Frequency of hepatitis D virus infection in hepatitis B surface antigen-positive liver diseases

To determine the frequency of HDV among hepatitis B surface antigen [HBsAg]-positive liver disorders. An observational cross-sectional study. Medical Unit I, Chandka Medical College Hospital, Larkana, from July 2003 to June 2008. Adult patients with HBs liver related disorders were evaluated for the presence of delta antibodies using commercially available ELISA kits. Descriptive statistcs were used for describing data. Proportions of anti D antibodies between gender and age were compared using chi-square test with significance at p < 0.05. Of the 774 cases, 438 were males [60.4%] and 336 were females [39.6%]. The mean age was 36.5 +/- 14.39 for males and 34.03 +/- 13.16 years for females ranging from 15 to 60 years. Anti-HDV was positive in 183 patients [23.6%].The frequency of HDV was not significantly different between the gender groups [p=0.718]. HDV infection was markedly higher in chronic than acute liver disorders. The HBV/HDV co-infection is frequent in the studied area. Therefore, practitioners and health care managers should be made aware of the risk of dual infection with HBV and HDV

Diabetes mellitus [diagnosed and undiagnosed] in acute myocardial infarction

To determine the proportion of Diabetes Mellitus [DM] in patients with documented first episode of Acute Myocardial Infarction [AMI], in both genders. A prospective, case control observational study. Emergency Room, CCU and Medical wards of Chandka Medical College Hospital Larkana, Pakistan, from January 2005 to August 2005. 200 patients 100 consecutive males and 100 consecutive females, presenting with definite first episode of AMI. Diagnosis of D.M established on previous history of D.M, medical record and medications used by patient, patients without previous diagnosis of D.M [Undiagnosed], were diagnosed by performing Fasting Plasma Glucose [FPG], once within around 72 hours and 8 weeks later on. Out of 200 patients 49 [24.5%] were known diabetics, 20 [10%] revealed hyperglycemia [suspected diabetics] on routine plasma glucose level and Fasting Plasma Glucose [FPG] petformed within 72 hours of the onset of AMI and on subsequent follow up after 8 weeks, FPG level performed revealed 12 [6%] newly diagnosed definitive diabetics, while 5 [2.5%] revealed Impaired Glucose Tolerance Test [GTT] and 3 [1.5%] were found to be non-diabetics, so that a total 61 [30.5%] were labeled as diabetics. one out of every three patients with AMI had DM, elevated levels of random blood glucose and FPG at the time of admission are not reliable measures to establish the diagnosis of diabetes in cases of AMI and thus follow up measurements after a period of 6-8 weeks are necessary to establish the diagnosis. Awareness in general public regarding deleterious effects of DM should be promoted

Systemic lupus erythematosus at Karachi and Larkana: a comparative study of 94 patients

Systemic lupus erythematosus [SLE], a multisystem disease thought to be an uncommon disease in our country was studied to see and compare its presentation and clinical features at Karachi and Larkana. Design: A cross-sectional and observational study. Place and Duration of Study: It was conducted at Karachi and Larkana during the period from January, 1991 to August, 1993 and March, 1997 to June, 2000 respectively. Subjects and All patients confirming the diagnostic criteria of American Rheumatism Association were included in the study. Clinical and physical examination details were recorded and laboratory investigations like complete blood count, urine detailed report, serum urea, liver bio-chemistry, immurological tests ANA, ASMA, AMA and Anti ds-DNA were carried out. Muscle, liver and skin biopsies, muscle enzymes and electromyography were done in selected cases only where indicated. Among 94 patients, evaluated during the study period, 55 included 10 [18.18%] males and 45 [81.81%] females who were diagnosed at Karachi center while 39 patients 6 [15.38%] males and 33 [84.62%] females at Larkana center. Fever was the most common symptom at the time of presentation in Karachi [80.0%] while arthralgia and arthritis [82.05%] were most common symptoms presented at Larkana [p < 0.05]. The most common complication reported at Karachi was proteinuria [90.91%] while at Larkana it was anemia [84.62%]. Conclusions: The presentation and clinical features of SLE at Karachi and Larkana were nearly similar