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INTRODUCTION: Recent years have been alarming due to the sudden, dramatic rise in the incidence of Clostridium difficile infection (CDI). Identifying and addressing the risk factors associated with CDI will help in reducing the incidence of infection and associated complications. METHODS: This case-control study was conducted in a tertiary care hospital in Pakistan from June 2020 to March 2021, in which 200 patients diagnosed with Clostridium difficile-associated diarrhea (CDAD) were enrolled in the study. CDAD was diagnosed based on clinical symptoms and stool enzyme immunoassay. Another 200 participants without a diagnosis of CDAD were enrolled from the outpatient department as a control group. Participants were enrolled after seeking informed consent. RESULTS: In patients older than 65, risk of CDI was higher compared to participants lower than 65 years old (15.5% vs. 8.0%; p value: 0.02). Hospitalization (25.5% vs. 6.0%; p value < 0.0001), the use of proton pump inhibitors in last 30 days (23.0% vs. 10.5%; p value: 0.001) , and use of antibiotics in the last 30 days (36.0% vs. 10.5%; p value < 0.0001) were significantly higher in participants with CDI. CONCLUSION: Hospitalization, the usage of proton pump inhibitors, and antibiotics in the last 30 days were significantly associated with CDI. A higher incidence of CDI was associated with risk factors like increased body mass index, diabetes, chronic kidney disease, and malignancy.
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Introduction There are few cardiovascular risk factors that are unique to females, such as after menopause, lipid profiles change unfavorably. Another risk factor that might be associated with an increased risk of cardiovascular diseases in women is the incidence of miscarriages and abortions. In this study, we will determine the association between the previous history of pregnancy loss and myocardial infarction (MI). Methods This case-control study was conducted from December 2019 to January 2021. We enrolled 600 female patients with a confirmed diagnosis of MI from the outpatient department (OPD) of the cardiology and internal medicine unit of a tertiary care hospital in Pakistan. Another 600 female participants without the diagnosis of MI were enrolled from the OPD as the control group. Participants were asked about the history of pregnancy, including the number of miscarriages, abortions, and stillbirths. Results Participants with myocardial infarction had experienced greater than one miscarriage compared to participants without MI (25.1% vs. 13.6%; p-value: <0.0001). Similarly, participants with MI had significantly more participants with stillbirth compared to participants without MI (12.0% vs. 6.66%; p-value: 0.0017). Conclusion Pregnancy loss is associated with MI in the future. Women with a history of pregnancy loss must undergo regular cardiovascular screening to protect themselves from cardiovascular events.
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This study was conducted to determine the frequency of subclinical hypothyroidism (SCH) in the old age population (>60 years). A cross-sectional study was conducted from July 2019 to January 2020 at Jinnah Postgraduate Medical Centre, Karachi, Pakistan. Healthy subjects (having no active complaint) of either sex aged 60-80 years were included. Those already on thyroid replacement, preexisting thyroid diseases, prior radiation therapy, or having chronic kidney disease were excluded. A total of 133 participants, 79 males and 54 females, were selected with a mean age of 69.5 ± 6.4 years. There were 29 diabetics, 30 hypertensives, and 10 smokers. A total of 17 (12.8%) were found to have SCH. On stratification, gender, diabetes mellitus, and hypertension had a significant association with the presence of SCH. SCH is a modifiable risk factor, more in females, diabetics, hypertensives, and the old age population. These results highlight the need for screening for SCH in primary care settings, especially in old age. Key Words: Subclinical hypothyroidism, Old age, Gender, Diabetes, Hypertension.
