Association of hyperuricemia with metabolic syndrome

Uric acid levels are often increased in subjects with metabolic syndrome but it is unclear whether it plays a causal role or it is a marker for metabolic syndrome. To find the association of hyperuricemia with various components of metabolic syndrome. The cross sectional analytical study was carried out in Sir Ganga Ram Hospital, Lahore, Pakistan. Total 600 subjects of both genders aged 30-70 years were recruited in the study. Demographic, clinical and biochemical variables were recorded by using a questionnaire. Fasting blood sample was used to estimate plasma glucose, serum lipid profile and uric acid. The cut-off for hyperuricemia was serum uric acid level >/=7.0 mg/dl for males and >/=5.7 mg/dl for females. Metabolic syndrome was diagnosed if subjects had any 3 of the 5 criteria described as per ATP III guidelines. The data was analyzed using SPSS Version 20. The study included 216 [36%] males and 384 [64%] females with mean age 47 +/- 10 years. Out of total 447 subjects, 62 [13.9%] with metabolic syndrome had hyperuricemia. Whereas 62 [75.6%] subjects out of total 82 subjects with hyperuricemia had metabolic syndrome. Different parameters of metabolic syndrome were statistically correlated with hyperuricemia but none showed significant correlation. Chi square and Wald Statistic [Logistic regression algorithm] showed that by using G-to-S [general to specific] approach hyperuricemia was significantly associated with female gender but did not show any association with metabolic syndrome. There was no association present between metabolic syndrome and hyperuricemia; therefore uric acid levels might not be important in the diagnosis of metabolic syndrome

Knowledge, attitude and practices of dentists about hepatitis B and C infection in Lahore

To assess the knowledge, attitude and practices of dentists of public and private sector in Lahore about Hepatitis B and C infection. This cross-sectional analytical study was conducted on private dental practitioners and public sector dental surgeons working in hospitals of Lahore. Private sector dentists of Lahore working in Shahdara, Badami Bagh, Mughalpura, Baghbanpura, Gulberg, Shadman, Mozang, Feroz pur Road, Model Town, Multan Road, Johar Town and Tohkher Niaz Baig were selected for the study. In the public sector hospitals, dental surgeons were selected from Demont Morency Dental College and Hospital, Mayo Hospital, Services Hospital, Govt. Mozang Hospital, Jinnah Hospital, Lahore General Hospital, Mian Munshi Hospital, Sheikh Zaid Hospital, Railway Hospital, Wapda Hospital and Combined Military Hospital by using convenient sampling technique. A self-administered, close- ended questionnaire was used and information was gathered about their knowledge, attitude and practices for HBV/HCV infection and its prevention. Data was entered in the SPSS-13 computer program. Frequency and percentages were calculated for different segments and comparison between the two groups was performed by using z-test for proportion. p-value

Association of insulin resistance with obesity in children

Insulin resistance is the primary metabolic disorder associated with obesity. Little is known about its role as a determinant of the metabolic syndrome in obese children. To assess the association of insulin resistance with metabolic syndrome in obese and non obese children. Study type and settings: Cross sectional analytical study conducted among children of ten Municipal Corporation high schools of Data Ganj Buksh Town Lahore. A total of 46 obese and 49 non obese children with consent were recruited for the study. Fasting blood glucose, serum insulin, high density lipoprotein cholesterol, triglycerides, cholesterol, non HDL-cholesterol LDL cholesterol were measured using standard methods. Data were analyzed by using statistical software SPSS-Version 15. A total of 95 children 49 obese and 46 non obese were recruited for the study. A significant association of serum triglyceride [p<0.001], high density lipoprotein cholesterol [p<0.001], fasting blood glucose [p<0.001], and insulin levels [p<0.001], was seen between the two groups. For each component of metabolic syndrome, when insulin resistance increased so did odds ratios for cardio metabolic risk factors. Insulin resistance was seen in 34.7% children. Metabolic syndrome was found in 31.6% children reflecting that obese children are at high risk for metabolic syndrome and have low HDL-cholesterol and high triglycerides levels

