Comparison of glycaemic response to honey and glucose in type 2 diabetes.

OBJECTIVE: To compare the glycaemic effect of 75 gram and 30 gram of natural honey in a honey tolerance test with that of 75 gram glucose in type 2 diabetics. METHODS: The experimental study was conducted at the Jinnah Medical College Hospital, Karachi, and comprised 97 type 2 diabetic patients who came to the out-patient department between March and August 2011. The patients were randomly divided into 75 gram honey group (group 1), 30 gram honey group (group 2), and 75 gram glucose group (group 3). Fasting blood samples were obtained as well as after 1 and 2 hour. SPSS 11 was used for statistical analysis. RESULTS: Of the 97 participants, 62 (64%) were females and 35 (36%) males.Their ages ranged from 25-68 years. Mean rise in blood glucose after two hours in group 2 was 30 mg/dl; group 1, 85mg/dl, and group 3, 170 mg/dl. The difference was statistically significant (p <0.005).The glucose response was significantly lower at 2 hours in group 2 (p <0.001) compared to group 1 or group 2. A significant difference was also seen in group 1 and 3 (p <0.0001). The plasma glucose level in response to honey peaked at 60 min and showed a rapid decline compared to that of glucose, indicating a lower glycaemic response of honey. A small proportion of patients 3 (10.7%) even showed a glucose lowering effect after low dose of honey. CONCLUSION: Low dose of honey can be a valuable sugar substitute for patients with diabetes.

Lupus, still a mystery: a comparison of clinical features of Pakistani population living in suburbs of Karachi with other Asian countries.

OBJECTIVE: To determine the presenting features of patients with systemic lupus erythematosus at a private hospital in Karachi, and to compare the features with those of other Asian populations. METHODS: The retrospective study comprised records of all lupus cases meeting the revised American Rheumatism Association criteria at the time of presentation at Jinnah Medical College Hospital, Karachi, from May 2008 to June 2011. Demographic and clinical data was analysed using SPSS 11.5. RESULTS: Of the 105 cases in the study, there were 6 (5.7%) males and 99 (94.3%) females, with a male-to-female ratio of 1:16 and a mean age of 31.6+/-10.5 years. Clinical manifestations included: constitutional symptoms in (n=69; 65.7%), arthropathy (n=81; 77%), cutaneous involvement (n=39; 37%), lupus nephritis (n=24; 22.8%), pleurisy (n=9; 8.6%), Raynaud's phenomenon (n=24; 22.8%), and vasculitis (n=18; 17%). One (0.95%) patient presented with mononeuritis multiplex, and 1 (0.95%) with acute pancreatitis. CONCLUSION: The diversity in clinical presentation appeared to be a reflection of the great variability that exists among Asian countries with regards to their genetic, environmental and socio-demographic backgrounds. The differences also existed in our own population, suggesting some unknown etiology.

Interferon-induced central retinal vein thrombosis.

A middle-aged lady presented with sudden onset of unilateral central retinal vein thrombosis after completing 6 months course of interferon and ribavirin for chronic hepatitis C infection. She had no risk factors and all her thrombophilia workup was normal, however, she was found to be dyslipidemic which may have contributed to atherosclerosis and predispose to thrombosis. Despite anticoagulation, her visual acuity deteriorated. This case illustrates the possibility of unpredictable visual complication of interferon. Frequent eye examination should be undertaken in patients having underlying risk factors like diabetes, hypertension or dyslipidemia undergoing interferon therapy.