Comparison of frequency of insulin resistance in patients with chronic obstructive pulmonary disease with normal controls

Objective: To compare mean homeostatic model assessment of insulin resistance (HOMA-IR) in patients with and without chronicobstructive pulmonary disease (COPD). Methods: A Case control analytic study was conducted in medical outpatient department of Medial Unit-II of Dow University of Health Sciences from April 2013 to September 2013. All patients with the diagnosis of COPD were included as cases. Controls were age match healthy individuals with minor illnesses. Age, weight, height and forced expiratory volume in one second to forced vital capacity (FEV1/FVC) ratio were documented. Fasting blood glucose and fasting insulin levels were done. Body mass index (BMI) and IR was calculated using the formulas. HOMA-IR was compared between cases and controls. Results: Forty COPD patients were compared with thirty five age match controls. HOMA-IR was found to be higher in cases as compared to controls (2.85 v/s 2.00) with a p value \u3c0.000. Conclusion: COPD is one of the chronic debilitating diseases in our region with various extra-pulmonary complications. We found IR to be present higher in COPD patients compared with healthy controls. Evaluating the pulmonary function as well as systemic metabolic parameters, may contribute to minimizing mortality and morbidity

Clinical Outcome of Cortical Venous Thrombosis in Stroke Patients at a Tertiary Care Hospital of Southern Punjab

Objective:  This study was determined to find out the clinical Outcome of Cortical Venous Thrombosis (CVT) in Stroke patients at a Tertiary Care Hospital of Southern Punjab. Material & Methods:  A total of 100 patients with cortical venous thrombosis were included in this descriptive case series study, which was conducted at Department of Neurology, Nishtar Hospital Multan. Outcome of patients in terms of partial recovery or complete recovery, any recurrence, any complication, indication for Surgery and any disability in terms of focal deficit, prolonged hospital stay and Mortality was followed. Results:  Our study included a total of 100 patients with cortical venous thrombosis (CVT), 35 (35%) were male and 65 (65%) were female patients with their mean age was 37.69 ± 16.52 years, ranging from 20 – 83 years (51.37 ± 17.44 in males versus 30.32 ± 10.15 years for females). Headache was noted in 80%, focal deficit in 57%, nerve palsy in 30%, coma in 22% and disability was noted in 35%. Partial recovery was noted in 65%, whereas complete recovery was noted in 35% while, complications were noted in 12 (12%) of these patients with CVT. Conclusion:  Cortical venous thrombosis was more prevalent in females in their younger age groups and it was associated with poor prognosis as high frequency of partial recovery was noted in our study. Keywords:  Cortical venous thrombosis, Stroke, headache, recovery, outcome

Comparative Study of Current Methods of Analysis of R.C. Structural Frames Based on Pushover Analysis

There has been a growth in extensive research aimed at examining the effects of seismic events on the performance of a structure. Buildings have a tendency to exhibit inelastic deformation in during seismic activities and post-elastic behavior. Hence, better insights of the performance of structure can be obtained by examining its post-elastic behavior. Non-linear static analysis (also known as Pushover Analysis) is an improved and effective modern way of examining structural performance in the event of potential seismic impact. Such an approach involves horizontally pushing a structure using a predetermined loading pattern which constantly increases over time thereby making it possible to determine the collapse conditions, associated lateral displacement and total applied shear force. It offers a sound Perception of Structural Performance against earthquake as well as damages suffered. Thus, pushover analysis makes it feasible to ascertain the responsive behavior of buildings in non-linear zones which is not catered for by conventional elastic designs

Maternal characteristics and outcomes affected by hypothyroidism during pregnancy (Maternal hypothyroidism on pregnancy outcomes, MHPO-1)

Background: Hypothyroidism in pregnancy is an arena of ongoing research, with international conflicts regarding screening, management, and outcomes. Various studies have described the outcomes depending on geographical and international diagnostic criteria. No study has been conducted in this regard from the region of Pakistan. Therefore, we aim to report the clinical features and maternal outcomes of hypothyroid pregnancies and compare the maternal outcomes between uncontrolled and controlled TSH levels in the preconception as well as the gestational period.Methods: We conducted a cross-sectional retrospective study on 718 cases in the Aga Khan University Hospital after ethical approval. We collected information on pregnant females who have diagnosed hypothyroidism before conception or during their antenatal period. We noted the maternal characteristics and maternal comorbidities. Laboratory data were recorded for thyroid stimulating hormone levels before conception and during gestation. We recorded maternal outcomes as pregnancy loss (including miscarriage, stillbirth/intrauterine death, medical termination of pregnancy and ectopic pregnancy), gestational hypertension, pre-eclampsia, postpartum hemorrhage, placental abruption, and modalities of delivery. Data analysis was performed on Statistical Package for the Social Sciences version 20.0.Results: Among 708 hypothyroid women 638 had live births. Postpartum hemorrhage was the most frequent maternal outcome (38.8%). The emergency cesarean section occurred in 23.4% of cases. We determined TSH levels in 53.2, 56.7, 61.7 and 66.6% of cases in preconception, 1st, 2nd, and 3rd trimester periods. A significant association existed between cesarean section and preconception thyrotropin levels \u3e 2.5 mIU/L, whereas postpartum hemorrhage was significantly associated with thyrotropin levels \u3e 2.5 mIU/L in the preconception and third trimester.Conclusion: Successful live births in our patients were complicated by maternal postpartum hemorrhage and a frequent number of emergency cesarean section

