Résumé
Uric acid levels are often increased in subjects with metabolic syndrome but it is unclear whether it plays a causal role or it is a marker for metabolic syndrome. To find the association of hyperuricemia with various components of metabolic syndrome. The cross sectional analytical study was carried out in Sir Ganga Ram Hospital, Lahore, Pakistan. Total 600 subjects of both genders aged 30-70 years were recruited in the study. Demographic, clinical and biochemical variables were recorded by using a questionnaire. Fasting blood sample was used to estimate plasma glucose, serum lipid profile and uric acid. The cut-off for hyperuricemia was serum uric acid level >/=7.0 mg/dl for males and >/=5.7 mg/dl for females. Metabolic syndrome was diagnosed if subjects had any 3 of the 5 criteria described as per ATP III guidelines. The data was analyzed using SPSS Version 20. The study included 216 [36%] males and 384 [64%] females with mean age 47 +/- 10 years. Out of total 447 subjects, 62 [13.9%] with metabolic syndrome had hyperuricemia. Whereas 62 [75.6%] subjects out of total 82 subjects with hyperuricemia had metabolic syndrome. Different parameters of metabolic syndrome were statistically correlated with hyperuricemia but none showed significant correlation. Chi square and Wald Statistic [Logistic regression algorithm] showed that by using G-to-S [general to specific] approach hyperuricemia was significantly associated with female gender but did not show any association with metabolic syndrome. There was no association present between metabolic syndrome and hyperuricemia; therefore uric acid levels might not be important in the diagnosis of metabolic syndrome
Sujets)
Humains , Mâle , Femelle , Syndrome métabolique X , Études transversales , Enquêtes et questionnaires , HypertriglycéridémieRésumé
To assess the knowledge, attitude and practices of dentists of public and private sector in Lahore about Hepatitis B and C infection. This cross-sectional analytical study was conducted on private dental practitioners and public sector dental surgeons working in hospitals of Lahore. Private sector dentists of Lahore working in Shahdara, Badami Bagh, Mughalpura, Baghbanpura, Gulberg, Shadman, Mozang, Feroz pur Road, Model Town, Multan Road, Johar Town and Tohkher Niaz Baig were selected for the study. In the public sector hospitals, dental surgeons were selected from Demont Morency Dental College and Hospital, Mayo Hospital, Services Hospital, Govt. Mozang Hospital, Jinnah Hospital, Lahore General Hospital, Mian Munshi Hospital, Sheikh Zaid Hospital, Railway Hospital, Wapda Hospital and Combined Military Hospital by using convenient sampling technique. A self-administered, close- ended questionnaire was used and information was gathered about their knowledge, attitude and practices for HBV/HCV infection and its prevention. Data was entered in the SPSS-13 computer program. Frequency and percentages were calculated for different segments and comparison between the two groups was performed by using z-test for proportion. p-value =0.05 was considered significant. A total of 209 dentisits agreed to participate in the study [105 in private and 104 in public sector]. The mean age of the respondents was 33+9.8. Although majority had good knowledge about these viruses, their spread and prevention but information was either lacking or was wrong in many dentists. Disease spread through close contact was thought by 35%, through mosquitoes by 15%, in closed environments by 8%. Sexual and perinatal transmission of these viruses was not known by 30% and 8% did not know that these can be transmitted by blood or unsterilized instruments. About 50% stated that B and C cases should be restricted from working in food industry. Vaccine for hepatitis B was not known in 7%, while 25% said that a vaccine is available for hepatitis C. Attitude evaluation highlighted that 98% dentitsts screened their patients for hepatitis-B and C prior to dental treatment and 80% gave virus positive patients the last appointment to prevent disease transmission. Almost 52% agreed that virus infected health professionals should not be discouraged from treating patients. Deficiencies were observed in the dental practices, which were more common in public sector like not being vaccinated for hepatitis B, infrequent use of special containers to dispose sharps. Deficiencies more marked in private sector included infrequent hand washing, not using autoclave for sterilization, not using new forceps/hand piece or personel protective equipments [mask/eye face shield]. There were deficiencies in the knowledge, attitude and practices about hepatitis B and C virus in dentists of both public and private sector which need to be addressed on priority basis to stop disease transmission from this very frequented site. Provision of a continuous formal and obligatory education on hepatitis B and C regarding its nature, causative organisims, risk factors, diagnosis management and prevention to update in infection control practices. The Dental Association should be made partner in the infection control campaign
Sujets)
Humains , Mâle , Femelle , Hépatite B , Hépatite C , Dentistes , Secteur privé , Secteur public , Études transversales , Enquêtes et questionnairesRésumé
