [age range 21-36 years] reported during February 2012 to November 2012. Tests for serum iron and ferritin were carried out in individuals showing low hemoglobin [Hb]. All the selected subjects' samples were subjected to blood morphology, comparison of MCV, RBC count. Red Cell Distribution Width [RDW] was noted from the Coulter Report whereas Red Cell Distribution Width Index [RDWI] value was calculated for all the samples

Results: A total of one hundred and thirty-five individuals with hypochromic microcytic anemia having normal hemoglobin F and hemoglobin A2 < 3.2% were inducted in the study. Ninety-three were diagnosed having IDA, whereas thirty-two were having beta TT. Ten individuals revealed other causes of anemia. The RBC count was higher, and MCV was much lower in beta TT as compared to IDA. Both groups were subjected to RDW and RDWI, however, RDWI which showed better sensitivity and specificity for beta TT

Conclusion: RDWI is a reliable and useful index for differentiation among IDA and beta TT, as compared to RDW

Cutaneous manifestations of diabetes mellitus type 2: prevalence and association with glycemic control

Objective: To determine the frequency and pattern of skin disorders in patients with type 2 diabetes mellitus and their association with glycemic control in our diabetics

Methods: This descriptive, cross-sectional study was conducted at departments of Medicine and Dermatology, Sir Syed College of Medical Sciences and Hospital, Karachi from 1[st] January to 30[th] June 2014. Adult patients belonging to both genders having diabetes mellitus type 2 with cutaneous manifestations were included. After taking the informed consent, demographic details, duration of diabetes, mode of treatment for diabetes, types of footwear, foot care and glycemic profile were documented

Results: In 203patients [41% male and 59% female], mean age was 50 +/- 11 years and mean duration of diabetes 8.5 +/- 7 years. Mean HbA1c was 8.6 +/- 1.5 with 68% patients having unsatisfactory glycemic control. Most frequently observed skin disease was bacterial infections [26%], followed by fungal infections [22%], acanthosis nigricans [20%], diabetic foot [16%], nail changes [16%], acrochordons [10%], diabetic dermopathy [9%], necrobiosis lipoidica [9%], viral infections [8%] pruritus [8%] and xanthelasma [8%]. There was significant association of unsatisfactory glycemic control with bacterial infections [p = 0.037] and fungal infections [p = 0.023]. Females especially had a higher frequency of association with acanthosis nigricans [p = 0.030]

Conclusion: Patients with type 2 DM have high frequency of infections especially bacterial and fungal. Other manifestations like acanthosis nigricans and diabetic foot are comparatively less common

Dermatological manifestations of obesity

To determine the frequency of various cutaneous manifestations in patients with obesity and correlate these skin changes with the grades of obesity. The study was conducted at Departments of Medicine and Dermatology, Sir Syed College of Medical Sciences and Hospital Karachi from 1[st] January 2014 till 30[th] June 2014. Patients belonging to both sexes and different age groups having body mass index [BMI] >/=25kg/m[2] with cutaneous manifestations of obesity were enrolled. Patients with skin changes secondary to other systemic illnesses, pregnancy and drugs were excluded. After an informed consent, demographic details, height and weight were documented. A clinical dermatological diagnosis was established after a detailed history and examination. Appropriate investigations were performed where required. 196 patients, 76 males [39%] and 120 females [61%] completed the study. Mean age was 43.6 +/- 10.8 years, age range being 19-70 years. Mean BMI 34 +/- 4.73 kg/m[2] [range 25-50], grade I obesity in 75 [38%] and grade II obesity in 121 [62%] cases. The most common finding observed was acanthosis nigricans [49%], followed by striae [17%], fungal infections [15%], acrochordons [12%], viral infections [11%], hirsutism [11%] and bacterial infections [7.5%]. Other less common associations included: xanthomas, corns, plantar hyperkeratosis and acne. Acanthosis nigricans and viral infections were significantly more among females; corn and callus among males. Obesity grade II was significantly associated with acanthosis nigricans, viral infections, hirsutism, striae and stasis dermatitis. Obesity is commonly associated with a wide range of dermatological manifestations like acanthosis nigricans, striae, hirsutism, skin infections. Other less common associations include: xanthomas, corns, plantar hyperkeratosis and acne

