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Stroke is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. It is also called as cereberovascular accident (CVA) or stroke syndrome. Objectives: To determine frequency of hypertension, diabetes mellitus and smoking in patients with ischemic stroke. Patients and methods: This cross sectional study of six months was carried out in the department of medicine, Liaquat University of Medical and Health Sciences. Patients aged 20-70 years of age with ischemic stroke on CT were enrolled in the study after taking consent from caretaker of patients. Detailed history focusing on hypertension, diabetes and smoking and their duration was taken. Blood pressure was recorded and fundoscopy was done to find out diabetic or hypertensive retinopathy. Thorough neurological examination was done and blood sugar (fasting and random) was evaluated. Data was entered and analyzed using SPSS version 16. Results: A total of 100 patients were included in the study during study period. 64% of patients were in≥50 years of age group with mean age of 52±11 years. A total of 66 (66%) were male; with male to female ratio was 2:1. Hypertension was present in 61% of cases, Diabetes was found in 32% cases and 40 patients were cigarette smokers. Conclusions: It was concluded that high blood pressure, diabetes mellitus and smoking are associated with ischemic stroke. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of H. pylori in patients with functional dyspepsia. Patients and methods: This six months multidisciplinary study was conducted at tertiary care teaching hospital as well as at private hospital Hyderabad from February 2012 to July 2012. All patients presented with history of dyspepsia were admitted and evaluated for functional dyspepsia by performing endoscopy. After confirmation of functional dyspepsia the subjects were further evaluated for H. pylori infection by taking the biopsy specimen, label it and sent to laboratory for histopathological examination. The data was entered, saved and analyzed in SPSS version 11.00. Results: During six month study period, total 100 patients with functional dyspepsia were recruited. Majority of patients were from low socioeconomic class (78%), have history of spicy food intake (68%) and epigastric pain (94%). The associated symptoms observed were nausea and vomiting (87%), anorexia (88%), early satiety (84%) and regurgitation (84%). The mean ±SD for age of patients with functional dyspepsia was 37.95±10.85. The mean age ±SD of H. pylori identified patients was 35.81±7.72. Majority of the subjects was 30-40 years of age and the male population predominant 64% (p-value 0.02, statistically significant). The H. pylori was identified in 62% of patients, of which 35 (56.5%) were males and 27(43.5%) were females (p-value 0.04, statistically significant) respectively. Conclusions: The H. pylori play a significant role in causing symptoms of functional dyspepsia. [ABSTRACT FROM AUTHOR]

Aims and Objectives: We evaluated whether HBV +ve and HCV +ve patients are at high risk for developing drug induced hepatitis than control subjects during treatment for tuberculosis with standard short course regimens. Study design: Observational cohort study. Place and duration: This study was conducted at Department of Medicine, Liaquat University of Medical and Health Sciences Jamshoro from May 2008 to May 2011. Material and Methods: All newly diagnosed active tuberculosis patients were included in the study population and they were further screened for hepatitis B surface antigen and HCV antibodies. All patients were divided into three groups. One having no co-infection with hepatitis B and Hepatitis C and was taken as control group, second group was co-infected with hepatitis B and third was co-infected with hepatitis C. short course anti tuberculous regimen was started and patients were followed for six months. Results: One hundred and twenty eight tuberculous patients were divided into three groups. 92 in control groups without any co-infection with hepatitis B and C, 10 were HBV +ve and 26 were HCV +ve. During follow up 24 developed drug induced hepatitis, 8(38.33%, n = 24) in control group, 2(8.33%, n = 24) in hepatitis B group and 14(58.33%, n = 24) in hepatitis C group. Conclusions: These findings suggest that treatment for tuberculosis in HCV seropositive patients is a risk factor for the development of hepatitis exacerbation and HBV seropositive patients shows no any increased risk of hepatitis exacerbation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to determine the frequency of skin lesions in type 2 diabetes patients. PATIENTS AND METHODS: A cross-sectional study was conducted at Muhammad Medical College Hospital Mirpukhas, Sindh from July 2008 to December 2009. The sample size comprised of 1270 type 2 diabetes patients. The patients were examined by a physician to determine the presence of diabetes mellitus-related skin lesions, skin infections and skin lesions caused by treatment. The data were collected on preformed proforma. Age, sex, duration of diabetes, mode of treatment, whether on oral hypoglycemic agents or insulin were noted. A multivariate logistic regression model was used to estimate the adjusted odds ratio (OR) for having diabetes related skin lesions. All data was analyzed by SPSS-10.0 for Windows (Chicago, IL. USA). The chi-square and student t-test were used as test of significance for qualitative and quantitative variables respectively. A p-value of <0.05 was considered statistically significant. RESULTS: The mean age of patients was 52±11 years, 768 (60.47%) were female and 502 (39.62%) were male. The mean duration of the diabetes was 19±7 years and mean HbAlc was 11.8±3g/dl. Oral hypoglycemic agents were used by 913 (81.88%) patients, insulin by 164 (12.91%) and both were used by 193 (15.19%). The skin lesions were observed 851 (67%). The most common lesion was diabetic dermopathy (28.34%), but different types of skin infections were seen in 42.6% of patients and thus forming the most common lesion. The third most common manifestation was pruritis (28.05%) and the least common was the perforating dermatoses (0.78%). The HbA1c was higher in patients suffering from diabetic foot ulcer and fungal infection than those without having these infections (10.34±1.67 and 11.5±1.4 vs.9.7±1.6 and 8.9±1.6, respectively) (p<0.05). CONCLUSION: This study shows that skin lesions are common in patients with type 2 diabetes mellitus. Therefore, frequent skin evaluation of the diabetic patients is warranted. [ABSTRACT FROM AUTHOR]

