Objective: To determine the frequency of vitamin D deficiency in patients presenting with diabetic peripheral neuropathyPatients and Methods: This cross sectional study was carried out in Department of Medicine and Neurology Indus Medical College, Tando Muhammad khan. from March 2017 to August 2017. Total 74 cases of Diabetes Mellitus presenting with peripheral diabetic neuropathy were selected for the study. Evolution of degree of Neuropathy was based on TCSS score as: {no neuropathy: ≤5, severe: ≥12, moderate: 9-11 and mild: 6-8}. Vitamin D level was categorized as (deficiency (0-20 ng/ml), insufficiency (21-30 ng/ml) sufficiency (>30 ng/ml), excess (>50 ng/ml) and toxicity (>100 ng/ml). All the data was entered in SPSS.Results: Total 74 patients with diabetic neuropathy were studied. Vast majority of patients 36(48.6%) were found in age group 51-60 years, Majority were males 45(60.8%). Most of the cases 35(47.3%) were with 1-3 years duration of neuropathy. Majority of patients 42(56.8%) were found with Mild peripheral neuropathy. Vitamin-D deficiency was present in 2(43.2%) cases and insufficiency was observed in 27(36.5%) cases. No significant association was found between vitamin D deficiency and severity of neuropathy.Conclusion: Vitamin D deficiency was found (43.2%) in patients of diabetic peripheral neuropathy. Vitamin screening and intake of supplement is necessary, will help to decrease the complication of peripheral neuropathy in Diabetic cases. Key words: Diabetes, Peripheral neuropathy, Vitamin D

Objective: To identify the indications and complications of the stoma. Methods: The study covered all patients who attended Outpatients department of General Surgery, Ziauddin Hospital in Karachi and met the inclusion criteria. After describing the study's process, hazards, and benefits, informed permission was obtained. The patients were followed after 4 weeks in the clinic and assessed for Indications (enteric perforation, intestinal tuberculosis, penetrating injury, intestinal obstruction, blunt abdominal trauma). Complications (excoriation, non-functioning stoma, retraction, prolapsed, stenosis of Stomas, wound infection). The proforma that is supplied at the end was filled out with all the acquired data and utilised electronically for research. Results: The mean age of patients was 38.5 ± 7.4 years and the body mass index was 26.8 ± 6.2 kg/m2. The most common indication for stoma was intestinal tuberculosis (41.0%) followed by enteric perforation (27%). The most common complications of stoma were non-functioning stoma (34.4%) followed by excoriation (23.9%). Stoma indication due to enteric perforation was significantly more common in patients aged between 16 and 40 years (p=0.003). Other indications were not significantly associated with age, BMI, and age. The rate of excoriation was 52 (20.1%) in patients with BMI of more than 24 kg/m2 which is significantly higher as compared to patients with lower BMI (p=0.029). The other complications were not significantly different between the age groups, BMI categories, and gender. Conclusion: The most frequent indications and consequences, respectively, were determined to be non-functioning stomas and intestinal tuberculosis. Reduced stoma development and related problems can be achieved with early detection and treatment of TB and enteric fever. Keywords: Indications, Complications, Stoma, Management, Intestinal Stoma, Ostomy, Colostomy

ABSTRACT… Objectives:To determine etiology and management outcome among patients presenting with chronic subdural hematoma at tertiary care Hospital. Study Design: Cross Sectional. Setting: Department of neurosurgery, Liaquat University Hospital, Hyderabad/ Jamshoro. Period: One year from 2015 to 2016. Material & Methods: All the patients with diagnosis of unilateral chronic subdural hematoma, and both male and female gender were included in this study. CT scan and other relevant laboratory investigations were done. All the patients underwent treatment of burr hole evacuation after taken informed consent. Antibiotics were given to all the patients pre-and post-operatively. All the subjects underwent CT scan for the evaluation of hematoma cavity. Patients were discharged generally following 1-week and were followed at outpatients department for 1-month, 3-months and 3-months, respectively. All the patients were assessed according to Glasgow Outcome Scale. Results: Over a period of one year; total thirty patients were selected, most of them were in the 6 th and 7 th decades of their lives and males were in majority 25(83%). Sixteen patients had a history of minor head injury, eleven patients had no obvious cause and one patient had chronic subdural hematoma secondary to over shunting. According to complications; intracerebral bleed was among 2(6%) cases and Pneumocephalus was in 2(6%) cases, followed by subdural empyema, acute subdural hematoma, extra dural hematoma, penetration into brain via drain catheter, C.S.F leakage and dysphasia were found in one patient, in each case, respectively. Almost every patient recovered and survival rate was 28(93%), while only two patients died. Conclusion: It was concluded that patients showed best outcome (93% survival rate) according to Glasgow Outcome Scale, after burr hole evacuation management. Head injury due to road traffic accident was the most common etiology and burr hole evacuation was the best treatment option for chronic subdural hematoma.

Objective: To determine the frequency of thyroid function changes in type II Diabetes mellitus patients Material and methods: This cross-sectional study was carried out at the Medicine OPD of Indus Medical College Tando Muhammad Khan. The study duration was six months, from December 2020 to May 2021. All the diagnosed cases of type 2 diabetes mellitus, aged 40 to 65 years and both genders were included. Each case underwent a 5 ml blood sample, which was sent immediately to the diagnostic laboratory of the hospital to assess the TSH level for thyroid function. The research proforma was applied to gather all the data, and SPSS software version 26 was utilized to analyse the results. Results: A total of 200 diabetic patients were studied; their average age was 46.23+7.11 years. Females were in the majority 60.0%. The overall average of HbA1c was 7.02+1.41%. Out of all the hypothyroidism cases were 6.5% and hyperthyroidism cases were 2.5%, while in 90.0% of the cases, thyroid stimulating hormone (TSH) was normal. Thyroid function abnormalities were statistically insignificant according to gender (p-993). Conclusion: As per the study conclusion, thyroid function abnormalities were observed to be 9% among patients of type II diabetes mellitus. Keywords: Diabetes, Type II, thyroid function, HBA1C

Objective: The objective of this study was to evaluate the low bone mineral density (BMD) in patients with liver cirrhosis. Methodology: This cross sectional study on 151 Liver cirrhotic patients was conducted at Liaquat University Hospital Hyderabad/Jamshoro. This study duration was 6 months, July 2015 to December 2015. The Assessment of bone mineral density (BMD) for each relevant patient was done using ultrasound impedance Dual Energy X-ray Absorptiometry  (DEXA) by senior pathologist having ≥05 years of experience, across the calcaneum, at lumbar spine  (LS) and femur neck (FN),  were computed by using computer supported device. The BMD was expressed in terms of T score. The WHO standard value was utilized to define the low BMD / osteoporosis is T score -1.5. Results: The mean age of subjects was 31.32±6.18 years. Out of all, 62.9% were males whereas 37.1% were females. About 21% patients had low/abnormal bone mineral density (BMD). Among these, 17.9% had bone mineral density (BMD) of -1.5 to -2.5 and 4% had BMD of <-2.5. Rest of 78.1% patients had a normal (>-1.5) bone mineral density (BMD). Majority of patients, 63.6% had a CTP grade B of liver cirrhosis, whereas 22.5% had A grade and 13.9% had C grade of liver cirrhosis. Conclusion: Conclusively, the risk of low bone mineral density (BMD) was evidently high for patients with hepatic cirrhosis. Male gender and age above 30 years were found at greater risk and CTP grade B of cirrhosis was most common.