Diabetic foot ulcer; sequelae

Objective: The number of diabetic patients is increasing at a rapid rate1. Management of diabetic foot has been a challenge for medical professionals. This study was carried out to find the sequelae of diabetic foot ulcer management. Study design: Observational analytical study. Setting: Military Hospital, Combined Military Hospitals Rawalpindi and MIMC teaching Hospital, Mirpur [AJK]. Period: Sep 2009 to August 2013

Materials and methods: Total 310 patients were included in this study as outdoor and indoor cases. Out of these 184 were males and 126 were females. Age affected ranged from 20 years to 90 years. Average age was 50 years. Wagner's grading for diabetic foot ulcer was used as guideline for management

Results: Hyperglycemia was controlled in consultation with physicians in all these patients. Out of these 310patients 199 [64%] patients got their feet wounds healed on conservative management without amputation while 111[35.8%] patients had to undergo some amputation at some level

Conclusion: Diabetes mellitus, fore runner of so many diseases requires multidisciplinary approach. Well controlled diabetes mellitus, good feet hygiene, rational antibiotics in light of culture/sensitivity report and timely conservative or active surgical intervention produce good results in diabetic foot management

Prevalence of hepatitis C, hepatitis B and human immunodeficiency virus infection among blood donors at Fatimid center Multan

To find out the prevalence of Hepatitis C, Hepatitis B and HIV infection among blood donors at Fatimid Center, Multan., determine whether the laboratory methods to be used for the detection of HBV, HCV and HIV infection and disseminate the findings of the study for the constitution of proper screening programme at blood transfusion centers. This cross-sectional study was designed to know the screening pattern of Hepatitis B, Hepatitis C and human immunodeficiency virus in blood donors at Fatimid Center Multan during the period from November 2001 to December 2001. Hepatitis C, Hepatitis B and HIV infection is commonly transmitted via blood, blood products and unsafe sex from one person to another in the community. 1014 blood donors were screened for Hepatitis B, Hepatitis C and HIV antigen. 79 were found reactive for HBV, 37 reactive for HCV and HIV reactive was found none. The recipients of Hepatitis C and Hepatitis B reactive blood are 20 times more likely to have evidence of post transfusion Hepatitis C and Hepatitis B infection than recipient of Hepatitis C and Hepatitis B non reactive blood. This study was carried out with the objectives to see prevalence of Hepatitis C, Hepatitis B and HIV infection in blood donors, Hepatitis B Hepatitis C and HIV infection association with parentraI therapies, etc. Blood donors record for HBV, HCV and HIV was collected from blood bank of Fatimid Center Multan. Among 79 Hepatitis B reactive blood donors 30 [37.97%] had history of previous blood transfusion, 7 [8.86%] had parentral therapy, 2 [2.53%] had history of drug addiction, 2 [2.53%] had history of sexual contact while 37 Hepatitis C reactive blood donors 5 [13.51%] had history of previous blood transfusion and 20 [54.05%] had history of parentral therapy. None had history drug addiction, 9 [24.32%] had history of sexual contact. Luckily no HIV infection reactive case was found. The results of the present study underline the dire need to have a national comprehensive plan with multidisciplinary approach for HBV, HCV, HIV prevention is the community. It is suggested that blood and blood products should be screened for HCV, HBV, HIV infection before transfusion and use of disposable syringes, other sterilized instruments during hospital stay and use of disposable razors at barbers shop must be kept in mind

Weaning practices in urban and rural areas of Pakistan

Weaning practices varies in different communities and affected by beliefs. Family feeding order, attitudes towards weaning nutrition, geography, economic status, climate etc. Detailed knowledge of above factors is essential to improve the child nutrition. The growth of an infant and a young child is almost totally dependent on the nutrition he is getting. Improper feeding practices and poor nutrition of a young child can lead to ill health and malnutrition. It is essential to explore the knowledge, customs, beliefs and their effects to overcome malnurition and growth retardation. It is also necessary to know about the knowledge, attitude and practices relating to weaning in different communities and factor influencing these. The study is conducted on mothers of children at the age of weaning from both unban and rural origin. Simple random sampling technique is adopted for the study purpose. A questionnaire prepared to evaluate knowledge, beliefs, customs, and dietary habits relating to weaning and effect of economy, demography, literacy etc. on the believes, customs and practices. After collection of data, analysis done to draw conclusions. The study shows that 65% children are weaned at the age of 4 to 6 months in urban population while 50% in rural areas. In both population middle class weaned their children early, education also improved the situation. Weaning before the age of 3 months existed to some extent in both populations. Mixed feeding prevalent in both communities. Trend towards introduction of processed foods is more in both populations, food fads and to boos are also present, but more prevalent in rural areas, due to these high energy and protein foods are usually prohibited for a young child. In urban areas, children of working mothers also affected due to improper look after by the servants and relatives. The study shows that many children in both rural and urban population do not receive the right food to eat in their early childhood. This is resulted in growth retardation, and ill health in most children. This is true more in rural areas as compared to urban areas, but there are no significant differences in both populations, Predisposing factors include low income of the family, illiteracy, delayed weaning, late introduction of high-energy foods, protein and other nutrients for infant growth. In case the weaning foods are introduced to the infant at the right age, their frequency is less than required number of feeds per day

Non-occupational lead exposure and hypertension in Pakistani adults / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Hypertension is one of the most prevalent diseases in the developed and developing countries. Based on the long historical association and the provocative findings of blood pressure effects at low level of lead exposure a study was carried out to determine if an association existed between low blood lead concentration and hypertension. In this study the effects of low-level exposure to lead on blood pressure were examined among 244 adults using atomic absorption spectrometer. For quality assurance purpose certified reference materials i.e., Animal blood A-13, Bovine liver 1577 and cotton cellulose V-9 from IAEA (International Atomic Energy Agency) and NIST (National Institute of Standard Technology) were analyzed under identical experimental conditions. The mean age of hypertensive adults was 52 years (range 43 - 66). The mean values of systolic and diastolic blood pressure were (209+/-11.7) (range 170 - 250) and (117+/-3.9) (range 105 - 140) mmHg respectively. Blood lead concentration ranged from 78 - 201 microg/L with a mean of 139 microg/L and 165 - 497 microg/L with a mean of 255 microg/L in normal and hypertensive adults respectively. Increase in systolic blood pressure was significantly predictive with increase in blood lead levels. Body mass index (BMI) and lipid profile including total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglyceride correlated with blood pressure.