Search

Objective: To find out the differences in disease severity of Rheumatoid Arthritis (RA) depending on clinic-demographic variables and determine association between clinic-demographic variables and disease severity of RA. Study Design: Cross-sectional Analytical study. Setting: Department of Medicine & Allied at CMA Hospital, Azra Naheed Medical College, Superior University Lahore. Period: August 2021 to April 2022. Material & Methods: After IRB approval 266 patients, aged 21 to 80 years, of both sexes, diagnosed with RA were enrolled. DAS-28 score was employed to assess disease severity. Demographic information and medical records of the patients were assessed and recorded. SPSS version 21 was used for data analysis. Results: Among the 133 patients with active disease, 113 (85.0%) were females and 20 (15.0%) male having mean age 40.0+12.8 years. Mean duration of disease in years was 8.3+6.2 and mean DAS-28 score was 5.5+0.9. RA Factor was positive in 96 (72.2%) and Anti-CCP antibody was seen in 78 (58.8%). Mean Hemoglobin level was 11.7+1.1 g/dl and anemia was found in 47 (35.5%) patients. Mean TLC and platelet count were 8.8+2.2 ×109/L and 375.9+83.5 ×109/L respectively. Among the 133 patients with LDA/remission, 106 (79.7%) were females and 27 (20.3%) male having mean age 44.5+15.5 years. Mean duration of disease in years was 8.5+7.6 and Mean DAS-28 score was 2.5+0.5. RA Factor was positive in 106 (79.7%) and Anti-CCP antibody was seen in 94 (70.7%). Mean Hemoglobin level was 12.6+1.8 g/dl and anemia was found in 29 (21.8%) patients. Mean TLC and platelet count were 9.5+3.5 ×109/L and 333.7+109.1 ×109/L respectively. Conclusion: Anti-CCP antibody positive patients with anemja and having disease for more than 3 years are more likely to have active rheumatoid arthritis whereas there was no significant difference with regards to age, sex and RA Factor status.

Objectives: To determine the frequency of silent cardiac ischemia in type II diabetes mellitus patients presenting to tertiary care facility. Methodology: This cross-sectional study was conducted from 20th October 2017 to 20th April 2018 at Department of Medicine Jinnah Hospital Lahore. After a detailed history, measurement of height, blood pressure, weight, fasting blood sugar, body mass index of 237 patients were recorded, and electrocardiography (ECG) was done before and after exercise tolerance testing (ETT). Changes in ECG were assessed and person labeled as having silent cardiac ischemia or not depending on the outcome of the ECG. Results: Mean age was 54.9 ± 5.9 (range: 45 – 63) years. There were 144 male patients and 93 female patients The mean duration of type II diabetes mellitus in the study population was 10.0 ± 2.6 (range: 6 – 15) years. The frequency of silent cardiac ischemia was found to be 45.1%. Increasing age, prolonged duration of diabetes mellitus, history of smoking and hypertension, and increased body mass index were significantly related to silent cardiac ischemia (p-value< 0.05). Conclusion: Silent cardiac is quite prevalent in our population that demands urgent efforts to diagnose this condition earlier for better future outcomes.

Anton's syndrome implies the situation when affected patient contradicts blindness in spite of objective documentation of loss of vision, and often confabulate to assert their bearing. It is an infrequent sequel of cortical blindness affecting both occipital cortex and other cortical centers, while patients genuinely act as if they are sighted. Our case report is of a lady, 55 years old, who presented to us with history of uncontrolled diabetes, hypertension and visual loss as a consequence of occipital lobe infarction bilaterally. In patients with evidence of occipital lobe injury and atypical visual loss, an assessment for cortical blindness and Anton's syndrome must be included. Anton's syndrome is most frequently caused by cerebrovascular disease. Any condition that causes cortical blindness may, however, lead to Anton's syndrome. Improvement in visual function after occipital lobe infarction due to cerebrovascular events is limited. Therefore, the management should be focused on rehabilitation and secondaryprevention. Keywords: Anton’s syndrome, Occipital lobe infarct, Diabetes mellitus, Hypertension.

Objective: To determine the frequency of anaemia among patients with human immune-deficiency virus / acquire immunodeficiency syndrome. Methods: The descriptive cross-sectional single-blind study was conducted at Jinnah Hospital, Lahore, Pakistan, from June 25 to December 25, 2016, and comprised human immune-deficiency virus / acquire immunodeficiency syndrome patients diagnosed at least 3 months earlier.. Demographic information was obtained along with sample of patient’s blood for haemoglobin level estimation. Anaemia was defined as haemoglobin 12g/dl. Overall, 152(66.1%) patients were anaemic and 78(33.9%) were normal. Age and socioeconomic status were significantly associated with anaemia status (p

Objective To compare the efficacy of lactulose plus rifaximin with efficacy of lactulose alone in the treatment of hepatic encephalopathy. Study design A randomized controlled trial. Place and duration of study Department of Medicine, Jinnah Hospital, Lahore, from December 2014 to June 2015. Methodology All patients who presented with hepatic encephalopathy due to decompensated chronic liver disease were randomly divided into two groups of 65 patients each. One group was given 30 ml thrice daily lactulose alone and the other lactulose plus rifaximin 550 mg twice daily for 10 days. Informed consents were taken from the participants' attendants. Grades II-IV hepatic encephalopathy was noted according to West-Haven Classification. All subjects were followed until 10 days after admission. Results The mean age of patients was 56.06 +11.2 years, among which 46.9% were females and 53.1% were males. After ten days of follow-up, reversal was seen in 58.46% in lactulose alone group and 67.69% in lactulose plus rifaximin group (Chi-square p=0.276). Conclusion There was no difference in effectiveness of lactulose plus rifaximin and lactulose alone in treatment of hepatic encephalopathy.