Frequency of anti-HCV, HBsAg and related risk factors in pregnant women at Nishtar Hospital, Multan

Viral hepatitis is a global issue. Among the hepatitis viruses hepatitis B and C are important in South Asia including Pakistan. There are various modes of transmission of these viruses. Vertical transmission is also gaining importance. Antepartum screening for HBV and HCV would help the infected women for appropriate antiviral therapy at appropriate time as well as for taking proper care of the newborns. The present study was designed to see the frequency of HBsAg and anti-HCV in pregnant women at Nishtar Hospital, Multan. This was a cross-sectional study carried out using non-probability purposive sampling technique. The period of the study was from June 2006 to August 2007. Five hundred [500] pregnant women attending outpatient department of Gynaecology and Obstetrics were included. Informed consent was taken. A specially designed proforma was filled in. Anti-HCV and HBsAg were tested by device method. Data were analyzed on SPSS-11. Out of 500 pregnant women 35 [7.00%] were found to be anti-HCV positive and 23 [4.60%] were positive for HBsAg. Mean age was 26.7 +/- 4.8 years. Majority of the patients 263 [52.60%] were in the age group 26-35 years. 138 [27.60%] women were nulliparous and 282 [56.40%] were para 1-4 and anti-HCV and HBsAg were common in this parity group. Only 80 [16.00%] women were para 5 or more. All anti-HCV and HBsAg positive women were house-wives. Most of them were belonging to rural areas having poor socio-economic status. Among 35 anti-HCV positive women, 20 [57.14%] had history of previous surgery, while 13 [37.14%] had history of multiple injections, 5 [14.28%] received blood transfusion, 4 [11.42%] had ear/nose piercing while tattooing was seen in only 2 [5.71%]. Among 23 HBsAg positive women, 10 [43.47%] had history of previous surgery. History of multiple injections was present in 6 [26.08%] patients, 4 [17.39%] patients had history of blood transfusion, tattooing, ear/nose piercing, history of dental procedure, history of sharing needles was observed in 1 each. Frequency of anti-HCV is more common than HBsAg in our study population. Previous history of surgery, multiple injection therapy and blood transfusion were observed as risk factors among anti-HCV and HBsAg positive pregnant women

Frequency of non alcoholic fatty liver disease [NAFLD] and its biochemical derangements in type-2 diabetic patients

To see the frequency of non-alcoholic fatty liver disease in Type-2 diabetic patients and to see biochemical derangements in NAFLD patients. It is a cross-sectional study, conducted at Diabetic Research Centre and outpatient department Nishtar Hospital and PMRC Research Centre Nishtar Medical College, Multan. One hundred patients of either sex having type 2 diabetes mellitus attending diabetic out-patient department Nishtar Hospital Multan were included in the study. A pre-designed study pro forma was filled with relevant investigations and clinical assessments were carried out in all cases. All the patients underwent abdominal ultrasonography. Data were entered in SPSS-11 and analyzed. Out of one hundred patients, 51 [51%] were female and 49 [49%] were male. Mean age of the patients was 47.93 +/- 8.57 years. Fifty one [51%] of the diabetic patients had fatty liver. Out of these 32 [62.75%] were female and 19 [37.25%] were male. Fatigue was present in 49 [53.26%], generalized weakness in 48 [52.18%], heaviness right upper abdomen in 22 [64.70%] and pain right upper abdomen in 20 [58.82%] of fatty liver patients. Corresponding figure in Non Fatty Liver Patients were 43 [46.74%], 44 [47.82%], 12 [35.30%] and 14[41.18%], respectively. Itching was noted in 19 [44.18%] patients of fatty liver while it was 24[55.82%] in non-fatty liver patients. Serum triglyceride level more than 160 mg/dl in 47 [92.15%] patients of fatty liver while serum cholesterol level more than 200mg/dl was seen in 24[47.05%]. Aspartate amino transferase [AST] more than 35 u/l was noted in seven [13.72%], alanine amino-transferase [ALT] more than 40u/l was noted in 6[11.76%] fatty liver patients while serum albumin and serum billirubin were within normal range in all fatty liver and non-fatty liver patients. Nonalcoholic fatty liver disease [NAFLD] is more commonly seen in Type-2 diabetic patients. Serum triglyceride and serum cholesterol are significantly raised in NAFLD patients. Raised ALT and AST was not a common finding in our NAFLD study patients. Diabetic patients having heaviness or pain right upper abdomen with raised serum triglycerides and cholesterol should be more closely observed for NAFLD and liver complications

Hepatitis B, hepatitis C and HIV: knowledge among general public of peripheral areas of Multan

