Vitamin thiamine and glucose homeostasis in alloxan induced diabetes mellitus

Objective: valuating the vitamin B[1] [thiamine] on glucose homeostasis and Glycosylated hemoglobin A1 [HbA1c] in Alloxan induced diabetic rat model

Study Design: Experimental study

Place and Duration of Study: This study was conducted at the Animal House, Isra University Hyderabad from September 2014 to March 2015

Materials and Methods: 60 adult albino rats were divided into four groups; Group 1. Controls, Group 2. Rats receiving thiamine added diet, Group 3. Diabetics rats on normal diet and Group 4. Diabetic rats receiving thiamine added diet. Alloxan [120 mg/kg] was introduced intraperitoneally to induce diabetes. Vitamin B1 was given orally at 1.6 g/kg body weight for 12 weeks. Venous blood was taken from tail vein by small bore cannula at the baseline and after 12[th] week. Blood glucose and HbA1c were detected at baseline and after 12[th] week. Data was saved in proforma and analyzed on SPSS 22.0 using paired student t-test at 95% confidence interval

Results: Blood glucose and HbA1c levels were found statistically significant in groups 1 vs. 3 [p=0.0001], 1 vs. 4 [p=0.0001], 2 vs. 3 [p=0.0001], 2 vs. 4, [p=0.001] and 3 vs. 4 [p=0.024] at the end of experiment period. Significant improvement in blood glucose and HbA1c was noted in the vitamin thiamine treated rats

Conclusion: Vitamin thiamine improved the blood glucose homeostasis and reduced Glycosylated Hemoglobin A1 effectively in experimental rats. It is recommended to supplement diabetic subjects with vitamin thiamine

Hyperlipidemia, hypercholesterolemia and glycemic control as risk factor for diabetic retinopathy

To investigate the blood lipids, serum cholesterol and glycaemic control as risk factor for Diabetic retinopathy [DR]. Cross sectional study. This study was conducted at Muhammad Medical College Hospital Mirpurkhas and Consultant Clinics Hyderabad from March 2014 to January 2015. 100 cases of DR were selected for present study. Fundoscopy was performed by the physician followed by a Consultant ophthalmologist. Blood was collected from peripheral vein after a fasting state of 8 - 12 hours. Glycated hemoglobin Al [A 1C] and lipids were evaluated by standard assays. Volunteers were requested to sign to informed consent profroma. Research topic was approved by ethics committee of institute. Statistix 8.1 for data analysis and P-value

Mean platelet volume in diabetic retinopathy and its association with duration of diabetes and glycaemic control in type 2 diabetics

To study the mean platelet volume [MPV] in diabetic retinopathy [DR] with special reference to duration of diabetes and glycaemic control [HbAlc] in type 2 diabetics [DM]. Case control study. This study was carried out at the Department of Medicine, Liaquat University HospitalJamshoro, from March 2014 to December 2014. 100 subjects; comprising of 50 controls and 50 cases of DR were selected as per criteria and evaluated for study variables. Blood sample were collected in anticoagulant sterilized bottles for analysis of hematoanalyzer. Volunteers were requested to sign the informed consent proforma. Statistix 8.1 was used for data analysis. Pearson's correlation r], student t test and Chi square were used for data analysis. p

Effect of silymarin therapy on liver aminotransferase in non-alcoholic fatty liver disease

Objective: The present study evaluated the effects of silymarin on blood glucose, blood lipids and liver amino-transferase [AST and ALT] in Non-alcoholic fatty liver disease [NAFLD]

Study Design: Randomized Placebo Controlled [double blind] Trial

Place and Duration of Study: This study was carried out at Consultant Clinic Cant area Hyderabad andDepartment of Medicine, Isra University Hospital Hyderabad from April 2012 to August2013

