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.
Objectives: To determine the prevalence of ulcerative colitis, extent and associations of disease with age, gender, indication of the procedure and coexisting disorders in patients who underwent sigmoidoscopy at Liver Clinic, Lahore, Pakistan. Study Design: Retrospective study. Setting: Liver Clinic, Lahore. Period: February 2010 to July 2017. Material & Methods: Group of ulcerative colitis patients was compared with group without ulcerative colitis among who underwent sigmoidoscop y from genders, age groups, indication for sigmoidoscopy, and presence of ulcerative colitis were the qualitative variables, while age of the patients was the only quantitative variable. Data was analysed on SPSS-25was used. Means with standard deviations were computed of quantitative variables, and frequencies-percentages for qualitative variables. Chi-square test for independence and Independent sample T test were used for qualitative and quantitative variables respectively to determine their significant association with presence of ulcerative colitis. The p values were taken statistically significant if < 0.05. Results: Out of total of 998 patients who underwent sigmoidoscopy, 115 (11.52%) had ulcerative colitis. The mean age of ulcerative colitis patients was 37.87 + 14.23 years while mean age of patients not suffering ulcerative colitis was 44.42 + 15.29 years. Among ulcerative colitis suffering cohort, 6.1% were children, 41.7% young adults, 44.3% middle aged adults and 7.8% were older adults. Out of 115 patients, 22 (19.1%) had ulcerative proctitis, 25 (21.7%) ulcerative proctosigmoiditis and in remaining 68 (59.1%) patients had colitis throughout visualized tract. 29 (25.2%) ulcerative colitis patients had supplementary associated disorders: 11 (37.9%) had superimposed pseudomembranous colitis, 8 (27.6%) had pseudopolyps formation, 7 (24.1%) had solitary benign polyps, 2 (6.9%) had internal hemorrhoids and 1 (3.4%) had malignant growth as well. The ulcerative colitis was more prevalent in female gender (p<0.01), younger age group (p<0.01) and where bloody diarrhea was presenting complaint (p<0.01). Conclusion: Ulcerative colitis is prevalent in all age groups and female gender is more affected in our population. Majority patients have disease not limited to only rectum and sigmoid colon, rather possess aggressive disease pattern associated with more risks and hazards. Ulcerative colitis usually presents with bloody diarrhea in our people. There are multiple coexisting disorders, where higher prevalence of pseudomembranous colitis in ulcerative colitisdemands avoidance of undue antibiotics and better hygiene.
ABSTRACT… Introduction: Atrioventricular (AV) block is a common complication of acute Myocardial Infarction (MI). In pre-thrombolytic era, high (second or third degree) AV block was seen in approximately 5-7% of patients presenting with acute MI. In setting of Inferior MI, this was even as high as 28%. Although, the advent of thrombolytic therapy has substantially decreased the mortality associated with acute MI, the incidence of AV block, particularly in the setting of inferior MI, remains high. AV block in the setting of inferior MI is also associated with high in-hospital mortality, however, its effect on long-term mortality is uncertain. Objectives: To compare the in-hospital mortality of acute inferior wall myocardial infarction with and without complete Atrioventricular block. Settings: Department of Cardiology Faisalabad Institute of Cardiology, Faisalabad. Duration of Study: Six months From: 01-05-2014 to 30-11-2014. Study Design: Cohort study. Results: In our study, out of 80 cases(40 in each group) 42.5%(n=17) in Group-A and 37.5%(n=15) in Group-B were between 20-50 years of age while 57.5%(n=23) in Group-A and 62.5%(n=25) in Group-B were between 51-70 years of age, mean+sd was calculated as 52.58+9.83 and 55.43+8.06 years respectively, 40%(n=16) in Group-A and 47.5%(n=19) in Group-B were male while 60%(n=24) in Group-A and 52.5%(n=21) in Group-B were females, comparison of in-hospital mortality in both groups was done showing 32.5%(n=13) in Group-A and 7.5%(n=3) while 67.5%(n=27) in Group-A and 92.5%(n=37) had no findings of in-hospital mortality, Relative Risk was calculated as 4.33 while P value:0.005. Conclusion:We concluded that in-hospital mortality is significantly high in acute inferior wall myocardial infarction complicated by atrioventricular block.
