National Journal of Health Sciences
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Prediction of Fibrosis in Chronic Hepatitis C by Mean Platelet Volume and Platelet to Lymphocyte Ratio
No full textAbstract: Introduction: Hepatitis C is a chronic inflammatory condition that associated with fibrosis. Novel inflammatory markers have been suggested to be related inflammatory condition. Therefore, we aimed to investigate hemogram derived indices, such as, Mean Platelet Volume (MPV) and Platelet to Lymphocyte ratio (PLR) in hepatitis C subjects and to compare those in healthy controls.
Materials and Methods: In present retrospective study, 17 HCV patients having mild fibrosis, 23 patients having advanced fibrosis and 68 control subjects were included whom visited outpatient clinics of our institution between 1.10. 2017 and 30.11.2019. Hemogram indices and laboratory characteristics were compared.
Results: Median MPV values of the advanced fibrosis patients [8.3 (6.5-14) fL] was significantly higher than that of the mild fibrosis patients [7.9 (6.5-11.1) fL] (p=0.002) and control subjects [7.2 (4.6-10.7) fL] p<0.001) whereas MPV values of mild and advanced fibrosis patients were similar (p=0.750). Median PLR values of the mild fibrosis, advanced fibrosis and control groups were 103 (58-223) %, 86 (45-358) %, and 77 (64-96) %, respectively (p=0.010). A ROC analysis revealed that a MPV value greater than 7.3 fL determines advanced fibrosis with 76% sensitivity and 59% specificity. A PLR greater than 92% determines advanced fibrosis with 73% sensitivity and 64% specificity.
Conclusion: We suggest that elevated PLR and MPV could predict of advanced fibrosis in chronic hepatitis
An Overview of Diabetes Mellitus in Egypt as a Major Public Health Problem
No full textAbstract: Introduction: The prevalence of diabetes mellitus is rising rapidly in Egypt with major health and socioeconomic consequences. The shortage of endocrinologists is another important issue in Egypt that must be taken into consideration.Objective: To review and discuss the epidemiology, risk factors, and different ways of diabetes care in Egypt. In addition, the aim is also to analyze the problem of the shortage of endocrinologists and how it can be solved.
Methods: Searching and reviewing medical literature using PubMed, Google scholar, and some other gray literature from the World Health Organization (WHO), International Diabetes Federation (IDF), and Centers for Disease Control and Prevention (CDC).
Results: Egypt is ranked ninth in the prevalence of diabetes worldwide according to IDF with a prevalence of 15.2% in the adult population in early 2020. The prevalence is expected to continue rising to more serious levels. This high prevalence is attributed to common risk factors in Egypt such as obesity, physical inactivity, chronic hepatitis C infection, pesticides, smoking, and bad eating habits. Moreover, we are in an increased demand for more endocrinologists in the Egyptian health care system.
Conclusion: Understanding and avoiding the risk factors of diabetes is a crucial step towards reducing its prevalence and minimizing its healthcare and socioeconomic burdens in Egypt. Effective strategies should be applied for proper diabetes management and improving the quality of life in diabetic patients. Increasing the number of endocrinologists is also a key element for better diabetes care
Frequency of Vitamin D Deficiency in Newly Diagnosed Type 2 Diabetes Mellitus Patients
No full textObjective: To determine the frequency of vitamin D deficiency in newly diagnosed patients of type 2 diabetes mellitus.Study Design: Prospective case control study.Place and Duration of Study: Department of medicine, Pakistan Navy Ship (PNS) Shifa Hospital Karachi from January to December 2015.Materials and Methods: A total of 302 study subjects were selected, out of which 151 healthy controls while 151 patients included in the study were newly diagnosed type-2 diabetes mellitus with non-probability, consecutive sampling at medical Out Patient Department (OPD) of PNS Shifa Karachi. All controls and newly diagnosed type-2 diabetics were tested for fasting plasma glucose, HbA1C and 25 hydroxycholecalciferol (25(OH) D3 / vitamin D) levels in pathology laboratory of PNS Shifa Hospital. Patients having serum level of 25(OH) D3 < 25 nmol/L was considered as having vitamin D deficiency.Results: Out of total 302 subjects, vitamin D levels of 36 ± 19nmol/L in newly diagnosed type 2 DM cases and of 65 ± 31nmol/L in controls of similar age groups and gender were found significantly lower in newly diagnosed type 2 DM. Vitamin D deficiency was found in 58 (38.4%) cases and 13 (8.6 %) in controls. In 151 newly diagnosed patients of type 2 Diabetes, 73 (48 %) were males and 78 (52 %) were females with mean age of 53.7 ± 8.7 years in both gender. In cases, mean and SD of fasting plasma glucose was 9.2 ± 1.5 mmol/L, HbA1C 9.4 ± 1.4 % and serum 25(OH) D3 36 ± 19 nmol/L. In cases, low vitamin D levels in different age groups and gender was found significant with advancing age predominantly in females. Significant correlation was found between hyperglycemia (HbA1C) and vitamin D deficiency (p-value < 0.001).Conclusion: Higher frequency of vitamin D deficiency was found among patients newly diagnosed as diabetes mellitus type-2 with advancing age especially in females. Vitamin D levels were inversely related to hyperglycemia. Considering such high frequency, screening of diabetic patients for vitamin D deficiency would be beneficial
Current Situation in the Struggle against Novel Coronavirus Infection (Covid-19)
