Atypical Cutaneous Presentation Of Adult Onset Still Disease.

Adult onset still disease is a rare systemic inflammatory disease which presents with cardinal symptoms of spiking fever, arthralgia, and characteristic non pruritic evanescent salmon pink rash and neutrophilic leukocytosis. However it can have accompanied atypical cutaneous manifestations of pruritic plaques and papules. Clinicians need to be aware of this condition so that they can correctly diagnose it and prevent its serious complications.

Correlation Of Deviance In Arterial Oxygenation With Severity Of Chronic Liver Disease.

BACKGROUND: Hepatitis B and C related chronic liver diseases have led to development of a serious threat to the people of South Asia. The main aim of this study was to evaluate the correlation of magnitude of arterial deoxygention to the severity of liver disease. METHODS: It was a hospital based cross-sectional descriptive study, carried out in the Medical Department of Khyber Teaching Hospital Peshawar. All in all 115 patients were assessed for the severity of the liver diseases and were correlated with arterial deoxygenation using linear regression models. RESULTS: Male to female ratio was 1.5:1. Males infected with hepatitis B, hepatitis C and both were 9, 60 and 1, while females suffered from hepatitis B, Hepatitis C and both were 2, 42 and 1 respectively. The linear relationship between A-a DO2 with severity of liver disease showed positive correlation while PO2 showed negative correlation with severity of liver disease. CONCLUSIONS: There was a positive correlation between A-a DO2 and severity of liver diseases while PO2 and severity of liver diseases showed negative correlation.

Hypovitaminosis-D: Frequency and association of clinical disease with biochemical levels in adult patients of RMI Medical OPD.

BACKGROUND AND OBJECTIVE: Vitamin D is steroid hormone essential for maintaining many important functions in the body. Hypovitaminosis D has become worldwide problem affecting all age groups and both genders, but its prevalence is very high in South Asia. Therefore this study was aimed to determine frequency of hypovitaminosis D in adult patients of RMI Medical Out Patients Department (OPD) and find association of clinical disease with biochemical levels. METHODS: It was a cross sectional study carried out on all patients visiting RMI Medical OPD from 1(st) Jan, 2015 to 30(th) April, 2015 with clinical indications using universal sampling technique involving 400 subjects. Data was analyzed using SPSS 16. RESULTS: Out of 400 subjects 85(21.3%) were males, 315(78.8%) were females, biochemical hydroxyvitamin-D3 deficiency was present in 320 (80%) subjects with 86(21.5%) having severe deficiency, 176(44%) having moderate deficiency and 58(14.5%) having mild deficiency. There was statistically significant association between biochemical deficiency and severity of clinical disease manifestation, calculated using chi square test. (p < 0.001). CONCLUSION: Most of the patient with musculoskeletal symptoms had vitamin D deficiency affecting all age groups and mostly female gender. There is a statistically significant association between low biochemical hydroxyvitamin-D3 levels and severity of clinical signs and symptoms which can provide evidence for replacement therapies in rural and far flung areas where biochemical assays are not available. Early recognition and replacement can prevent the massive complications, which deficiency of vitamin D makes us prone to develop.

Knowledge of modifiable risk factors of cardiovascular diseases among patients with acute myocardial infarction.

BACKGROUND: Cardiovascular disease is a major cause of mortality and morbidity in Pakistan. Knowledge regarding any disease is an important pre-requisite for implementation of preventive and control measures. This study aimed to evaluate the knowledge of modifiable risk factors of cardiovascular diseases in acute myocardial infarction (MI) patients admitted to Ayub Teaching Hospital, Abbottabad, Pakistan. METHODS: It was a hospital based cross sectional descriptive study carried out in cardiology unit of Ayub Teaching Hospital, on 150 patients with first attack of acute MI. knowledge of four modifiable risk factors; fatty food consumption, smoking, physical activities and obesity, was assessed. RESULTS: Among 150 subjects, 103 (68.7%) were males while 47 (31.3%) were females. Forty three (28.7%) of the patients were having good level of knowledge. Male gender and educational status were associated with good level of knowledge. CONCLUSION: There is a lack of good level of knowledge among patients admitted with acute MI. Implementing aggressive educational strategies is of utmost importance in Pakistani population for preventing the rising prevalence of this disease to combat the burdeni of MI.

Frequency of modifiable risk factors in stroke patients.

BACKGROUND: Stroke is one of the common causes of admission in medical and neurology units in hospitals. The aim of this study was to find out the frequency of modifiable risk factors, and association of ischaemic stroke with these risk factors in stroke patients admitted in Ayub Teaching Hospital Abbottabad. METHODS: This a cross-sectional descriptive hospital based study, carried out in medical units of Ayub Teaching Hospital, Abbottabad on 150 patients with stroke. Thorough history, clinical examination and appropriate investigations were performed to collect all the relevant information. CT scan was done to confirm the diagnosis. RESULTS: Out of 150 subjects, 90 (60%) were males, while 60 (40%) were females. Ischaemic stroke was found in 105 (70%) patients and 45 (30%) were having haemorrhagic stroke. The risk factors were hypertension in 127 (84.7%), diabetes 31 (20.7%), Coronary artery diseases 31 (20.7%), previous TIA/stroke 42 (28%), smoking 28 (16.7%) and obesity 16 (10.7%). CONCLUSION: There was no statistically significant association between risk factors and type of stroke except coronary artery diseases.

Knowledge and perceptions of diabetes in urban and semi urban population of Peshawar, Pakistan.

BACKGROUND: Diabetes mellitus is a major health issue in Pakistan. The aim of this study was to evaluate the knowledge and perceptions of diabetes in a sample population of Peshawar. METHODS: This cross-sectional, descriptive study was carried out in seven different localities of Peshawar. A sample of 305 residents were interviewed aged from 15-60 years and above, using a questionnaire specifically designed and translated into Urdu language for convenience of selected subjects. RESULTS: Knowledge of diabetes was suboptimal. The mean percentages of correct responses to questions regarding three classical symptoms and given complications were 47.1% and 30.8%. Excessive sugar intake, obesity, family history, lack of physical activities and stress were acknowledged by 46.2%, 42.3%, 39.3%, 33.4%, and 31.8% of the subjects respectively. Presence of family history and level of education were recognised to be associated with more knowledge. CONCLUSION: There is lack of awareness of major risk factors and some complications of diabetes mellitus. Level of education is a significant predictor regarding knowledge of diabetes and its prevention. Prevalence of diabetes has increased in Pakistan.