Polyostotic Paget's disease

Paget's disease of bone is a common metabolic bone disease in most of the European countries. The disease has distinct geographical distribution being rare in Asia. We report Paget's disease in a 70 years old Pakistani male who presented with history of pain in right leg with difficulty in walking for the last 5 months. Plain X-ray raised suspicion of Paget's disease of bone. Technetium-99m MDP bone scan showed involvement of multiple bones. Bone biopsy confirmed the diagnosis. This case illustrates that Paget's disease of bone does exist in Pakistan

Single flexible postprandial plasma glucose test as a new screening modality for diabetes mellitus

The study was aimed at assessing the adequacy of single flexible potprandial plasma glucose [FPPPG] test with time of sampling between 30-120 min after breakfast/meal as a screening test for diabetes mellitus and IGT. Cross sectional study. Study was carried out in the Department of Chemical Pathology and Endocrinology at Armed Forces institute of Pathology, Rawalpindi from January to November 1995. Eighty eight consecutive patients referred to AFIP for oral glucose tolerance test were included. The ages of patients ranged from 30-65 y. In the first step, on day 1 oral glucose tolerance test and in the second step, on day 2 flexible time based postprandial plasma glucose [FPPPG] 30-120 min after breakfast/snack/meal were performed. 12 patients did not turn up on day 2 for FPPPG test. In this study we performed FPPPG test on 76 patients as a screening test, with a cutoff point of 7.0 mmol/l. The study revealed that all 22 diabetic patients [100%] had levels above the limit whereas, 15 [83.3%] out of 19 patients of IGT had levels above cutoff level. On the other hand out of 35 healthy subjects only 2 [5.71%] had values above the limit. This study proposes a new screening test [FPPPG] for diabetes mellitus and IGT, which has a sensitivity of [100%], specificity of [66.7%] and positive predictive value of [55%]