Statins everyday versus alternate days: Is there a difference in myalgia rates?

Objective Statins are widely used drugs, known to cause myalgia, leading to high discontinuation rates. The objective of our study was to determine the frequency of myalgia in patients on everyday-dose (EDD) regimen with those on alternate-day dose (ADD) regimen. Methods This cross sectional study was conducted in a tertiary care hospital of Pakistan. A sample size of 400 patients between the age of 40–70 years, taking simvastatin 40 mg for at least 6 months or more were selected. Patients with prior musculoskeletal or neuromuscular complains, and family history of muscular disorders were excluded. Subjects were evaluated for myalgia via a self-administered questionnaire, and those complaining of myalgia were then evaluated for serum vitamin D levels. Data was analyzed through SPSS 16.0 and compared using chi square test. Results The overall prevalence of myalgia was 7% (28/400). Frequency of myalgia in patients taking simvastatin everyday (n = 20, 10%) was significantly higher compared to those taking it every alternate day (n = 8, 4%) (p = 0.02). There was no significant difference between the time of onset, nature, severity, type, or location of myalgia between the 2 groups. The most common cited triggering factor for pain was physical exercise. Of the patients experiencing myalgia, 13 (6.5%) from the EDD group and 6 (3%) from the ADD group had low levels of vitamin D. Conclusions ADD regime was better tolerated by the patients than EDD regime. Alternate day therapy, with or without vitamin D supplementation, may be used by the physicians for troublesome muscular complains.

prophylactic role of probiotics for preterm infants/neonates

Necrotizing enterocolitis [NEC] is a major morbidity and cause of mortality in preterm neonates. Probiotics seem to have a beneficial role in preventing NEC, which is confirmed in meta-analyses of randomized controlled trials [RCTs]

We therefore aimed to review and confirm the efficacy of probiotics in preterm neonates obtained in observational studies. To assess the effects of prophylactic probiotics in preterm infants. Keywords: Prophylactic, Probiotics, Preterm Infants

prevalence of glucose-6-phosphate dehydrogenase deficiency in people visiting health care center, KFU, Al-Hasa

Objective: To determine the prevalence of G6PD deficiency in people visiting Health Care Center of King Faisal University [KFU], Al-Hasa

Study Design: Observational / Descriptive study

Place and Duration of Study: This study was conducted at the Health Care Center, KFU, Al-Hasa, from August 2014 to April 2015

Materials and Methods: Patients presenting with weakness and anemia were included in the study. Total 214 patients, consisting of 116 children [age 3 to 14 years] and 98 adults [age 15 to 50 years], were screened. The blood samples were analyzed by using [G6P-DH Fluorescence Screening Test]

This kit detects fluorescence under U/V lamp if the sample has G6PD activity

Results: Total 36 [16.8%] of the 214 patients, tested, were deficient for G6PD. Among those deficient patients, 15 [7%] were children [11 males and 4 females], and 21 [9.8%] were adults [13 males and 8 females]. The highest prevalence of G6PD-deficiency occurred among adults, particularly males

Breastfeeding: motivations and obstacles in achieving the milestones

Background: Breast milk is produced by the breast of the mother which is a complete nutrition for infants. In Pakistan, breastfeeding is suboptimal and beyond the set targets of World Health Organization [WHO]. There are certain supportive factors and obstacles for the mothers, which play their roles in initiation and maintaining the breastfeeding

Objective: This study was conducted, to find out the supportive factors and obstacles in the initiation and maintaining the breastfeeding

Subjects and Methods: This was a cross sectional study, conducted in the Pediatric Unit of Sheikh Zayed Medical College / Hospital Rahim Yar Khan, during the month of March 2014. The study subjects were only those mothers who were present in the ward along with their infants under 6 months of age. A questionnaire was designed and 189 mothers were interviewed regarding different factors in initiation and continuation of breastfeeding, after taking their consent

Results: This study was conducted on 189 mothers. Regarding place of delivery 102 mothers who had domiciliary delivery, 88 [86.27%] breastfed their baby, 74 mothers who had normal hospital delivery, 51 [69%] preferred breastfeeding and among 13 C-section cases 5 [38.46%] mothers chose to breastfeed their babies. The results shows that 78.95%, 63.41% and 33.33% mothers chose breast-feeding in first, second and successive deliveries respectively. 13 [38.09%] out of 21 teenage mothers not their babies and in mothers of 21-30 years of age, 28[25%] did not breast fest fed their child. In mothers out of 30 years of age, 23[43%] out of 53 mothers did not breastfed

Conclusion: Our study showed that domiciliary place of delivery, 1[st] delivery, age of mother in twenties, family motivation and housewives were the factors that promoted the breast feeding practices. A collaborative awareness campaign by social media, family workers and health personals about breastfeeding should be designed especially for teenagers and primiparas that could settle their apprehensions and other issues about problems of lactation

Frequency and antimicrobial susceptibility of gram negative rods in high vaginal swabs