Insulin resistance is the primary metabolic disorder associated with obesity. Little is known about its role as a determinant of the metabolic syndrome in obese children. To assess the association of insulin resistance with metabolic syndrome in obese and non obese children. Study type and settings: Cross sectional analytical study conducted among children of ten Municipal Corporation high schools of Data Ganj Buksh Town Lahore. A total of 46 obese and 49 non obese children with consent were recruited for the study. Fasting blood glucose, serum insulin, high density lipoprotein cholesterol, triglycerides, cholesterol, non HDL-cholesterol LDL cholesterol were measured using standard methods. Data were analyzed by using statistical software SPSS-Version 15. A total of 95 children 49 obese and 46 non obese were recruited for the study. A significant association of serum triglyceride [p<0.001], high density lipoprotein cholesterol [p<0.001], fasting blood glucose [p<0.001], and insulin levels [p<0.001], was seen between the two groups. For each component of metabolic syndrome, when insulin resistance increased so did odds ratios for cardio metabolic risk factors. Insulin resistance was seen in 34.7% children. Metabolic syndrome was found in 31.6% children reflecting that obese children are at high risk for metabolic syndrome and have low HDL-cholesterol and high triglycerides levels
Résumé
The dyslipidaemia associated with type-2 diabetes is associated with raised plasma triglycerides, low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol and very low-density lipoprotein cholesterol levels and is a risk factor of cardiovascular disease. To assess the lipid abnormalities in patients with type-2 diabetes. A cohort study carried out at Diabetic Clinic of PMRC Research Centre, FJMC, Lahore, Pakistan. Eight years case records of type-2 diabetic patients seen at the research centre from 1999-2006 were reviewed. The research centre is a specialized centre for diagnosing and treating diabetes mellitus. All the patients were recruited for their follow up check up and laboratory investigations for dislipidemia. Adult treatment panel III guidelines for dyslipidaemia were followed. A 12 hours fasting blood sample was collected from each patient for serum total cholesterol, triglycerides, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and glucose as well as glycosylated hemoglobin [HbA1c] by using standard methods at Biochemistry laboratory of the research centre. LDL-C/ HDL-C ratios, Very low-density lipoprotein cholesterol [VLDL-C] and body mass index was calculated after anthropometery body mass index [BMI] >/= 25 was considered as overweight while >/= 30 obese. HbA1c<6.1 was considered as poor glycemic control. Data was analyzed by using statistical software SPSS-15. a total of 1200 type-2 diabetes were seen in 8 years. There was poor glycemic control, in 87.5% subjects judged on blood HbA1c levels. These patients had higher total cholesterol, LDL-C and low HDL-C levels in blood. The percentage of patients with high, borderline and near optimal risk LDL-C was 62.7, 26.9 and 10.4% respectively, while HDL-C >40mg/dl were seen in 67%. Raised VLDL-C [above 40 mg/dl] was seen in 32.9% cases. The group with high LDL and VLDL is at risk of developing cardiovascular disease. Hypertriglyceridaemia was found in 55% and hypercholesterolaemia in 45.4% cases. Obesity as indicated by body mass index was found in 53.7% patients. Statistically significant association of hypercholesterolemia, hypertriglyceridemia, hypo HDL cholesterolemia and VLDL-C was found with advancing age while only hypertriglyceridemia and VLDL-C showed a positive association with duration of diabetes. A significant association of hyperglycemia [raised HbA1c] was seen with hypertriglyceridemia and high LDL-C along with high body mass index i.e. obesity. Hypertriglyceridemia, high LDL-C and VLDL-C, low HDL-C levels and obesity were the pattern of dyslipidemia found in our diabetic population
Sujets)
Humains , Femelle , Mâle , Diabète de type 2/métabolisme , Diabète de type 2/sang , Prévalence , Cholestérol , Études de cohortes , Cholestérol LDL , Cholestérol HDL , Hypertriglycéridémie , Hémoglobine glyquée , Maladies cardiovasculairesRésumé
Syphilis, a sexually transmitted disease which seemed to have disappeared or had been controlled over the years, has now been re-emerged as a major public health problem in many communities. It can complicate the pregnancies with serious consequences. Appropriate treatment of pregnant women often prevents such complications. To study the frequency of syphilis in pregnant women attending a tertiary care public sector hospital, and see the positivity for HIV/AIDS among syphilis positive women. This cross sectional and interventional study was conducted among pregnant women attending Sir Ganga Ram hospital for antenatal care at PMRC Research Centre, Fatima Jinnah Medical College, Lahore. Blood samples from 2000 women were collected after taking consent. The blood was tested for syphilis by Treponema Pallidum Haemagglutination.History of the subjects for risks factors was also taken. Syphilis positive women were further screened for human immunodeficiency virus positivity. The treponemal antibodies were detected in less than one percent [9] pregnant women. The highest positivity was observed among age group of 21-26 years. Women in third trimester were significantly more infected with syphilis. Risk factors included husband's history with frequent traveling and drug abuse. All husbands of syphilis positive women were also positive. All syphilis positive women and their husbands were negative for Human immunodeficiency virus /Acquired immune deficiency syndrome. Less than 1% of pregnant women were infected with syphilis, and most of the spouses of these positive women were either travelers or drug addicts. Screening for syphilis should continue in pregnant cases and high risk individuals
