Comparison of the frequency of metabolic syndrome among diabetic and non-diabetic outpatients of a tertiary care public sector hospital in Karachi

To compare the frequency of Metabolic Syndrome among diabetic and non-diabetic out-patients of a tertiary care hospital with increased waist circumference. This cross-sectional study was conducted in Medical unit-II of Abbasi Shaheed Hospital, Karachi from September 2008 to January 2009. A total of 100 patients i.e. 50 diabetics and 50 nondiabetics were selected by non-probability, purposive sampling technique. After taking the informed consent, patients of age 30-50 years with waist circumference >102 cm in males and >88 cm in females non-diabetic and diabetic for three years were inducted in the study from out-patient department, while patients having ischaemic heart diseases, nephrotic syndrome and gestational diabetes were excluded. Blood sample was taken for lipid profile and blood glucose after 12 hours of fasting. Waist circumference in straight standing position was measured. Relevant information including age, sex, waist circumference, fasting blood glucose, lipid levels and diagnosis of Metabolic Syndrome were recorded on proforma by a physician and analyzed through SPSS-15. Among diabetics, 62% were males and 38% were females while in non-diabetics, 58% were males and 42% were females. Hundred percent diabetic patients had dyslipidaemia compared to 88% non-diabetics. Among diabetics, 88% were hypertensive while 34% non-diabetics were hypertensive. Sixty percent of diabetics and 28% of non-diabetics had metabolic syndrome [p = 0.001]. There was a significantly high proportion of Metabolic Syndrome with increased waist circumference in diabetic patients

Gerd symptoms and body mass index: a study in outpatients of Abbasi Shaheed hospital

This study aimed to determine the association between GERD [Gastro-Esophageal Reflux Disease] symptoms and Body Mass Index [BMI] in the outpatients of Abbasi Shaheed Hospital, Karachi. A comparative cross-sectional study was conducted in Abbasi Shaheed Hospital, Karachi from December 2008 to March 2009. By convenient sampling method, 200 outpatients who met the inclusion criteria were enrolled in the study, visiting the hospital with symptoms of epigastric pain, nausea, vomiting, acid regurgitation, heart burn, burping, belching, and feeling of wind. A questionnaire was filled, which contained patient's demographic profile, information on the frequency of all GERD symptoms and severity of main GERD symptoms. History of smoking, alcohol, drugs or any illness were also inquired and noted. Statistical analysis was done by SPSS version 16. Among 200 outpatients, 65% were females and 35% were male. Mean age was 38.4 years. Nausea was complained in 87%, epigastric pain in 66%, acid regurgitation in 66% and heart burning in 64% of patients. The frequency of heartburn and acid regurgitation was seen once a week in 39% and 45% of patients respectively while severity of heartburn and acid regurgitation was found 25% and 33% of patients respectively and there relation with body mass index were found insignificant. Co-relation of body mass index was not associated with symptoms of gastro-esophageal reflux disease i.e.: nausea [p=0.06], epigastric pain [p=0.658], acid regurgitation [p=0.935], heart burn [0.525]. Our study concludes that in our setting, the symptoms of GERD occur independently of body mass index. It seems that high BMI plays a more important role to cause symptoms of GERD among western population but not in Asian populations. However, further studies in Asian communities are also required in this regard

Risk of hypoxia during flexible upper GI endoscopy in unsedated patients of a tertiary care public sector hospital in Karachi, Pakistan

To measure the changes in oxygen saturation using pulse oximetry during flexible upper gastrointestinal endoscopy in unsedated patients. This is an observational study conducted on 356 patients undergoing unsedated upper gastrointestinal Endoscopy, during April 2009 to January 2010. Complete demographic data, systemic history, smoking history, laboratory evaluation and American Society of Anesthesiologists Physical Status [ASA-PS] were recorded in all patients. Patients with severe systemic disease [ASA-PS III-VI], those who needed emergency endoscopy and with anemia of hemoglobin <8gm/dl were excluded from the study. Out of 356 patients 186 [52.2%] were male and 170 [47%.8] were female. All the patients tolerated the procedure well at the start and at the end and had no oxygen desaturation. At mid of the procedure 21 [5.9%] patients showed mild oxygen desaturation and 4 [1.1%] showed moderate oxygen desaturation while 331 [93%] showed no oxygen desaturation. No patient at any stage showed severe oxygen desaturation. Relationship of smoking, co-morbidity and clinical signs with mid procedure oxygen saturation is insignificant in both genders. It is concluded that mild to moderate hypoxia is some what common during therapeutic endoscopic procedure and of no serious consequence. However, severe hypoxia is not recorded in our study. The unsedated gastrointestinal endoscopy is a safe procedure for the diagnostic purpose, as it does not produce hypoxia during this; therefore pulse oximetry is not a precondition in patients undergoing unsedated diagnostic endoscopy without severe systemic disease. We recommend monitoring through pulse oximetry in patients with age greater than 45 years and procedure longer than 8 minutes

Total abdominal paracentesis in cirrhotic patients with ascites with I/V albumin of polygeline

Ascites is a frequently encountered problem in Cirrhotics and Total Abdominal Paracentesis is an easy and quick way of relieving these patients. To observe the Total Abdominal Paracentesis with IV Albumin or Hemaccel and observe systemic hemodynamics, electrolytes and renal function. Material and 30 patients who were admitted in A.S.H. were included in study. Patients with hepatocellular carcinoma, child Grade, increased Prothrombin time etc. were excluded. Out of 30 patients enrolled, one expired as he was erroneously included in study. In rest of patients all were hemodynamically stable after one day. Total Abdominal Paracentesis is a safe procedure and can be used to relieve patients with tenso ascites in fast and safe way

Polycythemia rubra vera. A report of three cases and review of literature

Three case reports of Polycythemia Rubra Vera are mentioned. Two were male and one was female, The hemorrhagic complications were seen in males only. The females presented with headache, abdominal pain and cyanosis. All patients responded to Hydorxy Urea. CASE: 65 yrs. Old Mr. M.S. resident of North Karachi presented to OPD of Abbasi Shaheed Hospital in July 2000 with complaints of persistent headache for last 6 months and painful swelling in left upper chest on the back for 2 days. He was non smoker and afebrile. On examination he was an old man of thin built having plethoric face and conjunctival injection. He had an overall dusky cyanotic complexion. The examination of swelling revealed a 25cm x 12cm fluctuant tender swelling. There was hepatosplenomegaly. A provisional diagnosis of polycytemia vera was made and blood was sent for investigation. Hemoglobin came to 18gm/dl