Background and Objective:Urinary tract infection is one of the commonest infections seen in clinical practice. Lack of compliance and unjustified antibiotic prescriptions has resulted in bacterial resistance and is proving as a major challenge in the management of these infections. Our aim was to identify the sensitivity pattern of commonly used antibiotics against urinary tract infections so as to suggest an improvised line of action against bacteria causing urinary tract infections’.Method:This was a hospital based cross sectional study extended over a period of four months. Patients were recruited from outpatients department of a tertiary care hospital in an industrial area of Karachi. Adult patients with symptomatic and documented UTI in urine detailed report (pus cells >10) were enrolled after informed consent. A clean catch midstream urine was collected for culture and sensitivity testing using the standard microbiological procedure. Data is analyzed on SPSS 16.Results:A total of 184 samples were collected in 4 months. The Male to Female ratio was 1:2 (n=58/126) with mean age 48.5±12 years. 83(45.6%) patients were between 45-60 years. Most common isolated pathogen was Eschericia coli 108(59%) followed by staphylococcus aureus 30(16.4%) and Klebsiella 20(11%). 55(30%) pathogens showed sensitivity to 4-6 antibiotics, 22(12%) strains to 7-9 antibiotics, 33(18%) were sensitive to ≤3 drugs and in 3(1.6%) patients resistance to all antibiotics is seen. The more resistant pathogens were sensitive to intravenous antibiotics alone.Conclusion:In this low socioeconomic cohort with UTI nearly half the isolated pathogens has shown resistance to most of the commonly used antibiotics recommended in the guidelines especially the floxacin group probably because of its unwarranted use. Therefore, a revised line of management should be developed locally in accordance with the susceptibility pattern of the urinary pathogens to avoid further resistance as well as morbidity of the patient.
Objective: This study was aimed to determine the predictive value of HbA1c in detecting dyslipidemia in patients with Type-2 Diabetes Mellitus. Methods: A total of 142 consecutive patients of Type-2 diabetes mellitus were recruited in this study after informed consent. The study was conducted for 6 months from January 2019 – June 2019 in Creek General Hospital, Korangi, Creek, Karachi. Demographic data and detailed history was taken. A complete systemic examination was done for any complications or co-morbids present and related investigations were performed including Fasting lipid profile (CHO, TG’s, HDL, LDL, CHO/HDL), serum HbA1c, Creatinine and ECG. Data is analyzed on SPSS 16 for mean, frequencies and correlations. Pearsons Chi square test is used for analyses of Correlation Results: In a total of 142 Type-2 diabetic patients 39(27.5%) were Males and 103(72.5%) were females with a male to female ratio of 1: 2.6. Mean age was 54.9yrs ± 10.7SD. Mean duration of diabetes was 7.37yrs ±5.64 SD years. Mean BMI is 26.8 ± 3.67kg/m2. 27(19.01%) patients had HbA1c ≤ 7% whereas 115(80.9%) had >7%. 81(57.04%) patients had dyslipidemia. HbA1c exhibited direct correlations with BMI, cholesterol, TG’s and LDL and inverse correlation with HDL with significant P value of <.05. TG’s were found significantly higher in females when compared with male patients. In addition, Metabolic syndrome also showed a strong correlation with increasing HbA1c levels especially in female gender (P0.001). Conclusion: The results of our study indicates that HbA1c can be used not only as a useful biomarker of long-term glycaemic control but also a good predictor of lipid profile. doi: https://doi.org/10.12669/pjms.36.6.2000 How to cite this:Kidwai SS, Nageen A, Bashir F, Ara J. HbA1c – A predictor of dyslipidemia in type 2 Diabetes Mellitus. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2000 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: To determine the frequency of dyslipidemia and its types in adult diabetics of Karachi. Study Design: Cross Sectional, Observational study. Setting: Diabetic Outpatient Clinic in JPMC, Karachi. Period: January 2019 to June 2019. Material & Methods: 248 adult diabetics presenting in diabetic outpatient clinic in JPMC, Karachi selected by non-purposive convenient sample technique. Diagnosed diabetics who were not on any lipid lowering therapy were included in the study. Non diabetics and those diabetics who are already on lipid lowering drugs were excluded. After relevant information is taken the lipid profile of the participants was done with a 12 hours fasting and the data was secured on a pre-designed performa. The results were analyzed on SPSS. Results: Among the 248 diabetics that presented 88(35.4%) were males and 160(64.5%) were females. The prevalence of dyslipidemia is 85.9% (213 diabetics had dyslipidemia). High triglycerides were present in 52.4% (130), high LDL in 28.2% (70) and low HDL in 175(70.6%). [P=0.000]. At least one dyslipidemic factor was deranged in 81(32.7%), two in 102(41.1%) and 3 in 30(12.1%) persons. In males, 53 out of 88(60.2%) were dyslipidemic, and in females all had dyslipidemia (100%). [P = 0.000]. Hypertriglyceridemia was present in 38(43.1%) males and 92(57.5%) females [P=.021], High LDL in 21(23.8%) males and 49(44%) females [P=.163], while low HDL was present in 16(22%) males and 159(99%) females [P=.000]. Conclusion: Dyslipidemia is highly prevalent in our population. Female diabetic patients had relatively higher triglycerides than men.
Objective: To detect the frequency of Obesity in type 2 diabetic patients. Methods: It was a Cross Sectional study carried out at Diabetes Clinic, Medical Unit III, Jinnah Postgraduate Medical Centre Karachi from 1st Jan 2012 to 30th June 2012. Three hundred and eighty seven (387) type II diabetic patients of either sex and any age were included in the study. Non-purposive convenience sampling technique was used to enroll patients in the study. History regarding diabetes, hypertension (HTN), Cerebrovascular Accidents (CVA), smoking and other tobacco exposure was taken. Physical examination was carried out and height, weight, body mass index (BMI), blood pressure, peripheral pulses and ankle-brachial index (ABI) was calculated. Categorical variables such as Gender, Age groups, BMI groups, HTN, smoking, hyperlipidemia and ABI were expressed as frequencies and proportions. Means with standard deviations were calculated for continuous variables such as age, duration of diabetes, BMI, duration of HTN and duration dyslipidemia. For categorical variables, differences between patients were tested using the chi-square test. P value of ≤ 0.05 was considered significant. Results: Males were 128 in number (33%) and female were 259 in number (67%). Mean age was 52 yrs (+/- 9.67) and the mean duration of diabetes was 9.36 yrs (+/- 6.39). Hypertension was seen in 210 people (54%). 49(12.7%) were smokers and 39(10%) chewed tobacco. Normal BMI was seen in 62 patients (16%), 44 (11.4%) were overweight and 281(72.6%) was obese. Obesity was much more prevalent amongst the female gender that is 208(80%) versus male which was 73 (57%) and this was statistically significant (p-value 0.001). Hypertension was also more prevalent in obese patients and was statistically significant (p-value 0.04). Statistically significant lower mean BMI was found in smokers, tobacco chewers and/or had exposure to tobacco (0.001, 0.04, and 0.001 respectively). Conclusion: The study shows that there is a strong association of diabetes with obesity. Female gender had relatively higher BMI. Hypertension was more prevalent in obese diabetic subjects. Smoking and nicotine exposure was associated with significantly lower BMI.
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