Factors affecting BMI assessment of the effect of sociodemographic factors on BMI in the population of Ghulam Mohammad Abad Faisalabad

To examine the effect of different sociodemographic factors on the BMI. Descriptive Cross Sectional Study. People of Ghulam Mohammadabad and Marzi Pura attending OPD at Independent University Hospital Ghulam Mohammadabad and Marzi Pura Faisalabad. One Month of duration extending from July to August 2012. 493 respondents were selected by convenient sampling. A semi structured questionnaire was used to collect the information from the sample. First of all, an informed consent was obtained from the respondents under study and secrecy of the information was ensured. By data analysis through SPSS Version 17, frequency tables were prepared. The result of this study shows that BMI is less than 18.5 in 25.4% of the males as compared to 11.5% in females. 22.9% married persons were having BMI above 30 as compared to 6.6 percent unmarried. This study also shows 21.1% of the smokers were having BMI above 30 as compared to 18.3% in non smokers. Similarly 18.2% of the respondents sleeping less than 10 hours per day were having BMI above 30 as compare to 15.4% sleeping more than 10 hours per day. Result also shows 25.8% diabetics having 18.5 to 24 BMI while 21.5% in non diabetics. There was family history of obesity in 22.4% only. Males are more underweight as compared to females and that females are always on higher side of BMI. Married persons were more obese as compared to unmarried. Per month income, background history of diabetes mellitus and family history of obesity found to have a profound effect on BMI

Hypoglycemia; experience in diabetics

Hypoglycemic symptoms are a very common experience for diabetics ranging from an innocent increased appetite to dreadful unconsciousness. This study was designed to assess the patient's awareness about the symptoms, experience of individual symptoms and their ability to recognize and to respond accordingly. All diabetic patients were assessed for the awareness of different symptoms of hypoglycemia, their experience of individual symptoms in last six months and ability of the patient and family members to recognize and to respond accordingly to these symptoms on a prescribed proforma with the help of trained staff. We had 1260 new cases of DM during the study period with valid diagnosis and taking either sulphonylurea or Insulin who were enrolled in the study. 280 patients had no idea of the symptoms. 564 patients knew no more than three symptoms. Palpitation and sweating were the most commonly known 80% and experienced 65% symptoms. Hunger and epigastric discomfort were the next best known 73% and experienced 58% symptoms. Loss of consciousness was the next in the list in terms of knowledge 52% and experience 23%. Coldness of body 28%, severe weakness 24%, blurred vision 12%, abnormal behavior 12% and altered consciousness 6% were the next in the list of experience. Early morning headache, night terror and frequent awakening were the least known 3% and recognized1% symptoms. Abnormal behavior and altered consciousness were not known to any patient as a symptom. Of those who knew or experienced the symptoms, eating anything available was the most common response, only 35% responded by eating rapidly available food items like sugar, honey, candies, beverages, fruit juice or jams. 3% of patients even resorted to taking diet colas initially and only later took other food after waiting for some time. In the event of patient getting unconscious, 80% of the times attendants did not consider hypoglycemia initially at home at first such experience. Patient must be properly educated about these symptoms before prescribing these agents and shall be repeatedly evaluated at each visit. Failing to recognize early and mild symptoms may lead to a terrifying experience

Amoebic liver abscess; incodence and outcome

Amoebic liver abscess is a common infection in third world countries like ours due to poor sanitary arrangements. It presents with severe pain and high grade fever and if not diagnosed and treated promptly, may lead to complications and mortality. To estimate the incidence, need for aspiration and treatment outcome. Case series study. At respective consultations centers in Faisalabad. From 1[st], January, 2007 to 31[st] December 2008. All patients suspected of the diagnosis of liver abscess whether presenting to physicians or surgeon were referred for ultrasonography for the confirmation of the diagnosis. Basic biodata, coexisting medical or surgical diseases and relevant investigation were recorded, and patient was assessed for the need to aspirate the abscess. After initial treatment patients were reassessed for the need to aspirate the abscess on third, tenth and twentieth day both clinically and ultrasonically. We had 188 cases in the study. There were 128 [68%] males and 60 [32%] females. Majority, 156 [76.6%], of the abscesses were single, 40 [21%] had double and 4 [2%] had three abscesses. 166 [83%] were situated in the right lobe, 28[15%] in the left lobe and 4 [2%] had abscess in both lobes. 16 [9%] were aspirated at presentation due to their size or position. Only 4 [2%] were aspirated at first follow-up on third day due to non resolution of pain or fever or increase in size. All the patients who were not lost from follow up responded to standard treatment of metronidazole. Amoebic liver abscess is a common diagnosis in our setup. Patients presents with right upper quadrant pain and fever. Clinical background and ultrasonogram give a reasonable suggestion about amoebic etiology. If initial aspiration is not indicated due to size larger than 5cm. or proximity to surface or nonresolution of symptoms or lesion in left lobe, conservative treatment with oral or intravenous metronidazole is successful