Materials and Methods: A sample of 64 subjects [33 cases and 31 controls] was selected for evaluating effects of silymarin. Subject selection observed the inclusion and exclusion criteria. Subjects with aspartate transaminase [AST] and alanine transaminase [ALT]>1.2 of normal were included. NAFLD diagnosis was confirmed by ultra-sonography. NAFLD cases were given silymarin[140 mg x2 tablets] daily for duration of 3 months. Controls received placebo. AST and ALT were checked after three months. Data variables were analyzed by SPSS version 21.0

Results: Mean +/- SD of aspartate transaminase [AST] and alanine transaminase [ALT] before intervention were found as 73.2 +/- 9.7 vs. 69.3 +/- 17.6 IUL[-1][p<0.021] and 92.1 +/- 19.4 vs.83 +/- 15.6 IUL[-1]in cases and controls [p < 0.0001] respectively. After three months the AST and ALT were found reduced compared to baseline. AST and ALT were found as 39.3 +/- 7.5 IUL[-1]and ALT to 39.3 +/- 10.9 IUL[-1]35.9 +/- 11.7 IUL[-1]and 83 +/- 15.6 IUL[-1]in cases and controls respectively. Blood lipids and blood glucose also showed statistically significant differences [p=0.0001]

Conclusion: Silymarin improves blood glucose, blood lipids and liver amino transferase in non-alcoholic fatty liver disease

Primary vaginal hydrocele; different surgical procedures: a comparative study

A hydrocele is a fluid - filled sac surrounding a testis that results in the swelling of scrotum. They can develop due to inflammation or injury within the scrotum. This study aimed to evaluate the efficacy and adaptation of different surgical procedures in the repair of hydrocele.Comparative, Retrospective study .The study was conducted at Fauji Foundation Hospital Karachi, Al-Tibri Medical College, Karachi and Civil Hospital Karachi from January, 2000 to December, 2013. Patients with primary vaginal hydrocele registered during the period of thirteen years in the out patient department of surgery were selected. A total of 300 patients were assessed clinically, diagnostically and radiologically about the status of hydrocele before the surgical procedures and anesthetic opinion. The different surgical technique were carried out in different group of patients asJaboulay's technique in 70 patients, Lord's procedure in 70 patients, Aspiration and Sclerotherapy in 05 patients, Window operation technique in 05 patients and the Hydrocelectomy by supra pubic procedure were carried out in 150 patients out of total 300 registered patients. The data collected and analyzed statistically in SPSS version 19.00. The different procedures have been adopted surgically in patients with primary vaginal hydrocele. The results showed that among the different operative techniques adopted, the best procedure regarding hydrocelectomy is the supra pubic approach line of treatment. It showed better result and recovery with very minimum complications and side effects as compared to other surgical procedure. The data thus concluded that hydrocelectomy done via supra pubic approach in number of patients proved to be the best procedure because of having very little complications

Hollow abdominal visceral injuries following minimally invasive gynecological procedure: a 16 year experience

To study the pattern of hollow abdominal visceral injuries during minimally invasive gynecological procedures. Retrospective, Descriptive Study. This study was conducted at Fauji Foundation Hospital Karachi, Gulshan General Hospital Karachi, Star General Hospital Karachi and Al-Tibri Medical College Hospital from July 1997 to December 2013. All patients admitted to above mentioned hospitals for minimally invasive gynecological procedures electively or in emergency were included in the study. Total 3050 minimally invasive gynecological procedures were carried out in the above mentioned hospitals and 77 [2.5 %] patients had complications following the procedures. Mean age was 28 years ranged from 20-55 years. 40 % patients had history of previous gynaecological surgery.Abdominal visceral injuries included small bowel perforation 30 [38.96 %] patients, sigmoid colon perforation 20 [25.97%] patients. Both small bowel and sigmoid colonic perforation 08 [10.38%] patients, Caecal perforation 01 [1.29 %] patient and Urinary Bladder 01 [1.29%] patient. 52 % cases were diagnosed within two days of primary surgery and rest within 10 days. All gynecologists must be skilled, vigilant and careful while doing minimally invasive gynecological procedures that visceral injury should not happen or ready to deal if it happens accidentally

