Objectives: To assess the correlation of different obstetrical factors with the hemoglobin level in multiparous pregnant females in Taif KSA. Anemia in pregnancy is a multifactorial phenomenon, among which obstetrical factors like parity, previous H/O abortions, inter pregnancy interval, mode of delivery etc are frequently associated. Study Design: Observational study. Setting: Outpatient department in King Faisal Hospital (KFH), Taif, Saudi Arabia. Period: 1st June 2018 and 31st August 2018. Material & Methods: Conducted in 200 pregnant women by random sampling technique. Hemoglobin value and all patient’s data was noted. All data was fed to SPSS version 23.0 and statistically analyzed using chi square test for qualitative and student’s t test for quantitative data. Results: The study was conducted in 200 patients that showed that there was no statistically significant association of increasing parity, inter pregnancy interval, mode of delivery (NVD or Cesarean section) & history of anemia and PPH in preceding pregnancy with the Hemoglobin level. While history of previous abortion is associated and a risk factor for anemia in pregnancy, 50% with history of 01 previous abortion had anemia while 100% of the cases with history of 02 previous abortions had moderate anemia. (Table-II). This association was observed statistically significant with p value of 0.001. Conclusion: This study concluded that anemia is a predictable as well as preventable entity. Obstetrical factors may be the contributory factors of anemia in pregnancy. Health education awareness programs, regular antenatal visits and iron supplements can be helpful to improve heath of pregnant women.
Objectives: To evaluate the association of hypertension and diabetic retinopathy in type 2 DM patients. Study Design: Case Control study. Setting: Diabetic Clinic Department of Medicine, Independent University Hospital, Faisalabad. Period: From January 2019 to June 2019. Material & Methods: One Hundred Type 2 diabetic patients of either sex were reviewed and these patients were screened for diabetic retinopathy using welchallyn ophthalmoscope. The patients with diabetic retinopathy fulfilling the inclusion criteria were placed in group A (cases) and patients without diabetic retinopathy were placed in group B (control). After resting the patient in supine position for 5 minutes, blood pressure (BP) measurements were taken in all these patients using mercury sphygmomanometer in two successive out-patient department visits, and mean value of B.P. was taken. All patients were asked for duration of diabetes, hypertension and visual problems specifically. These patients were advised following investigations: - FBS. - RBS. - HbAlc. Relevant statistics, mean & standard deviation were computed for variables. T-test was applied on hypertension (independent) and DM retinopathy (dependent) variables. Results: Systolic and diastolic blood pressure were significantly higher in the patients with retinopathy (mean systolic B.P 153.4± 17.13 and mean diastolic B.P. 84.1±9.26) than in those without retinopathy (mean systolic B.P. 130.65±11.94 and mean diastolic B.P 77.3 ±6.64). There was significant correlation of diabetic retinopathy with systolic hypertension (P<0.05) and diastolic hypertension (P<0.001). Conclusion: There is strong association between diabetic retinopathy and hypertension. So early detection and treatment of hypertension can retard the development and progression of diabetic retinopathy.
Background: Vancomycin is a narrow therapeutic agent, and it is necessary to optimize the dose to achieve safe therapeutic outcomes. The purpose of this study was to identify the significant covariates for vancomycin clearance and to optimize the dose among surgical patients in Pakistan.Methods: Plasma concentration data of 176 samples collected from 58 surgical patients treated with vancomycin were used in this study. A population pharmacokinetic model was developed on NONMEM® using plasma concentration–time data. The effect of all available covariates was evaluated on the pharmacokinetic parameters of vancomycin by stepwise covariate modeling. The final model was evaluated using bootstrap, goodness-of-fit plots, and visual predictive checks.Results: The pharmacokinetics of vancomycin followed a one-compartment model with first-order elimination. The vancomycin clearance (CL) and volume of distribution (Vd) were 2.45 L/h and 22.6 l, respectively. Vancomycin CL was influenced by creatinine clearance (CRCL) and body weight of the patients; however, no covariate was significant for its effect on the volume of distribution. Dose tailoring was performed by simulating dosage regimens at a steady state based on the CRCL of the patients. The tailored doses were 400, 600, 800, and 1,000 mg for patients with a CRCL of 20, 60, 100, and 140 ml/min, respectively.Conclusion: Vancomycin CL is influenced by CRCL and body weight of the patient. This model can be helpful for the dose tailoring of vancomycin based on renal status in Pakistani patients.
Objectives: To see the clinical characteristics and laboratory parameters of influenza A (H1N1) infection on hajj occasion 2018. Introduction: World Health Organization in 2009 declared H1N1 as pandemic, when about 70 countries documented approximately 30,000 cases of H1N1 infection. Saudi Arabia is representing a hot zone for influenza virus epidemics especially during Hajj gathering. Commonly H1N1 infection presents with flue like symptoms. Influenza infection is a major public health threat especially area like Makkah. Study Design: It was observational study. Setting: Done in Security Forces Hospital Makkah. Period: On hajj occasion from July to August 2018. Material and Methods: Total 50 admitted patients in isolation were included in study. Data was collected and analyzed using SPSS version 24. Results: In this study 08% patients had H1N1 +ve out of total patients included in study. Predominantly (75%) were < 14 years with 75% males. The most common presenting symptoms of these patients were Cough (100%), Fever (100%), breathlessness (75%), throat pain (50%), runny nose (75%), headache and lethargy (50%). Twenty five percent patients had hypoxia. Leukopenia was seen in 50% patients and thrombocytopenia was not documented in any patient. Liver Function Tests were deranged in 75% patients and Renal Function Tests were normal in all patients. Number of complications (pneumonia) was 25%. Conclusion: Clinical features and serological markers of influenza A +ve patients were same as reports globally and in KSA.
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