Early Detection of Osteoporosis by Dual Energy X-ray Absorptiometry.

BACKGROUND AND OBJECTIVE: An early detection of osteoporosis through DEXA procedure will not only improve the disease management practices but also would help in impeding national productivity losses by mass screening and awareness. Our objective was to measure efficacy of DEXA procedure in early detection of osteoporosis and prevention of its complications. METHODS: This case series observational study was designed to confirm the bone mineral density by dual energy x-ray absorptiometery (DEXA). The duration of study was three years from November 2010 to October 2013. Subjects aged between 30 (when the risk of osteoporosis is low) to 60 (when osteoporosis is almost sure to be found). RESULTS: Three hundred thirty patients were evaluated. There were 23 (6.96%) male and 307 (93.03%) female. Normal male were 09 (39.10%), osteopenia 11 (47.80%) and osteoporosis 3 (13%). Normal females were 72 (23.50%), osteopenia 140 (45.60%) and osteoporosis 95 (30.90%). P-value was more then 0.005 and not significant. Mean age was 48.73, minimum 30, maximum 60 and SD 7.247. Population category distribution was 243(76.6%) from urban and 87(26.4%) rural. In urban areas normal were 56(23%), osteopenia 113(46.50%) and osteoporosis 74(30.50%). In rural areas normal 25(28.70%), osteopenia 38(43.70%) and osteoporosis 24(27.60%). P-value was 0.567. Out of 330 there were 81(24.54%) normal, 98 ((29.69%) osteoporosis and 151 (45.75%) osteopenia. CONCLUSION: Osteopenia was the most common diagnosis mostly in younger age group and early diagnosis of this problem can help prevent osteoporosis.

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.

Clinical characteristics of 226 college-going female migraineurs in Lahore, Pakistan - putting ICHD-2 to the road test.

The International Headache Society (IHS) criteria-based questionnaires were given to 647 college-going females (faculty and students) of selected universities in Lahore, Pakistan. Forty five (7%) were diagnosed with Migraine with Aura (MWA), 181 (28%) with Migraine without Aura (MWOA) and 421 (65%) as NMH (non-migrainous headache). We found 'Photophobia and Phonophobia' as the most common headache-associated symptoms, and 'Stress' and lack of sleep' as the most commonly reported triggers of MWA (44%) and MWOA (38%). Most common headache management practice amongst migraineurs was 'sleep' [MWA (35%) and MWOA (39%)]. This is the first paper which elucidates the symptomatology, risk factors and treatment modalities of migraineurs in Pakistan.

Surgical site infection rate and associated risk factors in elective general surgery at a public sector medical university in Pakistan.

This prospective study aimed to determine the surgical site infection (SSI) rate and associated risk factors was carried in a general surgical ward at Liaquat University Hospital Jamshoro. A total of 460 patients requiring elective general surgery from July 2005 to June 2006 were included in this study. All four surgical wound categories were included. Primary closure was employed in all cases. Patients were followed up to 30th day postoperatively. All cases were evaluated for postoperative fever, redness, swelling of wound margins and collection of pus. Cultures were taken from all the cases with any of the above finding. Mean +/- SD age of the patients was 38.8 +/- 17.4 years with male to female ratio of 1.5:1. The overall rate of surgical site infection was 13.0%. The rate of wound infection was 5.3% in clean operations, 12.4% in clean-contaminated, 36.3% in contaminated and 40% in dirt-infected cases. Age, use of surgical drain, duration of operation and wound class were significant risk factors for increased surgical site infection (P < 0.05). Postoperative hospital stay was double in cases who had surgical site infection. Sex, haemoglobin level and diabetes were not statistically significant risk factors (P > 0.05). In conclusion, surgical site infection causes considerable morbidity and economic burden. The routine reporting of SSI rates stratified by potential risk factors associated with increased risk of infection is highly recommended.