Intestinal amoebiasis in children and its effect on nutritional status

To determine the frequency and clinical presentation of amoebic diarrhea in children and its effect on the nutritional status of the affected children. Descriptive. Department of Diarrhea Treatment Unit [DTU], Dow Medical College and Civil Hospital, Karachi, from November 1998 to April 2001. Paediatric patients between the ages of > 1 month to 15 years were included, who visited the DTU of the department with diarrhea. Stool samples of all these patients were checked under microscope for the vegetative forms of Entamoeba histolytica [E.h.]. Patients who were positive for E.h. were evaluated for the symtomatology including the type of diarrhea [acute watery diarrhea [AWD] or dysentery], abdominal pain, tenesmus and nausea/vomiting. Examination carried out was assessed for state of hydration, fever and anaemia and nutritional status of those less than 5 years of age. The patients were divided into three age groups to assess the association of the age with severity and type of clinical presentation. Chi- square test was applied to calculate the p-values. P-values of 0.05 or less were considered statistically significant. The stool samples of 3870 patients with diarrhea were examined under microscope. Three hundred and twenty eight [8.47%] of these samples were positive for E.h. The difference between the number of patients presenting with acute watery diarrhea n=157, 47.86% and with dysentery n=171, 52.13% was found to be statistically non-significant [p=0.364]. Two hundred and seventy seven [84.45%] patients had tenesmus, while abdominal pain was present in 287 [87.5%]. Fever and malnutrition were present in 169 [51.52%] patients each. Malnutrition was significantly most frequent in 1-5 years of age groups [n=98, 57.98%, p=0.026]. The nutritional evaluation of the 272 under-5 children with amoebic diarrhea showed a significantly normal status in 123 [45.55%, p-value <0.001]. All the signs and symptoms followed a similar trend with 1 -5 years age group being the most affected group. However, the frequency of blood in stools increased in direct proportion to the increasing age. Although dysentery was the more common presenting complaint, almost half of the patients presented with watery diarrhea. Most of the patients with dysentery were under the age of 5 years. Fever was present in a high number of patients. The age group most affected by amoebiasis and malnutrition was 1-5 years

Malaria morbidity in Sindh and the plasmodium species distribution

To determine the prevalence of Malarial parasites and species responsible in Sindh Province of Pakistan. It is a cross sectional descriptive study conducted in all Districts of Sindh during January 2002 to December 2006. It was based on surveillance data of Malaria control program Sindh in which blood smears from febrile cases in all age group of male and female were seen by facility microscopist in all districts. Senior microscopist rechecked all positive slides. All slides data of different districts of Sindh was reported on monthly basis to provisional centre at Hyderabad for compiling and analysis. During 2002-2006, out of 5.84 million slides, those with positive malarial parasites were approx. 0.16 million giving an average blood examination rate [BER] 4.46, slide positivity rate [SPR] 2.94, Falciparum ratio[FR] was 41%, annual parasite incidences [API] was 1.36. More cases were seen in post monsoon season. All basic indicators of Malaria disease are higher than optimum level. Estimated burden can be much higher, Roll Back Malaria goals are lagging far behind to reduce the disease burden. As such integrated approach of diagnosis, treatment and prevention is required

Serum zinc and magnesium in Type-2 Diabetic Patients

To assess serum zinc and magnesium level in type-2 diabetic patients and the effect of age, gender, glycemic control and duration of diabetes on these trace elements in comparison with those of control subjects. Non-interventional case control study. Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, from October 2007 to March 2008. There were 42 diabetic patients and 42 age matched non-diabetic [control] subjects included in this study. Serum zinc, serum magnesium and fasting blood sugar measured among the diabetic and control groups and association of both trace elements were assessed with glycemic status, age, gender and duration of diabetes using SPSS version 16.0 for analysis. Serum zinc level was significantly lower [mean 2.03+0.39 mg/dL] in diabetic patients as compared to control subjects [4.84 +/- 4.217 mg/dL, p = < 0.001]. No significant difference was found in serum magnesium level with mean of 22.67 +/- 24.5 mg/dL in diabetic patients as compared to controls [18.3 +/- 3.4 mg/dL, p = 0.26]. Serum zinc level was significantly lower in type-2 diabetics, whereas no significant difference was found in serum magnesium level when compared with control subjects. There was no association of age, gender, glycemic status and duration of diabetes on the serum concentration of these trace elements in type-2 diabetic patients

