Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low-... more Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low- and high-income countries. They are relatively common worldwide, affecting 3% to 5% of live births. Methods: A cross-sectional study was conducted from January 2014 to June 2014 at the Khyber teaching hospital in Peshawar. Specific patient information was obtained from patient records at the beginning of the study. Those individuals found to have at least one birth defect were approached and their attendants (mothers) were interviewed. Information regarding various risk factors was collected. Descriptive analyses were carried out. Results: Out of 1062 deliveries, 2.9% (31) of newborns had various congenital anomalies.b Hydrocephalus (22.6%), anencephaly (12.9%), and spina bifida (9.7%) were major anomalies. The maternal age ranged from 18 years to 46 years (mean: 30 ± 8). Most of the anomalies (35.5%) were present in the 26-30 years age group. Out of 31 babies, 6.4% had multiple anomali...
Background and Objective: It has been observed that in a clinical condition like hypoxemia there ... more Background and Objective: It has been observed that in a clinical condition like hypoxemia there is an increase in the serum Uric acid level. The objective of our study was to find out the relationship between serum uric acid levels in the severity of Heart failure. Methods: We analyze 285 patients with a diagnosis of Congestive heart failure admitted in Lady Reading Hospital Peshawar from March 1 st to August 2016. Age group of patients was 17-67 years. New York Health Association (NYHA) scoring were used to access the severity of Congestive Heart Failure. Serum UA level >7.0 mg/dl was considered high. Results: Total 285 patients with CHF were analyzed with a mean age of 54±2.8 years in which males were 65.96% and 34.03% were female. 40% were in class II of New York Health Association (NYHA), 32.63% in class III and 25.61% in class IV and 1.75% were in class I. Out of 285, 59.29% met the definition of hyperuricemia. In which 83.43% were male and 16.57% were female. Most of the Hyperuricemic patients 62.13% were in age group of 51-60 years, with a mean age of 57±4.5 years. We found a significant correlation between uric acid level and BNP (p= <0.001), and use of diuretics (p=<0.001). 34.93% of the Hyperuricemic CHF patients were in NYHA III and NYHA IV whose SUA was above 8 mg/dl as compared to 31.57% Hyperuricemic CHF patients whose SUA was below 8 mg/dl. Conclusion: High serum Uric acid was observed in 59.29% of patients with CHF. The observed significant correlation between UA level and some established prognostic markers in these patients may indicate that serum UA could provide additional prognostic information in this population. SUA as a marker can be measured anywhere at a low cost to help identify high-risk patients with CHF. Lowing uric acid is expected to be a new approach for prevention and therapy of HF.
When there is occlusion of an epicardial coronary artery, ST elevation is shown on ECG which is e... more When there is occlusion of an epicardial coronary artery, ST elevation is shown on ECG which is electrical manifestation of the pathophysiological changes and is known as ST-Elevation Myocardial Infarction (STEMI). 1 Acute myocardial infarction can be defined by taking into account clinical, biochemical, electrographic and pathological characteristics.
Objective: To identify the common indications for (50%) patients. The most common risk factors Ex... more Objective: To identify the common indications for (50%) patients. The most common risk factors Exercise tolerance Test (ETT) and to determine were smoking, hypertension, obesity and the frequency of IHD among subjects who diabetes. Majority of subjects 148 (74%) were test presented with chest pain. negative for ischemic heart disease and angina, Methodology: It was a cross-sectional study; the 36 (18%) had test positive for ischemia and data was taken from ETT Unit at Department of angina and only 16 (8%) ETT were negative for Cardiology Rehman Medical Institute, Peshawar, ischemic heart disease and positive for Pakistan using Bruce protocol. arrhythmias. Result: Out of 200 patients, there were 116 (58%) Conclusions: We recommend using ETT as a males and 84 (42%) females who presented in the screening tool in patients who present with cardiology department for ETT. Common features simulating angina, this prevent indications for ETT were chest pain 124 (62%) unnecessary hospital admissions. (Rawal Med J and shortness of breath 24(12%), while 24(12%) 2013;38: 117-120). and 28(14%) of subject were referred for general
Objective in patients with cirrhosis compared to the To determine lipid profile in cirrhotic pati... more Objective in patients with cirrhosis compared to the To determine lipid profile in cirrhotic patients and comparison group (mean of 84.2 vs. 189.8, 140.9 to assess its relationship with the severity of the vs. 186.6, 82.5 vs. 139.2 and 38.7 vs. 42.5 mg/dL, disease. respectively; all p<0.05). Comparison of lipid Patients and Methods profile with pathologic progression of cirrhosis In this cross-sectional study, we studied 204 revealed that apart from serum triglyceride level, patients with cirrhosis (case) and 50 age and serum lipid levels diminish linearly with gender matched healthy normolipidemic patients progression of liver damage. (comparison). A questionnaire containing Conclusions personal characteristics, etiology of cirrhosis, Serum total, LDL and HDL cholesterol level in pathologic criteria of Child Pugh and MELD patients with cirrhosis is inversely correlated with (model for endstage liver disease) and lipid profile severity of cirrhosis. (Rawal Med J 2012;37:387was completed for every patient. 389). Results Keywords There was a significant decrease in serum total Lipid profile, cirrhosis, MELD score, Child Pugh cholesterol, triglyceride, LDL and HDL cholesterol Score.
JPMA. The Journal of the Pakistan Medical Association, 2017
To determine major symptoms and signs in patients of systemic lupus erythematosus. This cross-sec... more To determine major symptoms and signs in patients of systemic lupus erythematosus. This cross-sectional study was conducted at the Lady Reading Hospital, Khyber Teaching Hospital and Hayatabad Medical Complex, Peshawar, Pakistan, from January 15, 2014, to August 15, 2016, and comprised patients of systemic lupus erythematosus. Data was collected through an interview-based questionnaire containing questions about different symptoms. SPSS 20 was used for data analysis. Of the 663 patients, 606(91.4%) were females and 57(8.6%) males. The overall mean age of patients was 33.09 ± 12.40 years and the mean age of diagnosis was 31.85 ± 12.40 years. The most common general symptom in our study was fatigue which was present in 524(79.03%) patients. Other constitutional symptoms were fever 334(50.04%), body aches 443(66.08%) and weakness 411(62%). The most common clinical manifestation in our study was arthritis 518(78.1%). Malar rash was found in 487(73.5%) patients. Dry eye was in 227(34.2%)...
Efficacy of valsartan plus amlodipine versus valsar tan plus hydro-chlorothiazide for control of ... more Efficacy of valsartan plus amlodipine versus valsar tan plus hydro-chlorothiazide for control of moderate to severe hypertension: a randomized controlled trial. Pak Heart J 2017; 50 (01): 39-45. To compare of the efficacy of valsartan plus amlodipine versus valsartan plus hydrochlorothiazide for control of moderate to severe hypertension This randomized controlled trial was conducted at Department of Cardiology, Lady Reading Hospital Peshawar from 1 January, 2015 to 30 June, 2015. All patients with stage 2 hypertension of either gender were randomly assigned into two groups. Patients in group A were subjected to combination of valsartan 160 mg plus amlodipine 10 mg and patients in group B were subjected to the combination of valsartan 160 mg plus hyrochlorothiazide 25 mg. Patients were selected by non probability purposive technique. All patients were followed for 4 weeks. A total of 88 patients were included in this study. Mean age in both groups was 65 ± 1.26 years. In group A, 27(62%) patients were males, where as in group B, 26(60%) patients were males. Valsartan + Amlodipine was effective in 32(72%) cases and was not effective in 12(28%) cases while Valsartan + Hydrochlorothiazide was effective in 35(80%) cases and was not effective in 9(20%) cases (p=0.2). Both combinations had similar anti-hypertensive effects, however Valsartan + Hydrochlorothiazide combination had a better therapeutic profile as it showed fewer side effects and less treatment dropout than Valsartan + Amlodipine combination.
