C - reactive protein; in patients with acute appendicitis

Acute appendicitis is the most common abdominal surgical emergency despite advances in radiographic imaging and diagnostic laboratory investigations; the diagnosis of acute appendicitis remains challenge. To evaluate the C-reactive protein in patients with acute appendicitis. This cross sectional descriptive study of six months study was conducted at Liaquat University Hospital Hyderabad. All the patients with acute appendicitis were admitted in the ward and were further evaluated for C-reactive protein. The data was analyzed in SPSS 16 and the frequency and percentage was calculated. One hundred subjects with acute appendicitis were recruited and studies. The mean age +/-SD of the patients was 27.83 +/-07.52 in overall population while it was 29.73 +/-06.64 and 25.84 +/- 04.92 in male and female subjects with acute appendicitis. The CRP was raised in 60% patients. The distribution of age in relation to gender and CRP was statisitically significant [p= 0.01 and <0.01] whereas the CRP was also observed as statistically significant in context to gender and histopathology [p= 0.02 and 0.03] respectively. The mean +/- SD of CRP was 7.53 +/-1.52 in overall population while it was 6.84 +/- 1.64 and 8.65 +/-1.53 in male and female patients with raised CRP. The CRP was elevated in patients with acute appendicitis

Hypoglycemia; patients with liver cirrhosis

To determine the frequency and severity of hypoglycemia in patients with liver cirrhosis. Cross sectional case series study. Six months. Liaquat University Hospital Hyderabad. All the patients of liver cirrhosis, of >12 years of age and of either gender were evaluated for hypoglycemia by assessing the glycemic status through random or fasting blood glucose level. The severity of liver cirrhosis was identified according to the Child-Pugh classification whereas the severity of hypoglycemia was grouped in mild, moderate and severe categories. The data was entered and saved in SPSS and frequency and percentage was calculated for hypoglycemia in patients with liver cirrhosis. The stratification was done for age, gender, hypoglycemia and severity of the disease and hypoglycemia. The chi-square test was applied between categorical variables at 95% confidence interval and p -value

Metabolic syndrome; gamma glutamyltransferase in patients

To determine the role of gamma glutamyltransferase as a biochemical marker for the diagnosis of metabolic syndrome. Cross sectional descriptive study. One year. Department of Medicine, Liaquat University Hospital Hyderabad / Jamshoro. All the patients with metabolic syndrome visited at OPD / admitted in the ward were further evaluated for serum gamma-glutamyltransferase level. The data was analyzed in SPSS 16 and the frequency and percentage was calculated. During one year study period, total one hundred patients [23 males and 77 were females] with metabolic syndrome were recruited and study for gamma glutamyl transferase level. The mean age +/-SD for overall population was 56.84+/-6.52 whereas it was 48.92+/-5.82 and 58.61+/-7.73 in male and female population respectively. The mean +/- SD of systolic and diastolic blood pressure [mmHg], triglycerides [mg/dl], high density lipoprotein pressure [mg/dl] and fasting blood sugar [mg/dl] in overall population was 161.20 +/- 16.74 and 95.60 +/- 8.34, 176.38 +/- 11.93, 29.44 +/- 2.90 and 108.42+/- 6.25. The mean gamma glutamyl transferase level in overall population was 86.75+/-7.74 while it was 84.83+/-5.32 and 89.52+/-6.84 in male and female population respectively. The gamma-glutamyltransferase was raised in 75 patients of which 13 were males and 62 were females [p=0.02] and majority of patients were 50-59 year age group [p <0.01]. It is concluded that GGT is a good diagnostic tool in metabolic syndrome with statistical significant results

Liver cirrhosis; frequency and severity of hyponatremia in patients

Liver cirrhosis results from prolonged, widespread but patchy hepato-cellular necrosis due to various reasons. To determine the frequency and severity of hyponatremia in patients with liver cirrhosis. Descriptive case series study. Six months. Liaquat University Hospital Hyderabad. The cirrhotic subjects were assessed for hyponatremia and its severity. The data was analyzed in SPSS 16 and the frequency and percentage was calculated for hyponatremia and statistically p -value

