The clinical and demographical profile of Coronavirus illness: The tale of Tablighi Jamaat and Zaireen in Quarantine / Isolation center at Sukkur and Hyderabad.

OBJECTIVES: To determine the clinical and demographical profile of corona-virus illness among Tablighi Jamaat and Zaireen kept in quarantine / isolation center at Sukkur and Hyderabad Sindh. METHODS: The cross-sectional descriptive study (late March-2020 to mid of April-2020) was conducted at Diagnostic & Research Laboratory LUMHS Jamshoro / Hyderabad. All the suspected cases for COVID-19 were recruited and screened for corona virus infection. The study explored the data of the suspected and diagnosed (confirmed) case of COVID-2019 (Tablighi Jamaat and Zaireen) reported by Diagnostic Research Laboratory Liaquat University of Medical and Health Sciences (LUMHS) Jamshoro who belonged to various parts of the country in general and province Sindh in particular. All the individuals regardless of age and gender presented either as asymptomatic, critical ill or having non-specific symptoms as fever, flu, cough; sore throat and shortness of breath were screened for COVID-19 by real time PCR after taking informed consent whereas the frequency / percentages (%) and means ±SD computed for study variables. RESULTS: During study period total 920 patients were explored and screened for Corona virus infection. The mean ± SD for age (yrs) of overall population of city Sukkur and Hyderabad was 57.83±8.84 and 59.62±9.72 respectively. The 700 people from Sukkur city was screened and out of them 276 (39.4%) were positive and 424 (60.5) were negative while the cure rate was 245 (88.7%) along with mean ± SD for recovery time was 9.41±2.97. The 220 people from Hyderabad city was screened and out of them 106 (48.1%) were positive and 114 (51.8%) were negative while the cure rate was 106 (100%) along with mean ± SD for recovery time was 11.54±3.42. The majority of cases at both centers were asymptomatic (90%), symptomatic (7%) and critically ill (3%). The mortality accounted for 2.8% cases at Hyderabad isolation center and all were having smoking history and co-morbidities as ischemic heart diseases, diabetes mellitus, obstructive lung disease and cerebrovascular accident whereas no mortality was observed at Sukkur isolation center. CONCLUSION: RT-PCR measure allowed fast, delicate, and explicit discovery of SARS-CoV in biochemical diagnosis. The majority of cases at both centers were asymptomatic while the mortality was identified in 2.8% cases (having co-morbidities) at Hyderabad isolation center whereas no mortality was observed at Sukkur isolation center.

Serum zinc level in patients with pneumonia: a six-month long cross-sectional descriptive study at Liaquat University Hospital Hyderabad, Sindh, Pakistan.

OBJECTIVE: To determine the serum zinc level in patients with pneumonia. METHODS: The descriptive cross-sectional study was conducted at the Liaquat University Hospital, Hyderabad, Pakistan, from September 2008 to February 2009. All patients above 12 years of age and of either gender who had been diagnosed with pneumonia were further evaluated for their serum zinc status.The data was analysed through SPSS 10.00, and p<0.05 was considered statistically significant. RESULT: The mean age of the 118 patients in the study was 25.64 +/- 6.53 years. The mean serum zinc level was 8.279 +/- 2.77 mmol/L, while the mean serum zinc levels in patients having low and normal levels was 6.740 +/- 1.47 mmol/L and 13.243 +/- 1.52 mmol/L respectively (p<0.001). The serum zinc was low in 42 of the 72 (58%) males, and 35 of the 46 (76%) females (p<0.04). There was also significant difference between mean serum zinc level in male and female patients (p<0.03). Out of 77 (65%) hypozincaemic patients, 69 (90%) recovered, while 08 (10%) failed to recover) during their hospital stay (p<0.33). Of the 69 who recovered, 29 (42%) patients did so in less than 2 weeks, while 40 (58%) patients recovered in more than 02 weeks. CONCLUSION: Serum zinc level was found to be low in patients with pneumonia.

Foetal outcome in patients with meconium stained liquor.

