Effect of fiber bread on the management of diabetes mellitus.

OBJECTIVE: To evaluate the effects of soluble fiber rich bread on lowering blood glucose, blood pressure and blood lipid levels. DESIGN: An interventional study. PLACE AND DURATION OF STUDY: The study was undertaken at Medical Unit III, Jinnah Postgraduate Medical Centre, Karachi. Duration of the project was one year (1997-1998). SUBJECTS AND METHODS: Twenty stable diabetics of both genders were included in this study. They were provided with this bread (test diet) to replace their usual breakfast bread and chapati for lunch and dinner. The intakes of other foods as well as medications were unchanged. Anthropometric measurements, fasting and 2 hours postprandial blood sugar, fasting serum cholesterol and triglyceride levels were recorded before and after 4 weeks of intervention. Blood sugar and blood pressure were checked every week. Quality of life was assessed subjectively with the help of questionnaire, which were asked before and after the end of the intervention. RESULTS: Glycemic control, both fasting and postprandial, improved significantly during intervention. Satisfactory reduction of blood pressure as well as serum cholesterol and triglyceride level was also observed in these cases. The medicines reduced significantly and quality of life improved in all subjects. None of these subjects complained any gastrointestinal discomfort during their consumption of this bread for 4 weeks. CONCLUSION: The use of soluble fiber rich bread helps to control blood sugar, the hyperlipidemia, and blood pressure which are elevated in poorly controlled diabetics. Thus, integrated improvement will improve the quality of life, reduce the cost of drugs as well as help to avoid harmful effect of drugs.

Frequency of hepatitis C in obstetric cases.

OBJECTIVE: To compare the frequency of antihepatitis C virus (HCV) after single blood transfusion, multiple blood transfusion and in non-transfused obstetric cases. DESIGN: A comparative descriptive study. PLACE AND DURATION OF STUDY: The Department of Obstetric and Gynaecology, Jinnah Postgraduate Medical Centre, during the period of one-year from January 2002 to December 2002. PATIENTS AND METHODS: Patients included in the study after single transfusion were 38, after multiple transfusion 39, and controls 120. History of patients regarding all the relevant information and clinical examination were recorded on a specially-designed and coded proforma. Anti-HCV was detected by Roche HCV EIA 2nd generation kit method in all cases and controls. Descriptive statistics and frequency of anti HCV in each group was calculated using SPSS version 10. RESULTS: Frequency of anti-HCV among patients with single blood transfusion was 13.2% (5), with multiple transfusion was 15.4% (6) and 6.6% (8) in non-transfused subjects. CONCLUSION: Anti-HCV frequency after one pint blood was almost same (13.2%) as after multiple transfusion (15.4%). This positively provided a firm argument for the necessity of a nationwide blood donor screening for anti-HCV by most sensitive immunoassay. Equally important was the need for clear cut indication for single blood transfusion.

Risk factors for gall bladder cancer in Karachi.

BACKGROUND: Frequency of gallbladder cancer in Karachi has been reported to be 8% and that from other parts of Pakistan varies between 6-7%. This is very high as compared with the Western studies. With this in mind a case control study was designed to identity risk factors responsible for gallbladder cancer. METHODS: This case control study included 107 histologically proven cases of gall bladder cancer from Jinnah Postgraduate Medical Center, Civil Hospital and two private hospitals of Karachi. Age and sex matched controls were of two types. Those with and without cholelithiasis screened sonographically. Demographic, socio-economic factors, life-style, dietary habits and dietary intake were recorded on a proforma. The cases and controls were compared for various factors using odds Ratio. RESULTS: Among 107 cancer cases 27 were males and 80 females (M:F = 1:3). Mean age of males was 59 years (range 35-82 years) and females 53 years (range 31-70 years). One hundred and five (98%) had associated choleliathiasis. Important risk factors appeared to be gallstones, high parity, young age at first delivery, low fiber and Vitamin A intake (p < 0.01), high fat intake (p < 0.01), prolonged fasting hours/habit of missing dinner (OR:6.8), using repeatedly boiled or improperly stored ghee or oil (OR:2.6). CONCLUSIONS: According to this case-control study major risk factors for gall bladder cancer were gallstones, dietary malpractices and poorly balanced diet. Poorly stored/processed food acts as a promoter in the presence of gall stones and may favour cancer development.