Liver cirrhosis; frequency and severity of thrombocytopenia in patients

To determine the frequency and severity of thrombocytopenia in patients with liver cirrhosis. Cross sectional study. 01-03-2013 to 31-08- 2013. Liaquat University Hospital, Hyderabad. The cirrhotic patients were assessed for thrombocytopenia and its severity. The data was analyzed in SPSS version 11.00 and frequency and percentage was computed. The chi-square test was applied and p -value

C-reactive protein [CRP]; in patients with metabolic syndrome

To determine the frequency of raised C-reactive protein [CRP] in patients with metabolic syndrome. This cross sectional descriptive study of six months study was conducted at Liaquat University Hospital Hyderabad. All the patients of 20 to 60 years of age, of either gender presented with symptoms of metabolic syndrome for more than 01 year duration were admitted and evaluated for C-reactive protein. The data was analyzed in SPSS 16 and the frequency and percentage was calculated. Total one hundred patients [59 females and 41 males] with metabolic syndrome were evaluated for C-reactive protein. The mean waist circumference for males and female patients with raised CRP was 48.93 +/- 2.33 and 48.42 +/- 3.41 while the mean +/- SD of serum triglycerides level for male and female with raised CRP was 192.41 +/- 3.21 and 196.31 +/- 3.43 respectively. The mean +/- SD of serum HDL-C level for male and female with raised CRP was 28.32 +/- 1.22 and 25.31 +/- 1.42. The mean +/- SD of systolic and diastolic pressure for males and female patients with raised CRP was 150 +/- 3.42 and 100.51 +/- 4.42. The mean +/- SD of serum fasting blood sugar for male and female patients with raised CRP was 131.52 +/- 3.33 and 143.42 +/- 7.42 respectively. The mean +/- SD of CRP for male and female patients with raised CRP was 4.42 +/- 1.21 and 5.8 +/- 2.52. In relation to gender distribution, the majority of subjects from 40-49 years of age group with female predominance [p = 0.01] while the CRP was raised in 67% patients in relation to age [p=0.05] and gender [p=0.04] respectively. Out of 67 subjects with raised CRP 44 were females and 23 were males

ST elevation myocardial infarction; hyponatremia and its prognostic importance

To evaluate the frequency of hyponatremia and its prognostic importance in ST elevation myocardial infarction. Six months. Case series. Tertiary care hospital Hyderabad. All the cases with ST elevation myocardial infarction admitted in the CCU were recruited and evaluate for serum sodium level at admission and then at 24, 48 and 72 hours. The data was analyzed in SPSS 16 and the frequency and percentage was calculated. One hundred patients with acute myocardial infarction were recruited and assessed for sodium level. The mean age +/- SD of whole population was 57.52 +/- 9.51 whereas in male and female population it was 58.72 +/- 7.53 and 53.84 +/- 7.93 respectively. The sodium level was 130.21 +/- 3.42 and 127.41 +/- 4.21 in male and female population. The p-value was statistically significant [<0.01] in context to age and sex whereas the age in context to hyponatremia is non significant [p=0.77]. The hyponatremia and its severity was statistically significant in context to sex [p=0.04] and duration of the myocardial infarction [p=0.03]. The serum sodium level in context to duration of MI was also significant [p=0.03] whereas the mortality at the end of 30 days was 11% of which 02 patients had normal sodium level while the 09 had low sodium level [hyponatremia]. Hyponatremia in patients with acute STEMI is a important predictor of thirty days mortality

Vivax malaria; frequency, severity of thrombocytopenia and variation in red cell distribution width [RDW]

To determine the frequency and severity of thrombocytopenia and to evaluate the variation of red cell distribution width [RDW] in patients with acute vivax malaria. Cross sectional descriptive case series study. Six months. Liaquat University Hospital. All the patients with acute vivax malaria were evaluated for thrombocytopenia its severity and RDW. The data was analyzed in SPSS 10 and the frequency and percentage was calculated. Total 126 patients with acute vivax malaria were recruited, of which 88 were males and 38 were females. The mean age +/- SD for male and female subjects was 44.76 +/- 6.83 and 40.83 +/- 7.42. The common features observed were fever 31%, rigor 15% and combined features 14% [p=0.05]. The thrombocytopenia was identified in 86 patients of which 65 were males and 21 were females [p=0.04]. The increased RDW was observed in 75 patients of which 57 were males and 18 were females [p=0.05]. The bleeding was detected in 56 and dyspnea and heart failure was found in 30 thrombocytopenic subjects [p=0.02]. Regarding outcome 82 subjects were recovered while the 04 patients were expired [p=0.05]. Regarding severity of thrombocytopenia majority 48.8% were in moderate category with male predominance [p=0.02]. The thrombocytopenia and increased RDW was observed in patients with acute vivax malaria