Outcome of AO external fixator for open tibial fractures

The purpose of the study was to evaluate the outcome of open tibial shaft fiactures [Gustilo IIWB] with A0 External Fixator and to document complications. Perspective study. This study was conducted at DHQ teaching Hospital, Gujranwala and at Fazil Memorial Hospital, Gujranwala from November 2010 to November 2012. 50 patients with open tibial shaft fractures were treated with AO External Fixator. Open fractures were classified according to Gustilo Anderson Criteria and wounds with EIA and IIIB were selected. Outcome was determined by the rate of union, while nonunion, pin tract infection, pin loosening and osteomylitis were recorded as complications. The follow up period was 08 months. Out of fifty cases of open tibial shaft fractures, 38 [76%] were men and 12 [24%] were Ladies. Mean age was 35.2 [8-67], 22 [44%] had Gustilo IIIB wound while 28 [56%] had Gustilo IIIA injuries. Pin tract infection and pin loosening rate were 12% and 16% respectively. Nonunion was seen in 10% of the cases. In 41 [82%] of the cases fracture united and average union time was about 26.5 weeks. No case of osteomylitis seen. External Fixator is simple and effective treatment for open tibial fractures

Pattern of skin diseases in a tertiary care private hospital, Karachi

To determine the pattern of skin diseases in a tertiary care hospital in Karachi and to compare the results with local and international literature. The current study was carried out in the Dermatology Department, Hamdard University Hospital, Karachi from 1[st] September 2011 to 31[st] August 2012 over a period of 1 year. All the freshly registered patients presenting in the outpatient were enrolled irrespective of gender and age, after an informed consent. Clinical diagnosis was made on the basis of detailed history and clinical examination. Laboratory investigations were performed where required e.g. routine investigations and biochemical profile. Skin biopsy and histopathology were performed in doubtful cases. All the findings were recorded, compiled, tabulated and analyzed. 1733 patients comprising 936 [54%] females and 797 [46%] males were enrolled. There were 728 [42%] children and 1005 [58%] adults. Infections and infestations were the most common skin conditions constituting 37.4% of all the enrolled patients of which 399 [23%] were children and 250 [14.4%] adults. Eczema was next in frequency comprising 313 [18%] patients including 150 [8.6%] children and 163 [9.4%] adults. Acne was seen in 229 [13%] patients, urticaria in 97 [5.5%] while hair disorders were recorded in 66 [4%] patients. Papulosquamous disorders and pigmentary dermatoses were observed in less than 3% of the patients studied. Scabies presented with the highest frequency [18%] and among pyodermas [10%], furunculosis [4%] and impetigo 59 [3%], being the most frequent. Fungal infections [3%] had a frequency more then viral infections [2%]. Atopic dermatitis was the most frequently seen eczema [6%] followed by seborrhoeic dermatitis [5%] and contact dermatitis [4.5%]. The pattern of skin diseases is same in various cities of Pakistan with minor differences. Scabies and infections remain the most common diseases while eczema also constitutes an important group of dermatoses in our part of the world

Self medication among non medical students of Islamia University Bahawalpur

Background: Use of medicine by a patient on his own initiative or on advice of a pharmacist or a lay person instead of consulting a medical practitioner is known as self-medication. Internationally self medication has been reported as being on rise. Little has been reported on the extent of self medication practices in Pakistan

Objective: To determine prevalence and commonly used drugs in self medication among non medical students of university

Subjects and Methods: This descriptive cross-sectional study was conducted in Baghdad campus of Islamia University Bahawalpur, from 1[st] May, 2011 to 15[th] June, 2011. Predesigned questionnaire was filled by the investigators themselves

Results: The prevalence of self medication was found to be 71.2%. The most common factors which led to it were "previous experience with similar symptoms [58%]", "Pharmacist's advice [28%]" and "friend's advice [15%]"

