Major attributes of the personality studies: review of dissertations and research reports submitted to the national institute of psychology, Quaid-I-Azam university, Islamabad

This study aims to explore the main features of the studies in the broad domain of personality psychology conducted at National Institute of Psychology, Quaid-I-Azam University. The sample consisted of 34 studies. Fourteen [were M.Sc. research reports, 19 were M.Phil, dissertations, and only 1 was PhD. dissertation. Ten studies were of year 1987 to 1999 and 24 studies were completed during 2000 to 2007. There were 7279 participants in these 34 studies. In that, 5279 were men, one was transgender, and 1999 were women. Most commonly used personality measures were Urdu versions of CPI [Ahmad, 1986], NEO PIR [Chishti, 2002], and Mini Marker Personality Inventory [Manzoor, 2000]. Researchers have analyzed data by using both descriptive as well as inferential statistics like mean, standard deviation, correlation, t-test, and ANOVA. Results of these studies supported that effect of different personality dimensions vary from situation to situation and from person to person

Prevalence of impaired glucose tolerance among obese teenagers

Obesity has been accompanied by an increase in the prevalence of type-2 diabetes among adolescents. We determined the prevalence of impaired glucose tolerance in a cohort of 100 obese teenagers. Department of Medicine, BV Hospital, Bahawalpur. From January 2005 to January 2007. All subjects underwent a two-hour oral glucose-tolerance test [1.75 mg of glucose per kilogram of body weight], and glucose levels were measured fasting and during the first 30 minutes after the ingestion of glucose. Impaired glucose tolerance was detected in 21 percent of the 100 obese adolescents [11 to 19 years of age]; silent type-2 diabetes was identified in 4 percent of the obese adolescents. After the body-mass index had been controlled for, insulin resistance was greater in the affected cohort and was the best predictor of impaired glucose tolerance. Impaired glucose tolerance is highly prevalent among adolescents with severe obesity, irrespective of ethnic group. Impaired oral glucose tolerance was probably associated with insulin resistance

Intervention of insulin resistance at two stages in the evolution of type 2 diabetes

The purpose of this study was to compare the impact of treating insulin resistance with a thiazolidinedione drug before versus at the onset of diabetes on as per diagnosed by glucose levels and funduscopy. The study was conducted in Medical OPD, BVH, BWP from January 2001 to January 2007. One hundred twenty six non-diabetic young women who were 18-30 year old, with a history of GDM in the prior 4 year and a total glucose level on a 75-g oral glucose tolerance test [oGTT] above the median for women with gestational diabetes mellitus [GDM]were randomized to troglitazone [early intervention], 400 mg/d, or placebo [later intervention]. Women who developed diabetes were placed on open-label troglitazone. Glucose tolerance, insulin resistance, and funduscopy were measured at randomization, at the diagnosis of diabetes, and 8 months post trial to determine the long-term impact of the two treatments strategies on glucose levels and eye. During a mean follow-up of 4.3 year between baseline and post-trial tests, glucose tolerance [oral glucose tolerance test, P<0.04] and insulin resistance [P< 0.02] worsened more in women randomized to late intervention [n= 69] than to early intervention [n = 57]. Among women in the late intervention group who developed diabetes, retinopathy and cataract deteriorated significantly during development of diabetes on placebo and then did not change significantly [P >0.50] during treatment with troglitazone and post-treatment washout. In high-risk women, amelioration of insulin resistance can stabilize glycemia at the time diabetes develops. These findings highlight the role of insulin resistance in the genesis of progressive evolution of type 2 diabetes and successful treatment of insulin resistance in young, nondiabetic women with recent GDM lowered endogenous insulin requirements and stabilized pancreatic-cell function, thereby preventing type 2 diabetes in later life

