Status of glycemic control in patients of type 2 diabetes mellitus

To determine the status of glycemic control in patients of type 2 diabetes mellitus. Cross sectional descriptive study. Medical out-patient/ in -patient departments at Military Hospital Rawalpindi from January 2011 to December 2012. Six hundred and fifty patients of type 2 DM fulfilling the required criteria were included in the study. Glycemic control of these patients was determined by estimation of blood glucose [fasting and random] and glycosylated haemoglobin [HbA1c]. The patients were grouped in three categories good, fair and poor diabetic control having their HbA1c values of being 6-7%, 7.1-8% and more than 8.1% respectively. Statistical package for social sciences [SPSS] version 15 was used for analysis. Out of 650 patients 377 [58%] had poor glycemic control with mean HbA1c of 9.5% +/- 0.95, 78 [12%] patients had fair control of glycemic control with mean HbA1c of 7.8 +/- 0.25, and 195 [30%] patients had good glycemic control with mean HbA1c of 6.4 +/- 0.17. Majority of patients had poor control of their glycemic status which is an important indicator and predictor of both micro and macrovascular complications

Risk factors for coronary heart disease in patients below 45 years of age

To examine the traditional risk factors and biochemical profile of patients with established CAD [coronary artery disease], and compare the trends of these in specified age groups of different populations as depicted in various studies. All consecutive patients below 45 years of age, having classical history of Ischemic heart disease and also having definite ECG changes consistent with coronary artery disease were enrolled. These patients were admitted to CCU/Intermediate Coronary Care Unit of Pakistan Ordinance Factories [POF] Hospital Wah Cantonment from April 2007 to December 2011. Patients who had doubtful history as regards CHD and those having ECG changes not classically consistent with CAD were excluded. Information collected through Performa included history including family history and details of risk factors. Clinical examination was carried out and relevant investigations including the serial ECG changes were recorded. Blood samples were collected after an overnight fast of 14 hours and tests were done for total cholesterol and HDL cholesterol by using Pioneer-USA, linear chemical kits by cholesterol oxidase and enzymatic calometric method. A total of 109 cases were included. Cigarette smoking [46%] Family history [43%], Hypertension [37%], Dyslipidemia [33%], Diabetes mellitus [18%] and above normal BMI [63.3%] are the most common risk factors in our patients. Increased abdominal girth has appeared to be an important risk factor and at occasions is documented to be independent of obesity. Casual dietary habits and sedentary life style are the other less important risk factors. The majority of risk factors were equally prevalent in males as well as females except smoking which was less prevalent in females. Our study shows that Family history, Smoking, Hypertension, increased BMI, increased Abdominal girth, Dyslipidemia and Diabetes Mellitus are the main risk factors. Considering the increasing incidence of the coronary heart disease in our society it is essential to assess and evaluate these risk factors at national level

Frequency of glucose-6-phosphate dehydrogenase deficiency in some ethnic groups of Pakistan

To determine the frequency of G6PD deficiency in young healthy adult males of some ethnic groups in Pakistan. Design: Descriptive study. Place and Duration of Study: Study performed in Combined Military Hospital, Attock in collaboration with Armed Forces Institute of Pathology, Rawalpindi from October 2003 to January 2004. Patients and Asymptomatic and healthy adult males were included in the study. A brief clinical record including age, ethnic group, place of residence, and history of past illnesses including fever, episodes of recurrent jaundice were recorded. Met-hemoglobin reduction test for G6PD screening was performed. Hemoglobin, red cell indices and total leukocyte count of G6PD deficient cases were measured on Sysmex KX 32 hematology analyzer. Three thousand adult males with age between 17 years to 23 years were screened. G6PD deficiency was detected in 1.8%. Deficiency state was 1.07% in Kashmiris, 1.47% in Punjabis, 2.77% in Sindhis, and 3.17% in Pathans. Past history of recurrent jaundice was present in 5.7%. Mild anemia was present in 3.8%. Frequency of G6PD deficiency was 1.8% in young healthy adults with insignificant difference among various ethnic groups except in Pathans

Seroprevalence of HBsAg and HCV antibodies in hospital workers compared to aged matched healthy blood donors

As study was planned to document the seroprevalence of HBsAg and HCV antibodies in hospital workers compared to age-matched volunteer healthy blood donors. The study was conducted at PNS Shifa Hospital Karachi from November 2001 to October 2003. Study group comprised of 305 voluntary hospital workers including 60 doctors, 101 female nurses and attendants, 116 male nurses and attendants and 18 sweepers. Control group comprised of 300 aged matched volunteer blood donors, 90 males and 30 females. A performa was designed to record various findings. Sera of subjects were tested by a standard method for the presence of HBsAg and HCV antibodies. Study group comprised 70 [23%] doctors, 60 males and 10 females. HBsAg was positive in 1[1.43%] and HCV antibodies in 2[2.85%]. Among 101[33%] of the female nurses and attendants, HBsAg was positive in 03 [3%] and HCV antibodies in 8[8%]. Among 116 [38%] male nurses and attendants, 04 [3.44%] were HBsAg positive and 07 [6.03%] HCV antibodies positive. Among 18[6%] khakrobs and sweepers 1[5.56%] was HBsAg positive and 2[11.11%] were HCV antibodies positive. In total 10[3.27%] hospital workers were found positive for HBsAg and 18 [5.90%] positive for HCV antibodies. In voluntary blood donors, HBsAg was detected in 2.4% and HCV antibodies in 3.2%. It is conduced that the seroprevalence of HBsAg is marginally higher in hospital workers while seroprevalence of HCV antibodies is reasonably higher in hospital workers compared to general healthy population

effects of exposure to crude oil on the health of workers involved in clean up operation