Prevalence and Types of Contraceptive Used in Pakistan- A National Survey

Introduction/background: Pakistan is among the fastest growing countries of the world as far as population growth is concerned. With a growth rate of 2percent, the contraceptive prevalence rate is stagnant at 30 percent for the last many years. Use of family planning methods is limited and steps should be taken to increase the uptake. Objectives: To find the prevalence of contraception and choice of technique used. Methodology: The study was descriptive and cross-sectional in nature, the questionnaire was self administered semi-structured ipsative and was pilot tested on a sample of 10 females of reproductive age group before the final administration. The study was carried out in all four provinces. The sample size 200 females per district and 4 districts were taken from each province. Data analysis was done using SPSS. Results: The survey covered 3200 women from 16 districts (4 each province). The overall use of contraceptives was found to be maximum in Punjab (36.5%), then Sindh (28.7%), KPK (24.6%) and least in Baluchistan (14.5%). In Punjab and Sindh most common method was tubal ligation (11% and 10% respectively), while in KPK it was condoms and in Baluchistan it was oral pills. The least preferred methods in Punjab were found to be Injectable hormones and IUCD’s (both 3.5%) while in Sindh (1%), KPK (2%) and Baluchistan (1%) it was reported to be IUCD’s. Conclusion: People should be counselee properly about use of contraceptives. Awareness programs through social media should be may become aware especially in Baluchistan and KPK

Dietary Catharanthus roseus modulates intestinal microarchitecture in broilers

The study evaluated the efficacy of ethanolic extracts of Catharanthus roseus (C. roseus) in altering growth performance, viscera  development and intestinal microarchitecture in broilers. Day-old broiler chicks (n = 175) were randomly divided into seven groups (n = 25/group) with 5 replicates (n = 5). The chicks in the control groups were fed a corn-soya-based basal diet, whereas groups 2 - 4 had the same basal diets supplemented with 0.05%, 0.1%, and 0.2% ethanolic leaf extracts (ELE), respectively. Chicks in groups 5 - 7 were fed the basal diet supplemented with 0.05%, 0.1%, and 0.2% ethanolic root extracts (ERE) of C. roseus, respectively. The growth performance and feed conversion ratio remained unchanged, but feed consumption of birds supplemented with 0.1% ERE increased in weeks 1 and 3. The relative length of the small intestine was lower in the 0.05% ERE group compared with the control. Villus height, width, surface area, and lamina propria thickness were higher in the 0.1% ERE group in all three segments of the small intestine than in the control. Broilers supplemented with 0.1% ERE performed better in terms of feed consumption and improved intestinal microarchitecture of the small intestine

Incidental Finding of Deranged Renal Function in Elderly Patients Presenting with Fractures in a Tertiary Care Hospital

Objective: To determine the incidental rate of renal impairment among elderly women with fractures who reported to the Orthopaedic OPD at a tertiary care Hospital. Methodology: This prospective cohort study was done at Orthopaedic department and OPD Fauji Foundation Hospital, Rawalpindi during a period of one year from March 2022 to February 2023. A total of 147 females aged >60 years presented with Hip fractures, surgically managed and who had history of normal pre-fracture renal function were included. A 5ml blood sample was obtained and sent to the Hospital diagnostic laboratory to evaluate the renal profile, serum calcium and vitamin D levels. All the information was recorded via pre-structured study proforma.  Results: The study enrolled 147 elderly participants with an average age of 66.82 years. Among the participants, 24 patients (16.3%) experienced Acute Kidney Injury (AKI), with 9.5% having stage-I AKI, 4.8% with stage II AKI, and 2.0% with stage III AKI. Before sustaining the hip fracture, the mean serum creatinine level was 67.04 µmol/L, and following the fracture, it increased to 81.95 µmol/L (p-value < 0.0001). The severity of AKI did not exhibit a statistically significant correlation with the age of the patients. However, there was a statistically significant increase in serum creatinine levels among patients based on the duration of their fractures (p-value < 0.001). Conclusion: The incidence of Acute Kidney Injury (AKI) in elderly patients following hip fractures was found to be 16.3%, with varying stages of severity

The Effects of Melatonin On The Oxidative Stress , Protein Glycation , Microalbuminuria and Lipid Profile In Type II Diabetes Mellitus

Previous studies indicated that supplementation with antioxidants has a protective effects against oxidative stress–induced damage in type 2 diabetes. In this study we evaluated the antioxidant effects of melatonin on the oxidative stress parameters and microalbuminuria in type 2 DM patients. 30 patients with type 2 DM were treated with 3mg/day melatonin for 90 days. Erythrocytes and plasma MDA and glutathione, fasting plasma glucose, %HbAIC, microalbuminuria, total plasma protein and lipid profile were measured each 30 days and compared with those obtained from 20 healthy controls. A decrease in MDA levels associated with the elevation in GSH levels were observed, compared with the pre–treatment levels. Fasting plasma glucose, glycated hemoglobin and microalbuminuria were significantly decreased, associated with an improvement in the total cholesterol, HDL–C and LDL–C levels, with respect to the pretreatment values.In conclusion , treatment of type 2 DM patients with melatonin may have protective effects against the oxidative stress–induced damage during the course of type 2 DM. Key words: Diabetes Mellitus, Oxidative Stress, Melatonin,Microalbuminuria