Objective:To determine the efficacy of Vitamin D supplementation in achieving an early sputum conversion in vitamin D deficient smear positive pulmonary tuberculosis patients.Methods:This randomized clinical trial was done at Mayo hospital Lahore from November 2015 to August 2016. One hundred twenty patients with sputum smear positive pulmonary tuberculosis were selected and randomized to Group-A (taking anti-tuberculous therapy (ATT) only) and Group-B (taking ATT with Vitamin D supplementation). Four doses of100,000 IU of Vitamin D injection intramuscularly were given after every 14 days during intensive-phase. Sputum examination was repeated at 2nd, 4th, 6th, 8th, 10th and 12th weeks. Efficacy of treatment in terms of early sputum conversion between both groups was tested using Chi square and independent sample t-test was applied to compare mean values of serum vitamin D before and after treatment. P-value ≤ 0.05 was considered as significant.Results:The mean age of patients was 37.18±6.81 years in Group-A and 39.02±7.56 years in Group-B. There were 63 (52.50%) males and 57 (47.50%) females. The mean serum Vitamin D was 17.07±1.44 in Group-A and 17.23±2.37 in Group-B at baseline and at 12th week, the levels were 21.77±2.23 in Group-A and 29.24±0.72 in Group-B. In Group-A, 7 (11.7%) patients showed positive sputum examination and in Group-B, only one (1.7%) patient had positive sputum examination at 12th week. The difference was statistically significant (p-value= 0.028).Conclusion:Four doses of intramuscular vitamin D given after every 14 days corrected vitamin D deficiency and improved the rate of sputum smear conversion in patients of pulmonary tuberculosis.
Objective:To measure the correlation between microalbuminuria and serum uric acid level in Type-2 diabetic nephropathy.Methods:This cross-sectional study was done in department of Medicine, Mayo hospital Lahore from August 2014 to February 2015. A total of 200 patients with Type-2 diabetic nephropathy were enrolled in the study. Demographic data and contact details were obtained. Serum Uric acid and microalbuminuria by albumin to creatinine ratio (ACR) in random urine sample was measured at the time of inclusion of patients. All the information was collected through a pre-defined proforma. Pearson correlation coefficient and t-test were used to assess correlation and significance respectively.Results:Out of 200 cases, 29%(n=58) were between 16-40 years of age while 71%(n=142) were between 41-65 years of age, Mean ± SD was calculated as 48.1±10.26 years, 48.5%(n=97) were male and 51.5%(n=103) were females, Mean serum uric acid level was calculated as 6.99±1.01 mg/dL while microalbuminuria was calculated as 5.63±1.08 mg/mmol, r value was 0.0838 which is a positive correlation.Conclusion:The results of our study concluded that level of serum uric acid and microalbuminuria are significantly correlated to nephropathy in patients having Type-2 diabetes mellitus.
Coronavirus, in December 2019, caused a SARS-2 pandemic. Primarily targeting the human respiratory system, the major symptoms of this disease are high grade fever, dry cough, shortness of breath, sore throat, and fatigue while symptoms involving other organ systems such as diarrhea, headache, conjunctivitis, and rash also develops. Like a SARS-CoV-1 outbreak in 2002, SARS-CoV-2 is difficult to treat as minimal data is available regarding its treatment strategies and potential cure of the disease. A thorough literature review was done to identify different potential treatments for SARS-CoV-2 and a perspective of a developing country, Pakistan, on managing and treating this infection was provided. We found that use of off-label drugs including including chloroquine, hydroxychloroquine, remdesivir, azithromycin, interferon, ribavirin, lopinavir-ritonavir, increased exponentially to treat COVID-19 patients around the world and studies suggested their efficacy against SARS-CoV-2. Use of adjunctive therapies including convalescent plasma, interferons, and corticosteroids also showed positive results in slowing down the progression of the disease. Different clinical trials are being conducted around the world to identify drugs and develop vaccine against infection caused by this deadly virus. Use of these off-label drugs and adjunctive therapies was also seen in a developing Country like Pakistan, which need desperate measures to overcome COVID-19 disease burden on the country’s people and the economy. Coronavirus is infecting thousands of people daily, worldwide. Major action including upgrading medical facilities, investing in health care sector, developing effective drugs, must be taken in both developed and developing countries like Pakistan to fight, contain and prevent future pandemics.
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