An oil tanker carrying crude oil was grounded near Karachi coastline. This observational non-interventional study was carried out to study the effect on health of workers who were involved in the clean-up operation. First fifty consecutive naval personnel who came in close contact with the spilled crude oil in the sea were evaluated. Their symptoms, physical signs and lung function tests were recorded before and then on daily basis for 2 weeks. All the 50 subjects had developed symptoms. The most frequent symptom was redness of eyes [60%] followed by headache [52%], nausea [50%], throat irritation [48%], dry cough [10%], tightness in the chest [8%], blurring of vision [8%] and other minor symptoms [18%]. None of the subjects was asked to stop the work because of the severity of toxic symptoms. Reversible obstructive airway disease was seen in only 4 subjects, all of them had dry cough before exposure. The data suggests that exposure to volatile products of crude oil leads to development of neurological, respiratory and eye symptoms. Mild reversible obstructive airway disease may only manifest in few individuals who already had respiratory symptoms before exposure

Clinical assistance of bone marrow examination in a secondary-care hospital

This study was performed to evaluate various clinical situations requiring bone marrow examination and to assess its advantages in a secondary care hospital. One hundred and five bone marrow examinations were performed from 1st April 2002 to 31st March 2003. The age ranged from 4 months to 70 years with a mean age of 32 years, 10 patients were children under the age of 15 years and 95 were adults. Male to female ratio was 3:1. Progressive pallor [26%], visceromegaly [25%], abdominal disturbances [19%], fever of unknown origin [8.5%], bleeding manifestations [8.5%], lymphadenopathy [8.5%] bone pains [5%], and suspected hematological malignancy [8.5%] were the common clinical situations where bone marrow examination was asked. Nutritional deficiency anemia constituted 61% of the bone marrow examination results. Other conditions were anemia of chronic disorder [13.5%], acute leukemia [5%], chronic leukemia [3%], multiple myeloma [2%], myelodysplastic syndrome[2%], congenital sideroblastic anemia[1%], storage disorder[1%] and metastatic bone disease[1%]. Bone marrow examination at secondary care hospitals carries many advantages. About 80% cases can be treated in these centers and do not require referral. The disease is usually at its early stage, marrow is unaffected by any therapy and has better diagnostic value

Prevalence of anti - hepatitis C antibodies and hepatitis B surface antigen in healthy male naval recruits.

Hepatitis B virus [HBV] and hepatitis C virus [HCV] are the commonest causes of chronic liver disease the world over including Pakistan. Various studies done in the past show wide variation in the results. Freshly inducted healthy recruits selected in Pakistan Navy were tested for hepatitis B surface antigen [HBsAg] and anti-hepatitis C antibodies [anti-HCV]. This study was carried out in PNS Shifa hospital Karachi. The prevalence of anti-HCV was 2.2% [95% CI:1.3-3.1%] and HBsAg was 3.2% [95% CI:2.1-4.3%]. There was variation in prevalence of anti-HCV and HBsAg in different cities. This study indicates that there is a considerable HBV and HCV threat to our population

comparison of clinical diagnosis and serological diagnosis in an epidemic of Crimean-Congo haemorrhagic fever

Crimean Congo Haemorrhagic Fever [CCHF] is life-threatening disease caused by Nairovirus of genus Bunyavirus caused by tick bite of Hayalomma species or by direct contact of the blood/sera of the patient and animals suffering from this disease. Epidemics have been occurring in Balochistan province of Pakistan and neighbouring Afghanistan and Iran from time to time with high mortality. Aim: In the absence of facilities for detection of serological markers of CCHF [IgM and IgG antibodies and PCR for viral RNA], a study was designed to diagnose and treat cases of CCHF reporting to a specialist unit hospital situated at Quetta, Pakistan. The aim was to compare the clinical features, complications and outcome of both groups of patients; one detecting the disease clinically only and the other depending upon serological tests for the diagnosis. Thirty-four patients having fever of less than two weeks of duration with features of bleeding from the skin and various orifices were included in this study from June 2001 to September 2001 after hospitalization. Index case and some of the consecutive cases were subjected to detection of serological markers. Rest of the cases were diagnosed on clinical grounds and baseline laboratory investigations only. Difference in both the groups was noted carefully. All the patients were given Ribavirin and blood products as and when required. Statistically there was no obvious difference in clinical manifestations [fever, body aches, purpuric spots, ecchymosis, epistaxis, gum bleed etc.] and laboratory findings [blood picture, serum ALT, serum urea and electrolytes, PT, APTT, etc]. There was also no difference in mortality of the two groups studied. In an on ongoing outbreak of CCHF, history, clinical findings and supportive baseline laboratory investigations may be sufficient for early detection and treatment of CCHF cases. However for documentation of start of epidemic, serological markers should be done. Therefore facilities for detection of viral markers of CCHF should be available at centers like Quetta

Hematological findings in acute malarial infection list of authors along with highest qualification and institute

Malaria is one of the common diseases in Pakistan. This study was designed to find out hematological parameters in patients suffering with acute malaria presenting at our hospital that represents a segment of. Balochistan population. All adults reporting with fever that had clinical features of malaria and were found positive for malarial parasites on blood film were included in this study. Hematological values were measured and slides were stained to detect malarial parasites and sub types. A total 4 306 patients were found to have malarial parasites in blood in one-year period, 48 were of plasmodium falciparum and 252 were with plasmodium vivax infection. Anemia was present in 79% patients of plasmodium falciparum infection and 25% patients with plasmodium vivax infection. Thrombocytopenia was observed in 70% patients of plasmodium vivax and 83.5% patients of plasmodium falciparum. Pancytopenia was detected in 1.5% patients of plasmodium vivax and 6% patients of plasmodium falciparum. Thrombocytopenia was the most common finding in our study