Pulmonary tuberculosis; cardiac manifestations

To determine the cardiac manifestations in patients with pulmonary tuberculosis. Case series study. Jan 2014 to June 2014. Liaquat University Hospital Hyderabad. All the patients presented with shortness of breath, cough with sputum, fever, haemoptysis, anorexia and weight loss were recruited and then the subjects with early morning sputum positive for acid fast bacilli and radiological lesions suggestive of pulmonary tuberculosis, of ?20 years of age and either gender were enrolled and entered in the study. The data was analyzed in SPSS 16 and the frequency and percentage was calculated. Total one hundred patients with pulmonary tuberculosis were evaluated for cardiac manifestation during six months study period. The mean +/- SD for age of patients with pulmonary tuberculosis was 45.21 +/- 8.95. The mean age +/- SD of patient with cardiac manifestations was 48.95 +/- 5.53. The majority of the subjects were in 30-49 years age group with male predominance [p<0.01]. The electrocardiographic findings were observed in 72/100 [72%] patients whereas echocardiographic changes were observed in 50/72 [69.4%] patients with pulmonary tuberculosis. The common ECG findings identified were tachycardia 30.5%, P-pulmonale 12.5% and PR prolonged in 9.7% patients with tuberculosis whereas the common echocardiographic findings noticed were pericardial effusion 42% and multiple abnormalities in 24% subjects with tuberculosis. The sinus tachycardia, cor-pulmonale and low voltage QRS complexes were predominant abnormalities on electrocardiograph whereas pericardial effusion was the common abnormality on echocardiography in patients with pulmonary tuberculosis

Essential hypertension; hyperuricemia in patients

Objectives: to determine the frequency of hyperuricemia in patients with essential hypertension

Study Design: cross sectional descriptive

Period: six months study

Setting: liaquat University Hospital Hyderabad

Patients and Methods: all the patients with essential hypertension visited at cardiac OPD / admitted in the ward were further evaluated for serum uric acid level. The data was analyzed in SPSS 16 and the frequency and percentage was calculated

Results: during six months study period, total one hundred and eighty [180] patients with essential hypertension were recruited and study for uric acid level. The mean age +/- SD for overall population was 52.84 +/- 8.72 whereas it was 55.83 +/- 7.93 and 50.75 +/- 8.95 in male and female population respectively. The mean +/- SD of systolic and diastolic blood pressure [mmHg] in overall population was 160.50 +/- 12.74 and 100.70 +/- 5.95 respectively. The mean +/- SD serum uric acid level in overall population was 13.74 +/- 4.83 while it was 11.74 +/- 6.44 and 14.43 +/- 4.31 in male and female population respectively]. The male population was predominant in relation to age [p=0.02], the hyperuricemia was identified in 117/180 [65%] patients and it is statistically significant in context to age [p<0.01] and gender [p<0.05] whereas mean +/- SD of systolic and diastolic blood pressure was also significant in relation to hyperuricemia

Conclusion: there is a relationship between hyperuricemia and hypertension and shown that the serum uric acid level was significantly increased in patients with essential hypertension

Metabolic syndrome; serum ferritin level in patients

To determine the frequency of raised serum ferritin level in patients with metabolic syndrome. Case series study. Liaquat University Hospital Hyderabad. All the patients with metabolic syndrome for >/= 01 year duration, >/=20 years of age and of either sex were recruited and entered in the study. The metabolic syndrome was detected according to the NCEP-ATP III protocol. After confirmation of metabolic syndrome, the 2cc venous blood sample was taken in a sterilize 5cc disposable syringe, labeled it and sent to laboratory for evaluation of serum ferritin levels. The data was analyzed in SPSS 16 and the frequency and percentage was calculated. Total one hundred patients with metabolic syndrome were evaluated for serum ferritin level during the study period. The mean +/- SD for age of patients with metabolic syndrome was 52.73 +/- 7.83 while the mean age +/- SD of patient with raised ferritin level was 50.23 +/- 8.21. The majority patients were 30-49 age group with female predominance [p<0.01] and exist four component of metabolic syndrome. The ferritin was raised in 60 patients with female predominance [p<0.04]. The mean +/- SD of raised ferritin level in male and female population was 350.10 +/- 19.38 and 270.34 +/- 34.39 [p<0.01]. The raised serum ferritin level was identified [60%] with female predominance in patients of metabolic syndrome

