Evaluation of factors influencing hypertension among adults of South Karnataka - India

Background: Studies have shown that BP is an independent risk factor for CVD. This relationship is independent as well as consistent and continuous. Observations involving more than 1 million individuals have shown that death from both CVD and stroke increases progressively and linearly from BP levels of as low as 115mm systolic and 75 mm diastolic upwards. The increased risks are present in all age groups ranging from 40 to 89 years old. Hence the present study was undertaken to evaluate the factors influencing hypertension among Adults.Methods: In the present study 400 patients both out-patient and in-patients attending Adichuchanagiri Institute of Medical Sciences were evaluated for factors influencing Hypertension and other cardiovascular diseases. The 400 patients were divided into 200 cases who were again divided into categories based on severity of hypertension into stage 1 and stage 2 and duration of <5 years and ≥5 years.Results: A positive correlation was found between the severity of hypertension, the patients who were found to be having stage 2 hypertension had an increase in SUA levels which was statistically significant when compared with those with stage 1 hypertension. Conclusions: With the results based on the study carried out author concluded that there is direct relation between hyperuricemia and hypertension. Also, the study showed that the SUA levels were significantly increased in patients with Stage 2 hypertension as compared with those of stage 1 hypertension, showing that the severity of hypertension also related to the SUA levels.

Primary tubercular submandibular abscess: a rare presentation in two years old girl

Retroperitoneal Lymphangiomas are rare and account for only 1% of lymphangiomas. They usually present in infancy, rarely they may present symptomatically in adulthood. We present a case of a 19-year old female with a symptomatic retroperitoneal lymphangioma. It was treated with complete surgical excision. Retroperitoneal lymphangiomas are rare. Imaging alone cannot differentiate them from other retroperitoneal cystic masses. Surgical excision is the treatment of choice and required for final diagnosis.

Awareness about the baseline blood glucose levels, risk factors and complications among diabetic patients attending OPD of national institute of diabetes and endocrinology, Karachi

Objective: To evaluate awareness among diabetic patients attending OPD of National Institute of Diabetes and Endocrinology, Karachi, about the baseline blood glucose levels, Risk factors and Complications

Study Design: Cross-sectional study

Place and Duration of Study: This study conducted at the OPD of National Institute of Diabetes and Endocrinology [NIDE], at OJHA campus of Dow University of Health Sciences, Karachi from January to March 2016 in Karachi

Materials and Methods: Adult, age 18 years and above, cases of diabetes were recruited from OPD of National Institute of Diabetes and Endocrinology [NIDE], at OJHA campus of Dow University of Health Sciences, Karachi. Data was collected using a structured questionnaire which was translated into local language i.e. Urdu. SPSS was used for statistical analysis

Results: A total of 100 participants completed the interview out of which 53% were male and 47% were female. Mean age of the participants was 49.3 +/- 10.7 years. Regarding the knowledge about target blood glucose levels, only 39% of the participants correctly identify the fasting blood glucose level while only 26% correctly answered random blood glucose levels. Overall mean score of knowledge and awareness was 40%. Male had better knowledge then female. Mean score for male was 50% compared to 30% among female. This difference was statistically significant p-value <0.05. Over all 45% of the participants were found to have poor knowledge scores, 35% had acceptable while only 20% had acceptable knowledge scores

Conclusion: This study found that there is low level of awareness among the patients attending diabetic outpatient clinics of NIDE. This indicates gaps in the patient care which needs attention. There is need to integrate patient education regarding glycemic targets, risk factors, complications and self-care as essential component of care through different channels of communication

Vacuum assisted closure- utilization as home based therapy in the managementof complex diabetic extremity wounds

Vacuum assisted closure is a reported technique to manage complex wounds. We have utilized this technique by using simple locally available material in the management of our patients on outpatient basis. The objective of this study is to present our experience. This study was conducted from June 2011 to June 2013 at Dow University Hospital and Aga Khan University Hospital, Karachi. There were 38 patients managed with vacuum assisted closure. Mean age was 56 +/- 7.8 years. Twenty three patients presented with necrotizing fasciitis and 15 patients with gangrene. Lower limbs were involved in majority of the patients. Debridement or amputations were done. Vacuum dressing was changed twice weekly in outpatient department. Wounds were closed secondarily if possible or covered with split thickness skin graft in another admission. All the wounds were successfully granulated at the end of vacuum therapy. Mean hospital stay was 7.5 days. Vacuum dressing was applied for a mean of 20 days. There was reduction in the size of the wound. Thirteen patients underwent secondary closure of the wound under local anesthesia, 18 patients required coverage with split thickness skin graft and 7 patients healed with secondary intention. Vacuum assisted closure appeared to be an effective method to manage complex diabetic wounds requiring sterile wound environment

Glomerular diseases outcome at one year in a tertiary care centre

To determine outcome in primary and secondary glomerular diseases at one year follow up. Study design is observational cohort, done in out-patient department, Dow Iinternational Medical College, DUHS. All information gathered on a proforma. All patients with dipstick positive proteinuria and clinical glomerular disease were included in study. Patients with no proteinuria were excluded so were patients with stage 5 CKD. Patients were followed for proteinuria and renal insufficiency at completion of one year follow up. Statistical analysis was done on SPSS version 16. Total number of patients who completed one year follow up was 173. Mean age of patients was 51.67 +/- 10.16 [range 15 to 75 years]. Ninety two [53.2%], were males and 81 [46.8%] were females, ratio being 1.1:1.0. Mean weight of our patients was 67.43 +/- 14.13 Kg, [35 to 107 kg]. Commonest cause of glomerular disease in our patient was diabetic nephropathy which was seen in 94.2% patients. Commonest associated problem with glomerular disease was hypertension seen in 66.5% of patients. Four out of 173 patients had stage 5 CKD at end of follow up at one year while quantitativ proteinuria remained same at one year follow up. One year follow up is critical for patients with glomerular disease associated with stage 4 CKD as progression to end stage renal failure may be seen within one year in these patients

Pyuric diabetic patients: a tertiary centre experience from Karachi

[1] To determine frequency of urinary tract infection among pyuric diabetic patients. [2] To determine sterile pyuria frequency among pyuric diabetic patients. [3] To determine factors predisposing to urinary tract infection. This is a non randomized, prospective observational study done in tertiary care set up of Dow University of Health Sciences, Karachi. Data collection done from June 2013 till August 2013. Sampling was done by convenient method, sample size of 97. Inclusion criteria was all adult [above 16] patients with diabetes mellitus and pyuria [more than 4 pus cells /HPF] whose urine culture report was also available. Verbal consent was sought from patients. All data was collected on a Performa. Data was maintained and analyzed on SPSS version 16. Total number of pyuric diabetic patients in study was 97. Frequency of Urinary tract infection was 59/97 [60.82%], prevalence of culture negative sterile pyuria was found 38/97 [39.17%]. Urinary tract infection was found to be more in females with lower urinary tract symptoms and flank pains. Stone disease, obstructed pelvicalyceal system, proteinuria, high serum creatinine and positive nitrites were found more in culture positive patients than in culture negative pyuric patients. Pyuric diabetic patients in our study population were found to have culture positive UTI in 60.82% and culture negative sterile pyuria among 39.17% of patients. UTI was found more in females, in symptomatic patient and with abnormal urinary tract anatomy and function