Prediction of large esophageal varices in patients with decompensated cirrhosis by child-pugh score, in medical unit-ii, chandka medical college hospital, larkana

To assess prediction of large esophageal varices in patients with decompensated cirrhosis by Child-Pugh score, in Medical Unit-II, Chandka Medical College Hospital Larkana. Cross sectional study. This study was carried out at Medical Unit II, Chandka Medical College and Hospital, Larkana from November 2011 to November 2012. In this study 88 consecutive cirrhotic patients with ascites [those Patients who fulfilled the inclusion criteria] were included; blood samples for Serum bilirubin, serum albumin, and INR ratio were sent to single laboratory. Then, child Pugh score were assigned to each patient on the basis of clinical and to laboratory parameter. The ultrasound of abdomen was carried out for size of liver and spleen, portal vein diameter, and quantification of ascits. Eligible patients were subjected for upper gastrointestinal endoscopy for the presence of esophageal varices and their grading. The data was analyzed using SPSS version 19. The mean age of enrolled patients was 43.19 +/- 7.1 years. Of 88 patients, 69 [78.4%] were male and 19 [21.6%] were female. Child Pugh class relation to number of patients were; 52, 20, and 16 in class A, B, and C respectively. While Child Pugh class relation to frequency of esophageal varices were; 6, 11 and 14 in class A, B, and C respectively. Frequency of grading of esophageal varices was; 4, 13, and 14 in grade one, two, and three respectively. Distribution of large esophageal varices [LEVX] in relation to child Pugh class is one in class A, two in class B and 11 in class C. It is concluded from this study that; as the child pugh score advances, the number and size of esophageal varices increases, and chance of absence of varices decreases

frequency of impaired glucose tolerance in patients of essential hypertension in tertiary care Hospital, Larkana

To determine the frequency of impaired glucose tolerance in patients of essential hypertension. Descriptive Cross sectional study. This study was conducted at the Medical Outpatient department of Chandka Medical College Hospital Larkana, over one year period from February 2012 to February 2013. Total 171 patients of age 40-70 years having hypertension more than 2 years were purposively selected, while Known cases of DM, secondary hypertension and metabolic syndrome were excluded. Oral glucose tolerance was performed on selected patients of essential hypertension and plasma glucose was measured 2 hours after giving 75 g of glucose to each patient. Patients with [2 hours plasma glucose] level of 140-199 mg/dl were considered impaired glucose tolerance. Frequency was calculated for gender, number and type of medication and impaired glucose tolerance. The mean and SD were calculated for age, height, weight, BMI and duration of HTN. Stratification of age, gender, BMI and duration of hypertension done while applying Chi-Square with p value <0.05 as significant. One hundred and seventy one [171] patients met the inclusion criteria with mean age of 53.42 +/- 8.059 among those 104 were males [60.81%] while 67 were females [39.19%]. Duration of hypertension ranged 3-15 years with a mean duration of 7.47 +/- 3.26 years. Mean Body mass index [BMI] was 25.95 +/- 4.32, minimum BMI 17.88 and maximum BMI was 39.91. Frequency of IGT was 39.2% [n=67]. Mean serum glucose level at 2 hours in these patients was 159.33 +/- 27.937 grams/dL. Males were more affected while age has little effect on IGT frequency. More the duration of hypertension more was the prevalence of IGT. BMI was significant effect modifier for IGT; in overweight and obese patients the frequency of IGT was much higher [40.58% in overweight and 69.23% in obese] than normal weight patients [27.78%]. [p value <0.003]. IGT is much frequent in essential hypertension. Hypertensive males, elder age, longer duration of hypertension, high BMI and use of more than one antihypertensive medicine are associated with higher rates of IGT. This study suggests that all the patients with essential hypertension should be scrutinized for blood glucose levels

Incidence of methicillin resistant Staphylococcus aureus in Peshawar

There is considerable variation in the percentage of isolates of methicillin resistant Staphylococcus aureus [MRSA]. There are several mechanisms for methicillin resistance. The most important is low affinity of penicillin binding proteins for beta-lactam antibiotics. The objectives of this study were to establish the pattern of MRSA incidence in Peshawar in recent years, and to identify high risk groups for acquiring infection amongst the city population. All positive MRSA cases reported at city laboratory were employed in the study. These were recorded over the time period elapsing from 2009 to 2011. For each patient, records were looked at for age, sex, specimen tested positive, hospital/community acquired and if hospital acquired then which particular hospital within the city was infection contracted at. Also patient records were addressed for any immune system abnormalities, any operation conducted, presence or absence of diabetes and any history of intravenous drug use. There were a total of 929 MRSA cases in our study, of which 538 were males and 391 were females. MRSA frequency for the year 2009 was 207, for 2010 it was 284 and for 2011 it was 438. The frequency of MRSA increased by 54% from the year 2009 to 2011. A potentially alarming increase in MRSA incidence within the city has been observed in recent years threatening to rise further judging the current trend. Those at a high risk of contracting infection include males aged between 20-29 years, hospitalised, diabetics, immune system compromised, and individuals with a history of IV drug use