ABSTRACT
INTRODUCTION: Recent years have been alarming due to the sudden, dramatic rise in the incidence of Clostridium difficile infection (CDI). Identifying and addressing the risk factors associated with CDI will help in reducing the incidence of infection and associated complications. METHODS: This case-control study was conducted in a tertiary care hospital in Pakistan from June 2020 to March 2021, in which 200 patients diagnosed with Clostridium difficile-associated diarrhea (CDAD) were enrolled in the study. CDAD was diagnosed based on clinical symptoms and stool enzyme immunoassay. Another 200 participants without a diagnosis of CDAD were enrolled from the outpatient department as a control group. Participants were enrolled after seeking informed consent. RESULTS: In patients older than 65, risk of CDI was higher compared to participants lower than 65 years old (15.5% vs. 8.0%; p value: 0.02). Hospitalization (25.5% vs. 6.0%; p value < 0.0001), the use of proton pump inhibitors in last 30 days (23.0% vs. 10.5%; p value: 0.001) , and use of antibiotics in the last 30 days (36.0% vs. 10.5%; p value < 0.0001) were significantly higher in participants with CDI. CONCLUSION: Hospitalization, the usage of proton pump inhibitors, and antibiotics in the last 30 days were significantly associated with CDI. A higher incidence of CDI was associated with risk factors like increased body mass index, diabetes, chronic kidney disease, and malignancy.
ABSTRACT
Introduction The prevalence of obesity in developing countries, including Pakistan, has increased several fold in recent times. Obesity appears to negatively affect sexual functioning, hence affecting the quality of life. Its impact on sexual function is understudied. In this study, we will determine the impact of weight loss in improving sexual function in the local setting. Methods This prospective study was conducted in the endocrinology unit of a tertiary care hospital in Pakistan from February 2019 to January 2021. After taking informed consent, 300 married female participants were enrolled in the study. The questionnaire was composed using the pointers from the female sexual function index (FSFI). The privacy of the participants was fully ensured. After the survey, participants were counseled on losing weight via various techniques. Participants were followed up on day 30, day 60, and finally on day 90. On day 90, the FSFI questionnaire was repeated to assess sexual function. Weight loss was measured at the end of day 90. Result A total of 208 participants completed the study. Significant improvement in FSFI score was seen in participants with weight loss between 2% and 5% of their initial body weight (24.01 ± 2.2 vs. 26.07 ± 2.6; p-value: <0.0001). Similarly, a significant improvement in FSFI score was seen in participants with weight loss of more than 5% (24.17 ± 2.2 vs. 27.01 ± 2.6; p-value: <0.0001). Conclusion In conclusion, weight loss is associated with improved sexual function in females. While discussing complications of obesity, impact on sexual function should also be discussed.
ABSTRACT
INTRODUCTION: Atherosclerosis contributes to the underlying pathophysiology for peripheral arterial disease (PAD), coronary artery disease (CAD), and cerebrovascular disease. Several studies have been conducted to demonstrate PAD as a major risk factor for cardiovascular (CV) events, however, the regional data are limited. This study aims to highlight PAD as a major risk factor in CV events in a local setting. METHODS: In this longitudinal study, 400 hypertensive patients with a confirmed diagnosis of PAD were enrolled from the outpatient department of the cardiology unit. Diagnosis of PAD was made using the ankle brachial index (ABI). ABI less than 0.9 was labeled as participants with PAD. Another group of 400 without PAD was also enrolled as the control group from the outpatient department of cardiology unit. Patients were followed up for 12 months or for the development of myocardial infarction (MI). RESULT: Participants with PAD had a significant increased risk of total MI events with a relative risk (RR) of 1.67 (confidence interval, CI 95%: 1.05-2.66; p-value: 0.02). The RR for fatal MI was 2.62 (CI 95%: 0.94-7.29; p-value: 0.06) compared to the participants without PAD, however, it was not significant. CONCLUSION: This study has focused on the risk factors of PAD and has suggested that the patients who have any of the mentioned risk factors should be treated with caution under strict instructions given by doctors. A variety of treatment options is available, but the initial changes should be made in the lifestyle of these patients, making sure the risk factors are being treated.