Dyslipidemia; Helicobacter pylori infected patients

To determine the frequency of dyslipidemia in Helicobacter pylori infected patients. This cross sectional descriptive study of six months study was conducted at Liaquat University Hospital Hyderabad from 01-03-2012 to 31-08- 2012. All the patients between 19 to 60 years of age present with symptoms of dyspepsia, bloating or epigastric discomfort for more than 01 week duration were admitted and evaluated for Helicobacter pylori infection. Thereafter the positive cases [Helicobacter pylori infected patients] were further evaluated for dyslipidemia. During six month study period, total 144 patients [95 males and 49 females] with Helicobacter pylori infection were evaluated for dyslipidemia [lipid profile]. Majority of patients were from urban areas 110/144 [76%]. The mean +/- SD for age of patients with Helicobacter pylori infection was 35.94 +/- 10.77. The mean age +/- SD of dyslipidemic patient was 32.62 +/- 6.52. The dyslipidemia was identified in 87 [60.4%] patients, of which 51[58.6%] were males and 36[41.4%] were females. Regarding the pattern of dyslipidemia, ten [11.4%] patients had raised serum triglycerides level, twenty eight [32%] had raised LDL-C level, twenty six [28.9%] had raised serum cholesterol level, seven [8.7%] had low HDL-C level and sixteen [18.3%] had mixed dyslipidemia. The mean +/- SD of hypertriglyceridemia, [Upwards Arrow] HDL-C, [Upwards Arrow] LDL-C and hypercholesterolemia in dyslipidemic Helicobacter pylori infected was 280.72 +/- 22.85, 24.21 +/- 2.63, 180.63 +/- 12.98 and 285.21 +/- 23.63 respectively. The H. pylori infected patients are prone to acquire dyslipidemia, therefore the present study observed 60.4% prevalence of dyslipidemia with male predominance [58.6%]

Serum iron level; patients with Helicobacter pylori infection

To determine the serum iron level in Helicobacter pylori infected patients. This cross sectional descriptive study was conducted at Liaquat University Hospital [a tertiary care teaching hospital] Hyderabad from July 2013 to December 2013. All the patients with history of presented with acute abdominal pain, dyspepsia, bloating and epigastric discomfort were evaluated for Helicobacter pylori infection by serology. Thereafter the Helicobacter pylori positive individuals were further evaluated for serum iron level. The data was collected, saved and analyzed in SPSS version 11.00. During six month study period total one hundred patients of H. pylori infection was recruited, of which sixty three [63%] were males and thirty seven were females. Sixty six [66%] patients belonged to urban areas while thirty four [34%] were rural population. The mean age +/- SD for overall population was 37.35 +/- 14.0 where as the mean age +/- SD of male and female population was 38.88 +/- 6.77 and 35.67 +/- 8.87 respectively. The serum iron was low in 68% Helicobacter pylori infected patients, of which 48 were males and 20 were females [p=0.02]. The overall mean +/- SD for serum iron level in study population was 49.17 +/- 37.86 mmol/L whereas the mean +/- SD of serum iron for male and female Helicobacter pylori infected population was 42.69 +/- 34.15 and 60.18 +/- 41.66 [p=0.03]. An association was identified between Helicobacter pylori and iron deficiency