Prevalence of dyslipidemia in patients with type-2 diabetes mellitus

The dyslipidaemia associated with type-2 diabetes is associated with raised plasma triglycerides, low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol and very low-density lipoprotein cholesterol levels and is a risk factor of cardiovascular disease. To assess the lipid abnormalities in patients with type-2 diabetes. A cohort study carried out at Diabetic Clinic of PMRC Research Centre, FJMC, Lahore, Pakistan. Eight years case records of type-2 diabetic patients seen at the research centre from 1999-2006 were reviewed. The research centre is a specialized centre for diagnosing and treating diabetes mellitus. All the patients were recruited for their follow up check up and laboratory investigations for dislipidemia. Adult treatment panel III guidelines for dyslipidaemia were followed. A 12 hours fasting blood sample was collected from each patient for serum total cholesterol, triglycerides, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and glucose as well as glycosylated hemoglobin [HbA1c] by using standard methods at Biochemistry laboratory of the research centre. LDL-C/ HDL-C ratios, Very low-density lipoprotein cholesterol [VLDL-C] and body mass index was calculated after anthropometery body mass index [BMI] >/= 25 was considered as overweight while >/= 30 obese. HbA1c<6.1 was considered as poor glycemic control. Data was analyzed by using statistical software SPSS-15. a total of 1200 type-2 diabetes were seen in 8 years. There was poor glycemic control, in 87.5% subjects judged on blood HbA1c levels. These patients had higher total cholesterol, LDL-C and low HDL-C levels in blood. The percentage of patients with high, borderline and near optimal risk LDL-C was 62.7, 26.9 and 10.4% respectively, while HDL-C >40mg/dl were seen in 67%. Raised VLDL-C [above 40 mg/dl] was seen in 32.9% cases. The group with high LDL and VLDL is at risk of developing cardiovascular disease. Hypertriglyceridaemia was found in 55% and hypercholesterolaemia in 45.4% cases. Obesity as indicated by body mass index was found in 53.7% patients. Statistically significant association of hypercholesterolemia, hypertriglyceridemia, hypo HDL cholesterolemia and VLDL-C was found with advancing age while only hypertriglyceridemia and VLDL-C showed a positive association with duration of diabetes. A significant association of hyperglycemia [raised HbA1c] was seen with hypertriglyceridemia and high LDL-C along with high body mass index i.e. obesity. Hypertriglyceridemia, high LDL-C and VLDL-C, low HDL-C levels and obesity were the pattern of dyslipidemia found in our diabetic population

Risk factors for syphilis and HIV infection in pregnant women attending a tertiary care public sector hospital

Syphilis, a sexually transmitted disease which seemed to have disappeared or had been controlled over the years, has now been re-emerged as a major public health problem in many communities. It can complicate the pregnancies with serious consequences. Appropriate treatment of pregnant women often prevents such complications. To study the frequency of syphilis in pregnant women attending a tertiary care public sector hospital, and see the positivity for HIV/AIDS among syphilis positive women. This cross sectional and interventional study was conducted among pregnant women attending Sir Ganga Ram hospital for antenatal care at PMRC Research Centre, Fatima Jinnah Medical College, Lahore. Blood samples from 2000 women were collected after taking consent. The blood was tested for syphilis by Treponema Pallidum Haemagglutination.History of the subjects for risks factors was also taken. Syphilis positive women were further screened for human immunodeficiency virus positivity. The treponemal antibodies were detected in less than one percent [9] pregnant women. The highest positivity was observed among age group of 21-26 years. Women in third trimester were significantly more infected with syphilis. Risk factors included husband's history with frequent traveling and drug abuse. All husbands of syphilis positive women were also positive. All syphilis positive women and their husbands were negative for Human immunodeficiency virus /Acquired immune deficiency syndrome. Less than 1% of pregnant women were infected with syphilis, and most of the spouses of these positive women were either travelers or drug addicts. Screening for syphilis should continue in pregnant cases and high risk individuals

Parasitic infestation in children of district Vehari: an underdeveloped area of Pakistan