Objective: To determine major symptoms and signs in patients of systemic lupus erythematosus.
Met... more Objective: To determine major symptoms and signs in patients of systemic lupus erythematosus. Methods: This cross-sectional study was conducted at the Lady Reading Hospital, Khyber Teaching Hospital and Hayatabad Medical Complex, Peshawar, Pakistan, from January 15, 2014, to August 15, 2016, and comprised patients of systemic lupus erythematosus. Data was collected through an interview-based questionnaire containing questions about different symptoms. SPSS 20 was used for data analysis. Results: Of the 663 patients, 606(91.4%) were females and 57(8.6%) males. The overall mean age of patients was 33.09 ± 12.40 years and the mean age of diagnosis was 31.85 ± 12.40 years. The most common general symptom in our study was fatigue which was present in 524(79.03%) patients. Other constitutional symptoms were fever 334(50.04%), body aches 443(66.08%) and weakness 411(62%). The most common clinical manifestation in our study was arthritis 518(78.1%). Malar rash was found in 487(73.5%) patients. Dry eye was in 227(34.2%) patients, followed by conjunctivitis 156(23.5%). Anaemia was present in 444(66.96%) patients, followed by leukopenia 166(25.03%) and thrombocytopenia 42(6.33%). Conclusion: Significant regional differences existed in the clinical manifestations of systemic lupus erythematosus in Khyber Pakhtunkhwa compared to other regions. Keywords: Systemic lupus erythematosus, Autoimmune disease, Lupus antibodies. (JPMA 67: 1180; 2017)
Background and Objective: It has been observed that in a clinical condition like hypoxemia there ... more Background and Objective: It has been observed that in a clinical condition like hypoxemia there is an increase in the serum Uric acid level. The objective of our study was to find out the relationship between serum uric acid levels in the severity of Heart failure. Methods: We analyze 285 patients with a diagnosis of Congestive heart failure admitted in Lady Reading Hospital Peshawar from March 1st to August 2016. Age group of patients was 17- 67 years. New York Health Association (NYHA) scoring were used to access the severity of Congestive Heart Failure. Serum UA level >7.0 mg/dl was considered high. Results: Total 285 patients with CHF were analyzed with a mean age of 54±2.8 years in which males were 65.96% and 34.03% were female. 40% were in class II of New York Health Association (NYHA), 32.63% in class III and 25.61% in class IV and 1.75% were in class I. Out of 285, 59.29% met the definition of hyperuricemia. In which 83.43% were male and 16.57% were female. Most of the Hyperuricemic patients 62.13% were in age group of 51- 60 years, with a mean age of 57±4.5 years. We found a significant correlation between uric acid level and BNP (p= <0.001), and use of diuretics (p=<0.001). 34.93% of the Hyperuricemic CHF patients were in NYHA III and NYHA IV whose SUA was above 8 mg/dl as compared to 31.57% Hyperuricemic CHF patients whose SUA was below 8 mg/dl. Conclusion: High serum Uric acid was observed in 59.29% of patients with CHF. The observed significant correlation between UA level and some established prognostic markers in these patients may indicate that serum UA could provide additional prognostic information in this population. SUA as a marker can be measured anywhere at a low cost to help identify high-risk patients with CHF. Lowing uric acid is expected to be a new approach for prevention and therapy of HF
Objective: To study the effect of timing of thrombolytic therapy, cardiac risk factors and site o... more Objective: To study the effect of timing of thrombolytic therapy, cardiac risk factors and site of infarction on S.T. resolution post thrombolysis in STEMI patients.
Methods: This was a descriptive hospital based study conducted at the Hayatabad Medical Complex Peshawar. The duration of our study was 5 months from February 2015 to June 2015. Diagnosis of STEMI in symptomatic patients was based on the ECG recognized. Definition of Myocardial Infarction. Time from onset of chest pain to presentation of patients in emergency was noted through history of patients along with time of streptokinase. ECG recordings of patients were taken upon presentation in Emergency. Serial ECG monitoring was done after administration of Streptokinase (SK). ST resolution was observed in the lead with the maximum ST elevation. Data were presented as frequencies and percentages, chi square test was applied.
Results: Among 83 patients with STEMI 50.6% were males and 49.4% were females with the age group range of 30-83 years. Fifty nine patients (71.08%) with STEMI underwent thrombolysis within 12 hours of onset of chest pain while 24 patients (28.92%), underwent thrombolysis after 12 hours of onset of chest pain. Out of the 59 patients who received thrombolytic therapy before 12 hours, 43 (72.88%) completely resolved, while those who received thrombolytic therapy after 12 hours none of them completely resolved as per ECG findings. By applying chi-square test it gives us value of 36.470, and p-value <0.001. In our study 28 patients were diabetic and out of these six (21.43%) completely resolved as per ECG post thrombolysis, 9 (32.14%) partially resolved and 13 (46.43%) failed to resolve. On the other hand, in non-diabetics out of 55, 37 (67.27%) completely resolved, 12 (21.82%) partially resolved and 6 (10.91%) failed to resolve. Among 61 hypertensive, 26 (42.62%) had complete resolution and in 22 who were non-hypertensive, 17 (77.27%) had complete resolution on ECG. Hyperlipidemia and site of infarction didn’t have statistically significant effect on the resolution of ECG post thrombolysis in STEMI patients.
Conclusion: Patients with diabetes, hypertension and those who receive thrombolysis after 12 hours of onset of chest pain respond poorly to thrombolytic therapy as per ECG findings whereas hyperlipidemia and site of infarction don’t affect the response of STEMI patients to thrombolysis.
Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low-... more Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low- and high-income countries. They are relatively common worldwide, affecting 3% to 5% of live births. Methods: A cross-sectional study was conducted from January 2014 to June 2014 at the Khyber teaching hospital in Peshawar. Specific patient information was obtained from patient records at the beginning of the study. Those individuals found to have at least one birth defect were approached and their attendants (mothers) were interviewed. Information regarding various risk factors was collected. Descriptive analyses were carried out. Results: Out of 1062 deliveries, 2.9% (31) newborns had various congenital anomalies. Hydrocephalus (22.6%), anencephaly (12.9%) and spina bifida (9.7%) were major anomalies. The maternal age ranged from 18 years to 46 years (mean 30±8). Most of the anomalies (35.5%) were present in the 26-30 years age group. Out of 31 babies, 6.4% had multiple anomalies. The preponderance of various congenital anomalies was seen in parity 1 (35.4%); parities 2 to 4 had lower incidences (35.4%). The consanguinity rate was 67.7%; only 32.3% of patients were using folic acid. History of passive smoking was positive in 16.1% of cases. Conclusion: Anencephaly and hydrocephalus were the most prominent anomaly detected; early prenatal diagnosis may be helpful in decreasing mortality by offering early termination.