Bowel injuries secondary to induced abortion: a dilemma

To study the pattern of bowel injuries incurred by induced abortion, and the morbidity and mortality associated with them. Prospective descriptive study from December 2002 to December 2005. Surgical Unit three Gynaecology and Obstertrics Unit two, Civil Hospital, Karachi. All patients with bowel injuries due to induced abortion. Detailed data of all the patients was collected and analyzed. A total of 22 patients, mostly young with an average age of 26.86 years, presented with bowel injuries following induced abortion. Severe hemorrhage occurred in 8[36.4%] patients while 11[50%] had ileal perforation; 9[40.9%] underwent primary repair and 2[9.1%] ileostomy formation. Two [9.1%] patients with jejunal perforation had primary repair, whereas two with both jejuna and ileal perforations underwent resections with anastomosis in one and ileostomy in another. Seven [31.8%] with large gut involvement had colostomy formation. Septicemia and wound infection occurred in 7[31.8%] patients each, faecal fistula and abdominal wound dehiscence in 3[13.6%], and pelvic abscess in 1[4.6%] patients. The total mortality in this series was 6[27.3%] patients. Iatrogenic injuries during induced abortion, most commonly caused by quacks, can be minimized substantially if the procedure is performed by qualified medical personnel in proper health care facilities. There is a need for radical overhauling of the mind set in our society together with legislation

Pattern of aetiological and predisposing factors regarding carcinoma breast

To study the pattern of aetiological and predisposing factors regarding Carcinoma Breast. Prospective, descriptive study from Jan. 2001 to Jan. 2006. Surgical Unit IV, Civil Hospital, Karachi. All the biopsy proven cases of Carcinoma Breast were included. The relevant data regarding history, risk factors, examination and treatment was recorded and analyzed. The total number Carcinoma Breast cases were 54. Out of these 37[68.5%] were under the age of 50 years and 45[83.3%] belonged to the lower socio-economic group. The mean age at menarche was 13.4 years and at menopause 45.13 years. Nine [16,6%] patients had a positive family history of breast carcinoma or other malignancies, and four [7.4%] patients were nulliparous. None of them had a history of long term use of hormonal therapy i-e oral contraceptives or hormone replacement therapy. The established risk factors like early menarche, late menopause, old age, nulliparity, family history, low socio-economic status differed from the international data. It, therefore, seems worthwhile that a larger scale, multicentric study should be conducted to verify and explain these patterns in our population

Spectrum of liver disorders in children: a hospital based study

The aim of the study was to find out the existing pattern of liver diseases in hospitalized children. Observation descriptive study. Paediatric Unit-III Civil Hospital Karachi.affilliated with Dow University of Health Sciences Karachi. From January 2001 to December 2005. Children ages more than two months to 15 years. During the study period, 92 children were included who fulfilled the criteria. Amongst Acute hepatitis [31.5%], HBV was [41.4%], HAV [27.6%], HCV [10.3%], drug induced [6.9%] and idiopathic causes [13.8%]. Chronic liver diseases were 51%, which constitute cryptogenic [42.5%] and post-hepatitis [32.0%], among which HBV [23.4%], HCV [8.5%] while Wilson [17%], Gaucher's disease [4.3%], hemochromatosis [2%] and autoimmune hepatitis was 2%. In acute hepatitis, HBV is more common while HAV is less than anticipated, HCV is significantly present. In chronic liver disease, the majority of causes are cryptogenic, posthepatitis, metabolic and storage disorders