Comparison of the impaired fasting blood glucose in young healthy individuals with diabetic and non-diabetic first degree relatives.

OBJECTIVE: To compare the fasting blood glucose (FBG) level in the healthy young individuals with diabetic first degree relatives considered as high risk and non-diabetic first degree relative considered as low risk. STUDY DESIGN: Cross-sectional, comparative study. PLACE AND DURATION OF STUDY: Department of Medicine, Liaquat University of Medical and Health Sciences Hospital, Hyderabad/Jamshoro, from January to November 2008. METHODOLOGY: Individuals aged between 20-40 years were selected and divided into two groups. Group A was considered as high risk included non-diabetic young offspring's of type-2 diabetic parents. Group B was considered as low risk nondiabetic offsprings of non-diabetic family (control group), of same age and gender. Fasting blood glucose levels were measured in each individual. Exclusion criteria were known diabetes and pregnancy. Mean glucose levels were compared using t-test. Proportions of impaired glucose level versus positive family history were compared using chi-square test. Significance was considered at p<0.05. RESULTS: There were a total of 500 subjects including 250 in each group with equal gender distribution in each group. The mean age was 27.46+/-5.71 years. Mean FBG was 87.4+/-13.82 mg/dl in group A and 77.7+/-15.18 mg/dl in group B (p=0.001). Twenty five (10%) in group A and five (2%) in group B individuals showed impaired fasting blood glucose (p=0.001). CONCLUSION: Impairment of fasting blood glucose was with family history of type-2 Diabetes mellitus in comparison to those without type-2 Diabetes mellitus.

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.

Frequency of anaemia in patients with systemic lupus erythematosus at tertiary care hospitals.

OBJECTIVE: To analyze the frequency and causes of anaemia in systemic lupus erythematosus (SLE) patients attending in department of medicine at tertiary care hospitals. METHODS: This retrospective, descriptive and analytical study was planned to analyze the frequency and causes of anaemia in SLE patients attending the department of medicine at (MMC) and (LUMHS) hospitals during the period of Jan 2006 to Nov 2008. The criteria used in this study were from the American College of Rheumatology. Investigations recorded were blood complete picture, absolute values, peripheral smear, and reticulocyte count in all patients of anaemia. These investigations were necessary to analyse the cases of anaemia in SLE. All investigations were not done in all cases. Patients with hypochromic microcytic anaemia were advised to have serum iron and ferritin levels, seven patients with macrocytic anaemia were advised to have direct and indirect coomb's test, LFTs, serum LDH, serum B12 and folate levels. Patients with normochromic and normocytic anaemia were considered to have anaemia of chronic disease. Bone marrow aspiration and Hb electrophoresis were done in two patients with anaemia of chronic disease. Thirty adult patients were included in this study. Special proforma were prepared to record the information from case sheets of patients including basic information, symptomatology and laboratory investigations. Severity and various types of anaemias were recorded. Anaemia was graded according to severity, as mild (Hb 10-12 G/dl), Moderate (Hb 8-10 G/dl) and severe (Hb < 8 G/dl). Haemoglobinopathies and other types of anaemias were excluded from study. RESULTS: Thirty adult diagnosed patients of SLE, were included. Their ages ranged from twenty years to fifty years at time of presentation. The mean age +/- SD (range) was 28 +/- 6.22 (20-50) years and median age was 31 years. Out of thirty patients, twenty seven (90%) were females and three (10%) were males. Twenty eight (93.33%) patients presented with anaemia, 14 (46.66%) patients were of mild anaemia, 8 (26.66%) patients were of moderate grade anaemia and 6 (20%) patients had severe anaemia. Iron deficiency anaemia was found in 9 (30%) patients, 12 (40%) patients had anaemia of chronic disease and 7 (23.33%) patients had haemolytic anaemia, out of theses 7 patients, 5 (16.66%) patients had Coomb's positive haemolytic anaemia. All thirty patients had ANA positive titres > 1:80; and nineteen (63.33%) patients had anti ds DNA positive, titres > 1:10. CONCLUSION: Haematologic abnormalities are common manifestations in patients with SLE. Most patients exhibit anaemia at some point during their disease course.

Serum zinc and magnesium in type-2 diabetic patients.

OBJECTIVE: To assess serum zinc and magnesium level in type-2 diabetic patients and the effect of age, gender, glycemic control and duration of diabetes on these trace elements in comparison with those of control subjects. STUDY DESIGN: Non-interventional case control study. PLACE AND DURATION OF STUDY: Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad, from October 2007 to March 2008. METHODOLOGY: There were 42 diabetic patients and 42 age matched non-diabetic (control) subjects included in this study. Serum zinc, serum magnesium and fasting blood sugar measured among the diabetic and control groups and association of both trace elements were assessed with glycemic status, age, gender and duration of diabetes using SPSS version 16.0 for analysis. RESULTS: Serum zinc level was significantly lower (mean 2.03 +/- 0.39 mg/dL) in diabetic patients as compared to control subjects (4.84 +/- 4.217 mg/dL, p = < 0.001). No significant difference was found in serum magnesium level with mean of 22.67 +/- 24.5 mg/dL in diabetic patients as compared to controls (18.3 +/- 3.4 mg/dL, p = 0.26). CONCLUSION: Serum zinc level was significantly lower in type-2 diabetics, whereas no significant difference was found in serum magnesium level when compared with control subjects. There was no association of age, gender, glycemic status and duration of diabetes on the serum concentration of these trace elements in type-2 diabetic patients.

Frequency of thyroid disorders during interferon and ribavirin therapy in chronic hepatitis C infection.

OBJECTIVE: The objective of this study was to assess the frequency of thyroid dysfunction in response to combination of interferon and ribavirin therapy in chronic hepatitis C (CHC) patients and HCV outcome. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: This study was conducted at Outpatient Department of Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad from September 2005 to September 2007. PATIENTS AND METHODS: One hundred cases of CHC, proven by anti-HCV and HCV RNA-positive with baseline TSH, FT4 and FT3 within the normal reference range, who were treated with interferon alpha-2b (3 million unit subcutaneously three times per week) and oral ribavirin (1000-1200 mg per day) were included in this study. All patients were assessed for TSH, FT4, FT3 levels at 12 weeks and 24 weeks during therapy. RESULTS: Among the 100 patients, overt thyroid disease developed in 13 (13%) and sub-clinical thyroid disease in 5 (5%). Out of 13 patients of overt thyroid disorders, 11 (84.6%) had hypothyroidism and 02 (15.3%) hyperthyroidism. Four (80%) patients were of sub-clinical hypothyroidism and 01 (20%) patient was of sub-clinical hyperthyroidism. Overall, thyroid disorders developed in 18 (18%) both as overt and sub-clinical thyroid disorders. Ninety one (91%) patients became negative by HCV RNA. CONCLUSION: Treatment of HCV with IFN-alpha and ribavirin can be safely continued in patients with over and sub clinical hypothyroidism because thyroid disease responds well to treatment.