Prevalence of Iron Deficiency Anaemia in School and College Going Students of District Shaheed Benazirabad Sindh Province, Pakistan

The present study aimed to estimate the occurrence of Iron Deficiency anemia (IDA) in school and college going students (aged 11 - 18 years). Anemia is the most public health problem in school age children. It has a wide range of adverse results involving, poor cognitive performance, poor development of infants, preschool and school-aged children. Anemia also causes the impairment of physical capacity, work performance of adolescents and adults, reduction in immune competence and increased morbidity from infections in all age groups. Our study based on 1686 volunteers was randomly selected from different Government High schools and colleges. A Questionnaire was utilized for data collection. BMI was also calculated by dividing weight in kg by the square of height in meters. Hemoglobin (Hb), Hematocrite (Hct), Mean Corpuscular volume (MCV), Mean Corpuscular hemoglobin concentration (MCHC), white blood cell (WBC) and red blood cell was examined using Sysmex kx-21N hemoglobin auto analyzer (Hedwin, 2008). The total percentage of anaemic students (43.1%) and non-anaemic (56.9%) were observed in district Shaheed Benazirabad. The mean Hb level of anaemic students (11.1 ± 4.94) was observed. In males (12.7%) and females (30.4%) anemic was observed. The prevalence of anemia high (16.2%) was observed in the age of 14 - 16 years. The majority of anemic patients (30.2%) belonged to low income group. Area wise prevalence, in rural areas 27.8% and urban areas 15.3% volunteers anaemic was observed. Taluka wise occurrence of anaemia in taluka Sakrand was (14.6%), in taluka Kazi Ahmed (15.0%), in taluka Daur (8.0%) and in taluka Nawabshah was (5.5%). Clinically signs and symptoms showed, pale skin 57.7% and weakness 42.3% were observed in school children.

Association of Low Serum Magnesium Levels in Type 2 Diabetes Mellitus with &without Hypertension

Background: Diabetes Mellitus is a widespread metabolic abnormality that constitutes a most important physical dilemma in the world. Hypomagnesaemia accelerates the rate of diabetic complications. Objective: To analyze the association of magnesium levels in DM (Type 2 Diabetes Mellitus) with and without complication of Hypertension. Design: It was a comparative analytical study. Setting: This research was carried out in medicine department, Peoples Medical College Hospital, Nawabshah from March 2016 to February 2017. Samples: 245 patients with Type 2 DM after fulfilling the selection criteria were included, out of them 123 with hypertension and 122 without hypertension. Methods: After a short-lived consultation, all the subjects were categorized for variable analyses like age, gender, Type 2 DM with and without hypertension, duration of diabetes and presence of hypomagnesaemia. Joint National Committee (JNC 8) classification of Hypertension was applied to collect data. Blood samples were drawn for research purpose in fasting state for serum magnesium level analyses on the basis of hypertension and without hypertension. Results: In 245 diagnosed Type 2 diabetic patients, 160 were males and 85 were females. Out of them, 123 were hypertensive while 122 were non hypertensive. Normal magnesium was present in 120 (48.97%) and low magnesium was present in 125 (51.02%) patients overall. A decreased serum level of magnesium was observed in 52.04% hypertensive subjects with diabetes and 50% non-hypertensive subjects with diabetes. Conclusion: Frequency of decreased serum magnesium is widespread in T2DM with and without hypertension.

Frequency of Low Vitamin D3 Levels in Subjects with Parkinson’s Disease. A Study Conducted at PMCH, a Tertiary Care Hospital, Nawabshah

Background: Lack of serum vitamin D3 is related to PD (Parkinson’s disease). Currently a valid place for vitamin D3 deficiency in Parkinson disease (PD) has been anticipated. The aim of present research was to evaluate insufficiency of D3 (vitamin) in subjects with PD (Parkinson’s disease). Many of physiological functions connected with higher risk of illness are maintained by vitamin D, which also plays significant task in pathogenesis of calcium homeostasis and skeletal ailments. It forecasts hazard of persistent ailments like malignancy, CVS conditions, and T2DM. Continuous insufficiency of this vitamin may lead to PD. Method: This was a cross sectional study. Conducted at People’s Medical College Hospital, Nawabshah during period of Jan. 2014-Dec. 2016, the sample size of 243 subjects clinically diagnosed as PD was enlisted. Inclusion criteria were all male and female subjects aged >50 years, clinically diagnosed Parkinson’s disease enlisted in research. Results: In 151 (62.1%) subjects, vitamin D3 levels were <30 ng/ml while in 92 (37.9%) subjects, vitamin D3 values were normal (30 - 150 ng/ml) (p = 0.000). Conclusion: Considerably low levels of vitamin D3 were seen in Parkinson’s disease. Our information sustains a legitimate part of vitamin D insufficiency in PD.

