Gestational diabetes; sensitivity, specificity and diagnostic accuracy of glucose challenge test in diagnosis

To find sensitivity specificity and diagnostic accuracy of Glucose Challenge test in diagnosing Gestational Diabetes in Pregnant women. Due to poor socioeconomical and educational status, dietary habits and ignorance regarding pregnancy related problems probably increase the prevalence and burden of gestational diabetes mellitus [GDM] and its complications in pregnancy. Best and simple strategy to identify women with gestational diabetes is still lacking and unclear. Cross sectional study. This study was performed at Jinnah Hospital Lahore, from Nov 2005 to Dec 2006. A glucose challenge test [GCT] was performed on 500 selected pregnant women by giving 50-g glucose in water orally. A serum glucose level ?140 mg/dl after an hour was taken as positive test. To confirm GDM, 75 g glucose in 200 ml of water was given and sugar levels after 2 hrs by Glucometer, >200 mg/dl confirmed GDM. An increasing trend in age, gestational age and BMI and a significant difference regarding positive family history of diabetes and gravidity was seen in patients with GDM compared to normal pregnant. The maximum percentage of GDM 2 was noted in multigravida, between 25-29 years, BMI >28kg/m, and a gestational age of 28 weeks. The sensitivity of GCT was 80%, specificity 97.8%., and diagnostic accuracy was 96.4%. Screening is necessary to identify women with GDM. A 50-g glucose challenge test might be acceptable as a screening test for GDM as it has high sensitivity, specificity and diagnostic accuracy

Hypoglycemic and anti-platelet aggregatory effect of acacia modesta leaves extract on alloxan induced diabetic rats

Objectives: To compare the hypoglycemic and anti-platelet aggregation effect of Acacia modesta leaves extract and Glibenclamide on alloxan induced diabetic rats

Study Design: Experimental study

Place And Duration: This Experimental study was performed at Shifa College of Medicine and National Institute of Health [NIH], Islamabad

Methodology: Diabetes mellitus was induced in 90 out of 120 male albino rats by intraperitoneal injection of 110 mg/kg bw of alloxan and was confirmed by measuring fasting blood glucose level >200 mg/dl on 4th post-induction day. The rats were equally divided into four groups, A [normal control], B [diabetic control], C [diabetic rats treated with glibenclamide], and group D [diabetic rats treated with plant extract]. Rats of group C and D were treated with single dose of 900 micro.g/kg b.w of glibenclamide and 400 mg/kg b.w of Acacia modesta leaves extract respectively for three weeks. Blood Glucose levels were measured by glucometer, Platelet aggregation by Dia-Med and serum beta-thromboglobulin by ELIZA technique

Results: The results showed significant hypoglycemic [p<0.01] and anti-platelet aggregatory [p<0.01] effect of glybenclamide and Acacia modesta leaves extract on diabetic control rats. Within the treatment groups, the fasting blood glucose, and serum beta-thromboglobulin levels were nearly equally significant [p<0.05] in diabetic rats treated with glibenclamide and plant extract

Conclusion: Acacia modesta leaves extract has a nearly equally significant hypoglycemic and anti-platelet aggregation effect on diabetic rats as that of glybenclamide

Emergency contraception: knowledge, attitude and practices among doctors of a tertiary care hospital

In Pakistan maternal mortality rate [MMR] is very high and more than one in five women die from pregnancy related causes; solution to this is to have low fertility rate. The emergency contraceptives [ECs] can be used to prevent unwanted pregnancies. The aim of this study was to assess the knowledge, attitude and practice about ECs among doctors. Institution-based crosssectional descriptive study on knowledge, attitude and practice of ECs was conducted at Rawal Hospital from Feb to May, 2012. Data was collected using structured questionnaire and analysed using SPSS-16. Fifty-seven percent of the respondents were >30 years of age, 94% were Muslim, 81% were married and 51% were women. Ninety-seven percent had heard of ECs before, only 17% knew Intra-uterine contraceptive device [IUCD] a method of EC. Sixty-one percent responded that IUCD should be removed if patient gets pregnant [p=0.007] and according to 31% ECs were not abortifacient [p=0.045]. Regarding attitude, 55.5% of the participants supported its use [p=0.027] and agreed to its easy accessibility [p=0.004]. Thirty-eight percent responded an increased dose of birth control pills as a form of EC [p=0.008], while 40% did not agree that ECs are effective when taken before intercourse [p=0.011]. Knowledge and practice of ECs is very low among doctors but a positive attitude is there. Evidence-based knowledge to family physicians regarding emergency contraception is strongly recommended to reduce the chances of MMR

Attitude of Pakistani doctors towards euthanasia and assisted suicide

To determine the attitude of junior and senior Pakistani physicians towards euthanasia and assisted suicide. A descriptive study. The study was carried out at Shifa International Hospital Islamabad in 2006 [January to November]. Shifa International Hospital Islamabad is a 500 bed tertiary care hospital with 400 resident staff and 140 specialists. An anonymous enclosed questionnaire on the respondent's opinion of euthanasia / assisted suicide was distributed to the doctors who were requested to rate according to degree of agreement, willingness to participate in these practices, and safeguard or restrictions needed if the practices were legalized. The total response rate was 66% and male to female ratio was 7:1. Most of the respondents were Muslims and had familiarity with the subject. Seventy seven percent believe that the practice of euthanasia and assisted suicide was not ethically justified, while 9% were in its favor. Pakistani doctors oppose euthanasia and assisted suicide

C-reactive protein and acute coronary syndrome: Comparison of conservative and interventional management

Inflammation plays a key rote in the initiation and progression of atherosclerosis, the most common cause of acute coronary syndrome. C-reactive protein [CRP] that enhances plaque inflammation is synthesized six hours after myocardial infarction. High sensitivity C-reactive protein was measured by Immunoturbiditory method in 50 healthy controls and 100 patients of acute coronary syndrome on conservative or interventional management. Serum C-reactive protein levels [mg/L +/- SEM] at the time of admission were significantly raised in patients of acute coronary syndrome [11.90 +/- 2.30] as compared to controls [2.30 +/- 0.18] and further increased progressively during 24 hours of follow up period. C-reactive protein levels also increased significantly in patients who underwent interventional management [115.90 +/- 7.73] as compared to those who were on conservative management [22.28 +/- 5.54]. Serum C-reactive protein levels were found to be significantly raised in patients with acute coronary syndrome as compared to controls. In addition, patients undergoing interventional management had higher C-reactive protein levels, post intervention, as compared to those on conservative management