© IDOSI Publications, 2013

Abstract: The main objective was to determine the complications of laparoscopic cholecystectomy (LC) and its causes at Liaquat University of Medical and Heath Sciences, Jamshoro. It was a prospective study carried out from February 2008 to January 2011. Data of all patients undergoing elective laparoscopic cholecystectomy during the study period and fulfilling the selection criteria was collected and entered in standardized proforma and analyzed on SPSS 10. A total of 100 patients underwent laparoscopic cholecystectomy with an overwhelming majority of females (87 out of 100). The age range from 22 to 60 years, mean age being 38 years. The overall complication rate was 9%. The complications included bleeding (4/100, 4%) from cystic artery and gall bladder bed, port site infection (4/100, 4%) One patient developed collection in pouch of Morrison and one patient developed stitch granuloma. There was no bile duct injury and colonic injury. The common causes of these complications were accident injury to cystic artery and gross spillage of infected bile. Bleeding and Port site infections were the commonest complications. The commonest cause of bleeding was cystic artery injury whereas the commonest cause of port site infection was gross spillage of infected bile. Key words: Laparoscopic cholecystectomy Cholilithiasis Complication

Hypocalcemia in Acute Gastroenteritis

Abstract: Objective: To determine the serum calcium level in adult patients with acute gastroenteritis Patients and Methods: This descriptive type cross sectional study was conducted at Liaquat University Hospital Hyderabad Sindh, Pakistan. All patients above 12 years of age, of either gender present with history of acute diarrhea were further evaluated for their serum calcium status. The control group was selected for statistical comparative purpose; the data was recorded in pre-design proforma and analyzed in SPSS version 11.00. Result: Sixty six (66) subjects in each group were studies, of which 72(55%) were males and 60 (45%) were females, the mean age was 36.76±13.40. The hypocalcemia was observed in 75 (57%) patients while the serum calcium was normal in 57(43%) patients. Majority of subjects 92 (70%) belonged to urban areas. The mean±SD of serum calcium level in patients with acute gastroenteritis was 6.8455 ± 1.8266 mg/dL while the mean±SD of serum calcium in control group was 9.2167 ± 0.4534 mg/dL respectively (P<0.001). Conclusion: The low serum calcium level (hypocalciemia) was identified in patients with acute gastroenteritis. Key words: Hypocalciemia Serum calcium Acute gastroenteritis Diarrhe

© IDOSI Publications, 2012 Coagulopathies in Patients with Liver Cirrhosis

Abstract: This six months descriptive case series study was conducted in medical unit at Liaquat University Hospital Hyderabad and Jamshoro for the evaluation of the frequency of Coagulation abnormalities in patients with cirrhosis of liver. 118 patients presenting with cirrhosis of liver were selected through non probability consecutive sampling and were evaluate for coagulation profile. The data was collected via questionnaire form and analyzed by SPSS (Statistical Packages for Social Sciences) version 16. The frequencies and percentage were calculated for descriptive analysis. In the present study, out of 118, seventy (59.3%) were males and 48(40.7%) were females. According to Child’s Pughs classification, 51(43.22%) cirrhotic patients were in class A, 18(15.25%) in class B and 49(41.53%) in class C. The PT was prolonged (mean + SD = 21.83 ± 4.82 sec) in 60 (50.85%) patients, while 58(49.15%) patients had normal PT which was less than 15 seconds (mean + SD = 12.51 ± 1.03sec). Activated partial thromboplastin time was prolonged in 61 (51.70%) patients, while 57 (48.30%) patients had normal APTT which was less than 40 seconds (mean + SD = 33.07 ± 3.21 sec). PT and APTT were significantly raised in cirrhotic patients

The Role of Excitatory Aminoacids and its Neurotoxic Impact in Severe Head Injury Patients

Abstract: Background: Knowledge on metabolic aspects is essential for a better understanding of new pharmacological avenues and non-pharmacological strategies. Traumatic brain injury results in changes the composition of cerebrospinal fluid (CSF), which may represent a unique clinical window on brain pathophysiology. The role of excitotoxicity in mechanically-induced cell death and the molecular events that excessive release of glutamate induce, including apoptosis and delayed inflammatory processes, are shown to be vital to determine the out come of the head injury. Besides, brain injury induces an inflammatory response and production of oxygen-derived reactive species which affect many organs including heart, brain, kidney and gastrointestinal tract. Method: Lumber CSF obtained from 33 patients with severe head injury was collected and HPLC was used for the quantification of aspartic acid and glutamic acid. Kit methods were used for the determining the enzyme activity of LDH. AKP, SGOT, SGPT and CPK by Microlab instrument. For comparison, CSF samples from 32 healthy subjects without any neurological defects were used. Similar protocol was followed for both patients and healthy subjectsResults: Aspartic and Glutamic acid are both increased significantly in patients with severe head injury. Among the enzyme analyzed, LDH and CPK both are increased and s-GPT or ALT decreased significantly. There is no change observed in AST and AKP.Conclusion: From this study besides the role of excitatory amino-acids, the impact on enzyme activities shows a clear sign on th