To determine parasitic infestation among children of rural and urban areas of district Vehari. Children Complex Hospital, at District Headquarter Hospital Vehari and PMRC Research Center, Nishtar Medical College, Multan, Pakistan. A cross-sectional study was done in 2006 where 500 children aged 1-10 years presenting with anaemia and malnutrition were studied. Demographic information included residential area [rural/urban], gender, socio-economic status, hygienic conditions, source of drinking water were recorded on a questionnaire. Parents were interviewed, while stool and blood samples of children were collected for parasites and to determine anemia. Parasites were found in 140[28%] children and anemia in 236[47%]. Prevalence of protozoa 102 [20.4%] was greater than intestinal helminthes 38 [7.6%]. The most common protozoa was Entamoeba histolytica 101 [20.2%] and in nematodes, Hymenolepis nana was seen in 28 [5.6%], Ancylostoma duodenale [hook worm] in 5 [1%], Ascaris lumbricoides [round worm] in 3 [0.6%] and Taenia saginata [tape worm] in 2 [0.4%]. Diarrhoea was seen in 254 [50.8%] cases, constipation in 191 [38.2%], abdominal pain in 245 [49%], anorexia in 181 [36.2%] and abdominal distension in 86 [17.2%] children. Rural children were significantly more infected with parasites, 81 cases [32.27%] compared with urban children 59 cases [23.69%] [p<0.05] and same was for poor children 81 [34.9%] compared with middle income 57[21.8%] [p<0.05]. Infected cases with poor hygienic conditions [77 cases 35.2%] were more infected than those with satisfactory 62 [24.4%] and good hygiene 1[3.7%]. Worm infestation was common 84[35.9%] in those using drinking water from hand pumps compared to those obtaining drinking water from government water supply 47[23.9%] and water filtration plant 9[13.%], a significant difference in infection due to poor quality drinking water was observed[p<0.05]. Worm infestation and anemia were inter related and 85 [60.7%] children with anaemia had parasites against 55 [39.3%] who were not anaemic [p<0.05]. Poor sanitation, hygiene and source of drinking water have appeared as major contributors towards parasitic infestation. Ent.histolytica was the most common protozoal infection found compared to helminths. Use of clean drinking water and good hygienic practices should be instituted throughout the country

Syphilis screening: outcome and interventions at an antenatal clinic

Syphilis, a sexually transmitted disease which seemed to had been controlled over the years, has now been re-emerged as a major public health problem in many communities. It can complicate the pregnancies with serious consequences. While appropriate treatment of pregnant women often prevents such complications. To study the frequency of syphilis in pregnant women coming to a public sector hospital and see the pregnancy outcome of positive mothers and disease transmission in neonates. This cross sectional and interventional study was conducted at PMRC Research Centre, Fatima Jinnaha Medical College, Lahore among pregnant women attending Sir Ganga Ram hospital for antenatal care. Blood samples from 2000 women were collected after taking consent from them. The blood was tested for syphilis by using Treponema pallidum haemagglutination assay. Infected mothers were administered intramuscularly with 2.4 million units of benzathine benzylpenicillin [penicillin G] after testing for hypersensitivity and followed for delivery outcomes such as abortion, miscarriage, intrauterine growth restriction, low birth weight, preterm delivery and still birth. Neonates born to infected women were examined for signs of congenital syphilis including non immune hydrops, jaundice, skin rash, pseudo paralysis and running nose along with blood test for either infection. Medical and reproductive histories were also obtained from women and recorded on a proforma. The treponemal antibodies were detected in 9[0.45%] pregnant women. The highest positivity was obtained among age group of 21-26 years. There was no statistically significant difference of acquiring infection among women of different age, education, and socioeconomic backgrounds. Women in third trimester were significantly more infected with syphilis. Out of 9 couples 3 refused treatment, 1 received only one dose of penicillin, 2 received two doses while only three couples completed all doses. Delivery outcome included one abortion, two preterm deliveries and none of the neonate had sign of congenital syphilis. Only one couple consented for blood sampling of their neonate which was positive for syphilis and was referred to pediatrician. Only 9[0.45%] of pregnant women were infected with syphilis, which can seriously complicate pregnancy and result in spontaneous abortion, and preterm delivery. Screening for syphilis in pregnant women is recommended to detect infected woman who requires treatment to prevent further transmission of this disease to new born