Estrogen replacement therapy for depression in perimenopausal women

To determine the effect of a four-week course of oral estrogen therapy on depression in aging women. Quasi experimental. The OPD, Bahawal Victoria Hospital, Bahawalpur, from September 2000 to January 2004. Forty-two depressed women [aged 42-57] who were either perimenopausal [n=20] or postmenopausal [n=22] received open label treatment with oral estrogen tablets[1.25mg/day] for 4 weeks. The Montgomery-Asberg Depression Rating Scale and the Beck Depression Inventory were used to assess depressive symptoms, the Greene Climacteric Scale was used to assess menopause-related symptoms, and the Clinical Global Impression[CGI] was used to assess global clinical improvement in these women at baseline and after treatment. Remission of depression was defined as a score <10 on the Montgomery-Asberg Depression Rating Scale and a score < 2 on the CGI at week 4. The women who completed the study had a median Montgomery-Asberg Depression Rating Scale score of 20 [range= 15-32] at study entry and 11.50 [range= 10-31.0] at week 4 [z = -3.43, p<0.01]. This improvement was consistent with that reported by the women themselves on the Beck Depression Inventory [rs=0.86, n=20, p<0.01]. The improvement measured by CGI scores was also significant [p<0.01]. Remission of depression was noted in 5 of the 40 women [after 1 year] who completed the study. Anti-depressant response was not associated with severity or subtypes of depression at study entry or with concomitant improvement in menopause-related symptoms. Perimenopausal and postmenopausal women benefit from short-term use of estrogen therapy. Antidepressant effect of estrogen therapy is independent of improvement in menopause-related symptoms

Clinical chemistry laboratory testing; Evaluation at Quaid-E-Azam medical college, Bahawalpur after autonomy

To determine the affect of autonomy on clinical chemical testing in pathology department Quaid-i-Azam Medical College and to assess the change in the attitudes of laboratorians and physicians Retrospective and comparative. 1-11-93 to 01-11-03. A retrospective study was carried out from 1-11-93 to 01-1103 in which records from 1-11-93 to 1-11-03 were collected and evaluated. Separate record of each month's revenue from clinical chemistry section was calculated. In order to determine what changes have been brought about after autonomy a universal questionnaire was used to assess the attitudes of physicians and surgeons of hospital inquiring whether they noticed any improvement in the efficiency of clinical chemical test results after autonomy. 620 doctors were interviewed through structured questionnaire. The questionnaire was designed to assess the knowledge, attitude and practices of doctors towards autonomy. In order to determine that who is the most beneficent of autonomy, different records were collected and discussions were made with consultants. Autonomy brought about a healthy change in the staff of clinical chemical section. Quality control has improved the morale of lab staff since technical deviations are more readily identified and corrected within the lab, gross errors are rarely found by the clinicians and so their respect for and confidence in the lab has strengthened Replenishment of chemicals/reagents are timely made. The number of available test has significantly increased which in turn has significantly raised the revenue generated since autonomy is awarded. Pilferage of chemicals has been stopped. Turn around time has been decreased. Clinical Chemical section participates in External Quality Assessment Scheme, NEQAPP [National External Quality Assessment Program Pakistan], which is an essential pad of the routine of a well-run lab. Patient is the most beneficent since autonomy is awarded to QMC/BVH, BWP. A significant improvement in the efficiency of the analytical performance has strengthened the faith of laboratorians and physicians in the test results after autonomy

Relationship between chronic hepatitis C and type-2 diabetes mellitus in Bhawalpurian patients

Objective: To establish a potential relationship between chronic hepatitis C virus infection and diabetes mellitus in Bahawalpur Design: Comparative study

Setting and Period: Bahawal Victoria Hospital and four different private clinics in Bahawalpur during 2002 to 2003

Material and Methods: 1. The case record files of 100 patients with chronic hepatitis C vs. 100 with chronic hepatitis B were reviewed and the laboratory and demographic data were extracted. 2. Anti-HCV and HBsAg were determined for 100 type 2 diabetes patients and 100 healthy adults by ELISA. The diagnosis of diabetes was based on the new WHO criteria. Pearson`s correlation coefficient was calculated and tested for significance

Results: 1. The occurrence of diabetes in patients with chronic hepatitis C was 19%, higher than 8% in patients with chronic hepatitis B [P<0.01]. Age and HCV infection were independent risk factors for diabetes. 2. Three patients with type 2 diabetes were anti-HCV positive while none of the 100 healthy adults was anti-HCV positive [P<0.05]. Four patients with diabetes and five healthy adults were HBsAg positive [P>0.05]

Conclusion: 1. Diabetes Mellitus was found to be significantly more frequent among HCV related liver disease patients when compared with HBV infected liver patients. 2. The frequency of anti HCV was higher in diabetes patients as compared to healthy adults. HCV can be a trigger factor in the development of diabetes mellitus

Chronic liver disease; precipitating factors for encephalopathy

Objective: To find out common precipitating factors leading to hepatic encephalopathy in selected known cases of cirrhosis of liver .Design: It is a descriptive study comprising patients selected through non-probability convenient sampling. Setting: Department of Medicine, Bahawal Victoria Hospital, Bahawalpur. Period: From January 2000 to December 2002

Subject: Fifty [50] known cases of cirrhosis of liver with encephalopathy

Main Outcome Measures: One or more precipitating factors leading to hepatic encephalopathy, grades of encephalopathy, etiology of cirrhosis of liver

