Hypertensive patients; frequency of diabetes mellitus and impaired fasting glucose levels

Objective: To see the frequency of diabetes mellitus and impaired fasting glucose levels in hypertensive patients

Design: Descriptive study

Place of Study: OPD / Filter clinic. Pakistan Institute of Medical Sciences. Islamabad

Patients and Methods: This study was carried out on 116 hypertensive patients during the period from August to September 2008. Out of 116 patients, 64 were females and 52 were males with age group between 20 to 70 years. Secondary causes are ruled out on the basis of history and physical examination. Blood samples were sent to PIMS laboratory for fasting glucose. Data and results were analyzed in SPSS

Results: According to this study, out of 116 patients, there were 18 patients who had diabetes mellitus while 33 had hypertension with impaired fasting glucose tolerance which is statistically significant. The females as compared to males were increased in number who had both diabetes mellitus and impaired fasting glucose. According to age diabetes mellitus increased in age groups between 41-50 and 61-70 years while impaired fasting glucose were increased in age group between 31-60 yrs. The results indicate that impaired fasting glucose is present in significant number of hypertensive patients

Conclusions: Hypertension is associated with diabetes mellitus and impaired fasting glucose

Nephritis and charcot-marie-tooth disease: an unusual association

A 24 years old male, who presented to us with uraemic symptoms secondary to chronic glomerulonephritis. On examination, he was found to have features of peripheral neuropathy which was confirmed as Charcot-Marie-Tooth type 1 on nerve conduction studies. Very few cases of glomerular disease, mainly focal segmental glomerulosclerosis have been associated with the Charcot-Marie-Tooth worldwide

Hemorrhagic and ischemic stroke; frequency in hypertensive patients presenting with stroke at Pakistan institute of medical sciences, Islamabad

To compare frequency of ischemic stroke with that of hemorrhagic stroke in hypertensive patients presenting with stroke at Pakistan Institute of Medical Sciences, Islamabad. A cross-sectional study. Department of Neurology, Pakistan Institute of Medical Sciences, Islamabad from 17th July to 17th October 2010. One hundred consecutive hypertensive patients with stroke were analysed for this study. Total of 100 cases, 52 cases were of ischemic stroke. Out of this, 50% had left middle cerebral artery, 42.30% right middle cerebral artery, 3.85% anterior cerebral artery and 3.85% posterior cerebral artery involved. 48 cases had haemorrhagic stroke. The cerebellum was involved in 2.08%, 2.08% had left anterior lobe involved. Pons and right parietal lobe was involved in 2.08% respectively. SAH in 12.50%, left basal ganglia in 29.17% and right basal ganglia was involved in 43.76%. The reported results suggest that in hypertensive patients the frequency of ischemic stroke is greater than hemorrhagic stroke

Hypertensionassociation of hypertension with central obesity in low to middle socioeconomic population

To evaluate association of hypertension with central obesity in low to middle socioeconomic population. Descriptive study. OPD, Filter Clinic. Pakistan Institute of Medical Sciences. Islamabad. June to September 2008. This study was carried out on 85 patients with history of hypertension. Out of total patients, 27 were males and 58 were females. The ages of the all patients were between 20 to 70 years. Parameters recorded included history, blood pressure, weight, height, waist circumference and hip circumference. The secondary causes were ruled out on the basis of history and physical examination. Data and results were analyzed in SPSS. Out of 85 patients, 74 including 21 males and 53 females had increased Waist Hip Ratio [WHR], 66 including 14 males and 61 females had increased Waist Circumference [WC], while the Body Mass Index [BMI] of 33 including 6 males and 27 females were found obese. It also showed that the females are more prone to obesity. The age group between 41-60 years was most effected. The results indicates that waist hip ratio is the most common indicator of obesity in patients with essential hypertension as compare to waist circumference and body mass index. Hypertension is associated with central obesity in low to middle socioeconomic status

Concurrent intramedullary spinal cord and intracranial tuberculomas

Tubeculosis commonly involves the nervous system, but involvement of spinal cord in the form of intramedullary tuberculoma is rare and concurrent occurrence of cranial and intramedullary tuberculomas is extremely rare. We report a case of concurrent occurrence of intramedullary tuberculoma with multiple intracranial tuberculomas in a young girl from lslamabad, who presented with one month history of paraplegia and with a sensory level at TB. MRI spine showed a well circumscribed lesion opposite T6, which was diagnosed as intramedullary tuberculoma. On cranial imaging, she was found to have multiple round contrast enhancing lesions which were diagnosed as intracranial tuberculomas based on their typical MRI findings. She had complete recovery with conventional treatment of ATT and steroids, without any surgical intervention. The follow-up MRI of patient showed disappearance and complete resolution of most of the lesions

Chest radiographic findings in neurotuberculosis without pulmonary signs and symptoms

To determine the chest radiographic findings in patients of adult neurotuberculosis, with no pulmonary signs and symptoms. Descriptive study. Department of Neurology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from January 2004 to January 2006. A total of 100 patients fulfilling pre-defined criteria of neurotuberculosis were included. Chest radiographic [CXR] evidence of pulmonary TB was looked for in those patients and its frequency, pattern and association with the clinical grades at presentation was determined by using Chi-square test. Out of the 100 patients of neurotuberculosis, with no clinical evidence of pulmonary TB, radiographic evidence of pulmonary TB was seen in only 30% patients. The predominant patterns on CXR were apical infiltration [26.6%], miliary mottling [20%] and hilar enlargement [16.6%]. Positive CXR was found in 16.7% patients in clinical grade I and 40% and 43.3% in patients in grade II and III respectively. There was a strong association of grade II and grade III with positive chest radiographic findings [p= 0.03]. Patients of neurotuberculosis may have chest radiographic evidence of pulmonary TB even in the absence of pulmonary signs and symptoms at presentation. There is a strong association of clinical grade II and grade III with positive chest radiographic findings

Eperisone compared to Physiotherapy on muscular tone of stroke patiehts: a prospective randomized open study

To compare the effects of Eperisone, a muscle relaxant and physiotherapy on the muscular tone after stroke. Twenty six [26] patients were included from age 15 to 75 years in an open prospective randomized study of threeweeks duration and were treated with either Eperisone [n=13] or were advised to undergo formal physiotherapy [n=13] at the department of physiotherapy PIMS. The end point was observed in the form of change in the grade of tone. Safety and tolerability was assessed on the basis of adverse events. Eperisone was found to be comparable to physiotherapy in reducing the spasticity in patients after stroke and improved the grade of tone from 3-2 [n=2], 4-3 [n=2], 2-1[n=2]. The safety analysis showed persistent vomiting [n=1], fatigue [n=1], headache and dry mouth [n=2], epigastric pain [n=1] and slight changes in blood pressure under Eperisone which was generally well tolerated by the patients. Eperisone was found to be comparable to physiotherapy in its effects to improve spasticity in patients after stroke [p>0.05] [JPMA 55:202;2005]