Acute myocardial infarction; hypomagnesemia in patients

This descriptive case series study evaluates the frequency of hypomagnesemia in patients with acute myocardial infarction. This multidisciplinary conducted at Liaquat University Hospital Hyderabad and a private hospital Hyderabad from May 2010 to October 2010. All patients diagnosed as acute myocardial infarction were further evaluated for type of myocardial infarction and serum magnesium level. Out of 100 diabetic patients, 77 were males and 23 patients were females. The mean age and standard deviation of patients of male and female was 54.78 +/- 8.82 [SD] and 53.64 +/- 10.82 [SD], respectively. The mean +/- SD for serum magnesium in overall subjects was 1.24 +/- 0.48. Regarding the type of AMI inferior wall in 22 [29%], lateral wall in 17 [22%], anteroseptal in 12 [16%], anterolateral -V1 in 07[09%], right ventricular in 10 [13%] and posterior wall in 07 [09%]. The mean duration of acute MI in male and female population was 8.71 +/- 6.73 hours and 17.70 +/- 14.57 hours [p<0.01] where as the mean duration of acute MI in hypomagnesemic and normomagnesemic patient was 5.16 +/- 2.49 hours and 26.60 +/- 8.27 [p = 0.02] respectively. The mean serum magnesium level in male as well as female population was 1.32 +/- 0.21 mg/dl and 1.46 +/- 0.53 mg/dl p = 0.05, respectively. Regarding the hypomagnesemia in male and female population was 34[75.6%] and 16[53.3%] p=0.04, respectively. The hypomagnesemia was more predominant in inferior 18[36.0%] and lateral 16 [32.0%] wall MI. The hypomagnesemia was observed in patients with acute myocardial infarction with statistical significance

Type 2 diabetes mellitus; C-reactive protein in patients

To determine the frequency of raised C-reactive protein [CRP] in patients with type 2 diabetes mellitus. This cross sectional descriptive study of six months study was conducted at Liaquat University Hospital Hyderabad from March 2013 to August 2013. All diabetic patients of >/=35 years age of either gender for >01 year duration visited at OPD were evaluated for C-reactive protein and their glycemic status by hemoglobin A1c. The data was analyzed in SPSS and the frequency and percentage was calculated. During six month study period, total 100 diabetic patients were evaluated for C-reactive protein. Majority of patients were from urban areas 75/100 [75%]. The mean +/-SD for age of patients with diabetes mellitus was 51.63+/-7.82. The mean age +/-SD of patient with raised CRP was 53+/-7.21. The mean +/-SD for HbA1c in patients with raised CRP is 9.55+/-1.73. The mean random blood sugar level in patients with raised CRP was 247.42 +/- 6.62. The majority of subjects from 50-69 years of age group with female predominance [p = 0.01] while the CRP was raised in 70[70%] patients in relation to age [p=0.02] and gender [p=0.01] respectively. Both HbA1c and CRP was raised in 64.9% [p = 0.04] in patients with type 2 diabetes mellitus. The mean +/-SD of CRP was 5.8+/-1.21 while for male and female individuals with raised CRP was 3.52+/-1.22 and 5.7+/-1.63 respectively. The raised CRP was observed in patients with type 2 diabetes mellitus

Hemorrhagic stroke; frequency of hypertension, diabetes and smoking in patients

To identify the frequency of risk factors in hemorrhagic stroke at Liaquat university of medical and health sciences. This Descriptive case series study of six months was carried out in the department of medicine, Liaquat University of Medical and Health Sciences. Patients aged 20-70 years of age with hemorrhagic stroke on CT were enrolled in the study after taking consent from caretaker of patients. Detailed history focusing on hypertension, diabetes and smoking and their duration was taken. Blood pressure was recorded and fundoscopy was done to find out diabetic or hypertensive retinopathy. Thorough neurological examination and fasting / random blood glucose level was evaluated while the data was done was analyzed using SPSS version 16. A total of 100 patients were included in the study during study period. 61% of patients were in > 50 years of age group with mean age of 53.4+/-11 years. A total of 66 [66%] were male; with male to female ratio was 2:1. Hypertension was present in 63% of cases, Diabetes was found in 24% cases and 44 patients were cigarette smokers. It was concluded that high blood pressure, diabetes mellitus and smoking are associated with hemorrhagic stroke

Hepatocellular carcinoma; different child-pugh classes based on alpha-fetoprotein level

