Objective: The aim of this study is to compare the severity of symptoms and outcomes among vaccinated and non-vaccinated COVID 19 patients in Khyber Pakhtunkhwa, Pakistan Study Design: A Retrospective/ Comparative study Place and Duration: The study was conducted at Medicine department of Lady Reading Hospital, Peshawar and DHQ Category A Hospital, Batkhela for duration of six months between December 2020 and May 2021. Methods: Total 170 patients of both genders had coronavirus disease were presented in this study. Patients were aged between 20-80 years. Demographical details of patients including age, sex, body mass index, residency and socio-economic status were recorded after taking informed written consent. Patients were admitted in COVID 19 ward. There were 70 vaccinated patients in group I and 100 non-vaccinated patients in group II. Co-morbidities among both groups were assessed. Effectiveness and outcomes among both groups were calculated in terms of mortality and reduction in severity of disease. Complete data was analyzed by SPSS 19.0 version. Results: There were 114 (67.1%) patients were males (50 in group I and 64 in group II) and 56 (32.4%) were females (28 in each group). Mean age of the vaccinated patients was 49.16 ±8.55 years with mean BMI 33.16 ±4.64 kg/m2 and in group II mean age was 47.18 ±4.77 years with mean BMI 31.12±12.73 kg/m2.Among 70 cases of group I, 40 (57.1%) were fully vaccinated and 30 (42.9%) patients received their first dose. 50 (71.4%) were educated in group I and in group II 46 (46%) patients were literate. Co-morbidities were diabetes mellitus, hypertension, ischaemic heart and chronic lung disease. Effectiveness among patients of group I was greater 55 (78.6%) as compared to non-vaccinated 36 (36%). Frequency of adverse outcomes hospitalization 10 (10%), ICU admission 14 (14%) and mortality 40 (40%) among non-vaccinated patients were significantly higher as compared to vaccinated patients in which hospitalization 3 (4.3%), ICU admission 2 (2.9%) and mortality was found in 10 (14.3%) cases. Conclusion: We concluded in this study that vaccination against coronavirus disease was effective and helpful for the reduction in severity of the disease. Except this the frequency of adverse outcomes (hospitalization, ICU admission and mortality) can be minimized by vaccination and there is need to give awareness among people to get vaccinated early. Keywords: COVID 19, Vaccination, Pandemic, Mortality
Introduction: Diabetes Mellitus (DM) is one of the leading causes of morbidity and mortality around the world and is responsible for 3.8 million deaths per year. Its prevalence had shown an exponential rise worldwide in the last two decades, from 30 million cases in 1985 to 177 million in 2000 Objective: To compare the efficacy of the combination of Metformin plus modified-release Gliclazide with a variety of Metformin plus Sitagliptin in patients with type-2 diabetes mellitus. Methodology: This study was conducted at the Department of Medicine, Lady Reading Hospital Peshawar. The study design was a randomized controlled trial conducted for one year from May 2017 to May 2018, in which 62 patients in each group were observed. All patients with type 2 Diabetes Mellitus with baseline HbA1c ≥ 8% and duration >1 year, either gender with age range 35 to 65 years, were included. All patients were subjected to detailed history and clinical examinations. All patients were randomly allocated in two groups by lottery method. Patients in Group A were subjected to the combination of Metformin (1gm twice daily) with modified-release Gliclazide (60mg), and patients in Group B were subjected to the variety of Metformin (1 gm twice daily) with Sitagliptin (50 mg twice daily). All patients were followed up after three months, and blood samples for HbA1c levels were obtained. The analysis was done in SPSS version 20. Results: The Study showed that the mean age in Group A was 58 years ± 12.78, and the mean age in Group B was 55 years ± 13.12. In Group A, 44% of patients were male, and 56% of patients were female, while in Group B, 45% of patients were male, and 55% of patients were female. Moreover, Group A (Metformin (1gm twice daily) + Gliclazide (60mg) was effective in 45% of patients while Group B Metformin (1 gm twice daily) + Sitagliptin (50 mg twice daily) was effective in 71% of patients. Conclusion: Our study concludes that Metformin plus Sitagliptin is more effective than Metformin plus modified-release Gliclazide.
