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Introduction Coronary artery disease is the leading cause of death worldwide by incidence. Over the years, many studies have been conducted to find predictors of coronary artery disease; however, in the last few decades, the level of HbA1c in diabetics has been investigated as a potential predictor. Our study offers additional insight by investigating similar relationships in non-diabetic patients and by investigating potential predictors more comprehensively, making it the first of its kind study. The aim of our study is to indicate that rising HbA1c levels suggest that there's a greater risk of coronary artery disease, which can further be confirmed by the SYNTAX score, degree of stenosis, and numbers of vessels involved. Methods Data from 177 diabetic and 378 non-diabetic patients, all of whom were above 18 years of age, were included in the research. HbA1c levels (>5.6%), SYNTAX score, hypertension, number of vessels involved, and other demographic elements, such as age, smoking, and body measurements, were calculated and compared for diabetics and non-diabetics. Results HbA1c was higher in comparison to non-diabetic subjects (p <0.001). Age >53 was found to be a predictor for SYNTAX score ≥23 in diabetic patients (p <0.05). Male gender and smoking were found to be independent predictors for three-vessel disease in the non-diabetic population (p-value<0.05). There was no significant relationship between the SYNTAX score and HbA1c levels in non-diabetics (p=0.885) and diabetics. In conclusion, there is no correlation between elevated HbA1c levels and SYNTAX score ≥23.
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Ecthyma gangrenosum is a skin lesion consequent to bacteremia, mostly due to Pseudomonas aeruginosa, although it may develop secondary to other organisms as well. The disease is often witnessed in patients with leukemia; however, a few cases of ecthyma gangrenosum in adults were reported to be associated with myelofibrosis. We report a case of ecthyma gangrenosum due to Escherichia coli (E. coli) in a two-year-old girl with idiopathic myelofibrosis.
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Background The prevalence of colorectal cancer (CRC) is growing in Pakistan; however, there are no national screening programs or guidelines in place to curb its development. This study was conducted with the aim of ascertaining public awareness and attitudes regarding CRC and current screening practices. Furthermore, the study assessed perceived barriers which could impact future screening processes. Methods A cross-sectional, questionnaire-based study was conducted among urban dwellers of Karachi, Pakistan. We excluded any individuals belonging to the medical profession, those diagnosed previously with CRC or having any significant co-morbidity. The validated and pre-tested questionnaire was administered among the study participants to record demographic information, awareness of CRC risk factors, symptoms and screening tests. Attitudes towards screening and perceived barriers to screening were also assessed. Data were analyzed using Statistical Package for Social Sciences (SPSS version 20.0) (IBM Corp., Armonk, NY). A knowledge score, out of a total of 14 points was calculated to reflect a participant's overall knowledge regarding CRC risk factors and signs/symptoms. Results The prevalence of CRC screening in eligible individuals (50 years or older) was 2.6% in our study population. Positive attitudes towards CRC management and screening were observed, with 75.1% (n = 296) acknowledging the preventive role of screening tests. Despite this only 14.9% (n = 58) of study participants expressed a future desire to undergo screening. Major barriers to screening were reported to be "a lack of knowledge regarding the screening procedure", a "lack of screening facilities" and that the "screening procedure is too expensive". A majority (n = 285, 72.3%) of the participants expressed a greater willingness to undergo screening if their doctor recommended it. Conclusion A national CRC screening and awareness program should be launched to promote awareness and facilitate screening in risk groups. General practitioners are needed to play a key role in counseling patients and endorsing healthy screening practices.
