Beneficial effects of sitagliptin and metformin in non-diabetic hypertensive and dyslipidemic patients

Obesity, dyslipidemia and hypertension are major risk factors for cardiovascular disease and its associated complications. To evaluate the beneficial effects of sitagliptin and metformin in non-diabetic dyslipidemic and hypertensive patients. A prospective randomized clinical trial was conducted on 70 newly diagnosed dyslipidemic patients with BMI >/= 25 and blood pressure >/= 130/80 at outpatient clinic of medical unit-1 of sheikh medical college /hospital Rahim Yar Khan. They were divided in to three groups each containing 35 patients; First group served as a healthy control while second and third study groups were given tablet sitagliptin 50mg and tab metformin 850mg respectively twice a day for twelve weeks. After three months treatment with sitagliptin and metformin there was significant reduction in body weight [Sitagliptin 6.5% vs Metformin 7.65%] and BMI [Sitagliptin 2.2% vs Metformin 2.8%] with p

Response to standard interferon and ribavirin combination in the treatment of patients with chronic hepatitis C

Background: Chronic hepatitis C is common in our country and before development of decompensation, it is treated with interferon and ribavirin. This is a costly treatment and many patients remain untreated due to financial constraints

Objective: To determine end of treatment response [ETR] to combination of standard interferon and ribavirin [non original brands] provided through Prime Minister program for prevention and control of hepatitis in management in chronic hepatitis C in our setup

Patients and Methods: This interventional study was carried out in medical outpatient clinic of Sheikh Zayed Hospital, Rahim Yar Khan, from August 2006 to February 2009. Adult patients [more than 18 years of age] suffering from HCV RNA positive chronic hepatitis were enrolled. Patients were given standard interferon 3 mu s/c thrice a week and ribavirin 800-1200 mg per day for 24 weeks. Four different brands of drugs were used. HCV RNA by qualitative PCR was tested at the end of treatment. End of treatment response was defined as absence of viral RNA

Results: 260 patients of chronic hepatitis C were enrolled. 148 patients were male and 112 were female. Their mean age was 34.11 +/- 9.18 years. Mean baseline serum ALT of these patients was 91.44 +/- 63.00. 217 patients [83.5%] achieved ETR. There was no statistically significant difference in ETR between various brands of interferon and ribavirin. Moreover, there was no significant difference in gender, age and ALT between patients who achieve ETR and those who did not achieve it

Conclusion: Combination treatment with non original brands standard interferon and ribavirin provided through Prime Minister program for prevention and control of hepatitis is effective in our patients with chronic hepatitis C

Frequency of carotid atherosclerosis in cerebral infarction

To know the frequency of carotid atherosclerosis in ischaemic stroke patients in our population using color Doppler ultrasound. This is an observational study conducted in Medical Unit-II of Jinnah Postgraduate Medical Centre [JPMC], Karachi from Oct 2003 to Feb 2004 in collaboration with Radiology Dept. All the patients admitted during this duration with CT scan proof of stroke were included in the study. Risk factors in all these patients were stratified. Doppler ultrasound was performed on all patients with ischaemic stroke according to the study protocol. A total of 100 patients were included in this study over a period of five months. 66% of these were having cerebral infarction. Hypertension [72%], diabetes [35%], smoking [29%] and obesity [20%] were the common risk factors. The frequency of significant carotid atherosclerosis in acute ischaemic stroke patients was 21%. Carotid atherosclerosis is one of the most important indicators, predictors as well as an independent risk factor in the development of ischaemic stroke

Esophageal varices: major endoscopic finding on upper GI endoscopy

To document the frequency of esophageal varices and their importance in a tertiary care hospital of Southern Punjab. Endoscopy unit of Sheikh Zayed Medical College/Hospital. From Nov 2005 to May 2007. The data of 500 patients who underwent upper GI endoscopy was analyzed. Demographic features, reasons for referral and endoscopic diagnoses were noted. Among 500 patients, 57% were referred due to upper GI bleeding, 9% due to dysphagia, 8% due to persistent vomiting and 7% due to dyspeptic symptoms. Common endoscopic diagnoses were esophageal varices [44%]. Major Endoscopic finding in our study was esophageal varices gastric or duodenal ulcers, congestive gastropathy, obstructive lesions of esophagus and stomach were the next most common observations

Ischaemic stroke; role of Carotid Doppler

To determine the frequency of carotid atherosclerosis in ischemic stroke patients in our population using color Doppler ultrasound. Observational. This study was conducted in Medical Unit II of Jinnah Postgraduate Medical Centre, Karachi from Oct 2002 to Feb 2003. All the patients admitted in our ward during this duration with CT scan proof of stroke were included in the study. Risk factors in all these patients were stratified. Complete history and examination was done and carotid Doppler ultrasound was performed on all patients with ischaemic stroke according to the study protocol. A total of 100 patients were included in this study following the above-mentioned protocol over a period of five months. 66% of these were having cerebral infarction. Hypertension [72%], diabetes [35%], smoking [29%] and obesity [20%] were the common risk factors in these patients. The frequency of significant carotid atherosclerosis in acute ischaemic stroke patients was 21%. Doppler ultrasound is non-invasive, safe and cost-effective modality for evaluation of carotid vessels. In symptomatic and high-risk group, it should be used as first diagnostic modality for management or selecting patients for further investigation

Upper Gl endoscopy - A review of 500 cases at Sheikh Zayed Medical College/Hospital Rahim Yar Khan

To document various endoscopic findings in patients undergoing upper Gl endoscopy in our endoscopy unit. Observational. The data of 500 patients who underwent upper Gl endoscopy in Endoscopy Unit of Sheikh Zayed Medical College/Hospital from November 2005 to May 2007 was analyzed. Demographic features, reasons for referral and endoscopic diagnoses were noted. Among 500 patients, 57% were referred due to upper Gl bleeding, 9% due to dysphagia, 8% due to persistent vomiting and 7% due to dyspeptic symptoms. Common endoscopic diagnoses were esophageal varices [44%], reflux esophagitis [9%], gastritis [4%] and gastric ulcer [4%].The most common presenting complaint was upper Gl bleeding and the most common endoscopic finding was esophageal varices