Low intake of folic acid and a high consanguinity rate were the common associated risk factors for congenital anomalies. These risk factors may be reduced by creating awareness regarding the avoidance of consanguineous marriage and promoting the use of folic acid during pregnancy
Objectives:
• To assess the prevalence of migraine in medical students
• To find out the common... more Objectives:
• To assess the prevalence of migraine in medical students
• To find out the common triggering factors for migraine in medical students
• To find out the common coping strategies for migraine in medical students.
Methodology: This cross sectional study was conducted during academic year 2012. A self-administered questionnaire was distributed among 500 medical students of selected medical colleges of Peshawar. Students were selected randomly from each professional year. Response rate was 81% (n=405; 188=male, 217=females). The Questionnaire included demographic data such as age, gender, family history questions on headache based on the international Headache Society. Data was analyzed using SPSS version 20. Frequency and percentages were calculated for various variables.
Result: Prevalence of migraine in medical student was 38.3% (41.93% in females and 34.04% males) The most common triggering factors were stress (93.54%), noise (73.54%), change in sleep patterns (62.58%), missed meal (60%%),
tiredness (53.54%), physical activity (50.96%), flickering light (48.38%), caffeine (41.29%), cheese (32.90%), smell (32.90%), chocolate (25.16%). About coping strategy we found that 87/155 (56.12%) students were using medicine, 31(20%) going to sleep, 9(5.80%) rest for couple of hours and 8(5.16%) take medicine and go to sleep and other 20 (12.90%) have no copping strategy.
Conclusion: The prevalence of migraine in medical students is quite high. Modification of the common triggering factors
like stress, noise and change in sleep patterns can help in reducing the frequency and severity of migraine. The majority of the students were taking medicines to cope up with their migraine problem.
Background and Aims: Lipid abnormalities are commonly observed in cirrhosis liver. This study was... more Background and Aims: Lipid abnormalities are commonly observed in cirrhosis liver. This study was conducted to determine lipid profile in cirrhotic patients and to assess its relationship with the severity of the disease.
Materials and Methods: In an analytical cross-sectional study, we studied 204 patients with cirrhosis (case) and 50 age- and sex-matched healthy normolipidemic patients (comparison) .A questionnaire containing personal characteristics, etiology of cirrhosis, pathologic criteria of Child Pugh and MELD (model for end–stage liver disease) and lipid profile (low density lipoprotein and high density lipoprotein, total cholesterol and triglyceride) was completed for every patient.
Results: There was a significant decrease in serum triglyceride, total, LDL and HDL cholesterol levels in patients with cirrhosis compared to the comparison group (mean of 84.2vs. 189.8, 140.9vs. 186.6, 82.5vs. 139.2, and 38.7vs. 42.5 mg/dL, respectively; all p<0.05). Comparison of lipid profile with pathologic progression of cirrhosis revealed that apart from serum triglyceride level, serum lipid levels diminish linearly with progression of liver damage.
Conclusions: Serum total, LDL and HDL cholesterol level in patients with cirrhosis is inversely correlated with severity of cirrhosis.
Keywords: Lipid profile Cirrhosis, MELD score, Child Pugh Score
Adnan Khan,1 Raza Jamali,1 Muneeb Jan,1 Maria Tasneem.2
Abstract
Background: A large number of ... more Adnan Khan,1 Raza Jamali,1 Muneeb Jan,1 Maria Tasneem.2
Abstract
Background: A large number of patients have been suffer from breast cancer worldwide and this trend is increasing. It is difficult to determine
whether a lump is benign or malignant from clinical assessment; thus, the need for micropic and tissue analysis arises. Methods:
This comparative retrospective cross sectional study was conducted in the Department of Pathology, Rehman Medical Institute, Peshawar,
Pakistan from January 2006 to March 2013, to determine the value of fine needle aspiration cytology (FNAC) in the diagnosis of breast
lump and to compare the result of FNAC with histological diagnosis to assess its accuracy. Results: Seventy-four cases with breast lumps
were presented for FNAC. Of these, 32.4% were reported as a C2 lesion, 4.1% were reported as benign with atypical cells (C3), 8.1% cases
were suspicious for malignancy (C4), and 55.4% were positive for malignancy (C5). On histopathology examination, out of 24 cases which
were reported as C2 lesions, 95.8% were benign and 4.1% turned out to be invasive ductal carcinoma. Of the cases that presented as C3
lesions, one was diagnosed as benign duct ectasia, one with ductal carcinoma in situ, and one with invasive ductal carcinoma on histopathological
examination. The cases that were diagnosed as C4 lesions all turned out to be carcinoma on histopathology. In this study,
FNAC and histopathology diagnoses were strongly correlated [r 0.92, p <0.001]. Conclusion: Diagnosis of breast lump based on FNAC should
be practiced as there is high correlation with histopathological finding. FNAC should be used as a routine diagnostic procedure due to its
cost effectiveness, thus maximizing the availability of effective health care to patients with breast lesions.
Objective: To identify the common indications for (50%) patients. The most common risk factors Ex... more Objective: To identify the common indications for (50%) patients. The most common risk factors Exercise tolerance Test (ETT) and to determine were smoking, hypertension, obesity and the frequency of IHD among subjects who diabetes. Majority of subjects 148 (74%) were test presented with chest pain.
Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low-... more Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low- and high-income countries. They are relatively common worldwide, affecting 3% to 5% of live births. Methods: A cross-sectional study was conducted from January 2014 to June 2014 at the Khyber teaching hospital in Peshawar. Specific patient information was obtained from patient records at the beginning of the study. Those individuals found to have at least one birth defect were approached and their attendants (mothers) were interviewed. Information regarding various risk factors was collected. Descriptive analyses were carried out. Results: Out of 1062 deliveries, 2.9% (31) of newborns had various congenital anomalies.b Hydrocephalus (22.6%), anencephaly (12.9%), and spina bifida (9.7%) were major anomalies. The maternal age ranged from 18 years to 46 years (mean: 30 ± 8). Most of the anomalies (35.5%) were present in the 26-30 years age group. Out of 31 babies, 6.4% had multiple anomali...
Background and Objective: It has been observed that in a clinical condition like hypoxemia there ... more Background and Objective: It has been observed that in a clinical condition like hypoxemia there is an increase in the serum Uric acid level. The objective of our study was to find out the relationship between serum uric acid levels in the severity of Heart failure. Methods: We analyze 285 patients with a diagnosis of Congestive heart failure admitted in Lady Reading Hospital Peshawar from March 1 st to August 2016. Age group of patients was 17-67 years. New York Health Association (NYHA) scoring were used to access the severity of Congestive Heart Failure. Serum UA level >7.0 mg/dl was considered high. Results: Total 285 patients with CHF were analyzed with a mean age of 54±2.8 years in which males were 65.96% and 34.03% were female. 40% were in class II of New York Health Association (NYHA), 32.63% in class III and 25.61% in class IV and 1.75% were in class I. Out of 285, 59.29% met the definition of hyperuricemia. In which 83.43% were male and 16.57% were female. Most of the Hyperuricemic patients 62.13% were in age group of 51-60 years, with a mean age of 57±4.5 years. We found a significant correlation between uric acid level and BNP (p= <0.001), and use of diuretics (p=<0.001). 34.93% of the Hyperuricemic CHF patients were in NYHA III and NYHA IV whose SUA was above 8 mg/dl as compared to 31.57% Hyperuricemic CHF patients whose SUA was below 8 mg/dl. Conclusion: High serum Uric acid was observed in 59.29% of patients with CHF. The observed significant correlation between UA level and some established prognostic markers in these patients may indicate that serum UA could provide additional prognostic information in this population. SUA as a marker can be measured anywhere at a low cost to help identify high-risk patients with CHF. Lowing uric acid is expected to be a new approach for prevention and therapy of HF.