Background: The normal vaginal flora contains a variety of microorganisms. Vaginal discharge is a common gynaecologic problem especially among sexually active females. Pathological vaginal discharges are usually due to infection or inflammation of vagina and/or cervix

Objective: To find out the frequency of aerobic gram negative rods in high vaginal swabs and to determine their antimicrobial susceptibility profile

Materials and Methods: This study was conducted in Microbiology laboratory, Pathology Department, SZMC/H, Rahim Yar Khan from 1[st] January, 2012 to 30[th] June, 2012. High vaginal swabs were collected from 100 females visiting antenatal clinics and gynae OPD of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. Samples were cultured on blood and Mac Conkey agar plates. Plates were incubated aerobically at 35-37°C. All positive cultures were identified by gram staining, cultural characteristics and biochemical reactions. The antimicrobial susceptibility testing of all isolates was done by standard disc diffusion method

Results: Majority of culture positive females were between 25 to 30 years of age. Escherichia coli [72%] was the predominant organism, followed by Klebsiella spp [16%], Enterobacter [6%], Proteus spp [2%], Morganella [2%], Pseudomonas spp [2%]. All these isolates showed good sensitivity towards imepenem and cefoperazone-Sulbactam

Conclusion: In this study, E.coli were the predominant organism, followed by Klebsiella spp. Imepenem and cefoperazone-sulbactam were the most effective antimicrobials against all isolates

Flood devastated the barriers of epidemics at district Rahim Yar Khan

Back ground: Natural disasters are catastrophic events with atmospheric, geologic, and hydrologic origins. Disasters include earthquakes, volcanic eruptions, landslides, tsunamis, floods and drought. Pakistan faced floods in 2010 that began following heavy monsoon rains in the Khyber Pakhtunkhwa, Sindh, Punjab and Balochistan regions of Pakistan

Objectives: To evaluate the prevalence of infectious diseases in the flood affectee persons at Bhung, District Rahim Yar Khan in southern Punjab

Patients and Methods: This cross sectional study was conducted among the flood affectee at the flood relief camp of Sheikh Zayed Hospital / Medical College, Rahim Yar Khan located at Bhung, Rahim Yar Khan, during the month of September 2010. The data regarding age, sex, education, occupation, geographical origin and nature of disease were obtained from the patients attending flood relief medical camp for health care and was analyzed on SPSS version 14

Results: During the study period, 8074 patients were examined. Patients of all ages and both sexes were included. Male to female ratio was 1 to 1.01.The patients ranged from neonates to more than 70 years of age. The children under the age of ten years were 40.99%. Among the flood affectee, the most common diseases in decreasing order of frequency were diarrhoea, RTI, skin infection, eye infection, ear infection and bone trauma

Conclusion: Clean water, environmental hygiene and health education with proper and timely medical cover can reduce mortality and morbidity

Education, the only vaccine available for the control of HIV/AIDS

Back ground: HIV/AIDS is a potentially fatal disease. However, vast majority of the world's youth are unaware about the modes of transmission and prevention

Objectives: the objective of this study was to assess the impact of health education on the knowledge and beliefs of college students toward HIV/AIDS in Pakistan

Patients and Methods: this was an interventional study conducted in the Government Khawaja Fareed Post Graduate Degree College, Rahim Yar Khan, during the year 2009. It was conducted in two phases. In first phase, baseline data was collected to assess level of knowledge and belief of students about HIV/ AIDS. 350 students of different classes participated in this study. Then a comprehensive lecture was delivered regarding transmission and prevention of HIV/AIDS. After a period of three months of this medical education intervention, the participants of first phase were asked to take part in second phase. A total of 314 students of previous group participated i.e 89.71% of the participants of the first phase. The data was collected and analyzed by SPSS version 14

Results: the mean age of the students was 17.44 +/- 1.28 years. The knowledge of the students of 13th and 14th years of education was better as compared to 11th and 12th years of education. In the second phase, 314 participants joined the study. There was significant improvement in the knowledge of students about HIV [p<0.000] and its modes of preventions [p < 0.000]

Conclusion: it is necessary that sufficient knowledge about transmission and prevention of HIV/AIDS should be given to adolescents especially college students. College students should be encouraged to discuss about HIV/AIDS sequelae and prevention

Glycemic control of type 2 diabetes mellitus

To determine the frequency of use of HbA1c level as an indicator for type 2 diabetes control and to identify the Glycaemia control among type 2 diabetic patients. A retrospective study. Dair Health Center. Medical records of all diabetic patients were reviewed for having a test result of HBA1c and for the average level of this test from first of January till the end of December 2004. The time of record review was from first of April 2005 till the end of May 2005. Among 383 type 2 diabetic patients treated at Dair Health Center during 2004, only 178 cases [46.5%] had HBA1c test. Out of these, twenty cases [11.2%] had an HBA1c level of 7% and below. There was no statistically significant difference between the mean of HBA1c for males and females. There was no statistically significant difference between the mean of HBA1c and the type of treatment. HBA1c was underused as an indicator for diabetic control in Dair health center. Furthermore, more stress on strict Glycemic control needs to be emphasized