Sujets)
Humains , Femelle , Complications de la grossesse/virologie , Infections à VIH/diagnostic , Études transversales , Facteurs de risque , Hôpitaux publicsRésumé
Syphilis, a sexually transmitted disease which seemed to had been controlled over the years, has now been re-emerged as a major public health problem in many communities. It can complicate the pregnancies with serious consequences. While appropriate treatment of pregnant women often prevents such complications. To study the frequency of syphilis in pregnant women coming to a public sector hospital and see the pregnancy outcome of positive mothers and disease transmission in neonates. This cross sectional and interventional study was conducted at PMRC Research Centre, Fatima Jinnaha Medical College, Lahore among pregnant women attending Sir Ganga Ram hospital for antenatal care. Blood samples from 2000 women were collected after taking consent from them. The blood was tested for syphilis by using Treponema pallidum haemagglutination assay. Infected mothers were administered intramuscularly with 2.4 million units of benzathine benzylpenicillin [penicillin G] after testing for hypersensitivity and followed for delivery outcomes such as abortion, miscarriage, intrauterine growth restriction, low birth weight, preterm delivery and still birth. Neonates born to infected women were examined for signs of congenital syphilis including non immune hydrops, jaundice, skin rash, pseudo paralysis and running nose along with blood test for either infection. Medical and reproductive histories were also obtained from women and recorded on a proforma. The treponemal antibodies were detected in 9[0.45%] pregnant women. The highest positivity was obtained among age group of 21-26 years. There was no statistically significant difference of acquiring infection among women of different age, education, and socioeconomic backgrounds. Women in third trimester were significantly more infected with syphilis. Out of 9 couples 3 refused treatment, 1 received only one dose of penicillin, 2 received two doses while only three couples completed all doses. Delivery outcome included one abortion, two preterm deliveries and none of the neonate had sign of congenital syphilis. Only one couple consented for blood sampling of their neonate which was positive for syphilis and was referred to pediatrician. Only 9[0.45%] of pregnant women were infected with syphilis, which can seriously complicate pregnancy and result in spontaneous abortion, and preterm delivery. Screening for syphilis in pregnant women is recommended to detect infected woman who requires treatment to prevent further transmission of this disease to new born
Sujets)
Humains , Femelle , Syphilis/transmission , Issue de la grossesse , Syphilis/épidémiologie , Complications infectieuses de la grossesse/diagnostic , Prise en charge prénatale , Études transversales , Treponema pallidum , Maladies sexuellement transmissiblesRésumé
To determine parasitic infestation among children of rural and urban areas of district Vehari. Children Complex Hospital, at District Headquarter Hospital Vehari and PMRC Research Center, Nishtar Medical College, Multan, Pakistan. A cross-sectional study was done in 2006 where 500 children aged 1-10 years presenting with anaemia and malnutrition were studied. Demographic information included residential area [rural/urban], gender, socio-economic status, hygienic conditions, source of drinking water were recorded on a questionnaire. Parents were interviewed, while stool and blood samples of children were collected for parasites and to determine anemia. Parasites were found in 140[28%] children and anemia in 236[47%]. Prevalence of protozoa 102 [20.4%] was greater than intestinal helminthes 38 [7.6%]. The most common protozoa was Entamoeba histolytica 101 [20.2%] and in nematodes, Hymenolepis nana was seen in 28 [5.6%], Ancylostoma duodenale [hook worm] in 5 [1%], Ascaris lumbricoides [round worm] in 3 [0.6%] and Taenia saginata [tape worm] in 2 [0.4%]. Diarrhoea was seen in 254 [50.8%] cases, constipation in 191 [38.2%], abdominal pain in 245 [49%], anorexia in 181 [36.2%] and abdominal distension in 86 [17.2%] children. Rural children were significantly more infected with parasites, 81 cases [32.27%] compared with urban children 59 cases [23.69%] [p<0.05] and same was for poor children 81 [34.9%] compared with middle income 57[21.8%] [p<0.05]. Infected cases with poor hygienic conditions [77 cases 35.2%] were more infected than those with satisfactory 62 [24.4%] and good hygiene 1[3.7%]. Worm infestation was common 84[35.9%] in those using drinking water from hand pumps compared to those obtaining drinking water from government water supply 47[23.9%] and water filtration plant 9[13.%], a significant difference in infection due to poor quality drinking water was observed[p<0.05]. Worm infestation and anemia were inter related and 85 [60.7%] children with anaemia had parasites against 55 [39.3%] who were not anaemic [p<0.05]. Poor sanitation, hygiene and source of drinking water have appeared as major contributors towards parasitic infestation. Ent.histolytica was the most common protozoal infection found compared to helminths. Use of clean drinking water and good hygienic practices should be instituted throughout the country