When there is occlusion of an epicardial coronary artery, ST elevation is shown on ECG which is e... more When there is occlusion of an epicardial coronary artery, ST elevation is shown on ECG which is electrical manifestation of the pathophysiological changes and is known as ST-Elevation Myocardial Infarction (STEMI). 1 Acute myocardial infarction can be defined by taking into account clinical, biochemical, electrographic and pathological characteristics.
Objective: To identify the common indications for (50%) patients. The most common risk factors Ex... more Objective: To identify the common indications for (50%) patients. The most common risk factors Exercise tolerance Test (ETT) and to determine were smoking, hypertension, obesity and the frequency of IHD among subjects who diabetes. Majority of subjects 148 (74%) were test presented with chest pain. negative for ischemic heart disease and angina, Methodology: It was a cross-sectional study; the 36 (18%) had test positive for ischemia and data was taken from ETT Unit at Department of angina and only 16 (8%) ETT were negative for Cardiology Rehman Medical Institute, Peshawar, ischemic heart disease and positive for Pakistan using Bruce protocol. arrhythmias. Result: Out of 200 patients, there were 116 (58%) Conclusions: We recommend using ETT as a males and 84 (42%) females who presented in the screening tool in patients who present with cardiology department for ETT. Common features simulating angina, this prevent indications for ETT were chest pain 124 (62%) unnecessary hospital admissions. (Rawal Med J and shortness of breath 24(12%), while 24(12%) 2013;38: 117-120). and 28(14%) of subject were referred for general
Objective in patients with cirrhosis compared to the To determine lipid profile in cirrhotic pati... more Objective in patients with cirrhosis compared to the To determine lipid profile in cirrhotic patients and comparison group (mean of 84.2 vs. 189.8, 140.9 to assess its relationship with the severity of the vs. 186.6, 82.5 vs. 139.2 and 38.7 vs. 42.5 mg/dL, disease. respectively; all p<0.05). Comparison of lipid Patients and Methods profile with pathologic progression of cirrhosis In this cross-sectional study, we studied 204 revealed that apart from serum triglyceride level, patients with cirrhosis (case) and 50 age and serum lipid levels diminish linearly with gender matched healthy normolipidemic patients progression of liver damage. (comparison). A questionnaire containing Conclusions personal characteristics, etiology of cirrhosis, Serum total, LDL and HDL cholesterol level in pathologic criteria of Child Pugh and MELD patients with cirrhosis is inversely correlated with (model for endstage liver disease) and lipid profile severity of cirrhosis. (Rawal Med J 2012;37:387was completed for every patient. 389). Results Keywords There was a significant decrease in serum total Lipid profile, cirrhosis, MELD score, Child Pugh cholesterol, triglyceride, LDL and HDL cholesterol Score.
JPMA. The Journal of the Pakistan Medical Association, 2017
To determine major symptoms and signs in patients of systemic lupus erythematosus. This cross-sec... more To determine major symptoms and signs in patients of systemic lupus erythematosus. This cross-sectional study was conducted at the Lady Reading Hospital, Khyber Teaching Hospital and Hayatabad Medical Complex, Peshawar, Pakistan, from January 15, 2014, to August 15, 2016, and comprised patients of systemic lupus erythematosus. Data was collected through an interview-based questionnaire containing questions about different symptoms. SPSS 20 was used for data analysis. Of the 663 patients, 606(91.4%) were females and 57(8.6%) males. The overall mean age of patients was 33.09 ± 12.40 years and the mean age of diagnosis was 31.85 ± 12.40 years. The most common general symptom in our study was fatigue which was present in 524(79.03%) patients. Other constitutional symptoms were fever 334(50.04%), body aches 443(66.08%) and weakness 411(62%). The most common clinical manifestation in our study was arthritis 518(78.1%). Malar rash was found in 487(73.5%) patients. Dry eye was in 227(34.2%)...
Efficacy of valsartan plus amlodipine versus valsar tan plus hydro-chlorothiazide for control of ... more Efficacy of valsartan plus amlodipine versus valsar tan plus hydro-chlorothiazide for control of moderate to severe hypertension: a randomized controlled trial. Pak Heart J 2017; 50 (01): 39-45. To compare of the efficacy of valsartan plus amlodipine versus valsartan plus hydrochlorothiazide for control of moderate to severe hypertension This randomized controlled trial was conducted at Department of Cardiology, Lady Reading Hospital Peshawar from 1 January, 2015 to 30 June, 2015. All patients with stage 2 hypertension of either gender were randomly assigned into two groups. Patients in group A were subjected to combination of valsartan 160 mg plus amlodipine 10 mg and patients in group B were subjected to the combination of valsartan 160 mg plus hyrochlorothiazide 25 mg. Patients were selected by non probability purposive technique. All patients were followed for 4 weeks. A total of 88 patients were included in this study. Mean age in both groups was 65 ± 1.26 years. In group A, 27(62%) patients were males, where as in group B, 26(60%) patients were males. Valsartan + Amlodipine was effective in 32(72%) cases and was not effective in 12(28%) cases while Valsartan + Hydrochlorothiazide was effective in 35(80%) cases and was not effective in 9(20%) cases (p=0.2). Both combinations had similar anti-hypertensive effects, however Valsartan + Hydrochlorothiazide combination had a better therapeutic profile as it showed fewer side effects and less treatment dropout than Valsartan + Amlodipine combination.
Objective: To determine major symptoms and signs in patients of systemic lupus erythematosus.
