A Retrospective Analysis on the Cystic Echinococcosis Cases Occured in Northeastern Punjab Province, Pakistan

A retrospective study was performed to report the case occurrence of cystic echinococcosis (CE) in three hospitals of north-eastern region in Punjab Province, Pakistan. We reviewed retrospectively the clinical records of patients in 4 hospitals which were diagnosed with CE during 2012–2017. A total of 198 cases, 82 (41.4%) male and 116 (58.6%) females were detected as CE. The most Highest incidence was revealed in.... 21–30 years-old group (24.2%) followed by 41–50 (22.7%), 31–40 (16.2%), 11–20 (13.6%), 51–60 (8.1%), below 10 (5.5%), over 71 (5.1%) and 61–70 year-old group (4.5%). CE was detected in various organs of infected individuals. However, most of CE cases were detected in the liver (47.4%) and lung (18.6%). The present study indicated that CE is more or less prevalent in surveyed areas and one of the most important public health problems in Punjab Province, Pakistan.

Validity of grace risk score as a prognostic marker of in-hospital mortality after acute coronary syndrome

Objective: to determine validity of GRACE risk score as a determinant of immediate death during hospitalization for Acute Coronary Syndrome [ACS] and analyze the percentage of cardiac deaths among high, intermediate and low risk groups

Study Design: cross-sectional study

Place and Duration of Study: Coronary Care Unit of Mayo Hospital, Lahore, from April to July 2015

Methodology: patients with acute chest pain were selected according to inclusion and exclusion criteria. Online GRACE risk score calculator was used to determine the predicted risk of death following ACS according to the score. Data was analyzed on SPSS 20. Quantitative data was in the form of median [IQR]. Discrimination of GRS was evaluated by using c-statistics, area under the ROC curve. Calibration of GRS was tested by Hosmer-Lameshow test. The correlation between GRACE risk score category and predicted risk of death was determined using Kendall's tau-b bivariate correlation test. Shapiro-Wilk test was applied to check normality of data. The various parameters of GRACE score were studied in patients using Mann-Whitney U-test. The statistically significant p-value was <0.05

Results: there were 165 cases in the study. Overall median GRS was 139 [54]. In-hospital deaths were 12.2%. Discrimination of GRS evaluated by area under the ROC curve was 0.913 [95% CI 0.843-0.982; p<0.0001]. Application of Hosmer-Lameshow test revealed a p-value of 0.236. Kendall's tau-b bivariate correlation coefficient was 0.384 [p<0.001]

Conclusion: GRS is an excellent tool to stratify patients of ACS into different risk categories according to various parameters noted at the time of presentation. The risk of predicted death according to the score was variable among different cases, especially those with higher scores. Even though GRS is an effective and valid tool, but it has some tendency of overestimating probability of death following ACS and may require a fine tuning in some cases

Frequency of Type-2 diabetes mellitus in Nephropathic patients and comparison of mean magnesium levels in Nephropathic patients with and without Type-2 diabetes mellitus

Objective: The objective of this study was to determine the frequency of Type 2 diabetes mellitus [T2DM] in patients with nephropathy [i.e. Chronic Kidney Disease Stage 1 to 3] and to compare the mean magnesium levels in diabetic nephropathic patients and non-diabetic nephropathic patients

Methods: This cross-sectional study was conducted in department of Medicine, Mayo Hospital Lahore from August 2014 to February 2015. Using non-probability purposive sampling 200 nephropathic [Chronic Kidney Disease Stage 1 to 3] patients were selected. Patients were assessed for T2DM and divided in two groups on the basis of presence or absence of DM. Magnesium levels were recorded in both groups. Percentages, mean, standard deviation and unpaired t-test was used to assess the data. SPSS was used for analysis of information

Results: Total number of cases were 200, 43.5% [n=87] out of them were between 25-50 years of age while 56.5% [n=113] patients were between 51-70 years. The Mean+SD was calculated to be 51.38+11.51 years, The male patients were 48.5 %[ n=109] while 51.5 %[ n=91] were females. The frequency of DM in patients with nephropathy was 25.5% [n=51]

Comparison of mean magnesium levels in nephropathic patients with and without diabetes was done. The results showed nephropathic patients having diabetes had 1.54+0,301 mg/dL magnesium levels while cases without diabetes had 1.92+0.313 mg/dL levels of magnesium, p value was calculated as 0.001 showing a significant difference between the two groups

Conclusion: The frequency of diabetes mellitus is higher among patients with nephropathy while on comparison of mean magnesium levels, nephropathic patients with diabetes had significant lower levels of magnesium as compared to without diabetes

Diagnostic accuracy of antinuclear antibodies and anti-double stranded DNA antibodies in patients of systemic lupus erythematosus presenting with dermatological features

Objective: To determine the diagnostic accuracy of antinuclear antibodies [ANA] and anti-double stranded DNA [dsDNA] antibodies in systemic lupus erythematosus patients presenting with dermatological features

Methods: In this cross-sectional study, 82 patients diagnosed as having systemic lupus erythematosus [SLE] per American College of Rheumatology [revised criteria 1997] from October 2012 to October 2013 and fulfilling the study's inclusion criteria were enrolled. These patients were first assessed by the dermatologist for four dermatological features, namely malar rash, discoid rash, photosensitivity and oral ulcers and were than referred to Department of Pathology for assessment of serological markers i.e. ANA and anti-dsDNA antibodies. The diagnostic accuracies of serological markers were analyzed to determine which one of the two serological markers is associated with any of the four dermatological features under observation in our study

Results: Out of 82 SLE patients, 77 [93.9%] patients were females and 5 [6.1 %] were males. Male to female ratio in this study was 1:15. Mean age of patients was 34.91 years and ranged between 8-62 years. Photosensitivity, malar rash, oral ulcers and discoid rash were found in 97.5%, 85.3%, 76.8% and 46.3% patients, respectively. ANA was not found to be statistically significantly associated with any of the dermatological features under observation in our study. However, anti-dsDNA antibodies were strongly associated with photosensitivity 0.024 [p<0.05] and malar rash was 0.003 [p<0.05]

Conclusion: The study proves that anti-dsDNA antibodies have high diagnostic accuracy for photosensitivity and malar rash in SLE patients and can be used alone with confidence in patients presenting with these two dermatological features, without burdening the lab with a lengthy serological evaluation