ObjectiveTo determine the correlation of glycated hemoglobin (HbA1c) with red cell width (RDW) and other analytic parameters of red blood cells (RBCs) in type II diabetic patients.DesignCross-sectional analytical study.Place and duration of the studyAl-Tibri Medical College and Hospital Karachi; from July 2017 to January 2018.Patients and methodsThis cross-sectional study was conducted on diagnosed type II diabetic patients visiting the outpatient department of medicine at Al-Tibri Medical College Hospital from July 2017 to January 2018. Diabetes mellitus was diagnosed according to American Diabetes Association (ADA) guidelines. After taking consent and conducting a clinical assessment (include history and physical examination), laboratory tests, such as fasting blood glucose, random blood glucose, complete blood count (CBC), and HbA1c, were collected on proforma.ResultsA total of 119 patients were eligible for the study with a mean age of 48.63±12.462 (range 24-76) years; among those, males were 74 (62.2%) and females were 45 (37.8%). The mean duration of diabetes mellitus (DM) was 6.735±3.759 (range 1-20) years. The mean hemoglobin of patients was 11.59±1.315 gm/dl. The mean corpuscular volume (MCV) was 76.65±11.121 fl and the mean RDW was found to be 18.287±4.352, with the highest value of 30.20. The mean MCH was 30.223±23.873 pg, with the highest value of 38.4 pg. The mean cell hemoglobin concentration (MCHC) was 28.214±4.7498 mg/dl.The HbA1c of the study population was found to be moderately uncontrolled and the mean HbA1c was 8.278±5.015%, with the highest value of 16.2%. The mean fasting blood sugar was 158±39.50 mg/dl while the mean random blood sugar was 236±57.390 mg/dl.The correlation of HbA1c with RDW turned out to be significant statistically (p-0.035) while other RBCs and/or hematological parameters, such as MCV, hemoglobin, and platelets, revealed no significant correlation.ConclusionThe study highlighted that RDW has a significant correlation with HbA1c and is an inexpensive and freely available test so it may be used as a marker of glycemic status.
Background: Liver abscesses are localized suppurative destruction of liver tissue due to infections of either bacterial (Pyogenic) or protozoa (Amoebic). Historically; pyogenic liver abscess has been described since the time of hippocrates (400 BC). Despite the more aggressive approach to treatment, the mortality rate remained at 60-80%.Methods: This Cross-sectional analytical study carried out at Department of Medicine, Al-Tibri Medical College Hospital, Karachi, from June 2017 to December 2018. All participants of either gender with diagnosis of liver abscess were included in this prospective study. Patients with co morbidities like malignancy, autoimmune disease or on immunosuppressive treatment for any reason were excluded from the study. Following confirmation of the diagnosis; different characteristics of either type of liver abscess like demographic, clinical features, biochemical and imaging findings were evaluated.Results: Data of 73 subjects, 65(89.0%) males and 08(11.0%) females were analyzed with mean age was 45.42±14.518 years. Fifty-four (73.97%) patients had pyogenic liver abscess while amoebic liver abscess was found in 19(26.03%) subjects. Clinically, the most common symptom was abdominal pain, found in 66(90.4%) subjects, followed by fever in 61(83.6%), hepatomegaly in 47(64.4%), jaundice in 18(24.7%) and vomiting in 10(13.7%) cases. Demographics and clinical features are shown in (Table 1).Conclusions: Local trends have been changing and majority of liver abscess were of pyogenic liver abscesses. Clinically, clear differentiation between two types of abscesses is not possible always but few manifestations like typical symptoms, raised alkaline phosphatase and leucocytosis may be helpful.
Objective: To determine the comparison between the capillary glucose and venous plasma glucose in type II diabetic patients. Study Design: Cross Sectional Observational study. Setting: Al–Tibri Medical College and Hospital Karachi. Period: 1st January 2020 to 30th April 2020. Material & Methods: A total of 86 diabetic patients from the out-patient department with non-probability consecutive sampling were selected. Subjects were diagnosed cases of type II diabetes based on the screening recommendation by the American Diabetes Association between 35-75 years of age of either gender included in this study. Patients with type I diabetes, pregnant females and hematocrit of more than 55% or less than 35%, and patients taking medications like Acetaminophen, and Ascorbic acid were excluded from the study. Each participant was measured for the capillary blood glucose levels by using Accu Chek, Easy max and On-call EZII, using strips by Glucose Oxidase Method. A venous sample was collected within 5 minutes of finger-prick test in a sodium fluoride tube. A Statistical Package for Social Sciences version 22 was used for data analysis. Results: Out of 86 patients in the study, 48(55.8%) were females and 38((44.2%) were males with a mean age of 47.16±9.916. The mean blood sugars by venous plasma glucose were 249.58±110.75 mg/dl, by Accu Chek 250.47±117.071 mg/dl, by EasyMax 259.26±119.751 mg/dl, and by On-call EZII 249.33±124.380 mg/dl which shows statistically significant correlation with a p value of <0.001. The glucometers accuracy was determined by using Error grid analysis showed a strong positive correlation between the Accu Chek R2= 0.917, EasyMax R2= 0.917, and Oncall glucometers R2= 0.868 with venous plasma glucose with a statistically significant (p <0.001). Conclusion: This study shows a strong positive correlation between capillary and venous glucose measurements.
Aim: To find out the demographic, clinical, laboratory and radiological spectrum of COVID-19 patients. Study design: Cross-sectional observational study. Place and duration of study: Al-Tibri Medical College Hospital, Isra University Karachi campus Karachi from June 2021 to December 2021. Methodology: The study enrolled adult patients of both genders with COVID-19 infection confirmed through positive qualitative RT‑PCR from nasal swab. After obtaining informed consent each confirmed patient with COVID-19 disease underwent a process of detailed medical history, clinical examination, laboratory tests, and radiological assessment. Based on presentation patients were divided into three groups; Group I, asymptomatic patients having only positive for COVID 19 were advised for self-isolation at home, Group 2 patients with mild symptoms and admitted to ward for observation and monitoring, while Group 3 were patients with moderate to severe disease and requiring intensive care. Results: A total of 179 patients with a mean age of 49.21813.237 years (rang 18 to 85 years) were enrolled in the study with gender based presentation 51 (28.5%) were women and 128 (71.5%) were men. Clinically; main symptoms were fever in 155 (86.6%), shortness of breath 129(72.1%), cough 126 (70.39%), and body ache in 104 (58.1%). Twenty six (14.5%) patients were asymptomatic (Group I), 107(59.8%) were symptomatic mild disease (Group II) and 37 (20.7%) patients presented with moderate to severe symptomatic illness (Group III). The majority of study participants 140 (78.21%) have various comorbidities, DM 60(33.5%), hypertension in 61(34.1%). Conclusion: Our study has highlighted the variability of most aspects of COVID-19 and this might be the main reason why the spectrum of the disease cannot be predicted. Radiologic, pulmonary with clinical patterns are relatively specific but extra pulmonary involvement especially hepatic may misguide and worse the prognosis. Keywords: COVID-19. Pandemic. Demographic. Clinical. Laboratory. Radiologic. Spectrum.
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