Conclusion: Prevalence of self-medication is high even in educated youth, despite majority being aware of it to be harmful

Clinical presentations of cutaneous tuberculosis

Objective: To determine the frequency of different clinical presentations of cutaneous tuberculosis in a tertiary care hospital

Methods: This cross-sectional study was carried out in the Department of Dermatology, Civil Hospital, Karachi and Department of Dermatology, Ziauddin University, Karachi, over three years from 5[th] March 2007 to 4[th] March 2010. Patients of both sexes and all age groups suffering from histologically-confirmed cutaneous tuberculosis for last 1 month to 10 years were enrolled. A detailed history and examination were recorded on a predesigned proforma. The collected data were computed and analyzed

Results: 57 diagnosed [biopsy proven] cases of cutaneous tuberculosis comprising 35 females [61.4%] and 22 males [38.6%] were enrolled. The age range was 1 up to 80 years. Among these subjects, half the patients were aged between 11-30 years. 17 patients [29.8%] had the disease for 1-2 years constituting the highest frequency for the duration of illness. Most of the patients i.e. 33 [57.5%] had more than one lesion. The lesions were most commonly seen on limbs in 25 [43.4%] patients, followed by face and neck, trunk and genitalia. Chronic discharging sinuses and plaques were the most common presentations. Scrofuloderma was the most common tuberculosis cutis seen in 35 [62%] patients followed by lupus vulgaris, warty tuberculosis and tuberculids. Overall frequency was higher in females. However, some of the types were more frequent in females while others in males. Mean age of presentation for scrofuloderma was 25.7+/-16.9 years, warty tuberculosis 25.7+/-15.9 years, lupus vulgaris 29.4+/-16.5 years and tuberculids 30+/-11.9 years [p=0.197]

Conclusion: Scrofuloderma is the most common clinical presentation of tuberculosis cutis seen in our setting followed by lupus vulgaris, tuberculosis verrucosa cutis and tuberculids

Practice of smoking; awareness among adolescents of Abasia higher secondary school and Ummul Qura Bahawalpur

Tobacco kills nearly 6 million people each year. More than five million of those deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke. Unless urgent action is taken, the annual death toll could rise to more than eight million by 2030[1]. To reduce this heavy morbidity and mortality due to tobacco use, can only be reduced by educating the masses regarding harmful effects of tobacco use. This cross sectional study was conducted with the objective, to assess the awareness and factors responsible for smoking among adolescents in Abbasia Higher secondary school and Umm ul Qura High School, Bahawalpur. The study was carried out in Abbasia Higher secondary school and Umm ul Qura High School. Duration: From 1 May 2011 to 15 June 2011. Subject/A preformed questionnaire was used to collect data from 150 subjects included in this study. Of all the subjects, 74% were aware of smoking, 22.67% were smokers. According to this study, 76.47% of smokers said that they smoked to enjoy some occasion, 17.65% smoked due to stress and 5% for exam preparation. Students were well aware of smoking hazards; prevalence of smoking was higher in Umm ul Qura High School students

Frequency of specific dermatoses of pregnancy in a tertiary care hospital

To assess the frequency of specific dermatoses of pregnancy in a tertiary care hospital. This cross sectional study was conducted on patients attending outpatient department of Dermatology, civil hospital, Karachi referred from the outpatient department of gynecology and obstetrics spanning, 1[st] May 2006 till 31[st] August 2006. Pregnant females of different age groups, both primigravida and multigravida fulfilling the selection criteria were enrolled. After an informed consent, selected patients were subjected to a detailed history and clinical examination. Diagnosis of the diseases was made clinically and relevant investigations were carried out where required. 100 patients, comprising 32 primigravida [32%] and 68 multigravida [68%], diagnosed as suffering from specific dermatoses of pregnancy completed the study. Minimum age of presentation was 20 years and maximum 44 years the mean age being 32 +/- 6.8 years. Prurigo of pregnancy [96%] was the most common dermatoses seen followed by pruritic folliculitis of pregnancy [2%], herpes gestationis [1%] and polymorphic eruption of pregnancy [1%]. Amongst 96 patients [96%] suffering from prurigo of pregnancy, there were 28 primigravida [29%] and 68 multigravida [71%]. Both the primigravida with pruritic folliculitis of pregnancy presented one each in the 2[nd] and 3[rd] trimester. Patients suffering from herpes gestationis and polymorphic eruption of pregnancy [PUPP] were primigravida presenting in 2[nd] trimester. Specific dermatoses of pregnancy can present in any trimester. Prurigo of pregnancy remains the most common disorder followed by pruritic folliculitis of pregnancy.

