RESUMEN
Background: Splenomegaly is usually the result of an underlying disorder; causes ranging from infections to blood cancers. Primary diseases of spleen are uncommon. Etiology of splenomegaly varies according to the geographical areas studied and depends upon the endemic, genetic and hematological diseases in the particular region. Purpose of this study was to find out the causes of splenomegaly in a tertiary care hospital representing almost entire interior of Sindh
Material and methods: This descriptive case series study was carried out at Department of Medicine Liaquat University Hospital Jamshoro from 1[st] March 2007 to 31[st] August 2007, over a period of six months. 100 Male and Female patients older than 13 years of age and admitted in ward with clinically enlarged spleen were selected for this study. Sampling technique was Non Probability convenient sampling. After getting informed consent from patients proforma was filled, elaborating history, important clinical findings and investigations like abdominal ultrasonography, CBC, LFT, HBsAg, Anti HCV etc were performed. Data analysis was carried out by SPSS 16 statistical software
Results: Among 100 patients with splenomegaly there was majority of male patients i.e.60%.The most common cause of splenomegaly found in our study was chronic liver disease i.e. 64% followed by malaria 16%, and hematological malignancies 14%. There were 2% patients found with enlarged spleen due to tuberculosis, remaining 4% comprised 1% each of enteric fever, infective endocarditis, CCF and SLE. Among the patients of hematological malignancies there were 9% patients of leukemia, 4% of lymphoma and 1% of myelofibrosis. As to the 9% leukemic patients, 4% suffered from Chronic Myeloid Leukemia, 3% from Acute Myeloid Leukemia and 2% from Chronic Lymphocytic Leukemia. Most common associated clinical sign was anemia demonstrated in 77% of patients
Conclusions: Chronic liver disease is the most common that leads to splenomegaly in population studied. Malaria and hematological malignancies appear to be the major contributors for splenomegaly. Finding of enlarge spleen needs clinical work up to reach the correct diagnosis
RESUMEN
OBJECTIVE: Type 2 Diabetes mellitus is more common among chronic hepatitis C patients$4Various risk factors that predisposes chronic hepatitis C patients' to develop Type 2 Diabetes, includes age, sex, BMI and positive family history of diabetes mellitus. The objective of present study is to determine the frequency of Type 2 Diabetes mellitus in chronic hepatitis C virus infection and to compare the clinico-demographic features of hepatitis C cases with or without diabetes mellitus
METHODS: This cross sectional study was done in medical wards of Liaquat University Hospital Hyderabad / Jamshoro from August 15, 2010 to February 15, 2011.Hundred consecutive patients of chronic hepatitis C virus infection were enrolled after getting informed consent. Baseline patient's data was collected with the help of a self-administered questionnaire which includes patient's history and physical examination. Patients were especially asked about family history of Diabetes mellitus and their body mass index [BMI] and blood pressure were recorded. Blood samples were drawn after twelve hours of fasting for fasting blood sugar and after two hours of taking meal for post prandial blood sugar. Liver function test, ultrasound abdomen and serological tests for hepatitis such as hepatitis B surface antigen [HBsAg] and anti hepatitis C antibody [antiHCV] were done in every patient. Patients with Type 1 Diabetes mellitus and those having positive results for both HBsAg and anti HCV antibody simultaneously were not included in the study. The data was analyzed by SPSS [statistical package for social science] version 10.0. For statistical data analysis, Chi square test was applied. A p value of 0.05 was considered as statistically significant
RESULTS: Hundred patients of chronic hepatitis C were included in the study. Sixty were males [60%] and forty [40%] were females. The age range of patients was 35-74 years and the mean age was 47.25+/- 11.02 [SD]. Out of hundred patients, twenty seven [27%] had positive family history of diabetes mellitus and twenty eight [28%] had diabetes mellitus themselves. The BMI range of patients was 21-37 kg/m2 and the mean BMI was 26.03kg/m2 +/- 4.30 [SD]. Correlation of age [p = 0.001], BMI [p = 0.009] and family history of diabetes mellitus[p = 0.001] with the frequency of type 2 Diabetes mellitus in HCV +ve patients was statistically significant while comparison of gender with T2DM in HCV patient was not statistically significant [p = 0.413]
CONCLUSION: Type 2 Diabetes mellitus is more common among patients with chronic hepatitis C than those without hepatitis C. Increasing age, positive family history of diabetes mellitus and raised BMI are the risk factors for its development