ABSTRACT… Introduction: Systemic lupus erythematosus (SLE) is a multiorgan autoimmune disease with an increased incidence rate of thrombotic events (9-37%). Metabolic syndrome (MetS) may contribute to increased cardiovascular risk in (SLE). The Metabolic syndrome is more prevalent in SLE patients than the general population and is associated with endothelial injury and coronary atherosclerosis. Objective: To determine the frequency of metabolic syndrome in systemic lupus erythematosus (SLE), patients presenting in a tertiary care hospital. Study Design: Cross-sectional survey. Study Settings: Medical out-patient Department of Jinnah Hospital Lahore. Duration of Study: Six months duration from 25 th June 2014 to 26 th December 2014). Subjects and Methods: Non-probability purposive sampling was done on 78 SLE patients (as per operational definition), which were enrolled after obtaining their written informed consent. Metabolic syndrome was labeled as per operational definition. Data was recorded on a specially designed performa. Results: From 78 cases of SLE there were 4% male and 96% were female. The mean age was 20-60 years with standard deviation of 40.21±10.67 years. It was observed that there were 38.5% cases of SLE with family history of CHD, 66.67% patients of SLE were smokers, 48.7% patients had central obesity, 47.4% patients had high fasting blood glucose, 44.9% cases were with low HDL and 39.7% patients had high blood pressure. Metabolic syndrome was found in 33.3% patients of SLE. Metabolic syndrome was significantly associated with high blood pressure (p= 0.00), central obesity (p= 0.00), high blood glucose (p= 0.00), low HDL (p= 0.00) and gender p=0.01) but association with age (p=0.33), smoking (p=0.73) and family history of CHD (p=0.32) was not significant. Conclusion: The frequency of metabolic syndrome in SLE patients presenting in a tertiary care hospital was found to be 33%. Metabolic syndrome was significantly associated with SLE. Key words:Systemic Lupus Erythematosus, Central Obesity, Coronary Artery Disease, metabolic syndrome. Article Citation: Khalid M, Anwar T, Naveed-ur-Rehman, Bashir MB. Metabolic syndrome; Frequency of metabolic syndrome in patients of systemic lupus erythematosus. Professional Med J 2017;24(7):960-965.
Objectives: To assess the frequency of acute exacerbation of chronic obstructive pulmonary disease in patients taking low dose azithromycin prophylaxis. Study Design: Cross Sectional study. Setting: Department of Medicine, Independent University Hospital, Faisalabad. Period: 01-07-2017 to 30-06-2018. Material & Methods: 100 patients having diagnosis of COPD according to the operational definition were selected from medical opd of hospital after consent of patients. All patients were given tablet azithromycin 250mg thrice weekly for 12 months, then these patients were followed up for episodes of exacerbations in one year. All patients were properly instructed to report in any change in their symptoms. Any episode of acute exacerbation was noted. There was no conflict of interest. Results: Frequency of acute exacerbation of chronic obstructive pulmonary disease was seen in 70 out of 100(70%) patients taking low dose azithromycin prophylaxis. In female patients frequency of acute exacerbation was high as compared to male patients. i.e. 62.9% vs. 37.1%. Frequency of acute exacerbation was higher in patients whose duration of disease was longer. i.e. 7-10 years followed by patients whose duration of disease was 4-6 years (28.6%) and 1-3 years (25.7%). Presence of acute exacerbation was significantly associated with decline in lung functions. Highest frequency of acute exacerbation was seen in patients who had 3-4 episodes. Conclusion: Results of this study showed a high frequency of acute exacerbation of COPD even with the prophylaxis of low dose azithromycin. However literature reported effectiveness of low dose azithromycin for acute exacerbation in patients of COPD. So further study in the form of randomized trail is needed to prove the efficacy of azithromycin.
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