Antibacterial effect of mango [mangifera indica Linn.] leaf extract against antibiotic sensitive and multi-drug resistant Salmonella typhi

Alternative herbal medicine has been used to treat various infections from centuries. Natural plants contain phytoconstituents having similar chemical properties as of synthetic antibiotics. Typhoid fever is a serious infection and failure of its treatment emerged multi-drug resistant [MDR] bugs of Salmonella typhi. Due to multiple and repeated issues with antibiotics efficacy, it became essential to evaluate biological properties of plants from different geographical origins. Mango leaves have been reported for various medicinal effects like antioxidant, antimicrobial, antihelminthic, antidiabetic and antiallergic etc. Objective of present study was to investigate anti-typhoid properties of acetone mango leaf extract [AMLE] against antibiotic sensitive and MDR S. typhi isolates. A total of 50 isolates of S. typhi including MDR [n=30] and antibiotic sensitive [n=20] were investigated. Staphylococcus aureus [ATCC 25923] and Salmonella typhimurium [ATCC14028] were used as quality control strains. AMLE was prepared and its antibacterial activity was evaluated by agar well diffusion screening method and minimum inhibitory concentration [MIC], by agar dilution technique. Zone of inhibition [mm] of AMLE against MDR and antibiotic sensitive isolates was 18 +/- 1.5mm [Mean +/- S.D]. Zone of S. aureus [ATCC 25923] and S. typhimurium [ATCC14028] was 20 +/- 1.5mm [Mean +/- S.D]. MIC of AMLE was reported in range from 10-50 mg/ml. The present study described the inhibitory effects of mango leaves against S. typhi

Frequency of pityriasis versicolor in patients with uncontrolled type 2 diabetes attending a tertiary care hospital

INTRODUCTION: Pityriasis versicolor is seen frequently in patients with uncontrolled diabetes mellitus

OBJECTIVE: The study was aimed to determine frequency of Pityriasis versicolor in patients with type 2 uncontrolled diabetes in a tertiary care hospital

STUDY DESIGN: Cross-sectional study

SETTING: Department of Dermatology, Civil Hospital Karachi and Department of Dermatology, Ziauddin University, Karachi

DURATION OF STUDY: Duration of study was 6 months from 1[st] May 2010 to 31[st] October 2010

SUBJECTS AND METHODS: Patients aged 40 to 70 years belonging to both sexes with uncontrolled diabetes mellitus of duration more than 5 years were included after an informed consent. Patients taking corticosteroid or immunosuppressive drugs or having any other co morbidity were excluded. Selected patients were examined with magnifying glass and wood's lamp. The diagnosis was confirmed by KOH smear, microscopy and Wood's lamp examination. The findings were recorded on a proforma. All the findings were compiled, tabulated and analyzed

RESULTS: 119 patients were included in the study comprising 68 males [57%] and 51 females [43%]. Patients aged 40 to 70 years, with the mean age of 51.3 years were studied in three age groups i.e. 40-50 years, 51-60 years and >60 years. Majority of patients [57%] belonged to the age group 40-50 years. The duration of diabetes was 5-10 years in maximum number of patients i.e. 72. Among these patients 5 [4.2%] had tinea versicolor comprising 3 males [60%] and 2 females [40%]. Three of these patients had diabetes for 5-10 years and 2 had the same for 11-15 years. 2 patients [40%] aged 40-50 years, 2 [40%] 51-60 years and remaining 1 patient aged between 61-70 years [20%]