Diabetic foot infections; role of granulocyte colony stimulating factor [G- CSF]

[1] To evaluate the effects of G-CSF in eliminating infection in diabetic foot wound [2] To compare the effects with conventional diabetic foot management. Prospective, open, randomized comparative study. Medical and Surgical Department of Allied, DHQ Hospital and Nawaz Medicare Faisalabad. From Jan 2000 to Nov 2000. Fifty diabetic patients with foot infections were included in this study. The mean age was 52 years ranging from 27 to 60 years. They were divided into two equal groups [Group A and Group B], The male patients were 41 [82%] and female 9 [18%]. Forty six percent of patients were on oral hypoglycaemic drugs, and 54% on insulin. The trauma preceding infection was 20%, Peripheral neuropathy 94% and peripheral vascular disease 34%. Thirty two percent of patients were smoker. Group A were subjected to G-CSF [Neupogen] therapy [n=25] subcutanously daily for 5days in addition to conventional measures. Whereas patients in Group B received only conventional therapy. Both groups received similar antibiotic and insulin treatment. G-CSF therapy was associated with earlier eradication of pathogens from the infected ulcer [median 5 [range 2-11] vs11 [6-31] days in the group B; [p=<0.0001], quicker resolution of cellulitis [6 vs 14 days; p<0.0001], shorter hospital stay [8 vs16 days; p<0.0001], and a shorter duration of intravenous antibiotic treatment [7 vs 14 days ;p<0.0001]. No G-CSF treated patient needed surgery, whereas three patients in group B underwent toe amputation and six had extensive debridement under anaesthesia [p<0.0001]. G-CSF therapy was generally well tolerated. Granulocyte colony stimulating factor [G-CSF] may be used as a good adjuvant therapy along with conventional measures for the management of diabetic foot infection, as it promotes the healing of diabetic foot ulcer/cellulitis and consequently prevents many hazardous complications like amputation of limbs, long hospital stays, extensive and prolonged antibiotic use and last but not the least the total misery of the patients

Typhoid Fever; clinical experience with levofloxacin, its efficacy and safety

To find out the efficacy and safety of Levofloxacin in patients suffering from typhoid fever. Non-comparative and prospective study. Medical Units of Allied and DHQ Hospital [PMC] Faisalabad. From May 2002 to July 2004. All suspected febrile patients were examined and provisionally diagnosed to have typhoid fever were admitted for the purpose of study till they were satisfactorily discharged. This clinical study was conducted on 70 patients of Enteric Fever. Fifty-two patients were male and 18 were female. The mean age for male patients in the study sample was 37.58 +/- 8.13 while the mean age of females was 21.92 +/- 4.73 years. Fever as a symptom was present in all 70 [100%] of the patients. Anorexia was there in 61 [85.5%] patients and abdominal pain in 49 [70%] patients. Twenty-seven [38.5%] patients had constipation along with other features. Diarrhea was present in 6 [8.5%] patients. Relative bradycardia was present in 20 [28.5%] patients. Hepa tomegaly was there in 31[44.3%] and Splenomegaly in 24 [34.3%]. Elevated liver enzymes were found in 29 [41.4%] of the patients and blood cultures positive for Salmonella typhi was seen in 19 [27.1%] patients. Widal test was positive at dilution of 1:160 in almost all of the cases and at 1:320 dilution in 18% of cases in current study. The success rate of Levofloxacin in our study was 100% in the form of settlement of fever and other symptoms and signs. The side effects were seen in 17 [24.2%] patients. In conclusion levofloxacin is effective in treatment of typhoid fever and its use in this indication is safe