OBJECTIVE: To determine the foetal outcome and mode of delivery in patients with meconium stained liquor during labour. METHODS: The observational study was carried out at the Obstetrics and Gynaecology Unit-II of Liaquat University of Medical Health Sciences from June to November 2007. The patients with gestational age more than 37 weeks who presented with meconium stained liquor and cephalic presentation were included and the foetal outcome and mode of delivery was assessed in all such subjects. The data was collected on pre-designed proforma and analysed using SPSS version 10. Chi square test was applied with 95% confidence interval and p-value < or = 0.05 was considered significant. RESULTS: A total of 75 patients with meconium stained liquor were identified during the study period. The patients with reactive cardiotocography (CTG) were 50 (66.7%) and with non-reactive CTG, 25 (33.36%). Of the total, 45 (60%) patients were delivered through normal vaginal delivery, while 30 (40%) were delivered by caesarean section. The rate of instrumental delivery was also increased which was 12 (26.7%). Among the neonates exposed to meconium stained liquor, 62 (82.7%) babies were delivered with apgar score > 7. Only 13 (17.3%) babies were delivered with apgar score < 7 in one minute. CONCLUSION: Meconium stained amniotic fluid is a common occurrence during labour and is associated with increased caesarean section rate and foetal morbidity and mortality.

Frequency of syphilis in female sex workers at red light area of Hyderabad, Pakistan.

OBJECTIVE: To determine the frequency of syphilis in female sex workers (FSWs) at red light area of Hyderabad. METHODS: This study was conducted on female sex workers at red light area of Hyderabad, Pakistan during 2003. All female subjects who were between 17-35 years of age were evaluated and enrolled in the study. All such subjects were screened. for Treponema pallidum infection/syphilis by Treponema Pallidum Haemagglutination assay (TPHA). The frequency was determined by identifying the positive Treponema pallidum infected patients. For getting results the data was saved and analyzed in SPSS version 10.00. RESULTS: Total fifty (50) female sex workers were studied; their mean age was 26.22 +/- 4.47 years. Syphilis was identified in 22 (44%) females with mean age of 22.68 +/-1.46 years while remaining 28 (56%) with mean age 29.00 +/- 4.06 years were free from syphilis (p < 0.001). CONCLUSION: The female sex workers are prone and at risk to acquire sexual transmitted infections (STI), therefore for control and preventive measures, screening programmes should be initialized.

Type 2 diabetes mellitus: A risk factor for Helicobacter pylori infection: A hospital based case-control study.

OBJECTIVE: To determine the frequency of Helicobacter pylori (H. pylori) infection in diabetic and non-diabetic patients and to compare the frequency of H. pylori infection in both groups. STUDY DESIGN: Case control. PLACE AND DURATION: Department of Medicine, Liaquat University Hospital from October 2007 to March 2008. MATERIALS AND METHODS: This hospital-based case-control study was conducted on 148 subjects and divided into two groups i.e. type 2 diabetics and non-diabetics; each group consisting of 74 patients. All diabetic patients of >/= 35 years of age, both gender and the known cases with history of dyspepsia, epigastric pain or bloating for more than a month were screened for Helicobacter pylori infection. The collected data of both groups was evaluated and separated for analysis. RESULTS: Majority of the patients were male with mean age +/- SD, 52.86 +/- 8.51. Among the diabetic group, HpSA was positive in 54/74 (73%), whereas in the non-diabetic group HpSA was positive in 38/74 (51.4%) cases. Fasting blood glucose was identified as low in 04 (5.40%) H. pylori infected - diabetic patients where as the blood glucose level of 07 (9.45%) known diabetic patients was raised despite the ongoing medication. CONCLUSION: Diabetic patients are more prone and at risk to acquire H. Pylori infection. Therefore proper monitoring of blood glucose level and screening for H. pylori infection are effective preventive measures for this life threatening infection.

Metabolic investigations in patients with hepatitis B and C.

AIM: To investigate the similarities and dissimilarities in patients with hepatitis B and hepatitis C, clinically and metabolically. METHODS: Fifty patients with hepatitis B virus and hepatitis C virus infection were included in this study, along with fifty healthy controls for comparison purposes. Intravenous blood (10 mL) samples from patients and healthy subjects were collected and made to clot before serum was separated and immediately levels of the enzymes, alkaline phosphatase (ALK), creatinine phosphokinase (CPK), lactate dehydrogenase (LDH), serum glutamate oxaloacetate transaminase (s-GOT) and serum glutamate pyruvate transaminase (s-GPT) were determined by a kit method. For total content of each metal the serum samples were analyzed using atomic absorption spectrophotometry. Levels of cholesterol, triglycerides, urea, creatinine and uric acid were determined using a kit method on Microlab 300. RESULTS: Serum magnesium and copper levels remained unchanged, whereas the concentration of zinc decreased and iron increased significantly in both groups of patients. Total antioxidant activity was significantly decreased in both hepatitis B and C. Among the enzymes analyzed, ALK, s-GPT, LDH and s-GOT were all significantly increased in both patients with hepatitis B and C whereas CPK was significantly decreased in patients with hepatitis B and remained unchanged in patients with hepatitis C. CONCLUSION: The information accumulated by this study will help provide a better understanding of involved metabolic processes in order to design appropriate therapeutic approaches for treating these patients, so they can recover and lead normal lives.

