Introduction: Inadequate control of glycemia in type-II diabetic patients is an important community health issue and a risk factor for the progression of problems among diabetic patients. Hypertension is a common disease accompanying diabetes. Among patients with diabetes mellitus; high blood pressure is an important factor involved in poor glycemic control which has not been adequately assessed in Pakistan. Aim: The main goal was to evaluate the glycemic control status in type II diabetic patient depending on the basis of blood pressure levels. Place and Duration: In Medicine Department of Islamic International Hospital and Medical College, Islamabad for the duration of six months from January 2021 to June 2021. Methods: 220 adult patients >18 years of age with type-II diabetes mellitus were included. Patients with conditions such as liver cirrhosis, systemic infection, pregnant females, end-stage renal disease and those who were not observing diabetes treatment, counting exercise, dietary restrictions and medication, they were omitted from the anlaysis. By evaluating medical records; the patient’s demographic information was obtained which includes medical history, patient age, clinical history, gender, hypertension and type of DM in addition to the assessment of blood sugar level control. Statistical analysis was performed by using the SPSS 20.0. Results: The patients mean age was 58.10 ± 10.94 years with 35-80 years of age range. Of 220 patients, 145 (65.9%) had hypertension and 75 (34.1%) had normal blood pressure, and 7.72 ± 1.28 years was the patient’s mean duration of hypertension. The males have the HbA1c levels of 7.11 ±1.34 and 7.81 ±1.58 in females. In the hypertensive group of patients; mean HbA1c was higher significantly in comparison to the normal blood pressure group (p = 0.003). The HbA1c mean levels were also higher significantly among hypertensive patients with duration for over ten years (p = 0.04) and in subjects using diuretics (p = 0.03) and beta-blockers (p = 0.006) as an antihypertensive drug. Among patients with normal body mass index and nutritional recommendations, the mean (± SD) HbA1c in patients with hypertension was 5.13 ± 0.03 compared with patients with normal blood pressure (p = 0.00007). Conclusions: The control of Glycemia in type II diabetic patients is poor with hypertension. There is a complex relation of various factors, including gender, age, hypertension duration, and drugs that strongly effect control of glycemia among hypertensive patients and type-II diabetes mellitus. Keywords: Hypertension, Type 2 diabetes, HbA1c
Objective: To determine the levels of anti-spike protein (S) antibody against SARS-CoV-2 among Vaccinated Healthcare workers of Islamabad.Methodology: Cross-sectional Observational study carried out at HBS General Hospital from March 2021 till May 2021 involving healthcare workers from HBS General Hospital, Rawal General Hospital, Polyclinic Hospital and PIMS. The non-probability sampling technique was used. The study included male and female healthcare workers over the age of 18 who had received their second dose of vaccine at least 2 weeks before sample collection and no more than 8 weeks before sample collection.Results: The study included 123 participants, of whom 6.5% did not have a detectable level of the antibody. The Male to Female ratio was 1.277:1 while mean age was 42.93±13.234 years. Side-effects were experienced by 42.3% (n=52) participants. Significantly higher levels of the antibody were observed in participants who had previous SARS-CoV2 infection and those who experienced vaccine side-effects.Conclusion: The BBIBP-CorV vaccine elicited immunogenicity, leading to detectable anti-spike protein S antibody levels in 93.5% of the patients in our study.
Background: Extended-spectrum β-lactamase (ESBL) producing organisms are resistant to a wide range of broad-spectrum antibiotics, and their emergence is a significant driving force of antibiotic resistance. Most South-Asian countries have become hotspots for antibiotic resistance, so specifics of ESBL data are critical to tackling antibiotic resistance. We present the temporal changes in ESBL-producing organisms cultured in our tertiary care referral centre.Methods: Over a year, a historical cohort analysis was carried out at our tertiary care referral centre in Southeast Asia. Samples from patients presenting with acute surgical conditions were sent for culture and sensitivity. The phenotype of all specimens was checked using the combination disc method. Antimicrobial susceptibilities to various antibiotics were also checked as per CLSI (Clinical and Laboratory Standard Institute) guidelines.Results: Specimens from 170 patients were analysed. The mean age was 44.73±19.89 years, and there was a female predominance of 62%. The most common organisms were Escherichia coli (70%), Klebsiella pneumoniae (18%), and Pseudomonas aeruginosa (16%). The percentage of ESBL-producing organisms was 54.7%, which is significantly higher than in previous reports. Widespread resistance was found against commonly used antibiotics, including co-amoxiclav (81.9%), ceftriaxone (75%), ciprofloxacin (47%), and levofloxacin (35.7%). Sensitivities to combination antibiotics like piperacillin-tazobactam (79.2% sensitive), cefoperazone-sulbactam (84.3% sensitive), and imipenem-cilastatin (91.1% sensitive) were also noted to be falling. Conclusion:The incidence of ESBL-producing organisms continues to increase at an alarming rate, which mandates strict antibiotic stewardship and amendments to local guidelines.
Abstract Objective: To determine the relationship of severity of thrombocytopenia with various grades of esophageal varices in patients with cirrhosis. Study design: A cross sectional observational study. Place and duration of study: Medicine department of Pakistan Railway General Hospital from 1st September, 2018 to 31st August, 2020. Material and Methods: The record of 100 patients with cirrhosis having concomitant thrombocytopenia and esophageal varices was retrospectively analyzed. The information about clinical, hematological, biochemical, ultrasound and endoscopic findings was retrieved from medical record. On the basis of platelet count, four groups were made. Group I consisted of patients with a platelet count ≤ 20,000/ µl, group II 21,000-49,000/ µl, group III 50,000-99,000/ µl, and group IV 100,000- 149,000/ µl. Esophageal varices were reclassified as small and large varices group depending on the size. Correlation of thrombocytopenia with grading of esophageal varices was calculated using spearman’s correlation. Results: Out of 100 patients, 76% had large varices and 24% had small varices. Thrombocytopenia was more severe in patients with large varices group when compared with small varices group. There was significant negative correlation between thrombocytopenia and grading of esophageal varices (r= -.691; P < 0.001). Conclusion: The severity of thrombocytopenia increased with increase in the size of esophageal varices. Low platelet count can strongly predict large varices in patients with cirrhosis.
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