To determine the frequency of hepatocellular carcinoma in different Child-Pugh classes based on Alfa fetoprotein level. Case series study. Six months. Medical Unit-I of Liaquat University Hospital, Hyderabad Sindh Pakistan. A total of 100 patients admitted [inpatients] in Medical Unit I with the diagnosis of cirrhosis were enrolled in the study. Patients with cirrhosis of liver [more than six month duration] of either gender were included. If patients had metastatic lesion of the liver, liver abscess, or acute liver failure then they were excluded. Child-Pugh score was calculated which included ascites, encephalopathy, prothrombin time, albumin and serum bilirubin. The levels of alpha-fetoprotein were measured and HCC was diagnosed. The primary outcome variable was presence of HCC in cirrhotic patients. The proportion of males [53%] was higher as compared to females [47%]. The mean age of the study patients was 40.47 years with a standard deviation of 11.5. At the beginning patients were categorized according to Child Pugh Classes [A= up to 6, B=7-9 and C=10-11], age groups [15-30 years, 31-50 years and 51- 70 years respectively]. The mean Child Pugh score was 6.83 with +/- 1.8 S.D. The majority of the cases of HCC [75.61%] occurred in the Child Class A, whereas 21.95% occurred in Child Class B and finally only one case of HCC [2.44%] was present in Child Class C. This study comprehensively demonstrated that hepatocellular carcinoma [HCC] is far more common in compensated cirrhosis [Child Pugh Class A] vs. decompensated cirrhosis [Child Pugh Class B and C]

Helicobacter pylori infection C-reactive protein in patients

To determine the frequency of raised C-reactive protein in patients with Helicobacter pylori infection. Design: Cross sectional descriptive study. Setting: Department of Medicine at Liaquat University Hospital [tertiary care teaching hospitals]. April 2012 to September 2012. All patients above 12 years of age, of either gender with history of nausea, vomiting, recurrent abdominal pain, dyspepsia or abdominal discomfort, heartburn, bloating and halitosis through casualty outdoor department [COD] or admitted in medical unit were evaluated and enrolled in the study. For the detection of Helicobacter pylori the 3 cc venous blood sample of relevant'patients was taken in a disposable syringe. After detecting the H. pylori infection, the H. pylori individuals were further evaluated for serum C-reactive protein by taking 3cc venous blood sample in a disposable syringe and sent to laboratory for analysis. The patients with raised CRP were also evaluated for their lipid profile to detect dyslipidemia. The data was collected on predesigned proforma and then entered, saved and analyzed in SPSS version 10.00. During six month study period total 92 patients with Helicobacter pylori infection were recruited and studied for serum C-reactive protein. The mean age +/- SD for overall population was 43.22 +/- 8.31, whereas the mean age +/- SD for male and female population was 41.24 +/- 7.94 and 44.76 +/- 9.42 respectively. The raised CRP was detected in 61[66%] patients [p=0.02]. The mean value +/- SD of raised CRP in male and female population was 6.30 +/- 2.86 and 7.82 +/- 3.21 respectively. Of 61 [66%] patients with raised CRP the dyslipidemia was identified in 45[74%] patients [p=0.03]. Out of 45, the raised triglycerides was observed in 08[18%] patients, low HDL in 10[22%] patients, raised LDL in 13[29%], raised cholesterol in 07[16%] whereas 07[16%] patients had mix dyslipidemia. The raised CRP was identified in patients with Helicobacter pylori infection, the dyslipidemia was observed in raised CRP population

Uterine rupture; its maternal consequenses

To evaluate frequency, maternal morbidity and mortality in patients with uterine rupture at Gynae Unit -II of civil Hospital Hyderabad. Prospective descriptive study. Department of Obstetrics and Gynecology, unit-ll Liaquat University Hospital Hyderabad Sindh Pakistan; from 1st October 2010 to 31st March 2011. All the patients diagnosed as case of uterine rupture was taken as study subject. Data was collected in a pre-designed porforma. Variable analyzed were frequency, demographic characters, maternal morbidity and mortality. During the study, 34 patients out of 1400 deliveries presented with uterine rupture resulting in a frequency of 2.42%or 1:41 deliveries. 64.7%[22] patients were between 26 to 35 years age and 67.64%[23] were multipara.26.47%[9] presented with extension of tears, 17.6%[6] with shock,20.5%[7] with septicemia and 20.5%[7] with wound infection. Uterine rupture is yet a common obstetrical emergency in our area. The significant morbidity and mortality deserves our special attention by a collaborative approach. Regular ante natal checkups, careful selection of patients for vaginal delivery, vigilantly monitoring during labor with smooth switch over to operative delivery can reduce this drastic obstetrical complication