RESUMO
Objective: To determine the frequency of disease staging according to international scoring system in patients who are newly diagnosed with Multiple Myeloma [MM] at a tertiary care hospital at Karachi
Methods: This single center, non probability consecutive, cross sectional study was conducted from Nov 11, 2015 to May 11, 2016. After taking informed written consent, detailed history was taken and serum beta2 microglobulin and albumin levels were checked to assess the study outcome variable i.e. stage of MM. All the collected information was entered in the prescribed performa
Results: Eighty newly diagnosed patients with multiple myeloma as per inclusion criteria were included. Sixty seven [83.75%] were male and 13[16.25] were females, with mean age of 58.35+10.077 years. Twenty seven patients [33.75%] were found to have stage-I disease, in 23 [28.75%] stage-II and stage-III in 30 [37.5%]
Conclusion: Multiple myeloma is relatively common in 5th decade, with male predominance. International Staging System have great potential for characterizing and stratifying multiple myeloma and revealed a predominance of advanced stage III disease in our setting
RESUMO
Heart failure is a progressive, chronic disorder. Insulin resistance [IR] has been more and more involved as a preliminary metabolic perturbance predisposing to hyperglycemia, hyperlipidemia and atherosclerosis with others heart diseases. To investigate the relation of insulin resistance [IR] in non-diabetic heart failure patients this case-control study was carried out to ascertain the presence of IR with the aid of Homeostasis Model Assessment of Insulin Resistance [HOMA-IR] in non-diabetic heart failure patients [NDHF patients] compared with healthy controls. The sample size was calculated for both, cases [NDHF patients] and control [healthy subjects], which was initially consisted of 113 respondents each. The study consisted of two phase duration. In Phase I, NDHF patients were approached initially; only 80 patients with NDHF completed the study procedure. In Phase II, 80 healthy subjects were targeted and matched. Fasting blood glucose level [FBGL] and serum insulin was estimated. Mathematical model to quantify beta-cell function and insulin resistance was also computed through Homeostasis Model Assessment of Insulin Resistance [HOMA-IR] in both groups. Data was analyzed on SPSS version 16. Mean values with +/- standard deviation [SD] of insulin [10.2+/-4.36] and HOMA-IR [2.52+/-1.15] were significantly [p <0.05] higher in NDHF patients as compared to control subject [6.4+/-3.39, 1.45+/-0.80]. Average insulin to glucose ratio was 0.10+/-0.044 in NDHF patients which was significantly [p <0.0001] lowered in controls i.e., 0.073+/-0.039. Marginal and matrix plot analysis revealed that a higher patients count have had the HOMA-IR values <1.5 units while opposite scenario was observed in control group. Regression analyses of HOMA-IR with FBGL [as independent indicator] also authenticate the similar pattern. The present study concludes that insulin resistance [decreased insulin sensitivity] is a characteristic finding in Pakistani population of heart failure as compared to matched healthy controls