Clinical spectrum and risk factors of stroke - a study of 80 patients

To determine the clinical presentation and frequency of hypertension, diabetes mellitus, hyperlipidaemia, ischaemic heart disease, obesity, and other disorders which have a role in pathogenesis of stroke in patients belonging North Punjab. Descriptive Study. Medicine Department of Combined Military Hospital Jhelum from September 2009 to September 2010. Patients with features of stroke confirmed by CT scan brain were enrolled. Brain imaging showing abnormality e.g. brain tumour, meningitis, multiple sclerosis and metabolic derangements that could explain focal neurologic deficit were the exclusion parameters. The clinical presentation and frequency of hypertension, diabetes mellitus, hyperlipidaemia, ischaemic heart disease, obesity, smoking, atrial fibrillation and past history of TIA /stroke among males and females were evaluated. A total of 80 consecutive patients with ischemic and hemorrhagic stroke were included in this study. There were 53 males and 27 female patients with male to female ratio of 1.9:1. The age of patients ranged from 50 to 80 years. [Mean-63.75 years]. Out of 80 patients, 42 [52.5%] had ischemic stroke and 35 [43.75%] had haemorrhagic stroke, 3 [3.75%] patients had subarachnoid haemmorrhage Sixty [75%] patients presented with right hemiparesis/hemiplegia, 17[21.25%] patients with left hemiparesis/hemiplegia, 12 [15%] were unable to speak properly, 24 [30%] patients had headache, 17[21.25%] patients developed coma, 08 [10%] had fits and 13 [16.25%] patients had vomiting. Hypertension was found in 51 [63.75%] patients, smoking in 35%, diabetes mellitus in 33.75%, hyperlipidaemia in 31.25%, ischaemic artery disease in 15%, obesity in 23.75%, past history of TIA /stroke in 15% and atrial fibrillation in 6.25%.Frequency of hypertension, diabetes mellitus, hyperlipidaemia, ischaemic heart disease, and smoking was high in stroke patients. These can be modified by proper health education. This can have a great impact on the morbidity and mortality of stroke.

Diabetes mellitus; prevalence in patients of chronic hepatitis C

To determine the prevalence of Diabetes mellitus in patients of hepatitis C virus infection. Prospective and observational study. Medical Wards at Combined Military Hospital Jhelum. Period: 1st November 2009 to 31st October 2010. Method: 100 cases of HCV positive on Elisa method were inducted. All cases were segregated into different states of liver disorders and were screened for Blood Sugar level, for one year. So as to observe the frequency of Diabetes Mellitus among HCV positive patients. Diabetes mellitus was considered to be present if patients were already on diabetes treatment or fasting or random blood sugar indicated diabetes mellitus according to standard criteria. One hundred patients were studied. Fifty five [55%] were males and forty five [45%] were females. The ages ranged from 15 to 71 years [Mean 44.24]. Out of these 100 patients, total of 28 [28%] had diabetes mellitus. Out of 100 patients, 82 patients had chronic hepatitis C virus infection without cirrhosis and 22 [26.4%] of these had diabetes. Twenty two patients with chronic hepatitis C, who had diabetes mellitus, twenty [90.9%] were non-insulin dependent diabetics and two [9.1%] were insulin dependent. Total of 18 patients had cirrhosis and out of these 6 patients [33.33%] had diabetes mellitus. Six patients with cirrhosis all had non-insulin dependent diabetes mellitus. Patient with chronic hepatitis C virus infection and cirrhosis secondary to hepatitis C virus infection have strong association with diabetes mellitus and great majority of them are non-insulin dependent diabetics

Clinical spectrum of cirrhosis liver a study of 167 cases

The present study was designed to find out the aetiological pattern, presentation and to assess the severity of liver disease in patients of cirrhosis at time of presentation. A descriptive study. The study was conducted in the medical department of CMH Peshawar from January 2007 to June 2008. This study was conducted in the Medical Department of Combined military hospital Nowshera and Combined military hospital Peshawar. Cirrhotic patients were admitted to Medical ward and necessary investigations were done. Serum was tested for Hepatitis B surface antigen [HBsAg] and antibodies against Hepatitis C virus [anti HCV] by ELISA method. Where negative, serum was tested for HBcAb [IgM as well as Total], Anti Nuclear antibody, Anti Smooth muscle antibody, Liver Kidney microsomal antibodies, serum Ferritin level, Transferrin saturation and serum ceruloplasmin level. Liver biopsy was done in selective cases. Ninety- eight patients [58.6%] were male and sixty-nine [41.3%] were female. Out of 167 patients, 113 [67.6%] were found infected with HCV, 30 [17.9%] with HBV. In 18 patients [10.7%] all serological and metabolic profile was negative. Major presentations of Cirrhosis were coagulopathy [88%], Ascites [53.9%], Anaemia [45.2%] and Jaundice [35.95%]. 66 patients [39.5%] were in class A of Child-Pugh scoring system, 59 patients [35.3%] in class B and 42 patients [25%] in class C respectively. Cirrhosis liver due to HCV is more common than HBV in this region. Males are affected more than females. Majority of patients are in Child-Pugh class A and B at presentation. Internal Medicine

Prevalence of anti hepatitis C antibodies and hepatitis B surface antigen in healthy blood donors in Baltistan

To determine the prevalence Hepatitis C and Hepatitis B in healthy blood donors in Baltistan. A descriptive study. All the healthy donors between 20-45 years of age visiting DHQ hospital Skardu were screened for Anti HCV and HBs Antigen. Eight Hundred and fifty donors were including in the study. The overall percentage of Anti HCV was 1.1% and HBs Ag was 8.4%. The percentage rate of Hepatitis B quite high in Baltistan, whereas HCV positivity in rather low in this areas