Met... more Objective: To determine major symptoms and signs in patients of systemic lupus erythematosus. Methods: This cross-sectional study was conducted at the Lady Reading Hospital, Khyber Teaching Hospital and Hayatabad Medical Complex, Peshawar, Pakistan, from January 15, 2014, to August 15, 2016, and comprised patients of systemic lupus erythematosus. Data was collected through an interview-based questionnaire containing questions about different symptoms. SPSS 20 was used for data analysis. Results: Of the 663 patients, 606(91.4%) were females and 57(8.6%) males. The overall mean age of patients was 33.09 ± 12.40 years and the mean age of diagnosis was 31.85 ± 12.40 years. The most common general symptom in our study was fatigue which was present in 524(79.03%) patients. Other constitutional symptoms were fever 334(50.04%), body aches 443(66.08%) and weakness 411(62%). The most common clinical manifestation in our study was arthritis 518(78.1%). Malar rash was found in 487(73.5%) patients. Dry eye was in 227(34.2%) patients, followed by conjunctivitis 156(23.5%). Anaemia was present in 444(66.96%) patients, followed by leukopenia 166(25.03%) and thrombocytopenia 42(6.33%). Conclusion: Significant regional differences existed in the clinical manifestations of systemic lupus erythematosus in Khyber Pakhtunkhwa compared to other regions. Keywords: Systemic lupus erythematosus, Autoimmune disease, Lupus antibodies. (JPMA 67: 1180; 2017)
Background and Objective: It has been observed that in a clinical condition like hypoxemia there ... more Background and Objective: It has been observed that in a clinical condition like hypoxemia there is an increase in the serum Uric acid level. The objective of our study was to find out the relationship between serum uric acid levels in the severity of Heart failure. Methods: We analyze 285 patients with a diagnosis of Congestive heart failure admitted in Lady Reading Hospital Peshawar from March 1st to August 2016. Age group of patients was 17- 67 years. New York Health Association (NYHA) scoring were used to access the severity of Congestive Heart Failure. Serum UA level >7.0 mg/dl was considered high. Results: Total 285 patients with CHF were analyzed with a mean age of 54±2.8 years in which males were 65.96% and 34.03% were female. 40% were in class II of New York Health Association (NYHA), 32.63% in class III and 25.61% in class IV and 1.75% were in class I. Out of 285, 59.29% met the definition of hyperuricemia. In which 83.43% were male and 16.57% were female. Most of the Hyperuricemic patients 62.13% were in age group of 51- 60 years, with a mean age of 57±4.5 years. We found a significant correlation between uric acid level and BNP (p= <0.001), and use of diuretics (p=<0.001). 34.93% of the Hyperuricemic CHF patients were in NYHA III and NYHA IV whose SUA was above 8 mg/dl as compared to 31.57% Hyperuricemic CHF patients whose SUA was below 8 mg/dl. Conclusion: High serum Uric acid was observed in 59.29% of patients with CHF. The observed significant correlation between UA level and some established prognostic markers in these patients may indicate that serum UA could provide additional prognostic information in this population. SUA as a marker can be measured anywhere at a low cost to help identify high-risk patients with CHF. Lowing uric acid is expected to be a new approach for prevention and therapy of HF
Objective: To study the effect of timing of thrombolytic therapy, cardiac risk factors and site o... more Objective: To study the effect of timing of thrombolytic therapy, cardiac risk factors and site of infarction on S.T. resolution post thrombolysis in STEMI patients.
Methods: This was a descriptive hospital based study conducted at the Hayatabad Medical Complex Peshawar. The duration of our study was 5 months from February 2015 to June 2015. Diagnosis of STEMI in symptomatic patients was based on the ECG recognized. Definition of Myocardial Infarction. Time from onset of chest pain to presentation of patients in emergency was noted through history of patients along with time of streptokinase. ECG recordings of patients were taken upon presentation in Emergency. Serial ECG monitoring was done after administration of Streptokinase (SK). ST resolution was observed in the lead with the maximum ST elevation. Data were presented as frequencies and percentages, chi square test was applied.
Results: Among 83 patients with STEMI 50.6% were males and 49.4% were females with the age group range of 30-83 years. Fifty nine patients (71.08%) with STEMI underwent thrombolysis within 12 hours of onset of chest pain while 24 patients (28.92%), underwent thrombolysis after 12 hours of onset of chest pain. Out of the 59 patients who received thrombolytic therapy before 12 hours, 43 (72.88%) completely resolved, while those who received thrombolytic therapy after 12 hours none of them completely resolved as per ECG findings. By applying chi-square test it gives us value of 36.470, and p-value <0.001. In our study 28 patients were diabetic and out of these six (21.43%) completely resolved as per ECG post thrombolysis, 9 (32.14%) partially resolved and 13 (46.43%) failed to resolve. On the other hand, in non-diabetics out of 55, 37 (67.27%) completely resolved, 12 (21.82%) partially resolved and 6 (10.91%) failed to resolve. Among 61 hypertensive, 26 (42.62%) had complete resolution and in 22 who were non-hypertensive, 17 (77.27%) had complete resolution on ECG. Hyperlipidemia and site of infarction didn’t have statistically significant effect on the resolution of ECG post thrombolysis in STEMI patients.
Conclusion: Patients with diabetes, hypertension and those who receive thrombolysis after 12 hours of onset of chest pain respond poorly to thrombolytic therapy as per ECG findings whereas hyperlipidemia and site of infarction don’t affect the response of STEMI patients to thrombolysis.
Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low-... more Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low- and high-income countries. They are relatively common worldwide, affecting 3% to 5% of live births. Methods: A cross-sectional study was conducted from January 2014 to June 2014 at the Khyber teaching hospital in Peshawar. Specific patient information was obtained from patient records at the beginning of the study. Those individuals found to have at least one birth defect were approached and their attendants (mothers) were interviewed. Information regarding various risk factors was collected. Descriptive analyses were carried out. Results: Out of 1062 deliveries, 2.9% (31) newborns had various congenital anomalies. Hydrocephalus (22.6%), anencephaly (12.9%) and spina bifida (9.7%) were major anomalies. The maternal age ranged from 18 years to 46 years (mean 30±8). Most of the anomalies (35.5%) were present in the 26-30 years age group. Out of 31 babies, 6.4% had multiple anomalies. The preponderance of various congenital anomalies was seen in parity 1 (35.4%); parities 2 to 4 had lower incidences (35.4%). The consanguinity rate was 67.7%; only 32.3% of patients were using folic acid. History of passive smoking was positive in 16.1% of cases. Conclusion: Anencephaly and hydrocephalus were the most prominent anomaly detected; early prenatal diagnosis may be helpful in decreasing mortality by offering early termination.
Low intake of folic acid and a high consanguinity rate were the common associated risk factors for congenital anomalies. These risk factors may be reduced by creating awareness regarding the avoidance of consanguineous marriage and promoting the use of folic acid during pregnancy
Objectives:
• To assess the prevalence of migraine in medical students
• To find out the common... more Objectives:
• To assess the prevalence of migraine in medical students
• To find out the common triggering factors for migraine in medical students
• To find out the common coping strategies for migraine in medical students.
Methodology: This cross sectional study was conducted during academic year 2012. A self-administered questionnaire was distributed among 500 medical students of selected medical colleges of Peshawar. Students were selected randomly from each professional year. Response rate was 81% (n=405; 188=male, 217=females). The Questionnaire included demographic data such as age, gender, family history questions on headache based on the international Headache Society. Data was analyzed using SPSS version 20. Frequency and percentages were calculated for various variables.
Result: Prevalence of migraine in medical student was 38.3% (41.93% in females and 34.04% males) The most common triggering factors were stress (93.54%), noise (73.54%), change in sleep patterns (62.58%), missed meal (60%%),
tiredness (53.54%), physical activity (50.96%), flickering light (48.38%), caffeine (41.29%), cheese (32.90%), smell (32.90%), chocolate (25.16%). About coping strategy we found that 87/155 (56.12%) students were using medicine, 31(20%) going to sleep, 9(5.80%) rest for couple of hours and 8(5.16%) take medicine and go to sleep and other 20 (12.90%) have no copping strategy.
Conclusion: The prevalence of migraine in medical students is quite high. Modification of the common triggering factors
like stress, noise and change in sleep patterns can help in reducing the frequency and severity of migraine. The majority of the students were taking medicines to cope up with their migraine problem.
Background and Aims: Lipid abnormalities are commonly observed in cirrhosis liver. This study was... more Background and Aims: Lipid abnormalities are commonly observed in cirrhosis liver. This study was conducted to determine lipid profile in cirrhotic patients and to assess its relationship with the severity of the disease.