Results: Thirty two [64%] patients were male and 18 [36%] females. The commonest age group involved was between 40-49 years [26%]. Most of the patients [46%] were in grade-IV encephalopathy. HBV [46%] was the commonest cause of cirrhosis. The most common precipitating factor of encephalopathy was gastrointestinal bleeding in 20[40%] patients. Other precipitating factors detected were, infections in 15[30%] patients, combination of gastrointestinal bleeding and infections in 7[14%], constipation in 3[6%], gastrointestinal bleeding and constipation in 2[4%], infections and constipation in 2[4%] and abdominal paracentesis in 1 [2%]patients

Conclusion: Gastrointestinal bleeding is the most common precipitating factor of encephalopathy followed by infections

Effect of pregnancy on diabetic nephropathy and retinopathy

To determine whether pregnancy worsens renal function in women with diabetic nephropathy and the effect of pregnancy on diabetic retinopathy. Design: Cross-sectional analytical study. Place and Duration of Study: The study was conducted in OPD, Bahawal Victoria Hospital, Bahawalpur from September 1997 to June 2003. Subjects and Thirty-five patients [aged 20-36 years] identified with diabetic nephropathy and moderate to severe renal dysfunction[creatinine [Cr] > 1.4 mg/dl] at pregnancy onset by retrospective chart review. Alterations in glomerular filtration rate [GFR] were estimated. An equal number of non-pregnant premenopausal type I diabetic women with similar degrees of renal dysfunction served as controls for non-pregnant rate of decline of renal function and potential contributing factors. Student's t-test and repeated measures analysis of variance were analyzed. Mean serum Cr rose from 1.8 mg/dl prepregnancy to 2.5 mg/dl in the third trimester. Renal function was stable in 27%, showed transient worsening in pregnancy in 27%, and demonstrated a permanent decline in 45%. Proteinuria increased in pregnancy in 79%.Exacerbation of hypertension or pre-eclampsia occurred in 73% and 71% of these showed acceleration of disease during the pregnancy. All the patients had diabetic retinopathy, though proliferative retinopathy was diagnosed and treated in only 54.5.% prepregnancy. The retinopathy progressed, requiring laser therapy, in 45.4%. Macular edema was noted in 6 of the patients. Other diabetic complications included peripheral and autonomic neuropathy in 8 patients. Pregnancy induced progression is seen in the decline of renal functions. Patients with diabetic nephropathy were found to have a > 40% chance of accelerated progression of their disease as a result of pregnancy. Forty-five% of the patients had permanent decline in GFR in association with pregnancy

Stroke in hypertensive patients

To find the incidence of hypertension in stroke patients comparing it with other common risk factors and to determine the frequency of occurrence of reactive rise in blood pressure in the acute stage of stroke in normotensive patients. A prospective study. The study was conducted in Medical Unit III B V Hospital Bahawalpur from Feb 2001 to May 2002. One hundred consecutive CT Scan confirmed patients of stroke from emergency department were evaluated for various risk factors by using a proforma to record the bio-data, history of hypertension, diabetes mellitus, ischemic heart disease, transient ischemic attacks, smoking and past history of stroke. After segregating the hypertensive stroke patients, the reactive rise in blood pressure due to acute stage of stroke was also studied in the normotensive patients. Out of the 1334 admitted patients 7.49% [100 patients] accounted for acute stroke. There were 64 [64%] males and 36 [36%] Female patient. 78 patients [78%] had cerebral infarction while 22 [22%] were having hemorrhagic stroke. 49 patients [49%] were hypertensive. Out of these 30 [61.22%] were males and 19 [38.77%] were females. 35 patients [7l.42%] had cerebral infarction while 14 [28.57%] patients had hemorrhagic stroke. Hypertension was a risk factor in 35 out of 78 patients [44.87%] with cerebral infarction, while it was present in 14 out of 22 patients [63.63%] with hemorrhagic stroke. Comparing hypertension 49% to the other commonly encountered risk factors in the study, smoking was found in 30%, diabetes mellitus in 19%, ischemic heart disease in 18%, atrial fibrillation in 6% and other cardiac diseases in 4% of all the cases of stroke. Reactive rise in blood pressure in normotensive patients with acute stroke was found in 51% [26 out of 51] cases. Hypertension is the most common risk factor for all types of strokes and a significantly high proportion of normotensive patients show a reactive rise in blood pressure in the acute stage of stroke, which usually becomes normal within a week, without any anti-hypertensive therapy.