CONCLUSION: It can be concluded from the above study that Pityriasis versicolor is not seen commonly in patients with diabetes mellitus

Frequency of oral lichen planus in patients with noninsulin dependent diabetes mellitus

The association between diabetes mellitus and lichen planus [LP], especially oral lichen planus, has been the subject of much research but the conclusion is controversial. The reported frequency of oral LP in diabetes mellitus varies from 1.6% to 85%. To determine the frequency of oral lichen planus in patients with noninsulin dependent diabetes mellitus as compared with normal subjects. Freshly registered cases of noninsulin-dependent diabetes mellitus with suspected lesions of oral lichen planus, fulfilling the selection criteria, belonging to both sexes, aged 40-70 years were enrolled. After an informed consent, enrolled patients were examined following a detailed history and were subjected to biopsy and histopathology. Any relevant investigations were performed where required. An equal number of age- and sex-matched controls were also studied for oral LP. 86 patients comprising 49 [57%] females and 37 [43%] males, aged 40 to 70 years, mean age being 51.3 years, were studied in three age groups i.e. 40-50 years, 51-60 years and >60 years. Among these patients 8 [6.9%] had histopathologically confirmed oral lichen planus [P<0.05]. Only 1 [1.2%] subject from the control group had the histopathologically confirmed disease. There were 5 females [62.5%] and 3 males [37.5%]. Buccal mucosa was involved in 7 patients [87.5%]. Oral lichen planus has a significant association with noninsulin dependent diabetes mellitus as compared to normal population

Diffusion weighted magnetic resonance imaging in the diagnosis and management of acute stroke

To evaluate the diagnostic accuracy of diffusion - weighted magnetic resonance [MR] imaging performed within 6 hours of the onset of stroke symptoms. Cross sectional study. This study was conducted at the Department of Radiology Nishtar Medical College and Hospital Multan from August, 2010 to August, 2011. Diffusion weighted MR imaging, along with conventional MR imaging performed in 36 patients who presented with acute stoke like symptoms within 6 hours of onset of symptoms. Diagnosis was noted. Patients admitted in medical ward. Follow up MR was performed after one weak. Findings compared with initial scan. Diffusion weighted MR and conventional MR diagnosis was compared with final clinical diagnosis. Diffusion weighted MR imaging indicated stroke in 30 patients, all of whom had a final diagnosis of acute stroke Diffusion weighted images were negative in six patients, all of whom had a final clinical diagnosis other than stroke [100% sensitivity, 100% specificity]. FLAIR images detected infarcts in 25 patients within 6 hours of onset of symptoms out of 30 patients having stroke on final diagnosis [83% sensitivity, 100% specificity]. T2-w images detected infarcts in 22 patients on initial scan with sensitivity of 73% and specificity of 100%. Diffusion weighted MR imaging is highly accurate for diagnosing acute ischemic stroke within 6 hours of symptoms onset and is superior to conventional MR imaging

Comparative study of non-contrast-enhanced spirat CT scan to ultrasonography in the diagnosis of acute renal colic

To evaluate the sensitivity and specificity of noncontrast spiral CT scan in ureteric colic with comparative evaluation of ultrasonography. Prospective comparative study. This study was conducted at the Dept. of Radiology, Nishtar Medical College and Hospital, Multan from June, 2010 to June 2011. 62 patients with flank pain were examined with both ultrasonography and non contrast enhanced 16 slice spiral CT scan over a period of one year. Both techniques were used to determine the presence, size, and location of ureteric stone, and the presence or absence of secondary signs like ureteral and calyceal dilatation, stranding of perinephric, periureteric fat and soft tissue rim sign. 43 of the 62 patients were confirmed as having ureteric calculi based on stoned recovery or urological intervention. Ultrasound showed 93% sensitivity and 95% specificity in the diagnosis of ureterolithiasis. CT scan showed 91% sensitivity and 95% specificity respectively. hydronephrosis was seen in all patients that were positive for ureteric calculi. Most common site of calculus was distal ureter. Perinephric fluid was demonstrated in three patients. Perinephric stranding was seen in 26 cases, and periureteric stranding in three patients on CT scan. Pathology unrelated to urinary stone disease was demonstrated in six patients. Although both modalities were excellent for detecting ureteric stones, consideration of cost and radiation lead us to suggest that ultrasound be employed first and CT scan be reserved for when ultrasound is unavailable or non-diagnostic