Materials and Methods: In an analytical cross-sectional study, we studied 204 patients with cirrhosis (case) and 50 age- and sex-matched healthy normolipidemic patients (comparison) .A questionnaire containing personal characteristics, etiology of cirrhosis, pathologic criteria of Child Pugh and MELD (model for end–stage liver disease) and lipid profile (low density lipoprotein and high density lipoprotein, total cholesterol and triglyceride) was completed for every patient.
Results: There was a significant decrease in serum triglyceride, total, LDL and HDL cholesterol levels in patients with cirrhosis compared to the comparison group (mean of 84.2vs. 189.8, 140.9vs. 186.6, 82.5vs. 139.2, and 38.7vs. 42.5 mg/dL, respectively; all p<0.05). Comparison of lipid profile with pathologic progression of cirrhosis revealed that apart from serum triglyceride level, serum lipid levels diminish linearly with progression of liver damage.
Conclusions: Serum total, LDL and HDL cholesterol level in patients with cirrhosis is inversely correlated with severity of cirrhosis.
Keywords: Lipid profile Cirrhosis, MELD score, Child Pugh Score
Adnan Khan,1 Raza Jamali,1 Muneeb Jan,1 Maria Tasneem.2
Abstract
Background: A large number of ... more Adnan Khan,1 Raza Jamali,1 Muneeb Jan,1 Maria Tasneem.2
Abstract
Background: A large number of patients have been suffer from breast cancer worldwide and this trend is increasing. It is difficult to determine
whether a lump is benign or malignant from clinical assessment; thus, the need for micropic and tissue analysis arises. Methods:
This comparative retrospective cross sectional study was conducted in the Department of Pathology, Rehman Medical Institute, Peshawar,
Pakistan from January 2006 to March 2013, to determine the value of fine needle aspiration cytology (FNAC) in the diagnosis of breast
lump and to compare the result of FNAC with histological diagnosis to assess its accuracy. Results: Seventy-four cases with breast lumps
were presented for FNAC. Of these, 32.4% were reported as a C2 lesion, 4.1% were reported as benign with atypical cells (C3), 8.1% cases
were suspicious for malignancy (C4), and 55.4% were positive for malignancy (C5). On histopathology examination, out of 24 cases which
were reported as C2 lesions, 95.8% were benign and 4.1% turned out to be invasive ductal carcinoma. Of the cases that presented as C3
lesions, one was diagnosed as benign duct ectasia, one with ductal carcinoma in situ, and one with invasive ductal carcinoma on histopathological
examination. The cases that were diagnosed as C4 lesions all turned out to be carcinoma on histopathology. In this study,
FNAC and histopathology diagnoses were strongly correlated [r 0.92, p <0.001]. Conclusion: Diagnosis of breast lump based on FNAC should
be practiced as there is high correlation with histopathological finding. FNAC should be used as a routine diagnostic procedure due to its
cost effectiveness, thus maximizing the availability of effective health care to patients with breast lesions.
Objective: To identify the common indications for (50%) patients. The most common risk factors Ex... more Objective: To identify the common indications for (50%) patients. The most common risk factors Exercise tolerance Test (ETT) and to determine were smoking, hypertension, obesity and the frequency of IHD among subjects who diabetes. Majority of subjects 148 (74%) were test presented with chest pain.
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Papers by Adnan khan
Methods: This cross-sectional study was conducted at the Lady Reading Hospital, Khyber Teaching Hospital and
Hayatabad Medical Complex, Peshawar, Pakistan, from January 15, 2014, to August 15, 2016, and comprised patients
of systemic lupus erythematosus. Data was collected through an interview-based questionnaire containing
questions about different symptoms. SPSS 20 was used for data analysis.
Results: Of the 663 patients, 606(91.4%) were females and 57(8.6%) males. The overall mean age of patients was
33.09 ± 12.40 years and the mean age of diagnosis was 31.85 ± 12.40 years. The most common general symptom in
our study was fatigue which was present in 524(79.03%) patients. Other constitutional symptoms were fever
334(50.04%), body aches 443(66.08%) and weakness 411(62%). The most common clinical manifestation in our
study was arthritis 518(78.1%). Malar rash was found in 487(73.5%) patients. Dry eye was in 227(34.2%) patients,
followed by conjunctivitis 156(23.5%). Anaemia was present in 444(66.96%) patients, followed by leukopenia
166(25.03%) and thrombocytopenia 42(6.33%).
Conclusion: Significant regional differences existed in the clinical manifestations of systemic lupus erythematosus
in Khyber Pakhtunkhwa compared to other regions.
Keywords: Systemic lupus erythematosus, Autoimmune disease, Lupus antibodies. (JPMA 67: 1180; 2017)
Methods: We analyze 285 patients with a diagnosis of Congestive heart failure admitted in Lady Reading Hospital Peshawar from March 1st to August 2016. Age group of patients was 17- 67 years. New York Health Association (NYHA) scoring were used to access the severity of Congestive Heart Failure. Serum UA level >7.0 mg/dl was considered high.
Results: Total 285 patients with CHF were analyzed with a mean age of 54±2.8 years in which males were 65.96% and 34.03% were female. 40% were in class II of New York Health Association (NYHA), 32.63% in class III and 25.61% in class IV and 1.75% were in class I. Out of 285, 59.29% met the definition of hyperuricemia. In which 83.43% were male and 16.57% were female. Most of the Hyperuricemic patients 62.13% were in age group of 51- 60 years, with a mean age of 57±4.5 years. We found a significant correlation between uric acid level and BNP (p= <0.001), and use of diuretics (p=<0.001). 34.93% of the Hyperuricemic CHF patients were in NYHA III and NYHA IV whose SUA was above 8 mg/dl as compared to 31.57% Hyperuricemic CHF patients whose SUA was below 8 mg/dl.
Conclusion: High serum Uric acid was observed in 59.29% of patients with CHF. The observed significant correlation between UA level and some established prognostic markers in these patients may indicate that serum UA could provide additional prognostic information in this population. SUA as a marker can be measured anywhere at a low cost to help identify high-risk patients with CHF. Lowing uric acid is expected to be a new approach for prevention and therapy of HF
Methods: This was a descriptive hospital based study conducted at the Hayatabad Medical Complex Peshawar. The duration of our study was 5 months from February 2015 to June 2015. Diagnosis of STEMI in symptomatic patients was based on the ECG recognized. Definition of Myocardial Infarction. Time from onset of chest pain to presentation of patients in emergency was noted through history of patients along with time of streptokinase. ECG recordings of patients were taken upon presentation in Emergency. Serial ECG monitoring was done after administration of Streptokinase (SK). ST resolution was observed in the lead with the maximum ST elevation. Data were presented as frequencies and percentages, chi square test was applied.