To assess the level of knowledge regarding hepatitis B hepatitis C and HIV among general public of peripheral areas of Multan. Cross-sectional study. Peripheral areas of Multan, village Budhla Sunnat, kusba Ayazabad Marrhal and PMRC Research Centre Nishtar Medical College Multan. From 01.05.2007 to 30.04.2008. Medical camps were established in peripheral areas of Multan, village Budhla Sunnat and kusba Ayazabad Marrhal. It was a cross-sectional study which was carried out using non-probability convenient sampling technique. Subjects of both sexes and adult age attending these medical camps were included in the study. Informed consent was taken and confidentiality of the personal information was ensured. Specially designed Proforma was filled in by the Research Officers and data entered in SPSS-11 and analyzed. Three hundred and eight subjects were interviewed. The age of subjects varied from 15-70 years. The mean age was 37.06 years +/- 15.59 years. Two hundred and twenty three [72.4%] were familiar with hepatitis B, 196 [63.6%] with hepatitis C and 146 [47.4%] with HIV and 133 [43.2%] were familiar with all three viruses while 81 [26.5%] were unfamiliar with these viruses. Most of the subjects 93 [30.2%] knew about the transmission through injection by un-sterilized syringes, 90 [29.2%] were knowing that infected blood is important source of spread while 87 [28.2%] of the subjects were knowing that these are spread through infected razors, 84 [27.2%] were knowing unsafe sex as a mode of transmission. Sharing objects can be the source of spread was known to very less number of people, 9 [2.9%] were aware that these can spread through sharing infected tooth brushes, 7 [2.3%] with sharing infected [Miswaks] and only 3 [1%] were aware that these can spread through infected combs. Electronic media was the major source of knowledge 82 [26.6%], interpersonal communication 69 [22.4%] and newspapers in only 1 [0.3%]. knowledge about hepatitis B, hepatitis C and HIV is low in our study population. The results of the study have shown that many people still think that HIV is the only virus which is transmitted through sexual contacts and hepatitis 8 and C through contaminated blood. The knowledge about the modes of transmission is lower in the rural and un-educated community. General public has very little knowledge that infected combs, infected toothbrushes and infected [Miswaks] can also lead to transmission of hepatitis B and C. Electronic media particularly television and radio and newspapers are the main source of knowledge and awareness for the urban population while in rural population it is not the case. Effective health awareness campaigns are needed to be started among rural population

Pattern of diseases in a medical unit at Nishtar Hospital, Multan

To assess the frequency and pattern of diseases in a medical unit at tertiary care, [Nishtar Hospital] Multan. Cross-sectional study. Medical Unit-I, Nishtar Hospital Multan. May, 2004 to May, 2005. Patients admitted at Medical Unit-I, Nishtar Hospital, Multan were included in the study. Specially designed proforma was filled, data were collected and analysed on SPSS-10. Total admitted patients in medical unit-I at Nishtar Hospital, Multan from May, 2004 to May, 2005 were 660. 390 [59.1%] were males and 270 [40.9%] were females. Age ranges from 12-70 and above. Mean age was 43.88 years with standard deviation 18.87 years. Mostly [63.5%] patients were from home district. Chief complaints were uncontrolled diabetes mellitus [17.6%], fever [13.6%], weakness of one-half of body [10%], uncontrolled hypertension [9.7%], cough and fever [8.5%], yellowness of eyes [5.8%] and vomiting [4.2%]. Most common disease was diabetes mellitus [19.1%] followed by hypertension [17.9%], cerebro-vascular accidents [10%], chronic liver diseases [9.7%], acute hepatitis [8.9%], pneumonia [7.4%], meningitis [5.9%], chronic renal failure [3.2%], acid peptic disease [2%] and acute myeloid leukemia [1.5%] [Table No. 5]. Study revealed diabetes mellitus, hypertension, ischemic heart disease [IHD] and Cerebro-vascular accident [CVA] are most common diseases. Important measure to control diabetes mellitus and hypertension must be adopted. More detailed and large scale study are needed on pattern of diseases at tertiary care hospital so that disease pattern are known and on these basis strategies for control of diseases and patients care can be derived

Morphometric study of the lumbar vertebral canal in the normal adult Pakistanis

1. To determine the normal values of the midsagittal diameters of the canal and body of lumbar vertebrae in Pakistanis. 2. To find out the relationship between the midsagittal diameters of the vertebral canal and the vertebral body at all lumbar levels. 3. To determine the anteroposterior diameter of inferior vertebral notch and to find out its ratio with the vertebral body. STUDY DESIGN: the anatomic dimensions of the vertebral body and spinal canal of the lumbar vertebral were analysed in Pakistanis. SETTING: Department of Anatomy Nishtar Medical College, Multan. PERIOD: June 1993 to December 1996. MATERIALS AND METHODS :one thousand five hundred measurements were performed on the midsagittal diameters of vertebral bodies, spinal canals and anteroposterior diameters of inferior vertebrae notches using complete sets of 75 lumbar vertebral. The mean midsagittal diameters of the lumber spinal canal in the Pakistani Population was less than that of South African and Nigerian population while the anteroposterior diameter of inferior vertebral notch was slightly greater then that of Nigerians. the midsagittal diameter of the lumbar spinal canal is narrowest in the East Asian population; the radiologic criteria of spinal stenosis should be reconsidered for these people