Frequency and pattern of gonorrhoea at Liaquat University Hospital, Hyderabad (a hospital based descriptive study).

OBJECTIVE: To determine the frequency and pattern of gonorrhoea at Liaquat University Hospital, Hyderabad. METHODS: This descriptive study of eight months was conducted at Liaquat University Hospital Hyderabad, Sindh, Pakistan from December 2007 to May 2008. All patients who were above 14 years of age and came with history of discharge from penis or vagina were evaluated and enrolled in the study. After recording demographic data these were screened for gonococcal infection by Gram's staining method. The frequency was determined by identifying the positive gonococcal infected patients while pattern was observed according to the presentation of patients. The data was analyzed by SPSS version 10.00. RESULT: One hundred and eighteen patients, 92 (78%) male and 26 (22%) females were identified to have infection out of 266 patients with mean age 27.4 +/- 7.77 years. Majority of the patients 92 (78%), presented in the department of dermatology. In the study group, 77 (65%) were unmarried and 41 (35%) were married, 71 (60%) belonged to Hyderabad and 47 (40%) came from periphery of Sindh province of Pakistan. Other features and presentation identified in such patients were painful micturition 98 (83%), burning micturition 94 (80%), frequent micturition 108 (92%), genital itching 85% (72%), intermenstrual bleeding 09 (8%), painful sexual intercourse 87 (74%) and skin lesions 24 (20%). All patients were treated by syndromic management. CONCLUSION: A relatively high prevalence of gonorrhoea (46% patients) was detected in the patients seen in Liaquat University Hospital.

Precipitating factors of hepatic encephalopathy at a tertiary care hospital Jamshoro, Hyderabad.

OBJECTIVE: To determine the precipitating factors of hepatic encephalopathy (HE) in patients with liver cirrhosis at Liaquat University Hospital Hyderabad/Jamshoro. METHODS: This hospital based descriptive study was conducted from April 2007 to September 2007. All the patients who were more than 12 years of age and were diagnosed as hepatic encephalopathy were studied. During this period, 87 patients of hepatic encephalopathy were admitted. All patients were carefully examined, relevant investigations were performed and data was collected through pre-designed proforma. RESULTS: Male patients were 65 (75%), above 40 years of age 58 (67%), belonging to interior/periphery of Sindh 54 (62%), in grade IV of hepatic encephalopathy 70 (80%) and Anti-HCV positive were 52 (60%). The most common precipitating factors detected were infection 58 (67%), constipation 43 (49%) and gastrointestinal bleeding 39 (45%). Out of 87 patients, 68 had increased total leucocytes count, 09 patients had hypokalaemia, 24 patients, hyponatraemia, 64 hypoalbuminaemia and 54 patients had a disturbed coagulation profile. Fifty nine patients recovered and were discharged while 20 patients expired. Majority of expired patients had Child-Pugh score 10-15 and were in grade IV of hepatic encephalopathy. CONCLUSION: The study concluded that there were different factors which play a key role in hepatic encephalopathy. In these factors, infection was the most common.

Frequency, pattern and etiology of nosocomial infection in intensive care unit: an experience at a tertiary care hospital.

BACKGROUND: Nosocomial infection is defined as an infection which develops 48 hours after hospital admission or within 48 hours after being discharged. The objectives were to assess the frequency of nosocomial infection in patients admitted to intensive care unit (ICU) and to determine the etiological factors in such patients. It was an Observational Study and conducted in Intensive Care Unit, Liaquat University Hospital Hyderabad Sindh Pakistan from January 2008 to November 2008. METHODS: All patients above 16 years of age admitted in the ICU for more than 48 hours and developed clinical evidence of infection that did not originate from patients' original diagnosis at the time of admission, were included in the study. Data was entered in a proforma and analyzed using SPSS version 10.0. RESULTS: During the study period, 97 out of 333 patients acquired nosocomial infection. The frequency of nosocomial infection was 29.13%. Respiratory tract infection was seen in 29 (30.1%), urinary tract infection in 38 (39.1%) and blood stream infection in 23 (23.7%) patients. Other infections we identified were skin, soft tissue, wound and gastrointestinal tract infections. CONCLUSION: Patients admitted in intensive care unit are at more risk of acquiring nosocomial infection from different sources. It is suggested that proper nursing care, sterilization and disinfection of instruments and equipment and careful handling of invasive procedures are the best tool to control these life threatening infections.