Results: Among 83 patients with STEMI 50.6% were males and 49.4% were females with the age group range of 30-83 years. Fifty nine patients (71.08%) with STEMI underwent thrombolysis within 12 hours of onset of chest pain while 24 patients (28.92%), underwent thrombolysis after 12 hours of onset of chest pain. Out of the 59 patients who received thrombolytic therapy before 12 hours, 43 (72.88%) completely resolved, while those who received thrombolytic therapy after 12 hours none of them completely resolved as per ECG findings. By applying chi-square test it gives us value of 36.470, and p-value <0.001. In our study 28 patients were diabetic and out of these six (21.43%) completely resolved as per ECG post thrombolysis, 9 (32.14%) partially resolved and 13 (46.43%) failed to resolve. On the other hand, in non-diabetics out of 55, 37 (67.27%) completely resolved, 12 (21.82%) partially resolved and 6 (10.91%) failed to resolve. Among 61 hypertensive, 26 (42.62%) had complete resolution and in 22 who were non-hypertensive, 17 (77.27%) had complete resolution on ECG. Hyperlipidemia and site of infarction didn’t have statistically significant effect on the resolution of ECG post thrombolysis in STEMI patients.
Conclusion: Patients with diabetes, hypertension and those who receive thrombolysis after 12 hours of onset of chest pain respond poorly to thrombolytic therapy as per ECG findings whereas hyperlipidemia and site of infarction don’t affect the response of STEMI patients to thrombolysis.
Low intake of folic acid and a high consanguinity rate were the common associated risk factors for congenital anomalies. These risk factors may be reduced by creating awareness regarding the avoidance of consanguineous marriage and promoting the use of folic acid during pregnancy
• To assess the prevalence of migraine in medical students
• To find out the common triggering factors for migraine in medical students
• To find out the common coping strategies for migraine in medical students.
Methodology: This cross sectional study was conducted during academic year 2012. A self-administered questionnaire was distributed among 500 medical students of selected medical colleges of Peshawar. Students were selected randomly from each professional year. Response rate was 81% (n=405; 188=male, 217=females). The Questionnaire included demographic data such as age, gender, family history questions on headache based on the international Headache Society. Data was analyzed using SPSS version 20. Frequency and percentages were calculated for various variables.
Result: Prevalence of migraine in medical student was 38.3% (41.93% in females and 34.04% males) The most common triggering factors were stress (93.54%), noise (73.54%), change in sleep patterns (62.58%), missed meal (60%%),
tiredness (53.54%), physical activity (50.96%), flickering light (48.38%), caffeine (41.29%), cheese (32.90%), smell (32.90%), chocolate (25.16%). About coping strategy we found that 87/155 (56.12%) students were using medicine, 31(20%) going to sleep, 9(5.80%) rest for couple of hours and 8(5.16%) take medicine and go to sleep and other 20 (12.90%) have no copping strategy.
Conclusion: The prevalence of migraine in medical students is quite high. Modification of the common triggering factors
like stress, noise and change in sleep patterns can help in reducing the frequency and severity of migraine. The majority of the students were taking medicines to cope up with their migraine problem.
Materials and Methods: In an analytical cross-sectional study, we studied 204 patients with cirrhosis (case) and 50 age- and sex-matched healthy normolipidemic patients (comparison) .A questionnaire containing personal characteristics, etiology of cirrhosis, pathologic criteria of Child Pugh and MELD (model for end–stage liver disease) and lipid profile (low density lipoprotein and high density lipoprotein, total cholesterol and triglyceride) was completed for every patient.
Results: There was a significant decrease in serum triglyceride, total, LDL and HDL cholesterol levels in patients with cirrhosis compared to the comparison group (mean of 84.2vs. 189.8, 140.9vs. 186.6, 82.5vs. 139.2, and 38.7vs. 42.5 mg/dL, respectively; all p<0.05). Comparison of lipid profile with pathologic progression of cirrhosis revealed that apart from serum triglyceride level, serum lipid levels diminish linearly with progression of liver damage.
Conclusions: Serum total, LDL and HDL cholesterol level in patients with cirrhosis is inversely correlated with severity of cirrhosis.
Keywords: Lipid profile Cirrhosis, MELD score, Child Pugh Score
Key words: Lipid profile cirrhosis, MELD score, Child Pugh Score
Abstract
Background: A large number of patients have been suffer from breast cancer worldwide and this trend is increasing. It is difficult to determine
whether a lump is benign or malignant from clinical assessment; thus, the need for micropic and tissue analysis arises. Methods:
This comparative retrospective cross sectional study was conducted in the Department of Pathology, Rehman Medical Institute, Peshawar,
Pakistan from January 2006 to March 2013, to determine the value of fine needle aspiration cytology (FNAC) in the diagnosis of breast
lump and to compare the result of FNAC with histological diagnosis to assess its accuracy. Results: Seventy-four cases with breast lumps
were presented for FNAC. Of these, 32.4% were reported as a C2 lesion, 4.1% were reported as benign with atypical cells (C3), 8.1% cases
were suspicious for malignancy (C4), and 55.4% were positive for malignancy (C5). On histopathology examination, out of 24 cases which
were reported as C2 lesions, 95.8% were benign and 4.1% turned out to be invasive ductal carcinoma. Of the cases that presented as C3
lesions, one was diagnosed as benign duct ectasia, one with ductal carcinoma in situ, and one with invasive ductal carcinoma on histopathological
examination. The cases that were diagnosed as C4 lesions all turned out to be carcinoma on histopathology. In this study,
FNAC and histopathology diagnoses were strongly correlated [r 0.92, p <0.001]. Conclusion: Diagnosis of breast lump based on FNAC should
be practiced as there is high correlation with histopathological finding. FNAC should be used as a routine diagnostic procedure due to its
cost effectiveness, thus maximizing the availability of effective health care to patients with breast lesions.
Methods: This cross-sectional study was conducted at the Lady Reading Hospital, Khyber Teaching Hospital and
Hayatabad Medical Complex, Peshawar, Pakistan, from January 15, 2014, to August 15, 2016, and comprised patients
of systemic lupus erythematosus. Data was collected through an interview-based questionnaire containing
questions about different symptoms. SPSS 20 was used for data analysis.
Results: Of the 663 patients, 606(91.4%) were females and 57(8.6%) males. The overall mean age of patients was
33.09 ± 12.40 years and the mean age of diagnosis was 31.85 ± 12.40 years. The most common general symptom in
our study was fatigue which was present in 524(79.03%) patients. Other constitutional symptoms were fever
334(50.04%), body aches 443(66.08%) and weakness 411(62%). The most common clinical manifestation in our
study was arthritis 518(78.1%). Malar rash was found in 487(73.5%) patients. Dry eye was in 227(34.2%) patients,
followed by conjunctivitis 156(23.5%). Anaemia was present in 444(66.96%) patients, followed by leukopenia
166(25.03%) and thrombocytopenia 42(6.33%).
Conclusion: Significant regional differences existed in the clinical manifestations of systemic lupus erythematosus
in Khyber Pakhtunkhwa compared to other regions.
Keywords: Systemic lupus erythematosus, Autoimmune disease, Lupus antibodies. (JPMA 67: 1180; 2017)
Methods: We analyze 285 patients with a diagnosis of Congestive heart failure admitted in Lady Reading Hospital Peshawar from March 1st to August 2016. Age group of patients was 17- 67 years. New York Health Association (NYHA) scoring were used to access the severity of Congestive Heart Failure. Serum UA level >7.0 mg/dl was considered high.
