Evaluation of serum ferritin as predictor of HbA1c in patients with type-2 diabetes mellitus

Background: Serum Ferritin is an acute phase protein and it is a marker of iron stores in the body. The HbA1c fraction is abnormally elevated in chronic hyperglycemic diabetic patients

Objective: To determine the association between serum ferritin and long term glycemic control by HbAIc in patients with diabetes mellitus type 2

Methodology: This was a case control study which was carried out in the chemical pathology department of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, from 1[ST] July 2016 to 31[ST] January 2017. A total of 290 study subjects were included in this study. 110[38%] were the cases [diabetics with high HbA1c]. Ferritin, hemoglobin, HbA1c, and fasting blood sugar were measured in blood samples. Exclusion criteria included anemia, or any other disease or drug that could affect ferritin levels. Results were analyzed statistically by t-test and Pearson correlation test. The data was entered and analyzed by SPSS version 17

Results: A total of 290 study subjects were included in this study.110 were the cases [diabetics with high HbA1c], and 180 normal subjects were included. The mean serum ferritin among cases was significantly higher than control group [137+/-64 vs. 94+/-61ng/ml]. [P<0.00]

Influence of different categories of iron deficiency on hemoglobin A1c levels among non-diabetic adult female

Objective: HbA1c shows the diabetic control of previous 3 months but its levels are affected by iron deficiency anemia. We performed our study in woman of child bearing age group that are mostly iron deficient and endeavorto examine effect of different categories of iron deficiency anemia on HbA1c levels

Material and Method: Three hundred and thirty non-diabetic, anemic female subjects were recruited from the Pathology departments of Bahawal Victoria Hospital Bahawalpur and Sheikh Zyed Hospital Rahimyar Khan who visited department for their annual fitness. 120 subjects who fulfilled inclusion criteria were compared with age matched female for hemoglobin, ferritin, fasting and postprandial glucose levels and HbA1c measurement. The data of 100 females was then divided on the basis of Hb level into mild, moderate and severe anemia [HbA, HbB and HbC]. The Pearson correlation was analyzed between three categories of anemia and their HbA1c levels

Results: The Hb levels among the IDA patients were significantly low [9.9 +/- 5.4 g/dl] as compared to control group. The mean HbA1c [7.4 +/- 0.43%] level in iron deficient females was higher than that in the control. Statistical analysis provided significant negative association between HbB and HbA1cB measurements [r= -0.79] while strong negative relationship existed as degree of anemia became severe [r=-0.86]

Conclusion: Iron deficiency anemia may raise HbA1c results upward depending on degree of anemia. So, iron status of female of reproductive age group should be improved before using HbA1c results for diagnosis of diabetes and monitoring of its long-term complication

Comparison of haemodynamic changes in patients undergoing unilateral and bilateral spinal anaesthesia

To assess the haemodynamic changes in patients receiving unilateral and bilateral spinal anaesthesia with their pre-anaesthesia recordings. Quasi-experimental study. Main Operation Theater, Liaquat National Hospital, Karachi, from May 2006 to February 2007. Sixty patients meeting the inclusion criteria were randomly allocated in two groups of 30 patients each. One and a half ml of 0.75% hyperbaric bupivacaine was injected with free flow of cerebrospinal fluid using a 23 gauge quincke needle. Lumbar puncture was performed in the sitting position at 3 - 4 or 4 - 5 lumbar interspace. Patients were then assigned to the supine or lateral decubitus position for 10 minutes. Heart rate, systolic, mean and diastolic blood pressures of patients were recorded with their pre-anaesthesia readings in the 1[st], 5[th], 15[th], 30[th] and then at every 15[th] minute till the end of procedure. Recovery room readings were also taken. The systolic, mean and diastolic blood pressure changes were significant in both groups. But from 1[st] minute to recovery room, statistically significant difference [p < 0.05] was found at each time interval, the unilateral groups [group A] being more stable with respect to pre-anaesthesia readings. The decrease in heart rate was comparable in both groups. Unilateral spinal anaesthesia was associated with a more stable cardiovascular profile, therefore, it is a valuable technique for high risk patients

Public awareness about anaesthesia and anaesthesiologist: a survey

Anaesthesiologists are playing a decisive role in patient management. Present day anaesthesio-logy is based on the use of newer and safer drugs, better patient monitoring, pain management and critical care. General public knows little of these developments. An awareness programme for general public and medical students was conducted on "Public awareness regarding Anaesthesia and Anaesthesiologist" in September 2009 at Liaquat National Hospital and Medical College Karachi. Audience of this well attended programme was provided with the questionnaire to conduct this survey. Study was conducted on 100 individuals between the ages of 20 - 70 years. They were divided into three groups according to their educational status and age. According to education level 39% were group 1 [Matric and above], 54% were group 2 [graduates] and 7% were group 3 [medical undergraduates]. It was revealed that educational level showed a clear cut influence in their response. People were more concerned about the immediate postoperative problems. 70% of the population evaluated had exposure of surgery for themselves or their relatives and friends and therefore had knowledge about anaesthesia and anaesthesiologist. This study proves that awareness programme is one of the ways to improve public knowledge regarding anaesthesia and anaesthesiologist

Combined thoracic epidural and light general anaesthesia for upper abdominal surgery in high risk patients

The goal of the study was to assess the safety and effectiveness of the thoracic epidural anesthesia [TEA] in high risk patients undergoing upper abdominal surgery. Quasi Experimental. Department of anaesthesia, Liaquat National Hospital, Karachi from August 2002 - July 2003. 20 adult patients aged between 50 - 70 years were selected with ASA status III and IV. TEA was performed in sitting position at the level of T7 -T8 using hanging drop method. Titrated doses of 0.25%. Bupivacaine and 1% Xylocaine was injected 1 ml / dermatome through the catheter, anesthetic levels achieved were found to be T4 - T10. Light general anesthesia was instituted by using I/V propofol 50 - 60 mg, I/V Nalbuphine 5 - 7.5 mg and Midazolam 1.5 - 2 mg I/V. Total dose of local anesthetic varied from 12 -18 ml [mean 16 ml]. Two patients had bradycardia with heart rate less than 60 beats/min treated with atropine. Two patients had hypotension treated with titrated doses of ephedrine and I/V Ringer's solution. Our results were very promising and we can state confidently that thoracic epidural is a viable option and safe alternative, reducing morbidity in high risk patients

To compare changes in serum electrolytes during turp, while using 5% dextrose water and glycine as irrigation fluids in two groups

To compare changes in serum electrolytes during TURP, while using 5% dextrose water and gly-cine as irrigation fluids in two groups. Experimental study design. Department of Anaesthesiology, Liaquat National Hospital, Karachi, from January 2004 to Jun 2004. 60 ASA I and II patients who presented for TURP under spinal anaesthesia were divided in two groups. 30 patients were included in each group. Patients in group A received 5% dextrose water as irrigation fluid while patients in group B received 1.5% glycine as irrigation fluid. Serum electrolytes were checked preoperatively, intraoperatively at every 15 minutes interval and postoperatively every hour for 2 hours. Serum Na+ level was decreased in both groups, but it was more marked in group A, maximum change being recorded at 45 minutes interval. These changes returned towards baseline with in 2 hours. Serum K[+], Cl and HCO[3] were also decreased in both the groups with more marked changes in group A. However, these changes were statistically insignificant. After comparing 1.5% glycine with 5% dextrose water as irrigation fluids during TURP, we concluded that glycine was found to be better irrigation fluid as dextrose water causes more evident hyperv-olemia, hyponatremia and hemodilution than glycine