DEMOGRAPHICS OF TUBERCULOSIS IN DISTRICT MANSEHRA.

BACKGROUND: Tuberculosis is one of the leading causes of morbidity and mortality across the globe. Pakistan is one of the 22 high tuberculosis burden countries of the world sharing more than 80% of the global burden of tuberculosis. METHODS: This study was a retrospective case-based study that analyzed secondary data obtained from TB-03 form at the office of the District Tuberculosis Control Officer (DTO), Mansehra. Data was entered into SPSS-20 and analysed. RESULTS: A total of 625 patients with a mean age of 32.1 ± 19.1 years were registered at the DTO office during the year 2013. Most of the patients were female (57%) as compared to males (43%). The most common treatment outcome was "treatment completed", recorded against 56% of the patients. The proportion of patients declared "cured" at the end of the treatment was 236 (37.8%). There were only 4 (0.64%) cases of treatment failure during 2013. CONCLUSION: Despite falling incidence of tuberculosis and mortality across the globe, tuberculosis is still a major determinant of disease in our society. Aggressive case detection and treatment is needed to manage this disease.

Frequency of metabolic syndrome in patients with type-2 diabetes.

BACKGROUND: Diabetes, Hypertension, Obesity and Ischaemic Heart Disease have become a problem of public health magnitude with substantial economic burden both in the developed as well as the developing countries. Obesity is quite frequent in Type 2 diabetics and also plays a central role in causing Metabolic Syndrome (MetS). Metabolic Syndrome significantly increases the incidence of cardiovascular complications. This study was done to determine the frequency of MetS in our Type 2 diabetic patients as most of the components of MetS can be modified and identifying/managing these at an early stage might be of considerable help in reducing cardiovascular complications. METHODS: This cross-sectional study was done in Medical 'B' and Medical 'A' wards of Ayub Teaching Hospital, Abbottabad from Nov, 08 to April, 09. Type 2 Diabetic patients aged above 40 years who gave informed consent were included in the study. Data was collected through a structured proforma. Frequency of Metabolic Syndrome was estimated according to the IDF consensus worldwide definition of the MetS. RESULTS: Of the 100 patients enrolled in this study 56 were females and 44 were males with a mean age of 59.9 years. Out of these 100 participants seventy six (76%) were diagnosed to have metabolic syndrome. Of the 56 females, forty eight (85.71%) were having metabolic syndrome while twenty eight (63.63%) of the 44 male participants were having the syndrome. The difference was statistically significant (p < 0.05). CONCLUSION: Frequency of MetS was found to be significantly high in this study with female preponderance. All the components, except Hypertension were more frequent in females. Diabetic patients with metabolic syndrome need more aggressive approach in management so as to decrease the incidence of cardiovascular complications.

Per-operative findings of blocked ventriculoperitoneal shunt: a study of 72 cases.

BACKGROUND: Most patients with hydrocephalus are treated with ventriculo-peritoneal (VP) shunt placement; however, malfunction is common and is usually caused by mechanical failure. The aim of this study was to evaluate the per-operative findings accompanying presumed VP shunt malfunction. METHODS: This is a descriptive study of 72 patients operated for shunt malfunction in the Department of Neurosurgery, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from January to December 2008. Presenting symptoms and signs, clinical shunt function, operative findings and outcome were recorded. RESULTS: Common presenting features were vomiting, irritability and general toxic look of patients. Male to female ratio was 3:1. Upper end block was observed in 39 patients while lower end and reservoir block was noted in 13 and 2 patients respectively. Choroids plexus was found in 29.2% of cases with upper end block, shunt revision was performed in most of cases (80.6%). CONCLUSION: The importance of clinical features cannot be overlooked in a patient with shunt malfunction. Upper end block due to choroids plexus is common operative finding.