Assessment of Serum Magnesium Level in Type 2 Diabetes Mellitus with Diabetic Foot Ulcers (Grade I and II) at Nawabshah, Pakistan

Diabetes Mellitus is a metabolic disorder increasing morbidity and mortality worldwide, which needs exact identification and proper management. Aim of this study was to analyze the serum Mg (magnesium) level in patients with Type 2 Diabetes Mellitus with grade I & II diabetic foot ulcers. This descriptive cross sectional study was conducted at Medicine Department, PMCH Nawabshah from June 2015 to December 2016. A total of 110 Type 2 Diabetes Mellitus with foot ulcer patients, 51 with grade I and 59 with grade II out of total were included by purposive sampling. After consultation, subjects were categorized as gender, age, Type 2 DM and foot ulcer duration, foot ulcer grading and grouping for analyses. Wagner’s classification of diabetic foot ulcers used to analyze the data and blood samples were collected for research purpose in fasting state for serum Magnesium level analyses. Out of 110, 67 (65.5%) males and 43 (34.5%) females were reported with Type 2 diabetic patients. Hypomagnesaemia was reported in 59% patients out of total, 24 found with grade I and 38 found with grade II from the studied subjects. P value &le;0.000 was in the studied population in relation to hypomagnesaemia. In conclusion, Hypomagnesaemia is common in Type 2 Diabetes Mellitus patients with grade I & II foot ulcers. As the duration of Diabetes along with duration of diabetic foot ulcer in Grade I and II increases, the level of serum magnesium decreases. As the duration of Diabetes Mellitus increases, the severity of complications might also increase.

Frequency of Various Risk Factors in HCV Positive Patients in Initial Diagnostic Phase

Viral hepatitis C is a type of illness, which is transmitted to patients by different methods in world. Here we will identify the different common risk factors for transmission of viral hepatitis C in our setup. Aim of study was to determine frequency of various risk factors in HCV positive patients. This study was cross sectional and conducted Department of Medicine PMC Hospital at Nawabshah. Duration of this study was one year from April 2016 to March 2017. After taking informed written consent, 243 diseased persons with positive anti Hepatitis C Antibodies were incorporated in this research. Frequency of variables i.e. Hepatitis C virus risk factors and different other demographic results was collected on preformed proforma. In total of 243 subjects there were 165 (67.9%) male and 78 (32.1%) females respectively. Most of the subjects have more than one risk factor. 19 (7.8%) had history of blood and blood products transfusion. IV drug abuse was detected in 08 (3.3%). Homosexuality and heterosexuality were observed in 14 (5.8%) and 12 (4.9%) subjects respectively. History of dental procedure was seen in 31 (12.8%). 228 (93.8%) had history of needle pricking in different ways. History of different surgical procedures was observed in 33 (13.8%). Calculated Mean and Standard Deviation for age was 39.2 ± 10.3 years. It was concluded that proper implementation of precautionary measures should be carried out for every human being to reduce burden of HCV illness in far near future.

Spontaneous Bilateral Pneumothorax with Recurrent Pneumothorax: A Case Report

Aim: To report a rare case of spontaneous bilateral pneumothorax with recurrent pneumothorax. Background: Spontaneous bilateral pneumothorax is medical and surgical emergency. It is presence of free air in the bilateral pleural spaces. It rarely occurs at any age but usually young age without apparent precipitating etiology in healthy subjects without any existing pathology. Case Report: In present case, a non smoker, uneducated, young housewife was received in emergency in critical condition and admitted in Intensive Care Unit directly, Peoples Medical university Hospital, Nawabshah, and Sindh, Pakistan. She felt difficulty in breath and after few moments she complained chest pain on right side of chest. They rushed in emergency in Peoples Medical University hospital and diagnosed as case of pneumothorax and at the same time her symptoms started worsening and she developed central cyanosis. In emergency chest X-ray was done showing bilateral pneumothorax, patient developed respiratory distress, emergency bilateral chest intubation was done and due to SO2 drop. Patient was kept on mechanical ventilation. After 24 hours she was weaned off and she was vitally in stable state and shifted in medical department and after 2 weeks she was discharged well. After 3 days of discharge she again came in emergency X-ray shown right sided recurrent pneumothorax, chest intubation done and she was referred to Oojha Institute of Chest Diseases, Karachi, Pakistan for further management and Pleurodesis. Conclusion: Bilateral spontaneous pneumothorax is medical and surgical emergency, diagnosis is thru clinical history, examination of chest and X-ray chest. Prompt diagnosis and management with chest intubation bilaterally and supportive treatment may decrease the morbidity in these critical cases.

Spontaneous Subcutaneous Emphysema with Pneumo-Mediastinum: A Case Report

Aim: To report a rare case of Spontaneous subcutaneous emphysema and pneumo-mediastinum Introduction: Spontaneous subcutaneous emphysema and pneumo-mediastinum may be defined as the presence of free gas or air in the subcutaneous tissue or mediastinal structures without an apparent precipitating cause. It most commonly occurs in adolescent in good physical health group devoid of severe existing lung pathology. Case Report: In our case, a middle aged married housewife was referred to Department of Medicine, Peoples Medical University Hospital Nawabshah, Sindh, Pakistan, by her local GP for the worsening of her condition due to development of acute neck pain, difficulty in breathing, eating and swallowing (mainly for solid foods) with swelling of neck. She was not complaining of any respiratory symptoms. The chest and neck radiographs showed subcutaneous emphysema and pneumo-mediastinum, there was no any evidence of air leakage from esophagus. She was subsequently put on free fluids, light diet, antibiotics, analgesia and other supportive measures along with close observation. After three days of admission, her clinical symptoms were alleviated to a great extent. She was discharged well from hospital after four days. Conclusion: Spontaneous subcutaneous emphysema with pneumo-mediastinum is medical and surgical emergency. Diagnosis may be made by routine chest X-rays and CT scan of the chest. Prompt diagnosis and immediate management may affect the morbidity and mortality outcomes in this condition.