RESUMEN
OBJECTIVE: To determine the frequency and risk factors of obesity and hypertension in female medical students
STUDY DESIGN: Descriptive cross sectional study
SETTING: Department of Medicine, Sir Syed College of Medical Sciences and Hospital Karachi
STUDY DURATION: 3 months [March 2014 to June 2014]
MATERIAL AND METHODS: Total 307 female medical students were included after ethical approval
Students with systemic illness, diabetes mellitus and taking corticosteroids were excluded
Demographic details obtained, followed by anthropometric measurements; height, weight, waist circumference and body mass index [BMI]. Students were classified as underweight, at risk, overweight, obesity grade I and obesity grade II as per WHO criteria for Asians. Blood pressure of each student was measured at two occasions. Outdoor activity time, screen time, sedentary time, dietary preferences, sleep hours and family history documented. Data analyzed via SPSS version 17 with significant p-value < 0.05
RESULTS: Among 307 students, obesity was found in 34% [25.4%obesity grade I and 8.8% obesity gradeII]. Hypertension was found in 4.88 %. There was significant association between hypertension and obesity [12 % obese hypertensiveversus 1.9 % non obese hypertensive students]
35 % students had higher waist circumference that was associated with hypertension. Excessive use of soft drinks, diet drinks, meat, dairy products, chocolates, oversleep on weekends and daily screen time >2 hours were found to be associated with obesity
CONCLUSION: Higher prevalence of obesity and obesity related hypertension in younger age group needs to be addressed. Those with obesity should be screened for the presence of hypertension at younger age. Waist circumference should be considered in addition to BMI while screening for obesity, and evaluation of its risk factors in Asians.Creating awareness and timely intervention in terms of dietary modification, adequate physical activity and sleep hours thus reducingthe screen time and sedentary time may help in controlling obesity and its complications among our young generation. Weight loss must be the first line of therapy in obesity related hypertension among younger obese population
RESUMEN
OBJECTIVE: To see the frequency of newly diagnosed Hepatitis-B and Hepatitis-C cases during pre-operative surgical assessment of patients from lower socioeconomic class and to study the possible risk factors
STUDY DESIGN: Descriptive Cross Sectional study
SETTING: Department of Surgery, Sir Syed College of Medical Sciences and Hospital, Karachi
STUDY DURATION: From July 2012 to July2013
MATERIAL AND METHODS: Total 107 patients [>18 years] of both genders from lower socioeconomic class planned for elective surgical procedure were included after ethical approval. Previously diagnosed cases of Hepatitis-B and C were excluded. After history and clinical examination, Hepatitis-B and Hepatitis-C serology was performed [ELIZA technique]. History of blood transfusion, previous dental or surgical procedures, intravenous injections, intravenous drug abuse, tattooing, piercing, circumcision, shaving by barbers, unprotected sex and Hepatitis-B vaccination status obtained. Data was analyzed by SPSS version 17
RESULTS: Among 107 cases [42% males and 58% females] with mean age 39+14 years, Hepatitis-B infection was present in 6[6%] cases, Hepatitis-C in 11[10%] and Hepatitis-B and C serology was negative in 90 [84%] cases. Frequency of Hepatitis-B was 3% [in males] versus 9% [in females]; Hepatitis-C 6.4% [in males] versus 15.5% [in females]. Among those with Hepatitis-B or C, history of previous surgical procedure present in 47% cases [vs. 21% in Hepatitis-B and C negative cases], dental procedure in 29.4% [vs. 7.7 %], intravenous injections in 94% [vs. 43%], intravenous drug abuse in 5.8% [vs. 0 %], blood transfusion in 35% [vs. 12%], tattooing in 0% [vs. 2%], unprotected sex in 5.8% [vs. 1%], piercing in 64.7% [vs. 39%], circumcision by barbers in 83.3%of males [vs. 80%], shaving by barbers in 66.6% of males [vs. 27%]. Hepatitis-B and C was found to be associated with history of blood transfusion, intravenous injections, dental procedures, shaving by barbers, piercing and intravenous drug abuse [p< 0.05]. Clinical stigmata of liver disease were present in 3% cases. Among all cases 9% were previously vaccinated for Hepatitis-B
CONCLUSION: Preoperative determination of Hepatitis viral markers is a good clinical practice to limit transmission from asymptomatic carriers and to diagnose new cases. Pakistan has high prevalence of Hepatitis-B and C and poverty and low literacy rate are the main determinants of its spread. Those who are negative for Hepatitis-B should be encouraged to get vaccinated
There is need for measures to create awareness about preventive measures and affective control of transmission of Hepatitis-B and C in community as well as at health care facilities
RESUMEN
To assess the association of Diabetic Retinopathy [DR] with type and duration of Diabetes Mellitus, mode of treatment and glycaemic control. An observational study was carried out. Patients with the diagnosis of either Type1, insulin dependent diabetes mellitus [IDDM] or Type 2, non-insulin dependent diabetes mellitus [NIDDM] were enrolled into the study through non-probability, convenient sampling method from Jinnah Medical College Hospital Karachi from July 2012 to March 2013. Thorough history and physical examination was done on each patient. Glycaemic control was assessed by glycosylated Hb level [HbAIc]. All information so collected was entered into a proforma. Data was analyzed using SPSS version 20. A total of 108 patients were examined. Out of these, 33 [30.6%] had Type 1 and 75 [69.4%] had Type 2 diabetes. In Type 1 group, 18 [54.5%] were female while in Type 2 group, 37 patients [49.3%] were female. In Type 1 group, 60.6% [n=20] had DR compared to 37.3% [n=28] in Type 2 group [p <0.005]. DR. was seen less frequently in subjects with less than five years duration in both the groups i.e. 12.6% in Type 1, and 15.7% in the Type 2 group. This increased to 100% [p<0.001] in Type 1, and 77.7% [p<0.02] in the Type 2 group with a duration of over 20 years of diabetes. In patients on insulin therapy, 60.6% in Type 1 group and 53.1% subjects in Type 2 had DR. In Type 2 group, 25.6% subjects on oral hypoglycaemics and/or diet therapy had DR. None of the subjects in both groups with HbA1c <7% had any evidence of DR. The frequency of DR. is higher in patients with Type 1, than those with Type 2, in patients receiving insulin therapy and with long duration of diabetes. Higher levels of HbA1c have clear relationship with development of DR