Correlation of Hepatitis B with multiple blood transfusions in children of Thalassemia major

To assess the correlation of Hepatitis B [HBV] virus with multiple blood transfusion in patients of Thalassemia major [TM]. Descriptive study. This was conducted in the Thalassemia center, Bolan Medical Complex Hospital Quetta for a period of six months. One hundred and fifty [150] patients of Thalassemia major [already diagnosed] who received two or more blood transfusions were included in this study. Blood sample from these 150 thalassemic patients was scrutinized for HBsAg. All 150 thalassemia patients were in the age range of 6 months to 20 years. Younger patients aged 0-4 years required transfusion every 4.6 weeks while patients above 15 required every 2 weeks. Every TM patients received a mean of 167.64 +/- 121.01 units of blood. A substantive number 25 [17%] were HBsAg positive. Direct correlation was found between HbsAg positivity and number of blood transfusions. Conservative management with blood transfusion is probably the best and sometimes the only survival for patients of TM in our country but it carries a substantial amount of risk of acquiring hepatitis B due to repeated blood transfusions. It is extremely important to sensitize the public regarding prevention of the disease

Prevalence of hypomagnesaemia in patients with acute myocardial infarction compared with normal subjects

Background: Magnesium, the second most abundant intracellular cation has several clinically important roles in the human ++ body. In addition to energy production and maintenance of electrolyte balance, Magnesium [Mg] is essential for normal ++ neuromuscular functions, excitation contraction coupling, maintenance of vascular tone, blood coagulation, as well as Ca and +++ K transport across the plasma membrane. Mg has also important role to play in cardiovascular homeostasis

Objectives: To ++ find out serum Mg levels in Acute Myocardial Infarction [AMI] patients at presentation to emergency departments and its comparison with normal subjects

Patients and Methods: This was a comparative study, conducted at Punjab Institute of Cardiology, Lahore from June to December 2000. A total of 125 subjects were enrolled for this study, with 88 patients having their first episode of AMI. These patients were divided into three groups A, B and C depending on age. 37 normal subjects were taken as comparative group

Results: There was hypomagnesemia [p< 0.001] in all the sub groups. Our results show that hypomagnesemia is present in all groups and as it is an important risk factor for post AMI complications. The corrective dose should not be empirical but be based on individual patient requirements, as mortality rate due to AMI and its complications is high

Conclusion: Hypomagnesemia was observed in all the sub groups A, B and C. Therefore, it is suggested that serum Magnesium ++ should be estimated in each case of AMI patient and emphasis given to Mg supplementation when needed

Complicated Jejunal diverticula as surgical emergency: experience at a tertiary care hospital in Peshawar, Pakistan

Diverticula of small intestine are rare. Jejunal diverticula can be single or multiple. Diverticula in the jejunum tend to be large and multiple. Clinically they may be asymptomatic or may give rise to symptoms like pain, flatulence and borborygmi, may produce malabsorption syndrome or may present in emergency with different acute pathologies like perforation, haemorrhage, obstruction, enterolith formation and inflammation. The Objective was to see the pattern of complications in jejunal diverticula presenting as a surgical emergency. This descriptive study was conducted at Surgical Units of the 3 tertiary care Hospitals of Peshawar, for 7 years from January 1, 2002 to December 31, 2008. Study included all patients presenting to and admitted in Surgical Unit, Hayatabad Medical Complex, Peshawar with complicated jejuna diverticula during the above mentioned period. Name, age, sex, other relevant data, history and examination findings and results of investigation were recorded. Uncomplicated jejuna diverticula were excluded from study. The operative findings and the type of complication were recorded. Ten patients were admitted during 7 years of study. Out of all patients 9 were male and 1 was female. Eight out of 10 patients presented with perforation of diverticula while 1 patient had severe inflammation of diverticulum causing pain, ileus and acute abdomen. One patient had acute pain due to adhesion formation. It is seen that complicated jejunal diverticulae are quite rare and the most common complication is perforation. Inflammation and adhesion are other complications with which jejunal diverticula presented during this study

