ABSTRACT
[1] To assess the perception of early initiation of insulin in type 2 diabetic mellitus in family physicians of Karachi. [2] To develop a plan to motivate the family physicians to give preference for insulin in type 2 diabetic patients. Cross sectional study. This study was conducted on Family Physicians of Karachi which was divided in 18 towns from April 2010 to December 2010. 10 family physicians were included from each town from hospitals and clinics through non probability purposive sampling technique. The data was collected through pre tested structured questionnaire have questions regarding their perception and preferences of use of insulin in type 2 diabetic patients as first treatment as compared to oral hypoglycemic therapy. Over all 180 family physicians were contacted out of which 133 were provide full information [response rate was 74%]. Out of these 93[69.1%] were male and 40[30.1%] were female family physicians. Overall perception [63.9%] was not in favor of early initiation of insulin as monotherapy or as combined therapy. The rest [36.1%] who were of the opinion that insulin is better than oral hypoglycemic therapy, non of them were apply it clinically. Majority of the family physicians suggest combination of life style changes with nutritional advice and oral hypoglycemic therapy. No one suggested insulin. Only few were had the knowledge about early insulin initiation as treatment in type 2 diabetics' mellitus. However all of them show their willingness for preferences to use insulin as first therapy in type 2 diabetes mellitus
ABSTRACT
To determine the relationship between type 2 diabetes and central obesity, we investigated the incidence of type 2 diabetes in people visiting the opd of hamdard medical hospital. We also investigated the independent effects of central obesity compared with those of overall obesity. Comparative study. This study was conducted at Hamdard University Hospital between October 2012 to September 2013. The subjects were 174 men and 261 women selected from 469 people who had undergone medical examinations at OPD of hamdard medical college between 2012 till 2013.Participants with central obesity were determined according to the new criteria announced by the IDF[9]. Central obesity in south east population is defined by the IDF as waist circumference >/= 90 cm for men and >/= 90 cm for women. Participants with overall obesity were defined as those with BMI >/= 25.0 kg/m[2]. The results of logistic regression analysis showed that both central obesity and overall obesity were closely related to type 2 diabetes and that the relative risks of occurrence of type 2 diabetes adjusted for age, sex, systolic blood pressure, total cholesterol, and smoking were 2.59 for central obesity and 2.06 for overall obesity. Central obesity maintained its significance when additionally adjusted for overall obesity, but overall obesity lost its significance when additionally adjusted for central obesity. In conclusion, our study suggested that the current cutoff points of waist circumference in the IDF definition for Asian population is useful for assessing the risk of type 2 diabetes and that central obesity may be more useful than overall obesity for evaluating the risk of type 2 diabetes
ABSTRACT
To evaluate the association between orthostatic hypotension and postural dizziness, and determined the factors most likely related to orthostatic hypotension in patients with diabetes. Comparative study. This study was conducted at the Hamdard University Hospital, Karachi between October 2010 and September 2012. The subjects were 102 consecutive non-insulin-dependent patients with diabetes and 204 age- and sex-matched control subjects. Orthostatic hypotension was defined as a decline of 20 mm Hg or more in systolic blood pressure 1 minute after standing. Postural dizziness was any feelings of dizziness, light-headedness, or faintness that occurred while standing during the examination. The prevalence of orthostatic hypotension and postural dizziness in patients with diabetes was higher than in control subjects. Those patients with both diabetes and orthostatic hypotension were older and had higher supine systolic blood pressures and higher plasma glycosylated hemoglobin and fasting glucose levels. They had higher prevalence of postural dizziness, hypertension, and cerebrovascular disease, and lower standing systolic blood pressures than those without orthostaticl hypotension. They also were more often being treated with antihypertensive agents. Only 30.8% of patients with diabetes with orthostatic hypotension suffered from postural dizziness. Postural dizziness, hypertension, cerebrovascular disease, and plasma glycosylated hemoglobin levels were independently associated with orthostaticl hypotension in patients with diabetes. Postural dizziness, glycemic control, hypertension, and cerebrovascular disease were important determinants of orthostatic hypotension in patients with diabetes. Orthostaticl hypotension was associated with postural dizziness, but it cannot be determined clinically just from the presence of postural dizziness because the sensitivity for diagnosis of orthostatic hypotension is low
ABSTRACT
To compare the frequency of hypertension in working and non- working women attending OPD of a Private sector hospital of Karachi. Comparative Cross Sectional Study A comparative cross sectional survey of women visiting medical OPD was conducted in a private sector hospital of Karachi from January 2010 to November 2011. Study was conducted on working and non working women having age 20 years and above coming for treatment in OPD of a Private sector hospital of Karachi from January, 2011 to November 2011. Taking ethical consideration, data was collected by interviewing method. Besides socio-economic data, Blood pressure, weight and height were measured to calculate BMI for defining obesity. BMI more than 30 were considered obese. Data was analyzed by using statistical package SPSS version 16.0. Chi square test was applied to see the significance difference in both the groups at P<0.05. Over all 540 women included in the study, 250[46.3%] were working women and 290 were non-working [53.7%]. Among the working women 88[35.2%] were hypertensive whereas among non working women 173 [59.7%] were hypertensive [p<0.000]. Most of the hypertensive working women were of the age group 40-49 years [44.4%] whereas hypertensive non working women were of age group 30-39 years. Among the working women 38% were obese while in non working women 56% were obese. Our study shows that hypertension and obesity is more common in non working women as compare to working women and its shows that it's not the working which is the risk for developing hypertension rather there are other factors which increases the risk of hypertension and there is need of further studies