No full textThe lives of billions in the world have become to change by the end of 2019, almost two years ago, after novel coronavirus (Covid-19) infection emerged in Wuhan, China. Covid-19 caused about 33 millions of infection and 1000040 deaths worldwide within 10 months of the pandemic [1]. By December 18th of 2021, number of the infected subjects and deaths rose up to 274 million and 5364119, respectively [2]. Despite its devastating effect on human life, not even a single drug has shown significant enough efficacy against Covid-19 to change the course of the pandemic. However, some new agents and repurposed drugs were able to show efficacy to some extent. In the past 2 years, we have noticed that many Covid-19 cases have actually recovered without any treatment other than general measures. Indeed, most young and middle-aged people survive the disease mildly, yet the diseasecan be severe in people with advanced age and who have significant additional comorbidities. That’s why, one of the most important things to do while waiting for the pandemic to end is to take and maintain measures to prevent the spread ofCovid-19 in societies. Nevertheless, as the outbreak progressed, we began to consider Covid-19-related deaths asordinary. Unfortunately, we also loosen the tight measures to control the disease
Vaccination against Hepatitis B Virus through Various Strategies
No full textAbstract: Hepatitis is the inflammation of liver which cause liver cirrhosis. It is the health problem. This may be acute or chronic. The chronic stage of hepatitis leads to liver cancer which is the last stage and ultimately causes death. It is the main cause of liver disease. It is much problematic and about 2 billion people infected from this deadline disease. There are three modes of hepatitis B transmission. One from the mother to infant, another one is the sexual transmission, and the last one is through blood transfusion and most in those people who are drug abusers. In 1995, the vaccination system was introduced to cure this disease. To eradicate HBV virus WHO introduced the vaccination system. Then the vaccination dose was given to infants at their birth to eliminate their HBV. This is a three-dose vaccination system and much other vaccination for adults and to eliminate this problem during pregnancy. For combat with this disease, many therapeutically vaccines have been introduced. WHO (World Health Organization) play a major role to eliminate this problem from the society
Post-Operative Intussusception in a Child after Pseudo Cyst of Pancreas Excision
No full textIntussusception is commonly seen in pediatric age group. It is rarely present as a cause of post-operative obstruction. Ileus andadhesion band are the common causes of postoperative obstruction. The classical presentation of intussusception is frequently absent in post-operative intussusception, so high degree of suspicious is required for early diagnosis. Timely intervention can give excellent results, so we have to consider it as a differential diagnosis in post-operative obstruction in pediatric age group. We are presenting here a case of post-operative intussusception in one and half year old male child after excision of pseudo cyst of pancreas
CHILD Syndrome
No full textCHILD syndrome is a rare X-linked genetic disorder caused by mutation of NSDHL (NADPH steroid dehydrogenase-like protein)at Xq28 gene. The mutation causes the defective synthesis of cholesterol, which is an important constituent of viscera, hormones etc. The predominantly it affects the musculoskeletal with a tendency to involve the heart, brain etc. Strikingly the signs and symptoms of this syndrome involve only one half of the body. CHILD syndrome is commonly identified in the females. We report a case of 5-month-old female who presented to us at Pediatric outpatient department. To our knowledge this is the first reported case of CHILD syndrome in Pakistan. The exceptionally rare presentation prompted us to report this case
Osteoporosis Knowledge, Attitude and Practice among Doctor Of Physical Therapy Students
No full textAbstract: Background: Osteoporosis is a metabolic disease which is common globally. It is defined as decrease in bone mass and bone tissue destruction that causes decrease in bone strength and increase the chances of fractures. Over 200 million people are suffering from osteoporosis worldly and the number of individuals will increase greatly in coming decades due to aging and sedentary lifestyle. Knowledge combined with strategic planning related to preventive measures decrease its occurrence.Objective: The objective of this study was to evaluate the knowledge, attitude and practice of osteoporosis in students of physical therapy.Materials and Methods: A Questionnaire-Based survey was conducted at Department of Physiotherapy, Isra University Hyderabad in April 2021 to December. 2021. The study approval was given by Ethical Committee of Isra Institute of Rehabilitation Sciences, Isra University Hyderabad. 200 students from 3rd to final year were asked to complete the questionnaire. The knowledge, attitude and practice (KAP) of osteoporosis questionnaire consisted of 20 close ended questions.Results: A total of 200 were selected out of which 182 participants completely filled and returned the questionnaire. The mean age of participants was 22.31±1.86 years. Male participants were 34 (18.7%) and female participants were 148 (81.35%) in this study. High knowledge regarding osteoporosis was found among students with percentage of 99.45%. The participants showed positive attitude related to osteoporosis with percentage of 60.9%. These students also had positive impression towards management practices for osteoporosis with the percentage of 70.33%.Conclusion: This study concluded that the participants have better knowledge regarding osteoporosis. Further proper health education programs must be held in university to encourage them to adopt healthy practices about osteoporosis in daily life
Tumor Board can save Sphincter, A Review of Contemporary Multidisciplinary Management of Rectal Cancer
No full textAbstract: Colorectal cancer ranks third amongst various malignancies worldwide out of which a major proportion is of rectal carcinoma. With increasing incidence of rectal cancer amongst younger population in past two decades various advancements towards organ preservation approach have been devised. Total Neo-adjuvant approach (TNT) is current standard of care in various clinical scenarios involving rectal malignancy. In this review article role of Radiation in neo adjuvant setting and various landmark trials leading to it are discussed in detail