Frequency and magnitude of anxiety and depression in patients with Psoriasis vulgaris

To determine the frequency of anxiety and depression in patients with psoriasis. Cross-sectional study. Outpatient Departments of Dermatology and Psychiatry, Ziauddin University Hospital, KDLB Campus, Karachi, from October 2005 to September 2006. All patients presenting with psoriasis vulgaris above the age of 15 years, of either gender, fulfilling the selection criteria were included in the study. Clinical diagnosis was confirmed by biopsy and histopathology. Documentation of disease severity as mild, moderate and severe was done, using Psoriasis Area Severity Index [PASI], Patients were asked to fill "AKUADS" for their psychiatric assessment and scoring was done on this basis. Patients scoring equal to or above 19 were labeled as having anxiety or depression. There were 56 males [62%] and 33 females [38%], aged 20 to 65 years in the study. Out of those, 52 [58%] were married; while 37 [42%] were unmarried. The minimum duration of illness was 6 months and maximum 15 years. Thirty-four patients [38%] were suffering from mild disease, 31 [35%] from moderate and the remaining 24 [27%] from severe psoriasis. Twenty-four [27%] were on topical therapy while the other 65 [73%] were receiving systemic as well as topical therapy. Joint involvement was seen in 25 patients [28%] and nail changes in 31 [35%]. Psychiatric illness was positive in 34 patients [38%, p<0.05] i.e. 20 males [59%] and 14 females [41%]. Twenty-six patients [76%] were married [p<0.05]. Anxiety and depression was seen irrespective of the disease duration. The mean "AKUADS" scores in accordance with disease severity were mild psoriasis 20, moderate psoriasis 22 and severe psoriasis 25. Twenty-one patients [62%, p=0.05] with joint involvement and another 23 [68%, p<0.05] with nail involvement had a score above 19. Thirty-one patients [91%] were receiving systemic as well as local therapy, while 3 patients [9%] were on topical treatment [p<0.05]. There is an association of psoriasis vulgaris with anxiety and depression. The magnitude of this anxiety and depression can be influenced by variables of disease and life

Frequency of antiphospholipid syndrome in deep vein thrombosis

To determine the frequency of antiphospholipid syndrome in patients of DVT. Single center descriptive study. It was carried out at Military Hospital Rawalpindi, from May to Oct 2003. Fifty patients of either sex with Deep vein thrombosis [DVT] legs, who were diagnosed clinically and later on confirmed on doppler ultrasound, were selected through non-probability convenience sampling. doppler ultrasound was done to diagnose DVT and antiphospholipid antibodies tested namely lupus anticoagulant and anticardiolipin antibodies. Other associated risk factors were also documented. Data collected and organised, descriptive statistics were applied to calculate the frequencies. The results were organised in graphs and tables. Out of 50 patients of DVT 38 [76%] were males and 12 [24%] were females. Mean age for males was 44.94 +/- 14.92 years whereas for females it was 27.66 +/- 5.97 years. Antiphospholipid syndrome was detected in 13[26%] patients; 11 [22%] were males and 2 [4%] females. Only lupus anticoagulant was detected in 9 [18%] patients. Anticardiolipin antibodies were detected in 3 [6%] patients. In 1 [2%] both lupus anticoagulant and anticardiolipin antibodies were detected. There is an association between antiphospholipid syndrome and DVT. Association of lupus anticoagulant is more, as compared to anticardiolipin antibodies with DVT. Additional risk factors make a person further susceptible to DVT