Background: Diabetes mellitus is on the rise at an alarming rate, and it has now become a global issue. Type 2 Diabetic Mellitus is a disease characterized by disturbances in glucose, protein, and fat metabolism. Diabetes has been increasingly common in recent decades, causing significant socioeconomic burden, particularly in poorer countries. Objective: To investigate the prevalence of vitamin B12 deficiency in Type 2 diabetes patients taking metformin. Methodology: This study was conducted on T2 diabetic patients in the Diabetic Department of Diabetes and Endocrinology HMC Hospital, Peshawar, for a year (10 February 2019 to 12 March 2020). The demographic data of the recruited patients was obtained after they gave their informed written consent. Patients inquired about their metformin use history, dosage, and duration of type 2 diabetes mellitus. A 5cc venous blood sample was taken from the arm and kept at 4 degrees Celsius. Vitamin B12 levels were measured using enzyme-linked immunoassay assays after serum was withdrawn. ELISA was used to determine the Vitamin B12 level in serums. Results: A total of 149 people were enrolled in this trial. The patients' average age was 55 years. In this study, there were 67 (38.8%) males and 82 (55.2%) females. The individuals had a 5.12-year history of diabetes mellitus. The average HbA1c level was 8.280.32. The individuals that were included have taken metformin for at least 4.8 years. There were 25 (22.6%) patients using 1000-1500 mg metformin daily, 76 (46.4%) receiving 1500-2000 mg metformin daily, and 48 (40.7%) taking greater than 2000 mg metformin daily. There were 44 patients with a normal BMI, 80 patients who were overweight, and 25 patients who were obese. The average B12 level in the blood was 223pg/ml. Vitamin B12 deficiency was found in 96 (49.1%) of the patients. There was no vitamin B12 deficiency in 53 (45.4%) of the patients. Recommendations: It is strongly advised based on the findings of this study that Serum cobalamin levels should be measured in Type II diabetes patients who are taking metformin, and patients should be given R.D.A (Recommended Dietary Allowance) multivitamins to avoid sequaela of cobalamin deficiency.
Introduction: Diabetes causes hyperglycemia, glucose, lipid, and protein metabolic issues owing to insufficient insulin production or activity resulting in dyslipidemia and hypertension. Dyslipidemia raises triglycerides, free fatty acids, and serum HDL cholesterol, causing cardiovascular events including high blood pressure. Objective: The current study aimed to evaluate the serum lipid profiles of type 02 diabetics with and without hypertension. Study layout The research strategy is experimental, using a comparative study method. Methodology: Mercy Teaching Hospital and Prime Hospital, Peshawar, performed the study. 6-month research. Peshawar's Prime and Mercy Teaching Hospitals conducted lab tests from July to December 2021. Descriptive-analytic research was our objective. Cases and controls were chosen among 200 type 02 diabetics. Cases comprised type 02 diabetics with hypertension; controls had none. Blood cholesterol, triglyceride, LDL, and HDL were measured. Statisticians utilised SPSS 24. Comparing groups' means using a student T-test. Result: Patients averaged 51.33 6.35 years old. Our patients were mostly 41-50. 82 (41%) men and 112 (59%) women participated in our research. Mean blood cholesterol, triglycerides, and low-density lipoprotein (LDL) values in cases and controls were 211.40 101.64 mg/dL vs 158.88 31.84 mg/dL, 307.95 167.17 mg/dL vs 154.39 59.12 mg/dL, and 115.57 82.26 mg/dL vs 94.40 Serum cholesterol, triglyceride, and LDL values were significant (p0.01). Serum HDL in controls (44.23 6.41mg/dL) was greater than in controls (41.13 4.96mg/dL) but not statistically significant (p-value > 0.05). Conclusion: Our study found that hyperlipidemia is common in type 2 diabetes mellitus patients with hypertension, However the mechanism of this connection is uncertain. Keywords: Diabetes mellitus type 2 , Dyslipidemia, hypertension, Peshawar, Pakistan
Malaria is one of the most common and dangerous tropical infections. WHO estimates 3 million people in 24 countries are at risk for malaria. Malaria eradication is a top global health priority. Mosquitos spread Malaria, WNV, and Dengue Fever. A female Anopheles mosquito bite transmits malaria. Night and dawn are peak times. Plasmodium falciparum, malaria, vivax, ovale, and knowlesi infect humans. The deadliest parasite is Plasmodium falciparum. Objective: To compare the sensitivity and specificity of blood and salivary PCR among malaria patients and assess saliva as a Malaria diagnostic medium. Methods: A cross-sectional survey was conducted from March 2020 to May 2020 at Rafah Hospital Islamabad. After approval from the ethical review board, 100 subjects were approached from patients admitted to the medical /pediatrics ward, diagnosed with malaria by ICT or Microscopy. After Informed consent, ICT malaria was again performed on all of these subjects; each subject had taken paired blood and saliva samples. Data were analyzed by using SPSS version 23 Results: The present study analyzed the prevalence of malarial DNA in the saliva of malaria- diagnosed patients and evaluated the efficiency of the saliva of malarial patients as an alternate medium for its diagnosis. Among 100 study participants, Blood PCR showed 100% Sensitivity and 51.9% specificity compared to salivary PCR among 100 study Participants. Moreover, Salivary PCR showed a Sensitivity of 65.8% and a Specificity of 27% compared to Blood PCR. Practical implication: This study will provide data about the comparison of sensitivity and specificity of blood and salivary PCR among malaria patients and assess saliva as a Malaria diagnostic medium. Conclusion: Our study concluded that Blood PCR has good sensitivity and specificity compared to saliva PCR keeping ICT as the Gold standard. Moreover, saliva can not be used as an effective medium for the Diagnosis of Malaria. Keywords: Malarial DNA, Saliva, Blood PCR, salivary PCR.
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