Diabetic foot risk classification in a tertiary care teaching hospital of Peshawar

To find out diabetic foot risk classification in patients admitted with diabetes mellitus at a tertiary care teaching hospital. The hospital record of one hundred and twenty seven patients of diabetes mellitus, admitted to the medicine department, Khyber teaching hospital Peshawar from 1st October 2005 to 31st March 2006 were evaluated against the Royal College of Physicians, London; Clinical Guidelines for Type 2 diabetes: prevention and management of foot problems. Both male and female indoor patients above 15 years of age were included in the study. An audit of 127 diabetes mellitus patient revealed that 25 [19.68%] patients were having low current risk, 21 [16.53%] were classified as having risk foot, 6 [4.72%] were categorized as high risk patients, 16 [12.59%] were admitted with ulcerated foot and 5 [3.39%] were having diabetic foot emergency according to Royal College of Physicians, London; Clinical Guidelines for Type 2 diabetes: prevention and management of foot problems. The main reason for poor diabetic foot outcomes in the tertiary care teaching hospital is the absence of classification of majority of diabetic patients into different risk groups for the appropriate treatment. This lack of risk classification results in ensuing gaps in the management and an overall increase in morbidity

Cirrhosis; frequency of HCV and mean age

To know the frequency of HCV in patients with cirrhosis and to know the mean age of patients with cirrhosis A descriptive study. Medical Unit Khyber Teaching Hospital Peshawar. From Jan 2007 to Jan 2008. 100 consecutive cirrhotic patients or those with signs and symptoms of cirrhosis, admitted to the medical units. They were either known cirrhotic or having signs and symptoms of chronic liver disease and diagnosed as cirrhotic during their stay in the hospital on the basis of ultrasound findings. The routine investigations including liver function test [LFTs], prothrombin time [PT], activated partial thromboplastin time [APTT], serum albumin were carried out in all patients. Ultrasound was the main tool for the diagnosis of cirrhosis liver. The hepatitis C virus [HCV] status was diagnosed by detecting Anti HCV antibodies by enzyme linked immunosorbent assay [ELISA]. Polymerase chain reaction [PCR] for HCV RNA was done only in affording patients. The overall frequency of HCV was 52 in 100 patients. Out of these 52 HCV positive patients, PCR for HCV RNA was positive in 20 patients [38.15%] and the rest of the patients were not able to afford the test. Out of 52 HCV positive patients the number of male were more [1.8:1] as compared to female. The age of the patients ranged from 45-65 years, the majority being from 45 to 65 years with the mean age of 52 years. The stratification of risk factors was not the objective of this study. However, a note was made of exposure to various risk factors. Most of the patients had the history of receiving injections in the past from quacks. It is concluded that chronic HCV infection is the commonest cause of cirrhosis leading to chronic ill health, great economic burden on family and health care system and mortality. As there is no treatment for cirrhosis so prevention, early detection of HCV infection and prompt treatment of HCV infected patients will undoubtedly lead to a decrease in morbidity and mortality from this silent epidemic