Results: Total 285 patients with CHF were analyzed with a mean age of 54±2.8 years in which males were 65.96% and 34.03% were female. 40% were in class II of New York Health Association (NYHA), 32.63% in class III and 25.61% in class IV and 1.75% were in class I. Out of 285, 59.29% met the definition of hyperuricemia. In which 83.43% were male and 16.57% were female. Most of the Hyperuricemic patients 62.13% were in age group of 51- 60 years, with a mean age of 57±4.5 years. We found a significant correlation between uric acid level and BNP (p= <0.001), and use of diuretics (p=<0.001). 34.93% of the Hyperuricemic CHF patients were in NYHA III and NYHA IV whose SUA was above 8 mg/dl as compared to 31.57% Hyperuricemic CHF patients whose SUA was below 8 mg/dl.
Conclusion: High serum Uric acid was observed in 59.29% of patients with CHF. The observed significant correlation between UA level and some established prognostic markers in these patients may indicate that serum UA could provide additional prognostic information in this population. SUA as a marker can be measured anywhere at a low cost to help identify high-risk patients with CHF. Lowing uric acid is expected to be a new approach for prevention and therapy of HF
Methods: This was a descriptive hospital based study conducted at the Hayatabad Medical Complex Peshawar. The duration of our study was 5 months from February 2015 to June 2015. Diagnosis of STEMI in symptomatic patients was based on the ECG recognized. Definition of Myocardial Infarction. Time from onset of chest pain to presentation of patients in emergency was noted through history of patients along with time of streptokinase. ECG recordings of patients were taken upon presentation in Emergency. Serial ECG monitoring was done after administration of Streptokinase (SK). ST resolution was observed in the lead with the maximum ST elevation. Data were presented as frequencies and percentages, chi square test was applied.
Results: Among 83 patients with STEMI 50.6% were males and 49.4% were females with the age group range of 30-83 years. Fifty nine patients (71.08%) with STEMI underwent thrombolysis within 12 hours of onset of chest pain while 24 patients (28.92%), underwent thrombolysis after 12 hours of onset of chest pain. Out of the 59 patients who received thrombolytic therapy before 12 hours, 43 (72.88%) completely resolved, while those who received thrombolytic therapy after 12 hours none of them completely resolved as per ECG findings. By applying chi-square test it gives us value of 36.470, and p-value <0.001. In our study 28 patients were diabetic and out of these six (21.43%) completely resolved as per ECG post thrombolysis, 9 (32.14%) partially resolved and 13 (46.43%) failed to resolve. On the other hand, in non-diabetics out of 55, 37 (67.27%) completely resolved, 12 (21.82%) partially resolved and 6 (10.91%) failed to resolve. Among 61 hypertensive, 26 (42.62%) had complete resolution and in 22 who were non-hypertensive, 17 (77.27%) had complete resolution on ECG. Hyperlipidemia and site of infarction didn’t have statistically significant effect on the resolution of ECG post thrombolysis in STEMI patients.
Conclusion: Patients with diabetes, hypertension and those who receive thrombolysis after 12 hours of onset of chest pain respond poorly to thrombolytic therapy as per ECG findings whereas hyperlipidemia and site of infarction don’t affect the response of STEMI patients to thrombolysis.
Low intake of folic acid and a high consanguinity rate were the common associated risk factors for congenital anomalies. These risk factors may be reduced by creating awareness regarding the avoidance of consanguineous marriage and promoting the use of folic acid during pregnancy
• To assess the prevalence of migraine in medical students
• To find out the common triggering factors for migraine in medical students
• To find out the common coping strategies for migraine in medical students.
Methodology: This cross sectional study was conducted during academic year 2012. A self-administered questionnaire was distributed among 500 medical students of selected medical colleges of Peshawar. Students were selected randomly from each professional year. Response rate was 81% (n=405; 188=male, 217=females). The Questionnaire included demographic data such as age, gender, family history questions on headache based on the international Headache Society. Data was analyzed using SPSS version 20. Frequency and percentages were calculated for various variables.
Result: Prevalence of migraine in medical student was 38.3% (41.93% in females and 34.04% males) The most common triggering factors were stress (93.54%), noise (73.54%), change in sleep patterns (62.58%), missed meal (60%%),
tiredness (53.54%), physical activity (50.96%), flickering light (48.38%), caffeine (41.29%), cheese (32.90%), smell (32.90%), chocolate (25.16%). About coping strategy we found that 87/155 (56.12%) students were using medicine, 31(20%) going to sleep, 9(5.80%) rest for couple of hours and 8(5.16%) take medicine and go to sleep and other 20 (12.90%) have no copping strategy.
Conclusion: The prevalence of migraine in medical students is quite high. Modification of the common triggering factors
like stress, noise and change in sleep patterns can help in reducing the frequency and severity of migraine. The majority of the students were taking medicines to cope up with their migraine problem.
Materials and Methods: In an analytical cross-sectional study, we studied 204 patients with cirrhosis (case) and 50 age- and sex-matched healthy normolipidemic patients (comparison) .A questionnaire containing personal characteristics, etiology of cirrhosis, pathologic criteria of Child Pugh and MELD (model for end–stage liver disease) and lipid profile (low density lipoprotein and high density lipoprotein, total cholesterol and triglyceride) was completed for every patient.
Results: There was a significant decrease in serum triglyceride, total, LDL and HDL cholesterol levels in patients with cirrhosis compared to the comparison group (mean of 84.2vs. 189.8, 140.9vs. 186.6, 82.5vs. 139.2, and 38.7vs. 42.5 mg/dL, respectively; all p<0.05). Comparison of lipid profile with pathologic progression of cirrhosis revealed that apart from serum triglyceride level, serum lipid levels diminish linearly with progression of liver damage.
Conclusions: Serum total, LDL and HDL cholesterol level in patients with cirrhosis is inversely correlated with severity of cirrhosis.
Keywords: Lipid profile Cirrhosis, MELD score, Child Pugh Score
Key words: Lipid profile cirrhosis, MELD score, Child Pugh Score
Abstract
Background: A large number of patients have been suffer from breast cancer worldwide and this trend is increasing. It is difficult to determine
whether a lump is benign or malignant from clinical assessment; thus, the need for micropic and tissue analysis arises. Methods:
This comparative retrospective cross sectional study was conducted in the Department of Pathology, Rehman Medical Institute, Peshawar,
Pakistan from January 2006 to March 2013, to determine the value of fine needle aspiration cytology (FNAC) in the diagnosis of breast
lump and to compare the result of FNAC with histological diagnosis to assess its accuracy. Results: Seventy-four cases with breast lumps
were presented for FNAC. Of these, 32.4% were reported as a C2 lesion, 4.1% were reported as benign with atypical cells (C3), 8.1% cases
were suspicious for malignancy (C4), and 55.4% were positive for malignancy (C5). On histopathology examination, out of 24 cases which
were reported as C2 lesions, 95.8% were benign and 4.1% turned out to be invasive ductal carcinoma. Of the cases that presented as C3
lesions, one was diagnosed as benign duct ectasia, one with ductal carcinoma in situ, and one with invasive ductal carcinoma on histopathological
examination. The cases that were diagnosed as C4 lesions all turned out to be carcinoma on histopathology. In this study,
FNAC and histopathology diagnoses were strongly correlated [r 0.92, p <0.001]. Conclusion: Diagnosis of breast lump based on FNAC should
be practiced as there is high correlation with histopathological finding. FNAC should be used as a routine diagnostic procedure due to its
cost effectiveness, thus maximizing the availability of effective health care to patients with breast lesions.