Frequency of prediabetes and its association with lipid profile in patients with non- alcoholic fatty liver disease

Objective: To determine the frequency of prediabetes in patients with non-alcoholic fatty liver disease and to compare the mean values of cholesterol, triglycerides, low density lipoproteins and high density lipoproteins in patients of non-alcoholic fatty liver disease with and without prediabetes

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted at Medical Outpatient Department, Sharif Medical City Hospital, Lahore from 30[th] December 20 1 3 to 29[th] June 20 14

Materials and Methods: Three hundred twenty five patients with ultrasonic diagnosis of NAFLD were included

All the patients with other causes like alcohol, viral hepatitis, toxins and drugs were excluded. All patients were screened by Glucose tolerance test [GTT] and if post GTT, blood sugar level came out greater than mg/dl, it was labeled prediabetes. Lipid profile was compared in both groups

Results: Frequency of the pre-Diabetes is quite high in our population with nonalcoholic fatty liver disease i.e.82.2% and means values of cholesterol, triglyceride low density of lipoprotein and high density lipoprotein in patients of non-alcoholic fatty liver disease are equally distributed patients with and without pre-diabetes

These mean values are, mean value of cholesterols patients with pre-diabetes was 1.86.8 +/- 2.3 mg/dl while without pre- diabetes it was 193.4 +/- 40.8 mg/dl while mean triglyceride level in patients with pre-diabetes was 180.5 +/- 37.2 mg/dl while without pre-diabetes patients it was with 180.7 +/- 40.4 mg/dl. Similarly the mean LDL level was 157.8 +/- 19.4 mg/dl and with pre-diabetes and 156.8 +/- 19.8 mg/dl in patients of NAFLD without pre-diabetes

Conclusion: It is concluded that frequency of prediabetes and dyslipidemia is quite high so we should screen all patients of NAFLD for glucose intolerance

Patterns of presentation of chronic ischemic heart disease with and without previous myocardial infarction

The prevalence of Ischemic Heart Disease [IHD] is on the rise, from increasing lifespan of population and availability of better medical facilities. We studied chronic IHD cases with and without previous myocardial infarction, in Hazara, NWFP, Pakistan to evaluate left ventricular [LV] dysfunction, wall motion abnormalities and complications of IHD. All patients presenting with history of chest pain in Medical 'C' Unit, Ayub Teaching Hospital, Abbottabad from June 2004 to May 2005 were included in the study. Patients with non-cardiac chest pain were excluded from the study. Cases with congenital and rheumatic heart disease, cardiomyopathies, unstable angina and acute MI were excluded. Patients with IHD with or without myocardial infarction [MI] were studied for left ventricular dysfunction [ejection fraction, left atrial size, E/A ratio], wall motion abnormalities and complications of IHD [Mitral regurgitation, Ventricular Septal Defect [VSD], LV aneurysm, LV clot]. Clinical and echocardiographic evaluation was done in each case. Out of 183 cases of chronic IHD, 123 patients were without previous MI and 60 had had previous MI. Ejection fraction [EF] was 45% +/- 15 in the group without MI and 35 +/- 11% in cases with MI. Left Atrium [LA] size was 35 +/- 6 mm and 39 +/- 4 mm in the two groups respectively. LV diastolic dysfunction was seen in 17% in the first and 24% in the second group respectively. Global hypokinesia was seen in 8% and 17% in the 2 groups respectively. Regional Wall Motion Abnormality [RWMA] was observed in 12% in patients without MI and in 58% cases with MI. Mitral regurgitation was seen in 10 and 20% in the 2 groups respectively LV clots, VSD, LV and aneurysm were seen in 8.4, 5, and 6.5% respectively, only in cases with previous MI. LV dysfunction, wall motion abnormalities and mitral regurgitation were more common in IHD cases with previous heart attack

Presentation of typhoid fever patients in Hazara division and response to different treatment regimens

Response to treatment can vary in patients with typhoid fever. This study was carried out on a group of typhoid patients who were treated in Medical 13 ward of Ayub Teaching Hospital. Resistance to antibiotic is commonly acquired by Salmonella typbi and is widely reported. Objective of study was to identify such resistance in patients coming from parts of Hazara Division. All patients vv ho presented with typhoid lever and admitted to Medical 13 Unit from 1st July to 30th September 2002 were included in study. Out of 76 patients 46 [60%] were male. Epidemiological [late, presenting symptoms, finding on physical examination, laboratory investigation and radiological examination were recorded. Then one of six commonly used treatment regimens were started. Response to treatment was studied. Common presenting symptoms and signs were recorded. Headache and fever were seen in 100% of patients. Cough and hypotension were among presenting features in 65% of patients. Lcucocyte count of Less than 4x1000/dl was seen in 11%] of samples. Liver functions and Renal function were found alterd ill 30% of patients. Study of response pattern to different regimens suggested relatively poor response to tlouroquinolones. Fever of those patients who were treated with cbloampbenicol and cefexime settled early as compared to patients on other regimens. Conclusions. In addition to well known presenting features of typhoid like headache, fever, cough, hypotension and leueopenia abnormalities of renal and liver functions were commonly seen. Response to quinolone was poor suggesting emergence of resistance of salmonella typhi in this area

study of the manifestations of a group of typhoid fever patients in 1984 in Bahrain

The manifestations of typhoid fever were studied in 50 patients who were admitted to salmaniya medical center, Bahrain during the typhoid outbreak in the summer months of 1984. young adults and those with reduced glucose 6 phosphate dehydrogenase activity were predominantly affected. There were no deaths. The results of drug therapy indicated an earlier response if chloramphenicol or cotrimoxazole were used rather than ampicillin as first line treatment