Accidental or intentional Isoniazid poisoning may manifest within half to three hours as intractable seizure, acidosis, and coma. Single high dose of pyridoxine was used as an antidote with good response as reported earlier. Ingestion of more than 80 mg/kg body weight produces severe central nervous system symptoms and a dose of 125 mg/kg is potentially lethal if not promptly treated. We report a case of suicidal attempt with use of Isoniazid, who developed grand mal seizures and was controlled with diazepam and symptomatic treatment.

Background: Malaria is usually associated with reduced blood cell counts & mild to moderate thrombocytopenia is a common association of malaria. The cause of thrombocytopenia is poorly understood, but the immune-mediated lysis, sequestration in the spleen and dyspoietic processes in the marrow with diminished platelet production have all been postulated. This study was conducted to evaluate thrombocytopenia in the patients suffering from acute Plasmodium falciparum malaria., Methods: This descriptive case series study was conducted at a tertiary care hospital, Liaquat University of Medical & Health Sciences Jamshoro, over a one-year period. A total of 370 Plasmodium falciparum positive on peripheral blood film were studied. Full blood counts were determined by using automated Coulter analyzer. Thick & thin smears were stained with Giemsa stains and studied by haematologist. Data was analyzed using the SPSS version 10.0., Results: Out of 370 patients, 260 were male & 110 were female, with M:F ratio of 2.36:1. Mean age was 34 +/- 1.7 years (range 16-53 years). Haemoglobin values were 12.7 +/- 1.4g% and white blood cells counts were found 12600 +/- 450/microL. Out of 370, 114 (30.81%) had normal platelet counts, and 256 (69.18%) had thrombocytopenia (p < 0.05). The mild, moderate and severe thrombocytopenia were found in 39 (10.5%), 180 (48.6%) and 37 (10%) respectively (p < 0.05)., Conclusions: We found high frequency of mild to moderate thrombocytopenia in the Plasmodium falciparum malaria. Finding of thrombocytopenia is of diagnostic help as it raises the suspicion of malaria.

Objective: To determine the frequency of Cardiac Autonomic Neuropathy (CAN) in type-1 Diabetes mellitus patients and its association with the duration of disease and glycemic control., Study Design: Descriptive study., Place and Duration of Study: Department of Medicine, Liaquat University Hospital, Hyderabad/Jamshoro, from December, 2004 to April, 2005., Methodology: Fifty patients of type-1 Diabetes Mellitus (DM) of >or=10 years duration were selected. CAN was evaluated in terms of presence of resting tachycardia, loss of sinus arrhythmia and heart rate response to Valsalva maneuver by electrocardiogram (ECG). An R-R variation with respiration of >15 beats per minute was taken normal, while 10-15 beats and <10 beats per minute were taken as borderline and definitive CAN respectively. QTc intervals were measured. Patients with HbA1c levels<7% were considered as well-controlled. The associations between CAN, the duration of diabetes and the diabetic control were determined., Results: The mean age was 35.16+/-10.58 years with 32 males and 18 females. The mean values for the known duration of diabetes and HbA1c were 13+/-7.3 years and 9.36+/-2.5 mg/dl respectively. Definitive and borderline CAN were noted in 20% and 24% respectively. Variability of heart rate with respiration was significantly related to the duration but not to the control of the diabetes (p<0.05). QTc showed a significant correlation with the known duration of diabetes and heart rate variability with respiration (p<0.05). Most of the patients had uncontrolled glycemic status., Conclusion: Cardiac autonomic neuropathy is common in long standing type-1 diabetics. CAN resulted in prolonged QTc interval that may result in cardiac arrhythmias and even death. Intensive glycemic control improves the cardiac autonomic nerve functions.