Hypomagnesemia in Patients with Diabetes mellitus

Abstract: This study evaluated the frequency of hypomagnesemia in patients with diabetes mellitus and was conducted at Liaquat University Hospital Hyderabad from October 2009 to March 2010. The diabetic patients (type 1 and 2) were evaluated for their serum magnesium level by taking 2cc venous blood sample and sent to laboratory for analysis. Total 100 diabetic patients were studies, of which 77(77%) patients were type 2 diabetic and 23(23%) patients were type 1 diabetic. The mean age and standard deviation of patients with type 1 and type 2 diabetes was 21.34 ± 3.43 (SD) and 42.43 ± 6.521 (SD), respectively. The mean ± SD for serum magnesium in overall subjects was 1.34 ± 0.53. The hypomagnesemia was identified in 08 (14.5%) patients of type 1 diabetes and 47 (85.5%) of type 2 diabetes (P = 0.02). The mean ± SD of serum magnesium level in male and female population was 1.3000 ±0.5087 and 1.3882 ± 0.5577, respectively.). The hypomagnesemia was identified in patients with diabetes mellitus (type 1 and type 2 with statistical significant values. Of 55 hypomagnesemic diabetic patients the Heamoglobin A1c (HbA1c) was raised in 40 (72.7%) patients

Original Article Treatment of extensive alopecia areata with oral prednisolone mini-pulse regimen

Background Systemic steroids in mini doses have been reported effective in the treatment of alopecia areata. Objective To evaluate the efficacy of oral prednisolone in mini pulse regimen in the treatment of severe forms of alopecia areata. Patients and methods This open uncontrolled study was conducted at the Department of Dermatology and Medicine, Liaquat University Hospital, Hyderabad from June, 2007 to July, 2008. All adult patients of both genders not receiving any topical or systemic treatment were enrolled in study. Non-probability convenience technique was used for sampling. After recording personal data and short history regarding the onset, duration and treatment received; thorough cutaneous and systemic examination was done. The patients were assessed clinically and with photographs at all visits. All patients received 30 mg oral prednisolone for 3 consecutive days in a week for 6 months. They were assessed for response and side effects at monthly intervals. The post treatment follow-up was done for 6 months. The findings were recorded on close ended proforma. The data were analyzed using SPSS software version 11.0. Results Fourteen male and 8 female patients aged between 16 and 40 years (mean 25.5 years) were enrolled for study. The duration of the disease at the time of presentation was from 6 months to 10 years (mean 3.6 years). Fourteen patients had extensive alopecia of scalp, 6 alopecia totalis while 2 alopecia universalis. Eight (15.7%) patients showed excellent response and 5 (9.8%) good response. The response was satisfactory in 7 (13.7%) and unsatisfactory in 2 (3.9%) patients. Conclusion Low dose steroids in mini-pulse regimen are an effective treatment modality for treating AA. Key words Alopecia areata, extensive alopecia areata, alopecia totalis, mini-pulse therapy, oral steroids

International Staging System: A Tool to Predict Survival in Patients with Multiple Myeloma

Abstract: This descriptive case series study was evaluates the International Staging System (ISS) for the prediction of survival in patients with multiple myeloma and was conducted in the department of Medicine at Liaquat University Hospital from June 2009 to June 2011. All patients above 12 years of age, of either gender with history of bone pain, usually in the back and ribs broken bones, usually in the spine, feeling weak and very tired, feeling very thirsty, frequent infections and fevers, weight loss, nausea, constipation and frequent urination were further evaluated for multiple myeloma. The widely accepted schema for the diagnosis of multiple myeloma uses particular combinations of laboratory, imaging and procedure findings, while the International Staging System for multiple myeloma was used for staging or prognosis purpose and the survival was measured from the onset of nonradiation therapy to time of death or last contact. During study period total 23 patients of multiple myeloma were evaluated for staging and prognosis by International Staging System. Of twenty three 16 (70%) were males and 07 (30) were females. The overall mean age was 62.78 ± 8.86 (SD) years while the mean age in male and female population was 56.82 ± 10.65 (SD) and 60.77 ±7.76 (SD) respectively. The mean haemoglobin, creatinine and calcium were 7.56±2.98 g/dl, 3.44±1.24 mg/dl and 13.72±3.88 mg/dl respectively. The male and female distribution in relation to International Staging System was 04(25.0%) and 01 (14.3%) in stage I, 04(25.0%) and 02(28.6%) in stage II while 08(50.0%) and 04 (57.1%) in stage III. The median survival in relatio

© IDOSI Publications, 2012 C-Reactive Protein in Patients with Pulmonary Tuberculosis

Abstract: The present study was conducted to evaluate the C-reactive protein (CRP) in patients with pulmonar

Fasting Blood Glucose and Serum Magnesium Levels in Patients with Hypertension

Abstract: This study was conducted in relation to determine the fasting blood glucose and serum magnesium levels in patients with hypertension in department of Medicine, Liaquat University Hospital Hyderabad from July 2011 to December 2011. The hypertensive patients were recruited and evaluated for their fasting blood glucose and serum magnesium levels. A total of 100 hypertensive patients was evaluated, of which, 72 were males and 28 were females. The mean ages of male and female hypertensive subjects were 47.76±7.53 and 51.83±8.62 respectively. The mean serum magnesium in overall subjects was 2.86±0.63. Hypomagnesemia was observed in 62 % subjects and raised fasting blood glucose was identified in 55 % of individuals. The mean fasting blood sugar level in overall subjects was 137±5.00. The mean serum magnesium levels in hypermagnesemic, normomagnesemic and hypomagnesemic hypertensive individuals were 3.15±1.53, 2.25±0.72 and 1.25±0.63 respectively. The mean blood glucose levels in hyperglycemic, normoglycemic and hypoglycemic individual were 148.00±7.00, 92.00±4.00 and 59.00±6.00 respectively. The mean systolic and diastolic blood pressure levels in overall population were 180.00±12 and 108±10 respectively. Majority of the patients belonged to rural population (78%). Occurrence of low serum magnesium and raised blood sugar level in patients with hypertension was observed